Development of an experimental test rig for cogeneration based on a Stirling engine and a biofuel burner

A system consisting of a last-generation Stirling engine (SE) and a fuel burner for distributed power generation has been developed and experimentally investigated. The heat generated by the combustion of two liquid fuels, a standard Diesel fuel and a rapeseed oil, is used as a heat source for the SE, that converts part of the thermal energy into mechanical and then electric energy. The hot head of the SE is kept in direct contact with the flame generated by the burner. The burner operating parameters, designed for Diesel fuel, were changed to make it possible to burn vegetable oils, not suitable for internal combustion engines. The possibility of adopting different configurations of the combustion chamber was taken into account to increase the system efficiency. The preliminary configurations adopted allowed to operate this integrated system, obtaining an electric power up to 4.4 kW(el)with a net efficiency of 11.6%

GRANULAR FLOW SIMULATIONS OF LIMITING REGIMES OF PARTICLES–WALL INTERACTION RELEVANT TO SLAGGING COAL GASIFIERS

In pilot entrained-flow slagging coal gasifiers, high conversion efficiency and low pollutant emission levels have been observed, but the mechanism leading to this behaviour is not fully understood. Recent literature proposes several different mechanisms as playing an important role, ranging from the sticking properties of both particles and slag-covered walls to the thermal and chemical history along the trajectory of the particles in the entire gasifier. Nonetheless, very few attention has been devoted to the role of particle–particle interactions, even if it has been shown that this mechanism can lead to new regimes likely to occur in slagging gasifiers and to promote the rise in the coal conversion efficiency. This study presents the results of a simplified configuration that allows to highlight the role of the four different interactions that can be envisaged when considering particles and confining walls as either sticky or non sticky. Particles are subjected to a body force that mimics the action of the drag exerted by a swirling flow field in a cylindrical vessel. Particle–particle collisions are modelled with an Hertzian approach that includes torque and cohesion effects. Results clearly indicate the different structure of the layer of particles establishing on the wall surface in the different interaction regimes. They confirm the importance to adequately take into account particle–particle interactions for a correct prevision of the fate of coal particles in slagging gasifiers

Combined use of volumetric expanders and Scheffler receivers to improve the efficiency of a novel direct steam solar power plant

This research proposes an innovative solar thermal plant able to generate mechanical power through an optimized system of heliostats with Scheffler-type solar receivers coupled with screw-type steam expanders. Scheffler receivers appear to perform better than parabolic trough collectors due to the high compactness of the focal receiver, which minimizes convective and radiative heat losses even at high vaporization temperatures. At the same time, steam screw expanders are volumetric machines that can be used to produce mechanical power with satisfactory efficiency also by admitting two-phase mixtures and with further advantages compared to steam turbines: low working fluid velocities, low operating pressures, and avoidance of overheating. This study establishes a mathematical model to assess the energetic advantages of the planned solar thermal power system by evaluating the solar-to-electricity efficiency for different off-design working conditions. For this purpose, a numerical model on the Scheffler receiver is initially investigated, thus assessing all the energy losses which affect the heat transfer phase. A thermodynamic model is then developed to evaluate the energy losses and performance of the screw expander under real working conditions. Finally, parametric optimization of the solar energy conversion is performed in a wide range of operating conditions by establishing thermodynamic formulations related to the whole solar electricity generation system. Water condensation pressure and vaporization temperature are so optimized with respect to global energy conversion efficiency which, under the best operating conditions achieved in this research, rises from 10.9% to 14.4% with increasing solar irradiation intensity. Hence, the combined use of screw expanders and Scheffler receivers for solar thermal power system application can be a promising technology with advantages over parabolic dish concentrators. Novelty statement: This research proposes an innovative direct steam solar power plant based on an SRC, with water utilized as both heat transfer and working fluid, equipped with Scheffler solar receivers as a thermal source and screw expanders as work-producing devices. Technical studies and energy assessments of this kind of SEGS at part-load operation do not exist in scientific literature; after reviewing the literature, it was determined that volumetric expanders have been rarely combined with Scheffler receivers for solar thermal power system application. In effect, combined use of screw expanders and Scheffler-type solar concentrator in a direct steam solar power system represents a completely new plant configuration; however, as a promising DSG solar system, at present numerical model of this new sort of SEGS is lacked in literature and the optimum operating conditions have yet to be defined. For this reason, the chief objective of this paper is to define a first parametric optimization of all thermodynamic variables involved to maximize global efficiency of the proposed solar thermal power generation system for ordinary working conditions

Ventricular arrhythmias in young competitive athletes: Prevalence, determinants, and underlying substrate

Whether ventricular arrhythmias (VAs) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of VAs in young competitive athletes.Background--Whether ventricular arrhythmias (VAs) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of VAs in young competitive athletes. Method and Results--We studied 288 competitive athletes (age range, 16-35 years; median age, 21 years) and 144 sedentary individuals matched for age and sex who underwent 12-lead 24-hour ambulatory electrocardiographic monitoring. VAs were evaluated in terms of number, complexity (ie, couplet, triplet, or nonsustained ventricular tachycardia), exercise inducibility, and morphologic features. Twenty-eight athletes (10%) and 13 sedentary individuals (11%) showed > 10 isolated premature ventricular beats (PVBs) or 651 complex VA (P=0.81). Athletes with > 10 isolated PVBs or 651 complex VA were older (median age, 26 versus 20 years; P=0.008) but did not differ with regard to type of sport, hours of training, and years of activity compared with the remaining athletes. All athletes with > 10 isolated PVBs or 651 complex VA had a normal echocardiographic examination; 17 of them showing > 500 isolated PVBs, exercise-induced PVBs, and/or complex VA underwent additional cardiac magnetic resonance, which demonstrated nonischemic left ventricular late gadolinium enhancement in 3 athletes with right bundle branch block PVBs morphologic features. Conclusions--The prevalence of > 10 isolated PVBs or 651 complex VA at 24-hour ambulatory electrocardiographic monitoring did not differ between young competitive athletes and sedentary individuals and was unrelated to type, intensity, and years of sports practice. An underlying myocardial substrate was uncommon and distinctively associated with right bundle branch block VA morphologic features

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Numerical evaluation of finite length tubes effects in Stirling engines heaters

The performance of Stirling engines is directly related to the amount of energy that, in the form of heat, participates in the thermodynamic cycle. A peculiar characteristic of this type of engine is the closed circuit of the working fluid, implying a periodic admission and extraction, ideally involving the whole working fluid, of the heat exchanged during the cycle without any exchange of material with the external environment. Several correlations have been proposed in the literature to predict the heat exchange in the hot side heat exchangers, but most of them are based on nondimensional numbers, usually expressed in terms of an oscillatory Reynolds number and a non-dimensional length, that even if they take into account the amplitude and frequency of the oscillating flow inside the tube with respect to its diameter, do not include any dependency upon the length of the tube. Nevertheless, the length of the tube can have a great impact on the performance of a Stirling engine. The heater forms a significant part of the dead volume of the engine, making the optimization of the volume to surface ratio necessary. The friction losses increase by increasing the length of the tubes, determining a negative impact while the exchange surface increases. Even the Nusselt number in the inner side of the tubes changes along the length, achieving the largest values alternatively in the first portions of the tube lengths because of entrance effects (Graetz problem). The picture is made even more complex because of the special velocity profiles that develop in oscillating flows in tubes. One of the effects less investigated in previous studies, which we could call a “breathing effect”, regards the amount of working fluid that, in a real engine, can effectively travel from the hot side to the cold side, thus reaching the conditions of nominal heat exchange with the thermal source and sink of the cycle. An idealized configuration has been devised to investigate, using CFD simulations, these effects. Results reporting how the friction coefficient and the Nusselt number depend on the finite length of the tube will be illustrated