Fuel cell as an effective energy storage in reverse osmosis desalination plant powered by photovoltaic system

A hybrid renewable energy systems (HRESs) comprises of photovoltaic (PV), and self-charging fuel cells (SCFC) is designed for securing electrical energy required to operate brackish water pumping (BWP) and reverse osmosis desalination (RO) plant of 150 m3 d-1 for irrigation purposes in remote areas. An optimal configuration of the proposed design is determined based on minimum cost of energy (COE) and the minimum total net present cost (NPC). Moreover, a comparison with a stand-alone diesel generation (DG) or grid extension is carried out against the optimal configuration of PV/SCFC HRES. The modeling, simulation, and techno-economic evaluation of the different proposed systems, including the PV/SCFC system are done using HOMER software. Results show that PV array (66 kW), FC (9 kW), converter (25 KW) –Electrolyzer (15 kW), Hydrogen cylinder (70 kg) are the viable economic option with a total NPC of $115,649 and$0.062 unit cost of electricity. The COE for the stand-alone DG system is 0.206 $/kWh, which is 69.90% higher than that of the PV/SCFC system. The PV/SCFC system is cheaper than grid extension. This study opens the way for using a fuel cell as an effective method for solving the energy intermittence/storage problems of renewable energy sources

Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

PURPOSE: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians

Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. Results A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Modification réversible des propriétés de surface de silice incorporée dans du polyéthylène ultra haute masse molaire. : application aux séparateurs de batteries

Malgré la croissance du marché des batteries lithium-ion, les batteries plomb-acide offrent toujours des avantages que les nouvelles ne sont pas en mesure d'assimiler, notamment en termes de coût, de procédés de fabrication et des besoins réels du marché. Dans ce contexte, l'objectif de ce travail est de valoriser les propriétés des séparateurs PE de batteries plomb-acide qui dominent 90% du marché des séparateurs de batteries plomb-acide. Ces membranes poreuses sont principalement constituées de silice précipitée, un squelette de polyéthylène haute masse molaire (UHMWPE) et elles sont élaborées par un procédé de séparation de phase induite thermiquement (TIPS) avec de l'huile naphténique qui est ensuite extraite. La porosité résultante est ensuite infiltrée avec l'électrolyte de la batterie. Cependant, en raison de la mouillabilité limitée des pores de la membrane par l'électrolyte polaire, seule une fraction de la porosité disponible est efficace. Cette thèse se concentre sur l'amélioration d'une telle porosité mouillable par l'électrolyte afin de réduire la résistivité électrique du séparateur. La mouillabilité des pores n'est pas seulement liée à la présence de silice mais également à la nature de sa surface. Paradoxalement, la silice hydrophobe favorise la qualité du mélange et la dispersion des agrégats; tandis que la silice hydrophile favorise la mouillabilité de la porosité par l'électrolyte. Pour remplir ces critères et obtenir un matériau le plus homogène possible avec une porosité maximale accessible, une modification réversible de la surface de la silice a été réalisée par imprégnation physique de tensioactifs ou par modification chimique avant le procédé d’élaboration de la membrane. Dans un premier temps, des mesures rhéologiques des suspensions de silice dans l’huile, les isothermes de sorption, l’angle de contact et d'autres techniques ont été utilisées pour évaluer le changement des propriétés de surface de la nouvelle silice. Ensuite, les silices préparées ont été dispersées dans les membranes et la porosité, l’état de dispersion, la structure, les propriétés électriques et mécaniques ont été étudiéesNotwithstanding the growth of the market of the new lithium-ion batteries, lead-acid batteries still offer advantages that the new ones are not able to equate especially in terms of cost, manufacturing base and the actual market need. In this context, the aim of this work is to enhance the properties of lead-acid batteries PE- separators that predominate 90% of the market of lead-acid batteries separators. These porous membranes consist mainly of precipitated silica, a backbone of ultra-high molecular weight Polyethylene (UHMWPE) and they are processed using a thermally induced phase separation process (TIPS) with naphthenic oil that is subsequently extracted. The resulting porosity is thereafter infiltrated with the electrolyte of the battery. Yet, due to the limited wettability of the pores of the membrane by the polar electrolyte, only a fraction of the available porosity is efficient. This thesis focuses on the enhancement of such wettable porosity by the electrolyte in order to reduce the electrical resistivity of the separator. The wettability of the pores is not only related to the presence of silica but also to the nature of silica surface. Paradoxically, hydrophobic silica favors the blend and the dispersion of aggregates; while hydrophilic silica promotes the wettability of the porosity by the electrolyte. To fulfill these criteria and obtain a material as homogeneous as possible with maximum accessible porosity, a reversible modification of the surface of silica was realized by physical impregnation of surfactants or by chemical modification before the blending and the dispersion in the membrane. Therefore, rheological characterization of the suspensions, contact angle and sorption isotherms and other techniques were used to evaluate the change in the surface properties of the new silica. Then, these tuned silica were dispersed in membranes and the prorosity, the structure, the electrical and mechanical properties were investigate

Crosslinked Elastomers: Structure–Property Relationships and Stress-Optical Law

We present a combination of independent techniques in order to characterize crosslinked elastomers. We combine well-established macroscopic methods, such as rheological and mechanical experiments and equilibrium swelling measurements, a more advanced technique such as proton multiple-quantum NMR, and a new method to measure stress-induced segmental orientation by in situ tensile X-ray scattering. All of these techniques give access to the response of the elastomer network in relation to the crosslinking of the systems. Based on entropic elasticity theory, all these quantities are related to segmental orientation effects through the so-called stress-optical law. By means of the combination of these techniques, we investigate a set of unfilled sulfur-vulcanized styrene butadiene rubber elastomers with different levels of crosslinking. We validate that the results of all methods correlate very well. The relevance of this approach is that it can be applied in any elastomer materials, including materials representative of various industrial application, without prerequisite as regards, e.g., optical transparency or simplified formulation. Moreover, the approach may be used to study reinforcement effects in filled elastomers with nanoparticles

Crosslinked Elastomers: Structure–Property Relationships and Stress-Optical Law

International audienc