How Power-to-Gas strategy could reduce national Natural Gas consumption over the energy crisis period

Europe is facing an energy crisis caused by the dramatic rise in gas prices. This situation is damaging the European economy and urgent measures to reduce gas consumption are crucial in the short term. This paper aims to analyse the potential contribution of the Power-to-Gas strategy to reduce the Italian consumption of Natural Gas (NG) in the context of the current energy crisis. To do so, the Italian energy system has been modelled by means the EnergyPLAN software. The electrolysers' installation in the Italian energy systems has been simulated in combination with different levels of additional RES installation. The hydrogen production and the NG abatement potential have been calculated in each simulated scenario. Furthermore, the Natural Gas Abatement Cost (NGAC) has been assessed. By installing 1.5 GW of electrolysers, along with an additional 25 GW of renewables, about 140 ktonH2/year can be produced only by exploiting the RES excess. The total NG reduction due to both the RES generation and the hydrogen injection is more than 60 TWh/year. The NG abatement cost varies between 45 and 54 €/MWh. At current gas prices, it is therefore extremely cheaper to invest in a drastic reduction of natural gas than to buy the same amount of gas on the wholesale market. Therefore, the current energy crisis can be an opportunity to accelerate the energy transition process. The proposed solutions allow a substantial reduction in gas consumption with the consequent reduction in emissions and the country's energy dependency

GI Bleeding in the Elderly

Purpose: To determine the risk factors contributing to and etiologies of gastrointestinal bleeding in an elderly patient population seen by Southwest Gastroenterology (SWGA) providers. Methods: This study reviews charts of patients with GI bleeding from documented sources between 1/1999 and 3/2006. The cases are gathered retrospectively from the clinical records of SWGA, a 12-person private, single specialty gastroenterology group serving community hospitals. Etiology and risk factors for GI hemorrhages are recorded in an elderly population, defined as patients age 55 and older. Results: GI hemorrhages are identified in 105 patients. The majority (83, 79%) of hemorrhages are upper GI bleeds (UGIB) comparing to 22 (21%) lower GI bleeds (LGIB). In the UGIB group, the most common etiology of bleed is gastric ulcer (29%). We also found 72% of UGIB patients on prescribed anticoagulation medications, including anti-platelet agents or non-steroidal anti-inflammatory drugs (NSAIDs). 20% of these patients are also positive for H. Pylori. Thirty patients in the UGIB group smoke or consume alcohol heavily (consuming more than 3 drinks per day for men and two drinks per day for women) while 2 patients smoke or consume alcohol in the LGIB group. Previous bleeds are common in both groups with 39 (41%) in UGIB and 9 (47%) in LGIB. Co-morbidity is the most common risk factor with 20 (91%) in LGIB and 73 (88%) in UGIB. In the peptic ulcer disease (PUD) bleeds, the majority (77%) are taking NSAIDs, while in the non-PUD bleeds, only 38% are currently on NSAIDs. Overall, there are 2 mortalities resulting from cardiovascular complications of GI bleeding. Conclusion: The etiologies of GI bleeds in this population are comparable to other studies in the literature. The ratio of UGIB to LGIB in this elderly population is also similar to that reported in the literature. The risk factors shown to be most correlated to bleeding are co-morbidities, previous episodes of bleeding, anticoagulation, NSAID use, smoking and alcohol use. NSAID use is significant in PUD bleed patients. This study reinforces that increased knowledge of etiology, incidence and contributing factors of GI bleeding are necessary for physicians to efficiently treat GI bleeds in the elderly population

Socio-Economic Regional Risk Assessment (SERRA) application to flood risk in the Vipacco Basin (north-east Italy)

According to EEA (European Environmental Agency), flood is the most dangerous natural hazard in Europe in terms of economic losses. TheKULTURisk Project (EU FP7) has developed a novel methodology for evaluating the integrated benefits of risk prevention of water related natural hazards: SERRA (i.e. Socio-Economic Regional Risk Assessment). The proposed methodology enhances the traditional flood risk assessment by integrating the missing socio-economic dimension into the established regional risk assessment. Several case studies across Europe allowed for the consolidation, validation, and refinement of SERRA. This paper presents the results of its application to assess the benefits deriving from the installation of an Early Warning System in Vipacco river basin in Friuli Venezia Giulia (Italy). Social, economic and physical data are used to assess the total expected risk for several receptors such as economic activities, cultural heritage, people, etc. The collected socio-economic data are stored in Geographic Information System (GIS) and processed according to SERRA algorithms to produce maps of various categories of costs (beyond physical-environmental damages) in order to assist the Decision Makers (DMs) in making more informative decisions. The visualization of total risk through GIS maps allows the DMs to understand the spatial distribution of social vulnerability, risk, and associated costs

Rivaroxaban for the treatment of cerebral venous thrombosis

Background: New Oral Anticoagulants (NOACs) such as Rivaroxaban are introduced as alternatives to conventional vitamin-K antagonists in the long-term treatment of thrombotic events due to their lower bleeding risk. There is a lack of evidence on the effectiveness and safety of Rivaroxaban in Cerebral venous thrombosis (CVT). This study aims to assess the effectiveness and bleeding risk of Rivaroxaban in comparison with Warfarin for the treatment of CVT. Materials and methods: 36 patients with diagnosis of CVT were included. Clinical and background information was assessed on admission and patients were followed for at least 12 months. Measured outcomes were modified Rankin Scale (mRS), evidence of recanalization on contrast-enhanced Brain MR venography (MRV) and major or minor bleeding. Patients were divided into two groups according to the type of oral anticoagulant (Rivaroxaban vs Warfarin). Groups were compared in terms of final outcomes and side effects. Result: Overall, 13 (36.11) patients received Warfarin and 23 (63.89) received Rivaroxaban. Optimal mRS score (0�1) was attained in 9 of 10 (90) of patients treated with Rivaroxaban and 19 of 22 (86.36) of patients received Warfarin. MRV showed complete or partial recanalization in 12 of 14 (85.71) patients treated with Rivaroxaban and all patients in the Warfarin group. There was no significant difference between the two groups in terms of major and minor hemorrhage. Conclusion: Rivaroxaban holds promise for the treatment of CVT. © 2021, The Author(s)

Rituximab and risk of COVID-19 infection and its severity in patients with MS and NMOSD

Background: Choosing a safe disease modifying therapy during the COVID-19 pandemic is challenging. This case series study was conducted to determine the incidence rate and the course of Covid-19 infection in MS/NMOSD patients treated with Rituximab. Methods: In this study, we designed a web-based questionnaire. Baseline information such as patient- reported walking disability, total number of Rituximab infusions received, delayed injections, occurrence of any relapse, and the use of corticosteroids during the pandemic were collected. Also, information regarding the Covid-19 pandemic such as adherence to self-isolation, any recent exposure to an infected individual and the presence of suggestive symptoms were collected. In case of positive test results, patients were grouped into 2 categories; mild to moderate and seriously ill and outcomes were evaluated as favorable (improved/ discharged) and unfavorable (expired). Results: Two hundred fifty-eight patients with Multiple Sclerosis were enrolled in this study, 9 of the subjects (3.4) were confirmed positive for Covid-19, five of which required hospitalizations (55.5), two patients required ICU admission (22.2) and 2 two patients died (22.2). None of these patients ever mentioned using corticosteroids during the pandemic. In comparison to MS patients who were not receiving disease modifying therapy (DMT), our study indicated a higher incidence of Covid-19 infection, higher ratio of serious illness and a higher fatality ratio. Conclusions: Rituximab seems not to be safe enough during the pandemic. © 2021, The Author(s)

Repeatability and reproducibility of deep-learning-based liver volume and Couinaud segment volume measurement tool

Purpose Volumetric and health assessment of the liver is crucial to avoid poor post-operative outcomes following liver resection surgery. No current methods allow for concurrent and accurate measurement of both Couinaud segmental volumes for future liver remnant estimation and liver health using non-invasive imaging. In this study, we demonstrate the accuracy and precision of segmental volume measurements using new medical software, Hepatica (TM).Methods MRI scans from 48 volunteers from three previous studies were used in this analysis. Measurements obtained from Hepatica (TM) were compared with OsiriX. Time required per case with each software was also compared. The performance of technicians and experienced radiologists as well as the repeatability and reproducibility were compared using Bland-Altman plots and limits of agreement.Results High levels of agreement and lower inter-operator variability for liver volume measurements were shown between Hepatica (TM) and existing methods for liver volumetry (mean Dice score 0.947 +/- 0.010). A high consistency between technicians and experienced radiologists using the device for volumetry was shown (+/- 3.5% of total liver volume) as well as low inter-observer and intra-observer variability. Tight limits of agreement were shown between repeated Couinaud segment volume (+ 3.4% of whole liver), segmental liver fibroinflammation and segmental liver fat measurements in the same participant on the same scanner and between different scanners. An underestimation of whole-liver volume was observed between three non-reference scanners.Conclusion Hepatica (TM) produces accurate and precise whole-liver and Couinaud segment volume and liver tissue characteristic measurements. Measurements are consistent between trained technicians and experienced radiologists.[GRAPHICS].Cardiovascular Aspects of Radiolog

Comparative efficacy assessment of Tramadol versus Morphine for post operative pain relief following abdominal surgery, Shariati Hospital (1999)

Introduction: The objective of the present study is to compare the respiratory function and pain relief of two parenteral analgesics tramadol and morphine under clinical conditions. Materials and Methods: The trial was conducted as an open label-randomized, single center study. The study was performed during 3 months in 1999. In total, 64 patients were enrolled in Shariatie University Hospital, while the other 32 patients were treated with morphine. Results: There were 12 male and 20 female in either groups. The mean age was 48±15 in tramadol versus 43±16 morphine group. Concerning the amount of the medication given to the patients. It would be observed that tramadol patients received 194±72 mg and morphine patients 17±7 mg out of drugs. At study admission vital signs were recorded. The pulse rate, blood pressure and respiratory rate are presented revealing no obvious differences between the treatment groups. There was a broad range regarding the underlying type of operation, however, a laparatomy or a cholecystectomy was performed in 24 (75.0%) Vs. 26 (81.3%) patients, respectively. All 64 patients were receiving anaesthetics as stipulated in the protocol. Of them being diazepam, sufentanil, succinylcholine chloride and thiopental as the most frequent reported, 4 Vs. 3 patient were given additional fentanylin a mean dosage of 220 mg Vs. 83 mcg. The oxygen saturation was the main safety parameter of the present study. No obvious differences between the two treatment groups can be detected (P<0.472). Primary efficacy end point was the pain assessment. The pain intensity at each scheduled time point was recorded. At study inclusion no differences between the treatment groups uncured, but during the 24 hour observation period the tramadol patients were in advantage (P<0.001). Conclusion: This study shows that long-term efficacy of tramadol is better than morphine