Smart energy regions - cost and value

Considering the high energy bill paid by developed countries when it comes to energy, especially that related with the built environment, it is not surprising that improving energy-efficiency in buildings is high on both the national and international political agenda. Unfortunately improving the energy- efficiency of buildings through applications such as installing double g or roof insulation or renewable energy devices such as solar water heaters or photovoltaic panels comes at a premium.peer-reviewe

Numerical analysis of hydraulic jumps using OpenFOAM

[EN] The present paper deals with a hydraulic jump study, characterization and numerical modeling. Hydraulic jumps constitute a common phenomenon in the hydraulics of open channels that increases the shear stress on streambeds, so promoting their erosion. A three-dimensional computational fluid dynamics model is proposed to analyze hydraulic jumps in horizontal smooth rectangular prismatic open-air channels (i.e., the so-called classical hydraulic jump). Turbulence is modeled using three widely used Reynolds-averaged Navier Stokes (RANS) models, namely: Standard k ε, RNG k ε, and SST k ω. The coexistence of two fluids and the definition of an interface between them are treated using a volume method in Cartesian grids of several element sizes. An innovative way to deal with the outlet boundary condition that allows the size of the simulated domain to be reduced is presented. A case study is conducted for validation purposes (FR1 ∼ 6.10, Re1 ∼ 3.5·105): several variables of interest are computed (sequent depths, efficiency, roller length, free surface profile, etc.) and compared to previous studies, achieving accuracies above 98% in all cases. In the light of the results, the model can be applied to real-life cases of design of hydraulic structures.This research was conducted thanks to the funding provided by the VALi + D R&D Program of the Generalitat Valenciana (Spain). It would not have been possible without the contribution of Daniel Valero and Beatriz Nacher of the Hydraulics Laboratory of the School of Civil Engineering (Universitat Politecnica de Valencia).Bayón Barrachina, A.; López Jiménez, PA. (2015). Numerical analysis of hydraulic jumps using OpenFOAM. Journal of Hydroinformatics. 17(4):662-678. https://doi.org/10.2166/hydro.2015.041S66267817

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Beam test performance of prototype silicon detectors for the Outer Tracker for the Phase-2 Upgrade of CMS

A new CMS tracker detector will be installed for operation at the High Luminosity LHC (HL-LHC). This detector comprises modules with two closely spaced parallel sensor plates and front-end ASICs capable of transmitting tracking information to the CMS Level-1 (L1) trigger at the 40 MHz beam crossing rate. The inclusion of tracking information in the L1 trigger decision will be essential for selecting events of interest efficiently at the HL-LHC. The CMS Binary Chip (CBC) has been designed to read out and correlate hits from pairs of tracker sensors, forming so-called track stubs. For the first time, a prototype irradiated module and a full-sized module, both equipped with the version 2 of the CBC, have been operated in test beam facilities. The efficiency of the stub finding logic of the modules for various angles of incidence has been studied. The ability of the modules to reject tracks with transverse momentum less than 2 GeV has been demonstrated. For modules built with irradiated sensors, no significant drop in the stub finding performance has been observed. Results from the beam tests are described in this paper.ISSN:1748-022

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)