Thermodynamics-Based Process Sustainability Evaluation

This article considers the problem of the evaluation of the sustainability of heterogeneous process systems, which can have different areas of focus: from single process operations to complete supply chains. The proposed method defines exergy-based concepts to evaluate the assets, liabilities, and the exergy footprint of the analysed process systems, ensuring that they are suitable for Life Cycle Assessment. The proposed concepts, evaluation framework and cumulative Exergy Composite Curves allow the quantitative assessment of process systems, including alternative solutions. The provided case studies clearly illustrate the applicability of the method and the close quantitative relationship between the exergy profit and the potential sustainability contribution of the proposed solutions. The first case study demonstrates how the method is applied to the separation and reuse of an acetic-acid-containing waste stream. It is shown that the current process is not sustainable and needs substantial external exergy input and deeper analysis. The second case study concerns Municipal Solid Waste treatment and shows the potential value and sustainability benefit that can be achieved by the extraction of useful chemicals and waste-to-energy conversion. The proposed exergy footprint accounting framework clearly demonstrates the potential to be applied to sustainability assessment and process improvement while simultaneously tracking di erent kinds of resources and impacts

Exergy Footprint Assessment of Cotton Textile Recycling to Polyethylene

Circular economy implementations tend to decrease the human pressure on the environment, but not all produce footprint reductions. That observation brings the need for tools for the evaluation of recycling processes. Based on the Exergy Footprint concept, the presented work formulates a procedure for its application to industrial chemical recycling processes. It illustrates its application in the example of cotton waste recycling. This includes the evaluation of the entire process chain of polyethylene synthesis by recycling cotton waste. The chemical recycling stages are identified and used to construct the entire flowsheet that eliminates the cotton waste and its footprints at the expense of additional exergy input. The exergy performance of the process is evaluated. The identified exergy assets and liabilities are 138 MJ/kg ethylene and 153 MJ/kg ethylene, reducing the Exergy Footprint by 75% and the greenhouse gas footprint by 43% compared to the linear pattern of polyethylene production. The exergy requirements for producing raw cotton constitute a large fraction of the liabilities, while the polyethylene degradation provides the main asset in the reduction of the Exergy Footprint

Exergy Footprint Assessment of Cotton Textile Recycling to Polyethylene

Circular economy implementations tend to decrease the human pressure on the environment, but not all produce footprint reductions. That observation brings the need for tools for the evaluation of recycling processes. Based on the Exergy Footprint concept, the presented work formulates a procedure for its application to industrial chemical recycling processes. It illustrates its application in the example of cotton waste recycling. This includes the evaluation of the entire process chain of polyethylene synthesis by recycling cotton waste. The chemical recycling stages are identified and used to construct the entire flowsheet that eliminates the cotton waste and its footprints at the expense of additional exergy input. The exergy performance of the process is evaluated. The identified exergy assets and liabilities are 138 MJ/kg ethylene and 153 MJ/kg ethylene, reducing the Exergy Footprint by 75% and the greenhouse gas footprint by 43% compared to the linear pattern of polyethylene production. The exergy requirements for producing raw cotton constitute a large fraction of the liabilities, while the polyethylene degradation provides the main asset in the reduction of the Exergy Footprint

Exergy Footprint Assessment of Cotton Textile Recycling to Polyethylene

Circular economy implementations tend to decrease the human pressure on the environment, but not all produce footprint reductions. That observation brings the need for tools for the evaluation of recycling processes. Based on the Exergy Footprint concept, the presented work formulates a procedure for its application to industrial chemical recycling processes. It illustrates its application in the example of cotton waste recycling. This includes the evaluation of the entire process chain of polyethylene synthesis by recycling cotton waste. The chemical recycling stages are identified and used to construct the entire flowsheet that eliminates the cotton waste and its footprints at the expense of additional exergy input. The exergy performance of the process is evaluated. The identified exergy assets and liabilities are 138 MJ/kg ethylene and 153 MJ/kg ethylene, reducing the Exergy Footprint by 75% and the greenhouse gas footprint by 43% compared to the linear pattern of polyethylene production. The exergy requirements for producing raw cotton constitute a large fraction of the liabilities, while the polyethylene degradation provides the main asset in the reduction of the Exergy Footprint

A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial

Background Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework. Methods We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero–one inflated beta regression. Results The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] − 3.30%; 3.40%], − 0.39% [95% CrI − 3.46%; 3.00%], and 0.64% [95% CrI − 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of − 3.55 days [95% CrI − 6.38; − 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% CrI − 1.87; 2.72) compared with the standard strategy and the probability that the accelerated strategy had more hospital-free days was 0.66. Conclusions In a Bayesian reanalysis of the STARRT-AKI trial, we found very low probability that an accelerated strategy has clinically important benefits compared with the standard strategy. Patients receiving the accelerated strategy probably have fewer days alive and KRT-free. These findings do not support the adoption of an accelerated strategy of KRT initiation

Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis.

ObjectivesAmong patients with severe acute kidney injury (AKI) admitted to the ICU in high-income countries, regional practice variations for fluid balance (FB) management, timing, and choice of renal replacement therapy (RRT) modality may be significant.DesignSecondary post hoc analysis of the STandard vs. Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial (ClinicalTrials.gov number NCT02568722).SettingOne hundred-fifty-three ICUs in 13 countries.PatientsAltogether 2693 critically ill patients with AKI, of whom 994 were North American, 1143 European, and 556 from Australia and New Zealand (ANZ).InterventionsNone.Measurements and main resultsTotal mean FB to a maximum of 14 days was +7199 mL in North America, +5641 mL in Europe, and +2211 mL in ANZ (p p p p p p p p = 0.007).ConclusionsAmong STARRT-AKI trial centers, significant regional practice variation exists regarding FB, timing of initiation of RRT, and initial use of continuous RRT. After adjustment, such practice variation was associated with lower ICU and hospital stay and 90-day mortality among ANZ patients compared with other regions