Indirectly heated fluidized bed biomass gasification using a latent heat ballast

The objective of this study is to improve the heating value of gas produced during gasification of biomass fuels using an indirectly heated gasifier based on latent heat ballasting. The latent heat ballast consists of lithium fluoride salt encased in tubes suspended in the reactor. The lithium fluoride has a melting point that is near the desired gasification temperature. With the ballast a single reactor operating in a cyclic mode stores energy during a combustion phase and releases it during a pyrolysis phase. Tests were carried out in a fluidized bed reactor to evaluate the concept. The time to cool the reactor during the pyrolysis phase from 1,172 K (1,650 F) to 922 K (1,200 F) increased 102% by use of the ballast system. This extended pyrolysis time allowed 33% more biomass to be gasified during a cycle. Additionally, the total fuel fraction pyrolyzed to produce useful gas increased from 74--80%. Higher heating values of 14.2 to 16.6 MJ/Nm{sup 3} (382--445 Btu/scf) on a dry basis were obtained from the ballasted gasifier

Deeltaak- versus hele-taakinstructie:Een onderzoek in het Praktijkonderwijs

Al heel lang probeert men leerlingen vaardigheden aan te leren door de vaardigheden op te splitsen in deelvaardigheden en deze achtereenvolgens te oefenen. Voor het uitvoeren van de eindvaardigheid moeten de deelvaardigheden worden samengevoegd door de lerende. Dat kan vooral problemen opleveren bij de lerende wanneer de eindtaak complex is. Daarentegen oriënteren recente instructietheorieën zich op complexe taken. Deze taken worden in tegenstelling tot die in de “traditionele” instructietheorie vanaf het begin in zijn geheel aangeboden. Dit zou tot betere toepassing van de vaardigheid in nieuwe situaties leiden (Van Merrienboer, 1997). De vraag is of een van deze twee benaderingen effectiever is voor leerlingen in het Praktijkonderwijs. Dit onderzoek spitst zich toe op het leren koken met als eindtaak het leren klaarmaken van een recept. In de hele-taakbenadering wordt vanaf het begin de vaardigheid van het uitvoeren van het kookrecept in zijn geheel aangeboden. In de deeltaakbenadering worden de technieken voor het klaar maken van een recept één voor één aangeleerd. Aan het eind kregen de leerlingen van beide instructiebenaderingen dezelfde toets: het zelfstandig uitvoeren van een nieuw recept. Het onderzoek is uitgevoerd bij leerlingen uit drie leerjaren van het Praktijkonderwijs. Klassen leerlingen werden binnen een leerjaar willekeurig toegewezen aan twee condities: een deeltaakconditie en een hele-taakconditie. Voor beide condities is een lessenserie ontworpen voor dezelfde eindtaken. Na de lessenserie werden de leerlingen getoetst met praktijktoetsen. Uit de resultaten blijkt dat in leerjaar 1 en 3 een significant verschil bestaat tussen de condities in het zelfstandig klaar maken van een onbekend recept. De leerlingen in de deeltaakconditie presteerden beter dan de leerlingen in de hele-taakconditie. In leerjaar 2 is er geen verschil. Het onderzoek geeft aanleiding te veronderstellen dat leerlingen in het Praktijkonderwijs meer baat hebben bij een deeltaakbenadering waarin voorafgaande taken worden herhaald in de daaropvolgende taken. In de discussie wordt verder op deze veronderstelling ingegaan en worden punten besproken waarop de huidige instructieaanpak van de Praktijkschool kan worden verbeterd

Non-excisional techniques for the treatment of intergluteal pilonidal sinus disease:a systematic review

Non-excisional techniques for pilonidal sinus disease (PSD) have gained popularity over the last years. The aim of this study was to review short and long-term outcomes for non-excisional techniques with special focus on the additive effect of treatment of the inner lining of the sinus cavity and the difference between primary and recurrent PSD. A systematic search was conducted in Embase, Medline, Web of Science Core Collection, Cochrane and Google Scholar databases for studies on non-excisional techniques for PSD including pit picking techniques with or without additional laser or phenol treatment, unroofing, endoscopic techniques and thrombin gelatin matrix application. Outcomes were recurrence rates, healing rates, complication rates, wound healing times and time taken to return to daily activities. In total, 31 studies comprising 8100 patients were included. Non-excisional techniques had overall healing rates ranging from 67 to 100%. Recurrence rates for pit picking, unroofing and gelatin matrix application varied from 0 to 16% depending on the follow-up time. Recurrence rates after additional laser, phenol and endoscopic techniques varied from 0 to 29%. Complication rates ranged from 0 to 16%, and the wound healing time was between three and forty-seven days. The return to daily activities varied from one to nine days. Non-excisional techniques are associated with fast recovery and low morbidity but recurrence rates are high. Techniques that attempt to additionally treat the inner lining of the sinus have worse recurrence rates than pit picking alone. Recurrence rates do not differ between primary and recurrent disease.</p

Enamel-based mark performance for marking Chinese mystery snail \u3ci\u3eBellamya chinensis\u3c/i\u3e

The exoskeleton of gastropods provides a convenient surface for carrying marks, and in the interest of improving future marking methods our laboratory assessed the performance of an enamel paint. The endurance of the paint was also compared to other marking methods assessed in the past. We marked the shells of 30 adult Chinese mystery snails Bellamya chinensis and held them in an aquarium for 181 days. We observed no complete degradation of any enamel-paint mark during the 181 days. The enamel-paint mark was superior to a nail-polish mark, which lasted a median of 100 days. Enamel-paint marks also have a lower rate of loss (0.00 month-1 181 days) than plastic bee tags (0.01 month-1, 57 days), gouache paint (0.07 month-1, 18.5 days), or car body paint from studies found in scientific literature. Legibility of enamelpaint marks had a median lifetime of 102 days. The use of enamel paint on the shells of gastropods is a viable option for studies lasting up to 6 months. Furthermore, visits to a capture-mark-recapture site 1 year after application of enamel-paint marks on B. chinensis shells produced several individuals on which the enamel paint was still visible, although further testing is required to clarify durability over longer periods

A new instrument to measure high value, cost-conscious care attitudes among healthcare stakeholders: Development of the MHAQ

Background: Residents have to learn to provide high value, cost-conscious care (HVCCC) to counter the trend of excessive healthcare costs. Their learning is impacted by individuals from different stakeholder groups within the workplace environment. These individuals' attitudes toward HVCCC may influence how and what residents learn. This study was carried out to develop an instrument to reliably measure HVCCC attitudes among residents, staff physicians, administrators, and patients. The instrument can be used to assess the residency-training environment. Method: The Maastricht HVCCC Attitude Questionnaire (MHAQ) was developed in four phases. First, we conducted exploratory factor analyses using original data from a previously published survey. Next, we added nine items to strengthen subscales and tested the new questionnaire among the four stakeholder groups. We used exploratory factor analysis and Cronbach's alphas to define subscales, after which the final version of the MHAQ was constructed. Finally, we used generalizability theory to determine the number of respondents (residents or staff physicians) needed to reliably measure a specialty attitude score. Results: Initial factor analysis identified three subscales. Thereafter, 301 residents, 297 staff physicians, 53 administrators and 792 patients completed the new questionnaire between June 2017 and July 2018. The best fitting subscale composition was a three-factor model. Subscales were defined as high-value care, cost incorporation, and perceived drawbacks. Cronbach's alphas were between 0.61 and 0.82 for all stakeholders on all subscales. Sufficient reliability for assessing national specialty attitude (G-coefficient > 0.6) could be achieved from 14 respondents. Conclusions: The MHAQ reliably measures individual attitudes toward HVCCC in different stakeholders in health care contexts. It addresses key dimensions of HVCCC, providing content validity evidence. The MHAQ can be used to identify frontrunners of HVCCC, pinpoint aspects of residency training that need improvement, and benchmark and compare across specialties, hospitals and regions

Impact of bariatric surgery in the short and long term: a need for time-dependent dosing of drugs

Sparse information is available on pharmacokinetic changes of drugs over time after bariatric surgery. By reviewing the literature on the short- and long-term pharmacokinetic changes of drugs, several patterns were identified for 39 drugs. No relevant pharmacokinetic changes were identified for roughly a third of the drugs. Of the remaining drugs, levels were variable and partly unpredictable shortly after the surgery. In the long term, most of the drug levels remain altered, but in some cases they returned to preoperative values. Based on the changes and the efficacy-safety balance of each drug, clinicians may need to perform additional clinical monitoring for specific drugs, including measuring drug levels. This review provides suggestions for clinicians and pharmacists for specific time-dependent drug dosing advice.Pharmacolog

Managing soil carbon and nitrogen for productivity and environmental quality

Includes bibliographical references (pages 774-775).In this study, we investigated the impact of cropping system management on C and N pools, crop yield, and N leaching in a long-term agronomic experiment in Southwest Michigan. Four management types, conventional (CO), integrated fertilizer (IF), integrated compost (IC), and transitional organic (TO) were applied to two crop sequences, a corn (Zea mays L.)–corn–soybean [Glycine max (L.) Merr.]–wheat (Triticum aestivum L.) rotation and continuous corn, which were grown with and without cover crops in the IF, IC, and TO managements. Using compost as a fertility source and reducing the use of herbicides and other chemicals resulted in long-term changes in soil organic matter pools such TO ≥ IC > IF ≥ CO for total C and N and for the labile C and N measured through aerobic incubations at 70 and 150 d. Mineralizable N varied within the rotation, tending to increase after soybean and decrease after corn production in all systems. Corn yield was closely associated with 70-d N mineralization potential, being greatest for first-year corn with cover and least for continuous corn without cover under all management types. Although the TO and IC systems produced the lowest yield for second-year or continuous corn, the combination of soybean and wheat plus red clover (Trifolium pratense L.) always supported high yield for first-year corn. Fall nitrate level and nitrate leaching were higher for commercially fertilized corn than for any other crop or for compost-amended corn

The structure of causal sets

More often than not, recently popular structuralist interpretations of physical theories leave the central concept of a structure insufficiently precisified. The incipient causal sets approach to quantum gravity offers a paradigmatic case of a physical theory predestined to be interpreted in structuralist terms. It is shown how employing structuralism lends itself to a natural interpretation of the physical meaning of causal sets theory. Conversely, the conceptually exceptionally clear case of causal sets is used as a foil to illustrate how a mathematically informed rigorous conceptualization of structure serves to identify structures in physical theories. Furthermore, a number of technical issues infesting structuralist interpretations of physical theories such as difficulties with grounding the identity of the places of highly symmetrical physical structures in their relational profile and what may resolve these difficulties can be vividly illustrated with causal sets.Comment: 19 pages, 4 figure

Post-operative critical care management of patients undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC)

<p>Abstract</p> <p>Background</p> <p>Cytoreductive surgery (CRS) and Heated Intraperitoneal Chemotherapy (HIPEC) results in a number of physiological changes with effects on the cardiovascular system, oxygen consumption and coagulation. The Critical Care interventions required by this cohort of patients have not yet been quantified.</p> <p>Methods</p> <p>This retrospective audit examines the experience of a Specialist Tertiary Centre in England over an 18 month period (January 2009-June 2010) during which 69 patients underwent CRS and HIPEC. All patients were extubated in the operating theatre and transferred to the Critical Care Unit (CCU) for initial post-operative management.</p> <p>Results</p> <p>Patients needed to remain on the CCU for 2.4 days (0.8-7.8). There were no 30 day mortalities. The majority of patients (70.1%) did not require post-operative organ support. 2 patients who developed pneumonia post-operatively required respiratory support. 18 (26.1%) patients required vasopressor support with norepinephrine with a mean duration of 13.94 hours (5-51 hours) and mean dose of 0.04 mcg/kg/min. Post-operative coagulopathy peaked at 24 hours. A significant drop in serum albumin was observed.</p> <p>Conclusion</p> <p>The degree of organ support required post-operatively is minimal. Early extubation is efficacious with the aid of epidural analgesia. Critical Care monitoring for 48 hours is desirable in view of the post-operative challenges.</p

Androgen Deprivation therapy for Oligo-recurrent Prostate cancer in addition to radioTherapy (ADOPT):study protocol for a randomised phase III trial

BACKGROUND: More than 60% of oligo-recurrent prostate cancer (PCa) patients treated with metastasis-directed radiotherapy (MDRT) develop biochemical recurrence within 2 years. This recurrence rate emphasises the need for improved treatment and patient selection. In line with the treatment of primary PCa, the efficacy of MDRT may be enhanced when combined with androgen-deprivation therapy (ADT). Furthermore, the availability of PSMA PET/CT offers an excellent tool for optimal patient selection for MDRT. This phase III randomised controlled trial will investigate the role of the addition of ADT to MDRT in oligo-recurrent PCa patients selected with PSMA PET/CT to enhance oncological outcome. METHODS: Two hundred and eighty patients will be randomised in a 1:1 ratio to the standard treatment arm (MDRT alone) or the experimental arm (MDRT + 6 months ADT). Patients with biochemical recurrence after primary treatment of PCa presenting with ≤ 4 metastases will be included. The primary endpoint is the 2.5-year metastases progression-free survival (MPFS). Secondary endpoints are acute and late toxicity, quality of life, biochemical progression-free survival, overall survival, and the sensitivity of the PSMA PET/CT for detecting oligometastases at low PSA-levels. So far, between March 2020 and December 2021, one hundred patients have been included. DISCUSSION: This phase III randomised controlled trial will assess the possible benefit of the addition of 6 months ADT to MDRT on metastases progression-free survival, toxicity, QoL and survival in PCa patients with 1-4 recurrent oligometastatic lesions. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04302454 . Registered 10 March 2020