Storage Material Effects on the Performance of Ru-Based CO2 Capture and Methanation Dual Functioning Materials

In this study, a systematic investigation on Dual Functioning Materials (DFMs) for the capture and methanation of CO₂ is carried out. The attention is focused on the nature of the CO₂ adsorbent component (storage material, SM) varying between alkaline (Li, Na, K) and alkaline-earth (Mg, Ca, Ba) metal oxides in combination with Ru, both supported on an Al₂O₃ support. Combining gas phase reactivity analysis and FT-IR characterization, the samples are characterized in terms of CO₂ storage capacity. It is found that all the SM-containing samples adsorb significant amounts of CO₂ as carbonate species, with the higher amounts being adsorbed when the more thermally stable species are formed, i.e., when Ca, Ba, or K are employed as SMs. In all cases, the hydrogenation of the adsorbed carbonates to CH₄ occurs at lower temperature, if compared to their thermal desorption. However, in the case of Ca- and Ba-based DFMs, resilient carbonates are present on the material surface. It was found that the SMs able to form the more thermally stable carbonates upon CO₂ adsorption also showed the best performances in capture/methanation cycles at 350 °C, even if some residual carbonates were left on the DFM after the hydrogenation step. In particular, the following order of reactivity has in fact been observed in terms of CH₄ production: Ru–K ≥ Ru–Ba > Ru–Ca > Ru–Na ≫ Ru–Mg ≅ Ru–Li ≅ Ru. The presence of steam and O₂ during the capture step has a detrimental effect on the CO₂ adsorption for all samples and, as a result, on CH₄ production due to the competition of CO₂ and water for the same adsorption sites. Thus, only SMs able to form strongly bound carbonates species upon CO₂ exposure can retain significant CO₂ storage capacity also in the presence of water in the adsorption feed

Adoption of 3D printed highly conductive periodic open cellular structures as an effective solution to enhance the heat transfer performances of compact Fischer-Tropsch fixed-bed reactors

Abstract Heat transfer is universally recognized as a key challenge for the intensification of the Fischer-Tropsch (FT) process in compact fixed-bed reactors. For the first time in the scientific literature we demonstrate experimentally that the adoption of a highly conductive periodic open cellular structure (POCS, 3D-printed in AlSi7Mg0.6 by Selective Laser Melting) packed with catalysts pellets is a promising solution to boost heat exchange in fixed-bed FT reactors. This reactor configuration enabled us to assess the performances of a highly active Co/Pt/Al2O3 catalyst packed into the POCS at process conditions relevant to industrial Fischer-Tropsch operation. Unprecedented performances (CO conversion ≈ 80%) could be thus achieved thanks to an outstanding heat management. In fact, almost flat axial and radial temperature profiles were measured along the catalytic bed even under the most severe process conditions (i.e. high CO conversions corresponding to high volumetric heat duties), demonstrating the effective potential of this reactor concept to manage the strong exothermicity of the FT reaction. The heat transfer of the packed-POCS reactor outperformed both packed-bed and packed-foam reactors, granting smaller radial temperature gradients in the catalytic bed, as well as smaller temperature differences at the reactor wall, with larger volumetric power releases. The strengths of the packed-POCS reactor configuration are its regular geometry, which enhances the effective radial thermal conductivity, and the improved contact between the structure and the reactor wall, which governs the limiting wall heat transfer coefficient

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020