Energy production by means of pumps as turbines in water distribution networks

This paper deals with the estimation of the energy production by means of pumps used as turbines to exploit residual hydraulic energy, as in the case of available head and flow rate in water distribution networks. To this aim, four pumps with different characteristics are investigated to estimate the producible yearly electric energy. The performance curves of Pumps As Turbines (PATs), which relate head, power, and efficiency to the volume flow rate over the entire PAT operation range, were derived by using published experimental data. The four considered water distribution networks, for which experimental data taken during one year were available, are characterized by significantly different hydraulic features (average flow rate in the range 10-116 L/s; average pressure reduction in the range 12-53 m). Therefore, energy production accounts for actual flow rate and head variability over the year. The conversion efficiency is also estimated, for both the whole water distribution network and the PAT alone.This paper deals with the estimation of the energy production by means of pumps used as turbines to exploit residual hydraulic energy, as in the case of available head and flow rate in water distribution networks. To this aim, four pumps with different characteristics are investigated to estimate the producible yearly electric energy. The performance curves of Pumps As Turbines (PATs), which relate head, power, and efficiency to the volume flow rate over the entire PAT operation range, were derived by using published experimental data. The four considered water distribution networks, for which experimental data taken during one year were available, are characterized by significantly different hydraulic features (average flow rate in the range 10-116 L/s; average pressure reduction in the range 12-53 m). Therefore, energy production accounts for actual flow rate and head variability over the year. The conversion efficiency is also estimated, for both the whole water distribution network and the PAT alone

Comparison of different approaches to predict the performance of pumps as turbines (PATs)

This paper deals with the comparison of different methods which can be used for the prediction of the performance curves of pumps as turbines (PATs). The considered approaches are four, i.e., one physics-based simulation model ("white box" model), two "gray box" models, which integrate theory on turbomachines with specific data correlations, and one "black box" model. More in detail, the modeling approaches are: (1) a physics-based simulation model developed by the same authors, which includes the equations for estimating head, power, and efficiency and uses loss coefficients and specific parameters; (2) a model developed by Derakhshan and Nourbakhsh, which first predicts the best efficiency point of a PAT and then reconstructs their complete characteristic curves by means of two ad hoc equations; (3) the prediction model developed by Singh and Nestmann, which predicts the complete turbine characteristics based on pump shape and size; (4) an Evolutionary Polynomial Regression model, which represents a data-driven hybrid scheme which can be used for identifying the explicit mathematical relationship between PAT and pump curves. All approaches are applied to literature data, relying on both pump and PAT performance curves of head, power, and efficiency over the entire range of operation. The experimental data were provided by Derakhshan and Nourbakhsh for four different turbomachines, working in both pump and PAT mode with specific speed values in the range 1.53-5.82. This paper provides a quantitative assessment of the predictions made by means of the considered approaches and also analyzes consistency from a physical point of view. Advantages and drawbacks of each method are also analyzed and discussed.This paper deals with the comparison of different methods which can be used for the prediction of the performance curves of pumps as turbines (PATs). The considered approaches are four, i.e., one physics-based simulation model ("white box" model), two "gray box" models, which integrate theory on turbomachines with specific data correlations, and one "black box" model. More in detail, the modeling approaches are: (1) a physics-based simulation model developed by the same authors, which includes the equations for estimating head, power, and efficiency and uses loss coefficients and specific parameters; (2) a model developed by Derakhshan and Nourbakhsh, which first predicts the best efficiency point of a PAT and then reconstructs their complete characteristic curves by means of two ad hoc equations; (3) the prediction model developed by Singh and Nestmann, which predicts the complete turbine characteristics based on pump shape and size; (4) an Evolutionary Polynomial Regression model, which represents a data-driven hybrid scheme which can be used for identifying the explicit mathematical relationship between PAT and pump curves. All approaches are applied to literature data, relying on both pump and PAT performance curves of head, power, and efficiency over the entire range of operation. The experimental data were provided by Derakhshan and Nourbakhsh for four different turbomachines, working in both pump and PAT mode with specific speed values in the range 1.53-5.82. This paper provides a quantitative assessment of the predictions made by means of the considered approaches and also analyzes consistency from a physical point of view. Advantages and drawbacks of each method are also analyzed and discussed

If seizures left speechless: CA-P-S C-A-R-E, a proposal of a new ictal language evaluation protocol

Introduction: We aimed to create standardized protocol for language examination in patients who underwent video-EEG recording and assessed its efficacy in the characterization of ictal language impairment, its ability to differentiate this from impaired awareness, and interobserver reliability in clinical practice. Methods: From our database of video-EEG recordings, we selected a representative sample of 63 focal seizures with presumed language impairment. A multidisciplinary team of epileptologists, EEG technicians, and speech therapists analyzed the selected videos to highlight the critical issues of ordinary ictal language evaluation. We subsequently followed a multi-step process to develop the protocol and assess its interobserver reliability. Results: A protocol based on seven tests in hierarchical succession was created, summed up in the acronym CA-P-S C-A-R-E (Closed Answers, Pro-speak question, Simple orders, Common object denomination, Audio repetition, Reading, Evoke). Following its preliminary administration for 5 months, we assessed the inter-observer reliability of 16 healthcare professionals in distinguishing between language impairment and impaired awareness among a sample of 10 seizures, finding a substantial agreement (kappa 0.61). Conclusion: The proposed protocol, made of simple and easy to memorize tests, is an effective tool that evaluates multiple domains beyond language. Its use could help to recognize ictal aphasia effectively and differentiate it from impaired awareness, minimizing inter-examiner variability

Efficacy of adalimumab as second-line therapy in a pediatric cohort of crohn’s disease patients who failed infliximab therapy: The Italian society of pediatric gastroenterology, hepatology, and nutrition experience

Background: Adalimumab (Ada) treatment is an available option for pediatric Crohn’s disease (CD) and the published experience as rescue therapy is limited. Objectives: We investigated Ada efficacy in a retrospective, pediatric CD cohort who had failed previous infliximab treatment, with a minimum follow-up of 6 months. Methods: In this multicenter study, data on demographics, clinical activity, growth, laboratory values (CRP) and adverse events were collected from CD patients during follow-up. Clinical remission (CR) and response were defined with Pediatric CD Activity Index (PCDAI) score ≤10 and a decrease in PCDAI score of ≥12.5 from baseline, respectively. Results: A total of 44 patients were consecutively recruited (mean age 14.8 years): 34 of 44 (77%) had active disease (mean PCDAI score 24.5) at the time of Ada administration, with a mean disease duration of 3.4 (range 0.3–11.2) years. At 6, 12, and 18 months, out of the total of the enrolled population, CR rates were 55%, 78%, and 52%, respectively, with a significant decrease in PCDAI scores (P<0.01) and mean CRP values (mean CRP 5.7 and 2.4 mL/dL, respectively; P<0.01) at the end of follow-up. Steroid-free remission rates, considered as the total number of patients in CR who were not using steroids at the end of this study, were 93%, 95%, and 96% in 44 patients at 6, 12, and 18 months, respectively. No significant differences in growth parameters were detected. In univariate analysis of variables related to Ada efficacy, we found that only a disease duration >2 years was negatively correlated with final PCDAI score (P<0.01). Two serious adverse events were recorded: 1 meningitis and 1 medulloblastoma. Conclusion: Our data confirm Ada efficacy in pediatric patients as second-line biological therapy after infliximab failure. Longer-term prospective data are warranted to define general effectiveness and safety in pediatric CD patients

Very Low Alcohol Consumption Is Associated with Lower Prevalence of Cirrhosis and Hepatocellular Carcinoma in Patients with Non-Alcoholic Fatty Liver Disease

The role of moderate alcohol consumption in the evolution of NAFLD is still debated. The aim of this study is to evaluate the impact of current and lifelong alcohol consumption in patients with NAFLD. From 2015 to 2020, we enrolled 276 consecutive patients fulfilling criteria of NAFLD (alcohol consumption up to 140 g/week for women and 210 g/week for men). According to their current alcohol intake per week, patients were divided in: abstainers, very low consumers (C1: <70 g/week) and moderate consumers (C2). We created a new tool, called LACU (Lifetime Alcohol Consuming Unit) to estimate the alcohol exposure across lifetime: 1 LACU was defined as 7 alcohol units per week for 1 drinking year. Patients were divided into lifelong abstainers and consumers and the latter furtherly divided into quartiles: Q1-Q4. Stratification according to alcohol intake, both current and cumulative as estimated by LACU, showed that very low consumers (C1 and Q1-Q3) displayed lower frequency of cirrhosis and hepatocellular carcinoma compared to abstainers and moderate consumers (C2 and Q4). We can speculate that up to one glass of wine daily in the context of a Mediterranean diet may be a long-term useful approach in selected NAFLD patients

Vaccines in children with inflammatory bowel disease: Brief review

Incidence of inflammatory bowel diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), is increasing worldwide. Children with IBDs have a dysfunctional immune system and they are frequently treated with immunomodulating drugs and biological therapy, which significantly impair immune system functions and lead to an increased risk of infections. Vaccines are essential to prevent at least part of these infections and this explains why strict compliance to the immunization guidelines specifically prepared for IBD patients is strongly recommended. However, several factors might lead to insufficient immunization. In this paper, present knowledge on the use of vaccines in children with IBDs is discussed. Literature review showed that despite a lack of detailed quantification of the risk of infections in children with IBDs, these children might have infections more frequently than age-matched healthy subjects, and at least in some cases, these infections might be even more severe. Fortunately, most of these infections could be prevented when recommended schedules of immunization are carefully followed. Vaccines given to children with IBDs generally have adequate immunogenicity and safety. Attention must be paid to live attenuated vaccines that can be administered only to children without or with mild immune system function impairment. Vaccination of their caregivers is also recommended. Unfortunately, compliance to these recommendations is generally low and multidisciplinary educational programs to improve vaccination coverage must be planned, in order to protect children with IBD from vaccine-preventable diseases

Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP)

Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and thera- peutic intervention that could be adopted in the context of public health policies for FAIs are needed. This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy

Self-Stabilizing Byzantine Resilient Topology Discovery and Message Delivery

Traditional Byzantine resilient algorithms use $2f + 1$ vertex disjoint paths to ensure message delivery in the presence of up to f Byzantine nodes. The question of how these paths are identified is related to the fundamental problem of topology discovery. Distributed algorithms for topology discovery cope with a never ending task, dealing with frequent changes in the network topology and unpredictable transient faults. Therefore, algorithms for topology discovery should be self-stabilizing to ensure convergence of the topology information following any such unpredictable sequence of events. We present the first such algorithm that can cope with Byzantine nodes. Starting in an arbitrary global state, and in the presence of f Byzantine nodes, each node is eventually aware of all the other non-Byzantine nodes and their connecting communication links. Using the topology information, nodes can, for example, route messages across the network and deliver messages from one end user to another. We present the first deterministic, cryptographic-assumptions-free, self-stabilizing, Byzantine-resilient algorithms for network topology discovery and end-to-end message delivery. We also consider the task of r-neighborhood discovery for the case in which $r$ and the degree of nodes are bounded by constants. The use of r-neighborhood discovery facilitates polynomial time, communication and space solutions for the above tasks. The obtained algorithms can be used to authenticate parties, in particular during the establishment of private secrets, thus forming public key schemes that are resistant to man-in-the-middle attacks of the compromised Byzantine nodes. A polynomial and efficient end-to-end algorithm that is based on the established private secrets can be employed in between periodical re-establishments of the secrets