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Commenced in January 2007
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Edition: International
Paper Count: 141

Search results for: hourly%20charge%20rate

21 Seasonal Short-Term Effect of Air Pollution on Cardiovascular Mortality in Belgium

Authors: Natalia Bustos Sierra, Katrien Tersago

Abstract:

It is currently proven that both extremes of temperature are associated with increased mortality and that air pollution is associated with temperature. This relationship is complex, and in countries with important seasonal variations in weather such as Belgium, some effects can appear as non-significant when the analysis is done over the entire year. We, therefore, analyzed the effect of short-term outdoor air pollution exposure on cardiovascular mortality during the warmer and colder months separately. We used daily cardiovascular deaths from acute cardiovascular diagnostics according to the International Classification of Diseases, 10th Revision (ICD-10: I20-I24, I44-I49, I50, I60-I66) during the period 2008-2013. The environmental data were population-weighted concentrations of particulates with an aerodynamic diameter less than 10 µm (PM₁₀) and less than 2.5 µm (PM₂.₅) (daily average), nitrogen dioxide (NO₂) (daily maximum of the hourly average) and ozone (O₃) (daily maximum of the 8-hour running mean). A Generalized linear model was applied adjusting for the confounding effect of season, temperature, dew point temperature, the day of the week, public holidays and the incidence of influenza-like illness (ILI) per 100,000 inhabitants. The relative risks (RR) were calculated for an increase of one interquartile range (IQR) of the air pollutant (μg/m³). These were presented for the four hottest months (June, July, August, September) and coldest months (November, December, January, February) in Belgium. We applied both individual lag model and unconstrained distributed lag model methods. The cumulative effect of a four-day exposure (day of exposure and three consecutive days) was calculated from the unconstrained distributed lag model. The IQR for PM₁₀, PM₂.₅, NO₂, and O₃ were respectively 8.2, 6.9, 12.9 and 25.5 µg/m³ during warm months and 18.8, 17.6, 18.4 and 27.8 µg/m³ during cold months. The association with CV mortality was statistically significant for the four pollutants during warm months and only for NO₂ during cold months. During the warm months, the cumulative effect of an IQR increase of ozone for the age groups 25-64, 65-84 and 85+ was 1.066 (95%CI: 1.002-1.135), 1.041 (1.008-1.075) and 1.036 (1.013-1.058) respectively. The cumulative effect of an IQR increase of NO₂ for the age group 65-84 was 1.066 (1.020-1.114) during warm months and 1.096 (1.030-1.166) during cold months. The cumulative effect of an IQR increase of PM₁₀ during warm months reached 1.046 (1.011-1.082) and 1.038 (1.015-1.063) for the age groups 65-84 and 85+ respectively. Similar results were observed for PM₂.₅. The short-term effect of air pollution on cardiovascular mortality is greater during warm months for lower pollutant concentrations compared to cold months. Spending more time outside during warm months increases population exposure to air pollution and can, therefore, be a confounding factor for this association. Age can also affect the length of time spent outdoors and the type of physical activity exercised. This study supports the deleterious effect of air pollution on cardiovascular mortality (CV) which varies according to season and age groups in Belgium. Public health measures should, therefore, be adapted to seasonality.

Keywords: air pollution, cardiovascular, mortality, season

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20 Analysis of Sea Waves Characteristics and Assessment of Potential Wave Power in Egyptian Mediterranean Waters

Authors: Ahmed A. El-Gindy, Elham S. El-Nashar, Abdallah Nafaa, Sameh El-Kafrawy

Abstract:

The generation of energy from marine energy became one of the most preferable resources since it is a clean source and friendly to environment. Egypt has long shores along Mediterranean with important cities that need energy resources with significant wave energy. No detailed studies have been done on wave energy distribution in the Egyptian waters. The objective of this paper is to assess the energy wave power available in the Egyptian waters for the choice of the most suitable devices to be used in this area. This paper deals the characteristics and power of the offshore waves in the Egyptian waters. Since the field observations of waves are not frequent and need much technical work, the European Centre for Medium-Range Weather Forecasts (ECMWF) interim reanalysis data in Mediterranean, with a grid size 0.75 degree, which is a relatively course grid, are considered in the present study for preliminary assessment of sea waves characteristics and power. The used data covers the period from 2012 to 2014. The data used are significant wave height (swh), mean wave period (mwp) and wave direction taken at six hourly intervals, at seven chosen stations, and at grid points covering the Egyptian waters. The wave power (wp) formula was used to calculate energy flux. Descriptive statistical analysis including monthly means and standard deviations of the swh, mwp, and wp. The percentiles of wave heights and their corresponding power are done, as a tool of choice of the best technology suitable for the site. The surfer is used to show spatial distributions of wp. The analysis of data at chosen 7 stations determined the potential of wp off important Egyptian cities. Offshore of Al Saloum and Marsa Matruh, the highest wp occurred in January and February (16.93-18.05) ± (18.08-22.12) kw/m while the lowest occurred in June and October (1.49-1.69) ± (1.45-1.74) kw/m. In front of Alexandria and Rashid, the highest wp occurred in January and February (16.93-18.05) ± (18.08-22.12) kw/m while the lowest occurred in June and September (1.29-2.01) ± (1.31-1.83) kw/m. In front of Damietta and Port Said, the highest wp occurred in February (14.29-17.61) ± (21.61-27.10) kw/m and the lowest occurred in June (0.94-0.96) ± (0.71-0.72) kw/m. In winter, the probabilities of waves higher than 0.8 m in percentage were, at Al Saloum and Marsa Matruh (76.56-80.33) ± (11.62-12.05), at Alexandria and Rashid (73.67-74.79) ± (16.21-18.59) and at Damietta and Port Said (66.28-68.69) ± (17.88-17.90). In spring, the percentiles were, at Al Saloum and Marsa Matruh, (48.17-50.92) ± (5.79-6.56), at Alexandria and Rashid, (39.38-43.59) ± (9.06-9.34) and at Damietta and Port Said, (31.59-33.61) ± (10.72-11.25). In summer, the probabilities were, at Al Saloum and Marsa Matruh (57.70-66.67) ± (4.87-6.83), at Alexandria and Rashid (59.96-65.13) ± (9.14-9.35) and at Damietta and Port Said (46.38-49.28) ± (10.89-11.47). In autumn, the probabilities were, at Al Saloum and Marsa Matruh (58.75-59.56) ± (2.55-5.84), at Alexandria and Rashid (47.78-52.13) ± (3.11-7.08) and at Damietta and Port Said (41.16-42.52) ± (7.52-8.34).

Keywords: distribution of sea waves energy, Egyptian Mediterranean waters, waves characteristics, waves power

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19 Most Recent Lifespan Estimate for the Itaipu Hydroelectric Power Plant Computed by Using Borland and Miller Method and Mass Balance in Brazil, Paraguay

Authors: Anderson Braga Mendes

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Itaipu Hydroelectric Power Plant is settled on the Paraná River, which is a natural boundary between Brazil and Paraguay; thus, the facility is shared by both countries. Itaipu Power Plant is the biggest hydroelectric generator in the world, and provides clean and renewable electrical energy supply for 17% and 76% of Brazil and Paraguay, respectively. The plant started its generation in 1984. It counts on 20 Francis turbines and has installed capacity of 14,000 MWh. Its historic generation record occurred in 2016 (103,098,366 MWh), and since the beginning of its operation until the last day of 2016 the plant has achieved the sum of 2,415,789,823 MWh. The distinct sedimentologic aspects of the drainage area of Itaipu Power Plant, from its stretch upstream (Porto Primavera and Rosana dams) to downstream (Itaipu dam itself), were taken into account in order to best estimate the increase/decrease in the sediment yield by using data from 2001 to 2016. Such data are collected through a network of 14 automatic sedimentometric stations managed by the company itself and operating in an hourly basis, covering an area of around 136,000 km² (92% of the incremental drainage area of the undertaking). Since 1972, a series of lifespan studies for the Itaipu Power Plant have been made, being first assessed by Sir Hans Albert Einstein, at the time of the feasibility studies for the enterprise. From that date onwards, eight further studies were made through the last 44 years aiming to confer more precision upon the estimates based on more updated data sets. From the analysis of each monitoring station, it was clearly noticed strong increase tendencies in the sediment yield through the last 14 years, mainly in the Iguatemi, Ivaí, São Francisco Falso and Carapá Rivers, the latter situated in Paraguay, whereas the others are utterly in Brazilian territory. Five lifespan scenarios considering different sediment yield tendencies were simulated with the aid of the softwares SEDIMENT and DPOSIT, both developed by the author of the present work. Such softwares thoroughly follow the Borland & Miller methodology (empirical method of area-reduction). The soundest scenario out of the five ones under analysis indicated a lifespan foresight of 168 years, being the reservoir only 1.8% silted by the end of 2016, after 32 years of operation. Besides, the mass balance in the reservoir (water inflows minus outflows) between 1986 and 2016 shows that 2% of the whole Itaipu lake is silted nowadays. Owing to the convergence of both results, which were acquired by using different methodologies and independent input data, it is worth concluding that the mathematical modeling is satisfactory and calibrated, thus assigning credibility to this most recent lifespan estimate.

Keywords: Borland and Miller method, hydroelectricity, Itaipu Power Plant, lifespan, mass balance

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18 Smart Irrigation System for Applied Irrigation Management in Tomato Seedling Production

Authors: Catariny C. Aleman, Flavio B. Campos, Matheus A. Caliman, Everardo C. Mantovani

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The seedling production stage is a critical point in the vegetable production system. Obtaining high-quality seedlings is a prerequisite for subsequent cropping to occur well and productivity optimization is required. The water management is an important step in agriculture production. The adequate water requirement in horticulture seedlings can provide higher quality and increase field production. The practice of irrigation is indispensable and requires a duly adjusted quality irrigation system, together with a specific water management plan to meet the water demand of the crop. Irrigation management in seedling management requires a great deal of specific information, especially when it involves the use of inputs such as hydrorentering polymers and automation technologies of the data acquisition and irrigation system. The experiment was conducted in a greenhouse at the Federal University of Viçosa, Viçosa - MG. Tomato seedlings (Lycopersicon esculentum Mill) were produced in plastic trays of 128 cells, suspended at 1.25 m from the ground. The seedlings were irrigated by 4 micro sprinklers of fixed jet 360º per tray, duly isolated by sideboards, following the methodology developed for this work. During Phase 1, in January / February 2017 (duration of 24 days), the cultivation coefficient (Kc) of seedlings cultured in the presence and absence of hydrogel was evaluated by weighing lysimeter. In Phase 2, September 2017 (duration of 25 days), the seedlings were submitted to 4 irrigation managements (Kc, timer, 0.50 ETo, and 1.00 ETo), in the presence and absence of hydrogel and then evaluated in relation to quality parameters. The microclimate inside the greenhouse was monitored with the use of air temperature, relative humidity and global radiation sensors connected to a microcontroller that performed hourly calculations of reference evapotranspiration by Penman-Monteith standard method FAO56 modified for the balance of long waves according to Walker, Aldrich, Short (1983), and conducted water balance and irrigation decision making for each experimental treatment. Kc of seedlings cultured on a substrate with hydrogel (1.55) was higher than Kc on a pure substrate (1.39). The use of the hydrogel was a differential for the production of earlier tomato seedlings, with higher final height, the larger diameter of the colon, greater accumulation of a dry mass of shoot, a larger area of crown projection and greater the rate of relative growth. The handling 1.00 ETo promoted higher relative growth rate.

Keywords: automatic system; efficiency of water use; precision irrigation, micro sprinkler.

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17 Modeling of Tsunami Propagation and Impact on West Vancouver Island, Canada

Authors: S. Chowdhury, A. Corlett

Abstract:

Large tsunamis strike the British Columbia coast every few hundred years. The Cascadia Subduction Zone, which extends along the Pacific coast from Vancouver Island to Northern California is one of the most seismically active regions in Canada. Significant earthquakes have occurred in this region, including the 1700 Cascade Earthquake with an estimated magnitude of 9.2. Based on geological records, experts have predicted a 'great earthquake' of a similar magnitude within this region may happen any time. This earthquake is expected to generate a large tsunami that could impact the coastal communities on Vancouver Island. Since many of these communities are in remote locations, they are more likely to be vulnerable, as the post-earthquake relief efforts would be impacted by the damage to critical road infrastructures. To assess the coastal vulnerability within these communities, a hydrodynamic model has been developed using MIKE-21 software. We have considered a 500 year probabilistic earthquake design criteria including the subsidence in this model. The bathymetry information was collected from Canadian Hydrographic Services (CHS), and National Oceanic Atmospheric and Administration (NOAA). The arial survey was conducted using a Cessna-172 aircraft for the communities, and then the information was converted to generate a topographic digital elevation map. Both survey information was incorporated into the model, and the domain size of the model was about 1000km x 1300km. This model was calibrated with the tsunami occurred off the west coast of Moresby Island on October 28, 2012. The water levels from the model were compared with two tide gauge stations close to the Vancouver Island and the output from the model indicates the satisfactory result. For this study, the design water level was considered as High Water Level plus the Sea Level Rise for 2100 year. The hourly wind speeds from eight directions were collected from different wind stations and used a 200-year return period wind speed in the model for storm events. The regional model was set for 12 hrs simulation period, which takes more than 16 hrs to complete one simulation using double Xeon-E7 CPU computer plus a K-80 GPU. The boundary information for the local model was generated from the regional model. The local model was developed using a high resolution mesh to estimate the coastal flooding for the communities. It was observed from this study that many communities will be effected by the Cascadia tsunami and the inundation maps were developed for the communities. The infrastructures inside the coastal inundation area were identified. Coastal vulnerability planning and resilient design solutions will be implemented to significantly reduce the risk.

Keywords: tsunami, coastal flooding, coastal vulnerable, earthquake, Vancouver, wave propagation

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16 Techno Economic Analysis for Solar PV and Hydro Power for Kafue Gorge Power Station

Authors: Elvis Nyirenda

Abstract:

This research study work was done to evaluate and propose an optimum measure to enhance the uptake of clean energy technologies such as solar photovoltaics, the study also aims at enhancing the country’s energy mix from the overdependence on hydro power which is susceptible to droughts and climate change challenges The country in the years 2015 - 2016 and 2018 - 2019 had received rainfall below average due to climate change and a shift in the weather pattern; this resulted in prolonged power outages and load shedding for more than 10 hours per day. ZESCO Limited, the utility company that owns infrastructure in the generation, transmission, and distribution of electricity (state-owned), is seeking alternative sources of energy in order to reduce the over-dependence on hydropower stations. One of the alternative sources of energy is Solar Energy from the sun. However, solar power is intermittent in nature and to smoothen the load curve, investment in robust energy storage facilities is of great importance to enhance security and reliability of electricity supply in the country. The methodology of the study looked at the historical performance of the Kafue gorge upper power station and utilised the hourly generation figures as input data for generation modelling in Homer software. The average yearly demand was derived from the available data on the system SCADA. The two dams were modelled as natural battery with the absolute state of charging and discharging determined by the available water resource and the peak electricity demand. The software Homer Energy System is used to simulate the scheme incorporating a pumped storage facility and Solar photovoltaic systems. The pumped hydro scheme works like a natural battery for the conservation of water, with the only losses being evaporation and water leakages from the dams and the turbines. To address the problem of intermittency on the solar resource and the non-availability of water for hydropower generation, the study concluded that utilising the existing Hydro power stations, Kafue Gorge upper and Kafue Gorge Lower to work conjunctively with Solar energy will reduce power deficits and increase the security of supply for the country. An optimum capacity of 350MW of solar PV can be integrated while operating Kafue Gorge power station in both generating and pumping mode to enable efficient utilisation of water at Kafue Gorge upper Dam and Kafue Gorge Lower dam.

Keywords: hydropower, solar power systems, energy storage, photovoltaics, solar irradiation, pumped hydro storage system, supervisory control and data acquisition, Homer energy

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15 Evaluating Energy Transition of a complex of buildings in a historic site of Rome toward Zero-Emissions for a Sustainable Future

Authors: Silvia Di Turi, Nicolandrea Calabrese, Francesca Caffari, Giulia Centi, Francesca Margiotta, Giovanni Murano, Laura Ronchetti, Paolo Signoretti, Lisa Volpe, Domenico Palladino

Abstract:

Recent European policies have been set ambitious targets aimed at significantly reducing CO2 emissions by 2030, with a long-term vision of transforming existing buildings into Zero-Emissions Buildings (ZEmB) by 2050. This vision represents a key point for the energy transition as the whole building stock currently accounts for 36% of total energy consumption across the Europe, mainly due to their poor energy performance. The challenge towards Zero-Emissions Buildings is particularly felt in Italy, where a significant number of buildings with historical significance or situated within protected/constrained areas can be found. Furthermore, an estimated 70% of the national building stock are built before 1976, indicating a widespread issue of poor energy performance. Addressing the energy ineƯiciency of these buildings is crucial to refining a comprehensive energy renovation approach aimed at facilitating their energy transition. In this framework the current study focuses on analysing a challenging complex of buildings to be totally restored through significant energy renovation interventions. The goal is to recover these disused buildings situated in a significant archaeological zone of Rome, contributing to the restoration and reintegration of this historically valuable site, while also oƯering insights useful for achieving zeroemission requirements for buildings within such contexts. In pursuit of meeting the stringent zero-emission requirements, a comprehensive study was carried out to assess the complex of buildings, envisioning substantial renovation measures on building envelope and plant systems and incorporating renewable energy system solutions, always respecting and preserving the historic site. An energy audit of the complex of buildings was performed to define the actual energy consumption for each energy service by adopting the hourly calculation methods. Subsequently, significant energy renovation interventions on both building envelope and mechanical systems have been examined respecting the historical value and preservation of site. These retrofit strategies have been investigated with threefold aims: 1) to recover the existing buildings ensuring the energy eƯiciency of the whole complex of buildings, 2) to explore which solutions have allowed achieving and facilitating the ZEmB status, 3) to balance the energy transition requirements with the sustainable aspect in order to preserve the historic value of the buildings and site. This study has pointed out the potentiality and the technical challenges associated with implementing renovation solutions for such buildings, representing one of the first attempt towards realizing this ambitious target for this type of building.

Keywords: energy conservation and transition, complex of buildings in historic site, zero-emission buildings, energy efficiency recovery

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14 Investigating the Urban Heat Island Phenomenon in A Desert City Aiming at Sustainable Buildings

Authors: Afifa Mohammed, Gloria Pignatta, Mattheos Santamouris, Evangelia Topriska

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Climate change is one of the global challenges that is exacerbated by the rapid growth of urbanizations. Urban Heat Island (UHI) phenomenon can be considered as an effect of the urbanization and it is responsible together with the Climate change of the overheating of urban cities and downtowns. The purpose of this paper is to quantify and perform analysis of UHI Intensity in Dubai, United Arab Emirates (UAE), through checking the relationship between the UHI and different meteorological parameters (e.g., temperature, winds speed, winds direction). Climate data were collected from three meteorological stations in Dubai (e.g., Dubai Airport - Station 1, Al-Maktoum Airport - Station 2 and Saih Al-Salem - Station 3) for a period of five years (e.g., 2014 – 2018) based upon hourly rates, and following clustering technique as one of the methodology tools of measurements. The collected data of each station were divided into six clusters upon the winds directions, either from the seaside or from the desert side, or from the coastal side which is in between both aforementioned winds sources, to investigate the relationship between temperature degrees and winds speed values through UHI measurements for Dubai Airport - Station 1 compared with the same of Al-Maktoum Airport - Station 2. In this case, the UHI value is determined by the temperature difference of both stations, where Station 1 is considered as located in an urban area and Station 2 is considered as located in a suburban area. The same UHI calculations has been applied for Al-Maktoum Airport - Station 2 and Saih Salem - Station 3 where Station 2 is considered as located in an urban area and Station 3 is considered as located in a suburban area. The performed analysis aims to investigate the relation between the two environmental parameters (e.g., Temperature and Winds Speed) and the Urban Heat Island (UHI) intensity when the wind comes from the seaside, from the desert, and the remaining directions. The analysis shows that the correlation between the temperatures with both UHI intensity (e.g., temperature difference between Dubai Airport - Station 1 and Saih Al-Salem - Station 3 and between Al-Maktoum Airport - Station 2 and Saih Al-Salem - Station 3 (through station 1 & 2) is strong and has a negative relationship when the wind is coming from the seaside comparing between the two stations 1 and 2, while the relationship is almost zero (no relation) when the wind is coming from the desert side. The relation is independent between the two parameters, e.g., temperature and UHI, on Station 2, during the same procedures, the correlation between the urban heat island UHI phenomenon and wind speed is weak for both stations when wind direction is coming from the seaside comparing the station 1 and 2, while it was found that there’s no relationship between urban heat island phenomenon and wind speed when wind direction is coming from desert side. The conclusion could be summarized saying that the wind coming from the seaside or from the desert side have a different effect on UHI, which is strongly affected by meteorological parameters. The output of this study will enable more determination of UHI phenomenon under desert climate, which will help to inform about the UHI phenomenon and intensity and extract recommendations in two main categories such as planning of new cities and designing of buildings.

Keywords: meteorological data, subtropical desert climate, urban climate, urban heat island (UHI)

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13 De-Pigmentary Effect of Ayurvedic Treatment on Hyper-Pigmentation of Skin Due to Chloroquine: A Case Report

Authors: Sunil Kumar, Rajesh Sharma

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Toxic epidermal necrolysis, pruritis, rashes, lichen planus like eruption, hyper pigmentation of skin are rare toxic effects of choloroquine used over a long time. Skin and mucus membrane hyper pigmentation is generally of a bluish black or grayish color and irreversible after discontinuation of the drug. According to Ayurveda, Dushivisha is the name given to any poisonous substance which is not fully endowed with the qualities of poison by nature (i.e. it acts as an impoverished or weak poison) and because of its mild potency, it remains in the body for many years causing various symptoms, one among them being discoloration of skin.The objective of this case report is to investigate the effect of Ayurvedic management of chloroquine induced hyper-pigmentation on the line of treatment of Dushivisha. Case Report: A 26-year-old female was suffering from hyper-pigmentation of the skin over the neck, forehead, temporo-mandibular joints, upper back and posterior aspect of both the arms since 8 years had history of taking Chloroquine came to Out Patient Department of National Institute of Ayurveda, Jaipur, India in Jan. 2015. The routine investigations (CBC, ESR, Eosinophil count) were within normal limits. Punch biopsy skin studied for histopathology under hematoxylin and eosin staining showed epidermis with hyper-pigmentation of the basal layer. In the papillary dermis as well as deep dermis there were scattered melanophages along with infiltration by mononuclear cells. There was no deposition of amyloid-like substances. These histopathological findings were suggestive of Chloroquine induced hyper-pigmentation. The case was treated on the line of treatment of Dushivisha and was given Vamana and Virechana (therapeutic emesis and purgation) every six months followed by Snehana karma (oleation therapy) with Panchatikta Ghrit and Swedana (sudation). Arogyavardhini Vati -1 g, Dushivishari Vati 500 mg, Mahamanjisthadi Quath 20 ml were given twelve hourly and Aragwadhadi Quath 25 ml at bed time orally. The patient started showing lightening of the pigments after six months and almost complete remission after 12 months of the treatment. Conclusion: This patient presented with the Dushivisha effect of Chloroquineandwas administered two relevant procedures from Panchakarma viz. Vamana and Virechana. Both Vamana and Virechanakarma here referred to Shodhana karma (purification procedures) eliminates accumulated toxins from the body. In this process, oleation dislodge the toxins from the tissues and sudation helps to bring them to the alimentary tract. The line of treatment did not target direct hypo pigmentary effects; rather aimed to eliminate the Dushivisha. This gave promising results in this condition.

Keywords: Ayurveda, chloroquine, Dushivisha, hyper-pigmentation

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12 Thermo-Economic Evaluation of Sustainable Biogas Upgrading via Solid-Oxide Electrolysis

Authors: Ligang Wang, Theodoros Damartzis, Stefan Diethelm, Jan Van Herle, François Marechal

Abstract:

Biogas production from anaerobic digestion of organic sludge from wastewater treatment as well as various urban and agricultural organic wastes is of great significance to achieve a sustainable society. Two upgrading approaches for cleaned biogas can be considered: (1) direct H₂ injection for catalytic CO₂ methanation and (2) CO₂ separation from biogas. The first approach usually employs electrolysis technologies to generate hydrogen and increases the biogas production rate; while the second one usually applies commercially-available highly-selective membrane technologies to efficiently extract CO₂ from the biogas with the latter being then sent afterward for compression and storage for further use. A straightforward way of utilizing the captured CO₂ is on-site catalytic CO₂ methanation. From the perspective of system complexity, the second approach may be questioned, since it introduces an additional expensive membrane component for producing the same amount of methane. However, given the circumstance that the sustainability of the produced biogas should be retained after biogas upgrading, renewable electricity should be supplied to drive the electrolyzer. Therefore, considering the intermittent nature and seasonal variation of renewable electricity supply, the second approach offers high operational flexibility. This indicates that these two approaches should be compared based on the availability and scale of the local renewable power supply and not only the technical systems themselves. Solid-oxide electrolysis generally offers high overall system efficiency, and more importantly, it can achieve simultaneous electrolysis of CO₂ and H₂O (namely, co-electrolysis), which may bring significant benefits for the case of CO₂ separation from the produced biogas. When taking co-electrolysis into account, two additional upgrading approaches can be proposed: (1) direct steam injection into the biogas with the mixture going through the SOE, and (2) CO₂ separation from biogas which can be used later for co-electrolysis. The case study of integrating SOE to a wastewater treatment plant is investigated with wind power as the renewable power. The dynamic production of biogas is provided on an hourly basis with the corresponding oxygen and heating requirements. All four approaches mentioned above are investigated and compared thermo-economically: (a) steam-electrolysis with grid power, as the base case for steam electrolysis, (b) CO₂ separation and co-electrolysis with grid power, as the base case for co-electrolysis, (c) steam-electrolysis and CO₂ separation (and storage) with wind power, and (d) co-electrolysis and CO₂ separation (and storage) with wind power. The influence of the scale of wind power supply is investigated by a sensitivity analysis. The results derived provide general understanding on the economic competitiveness of SOE for sustainable biogas upgrading, thus assisting the decision making for biogas production sites. The research leading to the presented work is funded by European Union’s Horizon 2020 under grant agreements n° 699892 (ECo, topic H2020-JTI-FCH-2015-1) and SCCER BIOSWEET.

Keywords: biogas upgrading, solid-oxide electrolyzer, co-electrolysis, CO₂ utilization, energy storage

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11 Gender Gap in Returns to Social Entrepreneurship

Authors: Saul Estrin, Ute Stephan, Suncica Vujic

Abstract:

Background and research question: Gender differences in pay are present at all organisational levels, including at the very top. One possible way for women to circumvent organizational norms and discrimination is to engage in entrepreneurship because, as CEOs of their own organizations, entrepreneurs largely determine their own pay. While commercial entrepreneurship plays an important role in job creation and economic growth, social entrepreneurship has come to prominence because of its promise of addressing societal challenges such as poverty, social exclusion, or environmental degradation through market-based rather than state-sponsored activities. This opens the research question whether social entrepreneurship might be a form of entrepreneurship in which the pay of men and women is the same, or at least more similar; that is to say there is little or no gender pay gap. If the gender gap in pay persists also at the top of social enterprises, what are the factors, which might explain these differences? Methodology: The Oaxaca-Blinder Decomposition (OBD) is the standard approach of decomposing the gender pay gap based on the linear regression model. The OBD divides the gender pay gap into the ‘explained’ part due to differences in labour market characteristics (education, work experience, tenure, etc.), and the ‘unexplained’ part due to differences in the returns to those characteristics. The latter part is often interpreted as ‘discrimination’. There are two issues with this approach. (i) In many countries there is a notable convergence in labour market characteristics across genders; hence the OBD method is no longer revealing, since the largest portion of the gap remains ‘unexplained’. (ii) Adding covariates to a base model sequentially either to test a particular coefficient’s ‘robustness’ or to account for the ‘effects’ on this coefficient of adding covariates might be problematic, due to sequence-sensitivity when added covariates are correlated. Gelbach’s decomposition (GD) addresses latter by using the omitted variables bias formula, which constructs a conditional decomposition thus accounting for sequence-sensitivity when added covariates are correlated. We use GD to decompose the differences in gaps of pay (annual and hourly salary), size of the organisation (revenues), effort (weekly hours of work), and sources of finances (fees and sales, grants and donations, microfinance and loans, and investors’ capital) between men and women leading social enterprises. Database: Our empirical work is made possible by our collection of a unique dataset using respondent driven sampling (RDS) methods to address the problem that there is as yet no information on the underlying population of social entrepreneurs. The countries that we focus on are the United Kingdom, Spain, Romania and Hungary. Findings and recommendations: We confirm the existence of a gender pay gap between men and women leading social enterprises. This gap can be explained by differences in the accumulation of human capital, psychological and social factors, as well as cross-country differences. The results of this study contribute to a more rounded perspective, highlighting that although social entrepreneurship may be a highly satisfying occupation, it also perpetuates gender pay inequalities.

Keywords: Gelbach’s decomposition, gender gap, returns to social entrepreneurship, values and preferences

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10 Energy Refurbishment of University Building in Cold Italian Climate: Energy Audit and Performance Optimization

Authors: Fabrizio Ascione, Martina Borrelli, Rosa Francesca De Masi, Silvia Ruggiero, Giuseppe Peter Vanoli

Abstract:

The Directive 2010/31/EC 'Directive of the European Parliament and of the Council of 19 may 2010 on the energy performance of buildings' moved the targets of the previous version toward more ambitious targets, for instance by establishing that, by 31 December 2020, all new buildings should demand nearly zero-energy. Moreover, the demonstrative role of public buildings is strongly affirmed so that also the target nearly zero-energy buildings is anticipated, in January 2019. On the other hand, given the very low turn-over rate of buildings (in Europe, it ranges between 1-3%/yearly), each policy that does not consider the renovation of the existing building stock cannot be effective in the short and medium periods. According to this proposal, the study provides a novel, holistic approach to design the refurbishment of educational buildings in colder cities of Mediterranean regions enabling stakeholders to understand the uncertainty to use numerical modelling and the real environmental and economic impacts of adopting some energy efficiency technologies. The case study is a university building of Molise region in the centre of Italy. The proposed approach is based on the application of the cost-optimal methodology as it is shown in the Delegate Regulation 244/2012 and Guidelines of the European Commission, for evaluating the cost-optimal level of energy performance with a macroeconomic approach. This means that the refurbishment scenario should correspond to the configuration that leads to lowest global cost during the estimated economic life-cycle, taking into account not only the investment cost but also the operational costs, linked to energy consumption and polluting emissions. The definition of the reference building has been supported by various in-situ surveys, investigations, evaluations of the indoor comfort. Data collection can be divided into five categories: 1) geometrical features; 2) building envelope audit; 3) technical system and equipment characterization; 4) building use and thermal zones definition; 5) energy building data. For each category, the required measures have been indicated with some suggestions for the identifications of spatial distribution and timing of the measurements. With reference to the case study, the collected data, together with a comparison with energy bills, allowed a proper calibration of a numerical model suitable for the hourly energy simulation by means of EnergyPlus. Around 30 measures/packages of energy, efficiency measure has been taken into account both on the envelope than regarding plant systems. Starting from results, two-point will be examined exhaustively: (i) the importance to use validated models to simulate the present performance of building under investigation; (ii) the environmental benefits and the economic implications of a deep energy refurbishment of the educational building in cold climates.

Keywords: energy simulation, modelling calibration, cost-optimal retrofit, university building

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9 Evaluation of the Performance Measures of Two-Lane Roundabout and Turbo Roundabout with Varying Truck Percentages

Authors: Evangelos Kaisar, Anika Tabassum, Taraneh Ardalan, Majed Al-Ghandour

Abstract:

The economy of any country is dependent on its ability to accommodate the movement and delivery of goods. The demand for goods movement and services increases truck traffic on highways and inside the cities. The livability of most cities is directly affected by the congestion and environmental impacts of trucks, which are the backbone of the urban freight system. Better operation of heavy vehicles on highways and arterials could lead to the network’s efficiency and reliability. In many cases, roundabouts can respond better than at-level intersections to enable traffic operations with increased safety for both cars and heavy vehicles. Recently emerged, the concept of turbo-roundabout is a viable alternative to the two-lane roundabout aiming to improve traffic efficiency. The primary objective of this study is to evaluate the operation and performance level of an at-grade intersection, a conventional two-lane roundabout, and a basic turbo roundabout for freight movements. To analyze and evaluate the performances of the signalized intersections and the roundabouts, micro simulation models were developed PTV VISSIM. The networks chosen for this analysis in this study are to experiment and evaluate changes in the performance of the movement of vehicles with different geometric and flow scenarios. There are several scenarios that were examined when attempting to assess the impacts of various geometric designs on vehicle movements. The overall traffic efficiency depends on the geometric layout of the intersections, which consists of traffic congestion rate, hourly volume, frequency of heavy vehicles, type of road, and the ratio of major-street versus side-street traffic. The traffic performance was determined by evaluating the delay time, number of stops, and queue length of each intersection for varying truck percentages. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. More specifically, it is clear that two-lane roundabouts are seen to have shorter queue lengths compared to signalized intersections and turbo-roundabouts. For instance, considering the scenario where the volume is highest, and the truck movement and left turn movement are maximum, the signalized intersection has 3 times, and the turbo-roundabout has 5 times longer queue length than a two-lane roundabout in major roads. Similarly, on minor roads, signalized intersections and turbo-roundabouts have 11 times longer queue lengths than two-lane roundabouts for the same scenario. As explained from all the developed scenarios, while the traffic demand lowers, the queue lengths of turbo-roundabouts shorten. This proves that turbo roundabouts perform well for low and medium traffic demand. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. Finally, this study provides recommendations on the conditions under which different intersections perform better than each other.

Keywords: At-grade intersection, simulation, turbo-roundabout, two-lane roundabout

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8 Case Report: Opioid Sparing Anaesthesia with Dexmedetomidine in General Surgery

Authors: Shang Yee Chong

Abstract:

Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

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7 Development and Adaptation of a LGBM Machine Learning Model, with a Suitable Concept Drift Detection and Adaptation Technique, for Barcelona Household Electric Load Forecasting During Covid-19 Pandemic Periods (Pre-Pandemic and Strict Lockdown)

Authors: Eric Pla Erra, Mariana Jimenez Martinez

Abstract:

While aggregated loads at a community level tend to be easier to predict, individual household load forecasting present more challenges with higher volatility and uncertainty. Furthermore, the drastic changes that our behavior patterns have suffered due to the COVID-19 pandemic have modified our daily electrical consumption curves and, therefore, further complicated the forecasting methods used to predict short-term electric load. Load forecasting is vital for the smooth and optimized planning and operation of our electric grids, but it also plays a crucial role for individual domestic consumers that rely on a HEMS (Home Energy Management Systems) to optimize their energy usage through self-generation, storage, or smart appliances management. An accurate forecasting leads to higher energy savings and overall energy efficiency of the household when paired with a proper HEMS. In order to study how COVID-19 has affected the accuracy of forecasting methods, an evaluation of the performance of a state-of-the-art LGBM (Light Gradient Boosting Model) will be conducted during the transition between pre-pandemic and lockdowns periods, considering day-ahead electric load forecasting. LGBM improves the capabilities of standard Decision Tree models in both speed and reduction of memory consumption, but it still offers a high accuracy. Even though LGBM has complex non-linear modelling capabilities, it has proven to be a competitive method under challenging forecasting scenarios such as short series, heterogeneous series, or data patterns with minimal prior knowledge. An adaptation of the LGBM model – called “resilient LGBM” – will be also tested, incorporating a concept drift detection technique for time series analysis, with the purpose to evaluate its capabilities to improve the model’s accuracy during extreme events such as COVID-19 lockdowns. The results for the LGBM and resilient LGBM will be compared using standard RMSE (Root Mean Squared Error) as the main performance metric. The models’ performance will be evaluated over a set of real households’ hourly electricity consumption data measured before and during the COVID-19 pandemic. All households are located in the city of Barcelona, Spain, and present different consumption profiles. This study is carried out under the ComMit-20 project, financed by AGAUR (Agència de Gestiód’AjutsUniversitaris), which aims to determine the short and long-term impacts of the COVID-19 pandemic on building energy consumption, incrementing the resilience of electrical systems through the use of tools such as HEMS and artificial intelligence.

Keywords: concept drift, forecasting, home energy management system (HEMS), light gradient boosting model (LGBM)

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6 Assessment of On-Site Solar and Wind Energy at a Manufacturing Facility in Ireland

Authors: A. Sgobba, C. Meskell

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The feasibility of on-site electricity production from solar and wind and the resulting load management for a specific manufacturing plant in Ireland are assessed. The industry sector accounts directly and indirectly for a high percentage of electricity consumption and global greenhouse gas emissions; therefore, it will play a key role in emission reduction and control. Manufacturing plants, in particular, are often located in non-residential areas since they require open spaces for production machinery, parking facilities for the employees, appropriate routes for supply and delivery, special connections to the national grid and other environmental impacts. Since they have larger spaces compared to commercial sites in urban areas, they represent an appropriate case study for evaluating the technical and economic viability of energy system integration with low power density technologies, such as solar and wind, for on-site electricity generation. The available open space surrounding the analysed manufacturing plant can be efficiently used to produce a discrete quantity of energy, instantaneously and locally consumed. Therefore, transmission and distribution losses can be reduced. The usage of storage is not required due to the high and almost constant electricity consumption profile. The energy load of the plant is identified through the analysis of gas and electricity consumption, both internally monitored and reported on the bills. These data are not often recorded and available to third parties since manufacturing companies usually keep track only of the overall energy expenditures. The solar potential is modelled for a period of 21 years based on global horizontal irradiation data; the hourly direct and diffuse radiation and the energy produced by the system at the optimum pitch angle are calculated. The model is validated using PVWatts and SAM tools. Wind speed data are available for the same period within one-hour step at a height of 10m. Since the hub of a typical wind turbine reaches a higher altitude, complementary data for a different location at 50m have been compared, and a model for the estimate of wind speed at the required height in the right location is defined. Weibull Statistical Distribution is used to evaluate the wind energy potential of the site. The results show that solar and wind energy are, as expected, generally decoupled. Based on the real case study, the percentage of load covered every hour by on-site generation (Level of Autonomy LA) and the resulting electricity bought from the grid (Expected Energy Not Supplied EENS) are calculated. The economic viability of the project is assessed through Net Present Value, and the influence the main technical and economic parameters have on NPV is presented. Since the results show that the analysed renewable sources can not provide enough electricity, the integration with a cogeneration technology is studied. Finally, the benefit to energy system integration of wind, solar and a cogeneration technology is evaluated and discussed.

Keywords: demand, energy system integration, load, manufacturing, national grid, renewable energy sources

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5 Improved Soil and Snow Treatment with the Rapid Update Cycle Land-Surface Model for Regional and Global Weather Predictions

Authors: Tatiana G. Smirnova, Stan G. Benjamin

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Rapid Update Cycle (RUC) land surface model (LSM) was a land-surface component in several generations of operational weather prediction models at the National Center for Environment Prediction (NCEP) at the National Oceanic and Atmospheric Administration (NOAA). It was designed for short-range weather predictions with an emphasis on severe weather and originally was intentionally simple to avoid uncertainties from poorly known parameters. Nevertheless, the RUC LSM, when coupled with the hourly-assimilating atmospheric model, can produce a realistic evolution of time-varying soil moisture and temperature, as well as the evolution of snow cover on the ground surface. This result is possible only if the soil/vegetation/snow component of the coupled weather prediction model has sufficient skill to avoid long-term drift. RUC LSM was first implemented in the operational NCEP Rapid Update Cycle (RUC) weather model in 1998 and later in the Weather Research Forecasting Model (WRF)-based Rapid Refresh (RAP) and High-resolution Rapid Refresh (HRRR). Being available to the international WRF community, it was implemented in operational weather models in Austria, New Zealand, and Switzerland. Based on the feedback from the US weather service offices and the international WRF community and also based on our own validation, RUC LSM has matured over the years. Also, a sea-ice module was added to RUC LSM for surface predictions over the Arctic sea-ice. Other modifications include refinements to the snow model and a more accurate specification of albedo, roughness length, and other surface properties. At present, RUC LSM is being tested in the regional application of the Unified Forecast System (UFS). The next generation UFS-based regional Rapid Refresh FV3 Standalone (RRFS) model will replace operational RAP and HRRR at NCEP. Over time, RUC LSM participated in several international model intercomparison projects to verify its skill using observed atmospheric forcing. The ESM-SnowMIP was the last of these experiments focused on the verification of snow models for open and forested regions. The simulations were performed for ten sites located in different climatic zones of the world forced with observed atmospheric conditions. While most of the 26 participating models have more sophisticated snow parameterizations than in RUC, RUC LSM got a high ranking in simulations of both snow water equivalent and surface temperature. However, ESM-SnowMIP experiment also revealed some issues in the RUC snow model, which will be addressed in this paper. One of them is the treatment of grid cells partially covered with snow. RUC snow module computes energy and moisture budgets of snow-covered and snow-free areas separately by aggregating the solutions at the end of each time step. Such treatment elevates the importance of computing in the model snow cover fraction. Improvements to the original simplistic threshold-based approach have been implemented and tested both offline and in the coupled weather model. The detailed description of changes to the snow cover fraction and other modifications to RUC soil and snow parameterizations will be described in this paper.

Keywords: land-surface models, weather prediction, hydrology, boundary-layer processes

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4 Management of Hypoglycemia in Von Gierke’s Disease

Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant

Abstract:

Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.

Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease

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3 Efficacy and Safety of Sublingual Sufentanil for the Management of Acute Pain

Authors: Neil Singla, Derek Muse, Karen DiDonato, Pamela Palmer

Abstract:

Introduction: Pain is the most common reason people visit emergency rooms. Studies indicate however, that Emergency Department (ED) physicians often do not provide adequate analgesia to their patients as a result of gender and age bias, opiophobia and insufficient knowledge of and formal training in acute pain management. Novel classes of analgesics have recently been introduced, but many patients suffer from acute pain in settings where the availability of intravenous (IV) access may be limited, so there remains a clinical need for rapid-acting, potent analgesics that do not require an invasive route of delivery. A sublingual sufentanil tablet (SST), dispensed using a single-dose applicator, is in development for treatment of moderate-to-severe acute pain in a medically-supervised setting. Objective: The primary objective of this study was to demonstrate the repeat-dose efficacy, safety and tolerability of sufentanil 20 mcg and 30 mcg sublingual tablets compared to placebo for the management of acute pain as determined by the time-weighted sum of pain intensity differences (SPID) to baseline over the 12-hour study period (SPID12). Key secondary efficacy variables included SPID over the first hour (SPID1), Total pain relief over the 12-hour study period (TOTPAR12), time to perceived pain relief (PR) and time to meaningful PR. Safety variables consisted of adverse events (AE), vital signs, oxygen saturation and early termination. Methods: In this Phase 2, double-blind, dose-finding study, an equal number of male and female patients were randomly assigned in a 2:2:1 ratio to SST 20 mcg, SS 30 mcg or placebo, respectively, following bunionectomy. Study drug was dosed as needed, but not more frequently than hourly. Rescue medication was available as needed. The primary endpoint was the Summed Pain Intensity Difference to baseline over 12h (SPIDI2). Safety was assessed by continuous oxygen saturation monitoring and adverse event reporting. Results: 101 patients (51 Male/50 Female) were randomized, 100 received study treatment (intent-to-treat [ITT] population), and 91 completed the study. Reasons for early discontinuation were lack of efficacy (6), adverse events (2) and drug-dosing error (1). Mean age was 42.5 years. For the ITT population, SST 30 mcg was superior to placebo (p=0.003) for the SPID12. SPID12 scores in the active groups were superior for both male (ANOVA overall p-value =0.038) and female (ANOVA overall p-value=0.005) patients. Statistically significant differences in favour of sublingual sufentanil were also observed between the SST 30mcg and placebo group for SPID1(p<0.001), TOTPAR12(p=0.002), time to perceived PR (p=0.023) and time to meaningful PR (p=0.010). Nausea, vomiting and somnolence were more frequent in the sufentanil groups but there were no significant differences between treatment arms for the proportion of patients who prematurely terminated due to AE or inadequate analgesia. Conclusions: Sufentanil tablets dispensed sublingually using a single-dose applicator is in development for treatment of patients with moderate-to-severe acute pain in a medically-supervised setting where immediate IV access is limited. When administered sublingually, sufentanil’s pharmacokinetic profile and non-invasive delivery makes it a useful alternative to IM or IV dosing.

Keywords: acute pain, pain management, sublingual, sufentanil

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2 An Integrated Multisensor/Modeling Approach Addressing Climate Related Extreme Events

Authors: H. M. El-Askary, S. A. Abd El-Mawla, M. Allali, M. M. El-Hattab, M. El-Raey, A. M. Farahat, M. Kafatos, S. Nickovic, S. K. Park, A. K. Prasad, C. Rakovski, W. Sprigg, D. Struppa, A. Vukovic

Abstract:

A clear distinction between weather and climate is a necessity because while they are closely related, there are still important differences. Climate change is identified when we compute the statistics of the observed changes in weather over space and time. In this work we will show how the changing climate contribute to the frequency, magnitude and extent of different extreme events using a multi sensor approach with some synergistic modeling activities. We are exploring satellite observations of dust over North Africa, Gulf Region and the Indo Gangetic basin as well as dust versus anthropogenic pollution events over the Delta region in Egypt and Seoul through remote sensing and utilize the behavior of the dust and haze on the aerosol optical properties. Dust impact on the retreat of the glaciers in the Himalayas is also presented. In this study we also focus on the identification and monitoring of a massive dust plume that blew off the western coast of Africa towards the Atlantic on October 8th, 2012 right before the development of Hurricane Sandy. There is evidence that dust aerosols played a non-trivial role in the cyclogenesis process of Sandy. Moreover, a special dust event "An American Haboob" in Arizona is discussed as it was predicted hours in advance because of the great improvement we have in numerical, land–atmosphere modeling, computing power and remote sensing of dust events. Therefore we performed a full numerical simulation to that event using the coupled atmospheric-dust model NMME–DREAM after generating a mask of the potentially dust productive regions using land cover and vegetation data obtained from satellites. Climate change also contributes to the deterioration of different marine habitats. In that regard we are also presenting some work dealing with change detection analysis of Marine Habitats over the city of Hurghada, Red Sea, Egypt. The motivation for this work came from the fact that coral reefs at Hurghada have undergone significant decline. They are damaged, displaced, polluted, stepped on, and blasted off, in addition to the effects of climate change on the reefs. One of the most pressing issues affecting reef health is mass coral bleaching that result from an interaction between human activities and climatic changes. Over another location, namely California, we have observed that it exhibits highly-variable amounts of precipitation across many timescales, from the hourly to the climate timescale. Frequently, heavy precipitation occurs, causing damage to property and life (floods, landslides, etc.). These extreme events, variability, and the lack of good, medium to long-range predictability of precipitation are already a challenge to those who manage wetlands, coastal infrastructure, agriculture and fresh water supply. Adding on to the current challenges for long-range planning is climate change issue. It is known that La Niña and El Niño affect precipitation patterns, which in turn are entwined with global climate patterns. We have studied ENSO impact on precipitation variability over different climate divisions in California. On the other hand the Nile Delta has experienced lately an increase in the underground water table as well as water logging, bogging and soil salinization. Those impacts would pose a major threat to the Delta region inheritance and existing communities. There has been an undergoing effort to address those vulnerabilities by looking into many adaptation strategies.

Keywords: remote sensing, modeling, long range transport, dust storms, North Africa, Gulf Region, India, California, climate extremes, sea level rise, coral reefs

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1 Acute Severe Hyponatremia in Patient with Psychogenic Polydipsia, Learning Disability and Epilepsy

Authors: Anisa Suraya Ab Razak, Izza Hayat

Abstract:

Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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