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Sample records for outcome modified rankin

  1. Optimizing cutoff scores for the Barthel Index and the modified Rankin Scale for defining outcome in acute stroke trials

    NARCIS (Netherlands)

    Uyttenboogaart, Maarten; Stewart, Roy E; Vroomen, Patrick C A J; De Keyser, Jacques; Luijckx, Gert-Jan

    Background and Purpose - There is little agreement on how to assess outcome in acute stroke trials. Cutoff scores for the Barthel Index (BI) and modified Rankin Scale (mRS) are frequently arbitrarily chosen to dichotomize favorable and unfavorable outcome. We investigated sensitivity and specificity

  2. Outcomes validity and reliability of the modified Rankin scale: implications for stroke clinical trials: a literature review and synthesis.

    Science.gov (United States)

    Banks, Jamie L; Marotta, Charles A

    2007-03-01

    The modified Rankin scale (mRS), a clinician-reported measure of global disability, is widely applied for evaluating stroke patient outcomes and as an end point in randomized clinical trials. Extensive evidence on the validity of the mRS exists across a large but fragmented literature. As new treatments for acute ischemic stroke are submitted for agency approval, an appreciation of the mRS's attributes, specifically its relationship to other stroke evaluation scales, would be valuable for decision-makers to properly assess the impact of a new drug on treatment paradigms. The purpose of this report is to assemble and systematically assess the properties of the mRS to provide decision-makers with pertinent evaluative information. A Medline search was conducted to identify reports in the peer-reviewed medical literature (1957-2006) that provide information on the structure, validation, scoring, and psychometric properties of the mRS and its use in clinical trials. The selection of articles was based on defined criteria that included relevance, study design and use of appropriate statistical methods. Of 224 articles identified by the literature search, 50 were selected for detailed assessment. Inter-rater reliability with the mRS is moderate and improves with structured interviews (kappa 0.56 versus 0.78); strong test-re-test reliability (kappa=0.81 to 0.95) has been reported. Numerous studies demonstrate the construct validity of the mRS by its relationships to physiological indicators such as stroke type, lesion size, perfusion and neurological impairment. Convergent validity between the mRS and other disability scales is well documented. Patient comorbidities and socioeconomic factors should be considered in properly applying and interpreting the mRS. Recent analyses suggest that randomized clinical trials of acute stroke treatments may require a smaller sample size if the mRS is used as a primary end point rather than the Barthel Index. Multiple types of evidence

  3. Adopting a Patient-Centered Approach to Primary Outcome Analysis of Acute Stroke Trials by Use of a Utility-Weighted Modified Rankin Scale

    Science.gov (United States)

    Chaisinanunkul, Napasri; Adeoye, Opeolu; Lewis, Roger J.; Grotta, James C.; Broderick, Joseph; Jovin, Tudor G.; Nogueira, Raul G.; Elm, Jordan; Graves, Todd; Berry, Scott; Lees, Kennedy R.; Barreto, Andrew D.; Saver, Jeffrey L.

    2015-01-01

    Background and Purpose Although the modified Rankin Scale (mRS) is the most commonly employed primary endpoint in acute stroke trials, its power is limited when analyzed in dichotomized fashion and its indication of effect size challenging to interpret when analyzed ordinally. Weighting the seven Rankin levels by utilities may improve scale interpretability while preserving statistical power. Methods A utility weighted mRS (UW-mRS) was derived by averaging values from time-tradeoff (patient centered) and person-tradeoff (clinician centered) studies. The UW-mRS, standard ordinal mRS, and dichotomized mRS were applied to 11 trials or meta-analyses of acute stroke treatments, including lytic, endovascular reperfusion, blood pressure moderation, and hemicraniectomy interventions. Results Utility values were: mRS 0–1.0; mRS 1 - 0.91; mRS 2 - 0.76; mRS 3 - 0.65; mRS 4 - 0.33; mRS 5 & 6 - 0. For trials with unidirectional treatment effects, the UW-mRS paralleled the ordinal mRS and outperformed dichotomous mRS analyses. Both the UW-mRS and the ordinal mRS were statistically significant in six of eight unidirectional effect trials, while dichotomous analyses were statistically significant in two to four of eight. In bidirectional effect trials, both the UW-mRS and ordinal tests captured the divergent treatment effects by showing neutral results whereas some dichotomized analyses showed positive results. Mean utility differences in trials with statistically significant positive results ranged from 0.026 to 0.249. Conclusion A utility-weighted mRS performs similarly to the standard ordinal mRS in detecting treatment effects in actual stroke trials and ensures the quantitative outcome is a valid reflection of patient-centered benefits. PMID:26138130

  4. Relationship between Barthel Index (BI and the Modified Rankin Scale (mRS Score in Assessing Functional Outcome in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    C S Mohanty

    2016-01-01

    Conclusion: Our study has demonstrated that stroke functional outcome can be predicted from the baseline BI and mRS scales. It is concluded thatBI and mRS Stroke scale can be used to prognosticate functional outcome at admission and at follow up.

  5. Mobile Phone-Based Questionnaire for Assessing 3 Months Modified Rankin Score After Acute Stroke: A Pilot Study.

    Science.gov (United States)

    Cooray, Charith; Matusevicius, Marius; Wahlgren, Nils; Ahmed, Niaz

    2015-10-01

    In many countries, a majority of stroke patients are not assessed for long-term functional outcome owing to limited resources and time. We investigated whether automatic assessment of the modified Rankin Scale (mRS) based on a mobile phone questionnaire may serve as an alternative to mRS assessments at clinical visits after stroke. We enrolled 62 acute stroke patients admitted to our stroke unit during March to May 2014. Forty-eight patients completed the study. During the stay, patients and/or caregivers were equipped with a mobile phone application in their personal mobile phones. The mobile phone application contained a set of 20 questions, based on the Rankin Focused Assessment, which we previously tested in a pilot study. Three months after inclusion, the mobile phone application automatically prompted the study participants to answer the mRS questionnaire in the mobile phones. Each question or a group of questions in the questionnaire corresponded to a certain mRS score. Using a predefined protocol, the highest mRS score question where the study participant had answered yes was deemed the final mobile mRS score. A few days later, a study personnel performed a clinical visit mRS assessment. The 2 assessments were compared using quadratic weighing κ-statistics. Mean age was 67 years (38% females), and median baseline National Institutes of Health Stroke Scale (NIHSS) score was 5 (interquartile range 2-10.5, range 0-23). Median and mean clinical visit mRS at 3 months was 2 and 2.3, respectively. We found a 62.5% agreement between clinical visit and mobile mRS assessment, weighted kappa 0.89 (95% confidence interval 0.82-0.96), and unweighted kappa 0.53 (95% confidence interval 0.36-0.70). Dichotomized mRS outcome separating functionally independent (mRS score 0-2) from dependent (mRS score 3-5) showed 83% agreement and unweighted kappa of 0.66 (95% confidence interval 0.45-0.87). Mobile phone-based automatic assessments of mRS performed well in comparison with

  6. Validation of a structured interview for telephone assessment of the modified Rankin Scale in Brazilian stroke patients.

    Science.gov (United States)

    Baggio, Jussara A O; Santos-Pontelli, Taiza E G; Cougo-Pinto, Pedro T; Camilo, Millene; Silva, Nathalia F; Antunes, Paula; Machado, Laura; Leite, João P; Pontes-Neto, Octavio M

    2014-01-01

    The modified Rankin Scale (mRS) is a commonly used scale to assess the functional outcome after stroke. Several studies on mRS showed good reliability, feasibility, and interrater agreement of this scale using a face-to-face assessment. However, telephone assessment is a more time-efficient way to obtain an mRS grade than a face-to-face interview. The aim of this study was to validate the telephone assessment of mRS among the Portuguese using a structured interview in a sample of Brazilian stroke patients. We evaluated 50 stroke outpatients twice. The first interview was face-to-face and the second was made by telephone and the time between the two assessments ranged between 7 and 14 days. Four certified raters evaluated the patients using a structured interview based on a questionnaire previously published in the literature. Raters were blinded for the Rankin score given by the other rater. For both assessments, the rater could also interview a caregiver if necessary. The patients' mean age was 62.8 ± 14.7, mean number of years of study 5.2 ± 3.4, 52% were males, 55.2% of patients needed a caregiver's help to answer the questions. The majority of caregivers were female (85%), mean age 49.1 ± 15, and mean number of years of study 8.3 ± 3.4. Perfect agreement between the telephone and face-to-face assessments was obtained for 27 (54%) patients, corresponding to an unweighted Kappa of 0.44 (95% CI 0.27-0.61) and a weighted Kappa of 0.89. The median of telephone assessment mRS was 3.5 (interquartile range = 2-4) and of face-to-face assessment was 4 (interquartile range = 2-5). There was no difference between the two assessments (Wilcoxon test, p = 0.35). Despite the low education level of our sample, the telephone assessment of functional impairment of stroke patients using a translated and culturally adapted Brazilian Portuguese version of the mRS showed good validity and reliability. Therefore, the telephone assessment of mRS can be used in clinical practice and

  7. Process integration of organic Rankine cycle

    International Nuclear Information System (INIS)

    Desai, Nishith B.; Bandyopadhyay, Santanu

    2009-01-01

    An organic Rankine cycle (ORC) uses an organic fluid as a working medium within a Rankine cycle power plant. ORC offers advantages over conventional Rankine cycle with water as the working medium, as ORC generates shaft-work from low to medium temperature heat sources with higher thermodynamic efficiency. The dry and the isentropic fluids are most preferred working fluid for the ORC. The basic ORC can be modified by incorporating both regeneration and turbine bleeding to improve its thermal efficiency. In this paper, 16 different organic fluids have been analyzed as a working medium for the basic as well as modified ORCs. A methodology is also proposed for appropriate integration and optimization of an ORC as a cogeneration process with the background process to generate shaft-work. It has been illustrated that the choice of cycle configuration for appropriate integration with the background process depends on the heat rejection profile of the background process (i.e., the shape of the below pinch portion of the process grand composite curve). The benefits of integrating ORC with the background process and the applicability of the proposed methodology have been demonstrated through illustrative examples.

  8. Statin treatment and stroke outcome in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Zivin, J.

    2009-01-01

    BACKGROUND AND PURPOSE: Laboratory experiments suggest statins reduce stroke severity and improve outcomes. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial was a placebo-controlled, randomized trial designed to determine whether treatment with atorvastatin reduces...... or 4), moderate (modified Rankin Scale score 3 or 2), and mild (modified Rankin Scale score 1 or 0) outcome ischemic strokes and transient ischemic attacks and an increase in the proportion of event-free subjects randomized to atorvastatin (P

  9. Ammonia-water Rankine cycle

    International Nuclear Information System (INIS)

    Bo Hanliang; Ma Changwen; Wu Shaorong

    1997-01-01

    On characteristics of heating source and cooling source in nuclear heating reactor cooperation, the authors advance a new kind of power cycle in which a multicomponent mixture as the work fluid, ammonia-water Rankine cycle, describe its running principle, and compare it with steam Rankine cycle in the same situation. The result is that: the new kind of power cycle, ammonia-water Rankine cycle has higher electricity efficiency; it suits for the situation of heating source and cooling source which offered by nuclear heating reactor cooperation. For low temperature heating source, it maybe has a widely application

  10. The SCSTPE organic Rankine engine

    Science.gov (United States)

    Boda, F. P.

    1980-01-01

    The organic Rankine cycle engine under consideration for a solar thermal system being developed is described. Design parameters, method of control, performance and cost data are provided for engine power levels up to 80 kWe; efficiency is shown as a function of turbine inlet temperature in the range of 149 C to 427 C.

  11. Rankine cycle system and method

    Science.gov (United States)

    Ernst, Timothy C.; Nelson, Christopher R.

    2014-09-09

    A Rankine cycle waste heat recovery system uses a receiver with a maximum liquid working fluid level lower than the minimum liquid working fluid level of a sub-cooler of the waste heat recovery system. The receiver may have a position that is physically lower than the sub-cooler's position. A valve controls transfer of fluid between several of the components in the waste heat recovery system, especially from the receiver to the sub-cooler. The system may also have an associated control module.

  12. Reporting outcomes of back pain trials: a modified Delphi study

    DEFF Research Database (Denmark)

    Froud, R.; Eldridge, S.; Kovacs, F.

    2011-01-01

    trials. METHODS: We presented experts with clinicians' views on different reporting methods and asked them to rate and comment on the suitability reporting methods for inclusion in a standardized set. Panellists developed a statement of recommendation over three online rounds. We used a modified Delphi......BACKGROUND: Low back pain is a common and expensive health complaint. Many low back pain trials have been conducted, but these are reported in a variety of ways and are often difficult to interpret. AIM: To facilitate consensus on a statement recommending reporting methods for future low back pain...... process and the RAND/UCLA appropriateness method as a formal framework for establishing appropriateness and quantifying panel disagreement. RESULTS: A group of 63 experts from 14 countries participated. Consensus was reached on a statement recommending that the continuous patient-reported outcomes...

  13. Combined rankine and vapor compression cycles

    Science.gov (United States)

    Radcliff, Thomas D.; Biederman, Bruce P.; Brasz, Joost J.

    2005-04-19

    An organic rankine cycle system is combined with a vapor compression cycle system with the turbine generator of the organic rankine cycle generating the power necessary to operate the motor of the refrigerant compressor. The vapor compression cycle is applied with its evaporator cooling the inlet air into a gas turbine, and the organic rankine cycle is applied to receive heat from a gas turbine exhaust to heat its boiler within one embodiment, a common condenser is used for the organic rankine cycle and the vapor compression cycle, with a common refrigerant, R-245a being circulated within both systems. In another embodiment, the turbine driven generator has a common shaft connected to the compressor to thereby eliminate the need for a separate motor to drive the compressor. In another embodiment, an organic rankine cycle system is applied to an internal combustion engine to cool the fluids thereof, and the turbo charged air is cooled first by the organic rankine cycle system and then by an air conditioner prior to passing into the intake of the engine.

  14. Organic Rankine Cycles. Old wine in new bottles; Organic Rankine Cycles. Oude wijn in nieuwe zakken

    Energy Technology Data Exchange (ETDEWEB)

    Den Hartog, T.L.B. [Cumae, Arnhem (Netherlands)

    2007-05-15

    An overview is given of the renewed interest for the Organic Rankine Cycle technology and new developments with regard to this power generating technology. [Dutch] Een overzicht wordt gegeven van de hernieuwde belangstelling voor de Organic Rankine Cycle (ORC) technologie en nieuwe ontwikkeling m.b.t. deze vorm van elektriciteitopwekking.

  15. Modifying Softball for Maximizing Learning Outcomes in Physical Education

    Science.gov (United States)

    Brian, Ali; Ward, Phillip; Goodway, Jacqueline D.; Sutherland, Sue

    2014-01-01

    Softball is taught in many physical education programs throughout the United States. This article describes modifications that maximize learning outcomes and that address the National Standards and safety recommendations. The modifications focus on tasks and equipment, developmentally appropriate motor-skill acquisition, increasing number of…

  16. Turbomachinery design for Rankine cycles in waste heat recovery applications

    OpenAIRE

    Agromayor Otero, Roberto

    2017-01-01

    Rankine Cycles are an effective and efficient manner to convert waste thermal energy into power. Numerous fluids can be used in Rankine cycles, including water, hydrocarbons, hydrofluorocarbons, siloxanes, alcohols or even mixtures of fluids. The performance of Rankine cycles is highly dependent on the optimization of the operating conditions and the design of its components. The expander is, perhaps, the most important component of the Rankine cycle, as it is the device where the energy of t...

  17. Rankine cycle waste heat recovery system

    Science.gov (United States)

    Ernst, Timothy C.; Nelson, Christopher R.

    2014-08-12

    This disclosure relates to a waste heat recovery (WHR) system and to a system and method for regulation of a fluid inventory in a condenser and a receiver of a Rankine cycle WHR system. Such regulation includes the ability to regulate the pressure in a WHR system to control cavitation and energy conversion.

  18. Leptomeningeal collateral status predicts outcome after middle cerebral artery occlusion

    DEFF Research Database (Denmark)

    Madelung, Christopher Fugl; Ovesen, C; Trampedach, C

    2017-01-01

    NCCT and according to European Cooperative Acute Stroke Study (ECASS) criteria. Modified Rankin Scale score was assessed at 90 days, and mortality at 1 year. RESULTS: At 90 days, median (IQR) modified Rankin Scale score in patients with poor collateral status was 4 (3-6) compared to 2 (1-4) in patients...... population (P = .001). CONCLUSIONS: Leptomeningeal collateral status predicts functional outcome, mortality, and hemorrhagic transformation following middle cerebral artery occlusion.......OBJECTIVES: Perfusion through leptomeningeal collateral vessels is a likely pivotal factor in the outcome of stroke patients. We aimed to investigate the effect of collateral status on outcome in a cohort of unselected, consecutive stroke patients with middle cerebral artery occlusion undergoing...

  19. Cascaded organic rankine cycles for waste heat utilization

    Science.gov (United States)

    Radcliff, Thomas D [Vernon, CT; Biederman, Bruce P [West Hartford, CT; Brasz, Joost J [Fayetteville, NY

    2011-05-17

    A pair of organic Rankine cycle systems (20, 25) are combined and their respective organic working fluids are chosen such that the organic working fluid of the first organic Rankine cycle is condensed at a condensation temperature that is well above the boiling point of the organic working fluid of the second organic Rankine style system, and a single common heat exchanger (23) is used for both the condenser of the first organic Rankine cycle system and the evaporator of the second organic Rankine cycle system. A preferred organic working fluid of the first system is toluene and that of the second organic working fluid is R245fa.

  20. Stroke Location Is an Independent Predictor of Cognitive Outcome.

    Science.gov (United States)

    Munsch, Fanny; Sagnier, Sharmila; Asselineau, Julien; Bigourdan, Antoine; Guttmann, Charles R; Debruxelles, Sabrina; Poli, Mathilde; Renou, Pauline; Perez, Paul; Dousset, Vincent; Sibon, Igor; Tourdias, Thomas

    2016-01-01

    On top of functional outcome, accurate prediction of cognitive outcome for stroke patients is an unmet need with major implications for clinical management. We investigated whether stroke location may contribute independent prognostic value to multifactorial predictive models of functional and cognitive outcomes. Four hundred twenty-eight consecutive patients with ischemic stroke were prospectively assessed with magnetic resonance imaging at 24 to 72 hours and at 3 months for functional outcome using the modified Rankin Scale and cognitive outcome using the Montreal Cognitive Assessment (MoCA). Statistical maps of functional and cognitive eloquent regions were derived from the first 215 patients (development sample) using voxel-based lesion-symptom mapping. We used multivariate logistic regression models to study the influence of stroke location (number of eloquent voxels from voxel-based lesion-symptom mapping maps), age, initial National Institutes of Health Stroke Scale and stroke volume on modified Rankin Scale and MoCA. The second part of our cohort was used as an independent replication sample. In univariate analyses, stroke location, age, initial National Institutes of Health Stroke Scale, and stroke volume were all predictive of poor modified Rankin Scale and MoCA. In multivariable analyses, stroke location remained the strongest independent predictor of MoCA and significantly improved the prediction compared with using only age, initial National Institutes of Health Stroke Scale, and stroke volume (area under the curve increased from 0.697-0.771; difference=0.073; 95% confidence interval, 0.008-0.155). In contrast, stroke location did not persist as independent predictor of modified Rankin Scale that was mainly driven by initial National Institutes of Health Stroke Scale (area under the curve going from 0.840 to 0.835). Similar results were obtained in the replication sample. Stroke location is an independent predictor of cognitive outcome (MoCA) at 3

  1. Modified Therapeutic Community Treatment for Offenders with Co-Occurring Disorders: Mental Health Outcomes

    Science.gov (United States)

    Sullivan, Christopher J.; Sacks, Stanley; McKendrick, Karen; Banks, Steven; Sacks, Joann Y.; Stommel, Joseph

    2007-01-01

    This paper examines outcomes 12 months post-prison release for offenders with co-occurring disorders (n = 185) randomly assigned to either a mental health control treatment (C) or a modified therapeutic community (E). Significant between-group differences were not found for mental health measures, although improvements were observed for each…

  2. Organic rankine cycle waste heat applications

    Science.gov (United States)

    Brasz, Joost J.; Biederman, Bruce P.

    2007-02-13

    A machine designed as a centrifugal compressor is applied as an organic rankine cycle turbine by operating the machine in reverse. In order to accommodate the higher pressures when operating as a turbine, a suitable refrigerant is chosen such that the pressures and temperatures are maintained within established limits. Such an adaptation of existing, relatively inexpensive equipment to an application that may be otherwise uneconomical, allows for the convenient and economical use of energy that would be otherwise lost by waste heat to the atmosphere.

  3. Rankine bottoming cycle safety analysis. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lewandowski, G.A.

    1980-02-01

    Vector Engineering Inc. conducted a safety and hazards analysis of three Rankine Bottoming Cycle Systems in public utility applications: a Thermo Electron system using Fluorinal-85 (a mixture of 85 mole % trifluoroethanol and 15 mole % water) as the working fluid; a Sundstrand system using toluene as the working fluid; and a Mechanical Technology system using steam and Freon-II as the working fluids. The properties of the working fluids considered are flammability, toxicity, and degradation, and the risks to both plant workers and the community at large are analyzed.

  4. Toluene stability Space Station Rankine power system

    Science.gov (United States)

    Havens, V. N.; Ragaller, D. R.; Sibert, L.; Miller, D.

    1987-01-01

    A dynamic test loop is designed to evaluate the thermal stability of an organic Rankine cycle working fluid, toluene, for potential application to the Space Station power conversion unit. Samples of the noncondensible gases and the liquid toluene were taken periodically during the 3410 hour test at 750 F peak temperature. The results obtained from the toluene stability loop verify that toluene degradation will not lead to a loss of performance over the 30-year Space Station mission life requirement. The identity of the degradation products and the low rates of formation were as expected from toluene capsule test data.

  5. Modified supine versus prone percutaneous nephrolithotomy: Surgical outcomes from a tertiary teaching hospital

    Directory of Open Access Journals (Sweden)

    Madeleine Nina Jones

    2016-07-01

    Full Text Available Purpose: The traditional prone positioning of percutaneous nephrolithotomy (PCNL is associated with various anesthetic and logistic difficulties. We aimed to compare the surgical outcomes of PCNLs performed using our modified supine position with those performed in the standard prone position. Materials and Methods: A prospective group of 236 renal units (224 patients undergoing PCNL were included in this 2 site study: 160 were performed in the modified supine position were compared with 76 undergoing PCNL in the prone position. The outcomes of radiation dose, radiation time, stone free rate, body mass index (BMI, stone size, operative time, length of stay (LOS, in hospital and complications were compared. Chi-square and t-tests were used. Results: There were no significant differences in mean radiation time, radiation dose or stone size between the modified supine and prone groups. The supine group had a higher mean BMI (31 kg/m2 vs. 28 kg/m2 , p=0.03, shorter mean surgical time (93 minutes vs. 123 minutes, p<0.001, shorter mean LOS (2 days vs. 3 days, p=0.005 and higher stone free rate (70% vs. 50%, p=0.005. There were no differences in septic or bleeding complications but the prone group had a higher rate of overall complications. Conclusions: Modified supine PCNL has significantly lower operative time, shorter LOS and higher stone-free rate compared with prone in our series, while remaining a safe procedure.

  6. Analysis of a combined Rankine-vapour-compression refrigeration cycle

    International Nuclear Information System (INIS)

    Aphornratana, Satha; Sriveerakul, Thanarath

    2010-01-01

    This paper describes a theoretical analysis of a heat-powered refrigeration cycle, a combined Rankine-vapour-compression refrigeration cycle. This refrigeration cycle combines an Organic Rankine Cycle and a vapour-compression cycle. The cycle can be powered by low grade thermal energy as low as 60 deg. C and can produce cooling temperature as low as -10 deg. C. In the analysis, two combined Rankine-vapour-compression refrigeration cycles were investigated: the system with R22 and the system with R134a. Calculated COP values between 0.1 and 0.6 of both the systems were found.

  7. Role of Acute Lesion Topography in Initial Ischemic Stroke Severity and Long-Term Functional Outcomes.

    Science.gov (United States)

    Wu, Ona; Cloonan, Lisa; Mocking, Steven J T; Bouts, Mark J R J; Copen, William A; Cougo-Pinto, Pedro T; Fitzpatrick, Kaitlin; Kanakis, Allison; Schaefer, Pamela W; Rosand, Jonathan; Furie, Karen L; Rost, Natalia S

    2015-09-01

    Acute infarct volume, often proposed as a biomarker for evaluating novel interventions for acute ischemic stroke, correlates only moderately with traditional clinical end points, such as the modified Rankin Scale. We hypothesized that the topography of acute stroke lesions on diffusion-weighted magnetic resonance imaging may provide further information with regard to presenting stroke severity and long-term functional outcomes. Data from a prospective stroke repository were limited to acute ischemic stroke subjects with magnetic resonance imaging completed within 48 hours from last known well, admission NIH Stroke Scale (NIHSS), and 3-to-6 months modified Rankin Scale scores. Using voxel-based lesion symptom mapping techniques, including age, sex, and diffusion-weighted magnetic resonance imaging lesion volume as covariates, statistical maps were calculated to determine the significance of lesion location for clinical outcome and admission stroke severity. Four hundred ninety subjects were analyzed. Acute stroke lesions in the left hemisphere were associated with more severe NIHSS at admission and poor modified Rankin Scale at 3 to 6 months. Specifically, injury to white matter (corona radiata, internal and external capsules, superior longitudinal fasciculus, and uncinate fasciculus), postcentral gyrus, putamen, and operculum were implicated in poor modified Rankin Scale. More severe NIHSS involved these regions, as well as the amygdala, caudate, pallidum, inferior frontal gyrus, insula, and precentral gyrus. Acute lesion topography provides important insights into anatomic correlates of admission stroke severity and poststroke outcomes. Future models that account for infarct location in addition to diffusion-weighted magnetic resonance imaging volume may improve stroke outcome prediction and identify patients likely to benefit from aggressive acute intervention and personalized rehabilitation strategies. © 2015 American Heart Association, Inc.

  8. Thermodynamic analysis of a simple Organic Rankine Cycle

    International Nuclear Information System (INIS)

    Javanshir, Alireza; Sarunac, Nenad

    2017-01-01

    Thermodynamic performance (thermal efficiency and net power output) of a simple subcritical and supercritical Organic Rankine Cycle (ORC) was analyzed over a range of operating conditions for a number of working fluids to determine the effect of operating parameters on cycle performance and select the best working fluid. The results show that for an ORC operating with a dry working fluid, thermal efficiency decreases with an increase in the turbine inlet temperature (TIT) due to the convergence of the isobaric lines with temperature. The results also show that efficiency of an ORC operating with isentropic working fluids is higher compared to the dry and wet fluids, and working fluids with higher specific heat capacity provide higher cycle net power output. New expressions for thermal efficiency of a subcritical and supercritical simple ORC are proposed. For a subcritical ORC without the superheat, thermal efficiency is expressed as a function of the Figure of Merit (FOM), while for the superheated subcritical ORC thermal efficiency is given in terms of the modified Jacob number. For the supercritical ORC, thermal efficiency is expressed as a function of dimensionless temperature. - Highlights: • Analyzing thermodynamic performance of ORC over a range of operating conditions. • Selecting the best working fluid suitable for a simple ORC. • Proposing new expressions for thermal efficiency of a simple ORC.

  9. Satisfactory surgical outcome of T2 gastric cancer after modified D2 lymphadenectomy.

    Science.gov (United States)

    Zhang, Shupeng; Wu, Liangliang; Wang, Xiaona; Ding, Xuewei; Liang, Han

    2017-04-01

    Though D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), the modified D2 (D1 + 7, 8a and 9) lymphadenectomy may be more suitable than D2 dissection for T2 stage GC. The purpose of this study is to elucidate whether the surgical outcome of modified D2 lymphadenectomy was comparable to that of standard D2 dissection in T2 stage GC patients. A retrospective cohort study with 77 cases and 77 controls matched for baseline characteristics was conducted. Patients were categorized into two groups according to the extent of lymphadenectomy: the modified D2 group (mD2) and the standard D2 group (D2). Surgical outcome and recurrence date were compared between the two groups. The 5-year overall survival (OS) rate was 71.4% for patients accepted mD2 lymphadenectomy and 70.1% for those accepted standard D2, respectively, and the difference was not statistically significant. Multivariate survival analysis revealed that curability, tumor size, TNM stage and postoperative complications were independently prognostic factors for T2 stage GC patients. Patients in the mD2 group tended to have less intraoperative blood loss (P=0.001) and shorter operation time (P<0.001) than those in the D2 group. While there were no significant differences in recurrence rate and types, especially lymph node recurrence, between the two groups. The surgical outcome of mD2 lymphadenectomy was equal to that of standard D2, and the use of mD2 instead of standard D2 can be a better option for T2 stage GC.

  10. Modifying risks to improve outcome in cardiac surgery: An anesthesiologist's perspective

    Directory of Open Access Journals (Sweden)

    Murali Chakravarthy

    2017-01-01

    Full Text Available Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal. Several activities such as institution of preoperative supportive circulatory, ventilatory, and systemic disease control maneuvers seem to have helped improving the outcome of these 'high risk ' patients. This review attempts to look at various interventions and the resulting improvement in outcomes. Several changes have happened in the realm of cardiac surgery and several more are en route. At times, for want of evidence, maximal optimization may not take place and the patient may encounter unfavorable outcomes.. This review is an attempt to bring the focus of the members of the cardiac surgical team on the value of preoperative optimization of risks to improve the outcome. The cardiac surgical patients may broadly be divided into adults undergoing coronary artery bypass graft surgery, valve surgery and pediatric patients undergoing repair/ palliation of congenital heart ailments. Optimization of risks appear to be different in each genre of patients. This review also brings less often discussed issues such as anemia, nutritional issues and endocrine problems. The review is an attempt to data on ameliorating modifiable risk factors and altering non modifiable ones.

  11. Subjective versus objective assessment in early clinical outcome of modified Lapidus procedure for hallux valgus deformity.

    Science.gov (United States)

    Chopra, S; Moerenhout, K; Crevoisier, X

    2016-02-01

    Studies have assessed the outcome of hallux valgus surgeries based on subjective questionnaires, usually the American Orthopaedic Foot and Ankle Society Score, and radiographic results reporting good to excellent outcome at 6-12 months postoperatively. However, contrasting results were reported by gait studies at 12-24 months postoperatively. In a previous study, we found nine gait parameters which can describe the altered gait in hallux valgus deformity. This study aimed, to assess the outcome of modified Lapidus at 6 months postoperatively, using gait assessment method, to determine if the nine specified gait parameters effectively relates with the clinical scores and the radiological results or add information missed by these commonly used clinical assessments. We assessed 21 participants including 11 controls and 10 patients with moderate to severe hallux valgus deformity. The patient group was followed 6 months postoperatively. The ambulatory gait assessment was performed utilizing pressure insoles and inertial sensors. Clinical assessment includes foot and ankle questionnaires along with radiographic results. Comparison was made using non parametric tests, Phallux valgus surgeries. The existing clinical assessment overestimates the functional outcome at the early postoperative phase. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Mean common or mean maximum carotid intima-media thickness as primary outcome in lipid-modifying intervention studies

    NARCIS (Netherlands)

    Dogan, Soner; Kastelein, Johannes Jacob Pieter; Grobbee, Diederick Egbertus; Bots, Michiel Leonardus

    2011-01-01

    Carotid intima-media thickness (CIMT) measurements are used as a disease outcome in randomized controlled trials that assess the effects of lipid-modifying treatment. It is unclear whether common CIMT or mean maximum CIMT should be used as the primary outcome. We directly compared both measurements

  13. Can we predict the outcome for people with patellofemoral pain? A systematic review on prognostic factors and treatment effect modifiers.

    Science.gov (United States)

    Matthews, M; Rathleff, M S; Claus, A; McPoil, T; Nee, R; Crossley, K; Vicenzino, B

    2017-12-01

    Patellofemoral pain (PFP) is a multifactorial and often persistent knee condition. One strategy to enhance patient outcomes is using clinically assessable patient characteristics to predict the outcome and match a specific treatment to an individual. A systematic review was conducted to determine which baseline patient characteristics were (1) associated with patient outcome (prognosis); or (2) modified patient outcome from a specific treatment (treatment effect modifiers). 6 electronic databases were searched (July 2016) for studies evaluating the association between those with PFP, their characteristics and outcome. All studies were appraised using the Epidemiological Appraisal Instrument. Studies that aimed to identify treatment effect modifiers underwent a checklist for methodological quality. The 24 included studies evaluated 180 participant characteristics. 12 studies investigated prognosis, and 12 studies investigated potential treatment effect modifiers. Important methodological limitations were identified. Some prognostic studies used a retrospective design. Studies aiming to identify treatment effect modifiers often analysed too many variables for the limiting sample size and typically failed to use a control or comparator treatment group. 16 factors were reported to be associated with a poor outcome, with longer duration of symptoms the most reported (>4 months). Preliminary evidence suggests increased midfoot mobility may predict those who have a successful outcome to foot orthoses. Current evidence can identify those with increased risk of a poor outcome, but methodological limitations make it difficult to predict the outcome after one specific treatment compared with another. Adequately designed randomised trials are needed to identify treatment effect modifiers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Fetal sex modifies effects of prenatal stress exposure and adverse birth outcomes.

    Science.gov (United States)

    Wainstock, Tamar; Shoham-Vardi, Ilana; Glasser, Saralee; Anteby, Eyal; Lerner-Geva, Liat

    2015-01-01

    Prenatal maternal stress is associated with pregnancy complications, poor fetal development and poor birth outcomes. Fetal sex has also been shown to affect the course of pregnancy and its outcomes. The aim of this study was to evaluate whether fetal sex modifies the association between continuous exposure to life-threatening rocket attack alarms and adverse pregnancy outcomes. A retrospective cohort study was conducted in which the exposed group was comprised of 1846 women exposed to rocket-attack alarms before and during pregnancy. The unexposed group, with similar sociodemographic characteristics, delivered during the same period of time at the same medical center, but resided out of rocket-attack range. Multivariable models for each gender separately, controlling for possible confounders, evaluated the risk associated with exposure for preterm births (PTB), low birthweight (LBW), small for gestational age and small head circumference (HC). In both univariable and multivariable analyses exposure status was a significant risk factor in female fetuses only: PTB (adj. OR = 1.43; 1.04-1.96), LBW (adj. OR = 1.41; 1.02-1.95) and HC stress.

  15. The Midterm Surgical Outcome of Modified Expansive Open-Door Laminoplasty

    Directory of Open Access Journals (Sweden)

    Kuang-Ting Yeh

    2016-01-01

    Full Text Available Laminoplasty is a standard technique for treating patients with multilevel cervical spondylotic myelopathy. Modified expansive open-door laminoplasty (MEOLP preserves the unilateral paraspinal musculature and nuchal ligament and prevents facet joint violation. The purpose of this study was to elucidate the midterm surgical outcomes of this less invasive technique. We retrospectively recruited 65 consecutive patients who underwent MEOLP at our institution in 2011 with at least 4 years of follow-up. Clinical conditions were evaluated by examining neck disability index, Japanese Orthopaedic Association (JOA, Nurick scale, and axial neck pain visual analog scale scores. Sagittal alignment of the cervical spine was assessed using serial lateral static and dynamic radiographs. Clinical and radiographic outcomes revealed significant recovery at the first postoperative year and still exhibited gradual improvement 1–4 years after surgery. The mean JOA recovery rate was 82.3% and 85% range of motion was observed at the final follow-up. None of the patients experienced aggravated or severe neck pain 1 year after surgery or showed complications of temporary C5 nerve palsy and lamina reclosure by the final follow-up. As a less invasive method for reducing surgical dissection by using various modifications, MEOLP yielded satisfactory midterm outcomes.

  16. Exergy analysis of micro-organic Rankine power cycles for a small scale solar driven reverse osmosis desalination system

    International Nuclear Information System (INIS)

    Tchanche, B.F.; Lambrinos, Gr.; Frangoudakis, A.; Papadakis, G.

    2010-01-01

    Exergy analysis of micro-organic Rankine heat engines is performed to identify the most suitable engine for driving a small scale reverse osmosis desalination system. Three modified engines derived from simple Rankine engine using regeneration (incorporation of regenerator or feedliquid heaters) are analyzed through a novel approach, called exergy-topological method based on the combination of exergy flow graphs, exergy loss graphs, and thermoeconomic graphs. For the investigations, three working fluids are considered: R134a, R245fa and R600. The incorporated devices produce different results with different fluids. Exergy destruction throughout the systems operating with R134a was quantified and illustrated using exergy diagrams. The sites with greater exergy destruction include turbine, evaporator and feedliquid heaters. The most critical components include evaporator, turbine and mixing units. A regenerative heat exchanger has positive effects only when the engine operates with dry fluids; feedliquid heaters improve the degree of thermodynamic perfection of the system but lead to loss in exergetic efficiency. Although, different modifications produce better energy conversion and less exergy destroyed, the improvements are not significant enough and subsequent modifications of the simple Rankine engine cannot be considered as economically profitable for heat source temperature below 100 °C. As illustration, a regenerator increases the system's energy efficiency by 7%, the degree of thermodynamic perfection by 3.5% while the exergetic efficiency is unchanged in comparison with the simple Rankine cycle, with R600 as working fluid. The impacts of heat source temperature and pinch point temperature difference on engine's performance are also examined. Finally, results demonstrate that energy analysis combined with the mathematical graph theory is a powerful tool in performance assessments of Rankine based power systems and permits meaningful comparison of different

  17. Long-term outcome of a modified balloon dilatation in the treatment of patients with achalasia

    Directory of Open Access Journals (Sweden)

    Doder Radoje

    2013-01-01

    Full Text Available Background/Aim. Balloon dilatation is a standard approach to the initial achalasia treatment. Modified dilatation is also applied to rise efficacy and to lower complications. Methods. A total of 57 patients were analysed within a median follow-up of 8.2 years. No premedication was used, dilatation was performed up to the pain treshold, while introduction and positioning of a dilatator was done in combination of endoscopic and radiological control. Dilatation effect was estimated by both Kim Symptom Scoring and objective parameters: body weight rise and radiological scintigraphic findings. Results. Excellent and good results were obtained in 50 (88% of the patients, while in 7 (12% of the patients surgery was performed. There was no difference in dilatation efficacy regarding sex of the patients, but the results were better in the patients above 40 years. Duration of symptoms, body weight loss, esophageal lumen width do not indicate the definitive dilatation outcome. Esophageal scintigraphy and body weight increase were in a direct correlation with the effect of dilatation measured with the Kim Symptom Scoring. After the one to two repeated dilatations the efficacy increased from 74% to 88% justifying the repetition of dilatation. In 2 (3.57% of the patients, that is in 2.65% of the totally dilated patients, perforation was recorded. There was no lethal outcome of dilatation, and the other complications were not clinically significant. Conclusion. Modified balloon dilatation can be recommended for initial method in achalasia treatment due to high efficacy, easy performance in daily hospital while complications are in standard range.

  18. Outcome after the modified Bentall technique with a long interposed graft to the left coronary artery.

    Science.gov (United States)

    Nakahira, Atsushi; Shibata, Toshihiko; Sasaki, Yasuyuki; Hirai, Hidekazu; Hattori, Koji; Hosono, Mitsuharu; Ehara, Shoichi; Suehiro, Shigefumi

    2009-01-01

    The modified Bentall technique, which was reported by Svensson in 1992, is an aortic root composite valve graft replacement involving reimplantation of the left coronary ostium with a long interposed graft wrapping behind the composite graft. The technique is technically advantageous, particularly for complicated or redo aortic roots. To justify the technique, the midterm outcome needs to be evaluated. Since 1992, 40 patients (4 with Marfan syndrome) underwent the modified Bentall technique (Svensson's modification). The mean age was 54.7 +/- 13.6 years, and 32 patients (80.0%) were male. All hospital survivors have been consecutively followed with annual echocardiographic evaluations. Furthermore, in 2007, multislice computed tomography was performed at 4.7 +/- 3.5 years (maximum, 14.9 years) postoperatively in 30 patients who had preserved renal function. No patients have experienced any complications regarding the technique at the follow-up of 5.7 +/- 4.0 years (maximum, 14.9 years), although there were 2 hospital deaths of emergency cases and 5 late deaths owing to noncardiac causes. In 35 patients (92.1% of hospital survivors), no structural complications were detected by multislice computed tomographies of the 30 patients or coronary angiograms of the remaining 5 patients. The consecutive echocardiographic follow-ups showed well-preserved left ventricular function with the most recent ejection fraction being 0.581 +/- 0.078. This Svensson's modification technique was associated with favorable midterm outcomes by multislice computed tomography and consecutive echocardiographic evaluations, indicating long-lasting advantages as well as technical benefits. Thus, the technique can be considered as a helpful and justifiable alternative method.

  19. Ocean Thermal Energy Conversion Using Double-Stage Rankine Cycle

    Directory of Open Access Journals (Sweden)

    Yasuyuki Ikegami

    2018-03-01

    Full Text Available Ocean Thermal Energy Conversion (OTEC using non-azeotropic mixtures such as ammonia/water as working fluid and the multistage cycle has been investigated in order to improve the thermal efficiency of the cycle because of small ocean temperature differences. The performance and effectiveness of the multistage cycle are barely understood. In addition, previous evaluation methods of heat exchange process cannot clearly indicate the influence of the thermophysical characteristics of the working fluid on the power output. Consequently, this study investigated the influence of reduction of the irreversible losses in the heat exchange process on the system performance in double-stage Rankine cycle using pure working fluid. Single Rankine, double-stage Rankine and Kalina cycles were analyzed to ascertain the system characteristics. The simple evaluation method of the temperature difference between the working fluid and the seawater is applied to this analysis. From the results of the parametric performance analysis it can be considered that double-stage Rankine cycle using pure working fluid can reduce the irreversible losses in the heat exchange process as with the Kalina cycle using an ammonia/water mixture. Considering the maximum power efficiency obtained in the study, double-stage Rankine and Kalina cycles can improve the power output by reducing the irreversible losses in the cycle.

  20. Modified Early Warning System improves patient safety and clinical outcomes in an academic community hospital

    Directory of Open Access Journals (Sweden)

    Chirag Mathukia

    2015-04-01

    Full Text Available Background and objective: Severe adverse events such as cardiac arrest and death are often heralded by abnormal vital signs hours before the event. This necessitates an organized track and trigger approach of early recognition and response to subtle changes in a patient's condition. The Modified Early Warning System (MEWS is one of such systems that use temperature, blood pressure, pulse, respiratory rate, and level of consciousness with each progressive higher score triggering an action. Root cause analysis for mortalities in our institute has led to the implementation of MEWS in an effort to improve patient outcomes. Here we discuss our experience and the impact of MEWS implementation on patient care at our community academic hospital. Methods: MEWS was implemented in a protocolized manner in June 2013. The following data were collected from non-ICU wards on a monthly basis from January 2010 to June 2014: 1 number of rapid response teams (RRTs per 100 patient-days (100PD; 2 number of cardiopulmonary arrests ‘Code Blue’ per 100PD; and 3 result of each RRT and Code Blue (RRT progressed to Code Blue, higher level of care, ICU transfer, etc.. Overall inpatient mortality data were also analyzed. Results: Since the implementation of MEWS, the number of RRT has increased from 0.24 per 100PD in 2011 to 0.38 per 100PD in 2013, and 0.48 per 100PD in 2014. The percentage of RRTs that progressed to Code Blue, an indicator of poor outcome of RRT, has been decreasing. In contrast, the numbers of Code Blue in non-ICU floors has been progressively decreasing from 0.05 per 100PD in 2011 to 0.02 per 100PD in 2013 and 2014. These improved clinical outcomes are associated with a decline of overall inpatient mortality rate from 2.3% in 2011 to 1.5% in 2013 and 1.2% in 2014. Conclusions: Implementation of MEWS in our institute has led to higher rapid response system utilization but lower cardiopulmonary arrest events; this is associated with a lower mortality

  1. Emissions-critical charge cooling using an organic rankine cycle

    Science.gov (United States)

    Ernst, Timothy C.; Nelson, Christopher R.

    2014-07-15

    The disclosure provides a system including a Rankine power cycle cooling subsystem providing emissions-critical charge cooling of an input charge flow. The system includes a boiler fluidly coupled to the input charge flow, an energy conversion device fluidly coupled to the boiler, a condenser fluidly coupled to the energy conversion device, a pump fluidly coupled to the condenser and the boiler, an adjuster that adjusts at least one parameter of the Rankine power cycle subsystem to change a temperature of the input charge exiting the boiler, and a sensor adapted to sense a temperature characteristic of the vaporized input charge. The system includes a controller that can determine a target temperature of the input charge sufficient to meet or exceed predetermined target emissions and cause the adjuster to adjust at least one parameter of the Rankine power cycle to achieve the predetermined target emissions.

  2. Leptomeningeal collateral status predicts outcome after middle cerebral artery occlusion.

    Science.gov (United States)

    Madelung, C F; Ovesen, C; Trampedach, C; Christensen, A; Havsteen, I; Hansen, C K; Christensen, H

    2018-01-01

    Perfusion through leptomeningeal collateral vessels is a likely pivotal factor in the outcome of stroke patients. We aimed to investigate the effect of collateral status on outcome in a cohort of unselected, consecutive stroke patients with middle cerebral artery occlusion undergoing reperfusion therapy. This retrospectively planned analysis was passed on prospectively collected data from 187 consecutive patients with middle cerebral artery occlusion admitted within 4.5 hours to one center and treated with intravenous thrombolysis alone (N = 126), mechanical thrombectomy alone (N = 5), or both (N = 56) from May 2009 to April 2014. Non-contrast CT (NCCT) and computed tomography angiography (CTA) were provided on admission and NCCT repeated at 24 hours. Collateral status was assessed based on the initial CTA. Hemorrhagic transformation was evaluated on the 24-hour NCCT and according to European Cooperative Acute Stroke Study (ECASS) criteria. Modified Rankin Scale score was assessed at 90 days, and mortality at 1 year. At 90 days, median (IQR) modified Rankin Scale score in patients with poor collateral status was 4 (3-6) compared to 2 (1-4) in patients with good collateral status (P collateral status were less likely to achieve a good 90-day outcome (modified Rankin Scale score 0-2) (Adjusted odds ratio 0.27, 95% CI: 0.09-0.86). During the first year, 40.9% of patients with poor collateral status died vs 18.2% of the remaining population (P = .001). Leptomeningeal collateral status predicts functional outcome, mortality, and hemorrhagic transformation following middle cerebral artery occlusion. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. A modified cutaneous ureterostomy provides satisfactory short and midterm outcomes in select cases.

    Science.gov (United States)

    Yadav, Priyank; Mittal, Varun; Gaur, Pankaj; Srivastava, Devarshi; Sureka, Sanjoy Kumar; Mandhani, Anil

    2018-03-06

    We present the outcomes of modification of cutaneous ureterostomy by extreme lateralization of the stoma and use of skin flap for formation of ureterostomy. Between June 2012 and June 2016, 36 patients had modified cutaneous ureterostomy for ureteral obstruction due to pelvic malignancy or genitourinary tuberculosis. Transureteroureterostomy was made with cutaneous stoma at anterior axillary line between iliac crest and lower rib cage, instead of spinoumbilical line. To prevent stenosis a 'V' shaped skin was fed into the stoma. Double J stents were used in all patients for 6 weeks. Perioperative morbidity and mortality were evaluated. All patients were followed up at 3 month intervals. Of 36 patients, 22 had radical cystoprostatectomy (including nephroureterectomy in 2 patients) and 7 had palliative cystectomy. Others had locally advanced prostate cancer (n=1), locally advanced cervical cancer (n=3), ovarian cancer (n=1) and genitourinary tuberculosis with small capacity bladder along with a large vesicovaginal fistula (n=1). One patient developed ureteral necrosis requiring conversion to ileal conduit. Three patients developed stomal stenosis: two were managed by self-dilatation while one required revision of stoma. Thirteen patients died of the disease at a median follow up of 6 months with functioning stoma. Remaining 19 patients survived without any complications at a median follow-up of 20.5 months (5.5-43.5 months). None of the patients had any problem related to ureterostomy bag application. Modified lateral cutaneous ureterostomy provides relatively straighter and shorter retroperitoneal course of ureter with acceptable morbidity and avoids use of bowel in selected patients.

  4. Modified Eversion Carotid Endarterectomy (mECEA): Analysis of Clinical and Financial Outcomes.

    Science.gov (United States)

    Musicant, Scott E; Guzzetta, Vincent J; Terramani, Thomas T; Greenwood, Kristina L; Chiodo, Wendy C; Heaney, Karen M; Berthiaume, Shelley J

    2017-07-01

    Several carotid endarterectomy techniques have been described, including conventional carotid endarterectomy (CCEA) performed with patch repair and eversion carotid endarterectomy (ECEA) performed with transection of the internal carotid artery. We describe our simplified technique of modified eversion carotid endarterectomy (mECEA) with longitudinal arteriotomy limited to the carotid bulb, without transection of the internal carotid artery and present our analysis of its safety, efficacy, and cost effectiveness. A retrospective review of all carotid endarterectomies performed by 3 vascular surgeons over a 3-year period was completed. About 197 mECEA were performed during the study period. Follow-up data were obtained on 77.7% of patients. A comparison was made with the contemporary literature with respect to outcomes for both CCEA and ECEA. Between January 2012 and December 2014, a total of 197 mECEA were performed. The perioperative stroke and death rates for those undergoing mECEA was 0.5% and 0.5%, respectively. Late stroke and death rates were 3.0% and 5.1%, respectively. Perioperative rate of myocardial infarction was 1.0%. Early restenosis rates of >70% occurred in 1.4%, whereas late restenosis of >70% occurred in 2.7%. Mean operating time for those undergoing mECEA was 57.9 min. Average costs savings for mECEA compared to CCEA were $5,835. This simplified technique has comparable outcomes to those described in the contemporary literature for both CCEA and ECEA with respect to postoperative neurologic events as well as restenosis rates. In our institution, the short mean operative times with mECEA has led to reduced resource utilization. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. DIETARY VITAMIN E DEFICIENCY AS A MODIFIER OF THE ASSOCIATIONS OF RESPIRATORY OUTCOMES WITH AIR POLLUTION IN ADOLESCENTS

    Science.gov (United States)

    Introduction: We investigated whether low dietary intake of the lipophilic antioxidant vitamin E may act as a modifier of chronic air pollution's associations with respiratory outcomes among adolescents due to an increased respiratory response to the oxidative effects of air pol...

  6. New concepts for organic Rankine cycle power systems

    NARCIS (Netherlands)

    Casati, E.I.M.

    2014-01-01

    Energy provision is one of the major challenges for the Human Society, and it is increasingly clear that the current production/consumption model is not sustainable. The envisaged energy system is smarter, more decentralised and integrated. Energy conversion systems based on the organic Rankine

  7. K-Rankine systems for piloted and cargo Mars missions

    International Nuclear Information System (INIS)

    Mills, J.C.; Rovang, R.D.; Johnson, G.A.

    1992-03-01

    Studies are performed to demonstrate the attractiveness of potassium-Rankine (K-Rankine) nuclear electric propulsion (NEP) systems for both piloted and cargo Mars missions. The key results of the piloted mission study are that a full-up piloted mission can be accomplished with a trip time of less than 390 days with an attractive initial mass in low earth orbit (IMLEO) of 700 metric tons. This is achieved by coupling two advanced cermet fuel reactors (1550 K outlet temperature) to K-Rankine power-conversion systems to produce the 46 MWe needed to power advanced ion engines. This design approach offers an alternative to a more risky split-sprint mission where comparable trip times and IMLEO can be achieved with a nearer-term reactor (SP-100 at 1350 K outlet temperature) technology. The results of the cargo-mission study indicate that a lower-power K-Rankine system (5.5 MWe) operating at SP-100 reactor conditions would best perform a representative Mars cargo transport. A round-trip mission (480 days outbound; 600 day return) to Mars requires only 225 metric tons IMLEO and permit possible system reuse. 6 refs

  8. Organic Rankine Cycle with Solar Heat Storage in Paraffin Way

    Directory of Open Access Journals (Sweden)

    Constantin LUCA

    2015-06-01

    Full Text Available The paper presents an electricity generation system based on an Organic Rankine Cycle and proposed storing the amount of the heat produced by the solar panels using large volume of paraffin wax. The proposed working fluid is R-134a refrigerant. The cycle operates at very low temperatures. A efficiency of 6,55% was obtained.

  9. Comparison between Modified Neuroendoscopy and Craniotomy Evacuation of Spontaneous Intra-Cerebral Hemorrhages: Study of Clinical Outcome and Glasgow Outcome Score

    Directory of Open Access Journals (Sweden)

    Arie Ibrahim

    2016-08-01

    Full Text Available Background and Purposes: Stroke is still one of a leading health-care problem in industrial country and in the developing country. Spontaneous Intra-cerebral Hemorrhage accounts for 30–60% of all stroke admissions into a hospital. Presence of intra-cerebral hemorrhage is considered a poor prognostic factor due to the resultant obstruction to the mass effect following the presence of blood resulting in raised intracranial pressure. While the craniotomy procedure failed to show more benefits over functional outcome, a less invasive and quicker surgical decompression might improve the outcome. Neuroendoscopy is one of promising optional  on minimal invasive  treatment  for spontaneous intra-cerebral hemorrhage. Material and Methods: We evaluated Glasgow Outcome Score and clinical outcome of patients with Spontaneous Intra-cerebral Hemorrhage who underwent modified neuroendoscopic surgery and craniotomy. Randomized control trial was performed during 27 months in 43 patients. Twenty-five patients treated with neuroendoscopy surgery and 18 patients with craniotomy. The removal of intra-cerebral hemorrhage was done by a modified neuroendoscopic transparent sheath made of silastic material, derived from pieces of thoracic tube No. 21F as a conduit working channel. Results: We analyzed statistically, clinical outcome assessment and Glasgow Outcome Scale 6 months post operative follow-up period. The mortality rate was significantly higher by Pearson chi-square methods, in craniotomy group n=12 (63.2% compared with neuroendoscopy group, n=7 (36.8% (p<.005. Patients with Glasgow Outcome Scale score 3–5 was higher in neuroendoscopy group, n=18 (75% compared with craniotomy group n=6 (25%. The survival rate analyzed by Kaplan Meier methods, found that patients in the neuroendoscopy group were a significantly longer survival rate compare with the craniotomy group during 6 months post operative follow-up period. Conclusions: Treatment of spontaneous

  10. Increasing thermal efficiency of Rankine cycles by using refrigeration cycles: A theoretical analysis

    International Nuclear Information System (INIS)

    Sarr, Joachim-André Raymond; Mathieu-Potvin, François

    2016-01-01

    Highlights: • A new stratagem is proposed to improve thermal efficiency of Rankine cycles. • Three new configurations are optimized by means of numerical simulations. • The Rankine-1SCR design is advantageous for 1338 different fluid combinations. • The Rankine-2SCR design is advantageous for 772 different fluid combinations. • The Rankine-3SCR design is advantageous for 768 different fluid combinations. - Abstract: In this paper, three different modifications of the basic Rankine thermodynamic cycle are proposed. The objective is to increase the thermal efficiency of power systems based on Rankine cycles. The three new systems are named “Rankine-1SCR”, “Rankine-2SCR”, and “Rankine-3SCR” cycles, and they consist of linking a refrigeration cycle to the basic Rankine cycle. The idea is to use the refrigeration cycle to create a low temperature heat sink for the Rankine cycle. These three new power plant configurations are modeled and optimized with numerical tools, and then they are compared with the basic Rankine cycle. The objective function is the thermal efficiency of the systems (i.e., net power output (kW) divided by heat rate (kW) entering the system), and the design variables are the operating temperatures within the systems. Among the 84 × 84 (i.e., 7056) possible combinations of working and cooling fluids investigated in this paper, it is shown that: (i) the Rankine-1SCR system is advantageous for 1338 different fluid combinations, (ii) the Rankine-2SCR system is advantageous for 772 different fluid combinations, and (iii) the Rankine-3SCR system is advantageous for 768 different fluid combinations.

  11. Decompressive craniotomy for the treatment of malignant infarction of the middle cerebral artery: mortality and outcome

    Directory of Open Access Journals (Sweden)

    Gianise Toboliski Bongiorni

    Full Text Available ABSTRACT Objective To assess, by Rankin scale, the functional disability of patients who had a malignant middle cerebral artery (MCA ischemic stroke, who underwent decompressive craniotomy (DC within the first 30 days. Methods A cross-sectional study in a University hospital. Between June 2007 and December 2014, we retrospectively analyzed the records of all patients submitted to DC due to a malignant MCA infarction. The mortality rate was defined during the hospitalization period. The modified outcome Rankin score (mRS was measured 30 days after the procedure, for stratification of the quality of life. Results The DC mortality rate was 30% (95% CI 14.5 to 51.9 for the 20 patients reported. The mRS 30 days postoperatively was ≥ 4 [3.3 to 6] for all patients thereafter. Conclusion DC is to be considered a real alternative for the treatment of patients with a malignant ischemic MCA infarction.

  12. Impact of body mass index on outcome in stroke patients treated with intravenous thrombolysis

    OpenAIRE

    Gensicke, H.; Wicht, A.; Bill, O.; Zini, A.; Costa, P.; Kagi, G.; Stark, R.; Seiffge, D. J.; Traenka, C.; Peters, N.; Bonati, L. H.; Giovannini, G.; De Marchis, G. M.; Poli, L.; Polymeris, A.

    2016-01-01

    Abstract: Background and purposeThe impact of body mass index (BMI) on outcome in stroke patients treated with intravenous thrombolysis (IVT) was investigated. MethodsIn a multicentre IVT-register-based observational study, BMI with (i) poor 3-month outcome (i.e. modified Rankin Scale scores 3-6), (ii) death and (iii) symptomatic intracranial haemorrhage (sICH) based on criteria of the ECASS II trial was compared. BMI was used as a continuous and categorical variable distinguishing normal wei...

  13. Multi-Objective Optimization of Organic Rankine Cycle Power Plants Using Pure and Mixed Working Fluids

    Directory of Open Access Journals (Sweden)

    Jesper G. Andreasen

    2016-04-01

    Full Text Available For zeotropic mixtures, the temperature varies during phase change, which is opposed to the isothermal phase change of pure fluids. The use of such mixtures as working fluids in organic Rankine cycle power plants enables a minimization of the mean temperature difference of the heat exchangers, which is beneficial for cycle performance. On the other hand, larger heat transfer surface areas are typically required for evaporation and condensation when zeotropic mixtures are used as working fluids. In order to assess the feasibility of using zeotropic mixtures, it is, therefore, important to consider the additional costs of the heat exchangers. In this study, we aim at evaluating the economic feasibility of zeotropic mixtures compared to pure fluids. We carry out a multi-objective optimization of the net power output and the component costs for organic Rankine cycle power plants using low-temperature heat at 90 ∘ C to produce electrical power at around 500 kW. The primary outcomes of the study are Pareto fronts, illustrating the power/cost relations for R32, R134a and R32/R134a (0.65/0.35 mole . The results indicate that R32/R134a is the best of these fluids, with 3.4 % higher net power than R32 at the same total cost of 1200 k$.

  14. Comparative investigation of working fluids for an organic Rankine cycle with geothermal water

    Directory of Open Access Journals (Sweden)

    Liu Yan-Na

    2015-06-01

    Full Text Available In this paper, the thermodynamic investigation on the use of geothermal water (130 °C as maximum for power generation through a basic Rankine has been presented together with obtained main results. Six typical organic working fluids (i.e., R245fa, R141b, R290, R600, R152a, and 134a were studied with modifying the input pressure and temperature to the turbine. The results show that there are no significant changes taking place in the efficiency for these working fluids with overheating the inlet fluid to the turbine, i.e., efficiency is a weak function of temperature. However, with the increasing of pressure ratio in the turbine, the efficiency rises more sharply. The technical viability is shown of implementing this type of process for recovering low temperature heat resource.

  15. Leak detectors for organic Rankine cycle power plants: On-line and manual methods

    Science.gov (United States)

    Robertus, R. J.; Pool, K. H.; Kindle, C. H.; Sullivan, R. G.; Shannon, D. W.; Pierce, D. D.

    1984-10-01

    Two leak detector systems were designed, built, and tested at a binary-cycle (organic Rankine cycle) geothermal plant. One system is capable of detecting water in hydrocarbon streams down to 100 ppm liquid water ion liquid isobutane. The magnitude of the leak is estimated from the frequency at which solenoid-operated valve opens and closes. The second system can detect the presence of isobutane on water or brine streams down to 2 ppm liquid isobutane in liquid water or brine. The unit first cools the liquid stream if necessary then reduces the pressure in an expansion chamber so the hydrocarbon will vaporize. In brine streams flashed CO2 carries the hydrocarbon to a non-dispersive infrared analyzer (NDIR). The NDIR was modified to be highly selective for isobutane. One can estimate the size of a leak knowing the total gas-to-liquid ratio entering the leak detection system and the concentration of hydrocarbon in the gas phase.

  16. Rankine-Brayton engine powered solar thermal aircraft

    Science.gov (United States)

    Bennett, Charles L [Livermore, CA

    2009-12-29

    A solar thermal powered aircraft powered by heat energy from the sun. A Rankine-Brayton hybrid cycle heat engine is carried by the aircraft body for producing power for a propulsion mechanism, such as a propeller or other mechanism for enabling sustained free flight. The Rankine-Brayton engine has a thermal battery, preferably containing a lithium-hydride and lithium mixture, operably connected to it so that heat is supplied from the thermal battery to a working fluid. A solar concentrator, such as reflective parabolic trough, is movably connected to an optically transparent section of the aircraft body for receiving and concentrating solar energy from within the aircraft. Concentrated solar energy is collected by a heat collection and transport conduit, and heat transported to the thermal battery. A solar tracker includes a heliostat for determining optimal alignment with the sun, and a drive motor actuating the solar concentrator into optimal alignment with the sun based on a determination by the heliostat.

  17. Exergy analysis of biomass organic Rankine cycle for power generation

    Science.gov (United States)

    Nur, T. B.; Sunoto

    2018-02-01

    The study examines proposed small biomass-fed Organic Rankine Cycle (ORC) power plant through exergy analysis. The system consists of combustion burner unit to utilize biomass as fuel, and organic Rankine cycle unit to produce power from the expander. The heat from combustion burner was transfered by thermal oil heater to evaporate ORC working fluid in the evaporator part. The effects of adding recuperator into exergy destruction were investigated. Furthermore, the results of the variations of system configurations with different operating parameters, such as the evaporating pressures, ambient temperatures, and expander pressures were analyzed. It was found that the largest exergy destruction occurs during processes are at combustion part, followed by evaporator, condenser, expander, and pump. The ORC system equipped with a recuperator unit exhibited good operational characteristics under wide range conditions compared to the one without recuperator.

  18. New concepts for organic Rankine cycle power systems

    OpenAIRE

    Casati, E.I.M.

    2014-01-01

    Energy provision is one of the major challenges for the Human Society, and it is increasingly clear that the current production/consumption model is not sustainable. The envisaged energy system is smarter, more decentralised and integrated. Energy conversion systems based on the organic Rankine thermodynamic cycle (ORC) have the potential to play a major role in this framework, being one of the most proven solutions for the exploitation of external thermal sources in the power-output range fr...

  19. Energy recovery system using an organic rankine cycle

    Science.gov (United States)

    Ernst, Timothy C

    2013-10-01

    A thermodynamic system for waste heat recovery, using an organic rankine cycle is provided which employs a single organic heat transferring fluid to recover heat energy from two waste heat streams having differing waste heat temperatures. Separate high and low temperature boilers provide high and low pressure vapor streams that are routed into an integrated turbine assembly having dual turbines mounted on a common shaft. Each turbine is appropriately sized for the pressure ratio of each stream.

  20. Pb-H2O Thermogravimetric Plants. The Rankine Cycle

    International Nuclear Information System (INIS)

    Arosio, S.; Carlevaro, R.

    2000-01-01

    An economic evaluation concerning Pb-H 2 O thermogravimetric systems with an electric power in the range 200-1.000 kW has been done. Moreover, plant and running costs for a thermogravimetric and a Rankine cycle, 1 MW power, have been compared. Basically due to the lead charge, the plant cost of the former is higher: nevertheless such amount can be recuperated in less than three years, being higher the running cost of the latter [it

  1. Experimental demonstrations of organic Rankine cycle waste heat rejection systems

    Science.gov (United States)

    Bland, Timothy J.; Lacey, P. Douglas

    Two phase fluid management is an important factor in the successful design of organic Rankine cycle (ORC) power conversion systems for space applications. The evolution of the heat rejection system approach from a jet condenser, through a rotary jet condenser, to a rotary fluid management device (RFMD) with a surface condenser has been described in a previous paper. Some of the test programs that were used to prove the validity of the selected approach are described.

  2. Modifying effect of prenatal care on the association between young maternal age and adverse birth outcomes.

    Science.gov (United States)

    Vieira, C L; Coeli, C M; Pinheiro, R S; Brandão, E R; Camargo, K R; Aguiar, F P

    2012-06-01

    The objectives were to investigate the prevalence of adverse birth outcomes according to maternal age range in the city of Rio de Janeiro, Brazil, in 2002, and to evaluate the association between maternal age range and adverse birth outcomes using additive interaction to determine whether adequate prenatal care can attenuate the harmful effect of young age on pregnancy outcomes. A cross-sectional analysis was performed in women up to 24 years of age who gave birth to live children in 2002 in the city of Rio de Janeiro. To evaluate adverse outcomes, the exposure variable was maternal age range, and the outcome variables were very preterm birth, low birth weight, prematurity, and low 5-minute Apgar score. The presence of interaction was investigated with the composite variable maternal age plus prenatal care. The proportions and respective 95% confidence intervals were calculated for adequate schooling, delivery in a public maternity hospital, and adequate prenatal care, and the outcomes according to maternal age range. The chi-square test was used. The association between age range and birth outcomes was evaluated with logistic models adjusted for schooling and type of hospital for each prenatal stratum and outcome. Attributable proportion was calculated in order to measure additive interaction. Of the 40,111 live births in the sample, 1.9% corresponded to children of mothers from 10-14 years of age, 38% from 15-19 years, and 59.9% from 20-24 years. An association between maternal age and adverse outcomes was observed only in adolescent mothers with inadequate prenatal care, and significant additive interaction was observed between prenatal care and maternal age for all the outcomes. Adolescent mothers and their newborns are exposed to greater risk of adverse outcomes when prenatal care fails to comply with current guidelines. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  3. Exergoeconomic comparison of TLC (trilateral Rankine cycle), ORC (organic Rankine cycle) and Kalina cycle using a low grade heat source

    International Nuclear Information System (INIS)

    Yari, M.; Mehr, A.S.; Zare, V.; Mahmoudi, S.M.S.; Rosen, M.A.

    2015-01-01

    Recently, the TLC (trilateral power cycle) has attracted significant interest as it provides better matching between the temperature profiles in the evaporator compared to conventional power cycles. This article investigates the performance of this cycle and compares it with those for the ORC (organic Rankine cycle) and the Kalina cycle, from the viewpoints of thermodynamics and thermoeconomics. A low-grade heat source with a temperature of 120 °C is considered for all the three systems. Parametric studies are performed for the systems for several working fluids in the ORC and TLC. The systems are then optimized for either maximum net output power or minimum product cost, using the EES (engineering equation solver) software. The results for the TLC indicate that an increase in the expander inlet temperature leads to an increase in net output power and a decrease in product cost for this power plant, whereas this is not the case for the ORC system. It is found that, although the TLC can achieve a higher net output power compared with the ORC and Kalina (KCS11 (Kalina cycle system 11)) systems, its product cost is greatly affected by the expander isentropic efficiency. It is also revealed that using n-butane as the working fluid can result in the lowest product cost in the ORC and the TLC. In addition, it is observed that, for both the ORC and Kalina systems, the optimum operating condition for maximum net output power differs from that for minimum product cost. - Highlights: • Exergoeconomic analysis of trilateral Rankine cycle is performed. • The system performance is compared with Organic Rankine and Kalina cycles. • Net power from trilateral Rankine cycle is higher than the other power systems. • Superiority of trilateral cycle depends on its expander isentropic efficiency

  4. Perinatal outcome in singletons after modified natural cycle IVF and standard IVF with ovarian stimulation

    NARCIS (Netherlands)

    Pelinck, Marie-Jose; Keizer, Marjan H.; Hoek, Annemieke; Simons, Arnold H. M.; Schelling, Karin; Middelburg, Karin; Heineman, Maas Jan

    Objective: Singletons born after IVF treatment are at risk for adverse pregnancy outcome, the cause of which is unknown. The aim of the present study was to investigate the influence of ovarian stimulation on perinatal outcome. Study design: In this single-centre retrospective study, perinatal

  5. Perinatal outcome in singletons after modified natural cycle IVF and standard IVF with ovarian stimulation

    NARCIS (Netherlands)

    Pelinck, Marie-José; Keizer, Marjan H.; Hoek, Annemieke; Simons, Arnold H. M.; Schelling, Karin; Middelburg, Karin; Heineman, Maas Jan

    2010-01-01

    Objective: Singletons born after IVF treatment are at risk for adverse pregnancy outcome, the cause of which is unknown. The aim of the present study was to investigate the influence of ovarian stimulation on perinatal outcome. Study design: In this single-centre retrospective study, perinatal

  6. Number theory and modular forms papers in memory of Robert A Rankin

    CERN Document Server

    Ono, Ken

    2003-01-01

    Robert A. Rankin, one of the world's foremost authorities on modular forms and a founding editor of The Ramanujan Journal, died on January 27, 2001, at the age of 85. Rankin had broad interests and contributed fundamental papers in a wide variety of areas within number theory, geometry, analysis, and algebra. To commemorate Rankin's life and work, the editors have collected together 25 papers by several eminent mathematicians reflecting Rankin's extensive range of interests within number theory. Many of these papers reflect Rankin's primary focus in modular forms. It is the editors' fervent hope that mathematicians will be stimulated by these papers and gain a greater appreciation for Rankin's contributions to mathematics. This volume would be an inspiration to students and researchers in the areas of number theory and modular forms.

  7. Assessment of outcome in patients undergoing surgery for intradural spinal tumor using the multidimensional patient-rated Core Outcome Measures Index and the modified McCormick Scale.

    Science.gov (United States)

    Bellut, David; Burkhardt, Jan-Karl; Mannion, Anne F; Porchet, François

    2015-08-01

    OBJECT The aim of this study was to evaluate outcome in patients undergoing surgical treatment for intradural spinal tumor using a patient-oriented, self-rated, outcome instrument and a physician-based disease-specific instrument. METHODS Prospectively collected data from 63 patients with intradural spinal tumor were analyzed in relation to scores on the multidimensional patient-rated Core Outcome Measures Index (COMI) and the physician-rated modified McCormick Scale, before and at 3 and 12 months after surgery. RESULTS There was no statistically significant difference between the scores on the modified McCormick Scale preoperatively and at the 3-month follow-up, though there was a trend for improvement (p = 0.073); however, comparisons between the scores determined preoperatively and at the 12-month follow-up, as well as 3- versus 12-month follow-ups, showed a statistically significant improvement in each case (p 0.05) up to 12 months postoperatively. In contrast, the overall COMI score, "worst pain," quality of life, and social disability not only showed a significant reduction from before surgery to 3 months after surgery (p 0.05), but did show a significant improvement (p = 0.011) from 3 months to 12 months after surgery. At the 3- and 12-month follow-ups, 85.2% and 83.9% of patients, respectively, declared that the surgical procedure had helped/helped a lot; 95.1% and 95.2%, respectively, declared that they were satisfied/very satisfied with their care. CONCLUSIONS COMI is a feasible tool to use in the evaluation of baseline symptoms and outcome in patients undergoing surgery for intradural spinal tumor. COMI was able to detect changes in outcome at 3 months after surgery (before changes were apparent on the modified McCormick Scale) and on later postoperative follow-up. The COMI subdomains are valuable for monitoring the patient's reintegration into society and the work environment. The addition of an item that specifically covers neurological deficits may

  8. Distal biceps brachii tendon repair: a systematic review of patient outcome determination using modified Coleman methodology score criteria.

    Science.gov (United States)

    Nyland, John; Causey, Brandon; Wera, Jeff; Krupp, Ryan; Tate, David; Gupta, Amit

    2017-07-01

    This systematic literature review evaluated the methodological research design quality of studies that evaluated patient outcomes following distal biceps brachii tendon repair and developed evidence-based recommendations for future patient clinical outcomes research. Following the preferred reporting items for systematic reviews and meta-analyses criteria, and using "biceps brachii", "tendon", "repair" and "outcome assessment" search terms, the CINAHL, Academic Search Premier and MEDLINE databases were searched from January 1960-October 2015. The modified Coleman methodology score (MCMS) served as the primary outcome measure. Descriptive statistical analysis was performed for composite and component MCMS and for patient outcome assessment methodology use frequency. A total of 93 studies were evaluated. Overall MCMS was low (57.1 ± 14). Only 12 (12.9 %) had prospective cohort or randomized controlled trial designs. There was a moderate relationship between publication year and MCMS (r = 0.53, P research study methodological scores improved on average since 2008, generally low MCMS scores, retrospective designs, lack of eccentric elbow flexor or supinator strength testing, and poorly described surgical and rehabilitation descriptions remain commonplace. These findings decrease clinical study validity and generalizability. III.

  9. Prevalence of Fabry Disease and Outcomes in Young Canadian Patients With Cryptogenic Ischemic Cerebrovascular Events.

    Science.gov (United States)

    Lanthier, Sylvain; Saposnik, Gustavo; Lebovic, Gerald; Pope, Karen; Selchen, Daniel; Moore, David F

    2017-07-01

    Previous studies reported Fabry disease in 0% to 4% of young patients with cryptogenic ischemic stroke (IS). We sought to determine the prevalence of Fabry and outcomes among young Canadians with cryptogenic IS or transient ischemic attack (TIA). We prospectively enrolled individuals aged 18 to 55 with IS or speech or motor TIA, and no cause identified despite predetermined investigation. α-galactosidase-A gene was sequenced for Fabry diagnosis. National Institutes of Health Stroke Scale score was measured at presentation to quantify stroke severity. Modified Rankin Scale determined functional outcomes ≤7 days after presentation and 6 months later. We enrolled 365 patients with IS and 32 with TIA. α-galactosidase-A sequencing identified a single carrier of a genetic variant of unknown significance (p.R118C) and no well-recognized pathogenic variants. Mean National Institutes of Health Stroke Scale score was 3.1. Proportion of patients with modified Rankin Scale of 0 to 2 was 70.7% at ≤7 days and 87.4% at 6 months. National Institutes of Health Stroke Scale score at presentation and diabetes mellitus predicted 6-month modified Rankin Scale. Thirteen patients experienced 5 recurrent IS and 9 TIA during follow-up. No patient died. Most patients (98.7%) returned home. Among previous workers, 43% had residual working limitations. In this Canadian cohort of patients with cryptogenic IS or TIA, the prevalence of Fabry was 0.3% if p.R118C variant is considered as pathogenic. This suggests that more cost-effective methods should be applied for diagnosis of Fabry rather than systematic genetic screening in this population. Overall, cryptogenic IS in young adults is associated with favorable outcomes. © 2017 American Heart Association, Inc.

  10. U-Pb zircon age for a volcanic suite in the Rankin Inlet Group, Rankin Inlet map area, District of Keewatin, Northwest Territories

    Energy Technology Data Exchange (ETDEWEB)

    Tella, S; Roddick, J C; VanBreemen, O [Geological Survey of Canada, Ottawa, ON (Canada)

    1997-12-31

    U-Pb zircon analyses from a felsic band within dominantly mafic volcanics of the Rankin Inlet Group yields a U-Pb upper concordia intercept age of 2663 {+-} 3 Ma. These supracrustals at Rankin Inlet appear to be 15-20 Ma younger than volcanics of the Kaminak Group in the Tavani area, 70 km to the southwest. The 2.68-2.66 Ga volcanism in the Tavani and Rankin Inlet areas coincided with the last stage of the main phase of magmatism in the Slave Structural Province. (author). 16 refs., 1 tab., 3 figs.

  11. U-Pb zircon age for a volcanic suite in the Rankin Inlet Group, Rankin Inlet map area, District of Keewatin, Northwest Territories

    International Nuclear Information System (INIS)

    Tella, S.; Roddick, J.C.; VanBreemen, O.

    1996-01-01

    U-Pb zircon analyses from a felsic band within dominantly mafic volcanics of the Rankin Inlet Group yields a U-Pb upper concordia intercept age of 2663 ± 3 Ma. These supracrustals at Rankin Inlet appear to be 15-20 Ma younger than volcanics of the Kaminak Group in the Tavani area, 70 km to the southwest. The 2.68-2.66 Ga volcanism in the Tavani and Rankin Inlet areas coincided with the last stage of the main phase of magmatism in the Slave Structural Province. (author). 16 refs., 1 tab., 3 figs

  12. Nuclear alkali metal Rankine power systems for space applications

    International Nuclear Information System (INIS)

    Moyers, J.C.; Holcomb, R.S.

    1986-08-01

    Nucler power systems utilizing alkali metal Rankine power conversion cycles offer the potential for high efficiency, lightweight space power plants. Conceptual design studies are being carried out for both direct and indirect cycle systems for steady state space power applications. A computational model has been developed for calculating the performance, size, and weight of these systems over a wide range of design parameters. The model is described briefly and results from parametric design studies, with descriptions of typical point designs, are presented in this paper

  13. Nuclear alkali metal Rankine power systems for space applications

    International Nuclear Information System (INIS)

    Moyers, J.C.; Holcomb, R.S.

    1986-01-01

    Nuclear power systems utilizing alkali metal Rankine power conversion cycles offer the potential for high efficiency, lightweight space power plants. Conceptual design studies are being carried out for both direct and indirect cycle systems for steady state space power applications. A computational model has been developed for calculating the performance, size, and weight of these systems over a wide range of design parameters. The model is described briefly and results from parametric design studies, with descriptions of typical point designs, are presented in this paper

  14. Status of the organic Rankine cycle for space applications

    Science.gov (United States)

    Bland, T. J.; Lacey, P. D.; Sorensen, G. L.

    The Organic Rankine Cycle (ORC) has been under continuous development and evaluation since the 1960s for both terrestrial and space power applications. Recent activities (Bland et al, 1987) have focused primarily on the Space Station's solar dynamic power system and Dynamic Isotope Power Systems (DIPS) applications. This paper addresses ORC-DIPS system level trade studies conducted during the past year and a half. Two companion papers (Bland and Pearson) present more detailed data on specific ORC-DIPS technology issues and testing conducted during the same period.

  15. Modified Therapeutic Community Treatment for Offenders with MICA Disorders: Antisocial Personality Disorder and Treatment Outcomes

    Science.gov (United States)

    McKendrick, Karen; Sullivan, Christopher; Banks, Steven; Sacks, Stanley

    2006-01-01

    Treatment outcomes 1 year after release from prison were compared for two subgroups of male inmates with co-occurring serious mental illness and chemical abuse (MICA) disorders, those with a diagnosis for Antisocial Personality Disorder (APD), and those without a diagnosis of APD. The foundation study had randomly assigned inmates to either…

  16. The influence of blood pressure management on neurological outcome in endovascular therapy for acute ischaemic stroke.

    Science.gov (United States)

    Rasmussen, M; Espelund, U S; Juul, N; Yoo, A J; Sørensen, L H; Sørensen, K E; Johnsen, S P; Andersen, G; Simonsen, C Z

    2018-06-01

    Observational studies have suggested that low blood pressure and blood pressure variability may partially explain adverse neurological outcome after endovascular therapy with general anaesthesia (GA) for acute ischaemic stroke. The aim of this study was to further examine whether blood pressure related parameters during endovascular therapy are associated with neurological outcome. The GOLIATH trial randomised 128 patients to either GA or conscious sedation for endovascular therapy in acute ischaemic stroke. The primary outcome was 90 day modified Rankin Score. The haemodynamic protocol aimed at keeping the systolic blood pressure >140 mm Hg and mean blood pressure >70 mm Hg during the procedure. Blood pressure related parameters of interest included 20% reduction in mean blood pressure; mean blood pressure blood pressure blood pressure; mean blood pressure at the time of groin puncture; postreperfusion mean blood pressure; blood pressure variability; and use of vasopressors. Sensitivity analyses were performed in the subgroup of reperfused patients. Procedural average mean and systolic blood pressures were higher in the conscious sedation group (Pblood pressure blood pressure blood pressure variability, and use of vasopressors were all higher in the GA group (Pblood pressure related parameters and the modified Rankin Score in the overall patient population, and in the subgroup of patients with full reperfusion. We found no statistically significant association between blood pressure related parameters during endovascular therapy and neurological outcome. NCT 02317237. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  17. Integrated biomass pyrolysis with organic Rankine cycle for power generation

    Science.gov (United States)

    Nur, T. B.; Syahputra, A. W.

    2018-02-01

    The growing interest on Organic Rankine Cycle (ORC) application to produce electricity by utilizing biomass energy sources are increasingly due to its successfully used to generate power from waste heat available in industrial processes. Biomass pyrolysis is one of the thermochemical technologies for converting biomass into energy and chemical products consisting of liquid bio-oil, solid biochar, and pyrolytic gas. In the application, biomass pyrolysis can be divided into three main categories; slow, fast and flash pyrolysis mainly aiming at maximizing the products of bio-oil or biochar. The temperature of synthesis gas generated during processes can be used for Organic Rankine Cycle to generate power. The heat from synthesis gas during pyrolysis processes was transfer by thermal oil heater to evaporate ORC working fluid in the evaporator unit. In this study, the potential of the palm oil empty fruit bunch, palm oil shell, and tree bark have been used as fuel from biomass to generate electricity by integrated with ORC. The Syltherm-XLT thermal oil was used as the heat carrier from combustion burner, while R245fa was used as the working fluid for ORC system. Through Aspen Plus, this study analyses the influences on performance of main thermodynamic parameters, showing the possibilities of reaching an optimum performance for different working conditions that are characteristics of different design parameters.

  18. Solar thermal organic rankine cycle for micro-generation

    Science.gov (United States)

    Alkahli, N. A.; Abdullah, H.; Darus, A. N.; Jalaludin, A. F.

    2012-06-01

    The conceptual design of an Organic Rankine Cycle (ORC) driven by solar thermal energy is developed for the decentralized production of electricity of up to 50 kW. Conventional Rankine Cycle uses water as the working fluid whereas ORC uses organic compound as the working fluid and it is particularly suitable for low temperature applications. The ORC and the solar collector will be sized according to the solar flux distribution in the Republic of Yemen for the required power output of 50 kW. This will be a micro power generation system that consists of two cycles, the solar thermal cycle that harness solar energy and the power cycle, which is the ORC that generates electricity. As for the solar thermal cycle, heat transfer fluid (HTF) circulates the cycle while absorbing thermal energy from the sun through a parabolic trough collector and then storing it in a thermal storage to increase system efficiency and maintains system operation during low radiation. The heat is then transferred to the organic fluid in the ORC via a heat exchanger. The organic fluids to be used and analyzed in the ORC are hydrocarbons R600a and R290.

  19. Performance of a reversible heat pump/organic Rankine cycle unit coupled with a passive house to get a positive energy building

    DEFF Research Database (Denmark)

    Dumont, Olivier; Carmo, Carolina; Fontaine, Valentin

    2016-01-01

    This paper presents an innovative technology that can be used to deliver more renewable electricity production than the total electrical consumption of a building while covering the heat demand on a yearly basis. The technology concept uses a heat pump (HP), slightly modified to revert its cycle...... and generate electricity, coupled to a solar thermal collector roof. This reversible HP/organic Rankine cycle unit presents three operating modes: direct heating, HP and organic Rankine cycle. This work focuses on describing the dynamic model of the multi-component system followed by a techno-economic analysis......Wh/year and total electrical consumption of 2318 kWh/year) with a 138.8 m2 solar roof in Denmark....

  20. Thermodynamic analysis of a Rankine cycle applied on a diesel truck engine using steam and organic medium

    International Nuclear Information System (INIS)

    Katsanos, C.O.; Hountalas, D.T.; Pariotis, E.G.

    2012-01-01

    Highlights: ► ORC improves bsfc from 10.7% to 8.4% as engine load increases from 25% to 100%. ► Increasing ORC high pressure increases thermodynamic efficiency and power output. ► Operating at high pressure the ORC is favorable for the engine cooling system. ► The low temperature values of the ORC favors heat extraction from the EGR gas. ► The impact of the exhaust gas heat exchanger on engine backpressure is limited. - Abstract: A theoretical study is conducted to investigate the potential improvement of the overall efficiency of a heavy-duty truck diesel engine equipped with a Rankine bottoming cycle for recovering heat from the exhaust gas. To this scope, a newly developed thermodynamic simulation model has been used, considering two different working media: water and the refrigerant R245ca. As revealed from the analysis, due to the variation of exhaust gas temperature with engine load it is necessary to modify the Rankine cycle parameters i.e. high pressure and superheated vapor temperature. For this reason, a new calculation procedure is applied for the estimation of the optimum Rankine cycle parameters at each operating condition. The calculation algorithm is conducted by taking certain design criteria into account, such as the exhaust gas heat exchanger size and its pinch point requirement. From the comparative evaluation between the two working media examined, using the optimum configuration of the cycle for each operating condition, it has been revealed that the brake specific fuel consumption improvement ranges from 10.2% (at 25% engine load) to 8.5% (at 100% engine load) for R245ca and 6.1% (at 25% engine load) to 7.5% (at 100% engine load) for water.

  1. Surgical decompression for space-occupying cerebral infarction: outcomes at 3 years in the randomized HAMLET trial.

    Science.gov (United States)

    Geurts, Marjolein; van der Worp, H Bart; Kappelle, L Jaap; Amelink, G Johan; Algra, Ale; Hofmeijer, Jeannette

    2013-09-01

    We assessed whether the effects of surgical decompression for space-occupying hemispheric infarction, observed at 1 year, are sustained at 3 years. Patients with space-occupying hemispheric infarction, who were enrolled in the Hemicraniectomy After Middle cerebral artery infarction with Life-threatening Edema Trial within 4 days after stroke onset, were followed up at 3 years. Outcome measures included functional outcome (modified Rankin Scale), death, quality of life, and place of residence. Poor functional outcome was defined as modified Rankin Scale >3. Of 64 included patients, 32 were randomized to decompressive surgery and 32 to best medical treatment. Just as at 1 year, surgery had no effect on the risk of poor functional outcome at 3 years (absolute risk reduction, 1%; 95% confidence interval, -21 to 22), but it reduced case fatality (absolute risk reduction, 37%; 95% confidence interval, 14-60). Sixteen surgically treated patients and 8 controls lived at home (absolute risk reduction, 27%; 95% confidence interval, 4-50). Quality of life improved between 1 and 3 years in patients treated with surgery. In patients with space-occupying hemispheric infarction, the effects of decompressive surgery on case fatality and functional outcome observed at 1 year are sustained at 3 years. http://www.controlled-trials.com. Unique identifier: ISRCTN94237756.

  2. An evaluation of surgical outcome of bilateral cleft lip surgery using a modified Millard′s (Fork Flap technique

    Directory of Open Access Journals (Sweden)

    W L Adeyemo

    2013-01-01

    Full Text Available Background: The central third of the face is distorted by the bilateral cleft of the lip and palate and restoring the normal facial form is one of the primary goals for the reconstructive surgeons. The history of bilateral cleft lip repair has evolved from discarding the premaxilla and prolabium and approximating the lateral lip elements to a definitive lip and primary cleft nasal repair utilising the underlying musculature. The aim of this study was to review surgical outcome of bilateral cleft lip surgery (BCLS done at the Lagos University Teaching Hospital. Materials and Methods: A review of all cases of BCLS done between January 2007 and December 2012 at the Lagos University Teaching Hospital was done. Data analysis included age and sex of patients, type of cleft deformity and type of surgery (primary or secondary and whether the cleft deformity was syndromic and non-syndromic. Techniques of repair, surgical outcome and complications were also recorded. Results: A total of 39 cases of BCLS involving 21 males and 18 females were done during the period. This constituted 10% (39/390 of all cases of cleft surgery done during the period. There were 5 syndromic and 34 non-syndromic cases. Age of patients at time of surgery ranged between 3 months and 32 years. There were 24 bilateral cleft lip and palate deformities and 15 bilateral cleft lip deformities. Thirty-one of the cases were primary surgery, while 8 were secondary (revision surgery. The most common surgical technique employed was modified Fork flap (Millard technique, which was employed in 37 (95% cases. Conclusion: Bilateral cleft lip deformity is a common cleft deformity seen in clinical practice, surgical repair of which can be a challenge to an experienced surgeon. A modified Fork flap technique for repair of bilateral cleft lip is a reliable and versatile technique associated with excellent surgical outcome.

  3. Outcomes of Modified Harrington Reconstructions for Nonprimary Periacetabular Tumors: An Effective and Inexpensive Technique.

    Science.gov (United States)

    Bernthal, Nicholas M; Price, Shawn L; Monument, Michael J; Wilkinson, Brandon; Jones, Kevin B; Randall, R Lor

    2015-11-01

    Metastatic disease to the acetabulum presents a difficult technical and philosophical challenge: complicated surgeries in patients with often short life expectancies force us to examine both the outcome and cost of these operations. Therefore, we studied the durability of a cement-screw rebar reconstruction technique and risk factors for failure, and we compare the results to other reconstruction options. This is a retrospective review of 52 acetabular reconstructions in 50 patients for nonprimary disease using a retrograde screw-rebar-cement all-polyethylene technique. Mean age was 57 years (range 25-81 years). Twenty-four lesions were classified as Harrington class II; 28 were Harrington class III. Mean follow-up was 17.7 months (range 1-92 months). Outcomes included patient survival, prosthesis survival, and complications. Forty-eight of 50 (96 %) patients ambulated after surgery. Five of 52 (9.6 %) of prostheses failed, three from loosening due to tumor progression, one from aseptic loosening, and one from soft tissue instability (dislocation). The three cases of tumor progression failure occurred in patients with massive preoperative ischial tumor burden. Mean surgical time was 198 min, and hospital stay was 5.2 days. The screw-cement-rebar all-polyethylene cup reconstruction technique is a comparatively successful and inexpensive reconstruction option for treating nonprimary oncologic disease in the acetabulum. All cases of loosening occurred beyond the median patient survival. Surgeons should be wary of massive ischial tumor burden in patients with projected longevity, as it may be associated with implant failure. Surgical time and hospital stay are consistent with historical data for alternative implants, and implant cost is lower.

  4. Integration between a thermophotovoltaic generator and an Organic Rankine Cycle

    International Nuclear Information System (INIS)

    De Pascale, Andrea; Ferrari, Claudio; Melino, Francesco; Morini, Mirko; Pinelli, Michele

    2012-01-01

    Highlights: ► A new energy system comprising a Thermo-Photo-Voltaic and Organic Rankine Cycle. ► An analytical model to calculate the performance of the system is introduced. ► The system shows promising results in terms of CHP performance. -- Abstract: The constant increase in energy need and the growing attention to the related environmental impact have given a boost to the development of new strategies in order to reduce the primary energy consumption and to improve its utilization. One of the possible strategies for achieving this aim is Combined Heat and Power (CHP) specially if coupled with the concept of on-site generation (also known as distributed generation). These approaches allow the reduction of fuel consumption and pollutant emissions and the increase of security in energy supply. This paper introduces the Thermophotovoltaic Organic Rankine Cycle Integrated System (TORCIS), an energy system integrating a ThermoPhotoVoltaic generator (TPV) and an Organic Rankine Cycle (ORC). This study represents the start-up of a research program which involves three research teams from IMEM – National Research Council, ENDIF – University of Ferrara and DIEM – University of Bologna. The aim of this research is the complete definition and the pre-prototyping characterization of this system covering all the unresolved issues in this field. More specifically, TPV is a system to convert the radiation emitted from an artificial heat source (i.e. the combustion of fuel) into electrical energy by the use of photovoltaic cells. In this system, the produced electrical power is strictly connected to the thermal one as their ratio is almost constant and cannot be changed without severe loss in performance. The coupling between TPV and ORC allows this limitation to be overcome by the realization of a CHP system which can be regulated with a large degree of freedom changing the ratio between the produced electrical and thermal power. In this study a thermodynamic

  5. DISEASE MODIFYING THERAPY AND OUTCOME OF RHEUMATOID ARTHRITIS: RETROSPECTIVE ASSESSMENT OF LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    D. E. Karateyev

    2000-01-01

    Full Text Available Aim of study: To investigate the relation between patterns of basic treatment and the outcome of disease in patients with rheumatoid arthritis (RA. Material and methods: We studied retrospectively two groups of patients with RA (1987 ACR criteria: 1 main group - died (72 patients, mean duration of disease from the onset to death 12.8±0.9 years; 2 control group - alive to 1999 with duration of disease at least 15 years (90 patients, mean follow-up period 19.4±0.47 years. Results: Some patterns of basic treatment were observed: 1 "passive ” strategy - only hydroxychloroquine or sulphasalazine during many years; 2 "inteirupted " treatment - early treatment gold or cytotoxics, but when improvement occurred, therapy with DMARD was interrupted for 1-2 years or more, after that re-started etc.; 3 “emergency” strategy’ - 7-10years of "passive" treatment, after that se\\>ere destruction and/or amyloidosis appeared, and cytotoxics started; 4 typical "pyramid " strategy; 5 "active " strategy - early start of treatment with active DMARD (melotrexate, gold with consecutive change of DMARDs without interruption of basic treatment (very close to "sawtooth ” strategy. The most of died patients were treated with "passive ” and "interrupted" strategies, but the most of patients in control group were treated with "pyramid” and "active" strategies. Conclusion: active strategy of basic treatment has a positive influence on the survival ofpatients with R.A.

  6. Postnatal weight gain modifies severity and functional outcome of oxygen-induced proliferative retinopathy.

    Science.gov (United States)

    Stahl, Andreas; Chen, Jing; Sapieha, Przemyslaw; Seaward, Molly R; Krah, Nathan M; Dennison, Roberta J; Favazza, Tara; Bucher, Felicitas; Löfqvist, Chatarina; Ong, Huy; Hellström, Ann; Chemtob, Sylvain; Akula, James D; Smith, Lois E H

    2010-12-01

    In clinical studies, postnatal weight gain is strongly associated with retinopathy of prematurity (ROP). However, animal studies are needed to investigate the pathophysiological mechanisms of how postnatal weight gain affects the severity of ROP. In the present study, we identify nutritional supply as one potent parameter that affects the extent of retinopathy in mice with identical birth weights and the same genetic background. Wild-type pups with poor postnatal nutrition and poor weight gain (PWG) exhibit a remarkably prolonged phase of retinopathy compared to medium weight gain or extensive weight gain pups. A high (r(2) = 0.83) parabolic association between postnatal weight gain and oxygen-induced retinopathy severity is observed, as is a significantly prolonged phase of proliferative retinopathy in PWG pups (20 days) compared with extensive weight gain pups (6 days). The extended retinopathy is concomitant with prolonged overexpression of retinal vascular endothelial growth factor in PWG pups. Importantly, PWG pups show low serum levels of nonfasting glucose, insulin, and insulin-like growth factor-1 as well as high levels of ghrelin in the early postoxygen-induced retinopathy phase, a combination indicative of poor metabolic supply. These differences translate into visual deficits in adult PWG mice, as demonstrated by impaired bipolar and proximal neuronal function. Together, these results provide evidence for a pathophysiological correlation between poor postnatal nutritional supply, slow weight gain, prolonged retinal vascular endothelial growth factor overexpression, protracted retinopathy, and reduced final visual outcome.

  7. Early functional outcome of a modified Brostrom-Gould surgery using bioabsorbable suture anchor for chronic lateral ankle instability.

    Science.gov (United States)

    Shahrulazua, A; Ariff Sukimin, M S; Tengku Muzaffar, T M; Yusof, M I

    2010-03-01

    The purpose of this study was to evaluate the early functional outcome following the use of a bioabsorbable suture anchor to simplify the repair of injured lateral ankle structures as a variation of an established technique known as the Brostrom-Gould procedure. This was a prospective study of 30 ankles with chronic lateral instability that underwent a modified Brostrom-Gould surgery using a bioabsorbable suture anchor, performed by a single surgeon. A total of 29 patients, aged 15 to 52 (mean is 33) years, were enrolled in the study. The follow-up period ranged from three to six (mean is four) months. The function of the patients' ankles was scored using the Kaikkonen Functional Scale, both preoperatively and postoperatively. Preoperatively, all ankles had poor scores (less than 50). Postoperatively, 28 ankles showed excellent scores and two ankles showed good scores, while none obtained a fair or poor score. The difference in the overall means between the postoperative and preoperative scores was statistically significant (p-value is 0.001). Post surgery, 24 ankles had no symptoms, while six had only mild ankle tightness with extreme inversion movement at the last review. All patients were able to walk normally, and 29 ankles regained their normal running capability. There was marked improvement in the ability to descend stairs, to rise on heels and toes, to perform a single-limb stance, and in range of motions of the ankle dorsiflexion as well as in ankle laxity. The modified Brostrom-Gould procedure using a bioabsorbable suture anchor allowed for early ankle rehabilitation and offered a reproducible and excellent early functional outcome with minimal complications.

  8. Solar-powered Rankine heat pump for heating and cooling

    Science.gov (United States)

    Rousseau, J.

    1978-01-01

    The design, operation and performance of a familyy of solar heating and cooling systems are discussed. The systems feature a reversible heat pump operating with R-11 as the working fluid and using a motor-driven centrifugal compressor. In the cooling mode, solar energy provides the heat source for a Rankine power loop. The system is operational with heat source temperatures ranging from 155 to 220 F; the estimated coefficient of performance is 0.7. In the heating mode, the vapor-cycle heat pump processes solar energy collected at low temperatures (40 to 80 F). The speed of the compressor can be adjusted so that the heat pump capacity matches the load, allowing a seasonal coefficient of performance of about 8 to be attained.

  9. RANKINE-HUGONIOT RELATIONS IN RELATIVISTIC COMBUSTION WAVES

    International Nuclear Information System (INIS)

    Gao Yang; Law, Chung K.

    2012-01-01

    As a foundational element describing relativistic reacting waves of relevance to astrophysical phenomena, the Rankine-Hugoniot relations classifying the various propagation modes of detonation and deflagration are analyzed in the relativistic regime, with the results properly degenerating to the non-relativistic and highly relativistic limits. The existence of negative-pressure downstream flows is noted for relativistic shocks, which could be of interest in the understanding of the nature of dark energy. Entropy analysis for relativistic shock waves is also performed for relativistic fluids with different equations of state (EoS), denoting the existence of rarefaction shocks in fluids with adiabatic index Γ < 1 in their EoS. The analysis further shows that weak detonations and strong deflagrations, which are rare phenomena in terrestrial environments, are expected to exist more commonly in astrophysical systems because of the various endothermic reactions present therein. Additional topics of relevance to astrophysical phenomena are also discussed.

  10. Organic Rankine Kilowatt Isotope Power System. Final phase I report

    International Nuclear Information System (INIS)

    1978-01-01

    On 1 August 1975 under Department of Energy Contract EN-77-C-02-4299, Sundstrand Energy Systems commenced development of a Kilowatt Isotope Power System (KIPS) directed toward satisfying the higher power requirements of satellites of the 1980s and beyond. The KIPS is a 238 PuO 2 fueled organic Rankine cycle turbine power system which will provide design output power in the range of 500 to 2000 W/sub (e)/ with a minimum of system changes. The principal objectives of the Phase 1 development effort were to: conceptually design a flight system; design a Ground Demonstration System (GDS) that is prototypic of the flight system in order to prove the feasibility of the flight system design; fabricate and assemble the GDS; and performance and endurance test the GDS using electric heaters in lieu of the isotope heat source. Results of the work performed under the Phase 1 contract to 1 July 1978 are presented

  11. Energy analysis of Organic Rankine Cycles for biomass applications

    Directory of Open Access Journals (Sweden)

    Algieri Angelo

    2015-01-01

    Full Text Available The present paper aims at analysing the performances of Organic Rankine Cycles (ORCs adopted for the exploitation of the biomass resulting from the pruning residues in a 3000 hectares district in Southern Italy. A parametric energy analysis has been carried out to define the influence of the main plant operating conditions. To this purpose, both subcritical and transcritical power plants have been examined and saturated and superheated conditions at the turbine inlet have been imposed. Moreover, the effect of the working fluid, condensation temperature, and internal regeneration on system performances has been investigated. The results show that ORC plants represent an interesting and sustainable solution for decentralised and small-scale power production. Furthermore, the analysis highlights the significant impact of the maximum temperature and the noticeable effect of internal regeneration on the performances of the biomass power plants.

  12. Optimal integration of organic Rankine cycles with industrial processes

    International Nuclear Information System (INIS)

    Hipólito-Valencia, Brígido J.; Rubio-Castro, Eusiel; Ponce-Ortega, José M.; Serna-González, Medardo; Nápoles-Rivera, Fabricio; El-Halwagi, Mahmoud M.

    2013-01-01

    Highlights: • An optimization approach for heat integration is proposed. • A new general superstructure for heat integration is proposed. • Heat process streams are simultaneously integrated with an organic Rankine cycle. • Better results can be obtained respect to other previously reported methodologies. - Abstract: This paper presents a procedure for simultaneously handling the problem of optimal integration of regenerative organic Rankine cycles (ORCs) with overall processes. ORCs may allow the recovery of an important fraction of the low-temperature process excess heat (i.e., waste heat from industrial processes) in the form of mechanical energy. An integrated stagewise superstructure is proposed for representing the interconnections and interactions between the HEN and ORC for fixed data of process streams. Based on the integrated superstructure, the optimization problem is formulated as a mixed integer nonlinear programming problem to simultaneously account for the capital and operating costs including the revenue from the sale of the shaft power produced by the integrated system. The application of this method is illustrated with three example problems. Results show that the proposed procedure provides significantly better results than an earlier developed method for discovering optimal integrated systems using a sequential approach, due to the fact that it accounts simultaneously for the tradeoffs between the capital and operating costs as well as the sale of the produced energy. Also, the proposed method is an improvement over the previously reported methods for solving the synthesis problem of heat exchanger networks without the option of integration with an ORC (i.e., stand-alone heat exchanger networks)

  13. Affordable Rankine Cycle Waste Heat Recovery for Heavy Duty Trucks

    Energy Technology Data Exchange (ETDEWEB)

    Subramanian, Swami Nathan [Eaton Corporation

    2017-06-30

    Nearly 30% of fuel energy is not utilized and wasted in the engine exhaust. Organic Rankine Cycle (ORC) based waste heat recovery (WHR) systems offer a promising approach on waste energy recovery and improving the efficiency of Heavy-Duty diesel engines. Major barriers in the ORC WHR system are the system cost and controversial waste heat recovery working fluids. More than 40% of the system cost is from the additional heat exchangers (recuperator, condenser and tail pipe boiler). The secondary working fluid loop designed in ORC system is either flammable or environmentally sensitive. The Eaton team investigated a novel approach to reduce the cost of implementing ORC based WHR systems to Heavy-Duty (HD) Diesel engines while utilizing safest working fluids. Affordable Rankine Cycle (ARC) concept aimed to define the next generation of waste energy recuperation with a cost optimized WHR system. ARC project used engine coolant as the working fluid. This approach reduced the need for a secondary working fluid circuit and subsequent complexity. A portion of the liquid phase engine coolant has been pressurized through a set of working fluid pumps and used to recover waste heat from the exhaust gas recirculation (EGR) and exhaust tail pipe exhaust energy. While absorbing heat, the mixture is partially vaporized but remains a wet binary mixture. The pressurized mixed-phase engine coolant mixture is then expanded through a fixed-volume ratio expander that is compatible with two-phase conditions. Heat rejection is accomplished through the engine radiator, avoiding the need for a separate condenser. The ARC system has been investigated for PACCAR’s MX-13 HD diesel engine.

  14. Parametric investigation of working fluids for organic Rankine cycle applications

    International Nuclear Information System (INIS)

    Brown, J. Steven; Brignoli, Riccardo; Quine, Timothy

    2015-01-01

    This paper investigates working fluids for organic Rankine cycle (ORC) applications with a goal of identifying “ideal” working fluids for five renewable/alternative energy sources. It employs a methodology for screening and comparing with good engineering accuracy the thermodynamic performance potential of ORC operating with working fluids that are not well characterized experimentally or by high-accuracy equations of state. A wide range of “theoretical” working fluids are investigated with the goals to identify potential alternative working fluids and to guide future research and development efforts of working fluids. The “theoretical” working fluids investigated are described in terms of critical state properties, acentric factor, and ideal gas specific heat capacity at constant pressure and are obtained by parametrically varying each of these parameters. The performances of these “theoretical” working fluids are compared to the performances of several “real” working fluids. The study suggests a working fluid's critical temperature and its critical ideal gas molar heat capacity have the largest impact on the cycle efficiency and volumetric work output, with “ideal” working fluids for high efficiency possessing critical temperatures on the order of 100%–150% of the source temperature and possessing intermediate values of critical ideal gas molar heat capacity. - Highlights: • “Ideal” working fluids are investigated for organic Rankine cycles (ORC). • The thermodynamic space of “ideal” working fluids is parametrically investigated. • Five low- and high-temperature ORC applications are investigated. • 1620 “ideal” and several “real” working fluids per application are investigated.

  15. Theoretical thermodynamic analysis of Rankine power cycle with thermal driven pump

    International Nuclear Information System (INIS)

    Lakew, Amlaku Abie; Bolland, Olav; Ladam, Yves

    2011-01-01

    Highlights: → The work is focused on theoretical aspects of thermal driven pump (TDP) Rankine cycle. → The mechanical pump is replaced by thermal driven pump. → Important parameters of thermal driven pump Rankine cycle are investigated. → TDP Rankine cycle produce more power but it requires additional low grade heat. - Abstract: A new approach to improve the performance of supercritical carbon dioxide Rankine cycle which uses low temperature heat source is presented. The mechanical pump in conventional supercritical carbon dioxide Rankine cycle is replaced by thermal driven pump. The concept of thermal driven pump is to increase the pressure of a fluid in a closed container by supplying heat. A low grade heat source is used to increase the pressure of the fluid instead of a mechanical pump, this increase the net power output and avoid the need for mechanical pump which requires regular maintenance and operational cost. The thermal driven pump considered is a shell and tube heat exchanger where the working fluid is contained in the tube, a tube diameter of 5 mm is chosen to reduce the heating time. The net power output of the Rankine cycle with thermal driven pump is compared to that of Rankine cycle with mechanical pump and it is observed that the net power output is higher when low grade thermal energy is used to pressurize the working fluid. The thermal driven pump consumes additional heat at low temperature (60 o C) to pressurize the working fluid.

  16. Thermo-economic analysis and selection of working fluid for solar organic Rankine cycle

    International Nuclear Information System (INIS)

    Desai, Nishith B.; Bandyopadhyay, Santanu

    2016-01-01

    Highlights: • Concentrating solar power plant with organic Rankine cycle. • Thermo-economic analysis of solar organic Rankine cycle. • Performance evaluation for different working fluids. • Comparison diagram to select appropriate working fluid. - Graphical Abstract: Display Omitted - Abstract: Organic Rankine cycle (ORC), powered by line-focusing concentrating solar collectors (parabolic trough collector and linear Fresnel reflector), is a promising option for modular scale. ORC based power block, with dry working fluids, offers higher design and part-load efficiencies compared to steam Rankine cycle (SRC) in small-medium scale, with temperature sources up to 400 °C. However, the cost of ORC power block is higher compared to the SRC power block. Similarly, parabolic trough collector (PTC) system has higher optical efficiency and higher cost compared to linear Fresnel reflector (LFR) system. The thermodynamic efficiencies and power block costs also vary with working fluids of the Rankine cycle. In this paper, thermo-economic comparisons of organic Rankine and steam Rankine cycles powered by line-focusing concentrating solar collectors are reported. A simple selection methodology, based on thermo-economic analysis, and a comparison diagram for working fluids of power generating cycles are also proposed. Concentrating solar power plants with any collector technology and any power generating cycle can be compared using the proposed methodology.

  17. Potential application of Rankine and He-Brayton cycles to sodium fast reactors

    International Nuclear Information System (INIS)

    Perez-Pichel, G.D.; Linares, J.I.; Herranz, L.E.; Moratilla, B.Y.

    2011-01-01

    Highlights: → This paper has been focused on thermal efficiency of several Rankine and Brayton cycles for SFR. → A sub-critical Rankine configuration could reach a thermal efficiency higher than 43%. → It could be increased to almost 45% using super-critical configurations. → Brayton cycles thermal performance can be enhanced by adding a super-critical organic fluid Rankine cycle. → The moderate coolant temperature at the reactor makes Brayton configurations have poorer. - Abstract: Traditionally all the demos and/or prototypes of the sodium fast reactor (SFR) technology with power output, have used a steam sub-critical Rankine cycle. Sustainability requirement of Gen. IV reactors recommends exploring alternate power cycle configurations capable of reaching high thermal efficiency. By adopting the anticipated working parameters of next SFRs, this paper investigates the potential of some Rankine and He-Brayton layouts to reach thermal efficiencies as high as feasible, so that they could become alternates for SFR reactor balance of plant. The assessment has encompassed from sub-critical to super-critical Rankine cycles and combined cycles based on He-Brayton gas cycles of different complexity coupled to Organic Rankine Cycles. The sub-critical Rankine configuration reached at thermal efficiency higher than 43%, which has been shown to be a superior performance than any of the He-Brayton configurations analyzed. By adopting a super-critical Rankine arrangement, thermal efficiency would increase less than 1.5%. In short, according to the present study a sub-critical layout seems to be the most promising configuration for all those upcoming prototypes to be operated in the short term (10-15 years). The potential of super-critical CO 2 -Brayton cycles should be explored for future SFRs to be deployed in a longer run.

  18. Optimization of organic Rankine cycle power systems considering multistage axial turbine design

    DEFF Research Database (Denmark)

    Meroni, Andrea; Andreasen, Jesper Graa; Persico, Giacomo

    2018-01-01

    Organic Rankine cycle power systems represent a viable and efficient solution for the exploitation of medium-to-low temperature heat sources. Despite the large number of commissioned units, there is limited literature on the design and optimization of organic Rankine cycle power systems considering...... multistage turbine design. This work presents a preliminary design methodology and working fluid selection for organic Rankine cycle units featuring multistage axial turbines. The method is then applied to the case of waste heat recovery from a large marine diesel engine. A multistage axial turbine model...

  19. Analysis of hot spots in boilers of organic Rankine cycle units during transient operation

    DEFF Research Database (Denmark)

    Benato, A.; Kærn, Martin Ryhl; Pierobon, Leonardo

    2015-01-01

    This paper is devoted to the investigation of critical dynamic events causing thermochemical decompositionof the working fluid in organic Rankine cycle power systems. The case study is the plant of an oiland gas platform where one of the three gas turbines is combined with an organic Rankine cycle...... and fluid decomposition. It is demonstrated thatthe use of a spray attemperator can mitigate the problems of local overheating of the organic compound.As a practical consequence, this paper provides guidelines for safe and reliable operation of organicRankine cycle power modules on offshore installations....

  20. Optimization of organic Rankine cycle power systems considering multistage axial turbine design

    DEFF Research Database (Denmark)

    Meroni, Andrea; Andreasen, Jesper Graa; Persico, Giacomo

    2017-01-01

    Organic Rankine cycle power systems represent a viable and efficient solution for the exploitation of medium-to-low temperature heat sources. Despite the large number of commissioned units, there is limited literature on the design and optimization of organic Rankine cycle power systems considering...... multistage turbine design. This work presents a preliminary design methodology and working fluid selection for organic Rankine cycle units featuring multistage axial turbines. The method is then applied to the case of waste heat recovery from a large marine diesel engine. A multistage axial turbine model...

  1. FLUOROETHERS AS A WORKING FLUIDS FOR LOW TEMPERATURE ORGANIC RANKINE CYCLE

    Directory of Open Access Journals (Sweden)

    Artemenko S.V

    2014-12-01

    Full Text Available Hydrofluoroethers as a new class of working fluids for the organic Rankine cycle have been considered to utilize the low-potential waste heat. Temperature range 300…400 K was chosen to provide energy conversion of waste heat from fuel cells. The direct assessment of the efficiency criteria for the Rankine cycle via artificial neural networks (ANN was used. To create ANN the critical parameters of substance and normal boiling temperature as input were chosen. The forecast of efficiency criteria for the Rankine cycle as output parameter which reproduces the coefficient of performance with high accuracy and without thermodynamic property calculations was presented.

  2. Low-order models of a single-screw expander for organic Rankine cycle applications

    Science.gov (United States)

    Ziviani, D.; Desideri, A.; Lemort, V.; De Paepe, M.; van den Broek, M.

    2015-08-01

    Screw-type volumetric expanders have been demonstrated to be a suitable technology for organic Rankine cycle (ORC) systems because of higher overall effectiveness and good part-load behaviour over other positive displacement machines. An 11 kWe single-screw expander (SSE) adapted from an air compressor has been tested in an ORC test-rig operating with R245fa as working fluid. A total of 60 steady-steady points have been obtained at four different rotational speeds of the expander in the range between 2000 rpm and 3300 rpm. The maximum electrical power output and overall isentropic effectiveness measured were 7.3 kW and 51.9%, respectively. In this paper, a comparison between two low-order models is proposed in terms of accuracy of the predictions, the robustness of the model and the computational time. The first model is the Pacejka equation-based model and the second is a semi-empirical model derived from a well-known scroll expander model and modified to include the geometric aspects of a single screw expander. The models have been calibrated with the available steady-state measurement points by identifying the proper parameters.

  3. Predictors of Good Outcome After Endovascular Therapy for Vertebrobasilar Occlusion Stroke.

    Science.gov (United States)

    Bouslama, Mehdi; Haussen, Diogo C; Aghaebrahim, Amin; Grossberg, Jonathan A; Walker, Gregory; Rangaraju, Srikant; Horev, Anat; Frankel, Michael R; Nogueira, Raul G; Jovin, Tudor G; Jadhav, Ashutosh P

    2017-12-01

    Endovascular therapy is increasingly used in acute ischemic stroke treatment and is now considered the gold standard approach for selected patient populations. Prior studies have demonstrated that eventual patient outcomes depend on both patient-specific factors and procedural considerations. However, these factors remain unclear for acute basilar artery occlusion stroke. We sought to determine prognostic factors of good outcome in acute posterior circulation large vessel occlusion strokes treated with endovascular therapy. We reviewed our prospectively collected endovascular databases at 2 US tertiary care academic institutions for patients with acute posterior circulation strokes from September 2005 to September 2015 who had 3-month modified Rankin Scale documented. Baseline characteristics, procedural data, and outcomes were evaluated. A good outcome was defined as a 90-day modified Rankin Scale score of 0 to 2. The association between clinical and procedural parameters and functional outcome was assessed. A total of 214 patients qualified for the study. Smoking status, creatinine levels, baseline National Institutes of Health Stroke Scale score, anesthesia modality (conscious sedation versus general anesthesia), procedural length, and reperfusion status were significantly associated with good outcomes in the univariate analysis. Multivariate logistic regression indicated that only smoking (odds ratio=2.61; 95% confidence interval, 1.23-5.56; P =0.013), low baseline National Institutes of Health Stroke Scale score (odds ratio=1.09; 95% confidence interval, 1.04-1.13; P <0.0001), and successful reperfusion status (odds ratio=10.80; 95% confidence interval, 1.36-85.96; P =0.025) were associated with good outcome. In our retrospective case series, only smoking, low baseline National Institutes of Health Stroke Scale score, and successful reperfusion status were associated with good outcome in patients with posterior circulation stroke treated with endovascular

  4. Recent research trends in organic Rankine cycle technology: A bibliometric approach

    DEFF Research Database (Denmark)

    Imran, Muhammad; Haglind, Fredrik; Asim, Muhammad

    2018-01-01

    This work describes the contribution of researchers around the world in the field of the organic Rankine cycle in the period 2000–2016. A bibliometric approach was applied to analyze the scientific publications in the field using the Scopus Elsevier database, together with Science Citation Index...... of active countries, institutes, authors, and journals in the organic Rankine cycle technology field. From 2000 to 2016, there were 2120 articles published by 3443 authors from 997 research institutes scattered over 71 countries. The total number of citations and impact factor are 36,739 and 4597...... are the leading countries in organic Rankine cycle research and account for 64% of the total number of publications. The core research activities in the field are mainly focused on applications of the organic Rankine cycle technology, working fluids selection/performance, cycle architecture, and design...

  5. Prospects of the use of nanofluids as working fluids for organic Rankine cycle power systems

    DEFF Research Database (Denmark)

    Mondejar, Maria E.; Andreasen, Jesper G.; Regidor, Maria

    2017-01-01

    The search of novel working fluids for organic Rankine cycle power systems is driven by the recent regulations imposing additional phase-out schedules for substances with adverse environmental characteristics. Recently, nanofluids (i.e. colloidal suspensions of nanoparticles in fluids) have been...... suggested as potential working fluids for organic Rankine cycle power systems due to their enhanced thermal properties, potentially giving advantages with respect to the design of the components and the cycle performance. Nevertheless, a number of challenges concerning the use of nanofluids must...... the prospects of using nanofluids as working fluids for organic Rankine cycle power systems. As a preliminary study, nanofluids consisting of a homogenous and stable mixture of different nanoparticles types and a selected organic fluid are simulated on a case study organic Rankine cycle unit for waste heat...

  6. Combined Turbine and Cycle Optimization for Organic Rankine Cycle Power Systems—Part B

    DEFF Research Database (Denmark)

    La Seta, Angelo; Meroni, Andrea; Andreasen, Jesper Graa

    2016-01-01

    Organic Rankine cycle (ORC) power systems have recently emerged as promising solutions for waste heat recovery in low- and medium-size power plants. Their performance and economic feasibility strongly depend on the expander. The design process and efficiency estimation are particularly challenging...... due to the peculiar physical properties of the working fluid and the gas-dynamic phenomena occurring in the machine. Unlike steam Rankine and Brayton engines, organic Rankine cycle expanders combine small enthalpy drops with large expansion ratios. These features yield turbine designs with few highly...... is the preliminary design of an organic Rankine cycle turbogenerator to increase the overall energy efficiency of an offshore platform. For an increase in expander pressure ratio from 10 to 35, the results indicate up to 10% point reduction in expander performance. This corresponds to a relative reduction in net...

  7. Vitreoretinal Complications and Outcomes in 92 Eyes Undergoing Surgery for Modified Osteo-Odonto-Keratoprosthesis: A 10-Year Review.

    Science.gov (United States)

    Rishi, Pukhraj; Rishi, Ekta; Agarwal, Vishvesh; Nair, Sridevi; Iyer, Geetha; Srinivasan, Bhaskar; Agarwal, Shweta

    2018-06-01

    To analyze vitreoretinal (VR) complications and treatment outcomes in eyes undergoing modified osteo-odonto-keratoprosthesis (OOKP) surgery. Retrospective case series. All patients who underwent modified OOKP (mOOKP) surgery at a tertiary eye-care center from March 2003 to February 2013 were included. Medical records were reviewed for relevant medical history, best-corrected visual acuity (BCVA), slit-lamp examination, ultrasound scan, oral examination findings, and VR complications. The BCVA at the last visit. Optimal anatomic outcome was attached retina with a normal intraocular pressure at the last visit. A total of 92 eyes of 90 patients were included. Indications for OOKP included Stevens-Johnson syndrome (n = 53), chemical injury (n = 36), and ocular cicatricial pemphigoid (n = 3). A total of 41 eyes of 39 patients developed VR complications, including vitritis (n = 21), retinal detachment (RD) (n = 12; primary RD = 5), retroprosthetic membrane (RPM) (n = 10; primary RPM = 2), endophthalmitis (n = 8), vitreous hemorrhage (VH) (n = 5; primary VH = 1), serous choroidal detachment (n = 5), hemorrhagic choroidal detachment (n = 2), and leak-related hypotony (n = 1). Mean interval from mOOKP surgery to occurrence of VR complication(s) was 43.8 months (median, 41.9 months; range, 0.2-95.5 months). After treatment of VR complication, visual improvement was seen in 17 eyes (42%) (mean improvement = 1.2 logarithm of the minimum angle of resolution [logMAR]; median, 0.8 logMAR; range, 0.1-2.5 logMAR), visual decline in 7 eyes (14%) (mean decline in BCVA = 0.6 logMAR; median, 0.4 logMAR; range, 0.3-1.8 logMAR), and no change in BCVA in 17 eyes (42%). However, BCVA ≥6/60 was retained in 19 eyes and ≥6/18 was retained in 9 eyes after final VR treatment. Vitreoretinal complications constitute a significant cause of visual morbidity in eyes undergoing mOOKP surgery and pose a challenging situation to manage. However, appropriate and timely intervention

  8. Genetically modified human bone marrow derived mesenchymal stem cells for improving the outcome of human islet transplantation.

    Directory of Open Access Journals (Sweden)

    Vaibhav Mundra

    Full Text Available The objective of this study was to determine the potential of human bone marrow derived mesenchymal stem cells (hBMSCs as gene carriers for improving the outcome of human islet transplantation. hBMSCs were characterized for the expression of phenotypic markers and transduced with Adv-hVEGF-hIL-1Ra to overexpress human vascular endothelial growth factor (hVEGF and human interleukin-1 receptor antagonist (hIL-1Ra. Human islets were co-cultured with hBMSCs overexpressing hVEGF and hIL-1Ra. Islet viability was determined by membrane fluorescent method and glucose stimulation test. Transduced hBMSCs and human islets were co-transplanted under the kidney capsule of NOD.Cg-Prkdc(scid Il2rg(tm1Wjl /SzJ (NSG diabetic mice and blood glucose levels were measured over time to demonstrate the efficacy of genetically modified hBMSCs. At the end of study, immunofluorescent staining of kidney section bearing islets was performed for insulin and von Willebrand Factor (vWF. hBMSCs were positive for the expression of CD73, CD90, CD105, CD146 and Stro-1 surface markers as determined by flow cytometry. Transduction of hBMSCs with adenovirus did not affect their stemness and differentiation potential as confirmed by mRNA levels of stem cell markers and adipogenic differentiation of transduced hBMSCs. hBMSCs were efficiently transduced with Adv-hVEGF-hIL-1Ra to overexpress hVEGF and hIL-1Ra. Live dead cell staining and glucose stimulation test have shown that transduced hBMSCs improved the viability of islets against cytokine cocktail. Co-transplantation of human islets with genetically modified hBMSCs improved the glycemic control of diabetic NSG mice as determined by mean blood glucose levels and intraperitoneal glucose tolerance test. Immunofluorescent staining of kidney sections was positive for human insulin and vWF. In conclusion, our results have demonstrated that hBMSCs may be used as gene carriers and nursing cells to improve the outcome of islet

  9. Modified osteo-odonto-keratoprosthesis for treatment of corneal blindness: long-term anatomical and functional outcomes in 181 cases.

    Science.gov (United States)

    Falcinelli, Giancarlo; Falsini, Benedetto; Taloni, Maurizio; Colliardo, Paolo; Falcinelli, Giovanni

    2005-10-01

    To evaluate long-term anatomical and functional outcomes of a modified osteo-odonto-keratoprosthesis (OOKP) technique for treatment of corneal blindness from various etiologies. Two-hundred three patients (224 eyes) underwent modified OOKP surgery between 1973 and 1999. Of the original cohort, 181 patients (98 men and 83 women; mean [SD], age 54.3 [15] years) in whom a standardized 2-step surgical procedure was performed were included in the study. Preoperative diagnoses were dry eye (n = 70) due to ocular pemphigoid (n = 39), Sjögren syndrome (n = 11), trachoma (n = 8), Lyell syndrome (n = 6), Stevens-Johnson syndrome (n = 4), and graft-vs-host disease (n = 1) and congenital lid coloboma (n = 1), severe corneal burns (n = 68), bullous keratopathy (n = 13), keratitis sequelae (n = 15), and bullous keratopathy secondary to antiglaucoma surgery (n = 15). Several innovations were made to the original Strampelli technique. Median follow-up duration was 12 years (range, 1-25 years). Anatomical complications leading to OOKP loss were found in 11 (6.07%) of 181 patients. Survival analysis estimated that 18 years after surgery, the probability of retaining an intact OOKP was 85% (95% confidence interval, 79.3%-90.7%). Pooling patient groups, mean (SD) best postoperative visual acuity was 0.76 (0.34). Mean (SD) final acuity at the end of follow-up declined slightly (0.69 [0.39]) but significantly (P<.01). In individual diagnostic groups, mean acuity decline reached statistical significance (P<.05) only in the pemphigoid (1 line), trachoma (1 line), and bullous keratopathy secondary to antiglaucoma surgery (2 lines) groups. Survival analysis estimated that 18 years after surgery, the probability of retaining best postoperative visual acuity (within 2 lines) was mean (SD) 55.5% (12.9%). Modified OOKP surgery for corneal blindness of different etiologies may provide, in the long-term, anatomically stable corneal prosthesis as well as an effective, rehabilitating recovery in

  10. Predictors of short-term outcome in patients with acute middle cerebral artery occlusion: unsuitability of fluid-attenuated inversion recovery vascular hyperintensity scores

    Directory of Open Access Journals (Sweden)

    Chan-chan Li

    2018-01-01

    Full Text Available Fluid-attenuated inversion recovery (FLAIR vascular hyperintensity (FVH is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days (National Institutes of Health Stroke Scale and 90 days (modified Rankin Scale to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.

  11. How a modified approach to dental coding can benefit personal and professional development with improved clinical outcomes.

    Science.gov (United States)

    Lam, Raymond; Kruger, Estie; Tennant, Marc

    2014-12-01

    One disadvantage of the remarkable achievements in dentistry is that treatment options have never been more varied or confusing. This has made the concept of Evidenced Based Dentistry more applicable to modern dental practice. Despite merit in the concept whereby clinical decisions are guided by scientific evidence, there are problems with establishing a scientific base. This is no more challenging than in modern dentistry where the gap between rapidly developing products/procedures and its evidence base are widening. Furthermore, the burden of oral disease continues to remain high at the population level. These problems have prompted new approaches to enhancing research. The aim of this paper is to outline how a modified approach to dental coding may benefit clinical and population level research. Using publically assessable data obtained from the Australian Chronic Disease Dental Scheme and item codes contained within the Australian Schedule of Dental Services and Glossary, a suggested approach to dental informatics is illustrated. A selection of item codes have been selected and expanded with the addition of suffixes. These suffixes provided circumstantial information that will assist in assessing clinical outcomes such as success rates and prognosis. The use of item codes in administering the CDDS yielded a large database of item codes. These codes are amenable to dental informatics which has been shown to enhance research at both the clinical and population level. This is a cost effective method to supplement existing research methods. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Exergoeconomic analysis of a solar-powered/fuel assisted Rankine cycle for power generation

    International Nuclear Information System (INIS)

    Cavalcanti, Eduardo J.C.; Motta, Henrique Pereira

    2015-01-01

    A Rankine System assisted for solar radiation and fuel combustion which produces 57 kW electrical power are evaluated from exergoeconomic point of view. The Parabolic trough collector efficiency has been performed to investigate its effect as heat source. The exergoeconomic parameters as the relative cost difference and the exergoeconomic factor for each component are evaluated. The analysis is based on the SPECO (Specific Exergy Costing) approach. The simulation of system on March, June, September and December 21st from 7 am to 4 pm for Natal/Brazil using real data was carried out. The results reveal the daily average values of collector efficiencies, ratio of the useful solar energy, electricity produced, the specific cost per exergy unit of the produced electricity and others heat rates. The system is advantageous for higher solar radiation. The outcome of the analysis can be useful in design, optimization of operating parameters and help to take decision of investment. - Highlights: • As the solar irradiation decreases, the electricity cost per exergy unit increases. • The cost rate is high at collector field due to higher purchase cost. • The system is advantageous when the solar radiation is high. • Further aspect as environmental impact is important

  13. Influence of mannan-binding lectin and MAp44 on outcome in comatose survivors of out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Thiel, Steffen

    2016-01-01

    as an endogenous inhibitor of MBL-mediated activities. The aim of this study was to investigate the possible association between MBL deficiency, MAp44 levels and outcome in comatose survivors of out-of-hospital cardiac arrest (OHCA). Methods: In a single center post hoc analysis of the prospective multicenter...... assessed by Cerebral Performance Category (CPC1-2) and modified Rankin Scale (mRS0-3) 180 days after OHCA. Results: Patients with MBL deficiency (defined as plasma levels ≤100 ng ml-1 at baseline) (n = 22) carried a 30-day mortality of 41% compared to 32% in MBL sufficient patient (n = 147), p = 0...

  14. Rankin-Selberg methods for closed string amplitudes

    CERN Document Server

    Pioline, Boris

    2014-01-01

    After integrating over supermoduli and vertex operator positions, scattering amplitudes in superstring theory at genus $h\\leq 3$ are reduced to an integral of a Siegel modular function of degree $h$ on a fundamental domain of the Siegel upper half plane. A direct computation is in general unwieldy, but becomes feasible if the integrand can be expressed as a sum over images under a suitable subgroup of the Siegel modular group: if so, the integration domain can be extended to a simpler domain at the expense of keeping a single term in each orbit -- a technique known as the Rankin-Selberg method. Motivated by applications to BPS-saturated amplitudes, Angelantonj, Florakis and I have applied this technique to one-loop modular integrals where the integrand is the product of a Siegel-Narain theta function times a weakly, almost holomorphic modular form. I survey our main results, and take some steps in extending this method to genus greater than one.

  15. Quasi-dynamic model for an organic Rankine cycle

    International Nuclear Information System (INIS)

    Bamgbopa, Musbaudeen O.; Uzgoren, Eray

    2013-01-01

    Highlights: • Study presents a simplified transient modeling approach for an ORC under variable heat input. • The ORC model is presented as a synthesis of its models of its sub-components. • The model is compared to benchmark numerical simulations and experimental data at different stages. - Abstract: When considering solar based thermal energy input to an organic Rankine cycle (ORC), intermittent nature of the heat input does not only adversely affect the power output but also it may prevent ORC to operate under steady state conditions. In order to identify reliability and efficiency of such systems, this paper presents a simplified transient modeling approach for an ORC operating under variable heat input. The approach considers that response of the system to heat input variations is mainly dictated by the evaporator. Consequently, overall system is assembled using dynamic models for the heat exchangers (evaporator and condenser) and static models of the pump and the expander. In addition, pressure drop within heat exchangers is neglected. The model is compared to benchmark numerical and experimental data showing that the underlying assumptions are reasonable for cases where thermal input varies in time. Furthermore, the model is studied on another configuration and mass flow rates of both the working fluid and hot water and hot water’s inlet temperature to the ORC unit are shown to have direct influence on the system’s response

  16. ALKASYS, Rankine-Cycle Space Nuclear Power System

    International Nuclear Information System (INIS)

    2001-01-01

    1 - Description of program or function: The program ALKASYS is used for the creation of design concepts of multimegawatt space power systems that employ potassium Rankine power conversion cycles. 2 - Method of solution: ALKASYS calculates performance and design characteristics and mass estimates for the major subsystems composing the total power system. Design and engineering performance characteristics are determined by detailed engineering procedures rather than by empirical algorithms. Mass estimates are developed using basic design principles augmented in some cases by empirical coefficients determined from the literature. The reactor design is based on a fast spectrum, metallic-clad rod fuel element containing UN pellets. 3 - Restrictions on the complexity of the problem: ALKASYS was developed primarily for the analysis of systems with electric power in the range from 1,000 to 25,000 kW(e) and full-power life from 1 to 10 years. The program should be used with caution in systems that are limited by heat flux (which might indicate need for extended surfaces on fuel elements) or criticality (which might indicate the need for other geometries or moderators)

  17. Rankine cycle generators using geothermal fluids. Final progress report

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    The Rankine Cycle generator was delivered and installed at Gila Hot Springs. Trial runs were made at that time, using Freon 12 as the expansion fluid. These tests showed that the boiler capacity was inadequate. It could not extract enough heat to generate sufficient volumes of Freon gas at the heat and pressure necessary to operate the system at an acceptable level. Increasing and decreasing the flow of hot water had a direct influence on efficiency, but it was not a linear relationship. Added amounts of hot water increased the power very little, but raised the water temperature at the discharge point. This implied that the heat exchange capacity of the boiler was saturated. The reverse was found in the condenser system. There was little increase in pressure of the condenser when we switched from static to run mode. Efficiency was maintained even when the cold water flow was reduced as much as 40%. The tests using Freon 12 resulted in the conclusion that the boiler volume needs to be increased and/or the configuration changed to radically increase its efficiency.

  18. Organic Rankine cycle - review and research directions in engine applications

    Science.gov (United States)

    Panesar, Angad

    2017-11-01

    Waste heat to power conversion using Organic Rankine Cycles (ORC) is expected to play an important role in CO2 reductions from diesel engines. Firstly, a review of automotive ORCs is presented focusing on the pure working fluids, thermal architectures and expanders. The discussion includes, but is not limited to: R245fa, ethanol and water as fluids; series, parallel and cascade as architectures; dry saturated, superheated and supercritical as expansion conditions; and scroll, radial turbine and piston as expansion machines. Secondly, research direction in versatile expander and holistic architecture (NOx + CO2) are proposed. Benefits of using the proposed unconventional approaches are quantified using Ricardo Wave and Aspen HYSYS for diesel engine and ORC modelling. Results indicate that, the implementation of versatile piston expander tolerant to two-phase and using cyclopentane can potentially increase the highway drive cycle power by 8%. Furthermore, holistic architecture offering complete utilisation of charge air and exhaust recirculation heat increased the performance noticeably to 5% of engine power at the design point condition.

  19. Performance analysis of organic Rankine cycles using different working fluids

    Directory of Open Access Journals (Sweden)

    Zhu Qidi

    2015-01-01

    Full Text Available Low-grade heat from renewable or waste energy sources can be effectively recovered to generate power by an organic Rankine cycle (ORC in which the working fluid has an important impact on its performance. The thermodynamic processes of ORCs using different types of organic fluids were analyzed in this paper. The relationships between the ORC’s performance parameters (including evaporation pressure, condensing pressure, outlet temperature of hot fluid, net power, thermal efficiency, exergy efficiency, total cycle irreversible loss, and total heat-recovery efficiency and the critical temperatures of organic fluids were established based on the property of the hot fluid through the evaporator in a specific working condition, and then were verified at varied evaporation temperatures and inlet temperatures of the hot fluid. Here we find that the performance parameters vary monotonically with the critical temperatures of organic fluids. The values of the performance parameters of the ORC using wet fluids are distributed more dispersedly with the critical temperatures, compared with those of using dry/isentropic fluids. The inlet temperature of the hot fluid affects the relative distribution of the exergy efficiency, whereas the evaporation temperature only has an impact on the performance parameters using wet fluid.

  20. Utilisation of diesel engine waste heat by Organic Rankine Cycle

    International Nuclear Information System (INIS)

    Kölsch, Benedikt; Radulovic, Jovana

    2015-01-01

    In this paper, three different organic liquids were investigated as potential working fluids in an Organic Rankine Cycle. Performance of Methanol, Toluene and Solkatherm SES36 was modelled in an ORC powered by a diesel engine waste heat. The ORC model consists of a preheater, evaporator, superheater, turbine, pump and two condensers. With variable maximum cycle temperatures and high cycle pressures, the thermal efficiency, net power output and overall heat transfer area have been evaluated. Methanol was found to have the best thermal performance, but also required the largest heat transfer area. While Toluene achieved lower thermal efficiency, it showed great work potential at high pressures and relatively low temperatures. Our model identified the risks associated with employing these fluids in an ORC: methanol condensing during the expansion and toluene not sufficiently superheated at the turbine inlet, which can compromise the cycle operation. The best compromise between the size of heat exchanger and thermodynamic performance was found for Methanol ORC at intermediate temperatures and high pressures. Flammability and toxicity, however, remain the obstacles for safe implementation of both fluids in ORC systems. - Highlights: • ORC powered by diesel-engine waste heat was developed. • Methanol, Toluene and Solkatherm were considered as working fluids. • Methanol was selected due to the best overall thermal performance. • Optimal cycle operating parameters and heat exchanger area were evaluated

  1. Bottoming micro-Rankine cycles for micro-gas turbines

    International Nuclear Information System (INIS)

    Invernizzi, Costante; Iora, Paolo; Silva, Paolo

    2007-01-01

    This paper investigates the possibility of enhancing the performances of micro-gas turbines through the addition of a bottoming organic Rankine cycle which recovers the thermal power of the exhaust gases typically available in the range of 250-300 o C. The ORC cycles are particularly suitable for the recovery of heat from sources at variable temperatures, and for the generation of medium to small electric power. With reference to a micro-gas turbine with a size of about 100 kWe, a combined configuration could increase the net electric power by about 1/3, yielding an increase of the electrical efficiency of up to 40%. A specific analysis of the characteristics of different classes of working fluids is carried out in order to define a procedure to select the most appropriate fluid, capable of satisfying both environmental (ozone depletion potential, global warming potential) and technical (flammability, toxicity, fluid critical temperature and molecular complexity) concerns. Afterwards, a thermodynamic analysis is performed to ascertain the most favourable cycle thermodynamic conditions, from the point of view of heat recovery. Furthermore, a preliminary design of the ORC turbine (number of stages, outer diameter and rotational speed) is carried out

  2. Internal Combustion Engine (ICE) bottoming with Organic Rankine Cycles (ORCs)

    International Nuclear Information System (INIS)

    Vaja, Iacopo; Gambarotta, Agostino

    2010-01-01

    This paper describes a specific thermodynamic analysis in order to efficiently match a vapour cycle to that of a stationary Internal Combustion Engine (ICE). Three different working fluids are considered to represent the main classes of fluids, with reference to the shape of the vapour lines in the T-s diagram: overhanging, nearly isoentropic and bell shaped. First a parametric analysis is conducted in order to determine optimal evaporating pressures for each fluid. After which three different cycles setups are considered: a simple cycle with the use of only engine exhaust gases as a thermal source, a simple cycle with the use of exhaust gases and engine cooling water and a regenerated cycle. A second law analysis of the cycles is performed, with reference to the available heat sources. This is done in order to determine the best fluid and cycle configuration to be employed, the main parameters of the thermodynamic cycles and the overall efficiency of the combined power system. The analysis demonstrates that a 12% increase in the overall efficiency can be achieved with respect to the engine with no bottoming; nevertheless it has been observed that the Organic Rankine Cycles (ORCs) can recover only a small fraction of the heat released by the engine through the cooling water.

  3. Efficiency optimization potential in supercritical Organic Rankine Cycles

    Energy Technology Data Exchange (ETDEWEB)

    Schuster, A.; Aumann, R. [Technische Universitaet Muenchen Institute of Energy Systems Boltzmannstr. 15, 85748 Garching (Germany); Karellas, S. [National Technical University of Athens Laboratory of Steam Boilers and Thermal Plants Heroon Polytechniou 9, 15780 Athens (Greece)

    2010-02-15

    Nowadays, the use of Organic Rankine Cycle (ORC) in decentralised applications is linked with the fact that this process allows the use of low temperature heat sources and offers an advantageous efficiency in small-scale concepts. Many state-of-the-art and innovative applications can successfully use the ORC process. In this process, according to the heat source level, special attention must be drawn to the choice of the appropriate working fluid, which is a factor that affects the thermal and exergetic efficiency of the cycle. The investigation of supercritical parameters of various working fluids in ORC applications seems to bring promising results concerning the efficiency of the application. This paper presents the results from a simulation of the ORC and the optimization potential of the process when using supercritical parameters. In order to optimize the process, various working fluids are considered and compared concerning their thermal efficiency and the usable percentage of heat. The reduction of exergy losses is discussed based on the need of surplus heat exchanger surface. (author)

  4. Performance of an organic Rankine cycle with multicomponent mixtures

    International Nuclear Information System (INIS)

    Chaitanya Prasad, G.S.; Suresh Kumar, C.; Srinivasa Murthy, S.; Venkatarathnam, G.

    2015-01-01

    There is a renewed interest in ORC (organic Rankine cycle) systems for power generation using solar thermal energy. Many authors have studied the performance of ORC with different pure fluids as well as binary zeotropic mixtures in order to improve the thermal efficiency. It has not been well appreciated that zeotropic mixtures can also be used to reduce the size and cost of an ORC system. The main objective of this paper is to present mixtures that help reduce the cost while maintaining high thermal efficiency. The proposed method also allows us to design an optimum mixture for a given expander. This new approach is particularly beneficial for designing mixtures for small ORC systems operating with solar thermal energy. A number of examples are presented to demonstrate this concept. - Highlights: • The performance of an ORC operating with different zeotropic multicomponent mixtures is presented. • A thermodynamic method is proposed for the design of multicomponent mixtures for ORC power plants. • High exergy efficiency as well as high volumetric expander work can be achieved with appropriate mixtures. • The method allows design of mixtures that can be used with off-the-shelf positive displacement expanders

  5. Biogas Engine Waste Heat Recovery Using Organic Rankine Cycle

    Directory of Open Access Journals (Sweden)

    Alberto Benato

    2017-03-01

    Full Text Available Italy is a leading country in the biogas sector. Energy crops and manure are converted into biogas using anaerobic digestion and, then, into electricity using internal combustion engines (ICEs. Therefore, there is an urgent need for improving the efficiency of these engines taking the real operation into account. To this purpose, in the present work, the organic Rankine cycle (ORC technology is used to recover the waste heat contained in the exhaust gases of a 1 MWel biogas engine. The ICE behavior being affected by the biogas characteristics, the ORC unit is designed, firstly, using the ICE nameplate data and, then, with data measured during a one-year monitoring activity. The optimum fluid and the plant configuration are selected in both cases using an “in-house” optimization tool. The optimization goal is the maximization of the net electric power while the working fluid is selected among 115 pure fluids and their mixtures. Results show that a recuperative ORC designed using real data guarantees a 30% higher net electric power than the one designed with ICE nameplate conditions.

  6. Interhospital Transfer of Neurosurgical Patients: Implications of Timing on Hospital Course and Clinical Outcomes.

    Science.gov (United States)

    Holland, Christopher M; Lovasik, Brendan P; Howard, Brian M; McClure, Evan W; Samuels, Owen B; Barrow, Daniel L

    2017-09-01

    Interhospital transfer of neurosurgical patients is common; however, little is known about the impact of transfer parameters on clinical outcomes. Lower survival rates have been reported for patients admitted at night and on weekends in other specialties. Whether time or day of admission affects neurosurgical patient outcomes, specifically those transferred from other facilities, is unknown. To examine the impact of the timing of interhospital transfer on the hospital course and clinical outcomes of neurosurgical patients. All consecutive admissions of patients transferred to our adult neurosurgical service were retrospectively analyzed for a 1-year study period using data from a central transfer database and the electronic health record. Patients arrived more often at night (70.8%) despite an even distribution of transfer requests. The lack of transfer imaging did not affect length of stay, intervention times, or patient outcomes. Daytime arrivals had shorter total transfer time, but longer intenstive care unit and overall length of stay (8.7 and 11.6 days, respectively), worse modified Rankin Scale scores, lower rates of functional independence, and almost twice the mortality rate. Weekend admissions had significantly worse modified Rankin Scale scores and lower rates of functional independence. The timing of transfer arrivals, both by hour or day of the week, is correlated with the time to intervention, hospital course, and overall patient outcomes. Patients admitted during the weekend suffered worse functional outcomes and a trend towards increased mortality. While transfer logistics clearly impact patient outcomes, further work is needed to understand these complex relationships. Copyright © 2017 by the Congress of Neurological Surgeons.

  7. Influence of arterial occlusion on outcome after intravenous thrombolysis for acute ischemic stroke.

    Science.gov (United States)

    Medlin, Friedrich; Amiguet, Michael; Vanacker, Peter; Michel, Patrik

    2015-01-01

    We aimed to assess the interaction between intravenous thrombolysis (IVT) and arterial occlusion on acute cervicocerebral computed tomographic angiography on the outcome of patients with acute ischemic stroke. Patients from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) registry with onset-to-door-time ≤4 hours, acute cervicocerebral computed tomographic angiography, a premorbid modified Rankin Scale ≤2, and a National Institute of Health Stroke Scale (NIHSS) >4 were selected. Patients with significant intracranial arterial obstruction (≥50%-99%) and undergoing acute endovascular treatment were excluded. An interaction analysis of IVT and initial arterial occlusion for favorable 3 months outcome (modified Rankin Scale <3) were performed with adjustment for potential confounders. Among 654 included patients, 382 (58%) showed arterial occlusion, of whom 263 (69%) received IVT. Two hundred seventy-two showed no/minimal obstruction of whom 139 (51%) received IVT. In the adjusted interaction analysis, there was a trend in favor of the arterial occlusion group (odds ratio [OR]=3.97; 95% confidence interval [CI], 0.83-18.97; P=0.08). IVT (versus no IVT) was associated with better outcome in patients with occlusion (adjusted OR for favorable outcome, 3.01; 95% CI, 1.10-8.28) but not in patients with no/minimal obstruction (OR, 0.76; 95% CI, 0.21-2.74). Conversely, patients with occlusion had a similar rate of favorable outcome as no/minimal obstruction when thrombolysed (OR, 0.5; 95% CI, 0.17-1.47) but had a less favorable outcome without thrombolysis (OR, 0.13; 95% CI, 0.04-0.44). In this retrospective analysis of consecutive patients with acute ischemic stroke, there was a trend for more favorable outcomes with IVT in the setting of initial arterial occlusion than in the setting of no/minimal obstruction. Before confirmation in randomized controlled studies, this information should not influence thrombolysis decisions, however. © 2014 American Heart

  8. Discriminative ability of commonly used indices to predict adverse outcomes after poster lumbar fusion: a comparison of demographics, ASA, the modified Charlson Comorbidity Index, and the modified Frailty Index.

    Science.gov (United States)

    Ondeck, Nathaniel T; Bohl, Daniel D; Bovonratwet, Patawut; McLynn, Ryan P; Cui, Jonathan J; Shultz, Blake N; Lukasiewicz, Adam M; Grauer, Jonathan N

    2018-01-01

    As research tools, the American Society of Anesthesiologists (ASA) physical status classification system, the modified Charlson Comorbidity Index (mCCI), and the modified Frailty Index (mFI) have been associated with complications following spine procedures. However, with respect to clinical use for various adverse outcomes, no known study has compared the predictive performance of these indices specifically following posterior lumbar fusion (PLF). This study aimed to compare the discriminative ability of ASA, mCCI, and mFI, as well as demographic factors including age, body mass index, and gender for perioperative adverse outcomes following PLF. A retrospective review of prospectively collected data was performed. Patients undergoing elective PLF with or without interbody fusion were extracted from the 2011-2014 American College of Surgeons National Surgical Quality Improvement Program (NSQIP). Perioperative adverse outcome variables assessed included the occurrence of minor adverse events, severe adverse events, infectious adverse events, any adverse event, extended length of hospital stay, and discharge to higher-level care. Patient comorbidity indices and characteristics were delineated and assessed for discriminative ability in predicting perioperative adverse outcomes using an area under the curve analysis from the receiver operating characteristics curves. In total, 16,495 patients were identified who met the inclusion criteria. The most predictive comorbidity index was ASA and demographic factor was age. Of these two factors, age had the larger discriminative ability for three out of the six adverse outcomes and ASA was the most predictive for one out of six adverse outcomes. A combination of the most predictive demographic factor and comorbidity index resulted in improvements in discriminative ability over the individual components for five of the six outcome variables. For PLF, easily obtained patient ASA and age have overall similar or better

  9. Psychometric Evaluation of the Lower Extremity Computerized Adaptive Test, the Modified Harris Hip Score, and the Hip Outcome Score.

    Science.gov (United States)

    Hung, Man; Hon, Shirley D; Cheng, Christine; Franklin, Jeremy D; Aoki, Stephen K; Anderson, Mike B; Kapron, Ashley L; Peters, Christopher L; Pelt, Christopher E

    2014-12-01

    The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood. To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision. Cohort study (diagnosis); Level of evidence, 2. Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index. All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good. The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior in all psychometric aspects examined in this study. Future

  10. Organic Rankine cycle for power recovery of exhaust flue gas

    International Nuclear Information System (INIS)

    Guo, Cong; Du, Xiaoze; Yang, Lijun; Yang, Yongping

    2015-01-01

    To study the effects of different working fluids on the performance of organic Rankine cycle (ORC), three working fluids, a mixture that matches with heat source, a mixture that matches with heat sink and a pure working fluid, are selected in this paper. Thermodynamic models were built in Matlab together with REFPROP, with which, the physical properties of the selected working fluids can be acquired. Heat source of the ORC system is the exhaust flue gas of boiler in a 240 MW pulverized coal-fired power plant. Some indicators such as thermal efficiency, inlet temperature of expander, superheat degree, mass flow, volumetric flow, and exergy destruction distribution, as well as the influence of recuperator are studied. The analytical results show that the mixture that matches with heat sink has the greatest efficiency and the mixture that matches with heat source has the lowest superheat degree. The rate of heat exchanged in recuperator to that in evaporator has a maximum value with evaporating pressure. There exists no optimal working fluid for all indicators (thermal efficiency, heat exchanger area, mass flow and volumetric flow etc.). An appropriate working fluid should be chosen by taking both investment cost and power generating benefits into account. The cost-benefit ratio of the proposed ORC plant was evaluated either. - Highlights: • Three types of working fluids are selected for ORC using exhaust flue gas. • The mixture that matches with heat sink has the greatest efficiency. • The mixture that matches with heat source has the lowest superheat degree. • There does not exist a working fluid that satisfies all the indicators

  11. Analysis of Low Temperature Organic Rankine Cycles for Solar Applications

    Science.gov (United States)

    Li, Yunfei

    The present work focuses on Organic Rankine Cycle (ORC) systems and their application to low temperature waste heat recovery, combined heat and power as well as off-grid solar power generation applications. As CO_2 issues come to the fore front and fossil fuels become more expensive, interest in low grade heat recovery has grown dramatically in the past few years. Solar energy, as a clean, renewable, pollution-free and sustainable energy has great potential for the use of ORC systems. Several ORC solutions have been proposed to generate electricity from low temperature sources. The ORC systems discussed here can be applied to fields such as solar thermal, biological waste heat, engine exhaust gases, small-scale cogeneration, domestic boilers, etc. The current work presents a thermodynamic and economic analysis for the use of ORC systems to convert solar energy or low exergy energy to generate electrical power. The organic working fluids investigated here were selected to investigate the effect of the fluid saturation temperature on the performance of ORCs. The working fluids under investigation are R113, R245fa, R123, with boiling points between 40°C and 200°C at pressures from 10 kPa to 10 MPa. Ambient temperature air at 20oC to 30oC is utilized as cooling resource, and allowing for a temperature difference 10°C for effective heat transfer. Consequently, the working fluids are condensed at 40°C. A combined first- and second-law analysis is performed by varying some system independent parameters at various reference temperatures. The present work shows that ORC systems can be viable and economical for the applications such as waste heat use and off-grid power generation even though they are likely to be more expensive than grid power.

  12. Clinical outcomes and repair integrity after arthroscopic full-thickness rotator cuff repair: suture-bridge versus double-row modified Mason-Allen technique.

    Science.gov (United States)

    Lee, Kwang Won; Yang, Dae Suk; Lee, Gyu Sang; Ma, Chang Hyun; Choy, Won Sik

    2018-05-23

    This retrospective study compared the clinical and radiologic outcomes of patients who underwent arthroscopic rotator cuff repairs by the suture-bridge and double-row modified Mason-Allen techniques. From January 2012 to May 2013, 76 consecutive cases of full-thickness rotator cuff tear, 1 to 4 cm in the sagittal plane, for which arthroscopic rotator cuff repair was performed, were included. The suture-bridge technique was used in 37 consecutive shoulders; and the double-row modified Mason-Allen technique, in 39 consecutive shoulders. Clinical outcomes at a minimum of 2 years (mean, 35.7 months) were evaluated postoperatively using the visual analog scale; University of California, Los Angeles Shoulder Scale; American Shoulder and Elbow Surgeons Subjective Shoulder Scale; and Constant score. Postoperative cuff integrity was evaluated at a mean of 17.7 months by magnetic resonance imaging. At the final follow-up, the clinical outcomes improved in both groups (all P  .05). The retear rate was 18.9% in the shoulders subjected to suture-bridge repair and 12.8% in the double-row modified Mason-Allen group; the difference was not significant (P = .361). Despite the presence of fewer suture anchors, the patients who underwent double-row modified Mason-Allen repair had comparable shoulder functional outcomes and a comparable retear rate with those who underwent suture-bridge repair. Therefore, the double-row modified Mason-Allen repair technique can be considered an effective treatment for patients with medium- to large-sized full-thickness rotator cuff tears. Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Experimental investigation on a small pumpless ORC (organic rankine cycle) system driven by the low temperature heat source

    International Nuclear Information System (INIS)

    Gao, P.; Wang, L.W.; Wang, R.Z.; Jiang, L.; Zhou, Z.S.

    2015-01-01

    A small pumpless ORC (organic rankine cycle) system with different scroll expanders modified from compressors of the automobile air-conditioner is established, and the refrigerant R245fa is chosen as the working fluid. Different hot water temperatures of 80, 85, 90 and 95 °C are employed to drive the pumpless ORC system. Experimental results show that a maximum shaft power of 361.0 W is obtained under the hot water temperature of 95 °C, whereas the average shaft power is 155.8 W. The maximum energy efficiency of 2.3% and the maximum exergy efficiency of 12.8% are obtained at the hot water temperature of 90 °C. Meanwhile a test rig for investigating the mechanical loss of the scroll expander is established. The torque caused by the internal mechanical friction of the expander is about 0.4 N m. Additionally, another scroll expander with a displacement of 86 ml/r is also employed to investigate how scroll expander displacement influences the performance of the pumpless ORC system. Finally, the performance of the pumpless ORC system is compared with that of the conventional ORC system, and experimental results show that the small pumpless ORC system has more advantages for the low-grade heat recovery. - Highlights: • A small pumpless ORC (organic rankine cycle) system is established, and different scroll expanders are tested. • The maximum energy and exergy efficiency are 2.3% and 12.8% respectively. • A maximum shaft power of 361.0 W is obtained under the heat source temperature of 95 °C. • The small pumpless ORC system has characteristics of the high efficiency.

  14. Poor long-term functional outcome after stroke among adults aged 18 to 50 years: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation (FUTURE) study.

    Science.gov (United States)

    Synhaeve, Nathalie E; Arntz, Renate M; Maaijwee, Noortje A M; Rutten-Jacobs, Loes C A; Schoonderwaldt, Henny C; Dorresteijn, Lucille D A; de Kort, Paul L M; van Dijk, Ewoud J; de Leeuw, Frank-Erik

    2014-04-01

    Stroke in young adults has a dramatic effect on life; therefore, we investigated the long-term functional outcome after transient ischemic attack, ischemic stroke, or intracerebral hemorrhage in adults aged 18 to 50 years. We studied 722 young patients with first-ever stroke admitted between January 1, 1980, and November 1, 2010. Functional outcome was assessed by stroke subtype with the modified Rankin Scale and Instrumental Activities of Daily Living scale. After a mean follow-up of 9.1 (SD, 8.2) years, 32.0% of all patients had a poor functional outcome (modified Rankin Scale, >2); for ischemic stroke, this was 36.5%, for intracerebral hemorrhage 49.3%, and for transient ischemic attack 16.8%. At follow-up, 10.8% of transient ischemic attack, 14.6% of ischemic stroke, and 18.2% of intracerebral hemorrhage patients had a poor outcome as assessed by Instrumental Activities of Daily Living (ischemic stroke or intracerebral hemorrhage in young adults, 1 of 8 survivors is still dependent in daily life.

  15. Modified Pfannenstiel Open Approach as an Alternative to Laparoscopic Total Proctocolectomy and IPAA: Comparison of Short- and Long-term Outcomes and Quality of Life.

    Science.gov (United States)

    Duraes, Leonardo C; Schroeder, Destiny A; Dietz, David W

    2018-05-01

    A laparoscopic approach to total proctocolectomy with IPAA has been suggested to have better short-term outcomes and cosmesis, whereas open surgery by midline incision may result in shorter operative times. We hypothesized that a modified Pfannenstiel open approach would combine the advantages of both techniques. The purpose of this study was to compare outcomes of open total proctocolectomy with IPAA using a modified Pfannenstiel incision versus those following the laparoscopic approach. This was a retrospective study comparing patients submitted to open IPAA using modified Pfannenstiel incision versus laparoscopy from 1998 to 2014. The study was conducted at a high-volume tertiary referral center. Among 1275 patients, 119 patients underwent the laparoscopic approach and 33 underwent the modified Pfannenstiel approach. Short- and long-term outcomes were evaluated, and quality-of-life questionnaires were assessed. Patients who underwent the modified Pfannenstiel approach were younger, more often women, and had lower BMI and ASA classification compared with those who underwent laparoscopy. Surgical time was lower in Pfannenstiel, and no difference was observed in length of hospital stay. No difference was observed in postoperative complications, pouch failure rate, or quality of life. Patients were then matched 1:1 by diagnosis, sex, age (±5 y) and BMI (±5 kg/m). The Pfannenstiel approach still had a shorter surgical time. No difference was observed in the length of hospital stay, complications, pouch failure, or quality of life. In long-term follow-up, pouchitis symptoms occurred more frequently in Pfannenstiel (mean follow-up = 7.3 y), and seepage was more frequently observed in the laparoscopy group (mean follow-up = 4.2 y). These differences were not observed in matched patients. The study was limited by its retrospective design and inherent selection bias. The modified Pfannenstiel approach provides equivalent short- and long-term outcomes and similar

  16. Blood hsCRP And PGE2 Content With Clinical Outcome Using Modified Fenestrat Restorative Spinoplasty Better Than Lamonectomy-Fusion In Lumbar Stenosis

    OpenAIRE

    T Mahadewa; Sri Maliawan; A Raka-Sudewi; M Wiryana

    2012-01-01

    Objective: Modified Fenestration-Restorative Spinoplasty (MFRS) technique is an alternative to lumbar stenosis treatment, providing the equal decompression comparing with laminectomy techniques, without the implant, less expensive and complication rates. The purpose of this study was to determine which technique gives better inflammation and clinical outcome based on high sensitive C-Reactive Protein biomarker (hsCRP) and Prostaglandin E2 (PGE 2), Visua...

  17. Tofacitinib with conventional synthetic disease‐modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis: Patient‐reported outcomes from a Phase 3 randomized controlled trial

    OpenAIRE

    Li, Zhanguo; An, Yuan; Su, Houheng; Li, Xiangpei; Xu, Jianhua; Zheng, Yi; Li, Guiye; Kwok, Kenneth; Wang, Lisy; Wu, Qizhe

    2018-01-01

    Abstract Aim Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease‐modifying anti rheumatic drugs (csDMARDs) on patient‐reported outcomes in Chinese patients with RA and inadequate response to DMARDs. Methods This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, p...

  18. ORACLE Stroke Study: Opinion Regarding Acceptable Outcome Following Decompressive Hemicraniectomy for Ischemic Stroke.

    Science.gov (United States)

    Honeybul, Stephen; Ho, Kwok M; Blacker, David W

    2016-08-01

    There continues to be considerable interest in the use of decompressive hemicraniectomy in the management of malignant cerebral artery infarction; however, concerns remain about long-term outcome. To assess opinion on consent and acceptable outcome among a wide range of healthcare workers. Seven hundred seventy-three healthcare workers at the 2 major public neurosurgical centers in Western Australia participated. Participants were asked to record their opinion on consent and acceptable outcome based on the modified Rankin Score (mRS). The evidence for clinical efficacy of the procedure was presented, and participants were then asked to reconsider their initial responses. Of the 773 participants included in the study, 407 (52.7%) initially felt that they would provide consent for a decompressive craniectomy as a lifesaving procedure, but only a minority of them considered an mRS score of 4 or 5 an acceptable outcome (for mRS score ≤4, n = 67, 8.7%; for mRS score = 4, n = 57, 7.4%). After the introduction of the concept of the disability paradox and the evidence for the clinical efficacy of decompressive craniectomy, more participants were unwilling to accept decompressive craniectomy (18.1% vs 37.8%), but at the same time, more were willing to accept an mRS score ≤4 as an acceptable outcome (for mRS score ≤4, n = 92, 11.9%; for mRS score = 4, n = 79, 10.2%). Most participants felt survival with dependency to be unacceptable. However, many would be willing to provide consent for surgery in the hopes that they may survive with some degree of independence. DESTINY, Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral ArterymRS, modified Rankin Scale.

  19. Experimental Study of a Low-Temperature Power Generation System in an Organic Rankine Cycle

    DEFF Research Database (Denmark)

    Mu, Yongchao; Zhang, Yufeng; Deng, Na

    2015-01-01

    This paper presents a new power generation system under the principle of organic Rankine cycle which can generate power with a low-temperature heat source. A prototype was built to investigate the proposed system. In the prototype, an air screw compressor was converted into an expander and used...... as the engine of the power generator. The style of the preheater was a shell and tube heat exchanger, which could provide a long path for the working fluid. A flooded heat exchanger with a high heat transfer coefficient was taken as the evaporator. R134a was used as working fluid for the Rankine cycle......, the average isentropic efficiency of the screw expander was 68%, and the efficiency of power generation varies from 1.2 to 4.56%. The highest value of thermodynamical perfectness was 29.06%. It can be concluded that organic Rankine cycle could be competitive for recovering low-temperature heat source...

  20. A review of the use of organic Rankine cycle power systems for maritime applications

    DEFF Research Database (Denmark)

    Mondejar, M. E.; Andreasen, J. G.; Pierobon, L.

    2018-01-01

    combustion, geothermal reservoirs, and waste heat from industrial processes. However, its economic feasibility has not yet been demonstrated for marine applications. This paper aims at evaluating the potential of using organic Rankine cycle systems for waste heat recovery aboard ships. The suitable vessels......Diesel engines are by far the most common means of propulsion aboard ships. It is estimated that around half of their fuel energy consumption is dissipated as low-grade heat. The organic Rankine cycle technology is a well-established solution for the energy conversion of thermal power from biomass...... in order to tackle the challenges limiting a widespread use of this technology in currently operating vessels and new-buildings. The results indicate that organic Rankine cycle units recovering heat from the exhaust gases of engines using low-sulfur fuels could yield fuel savings between 10% and 15%....

  1. Power generation and heating performances of integrated system of ammonia–water Kalina–Rankine cycle

    International Nuclear Information System (INIS)

    Zhang, Zhi; Guo, Zhanwei; Chen, Yaping; Wu, Jiafeng; Hua, Junye

    2015-01-01

    Highlights: • Integrated system of ammonia–water Kalina–Rankine cycle (AWKRC) is investigated. • Ammonia–water Rankine cycle is operated for cogenerating room heating-water in winter. • Kalina cycle with higher efficiency is operated for power generation in other seasons. • Power recovery efficiency accounts thermal efficiency and waste heat absorbing ratio. • Heating water with 70 °C and capacity of 55% total reclaimed heat load is cogenerated. - Abstract: An integrated system of ammonia–water Kalina–Rankine cycle (AWKRC) for power generation and heating is introduced. The Kalina cycle has large temperature difference during evaporation and small one during condensation therefore with high thermal efficiency for power generation, while the ammonia–water Rankine cycle has large temperature difference during condensation as well as evaporation, thus it can be adopted to generate heating-water as a by-product in winter. The integrated system is based on the Kalina cycle and converted to the Rankine cycle with a set of valves. The performances of the AWKRC system in different seasons with corresponding cycle loops were studied and analyzed. When the temperatures of waste heat and cooling water are 300 °C and 25 °C respectively, the thermal efficiency and power recovery efficiency of Kalina cycle are 20.9% and 17.4% respectively in the non-heating seasons, while these efficiencies of the ammonia–water Rankine cycle are 17.1% and 13.1% respectively with additional 55.3% heating recovery ratio or with comprehensive efficiency 23.7% higher than that of the Kalina cycle in heating season

  2. Study of working fluid selection of organic Rankine cycle (ORC) for engine waste heat recovery

    International Nuclear Information System (INIS)

    Wang, E.H.; Zhang, H.G.; Fan, B.Y.; Ouyang, M.G.; Zhao, Y.; Mu, Q.H.

    2011-01-01

    Organic Rankine Cycle (ORC) could be used to recover low-grade waste heat. When a vehicle is running, the engine exhaust gas states have a wide range of variance. Defining the operational conditions of the ORC that achieve the maximum utilization of waste heat is important. In this paper the performance of different working fluids operating in specific regions was analyzed using a thermodynamic model built in Matlab together with REFPROP. Nine different pure organic working fluids were selected according to their physical and chemical properties. The results were compared in the regions when net power outputs were fixed at 10 kW. Safety levels and environmental impacts were also evaluated. The outcomes indicate that R11, R141b, R113 and R123 manifest slightly higher thermodynamic performances than the others; however, R245fa and R245ca are the most environment-friendly working fluids for engine waste heat-recovery applications. The optimal control principle of ORC under the transient process is discussed based on the analytical results. -- Highlights: → R11, R141b, R113 and R123 manifest the best thermodynamic performances. → R245fa and R245ca are the most environment-friendly working fluids for the engine waste heat-recovery application. → The condensing temperature has more important effect than the evaporating pressure to the performance of ORC. → The optimal control principle of ORC under the transient process was defined according to the calculation results for the vehicle engine waste heat-recovery application. → ORC thermodynamic model was built in Matlab together with REFPROP.

  3. Equation of State Selection for Organic Rankine Cycle Modeling Under Uncertainty

    DEFF Research Database (Denmark)

    Frutiger, Jerome; O'Connell, John; Abildskov, Jens

    In recent years there has been a great interest in the design and selection of working fluids for low-temperature Organic Rankine Cycles (ORC), to efficiently produce electrical power from waste heat from chemical engineering applications, as well as from renewable energy sources such as biomass...... cycle, all influence the model output uncertainty. The procedure is highlighted for an ORC for with a low-temperature heat source from exhaust gas from a marine diesel engine.[1] Saleh B, Koglbauer G, Wendland M, Fischer J. Working fluids for lowtemperature organic Rankine cycles. Energy 2007...

  4. Optimal design of compact organic Rankine cycle units for domestic solar applications

    DEFF Research Database (Denmark)

    Barbazza, Luca; Pierobon, Leonardo; Mirandola, Alberto

    2014-01-01

    criteria, i.e., compactness, high performance and safe operation, are targeted by adopting a multi-objective optimization approach modeled with the genetic algorithm. Design-point thermodynamic variables, e.g., evaporating pressure, the working fluid, minimum allowable temperature differences......Organic Rankine cycle turbogenerators are a promising technology to transform the solar radiation harvested by solar collectors into electric power. The present work aims at sizing a small-scale organic Rankine cycle unit by tailoring its design for domestic solar applications. Stringent design...

  5. Combined Turbine and Cycle Optimization for Organic Rankine Cycle Power Systems—Part A

    DEFF Research Database (Denmark)

    Meroni, Andrea; La Seta, Angelo; Andreasen, Jesper Graa

    2016-01-01

    Axial-flow turbines represent a well-established technology for a wide variety of power generation systems. Compactness, flexibility, reliability and high efficiency have been key factors for the extensive use of axial turbines in conventional power plants and, in the last decades, in organic...... Rankine cycle power systems. In this two-part paper, an overall cycle model and a model of an axial turbine were combined in order to provide a comprehensive preliminary design of the organic Rankine cycle unit, taking into account both cycle and turbine optimal designs. Part A presents the preliminary...

  6. Endovascular treatment outcomes using the Stroke Triage Education, Procedure Standardization, and Technology (STEPS-T) program.

    Science.gov (United States)

    Hassan, Ameer E; Sanchez, Christina; Johnson, Angela N

    2018-02-01

    Background "Door to treatment" time affects outcomes of acute ischemic stroke (AIS) patients undergoing endovascular treatment (EVT). However, the correlation between staff education and accessible technology with stroke outcomes has not been demonstrated. Objective The objective of this paper is to demonstrate the five-year impact of the Stroke Triage Education, Procedure Standardization, and Technology (STEPS-T) program on time-to-treat and clinical outcomes. Methods The study analyzed a prospectively maintained database of AIS patients who benefited from EVT through implementation of STEPS-T. Demographics, clinical characteristics, and modified Rankin Score at three months were analyzed. Thrombolysis in Cerebral Infarction (TICI) scale was used to grade pre- and post-procedure angiographic recanalization. Using electronic hemodynamic recording, stepwise workflow times were collected for door time (T D ), entering angiography suite (T A ), groin puncture (T G ), first DSA (T DSA ), microcatheter placement (T M ), and final recanalization (T R ). Median intervention time (T A to T R ) and recanalization time (T G to T R ) were compared through Year 1 to Year 5. Results A total of 230 individuals (age 74 ± 12, between 30 to 95) were enrolled. Median intervention and recanalization times were significantly reduced, from 121 minutes to 52 minutes and from 83 minutes to 36 minutes respectively from Year 1 to Year 5, ( p < 0.001). Across the study period, annual recruitment went up from 12 to 66 patients, and modified Rankin Score between 0 and 2 increased from 36% to 59% ( p = 0.024). Conclusions STEPS-T improved time-to-treat in patients undergoing mechanical thrombectomy for AIS. During the observation period, clinical outcomes significantly improved.

  7. Outcomes of the modified Brostrom procedure using suture anchors for chronic lateral ankle instability--a prospective, randomized comparison between single and double suture anchors.

    Science.gov (United States)

    Cho, Byung-Ki; Kim, Yong-Min; Kim, Dong-Soo; Choi, Eui-Sung; Shon, Hyun-Chul; Park, Kyoung-Jin

    2013-01-01

    The present prospective, randomized study was conducted to compare the clinical outcomes of the modified Brostrom procedure using single and double suture anchors for chronic lateral ankle instability. A total of 50 patients were followed up for more than 2 years after undergoing the modified Brostrom procedure. Of the 50 procedures, 25 each were performed using single and double suture anchors by 1 surgeon. The Karlsson scale had improved significantly to 89.8 points and 90.6 points in the single and double anchor groups, respectively. Using the Sefton grading system, 23 cases (92%) in the single anchor group and 22 (88%) in the double anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation on stress radiographs using the Telos device had improved significantly to an average of 5.7° and 4.6 mm in the single anchor group and 4.5° and 4.3 mm in the double anchor group, respectively. The double anchor technique was superior with respect to the postoperative talar tilt. The single and double suture anchor techniques produced similar clinical and functional outcomes, with the exception of talar tilt as a reference of mechanical stability. The modified Brostrom procedure using both single and double suture anchors appears to be an effective treatment method for chronic lateral ankle instability. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Clinical outcomes of modified minimally invasive approach and de-rotation of symptomatic chronic gastric volvulus – A tertiary centre experience

    Directory of Open Access Journals (Sweden)

    Bin Chet Toh

    Full Text Available Introduction: Gastric volvulus is a surgical condition that should be recognised promptly to prevent life-threatening gastric ischaemia and perforation in acute setting. There are two peak age group of incidence with children less than one year old and at fifth decade.1 The mortality rates for acute gastric volvulus remain high with reported range from 30% to 50% signifying the need of early diagnosis and treatment.2 These case series reported modified minimal invasive approach for symptomatic chronic gastric volvulus in a tertiary upper gastrointestinal unit in Singapore. Methods: Retrospective case series reviewed in single centre from 1st May 2016 to 1st May 2017 of clinical outcomes of modified minimally invasive approach and de-rotation of symptomatic chronic gastric volvulus. Results: Three symptomatic patients with evidence of gastric volvulus on CT-scan underwent minimally invasive repair with the aids of GastriSail™ Gastric positioning system. GastriSail™ was used for gastric volvulus de-rotation prior to repair definitely. Two patients had fundoplication done and one patient had gastropexy performed successfully. All patients started on blended diet post-operative day 1 and discharged well. Patient remained asymptomatic and nil recurrence at 3 months follow-up post-operation. Conclusion: Based on our experience, we advocate modified minimally invasive repair of chronic gastric volvulus as an alternative to traditional open surgical technique with acceptable good clinical outcomes. Keywords: Chronic gastric volvulus, Minimal invasive surgery, Upper gastrointestinal tract

  9. Multiple regression models for the prediction of the maximum obtainable thermal efficiency of organic Rankine cycles

    DEFF Research Database (Denmark)

    Larsen, Ulrik; Pierobon, Leonardo; Wronski, Jorrit

    2014-01-01

    Much attention is focused on increasing the energy efficiency to decrease fuel costs and CO2 emissions throughout industrial sectors. The ORC (organic Rankine cycle) is a relatively simple but efficient process that can be used for this purpose by converting low and medium temperature waste heat ...

  10. Constrained multi-objective optimization of radial expanders in organic Rankine cycles by firefly algorithm

    International Nuclear Information System (INIS)

    Bahadormanesh, Nikrouz; Rahat, Shayan; Yarali, Milad

    2017-01-01

    Highlights: • A multi-objective optimization for radial expander in Organic Rankine Cycles is implemented. • By using firefly algorithm, Pareto front based on the size of turbine and thermal efficiency is produced. • Tension and vibration constrains have a significant effect on optimum design points. - Abstract: Organic Rankine Cycles are viable energy conversion systems in sustainable energy systems due to their compatibility with low-temperature heat sources. In the present study, one dimensional model of radial expanders in conjunction with a thermodynamic model of organic Rankine cycles is prepared. After verification, by defining thermal efficiency of the cycle and size parameter of a radial turbine as the objective functions, a multi-objective optimization was conducted regarding tension and vibration constraints for 4 different organic working fluids (R22, R245fa, R236fa and N-Pentane). In addition to mass flow rate, evaporator temperature, maximum pressure of cycle and turbo-machinery design parameters are selected as the decision variables. Regarding Pareto fronts, by a little increase in size of radial expanders, it is feasible to reach high efficiency. Moreover, by assessing the distribution of decision variables, the variables that play a major role in trending between the objective functions are found. Effects of mechanical and vibration constrains on optimum decision variables are investigated. The results of optimization can be considered as an initial values for design of radial turbines for Organic Rankine Cycles.

  11. Technical and economical feasibility of the Rankine compression gas turbine (RCG)

    NARCIS (Netherlands)

    Ouwerkerk, H.; Lange, de H.C.

    2006-01-01

    The Rankine compression gas turbine (RCG) is a new type of combined cycle, i.e. combined steam and gas turbine installation, that returns all shaft power on one free power turbine. The novelty of the RCG is that the steam turbine drives the compressor of the gas turbine cycle. This way, the turbine

  12. Performance analysis of different organic Rankine cycle configurations on board liquefied natural gas-fuelled vessels

    DEFF Research Database (Denmark)

    Baldasso, Enrico; Andreasen, Jesper Graa; Meroni, Andrea

    2017-01-01

    Gas-fuelled shipping is expected to increase significantly in the coming years. Similarly, much effort is devoted to the study of waste heat recovery systems to be implemented on board ships. In this context, the organic Rankine cycle (ORC) technology is considered one of the most promising...

  13. A thermodynamic study of waste heat recovery from GT-MHR using organic Rankine cycles

    International Nuclear Information System (INIS)

    Yari, Mortaza; Mahmoudi, S.M.S.

    2011-01-01

    This paper presents an investigation on the utilization of waste heat from a gas turbine-modular helium reactor (GT-MHR) using different arrangements of organic Rankine cycles (ORCs) for power production. The considered organic Rankine cycles were: simple organic Rankine cycle (SORC), ORC with internal heat exchanger (HORC) and regenerative organic Rankine cycle (RORC). The performances of the combined cycles were studied from the point of view of first and second-laws of thermodynamics. Individual models were developed for each component and the effects of some important parameters such as compressor pressure ratio, turbine inlet temperature, and evaporator and environment temperatures on the efficiencies and on the exergy destruction rate were studied. Finally the combined cycles were optimized thermodynamically using the EES (Engineering Equation Solver) software. Based on the identical operating conditions for the GT-MHR cycle, a comparison between the three combined cycles and a simple GT-MHR cycle is also were made. This comparison was also carried out from the point of view of economics. The GT-MHR/SORC combined cycle proved to be the best among all the cycles from the point of view of both thermodynamics and economics. The efficiency of this cycle was about 10% higher than that of GT-MHR alone. (orig.)

  14. Design of organic Rankine cycle power systems accounting for expander performance

    DEFF Research Database (Denmark)

    La Seta, Angelo; Andreasen, Jesper Graa; Pierobon, Leonardo

    2015-01-01

    Organic Rankine cycle power systems have recently emerged as promising solutions for waste heat recovery in low- and medium-size power plants. Their performance and economic feasibility strongly depend on the expander. Its design process and efficiency estimation are particularly challenging due...

  15. Working fluid charge oriented off-design modeling of a small scale Organic Rankine Cycle system

    International Nuclear Information System (INIS)

    Liu, Liuchen; Zhu, Tong; Ma, Jiacheng

    2017-01-01

    Highlights: • Organic Rankine Cycle model considering working fluid charge has been established. • Overall solution algorithm of system off-design performance is proposed. • Variation trend of different zones in both heat exchangers can be observed. • Optimal working fluid charge volume for different output work has been estimated. - Abstract: Organic Rankine Cycle system is one of the most widely used technique for low-grade waste heat recovery. Developing of dynamic Organic Rankine Cycle models played an increasingly important part in system performance prediction. The present paper developed a working fluid charge oriented model for an small scale Organic Rankine Cycle to calculate the theoretical value of working fluid charge level for the system under rated condition. The two heat exchangers are divided into three different zones and related heat transfer correlations are employed to estimate the length variation of each zones. Steady state models have been applied to describe the performance of pump and expander. Afterwards, an overall solution algorithm based on the established model has been proposed in order to exact simulate the system’s off-design performance. Additionally, the impact of different working fluid charge volumes has also been discussed. Simulation results clearly shows the variation trend of different zones in both heat exchangers, as well as the variation trend of system operating parameters under various expander output work. Furthermore, the highest thermal efficiency can be reached 6.37% under rated conditions with a working fluid charge volume of 34.6 kg.

  16. Modelling of an air-cooled two-stage Rankine cycle for electricity production

    International Nuclear Information System (INIS)

    Liu, Bo

    2014-01-01

    This work considers a two stage Rankine cycle architecture slightly different from a standard Rankine cycle for electricity generation. Instead of expanding the steam to extremely low pressure, the vapor leaves the turbine at a higher pressure then having a much smaller specific volume. It is thus possible to greatly reduce the size of the steam turbine. The remaining energy is recovered by a bottoming cycle using a working fluid which has a much higher density than the water steam. Thus, the turbines and heat exchangers are more compact; the turbine exhaust velocity loss is lower. This configuration enables to largely reduce the global size of the steam water turbine and facilitate the use of a dry cooling system. The main advantage of such an air cooled two stage Rankine cycle is the possibility to choose the installation site of a large or medium power plant without the need of a large and constantly available water source; in addition, as compared to water cooled cycles, the risk regarding future operations is reduced (climate conditions may affect water availability or temperature, and imply changes in the water supply regulatory rules). The concept has been investigated by EDF R and D. A 22 MW prototype was developed in the 1970's using ammonia as the working fluid of the bottoming cycle for its high density and high latent heat. However, this fluid is toxic. In order to search more suitable working fluids for the two stage Rankine cycle application and to identify the optimal cycle configuration, we have established a working fluid selection methodology. Some potential candidates have been identified. We have evaluated the performances of the two stage Rankine cycles operating with different working fluids in both design and off design conditions. For the most acceptable working fluids, components of the cycle have been sized. The power plant concept can then be evaluated on a life cycle cost basis. (author)

  17. A hybrid Rankine cycle (HyRC) with ambient pressure combustion (APC)

    International Nuclear Information System (INIS)

    Wu, Lijun; Thimsen, David; Clements, Bruce; Zheng, Ligang; Pomalis, Richard

    2014-01-01

    The main losses in thermal power generation include heat in exhaust flue gas, heat rejected through steam condensation of low-pressure turbine, and exergy destruction in heat exchange process etc. To the extent that the heat losses are significantly greater in temperature than either air or water coolant resources, these losses also represent exergy losses which might be exploited to improve plant capacity and efficiency. This paper presents a hybrid Rankine cycle (HyRC) with an ambient pressure combustion (APC) boiler to address the recovery potential of these losses within the steam Rankine cycle (SRC). The APC–HyRC concept employs an organic Rankine cycle (ORC) to supplement SRC and to reduce cycle energy losses to the atmosphere since organic fluids are capable of lowering cycle condensation temperature when a very low temperature heat sink is available. The case studies based on a 399 MW SRC unit show that the APC–HyRC configurations have better thermodynamic performance than its base case SRC at a cycle condensation temperature of 30 °C and below. The best APC–HyRC configuration generates up to 14% more power than the baseline steam cycle which is a 5.45% increase in overall gross efficiency with a cycle condensation temperature at 4 °C. - Highlights: • A hybrid Rankine cycle with water and organic fluid is presented. • Heat losses in exhaust flue gas and exhaust steam are reduced. • Exergy losses in regeneration process are reduced. • Efficiency improvements are made to the conventional steam Rankine cycle. • Issues in design/construction of greenfield and repowering project are discussed

  18. The total cholesterol to high-density lipoprotein cholesterol as a predictor of poor outcomes in a Chinese population with acute ischaemic stroke.

    Science.gov (United States)

    Chen, Lifang; Xu, Jianing; Sun, Hao; Wu, Hao; Zhang, Jinsong

    2017-11-01

    High admission cholesterol has been associated with better outcome after acute ischaemic stroke (AIS), but a paradox not completely illustrated. The purpose of this study was to investigate the effect of the total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) on short-term survival after AIS. Consecutive patients admitted in 2013 and 2015 were enrolled in the present study. The logistic regression analysis was conducted to evaluate predictors of 3-month outcomes. The primary endpoint was death. Secondary endpoint was good (modified Rankin Scale score 0-2 or equal to prestrike modified Rankin Scale score) at 3 months. Of 871 patients enrolled in the final analysis, 94 (10.8%) individuals died during 3 months of observation. The serum TC and TC/HDL-C levels at admission were significantly associated with stroke outcomes at 3 months, and the HDL-C level was only correlated with the good outcomes at 3 months. Mortality risk was markedly decreased for patients with high TC/HDL-C ratio (odds ratio: 0.23, 95% confidence interval [CI]: 0.10-0.50 for Q4:Q1; P-trend <.001) after adjustment. The effect of TC/HDL-C ratio on the probability of good outcomes was still obvious (odds ratio: 2.18, 95% CI: 1.40-3.39 for Q4:Q1; P-trend=.029). According to the receiver operating characteristic analyses, the best discriminating factor was a TG/HDL-C ≥3.37 (area under the ROC curve [AUC]=0.643, sensitivity 61.3%, specificity 61.7%) as well as the TC/HDL-C ≥4.09 for good outcomes (AUC: 0.587, sensitivity 63.9%, specificity 79.7%). High TC/HDL-C ratio may be associated with increased short-term survival and better outcomes after AIS. © 2017 Wiley Periodicals, Inc.

  19. PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) Scale in Stroke: A Validation Study.

    Science.gov (United States)

    Katzan, Irene L; Lapin, Brittany

    2018-01-01

    The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P 0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.

  20. Safety and functional outcome of thrombolysis in dissection-related ischemic stroke: a meta-analysis of individual patient data.

    Science.gov (United States)

    Zinkstok, Sanne M; Vergouwen, Mervyn D I; Engelter, Stefan T; Lyrer, Philippe A; Bonati, Leo H; Arnold, Marcel; Mattle, Heinrich P; Fischer, Urs; Sarikaya, Hakan; Baumgartner, Ralf W; Georgiadis, Dimitrios; Odier, Céline; Michel, Patrik; Putaala, Jukka; Griebe, Martin; Wahlgren, Nils; Ahmed, Niaz; van Geloven, Nan; de Haan, Rob J; Nederkoorn, Paul J

    2011-09-01

    The safety and efficacy of thrombolysis in cervical artery dissection (CAD) are controversial. The aim of this meta-analysis was to pool all individual patient data and provide a valid estimate of safety and outcome of thrombolysis in CAD. We performed a systematic literature search on intravenous and intra-arterial thrombolysis in CAD. We calculated the rates of pooled symptomatic intracranial hemorrhage and mortality and indirectly compared them with matched controls from the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. We applied multivariate regression models to identify predictors of excellent (modified Rankin Scale=0 to 1) and favorable (modified Rankin Scale=0 to 2) outcome. We obtained individual patient data of 180 patients from 14 retrospective series and 22 case reports. Patients were predominantly female (68%), with a mean±SD age of 46±11 years. Most patients presented with severe stroke (median National Institutes of Health Stroke Scale score=16). Treatment was intravenous thrombolysis in 67% and intra-arterial thrombolysis in 33%. Median follow-up was 3 months. The pooled symptomatic intracranial hemorrhage rate was 3.1% (95% CI, 1.3 to 7.2). Overall mortality was 8.1% (95% CI, 4.9 to 13.2), and 41.0% (95% CI, 31.4 to 51.4) had an excellent outcome. Stroke severity was a strong predictor of outcome. Overlapping confidence intervals of end points indicated no relevant differences with matched controls from the Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register. Safety and outcome of thrombolysis in patients with CAD-related stroke appear similar to those for stroke from all causes. Based on our findings, thrombolysis should not be withheld in patients with CAD.

  1. A Comparison of Organic and Steam Rankine Cycle Power Systems for Waste Heat Recovery on Large Ships

    Directory of Open Access Journals (Sweden)

    Jesper Graa Andreasen

    2017-04-01

    Full Text Available This paper presents a comparison of the conventional dual pressure steam Rankine cycle process and the organic Rankine cycle process for marine engine waste heat recovery. The comparison was based on a container vessel, and results are presented for a high-sulfur (3 wt % and low-sulfur (0.5 wt % fuel case. The processes were compared based on their off-design performance for diesel engine loads in the range between 25% and 100%. The fluids considered in the organic Rankine cycle process were MM(hexamethyldisiloxane, toluene, n-pentane, i-pentane and c-pentane. The results of the comparison indicate that the net power output of the steam Rankine cycle process is higher at high engine loads, while the performance of the organic Rankine cycle units is higher at lower loads. Preliminary turbine design considerations suggest that higher turbine efficiencies can be obtained for the ORC unit turbines compared to the steam turbines. When the efficiency of the c-pentane turbine was allowed to be 10% points larger than the steam turbine efficiency, the organic Rankine cycle unit reaches higher net power outputs than the steam Rankine cycle unit at all engine loads for the low-sulfur fuel case. The net power production from the waste heat recovery units is generally higher for the low-sulfur fuel case. The steam Rankine cycle unit produces 18% more power at design compared to the high-sulfur fuel case, while the organic Rankine cycle unit using MM produces 33% more power.

  2. Energy efficiency analysis of Organic Rankine Cycles with scroll expanders for cogenerative applications

    International Nuclear Information System (INIS)

    Clemente, Stefano; Micheli, Diego; Reini, Mauro; Taccani, Rodolfo

    2012-01-01

    Highlights: ► We present an ORC model composed of a scroll 1D model and a cycle thermodynamic one. ► High-series production components from HVAC field are considered to reduce costs. ► Couplings of the micro-CHP with low-temperature heat sources are analyzed. ► Small and low-cost CHP systems with acceptable electrical efficiency are realizable. ► Higher electrical efficiency are possible modifying the scroll geometry. -- Abstract: Small scale Organic Rankine Cycle (ORC) systems has been the object of a large number of studies in the last decade, because of their suitability for energy recovery and cogenerative applications. The paper presents an ORC numerical model and its applications to two different case studies; the code has been obtained by combining a one-dimensional model of a scroll machine and a thermodynamic model of a whole ORC system. Series production components, such as scroll compressors, from HVAC field, have been first considered in order to reduce costs, because this is a critical issue for small scale energy recovery and cogeneration systems. The detailed model of the scroll machine is capable to calculate the performances of both a compressor and an expander, as function of the geometry of the device and of the working fluid. The model has been first tested and validated by comparing its outputs with experimental tests on a commercial scroll compressor, then used to calculate the working curves of commercial scroll machines originally designed as compressors in the HVAC field, but operating as expanders. The model of the expander has been then integrated in the thermodynamic model of the ORC system. A series of comparisons have been carried out in order to evaluate how the performances are influenced by cycle parameters, scroll geometry and working fluid for different applications. The results confirm the feasibility of small scale CHP systems with acceptable electrical efficiency, taking into account the low-temperature thermal source

  3. Reliability and validity of a modified MEDFICTS dietary fat screener in South African schoolchildren are determined by use and outcome measures.

    Science.gov (United States)

    Wenhold, Friedeburg Anna Maria; MacIntyre, Una Elizabeth; Rheeder, Paul

    2014-06-01

    In South Africa, noncommunicable diseases and obesity are increasing and also affect children. No validated assessment tools for fat intake are available. To determine test-retest reliability and relative validity of a pictorial modified meats, eggs, dairy, fried foods, fats in baked goods, convenience foods, table fats, and snacks (MEDFICTS) dietary fat screener. We determined test-retest reliability and diagnostic accuracy with the modified MEDFICTS as the index test and a 3-day weighed food record and parental completion of the screener as primary and secondary reference methods, respectively. Grade-six learners (aged 12 years, 4 months) in an urban, middle-class school (n=93) and their parents (n=72). Portion size, frequency of intake, final score, and classification of fat intake of the modified MEDFICTS, and percent energy from fat, saturated fatty acids, and cholesterol of the food record. For categorical data agreement was based on kappa statistics, McNemar's test for symmetry, and diagnostic performance parameters. Continuous data were analyzed with correlations, mean differences, the Bland-Altman method, and receiver operating characteristics. The classification of fat intake by the modified MEDFICTS was test-retest reliable. Final scores of the group did not differ between administrations (P=0.86). The correlation of final scores between administrations was significant for girls only (r=0.58; P=0.01). Reliability of portion size and frequency of intake scores depended on the food category. For girls the screener final score was significantly (P90%), but chance corrected agreement between the classifications was poor. Parents did not agree with their children. Test-retest reliability and relative validity of a modified MEDFICTS dietary fat screener in South African schoolchildren depended on the use and outcome measures applied. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. A Comparison of Organic and Steam Rankine Cycle Power Systems for Waste Heat Recovery on Large Ships

    DEFF Research Database (Denmark)

    Andreasen, Jesper Graa; Meroni, Andrea; Haglind, Fredrik

    2017-01-01

    %) fuel case. The processes were compared based on their off-design performance for diesel engine loads in the range between 25% and 100%. The fluids considered in the organic Rankine cycle process were MM(hexamethyldisiloxane), toluene, n-pentane, i-pentane and c-pentane. The results of the comparison....... The net power production from the waste heat recovery units is generally higher for the low-sulfur fuel case. The steam Rankine cycle unit produces 18% more power at design compared to the high-sulfur fuel case, while the organic Rankine cycle unit using MM produces 33% more power....

  5. Long-term outcome of a multidisciplinary concept of spinal dural arteriovenous fistulae treatment

    International Nuclear Information System (INIS)

    Sherif, Camillo; Gruber, Andreas; Bavinzski, Gerhard; Standhardt, Harald; Widhalm, Georg; Knosp, Engelbert; Gibson, Daniel; Richling, Bernd

    2008-01-01

    The optimal treatment of spinal dural arteriovenous fistulae (SDAVF) remains controversial and long-term follow-up data, especially data from multidisciplinary treatment, are rarely available. Thus, long-term outcomes following a multidisciplinary approach to the treatment of SDAVF were investigated. The investigation included 26 patients with SDAVF treated at the authors' department over a 15-year period including a follow-up of more than 2 years. The treatment strategy when occlusion of the draining vein could be achieved was to embolize the fistula with Histoacryl, with surgery reserved for those patients unsuitable for embolization. Posttreatment angiography followed by MRI was performed in all patients. Clinical follow-up was performed using the gait and micturition Aminoff-Logue scale scores and the modified Rankin scale score. Embolization was performed in 19 patients (73.1%), and direct surgery in 7 patients (26.9%). Follow-up angiography (at a mean of 21.7 months) showed occlusion of the SDAVF in 24 patients (92.3%). Of the 19 embolized patients, 2 (10.5%) developed recurrence secondary to insufficient occlusion of the SDAVF draining vein, and one of these two patients underwent re-embolization and one re-operation. No negative effects of SDAVF recurrence on the final clinical outcome were identified in either patient. MRI after angiography (at a mean of 91.5 months) demonstrated occlusion of all SDAVFs. After a mean clinical follow-up of 103.4 months there was a statistically significant improvement in both the modified Rankin scale score and the Aminoff-Logue gait scale score (P < 0.05). The present multidisciplinary study showed for the first time that embolization leads to stable neuroradiological results and favourable clinical outcomes even for very long follow-up times of more than 100 months. Microsurgery remains the treatment of choice when safe embolization of the draining vein cannot be achieved. (orig.)

  6. Outcome after 8 years of a modified conservative treatment experience in keratocystic odontogenic tumor in 5 patients

    Directory of Open Access Journals (Sweden)

    Alberto Peraza, DDS, Ms

    2017-06-01

    Full Text Available The keratocystic odontogenic tumor (KCOT according to WHO classification comprises approximately 12% of all tumors of the jaw. The pathognomonic microscopic findings are the parakeratin at the superficial layer. Their clinical and radiographic presentation is variable, showing different degrees of aggressive behavior and recurrences. We present a retrospective study with a modified conservative approach for the treatment of the KCOT. Five patients between 16 and 23 years old were treated in 2009. These presented radiologic features suggestive of KCOT such as unilocular lesions in the mandible. The diagnosis was confirmed by incisional biopsy and histopathological study of every lesion. The treatment performed was: Carnoy's solution by 5 minutes without chloroform and decompression with plastic stents from 7 to 11 months, switching the position of the stents once bone formation was evident, Carnoy's again for 3 minutes, enucleation, peripheral ostectomy, and concomitant xenograft. All the patients underwent simultaneous xenograft reconstruction after enucleation. Recurrence was negative after 8 years of follow up. No patient showed infection or fracture, only 1 reported discomfort with the stent. The modified treatment in our study suggests that this protocol so far has a low recurrence rate. The commitment of the patient is important for the long-term follow up and treatment.

  7. A comparative analysis of rankine and absorption power cycles from exergoeconomic viewpoint

    International Nuclear Information System (INIS)

    Shokati, Naser; Ranjbar, Faramarz; Yari, Mortaza

    2014-01-01

    Highlights: • The Rankine and absorption power cycles are compared from exergoeconomic viewpoint. • The LiBr–H 2 O cycle has the highest unit cost of electricity produced by turbine. • The LiBr–H 2 O cycle has the lowest exergy destruction cost rate. • In LiBr–H 2 O cycle, the generator has the maximum value regarding (C-dot) D,k +(C-dot) L,k +(Z-dot) k . - Abstract: In this paper LiBr–H 2 O and NH 3 –H 2 O absorption power cycles and Rankine cycle which produce 1 MW electrical power in same conditions of heat sources are compared from exergoeconomic point of view. Exergoeconomic analysis is performed using the specific exergy costing (SPECO) method. The results show that among these cycles, although the LiBr–H 2 O cycle has the highest first law efficiency, but unit cost of electricity produced by turbine for LiBr–H 2 O cycle is more than that for Rankine cycle. This value is lowest for the NH 3 –H 2 O cycle. Moreover, the NH 3 –H 2 O cycle has the highest and the LiBr–H 2 O cycle has the lowest exergy destruction cost rate. The generator, the absorber and the boiler in all considered cycles have the maximum value of sum of cost rate associated with capital investment, operating and maintenance, exergy destruction and exergy losses. Therefore, these components should be taken into consideration from exergoeconomic viewpoint. In parametric study, it is observed that in the constant generator temperature, as the generator pressure increases, unit cost of power produced by turbine for LiBr–H 2 O and Rankine cycles decreases. This value for Rankine cycle is lower than for LiBr–H 2 O cycle whereas Rankine cycle efficiency is less than the efficiency of LiBr–H 2 O cycle. Also, in LiBr–H 2 O cycle, at constant temperature of the generator, the value of exergy destruction cost rate is minimized and exergoeconomic factor is maximized at particular values of generator pressure and the more absorber pressure results the minimum value of

  8. Working fluid selection for the Organic Rankine Cycle (ORC) exhaust heat recovery of an internal combustion engine power plant

    Science.gov (United States)

    Douvartzides, S.; Karmalis, I.

    2016-11-01

    Organic Rankine cycle technology is capable to efficiently convert low-grade heat into useful mechanical power. In the present investigation such a cycle is used for the recovery of heat from the exhaust gases of a four stroke V18 MAN 51/60DF internal combustion engine power plant operating with natural gas. Design is focused on the selection of the appropriate working fluid of the Rankine cycle in terms of thermodynamic, environmental and safety criteria. 37 candidate fluids have been considered and all Rankine cycles examined were subcritical. The thermodynamic analysis of all fluids has been comparatively undertaken and the effect of key operation conditions such as the evaporation pressure and the superheating temperature was taken into account. By appropriately selecting the working fluid and the Rankine cycle operation conditions the overall plant efficiency was improved by 5.52% and fuel consumption was reduced by 12.69%.

  9. Investigations on the application of zeotropic fluid mixtures in the organic rankine cycle for the geothermal power generation; Untersuchung zum Einsatz von zeotropen Fluidgemischen im Organic Rankine Cycle fuer die geothermische Stromerzeugung

    Energy Technology Data Exchange (ETDEWEB)

    Heberle, Florian

    2013-04-01

    The organic rankine cycle is a thermodynamic cycle process which uses an organic fluid working fluid instead of water in comparison to the commercial rankine process. The organic rankine cycle facilitates sufficiently high pressures at moderate temperatures. The organic rankine cycle significantly expands the technically possible and economically feasible ranges of application of such heat and power processes. The geothermal power is a very attractive field of application. Thermal water with a temperature of nearly 100 Celsius can be used for the power generation by means of the organic rankine cycle. Especially zeotropic mixtures are interesting as a working fluid. This is due to a non-isothermal phase change to a temperature glide which adapts very well to the temperature progress of the heat source. The author of the book under consideration reports on the application of different mixtures in the organic rankine cycle. The evaluation is based on a thermodynamic analysis and considers also toxicological, ecologic, technical as well as economic aspects.

  10. Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

    International Nuclear Information System (INIS)

    Contreras-Yanez, Irazu; Rull-Gabayet, Marina; Vazquez-LaMadrid, Jorge; Pascual-Ramos, Virginia

    2011-01-01

    Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with ≤12 months of disease duration, ≥3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 ± 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

  11. Radiographic outcome in Hispanic early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs

    Energy Technology Data Exchange (ETDEWEB)

    Contreras-Yanez, Irazu, E-mail: uzari02@hotmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Rull-Gabayet, Marina, E-mail: rull.marina@gmail.com [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Vazquez-LaMadrid, Jorge, E-mail: docjvlradiologo@yahoo.com [Department of Radiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico); Pascual-Ramos, Virginia, E-mail: virtichu@gmail.com.mx [Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Seccion XVI, C.P. 14000, Tlalpan, Mexico, D.F. (Mexico)

    2011-08-15

    Objectives: To determine rates of incident erosive disease in early rheumatoid arthritis patients, to identify baseline predictors and to evaluate erosion's impact on patient-reported outcomes. Methods: 82 patients with {<=}12 months of disease duration, {>=}3 years of follow-up and conventional treatment were included. Consecutive evaluations assessed swollen and tender joint counts, treatment and comorbidity, acute reactant-phase determinations and patient-reported outcomes. Digitized radiographs of the hands and feet were obtained at baseline and yearly thereafter. RA was defined as erosive when at least one unequivocal cortical bone defect was detected. Descriptive statistics and Cox regression analysis were performed. Results: At baseline, 71 of the patients were Female Sign , population median (range) age was of 38.7 (16-78.2) years, 58 patients had antibodies and all the patients had active disease and substantial disability. Follow-up cohort was of 299.3 person-years. At last follow-up (49 {+-} 13.8 months), 28 patients developed erosions. Erosion's location was the feet, in 12 patients. Incident rates of erosive disease at one, two, three and four years were of 8.1, 12.8, 13.8 and 5.6 per 100 person-years, respectively. Higher C-reactive protein (HR: 1.20, 95%CI: 1.04-1.4, p = 0.01) and positive antibodies (HR: 5.09, 95%CI: 1.08-23.86, p = 0.04) were baseline predictors of incident erosive disease. Erosions had minor impact on patient-reported outcomes. Conclusion: Rheumatoid arthritis patients with antibodies and higher C reactive protein at baseline are at risk for incident erosions which appear most frequently at the feet. Up to 1/3 patients conventionally treated develop incident erosions, which minimally impact function.

  12. Clinical Outcomes of the Modified Broström Technique in the Management of Chronic Ankle Instability After Early, Intermediate, and Delayed Presentation.

    Science.gov (United States)

    Hassan, Sami; Thurston, Daniel; Sian, Tanvir; Shah, Rohi; Aziz, Abdul; Kothari, Paresh

    2018-04-11

    The modified Broström technique (MBT) is considered the reference standard for surgical management of ankle instability, with good short-term outcomes. However, limited evidence is available regarding outcomes for delayed presentations of instability. We report our outcomes for patients who underwent ligament repair using the MBT, from a single-surgeon retrospective study of consecutive patients. The minimum postoperative follow-up period was 6 months during a 5-year study period. The patients were retrospectively divided into 3 groups according to the delay in presentation: group 1, 6 months to 2 years; group 2, 2 to 4 years; and group 3, >4 years. We collected data on patient demographics, injury pattern, and intraoperative surgeon findings. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale (AHS) was used to evaluate patient outcomes and satisfaction with surgery. Twenty-six patients were treated with MBT. The mean follow-up period was 36.9 (range 6-42) months. Twenty-five (96.2%) patients had unilateral injuries, and 1 (3.85%) had bilateral repairs. Of the 26 patients, 21 (80.8%) completed the AOFAS-AHS, with a mean score of 87.4 (range 12 to 100). The mean interval from injury to surgery was 47.9 months. The results were excellent in 15 (71.4%), good in 3 (14.3%), fair in 1 (4.8%), and poor in 2 (9.5%) using the AOFAS-AHS. We found no significant difference in the overall AOFAS-AHS score or postoperative satisfaction among the groups (p > .05). All patients had a stable ankle joint at their final follow-up visit. In conclusion, patients with persistent or chronic ankle instability have good clinical outcomes and satisfaction after the MBT, irrespective of the time from injury to presentation. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Comparative thermodynamic performance of some Rankine/Brayton cycle configurations for a low-temperature energy application

    Science.gov (United States)

    Lansing, F. L.

    1977-01-01

    Various configurations combining solar-Rankine and fuel-Brayton cycles were analyzed in order to find the arrangement which has the highest thermal efficiency and the smallest fuel share. A numerical example is given to evaluate both the thermodynamic performance and the economic feasibility of each configuration. The solar-assisted regenerative Rankine cycle was found to be leading the candidates from both points of energy utilization and fuel conservation.

  14. Studi Variasi Flowrate Refrigerant pada Sistem Organic Rankine Cycle dengan Fluida Kerja R-123

    Directory of Open Access Journals (Sweden)

    Aria Halim Pamungkas

    2013-09-01

    Full Text Available Saat ini kelangkaan sumber energi fosil telah menjadi isu utama di seluruh dunia. Hal tersebut memberikan dampak yang signifikan di setiap aspek kehidupan dan salah satunya adalah di bidang pembangkit listrik. Salah satu sistem pembangkit listrik yang tidak menggunakan energi fosil adalah Organic rankine cycle (ORC. Pada penelitian ini dilakukan dengan metode eksperimental pada suatu sistem Organic rankine cycle yang telah dibangun. Penelitian ini yang divariasikan adalah flowrate dari fluida kerja dalam hal ini R-123. Variasi flowrate yang digunakan yaitu 3-1 GPM (Galon per menit dengan penurunan 0,5 GPM setiap pengambilan data. Hasil yang didapatkan dari penelitian ini berupa grafik–grafik daya pada turbin, kondensor, pompa dan evaporator, efisiensi siklus dan back work ratio  fungsi flowrate fluida kerja. Efisiensi siklus tertinggi adalah 5,86% yang terjadi pada flowrate 3 GPM dan efisiensi siklus terendah adalah 4,32% yang terjadi pada flowrate 1 GPM.

  15. A review of the use of organic Rankine cycle power systems for maritime applications

    DEFF Research Database (Denmark)

    Mondejar, M. E.; Andreasen, J. G.; Pierobon, L.

    2018-01-01

    Diesel engines are by far the most common means of propulsion aboard ships. It is estimated that around half of their fuel energy consumption is dissipated as low-grade heat. The organic Rankine cycle technology is a well-established solution for the energy conversion of thermal power from biomass...... combustion, geothermal reservoirs, and waste heat from industrial processes. However, its economic feasibility has not yet been demonstrated for marine applications. This paper aims at evaluating the potential of using organic Rankine cycle systems for waste heat recovery aboard ships. The suitable vessels...... and engine heat sources are identified by estimating the total recoverable energy. Different cycle architectures, working fluids, components, and control strategies are analyzed. The economic feasibility and integration on board are also evaluated. A number of research and development areas are identified...

  16. Study of toluene stability for an Organic Rankine Cycle (ORC) space-based power system

    Science.gov (United States)

    Havens, Vance; Ragaller, Dana

    1988-01-01

    The design, fabrication, assembly, and endurance operation of a dynamic test loop, built to evaluate the thermal stability of a proposed Organic Rankine Cycle (ORC) working fluid, is discussed. The test fluid, toluene, was circulated through a heater, simulated turbine, regenerator, condenser and pump to duplicate an actual ORC system. The maximum nominal fluid temperature, 750 F, was at the turbine simulator inlet. Samples of noncondensible gases and liquid toluene were taken periodically during the test. The samples were analyzed to identify the degradation products formed and the quantity of these products. From these data it was possible to determine the degradation rate of the working fluid and the generation rate of noncondensible gases. A further goal of this work was to relate the degradation observed in the dynamic operating loop to degradation obtained in isothermal capsule tests. This relationship was the basis for estimating the power loop degradation in the Space Station Organic Rankine Cycle system.

  17. Modeling and analysis of scroll compressor conversion into expander for Rankine cycles

    Energy Technology Data Exchange (ETDEWEB)

    Oralli, E.; Dincer, I.; Zamfirescu, C. [Faculty of Engineering and Applied Science, University of Ontario Institute of Technology (Canada)], E-mail: Emre.Oralli@uoit.ca, email: Ibrahim.Dincer@uoit.ca, email: Calin.Zamfirescu@uoit.ca

    2011-07-01

    With the current push towards the use of sustainable energies, low power heat generation systems are shifting towards sustainable heat sources such as geothermal, solar, industrial waste and cogeneration energy. The aim of this paper is to investigate the use of a scroll expander for power generation using the Rankine cycle. A parametric study was carried out on a refrigeration scroll compressor to determine the impact of geometry, working fluid, and operating conditions on the efficiency of the Rankine heat engine. In addition modifications were made to the expander to optimize its operation. Results showed that organic fluids should be used at saturated conditions, that decreasing the temperature of the condenser leads to an increased thermal efficiency of ORC and that the designed radius is an optimum value. This study highlighted the impacts of geometric and thermodynamic parameters on scroll expanders.

  18. Performance Estimation of Organic Rankine Cycle by Using Soft Computing Technics

    Directory of Open Access Journals (Sweden)

    Tuğba Kovacı

    2017-10-01

    Full Text Available In this study, the thermal efficiency values of Organic Rankine cycle system were estimated depending on the condenser temperature and the evaporator temperatures values by adaptive network fuzzy interference system (ANFIS and artificial neural networks system (ANN. Organic Rankine cycle (ORC fluids of R365-mfc and SES32 were chosen to evaluate as the system fluid. The performance values of ANN and ANFIS models are compared with actual values. The R2 values are determined between 0.97 and 0.99 for SES36 and R365-mfc, and this is satisfactory. Although it was observed that both ANN and ANFIS models obtained a good statistical prediction performance through coefficient of determination variance, the accuracies of ANN predictions were usually imperceptible better than those of ANFIS predictions.

  19. Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic.

    Science.gov (United States)

    Moura, Lidia M V R; Schwamm, Eli; Moura Junior, Valdery; Seitz, Michael P; Hsu, John; Cole, Andrew J; Schwamm, Lee H

    2016-12-06

    To determine whether patients could self-report physical and mental health assessments in the waiting room and whether these assessments would be associated with modified Rankin Scale (mRS) and Quality of Life in Epilepsy (QOLIE-10) scores. We offered iPad-based surveys to consecutive adult neurology patients at check-in to collect patient-reported outcome measures (PROMs). We collected demographic and clinical data on 6,075 patients through survey or administrative claims and PROMs from participating patients. We compared demographic characteristics of participants and nonparticipants and tested associations between physical and mental health scores and mRS and QOLIE-10. Of 6,075 patients seen by neurologists during the study period, 2,992 (49.3%) participated in the survey. Compared to nonparticipating patients, participating patients more often were privately insured (53.5% vs 42.7%, p neurology (nonsubspecialty) clinics (53.1% vs 46.6%, p Neurology.

  20. External validation of the ability of the DRAGON score to predict outcome after thrombolysis treatment

    DEFF Research Database (Denmark)

    Ovesen, Christian Aavang; Christensen, Anders; Nielsen, J K

    2013-01-01

    Easy-to-perform and valid assessment scales for the effect of thrombolysis are essential in hyperacute stroke settings. Because of this we performed an external validation of the DRAGON scale proposed by Strbian et al. in a Danish cohort. All patients treated with intravenous recombinant plasmino......Easy-to-perform and valid assessment scales for the effect of thrombolysis are essential in hyperacute stroke settings. Because of this we performed an external validation of the DRAGON scale proposed by Strbian et al. in a Danish cohort. All patients treated with intravenous recombinant...... and their modified Rankin Scale (mRS) was assessed after 3 months. Three hundred and three patients were included in the analysis. The DRAGON scale proved to have a good discriminative ability for predicting highly unfavourable outcome (mRS 5-6) (area under the curve-receiver operating characteristic [AUC-ROC]: 0...

  1. Relationship between MRI findings and outcome in supratentorial branch atheromatous disease (BAD)

    International Nuclear Information System (INIS)

    Moriya, Saori; Adachi, Tomohide; Goto, Jun; Arakawa, Chiaki; Takagi, Makoto; Mizoi, Yoshikazu

    2006-01-01

    Branch atheromatous disease has been recognized as one of the types of stroke which is often associated with clinical deterioration. We investigated the correlation between diffusion weighted imaging (DWI) findings and clinical courses of 33 patients with branch atheromatous diseases (BADs) in the territory of the lenticulostriate arteries. The DWI findings associated with the poor outcomes (modified Rankin Scale mRS>or=3) are (1) the larger lesion size in a direction perpendicular to axial section and (2) the lesions located in the inferior portion of basal ganglia. The findings correlated with progressive motor deficits are (1) the lesions closer to the posterior limb of internal capsule (medial type) and (2) the lesions located in the inferior portion of basal ganglia. These characteristics of DWI may play an important role to distinguish the progressing ischemic strokes as BAD from non-progressing ones. (author)

  2. Instability of a two-step Rankine vortex in a reduced gravity QG model

    Energy Technology Data Exchange (ETDEWEB)

    Perrot, Xavier [Laboratoire de Météorologie Dynamique, Ecole Normale Supérieure, 24 rue Lhomond, F-75005 Paris (France); Carton, Xavier, E-mail: xperrot@lmd.ens.fr, E-mail: xcarton@univ-brest.fr [Laboratoire de Physique des Océans, Université de Bretagne Occidentale, 6 avenue Le Gorgeu, F-29200 Brest (France)

    2014-06-01

    We investigate the stability of a steplike Rankine vortex in a one-active-layer, reduced gravity, quasi-geostrophic model. After calculating the linear stability with a normal mode analysis, the singular modes are determined as a function of the vortex shape to investigate short-time stability. Finally we determine the position of the critical layer and show its influence when it lies inside the vortex. (papers)

  3. System and method for regulating EGR cooling using a rankine cycle

    Science.gov (United States)

    Ernst, Timothy C.; Morris, Dave

    2015-12-22

    This disclosure relates to a waste heat recovery (WHR) system and method for regulating exhaust gas recirculation (EGR) cooling, and more particularly, to a Rankine cycle WHR system and method, including a recuperator bypass arrangement to regulate EGR exhaust gas cooling for engine efficiency improvement and thermal management. This disclosure describes other unique bypass arrangements for increased flexibility in the ability to regulate EGR exhaust gas cooling.

  4. Parametric Adjustments to the Rankine Vortex Wind Model for Gulf of Mexico Hurricanes

    Science.gov (United States)

    2012-11-01

    2012 4. TITLE AND SUBTITLE Parametric Adjustments to the Rankine Vortex Wind Model for Gulf of Mexico Hurricanes 5a. CONTRACT NUMBER 5b. GRANT ...may be used to construct spatially varying wind fields for the GOM region (e.g., Thompson and Cardone [12]), but this requires using a complicated...Storm Damage Reduc- tion, and Dredging Operations and Environmental Research (DOER). The USACE Headquarters granted permission to publish this paper

  5. Energy and exergy analysis of integrated system of ammonia–water Kalina–Rankine cycle

    International Nuclear Information System (INIS)

    Chen, Yaping; Guo, Zhanwei; Wu, Jiafeng; Zhang, Zhi; Hua, Junye

    2015-01-01

    The integrated system of AWKRC (ammonia–water Kalina–Rankine cycle) is a novel cycle operated on KC (Kalina cycle) for power generation in non-heating seasons and on AWRC (ammonia–water Rankine cycle) for cogeneration of power and heating water in winter. The influences of inlet temperatures of both heat resource and cooling water on system efficiencies were analyzed based on the first law and the second law of thermodynamics. The calculation is based on following conditions that the heat resource temperature keeps 300 °C, the cooling water temperature for the KC or AWRC is respectively 25 °C or 15 °C; and the temperatures of heating water and backwater are respectively 90 °C and 40 °C. The results show that the evaluation indexes of the power recovery efficiency and the exergy efficiency of KC were respectively 18.2% and 41.9%, while the composite power recovery efficiency and the composite exergy efficiency of AWRC are respectively 21.1% and 43.0% accounting both power and equivalent power of cogenerated heating capacity, including 54.5% heating recovery ratio or 12.4% heating water exergy efficiency. The inventory flow diagrams of both energy and exergy gains and losses of the components operating on KC or AWRC are also demonstrated. - Highlights: • An integrated system of AWKRC (ammonia–water Kalina–Rankine cycle) is investigated. • NH_3–H_2O Rankine cycle is operated for cogenerating power and heating-water in winter. • Heating water with 90 °C and capacity of 54% total reclaimed heat load is cogenerated. • Kalina cycle is operated for power generation in other seasons with high efficiency. • Energy and exergy analysis draw similar results in optimizing the system parameters.

  6. Stand-Alone Solar Organic Rankine Cycle Water Pumping System and Its Economic Viability in Nepal

    OpenAIRE

    Suresh Baral; Kyung Chun Kim

    2015-01-01

    The current study presents the concept of a stand-alone solar organic Rankine cycle (ORC) water pumping system for rural Nepalese areas. Experimental results for this technology are presented based on a prototype. The economic viability of the system was assessed based on solar radiation data of different Nepalese geographic locations. The mechanical power produced by the solar ORC is coupled with a water pumping system for various applications, such as drinking and irrigation. The thermal ef...

  7. Thermo- economical consideration of Regenerative organic Rankine cycle coupling with the absorption chiller systems incorporated in the trigeneration system

    International Nuclear Information System (INIS)

    Anvari, Simin; Taghavifar, Hadi; Parvishi, Alireza

    2017-01-01

    Highlights: • A new trigeneration cycle was studied from a new viewpoint of exergoeconomic and thermodynamic. • Organic Rankine and refrigeration cycles are used for recovery waste heat of cogeneration system. • Application of trigeneration cycles is advantageous in economical and thermodynamic aspects. - Abstract: In this paper, a combined cooling, heating and power cycle is proposed consisting of three sections of gas turbine and heat recovery steam generator cycle, Regenerative organic Rankine cycle, and absorption refrigeration cycle. This trigeneration cycle is subjected to a thorough thermodynamic and exergoeconomic analysis. The principal goal followed in the investigation is to address the thermodynamic and exergoeconomic of a trigeneration cycle from a new prospective such that the economic and thermodynamic viability of incorporating Regenerative organic Rankine cycle, and absorption refrigeration cycle to the gas turbine and heat recovery steam generator cycle is being investigated. Thus, the cost-effectiveness of the introduced method can be studied and further examined. The results indicate that adding Regenerative organic Rankine cycle to gas turbine and heat recovery steam generator cycle leads to 2.5% increase and the addition of absorption refrigeration cycle to the gas turbine and heat recovery steam generator/ Regenerative Organic Rankine cycle would cause 0.75% increase in the exergetic efficiency of the entire cycle. Furthermore, from total investment cost of the trigeneration cycle, only 5.5% and 0.45% results from Regenerative organic Rankine cycle and absorption refrigeration cycles, respectively.

  8. Thermodynamic analysis of high-temperature regenerative organic Rankine cycles using siloxanes as working fluids

    International Nuclear Information System (INIS)

    Fernandez, F.J.; Prieto, M.M.; Suarez, I.

    2011-01-01

    A recent novel adjustment of the Span-Wagner equation of state for siloxanes, used as working fluids in high-temperature organic Rankine cycles, is applied in a mathematical model to solve cycles under several working conditions. The proposed scheme includes a thermo-oil intermediate heat circuit between the heat source and the organic Rankine cycle. Linear and cyclic siloxanes are assayed in saturated, superheated and supercritical cycles. The cycle includes an internal heat exchanger (regenerative cycle), although a non-regenerative scheme is also solved. In the first part of the study, a current of combustion gases cooled to close to their dew point temperature is taken as the reference heat source. In the second part, the outlet temperature of the heat source is varied over a wide range, determining appropriate fluids and schemes for each thermal level. Simple linear (MM, MDM) siloxanes in saturated regenerative schemes show good efficiencies and ensure thermal stability of the working fluid. -- Highlights: → Organic Rankine cycles with polymethylsiloxanes as working fluids were modelled. → The cycle scheme is regenerative and includes an intermediate heat transfer fluid. → The fluid properties were calculated by means of the Span-Wagner equation of state. → Vapour conditions to the expander and source thermal level were analysed. → Siloxanes MM, MDM and D 4 under saturated conditions were the best options.

  9. Design of a Rankine cycle operating with a passive turbine multi fluid

    Energy Technology Data Exchange (ETDEWEB)

    Placco, Guilherme M., E-mail: guilhermeplacco@gmail.com [Instituto Tecnológico de Aeronáutica (ITA), São José dos Campos, SP (Brazil); Guimarães, Lamartine N.F., E-mail: guimarae@ieav.cta.br [Instituto de Estudo Avançados (CTA/IEAV), São José dos Campos, SP, (Brazil); Santos, Gabriela S. B., E-mail: siqueira.gsb@gmail.com [Universidade Paulista (UNIP), São José dos Campos, SP (Brazil)

    2017-07-01

    The Institute of Advanced Studies - IEAv, has been conducting a project called TERRA - 'Fast Advanced Reactors Technology', which aims to study the effects on the working of a Rankine cycle operating with a Multi Fluid Passive Turbine - TPMF. This turbine has the main characteristic operate bladeless using discs arranged in parallel along a rotating axis. After a thorough literature search, we have not found a previous operating Rankine cycle with this kind of turbine. Thus, the work presented here, began its development with few guidelines to follow. It will be presented, of a sucint way, of the design of the parts that makes up a Rankine cycle; the boundary conditions of the cycle; Data acquisition system; the development schedule; assembly of the components; some associated costs and project management. Experimental results thermal conduction through the cycle; the results of net power generated by the turbine and a comparison between thermal energy to mechanical energy in the turbine (efficiency curve). (author)

  10. Design of a Rankine cycle operating with a passive turbine multi fluid

    International Nuclear Information System (INIS)

    Placco, Guilherme M.; Guimarães, Lamartine N.F.; Santos, Gabriela S. B.

    2017-01-01

    The Institute of Advanced Studies - IEAv, has been conducting a project called TERRA - 'Fast Advanced Reactors Technology', which aims to study the effects on the working of a Rankine cycle operating with a Multi Fluid Passive Turbine - TPMF. This turbine has the main characteristic operate bladeless using discs arranged in parallel along a rotating axis. After a thorough literature search, we have not found a previous operating Rankine cycle with this kind of turbine. Thus, the work presented here, began its development with few guidelines to follow. It will be presented, of a sucint way, of the design of the parts that makes up a Rankine cycle; the boundary conditions of the cycle; Data acquisition system; the development schedule; assembly of the components; some associated costs and project management. Experimental results thermal conduction through the cycle; the results of net power generated by the turbine and a comparison between thermal energy to mechanical energy in the turbine (efficiency curve). (author)

  11. On the Rankin-Selberg method for higher genus string amplitudes

    CERN Document Server

    Florakis, Ioannis

    2017-01-01

    Closed string amplitudes at genus $h\\leq 3$ are given by integrals of Siegel modular functions on a fundamental domain of the Siegel upper half-plane. When the integrand is of rapid decay near the cusps, the integral can be computed by the Rankin-Selberg method, which consists of inserting an Eisenstein series $E_h(s)$ in the integrand, computing the integral by the orbit method, and finally extracting the residue at a suitable value of $s$. String amplitudes, however, typically involve integrands with polynomial or even exponential growth at the cusps, and a renormalization scheme is required to treat infrared divergences. Generalizing Zagier's extension of the Rankin-Selberg method at genus one, we develop the Rankin-Selberg method for Siegel modular functions of degree 2 and 3 with polynomial growth near the cusps. In particular, we show that the renormalized modular integral of the Siegel-Narain partition function of an even self-dual lattice of signature $(d,d)$ is proportional to a residue of the Langla...

  12. Performance analysis of double organic Rankine cycle for discontinuous low temperature waste heat recovery

    International Nuclear Information System (INIS)

    Wang Dongxiang; Ling Xiang; Peng Hao

    2012-01-01

    This research proposes a double organic Rankine cycle for discontinuous waste heat recovery. The optimal operation conditions of several working fluids have been calculated by a procedure employing MATLAB and REFPROP. The influence of outlet temperature of heat source on the net power output, thermal efficiency, power consumption, mass flow rate, expander outlet temperature, cycle irreversibility and exergy efficiency at a given pinch point temperature difference (PPTD) has been analyzed. Pinch point analysis has also been employed to obtain a thermodynamic understanding of the ORC performance. Of all the working fluids investigated, some performances between each working fluid are rather similar. For a fixed low temperature heat source, the optimal operation condition should be mainly determined by the heat carrier of the heat source, and working fluids have limited influence. Lower outlet temperature of heat source does not always mean more efficient energy use. Acetone exhibits the least exergy destruction, while R245fa possesses the maximal exergy efficiency at a fixed PPTD. Wet fluids exhibit lower thermal efficiency than the others with the increasing of PPTD at a fixed outlet temperature of heat source. Dry and isentropic fluids offer attractive performance. - Highlights: ► We propose a double organic Rankine cycle for discontinuous waste heat recovery. ► Performance of organic Rankine cycle (ORC) is analyzed by pinch point analysis. ► The heat carrier of the heat source determines ORC optimal operation condition. ► Design of ORC heat exchangers prefers lower pinch point temperature difference.

  13. Thermodynamic Analysis of a Rankine Cycle Powered Vapor Compression Ice Maker Using Solar Energy

    Directory of Open Access Journals (Sweden)

    Bing Hu

    2014-01-01

    Full Text Available To develop the organic Rankine-vapor compression ice maker driven by solar energy, a thermodynamic model was developed and the effects of generation temperature, condensation temperature, and working fluid types on the system performance were analyzed. The results show that the cooling power per square meter collector and ice production per square meter collector per day depend largely on generation temperature and condensation temperature and they increase firstly and then decrease with increasing generation temperature. For every working fluid there is an optimal generation temperature at which organic Rankine efficiency achieves the maximum value. The cooling power per square meter collector and ice production per square meter collector per day are, respectively, 126.44 W m−2 and 7.61 kg m−2 day−1 at the generation temperature of 140°C for working fluid of R245fa, which demonstrates the feasibility of organic Rankine cycle powered vapor compression ice maker.

  14. Technical and economic study of Stirling and Rankine cycle bottoming systems for heavy truck diesel engines

    Science.gov (United States)

    Kubo, I.

    1987-01-01

    Bottoming cycle concepts for heavy duty transport engine applications were studied. In particular, the following tasks were performed: (1) conceptual design and cost data development for Stirling systems; (2) life-cycle cost evaluation of three bottoming systems - organic Rankine, steam Rankine, and Stirling cycles; and (3) assessment of future directions in waste heat utilization research. Variables considered for the second task were initial capital investments, fuel savings, depreciation tax benefits, salvage values, and service/maintenance costs. The study shows that none of the three bottoming systems studied are even marginally attractive. Manufacturing costs have to be reduced by at least 65%. As a new approach, an integrated Rankine/Diesel system was proposed. It utilizes one of the diesel cylinders as an expander and capitalizes on the in-cylinder heat energy. The concept eliminates the need for the power transmission device and a sophisticated control system, and reduces the size of the exhaust evaporator. Results of an economic evaluation indicate that the system has the potential to become an attractive package for end users.

  15. Surgical outcomes and nipple projection using the modified skate flap for nipple-areolar reconstruction in a series of 422 implant reconstructions.

    Science.gov (United States)

    Zhong, Toni; Antony, Anu; Cordeiro, Peter

    2009-05-01

    Numerous techniques have been used in an attempt to achieve long-term nipple projection following nipple-areolar reconstruction (NAR). A common setback, however, is the diminution of projection over time; this phenomenon is particularly evident following implant based breast reconstruction. The purpose of this report was thus to evaluate surgical outcomes and long-term nipple projection with the use of "modified skate flap" technique in exclusively implant based postmastectomy reconstructions. A retrospective review was performed for the period between 1993 and 2007. All consecutive patients with 2-staged tissue expander/implant reconstructions followed by NAR using the modified skate flap technique performed by the senior author (P.C.) were identified in a prospectively maintained breast reconstruction database. Only patients with a minimum of 1-year follow-up were included in the study. Patients with a history of irradiation to the breast were excluded from nipple projection assessment. Clinical outcome measurements included long-term nipple projection as well as incidence of complications from the NAR procedure using the modified skate flap technique. Over the 15-year study period, 475 patients underwent 2-staged tissue expander/implant reconstruction followed by NAR using the modified skate flap technique. Of these, there was a total of 292 patients with the minimum requirement of 1-year follow-up post NAR (61% follow-up rate). The total number of reconstructed nipple areolar complexes evaluated in this series was 422 (130 bilateral and 162 unilateral NAR). Forty patients (28 unilateral and 12 bilateral NAR) who received radiation to their breasts were excluded from nipple projection assessment. At a median follow-up of 44 months (range: 12-84 months), mean nipple projection was 2.5 mm (range: 1-4 mm). Minor complications occurred in 7.2% of the patients (n = 292). Skin graft donor site dehiscence was the most common complication (3.1%) followed by partial skin

  16. Safety and feasibility of modified chair-yoga on functional outcome among elderly at risk for falls

    Directory of Open Access Journals (Sweden)

    Mary Lou Galantino

    2012-01-01

    Full Text Available Falls are among the most common problems affecting older adults. At least 50% of those over the age of 80 fall annually. The goal of this pilot study was to assess the safety and feasibility of structured yoga in an elderly population with fall risk. Seniors at risk for falls were identified and enrolled in a single arm pilot trial. A chair based yoga program was provided twice a week for 8 weeks. The program was designed from previously published pilot data. A battery of validated instruments was administered at baseline and week eight and was used to identify which instruments may be sensitive to change as a result of a yoga program. Among sixteen seniors (median age of 88 with a previous history of falls, 87% provided data for assessment at the end of the intervention. Two patients withdrew, one due to a fall outside the institution and the other due to lack of time and interest. There were no adverse events during the yoga sessions. Paired-t tests compared pre-post changes and gains were noted in Fear of Falling (5.27 to 2.60; P = 0.029 and SPPB sit to stand subscale (0.31 to 1.00; P =.022. Improved trends were noted in anxiety and the timed up and go assessments. We found the modified chair-yoga program is safe and recruitment is feasible. Our data suggests that yoga may be beneficial in improving mobility and reducing fear of falling which warrants additional research via randomized controlled trial.

  17. Short- to Medium-term Outcomes After a Modified Broström Repair for Lateral Ankle Instability With Immediate Postoperative Weightbearing.

    Science.gov (United States)

    Petrera, Massimo; Dwyer, Tim; Theodoropoulos, John S; Ogilvie-Harris, Darrell J

    2014-07-01

    Anatomic techniques of ankle ligament repair have the advantage of restoring the anatomy and kinematics of the joint. This study presents a technique for anatomic reconstruction of the lateral ligament complex by way of lateral ligament advancement using suture anchors associated with immediate protected full weightbearing; 2- to 5-year clinical outcomes are reported. This technique of providing an anatomic reconstruction with a secure fixation will enable early rehabilitation with immediate, protected weightbearing, with favorable outcomes. Case series; Level of evidence, 4. Fifty-five patients with chronic lateral ankle instability who failed nonoperative management underwent modified Broström repair (lateral ligament fibular advancement) between 2005 and 2008. The anterior talofibular ligament and calcaneofibular ligament were released from the fibula and advanced using 2 double-loaded metallic suture anchors (3.5 mm). Full weightbearing in a walking boot was allowed from the first postoperative day. Patients were assessed preoperatively and at a minimum 2-year follow-up using the Foot and Ankle Outcome Score. Complication, failure (recurrent instability), and return-to-sport rates were also recorded. Six patients (11%) were lost to follow-up, leaving a study group of 49 patients (23 men, 26 women). The mean age at the time of surgery was 25 years (range, 18-37 years), with a mean duration of symptoms of 1.8 years (range, 6 months to 5 years). The mean follow-up time was 42 months (range, 24-60 months). Significant improvement was seen in the Foot and Ankle Outcome Score from preoperatively to postoperatively (from 36 to 75.4, P ankle-related quality of life subscale from 35 to 78 (P anchor fixation is an effective procedure for the treatment of chronic lateral ankle instability and allows immediate weightbearing. © 2014 The Author(s).

  18. Risk factors, aetiology and outcome of ischaemic stroke in young adults: the Swiss Young Stroke Study (SYSS).

    Science.gov (United States)

    Goeggel Simonetti, Barbara; Mono, Marie-Luise; Huynh-Do, Uyen; Michel, Patrik; Odier, Celine; Sztajzel, Roman; Lyrer, Philippe; Engelter, Stefan T; Bonati, Leo; Gensicke, Henrik; Traenka, Christopher; Tettenborn, Barbara; Weder, Bruno; Fischer, Urs; Galimanis, Aekaterini; Jung, Simon; Luedi, Rudolf; De Marchis, Gian Marco; Weck, Anja; Cereda, Carlo W; Baumgartner, Ralf; Bassetti, Claudio L; Mattle, Heinrich P; Nedeltchev, Krassen; Arnold, Marcel

    2015-09-01

    Ischaemic stroke (IS) in young adults has been increasingly recognized as a serious health condition. Stroke aetiology is different in young adults than in the older population. This study aimed to investigate aetiology and risk factors, and to search for predictors of outcome and recurrence in young IS patients. We conducted a prospective multicentre study of consecutive IS patients aged 16-55 years. Baseline demographic data, risk factors, stroke aetiology including systematic genetic screening for Fabry disease and severity were assessed and related to functional neurological outcome (modified Rankin Scale, mRS), case fatality, employment status, place of residence, and recurrent cerebrovascular events at 3 months. In 624 IS patients (60% men), median age was 46 (IQR 39-51) years and median NIHSS on admission 3 (IQR 1-8). Modifiable vascular risk factors were found in 73%. Stroke aetiology was mostly cardioembolism (32%) and of other defined origin (24%), including cervicocerebral artery dissection (17%). Fabry disease was diagnosed in 2 patients (0.3%). Aetiology remained unknown in 20%. Outcome at 3 months was favourable (mRS 0-1) in 61% and fatal in 2.9%. Stroke severity (p young adults with IS had modifiable vascular risk factors, emphasizing the importance of prevention strategies. Outcome was unfavourable in more than a third of patients and was associated with initial stroke severity and diabetes mellitus. Previous cerebrovascular events predicted recurrent ones.

  19. Thermodynamic, economic and thermo-economic optimization of a new proposed organic Rankine cycle for energy production from geothermal resources

    International Nuclear Information System (INIS)

    Kazemi, Neda; Samadi, Fereshteh

    2016-01-01

    Highlights: • A new cycle was designed to improve basic organic Rankine cycle performance. • Peng Robinson equation of state was used to obtain properties of working fluids. • Operating parameters were optimized with three different objective functions. • Efficiency of new organic Rankine cycle is higher than other considered cycles. • Return on investment of new cycle for Iran is more than France and America. - Abstract: The main goal of this study is to propose and investigate a new organic Rankine cycle based on three considered configurations: basic organic Rankine cycle, regenerative organic Rankine cycle and two-stage evaporator organic Rankine cycle in order to increase electricity generation from geothermal sources. To analyze the considered cycles’ performance, thermodynamic (energy and exergy based on the first and second laws of thermodynamics) and economic (specific investment cost) models are investigated. Also, a comparison of cycles modeling results is carried out in optimum conditions according to different optimization which consist thermodynamic, economic and thermo-economic objective functions for maximizing exergy efficiency, minimizing specific investment cost and applying a multi-objective function in order to maximize exergy efficiency and minimize specific investment cost, respectively. Optimized operating parameters of cycles include evaporators and regenerative temperatures, pinch point temperature difference of evaporators and degree of superheat. Furthermore, Peng Robinson equation of state is used to obtain thermodynamic properties of isobutane and R123 which are selected as dry and isentropic working fluids, respectively. The results of optimization indicate that, thermal and exergy efficiencies increase and exergy destruction decrease especially in evaporators for both working fluids in new proposed organic Rankine cycle compared to the basic organic Rankine cycle. Moreover, the amount of specific investment cost in new

  20. Functional outcome of microsurgical clipping compared to endovascular coiling.

    Science.gov (United States)

    Premananda, R M; Ramesh, N; Hillol, K P

    2012-12-01

    Endovascular coiling has been used increasingly as an alternative to neurosurgical clipping for treating subarachnoid hemorrhage secondary to aneurysm rupture. In a retrospective cohort review on the treatment methods of aneurysm rupture in Hospital Kuala Lumpur over the period of five years (2005-2009) a total of 268 patients were treated. These patients were broadly categorized into two groups based on their treatment mode for ruptured aneurysms. Statistical analysis was determined using Chi- Square tests to study these associations. In our study, 67.5% of patients presented with Good World Federation of Neurosurgical Societies (WFNS) grade (WFNS1-2) while 32.5% patients presented with Poor WFNS prior to intervention. In our outcome, it was noted that 60.4% had good functional outcome (mRS grade 0-2) as compared to 39.6% patients who had poor mRS(modified rankin scale) outcome (mRS 3-6). In the good WFNS group, 76% of patients in clipping group had a good mRS outcome while, 86.5% patients in coiling group had good mRS outcome (p=0.114). In poor WFNS presentation, it was noted that in 77.3% patients in clipping group, had poor mRS outcome. Similarly with poor WFNS presentation, 83.3% of patient in coiling group had poor outcome. (p=1.00). Hence when we control the WFNS group, there was no significant association between treatment group (clipping and coiling) and mRS outcome at 6 months. The outcome of patient is determined by initial clinical presentation (WFNS grade) and influenced by requirement of Extraventricular drain (EVD) in presence of hydrocephalus, CSF infection and pneumonia. Therefore the decision regarding treatment option needs to be individualized based on the presentation of the patient.

  1. Loading cisplatin onto 6-mercaptopurine covalently modified MSNS: a nanomedicine strategy to improve the outcome of cisplatin therapy

    Directory of Open Access Journals (Sweden)

    Lv X

    2016-12-01

    Full Text Available Xiaojie Lv,1 Ming Zhao,1,2 Yuiji Wang,1 Xi Hu,1 Jianhui Wu,1 Xueyun Jiang,1 Shan Li,1 Chunying Cui,1 Shiqi Peng1 1Beijing Area Major Laboratory of Peptide and Small Molecular Drugs, Engineering Research Center of Endogenous Prophylactic of Ministry of Education of China, Beijing Laboratory of Biomedical Materials, College of Pharmaceutical Sciences, Capital Medical University, Beijing, People’s Republic of China; 2Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan Abstract: In the treatment of cancer patients, cisplatin (CDDP exhibits serious cardiac and renal toxicities, while classical combinations related to CDDP are unable to solve these problems and may result in worse prognosis. Alternately, this study covalently conjugated 6-mercaptopurine (6MP onto the surface of mercapto-modified mesoporous silica nanoparticles (MSNS to form MSNS-6MP and loaded CDDP into the holes on the surface of MSNS-6MP to form MSNS-6MP/CDDP, a tumor-targeting nano-releasing regime for CDDP and 6MP specifically. In the S180 mouse model, the anti-tumor activity and overall survival of MSNS-6MP/CDDP (50 mg·kg-1·day-1, corresponding to 1 mg·kg-1·day-1 of 6MP and 5 mg·kg-1·day-1 of CDDP were significantly higher than those of CDDP alone (5 mg·kg-1·day-1 or CDDP (5 mg·kg-1·day-1 plus 6MP (1 mg·kg-1·day-1. The assays of serum alanine aminotransferase, aspartate aminotransferase and creatinine, as well as the images of myocardium and kidney histology, support that MSNS-6MP/CDDP is able to completely eliminate liver, kidney and heart toxicities induced by CDDP alone or CDDP plus 6MP. Keywords: 6-mercaptopurine, cisplatin, mesoporous silica nanoparticles, cancer therapy, nanomedicine

  2. Number needed to treat to benefit and to harm for intravenous tissue plasminogen activator therapy in the 3- to 4.5-hour window: joint outcome table analysis of the ECASS 3 trial.

    Science.gov (United States)

    Saver, Jeffrey L; Gornbein, Jeffrey; Grotta, James; Liebeskind, David; Lutsep, Helmi; Schwamm, Lee; Scott, Phillip; Starkman, Sidney

    2009-07-01

    Measures of a therapy's effect size are important guides to clinicians, patients, and policy-makers on treatment decisions in clinical practice. The ECASS 3 trial demonstrated a statistically significant benefit of intravenous tissue plasminogen activator for acute cerebral ischemia in the 3- to 4.5-hour window, but an effect size estimate incorporating benefit and harm across all levels of poststroke disability has not previously been derived. Joint outcome table specification was used to derive number needed to treat to benefit (NNTB) and number needed to treat to harm (NNTH) values summarizing treatment impact over the entire outcome range on the modified Rankin scale of global disability, including both expert-dependent and expert-independent (algorithmic and repeated random sampling) array generation. For the full 7-category modified Rankin scale, algorithmic analysis demonstrated that the NNTB for 1 additional patient to have a better outcome by >or=1 grades than with placebo must lie between 4.0 and 13.0. In bootstrap simulations, the mean NNTB was 7.1. Expert joint outcome table analyses indicated that the NNTB for improved final outcome was 6.1 (95% CI, 5.6-6.7) and the NNTH 37.5 (95% CI, 34.6-40.5). Benefit per 100 patients treated was 16.3 and harm per 100 was 2.7. The likelihood of help to harm ratio was 6.0. Treatment with tissue plasminogen activator in the 3- to 4.5-hour window confers benefit on approximately half as many patients as treatment <3 hours, with no increase in the conferral of harm. Approximately 1 in 6 patients has a better and 1 in 35 has a worse outcome as a result of therapy.

  3. Modifying the Sleep Treatment Education Program for Students to include technology use (STEPS-TECH): Intervention effects on objective and subjective sleep outcomes.

    Science.gov (United States)

    Barber, Larissa K; Cucalon, Maria S

    2017-12-01

    University students often have sleep issues that arise from poor sleep hygiene practices and technology use patterns. Yet, technology-related behaviors are often neglected in sleep hygiene education. This study examined whether the Sleep Treatment Education Program for Students-modified to include information regarding managing technology use (STEPS-TECH)-helps improve both subjective and objective sleep outcomes among university students. Results of an experimental study among 78 university students showed improvements in objective indicators of sleep quantity (total sleep time) and sleep quality (less awakenings) during the subsequent week for students in the STEPS-TECH intervention group compared to a control group. Exploratory analyses indicated that effects were driven by improvements in weekend days immediately following the intervention. There were also no intervention effects on subjective sleep quality or quantity outcomes. In terms of self-reported behavioral responses to educational content in the intervention, there were no group differences in sleep hygiene practices or technology use before bedtime. However, the intervention group reported less technology use during sleep periods than the control group. These preliminary findings suggest that STEPS-TECH may be a useful educational tool to help improve objective sleep and reduce technology use during sleep periods among university students. Copyright © 2017 John Wiley & Sons, Ltd.

  4. Comparison of In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycle Outcome in Patients with and without Polycystic Ovary Syndrome: A Modified Poisson Regression Model.

    Science.gov (United States)

    Almasi-Hashiani, Amir; Mansournia, Mohammad Ali; Sepidarkish, Mahdi; Vesali, Samira; Ghaheri, Azadeh; Esmailzadeh, Arezoo; Omani-Samani, Reza

    2018-01-01

    Polycystic ovary syndrome (PCOS) is a frequent condition in reproductive age women with a prevalence rate of 5-10%. This study intends to determine the relationship between PCOS and the outcome of assisted reproductive treatment (ART) in Tehran, Iran. In this historical cohort study, we included 996 infertile women who referred to Royan Institute (Tehran, Iran) between January 2012 and December 2013. PCOS, as the main variable, and other potential confounder variables were gathered. Modified Poisson Regression was used for data analysis. Stata software, version 13 was used for all statistical analyses. Unadjusted analysis showed a significantly lower risk for failure in PCOS cases compared to cases without PCOS [risk ratio (RR): 0.79, 95% confidence intervals (CI): 0.66-0.95, P=0.014]. After adjusting for the confounder variables, there was no difference between risk of non-pregnancy in women with and without PCOS (RR: 0.87, 95% CI: 0.72-1.05, P=0.15). Significant predictors of the ART outcome included the treatment protocol type, numbers of embryos transferred (grades A and AB), numbers of injected ampules, and age. The results obtained from this model showed no difference between patients with and without PCOS according to the risk for non-pregnancy. Therefore, other factors might affect conception in PCOS patients. Copyright© by Royan Institute. All rights reserved.

  5. Nonsense-mediated decay mechanism is a possible modifying factor of clinical outcome in nonsense cd39 beta thalassemia genotype

    Directory of Open Access Journals (Sweden)

    Maria Concetta Renda

    2012-11-01

    Full Text Available Nonsense-mediated mRNA decay (NMD is a surveillance system to prevent the synthesis of non-functional proteins. In β-thalassemia, NMD may have a role in clinical outcome. An example of premature translation stop codons appearing for the first time is the β-globin cd39 mutation; when homozygous, this results in a severe phenotype. The aim of this study was to determine whether the homozygous nonsense cd39 may have a milder phenotype in comparison with IVS1,nt110/cd39 genotype. Genotypes have been identified from a cohort of 568 patients affected by β-thalassemia. These genotypes were compared with those found in 577 affected fetuses detected among 2292 prenatal diagnoses. The nine most common genotypes, each with an incidence rate of 1.5% or over, and together accounting for 80% of genotype frequencies, underwent statistical analysis. Genotype prevalence was calculated within the overall group. Results are expressed as proportions with 95% confidence intervals; P≤0.05 was considered statistically significant. A binomial distribution was assumed for each group; z-tests were used to compare genotype frequencies observed in the patient group with frequencies in the affected fetus group. In the absence of selecting factors, prevalence of these two genotypes was compared between a cohort of 568 β-thalassemia patients (PTS and 577 affected fetuses (FOET detected during the same period. IVS1,nt110/cd39 was significantly more prevalent in FOET than PTS (P<0.0001, while there was no significant difference in prevalence of cd39/cd39 in FOET compared with PTS (P=0.524. These results suggest a cd39 genotype NMD mechanism may be associated with improved clinical outcomes in thalassemia major. 无义介导的mRNA 降解(NMD) 是一种预防非功能性蛋白质合成的监控系统。在β地中海贫血中,NMD可能对临床结果有影响。第一次出现的过早终止密码子(PTC)为β珠蛋白cd39突变;若为纯合

  6. Validation of the DRAGON Score in a Chinese Population to Predict Functional Outcome of Intravenous Thrombolysis-Treated Stroke Patients.

    Science.gov (United States)

    Zhang, Xinmiao; Liao, Xiaoling; Wang, Chunjuan; Liu, Liping; Wang, Chunxue; Zhao, Xingquan; Pan, Yuesong; Wang, Yilong; Wang, Yongjun

    2015-08-01

    The DRAGON score predicts functional outcome of ischemic stroke patients treated with intravenous thrombolysis. Our aim was to evaluate its utility in a Chinese stroke population. Patients with acute ischemic stroke treated with intravenous thrombolysis were prospectively registered in the Thrombolysis Implementation and Monitor of acute ischemic Stroke in China. We excluded patients with basilar artery occlusion and missing data, leaving 970 eligible patients. We calculated the DRAGON score, and the clinical outcome was measured by the modified Rankin Scale at 3 months. Model discrimination was quantified by calculating the C statistic. Calibration was assessed using Pearson correlation coefficient. The C statistic was .73 (.70-.76) for good outcome and .75 (.70-.79) for miserable outcome. Proportions of patients with good outcome were 94%, 83%, 70%, and 0% for 0 to 1, 2, 3, and 8 to 10 score points, respectively. Proportions of patients with miserable outcome were 0%, 3%, 9%, and 50% for 0 to 1, 2, 3, and 8 to 10 points, respectively. There was high correlation between predicted and observed probability of 3-month favorable and miserable outcome in the external validation cohort (Pearson correlation coefficient, .98 and .98, respectively, both P DRAGON score showed good performance to predict functional outcome after tissue-type plasminogen activator treatment in the Chinese population. This study demonstrated the accuracy and usability of the DRAGON score in the Chinese population in daily practice. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study

    Science.gov (United States)

    González, R. Gilberto; Lev, Michael H.; Goldmacher, Gregory V.; Smith, Wade S.; Payabvash, Seyedmehdi; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter J.; Camargo, Erica C. S.; Dillon, William P.; Furie, Karen L.

    2012-01-01

    Purpose To improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA). Methods In a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS>2. Strokes were classified as “major” by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was≤7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores>10. Results Of 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p10/BASIS+ had poor outcomes, versus 21.5% (77/358) with NIHSS≤10/BASIS− (p10/BASIS+ compared to patients who are NIHSS≤10/BASIS−; the odds ratio is 5.4 (95% CI: 3.5 to 8.5) when compared to patients who are only NIHSS>10 or BASIS+. Conclusions BASIS and NIHSS are independent outcome predictors. Their combination is stronger than either instrument alone in predicting outcomes. The findings suggest that CTA is a significant clinical tool in routine acute stroke assessment. PMID:22276182

  8. Comparison between regenerative organic Rankine cycle (RORC) and basic organic Rankine cycle (BORC) based on thermoeconomic multi-objective optimization considering exergy efficiency and levelized energy cost (LEC)

    International Nuclear Information System (INIS)

    Feng, Yongqiang; Zhang, Yaning; Li, Bingxi; Yang, Jinfu; Shi, Yang

    2015-01-01

    Highlights: • The thermoeconomic comparison of regenerative RORC and BORC is investigated. • The Pareto frontier solution with bi-objective compares with the corresponding single-objective solutions. • The three-objective optimization of the RORC and BORC is studied. • The RORC owns 8.1% higher exergy efficiency and 21.1% more LEC than the BORC under the Pareto-optimal solution. - Abstract: Based on the thermoeconomic multi-objective optimization by using non-dominated sorting genetic algorithm (NSGA-II), considering both thermodynamic performance and economic factors, the thermoeconomic comparison of regenerative organic Rankine cycles (RORC) and basic organic Rankine cycles (BORC) are investigated. The effects of five key parameters including evaporator outlet temperature, condenser temperature, degree of superheat, pinch point temperature difference and degree of supercooling on the exergy efficiency and levelized energy cost (LEC) are examined. Meanwhile, the Pareto frontier solution with bi-objective for maximizing exergy efficiency and minimizing LEC is obtained and compared with the corresponding single-objective solutions. Research demonstrates that there is a significant negative correlation between thermodynamic performance and economic factors. And the optimum exergy efficiency and LEC for the Pareto-optimal solution of the RORC are 55.97% and 0.142 $/kW h, respectively, which are 8.1% higher exergy efficiency and 21.1% more LEC than that of the BORC under considered condition. Highest exergy and thermal efficiencies are accompanied with lowest net power output and worst economic performance. Furthermore, taking the net power output into account, detailed investigation on the three-objective optimization for maximizing exergy efficiency, maximizing net power output and minimizing LEC is discussed

  9. Blood hsCRP And PGE2 Content With Clinical Outcome Using Modified Fenestrat Restorative Spinoplasty Better Than Lamonectomy-Fusion In Lumbar Stenosis

    Directory of Open Access Journals (Sweden)

    T Mahadewa

    2012-05-01

    Full Text Available Objective: Modified Fenestration-Restorative Spinoplasty (MFRS technique is an alternative to lumbar stenosis treatment, providing the equal decompression comparing with laminectomy techniques, without the implant, less expensive and complication rates. The purpose of this study was to determine which technique gives better inflammation and clinical outcome based on high sensitive C-Reactive Protein biomarker (hsCRP and Prostaglandin E2 (PGE 2, Visual Analog Scale (VAS of the day 7th postsurgery and ODI scores 3rd month post surgery. Methods: This study design is an experimental pretest-posttest randomized control group design. Results: This study results showed that the mean levels of hsCRP day 7th postsurgery were differ significantly between MFRS (23,09 ± 15,3 mg/L compared to LF (39,53 ± 24,4 mg/L. Likewise for the mean levels of PGE2 day 7th postsurgery were differ significantly between MFRS (491,39 ± 528,5 pg/ml compared to LF (1103,7 ± 1033,6 pg/ml at the significance level of p <0.05. MFRS clinical outcomes better than LF (p <0.05, for means of VAS value day 7th postsurgery and ODI score 3rd month postsurgery. Perioperative variable analysis shows that MFRS was better than LF in: length of surgery, blood loss, postsurgery Hb and patient length of stay (p<0,05. Conclusions: MFRS technique is an alternative technique of lumbar stenosis treatment better than the LF, in terms of improved levels of hsCRP and PGE2, leading to faster clinical outcomes improvement, less complications and lower costs. MFRS technique should be used as a treatment of lumbar stenosis.

  10. Predicting Outcome in Comatose Patients: The Role of EEG Reactivity to Quantifiable Electrical Stimuli

    Directory of Open Access Journals (Sweden)

    Gang Liu

    2016-01-01

    Full Text Available Objective. To test the value of quantifiable electrical stimuli as a reliable method to assess electroencephalogram reactivity (EEG-R for the early prognostication of outcome in comatose patients. Methods. EEG was recorded in consecutive adults in coma after cardiopulmonary resuscitation (CPR or stroke. EEG-R to standard electrical stimuli was tested. Each patient received a 3-month follow-up by the Glasgow-Pittsburgh cerebral performance categories (CPC or modified Rankin scale (mRS score. Results. Twenty-two patients met the inclusion criteria. In the CPR group, 6 of 7 patients with EEG-R had good outcomes (positive predictive value (PPV, 85.7% and 4 of 5 patients without EEG-R had poor outcomes (negative predictive value (NPV, 80%. The sensitivity and specificity were 85.7% and 80%, respectively. In the stroke group, 6 of 7 patients with EEG-R had good outcomes (PPV, 85.7%; all of the 3 patients without EEG-R had poor outcomes (NPV, 100%. The sensitivity and specificity were 100% and 75%, respectively. Of all patients, the presence of EEG-R showed 92.3% sensitivity, 77.7% specificity, 85.7% PPV, and 87.5% NPV. Conclusion. EEG-R to quantifiable electrical stimuli might be a good positive predictive factor for the prognosis of outcome in comatose patients after CPR or stroke.

  11. ASTRAL, DRAGON and SEDAN scores predict stroke outcome more accurately than physicians.

    Science.gov (United States)

    Ntaios, G; Gioulekas, F; Papavasileiou, V; Strbian, D; Michel, P

    2016-11-01

    ASTRAL, SEDAN and DRAGON scores are three well-validated scores for stroke outcome prediction. Whether these scores predict stroke outcome more accurately compared with physicians interested in stroke was investigated. Physicians interested in stroke were invited to an online anonymous survey to provide outcome estimates in randomly allocated structured scenarios of recent real-life stroke patients. Their estimates were compared to scores' predictions in the same scenarios. An estimate was considered accurate if it was within 95% confidence intervals of actual outcome. In all, 244 participants from 32 different countries responded assessing 720 real scenarios and 2636 outcomes. The majority of physicians' estimates were inaccurate (1422/2636, 53.9%). 400 (56.8%) of physicians' estimates about the percentage probability of 3-month modified Rankin score (mRS) > 2 were accurate compared with 609 (86.5%) of ASTRAL score estimates (P DRAGON score estimates (P DRAGON score estimates (P DRAGON and SEDAN scores predict outcome of acute ischaemic stroke patients with higher accuracy compared to physicians interested in stroke. © 2016 EAN.

  12. Plasma 8-iso-Prostaglandin F2α concentrations and outcomes after acute intracerebral hemorrhage.

    Science.gov (United States)

    Du, Quan; Yu, Wen-Hua; Dong, Xiao-Qiao; Yang, Ding-Bo; Shen, Yong-Feng; Wang, Hao; Jiang, Li; Du, Yuan-Feng; Zhang, Zu-Yong; Zhu, Qiang; Che, Zhi-Hao; Liu, Qun-Jie

    2014-11-01

    Higher plasma 8-iso-Prostaglandin F2α concentrations have been associated with poor outcome of severe traumatic brain injury. We further investigated the relationships between plasma 8-iso-Prostaglandin F2α concentrations and clinical outcomes in patients with acute intracerebral hemorrhage. Plasma 8-iso-Prostaglandin F2α concentrations of 128 consecutive patients and 128 sex- and gender-matched healthy subjects were measured by enzyme-linked immunosorbent assay. We assessed their relationships with disease severity and clinical outcomes including 1-week mortality, 6-month mortality and unfavorable outcome (modified Rankin Scale score>2). Plasma 8-iso-Prostaglandin F2α concentrations were substantially higher in patients than in healthy controls. Plasma 8-iso-Prostaglandin F2α concentrations were positively associated with National Institutes of Health Stroke Scale (NIHSS) scores and hematoma volume using a multivariate linear regression. It emerged as an independent predictor for clinical outcomes of patients using a forward stepwise logistic regression. ROC curves identified the predictive values of plasma 8-iso-Prostaglandin F2α concentrations, and found its predictive value was similar to NIHSS scores and hematoma volumes. However, it just numerically added the predictive values of NIHSS score and hematoma volume. Increased plasma 8-iso-Prostaglandin F2α concentrations are associated with disease severity and clinical outcome after acute intracerebral hemorrhage. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Association between seizures after ischemic stroke and stroke outcome

    Science.gov (United States)

    Xu, Tao; Ou, Shu; Liu, Xi; Yu, Xinyuan; Yuan, Jinxian; Huang, Hao; Chen, Yangmei

    2016-01-01

    Abstract A systematic review and meta-analysis were performed to investigate a potential association between post-ischemic stroke seizures (PISS) and subsequent ischemic stroke (IS) outcome. A systematic search of two electronic databases (Medline and Embase) was conducted to identify studies that explored an association between PISS and IS outcome. The primary and secondary IS outcomes of interest were mortality and disability, respectively, with the latter defined as a score of 3 to 5 on the modified Rankin Scale. A total of 15 studies that were published between 1998 and 2015 with 926,492 participants were examined. The overall mortality rates for the patients with and without PISS were 34% (95% confidence interval [CI], 27–42%) and 18% (95% CI, 12–23%), respectively. The pooled relative ratio (RR) of mortality for the patients with PISS was 1.97 (95% CI, 1.48–2.61; I2 = 88.6%). The overall prevalence rates of disability in the patients with and without PISS were 60% (95% CI, 32–87%) and 41% (95% CI, 25–57%), respectively. Finally, the pooled RR of disability for the patients with PISS was 1.64 (95% CI, 1.32–2.02; I2 = 66.1%). PISS are significantly associated with higher risks of both mortality and disability. PISS indicate poorer prognoses in patients experiencing IS. PMID:27399117

  14. Surgical Management of Aneurysmal Hematomas: Prognostic Factors and Outcome.

    Science.gov (United States)

    Meneghelli, P; Cozzi, F; Hasanbelliu, A; Locatelli, F; Pasqualin, Alberto

    2016-01-01

    From 1991 until 2013, 304 patients with intracranial hematomas from aneurysmal rupture were managed surgically in our department, constituting 17 % of all patients with aneurysmal rupture. Of them, 242 patents presented with isolated intracerebral hematomas (in 69 cases associated with significant intraventricular hemorrhage), 50 patients presented with combined intracerebral and subdural hematomas (in 11 cases associated with significant intraventricular hemorrhage), and 12 presented with an isolated subdural hematoma. The surgical procedure consisted of simultaneous clipping of the aneurysm and evacuation of the hematoma in all cases. After surgery, 16 patients (5 %) submitted to an additional decompressive hemicraniectomy, and 66 patients (21 %) submitted to a ventriculo-peritoneal shunt. Clinical outcomes were assessed at discharge and at 6 months, using the modified Rankin Scale (mRS); a favorable outcome (mRS 0-2) was observed in 10 % of the cases at discharge, increasing to 31 % at 6 months; 6-month mortality was 40 %. Applying uni- and multivariate analysis, the following risk factors were associated with a significantly worse outcome: age >60; preoperative Hunt-Hess grades IV-V; pupillary mydriasis (only on univariate); midline shift >10 mm; hematoma volume >30 cc; and the presence of hemocephalus (i.e., packed intraventricular hemorrhage). Based on these results, an aggressive surgical treatment should be adopted for most cases with aneurysmal hematomas, excluding patients with bilateral mydriasis persisting after rescue therapy.

  15. Parametric analysis of blade configurations for a small-scale nitrogen axial expander with hybrid open-Rankine cycle

    International Nuclear Information System (INIS)

    Khalil, Khalil M.; Mahmoud, S.; Al- Dadah, R.K.; AL-Mousawi, Fadhel

    2017-01-01

    Highlights: • Develop cryogenic energy storage and efficient recovery technologies. • Integrate small scale closed and cryogenic open-Rankine cycles. • Investigate blade configuration on small-scale axial expander performance. • Use mean line and 3D CFD simulation for expander robust design procedure. • Predict effects of expander efficiency on hybrid open-Rankine cycle efficiency. - Abstract: During the last few decades, low-grade energy sources such as solar energy and wind energy have enhanced the efficiency of the advanced renewable technologies such as the combined Rankine. Furthermore, these heat sources have contributed to a reduction in CO2 emissions. To address the problem of the intermittent nature of such renewable sources, energy storage technologies have been used to balance the power demand and smooth out energy production. In this study, the direct expansion cycle (open Rankine cycle) is combined with a closed loop Rankine cycle to generate power more efficiently and address the problem of discontinuous renewable sources. The topping cycle of this system is a closed looped Rankine cycle and propane is used as a hydrocarbon fluid, while the direct expansion cycle is considered to be the bottoming cycle utilizing nitrogen as cryogen fluid. Small-scale expanders are the most important parts in many thermal power cycles, such as the Rankine cycle, due to the significant impact on the overall cycle’s efficiency. This work investigated the effect of using a number of blade configurations on the cycle’s performance using a small-scale axial expander. A three-dimensional Computational Fluid Dynamic (CFD) simulation was used to examine four proposed blade configurations (lean, sweep, twist, bowl) with three hub- tip ratios (0.83, 0.75, 0.66). In addition, a numerical simulation model of the hybrid open expansion- Rankine cycle was designed and modeled in order to estimate the cycle’s performance. The results show that when the expander

  16. Proposal of a combined heat and power plant hybridized with regeneration organic Rankine cycle: Energy-Exergy evaluation

    International Nuclear Information System (INIS)

    Anvari, Simin; Jafarmadar, Samad; Khalilarya, Shahram

    2016-01-01

    Highlights: • A new thermodynamic cogeneration system is proposed. • Energy and exergy analysis of the considered cycle were performed. • An enhancement of 2.6% in exergy efficiency compared to that of baseline cycle. - Abstract: Among Rankine cycles (simple, reheat and regeneration), regeneration organic Rankine cycle demonstrates higher efficiencies compared to other cases. Consequently, in the present work a regeneration organic Rankine cycle has been utilized to recuperate gas turbine’s heat using heat recovery steam generator. At first, this cogeneration system was subjected to energy and exergy analysis and the obtained results were compared with that of investigated cogeneration found in literature (a cogeneration system in which a reheat organic Rankine cycle for heat recuperation of gas turbine cycle was used with the aid of heat recovery steam generator). Results indicated that the first and second thermodynamic efficiencies in present cycle utilizing regeneration cycle instead of reheat cycle has increased 2.62% and 2.6%, respectively. In addition, the effect of thermodynamic parameters such as combustion chamber’s inlet temperature, gas turbine inlet temperature, evaporator and condenser temperature on the energetic and exergetic efficiencies of gas turbine-heat recovery steam generator cycle and gas turbine-heat recovery steam generator cycle with regeneration organic Rankine cycle was surveyed. Besides, parametric analysis shows that as gas turbine and combustion chamber inlet temperatures increase, energetic and exergetic efficiencies tend to increase. Moreover, once condenser and evaporator temperature raise, a slight decrement in energetic and exergetic efficiency is expected.

  17. Thermodynamic analysis of a low-temperature organic Rankine cycle power plant operating at off-design conditions

    International Nuclear Information System (INIS)

    He, Zhonglu; Zhang, Yufeng; Dong, Shengming; Ma, Hongting; Yu, Xiaohui; Zhang, Yan; Ma, Xuelian; Deng, Na; Sheng, Ying

    2017-01-01

    Highlights: • An ORC power plant driven by low grade heat source is set up. • Energy and exergy analysis at off-design conditions is conducted. • The twin screw expander performance is characterized. • An empirical model to predict the net power output and thermal efficiency. - Abstract: This paper deals with an experimental study on a 50-kW Organic Rankine cycle (ORC) power generation plant driven by low-grade heat source. Hot water boiler and solar-thermal system were used as the low-grade heat source providing hot water at temperature ranging from 65 to 95 °C. A twin screw compressor has been modified as the expansion machine in the ORC module and its expansion efficiency under variable operating conditions was tested in the experiments. This work was purposed to assess the ORC system and get the performance map at off-design operating conditions in a typical year from the view of the first and the second law of thermodynamics. The maximum electricity production and thermal efficiency were 46.5 kW and 6.52% respectively at the optimal operating condition. The highest exergetic efficiency reached 36.3% and the exergy analysis showed that evaporation pressure and condensation pressure were the key parameters to influence the exergy flow and exergetic efficiency. Furthermore, by fitting the actual plant data obtained in different months, an empirical model has been developed to predict the net power output and thermal efficiency with acceptable accuracy. Lastly, as an illustration, the empirical model is used to analyze the performance of the solar-driven ORC system.

  18. Exergy analysis and parameter study on a novel auto-cascade Rankine cycle

    International Nuclear Information System (INIS)

    Bao, Junjiang; Zhao, Li

    2012-01-01

    A novel auto-cascade Rankine cycle (ARC) is proposed to reduce thermodynamics irreversibility and improve energy utilization. Like the Kalina cycle, the working fluid for the ARC is zeotropic mixture, which can improve the system efficiency due to the temperature slip that zeotropic mixtures exhibit during phase change. Unlike the Kalina cycle, two expanders are included in the ARC rather than a expander and a throttling valve in the Kalina cycle, which means more work can be obtained. Using the exhaust gas as the heat source and water as the heat sink, a program is written by Matlab 2010a to carry out exergy analysis and parameter study on the ARC. Results show that the R245fa mass fraction in the primary circuit exists an optimum value with respect to the minimum total cycle irreversibility. The largest exergy loss occurs in evaporator, followed by the superheater, condenser, regenerator and IHE (Internal heat exchanger). As the R245fa mass fraction increases, the exergy losses of different components vary diversely. With the evaporation pressure rises, the total cycle irreversibility decreases and work output increases. Separator temperature has a greater influence on the system performance than superheating temperature. Compared with ORC (organic Rankine cycle) and Kalina cycle in the literature, the ARC has proven to be thermodynamically better. -- Highlights: ► We have proposed a novel auto-cascade Rankine cycle (ARC) system. ► The zeotropic mixture Isopentane/R245fa is employed in this system. ► Exergy analysis and parameter study on the ARC are presented. ► Compared with ORC and Kalina cycle in the literature, the ARC has proven to be thermodynamically better.

  19. A synthesis/design optimization algorithm for Rankine cycle based energy systems

    International Nuclear Information System (INIS)

    Toffolo, Andrea

    2014-01-01

    The algorithm presented in this work has been developed to search for the optimal topology and design parameters of a set of Rankine cycles forming an energy system that absorbs/releases heat at different temperature levels and converts part of the absorbed heat into electricity. This algorithm can deal with several applications in the field of energy engineering: e.g., steam cycles or bottoming cycles in combined/cogenerative plants, steam networks, low temperature organic Rankine cycles. The main purpose of this algorithm is to overcome the limitations of the search space introduced by the traditional mixed-integer programming techniques, which assume that possible solutions are derived from a single superstructure embedding them all. The algorithm presented in this work is a hybrid evolutionary/traditional optimization algorithm organized in two levels. A complex original codification of the topology and the intensive design parameters of the system is managed by the upper level evolutionary algorithm according to the criteria set by the HEATSEP method, which are used for the first time to automatically synthesize a “basic” system configuration from a set of elementary thermodynamic cycles. The lower SQP (sequential quadratic programming) algorithm optimizes the objective function(s) with respect to cycle mass flow rates only, taking into account the heat transfer feasibility constraint within the undefined heat transfer section. A challenging example of application is also presented to show the capabilities of the algorithm. - Highlights: • Energy systems based on Rankine cycles are used in many applications. • A hybrid algorithm is proposed to optimize the synthesis/design of such systems. • The topology of the candidate solutions is not limited by a superstructure. • Topology is managed by the genetic operators of the upper level algorithm. • The effectiveness of the algorithm is proved in a complex test case

  20. Influence of working fluids on Organic Rankine Cycle for waste heat recovery applications

    Energy Technology Data Exchange (ETDEWEB)

    Struzyna, Ralf; Eifler, Wolfgang; Steinmill, Jens [Bochum Univ. (Germany). Lehrstuhl fuer Verbrennungsmotoren

    2012-11-01

    More than 50% of the energy contained in fuel is lost due to the loss of heat content to the exhaust gas, the cooling water or the charge air cooler medium. Therefore, one of the most promising attempts to further increase the efficiency of internal combustion engines is waste heat recovery by means of a combined process. The Organic Rankine Cycle (ORC) is a promising process for waste heat recovery systems. The main purpose is to identify suitable working fluids to achieve best system performance. Therefore an analysis of the influence of different working fluids on system output is required. (orig.)

  1. Fluid selection for a low-temperature solar organic Rankine cycle

    International Nuclear Information System (INIS)

    Tchanche, Bertrand Fankam; Papadakis, George; Lambrinos, Gregory; Frangoudakis, Antonios

    2009-01-01

    Theoretical performances as well as thermodynamic and environmental properties of few fluids have been comparatively assessed for use in low-temperature solar organic Rankine cycle systems. Efficiencies, volume flow rate, mass flow rate, pressure ratio, toxicity, flammability, ODP and GWP were used for comparison. Of 20 fluids investigated, R134a appears as the most suitable for small scale solar applications. R152a, R600a, R600 and R290 offer attractive performances but need safety precautions, owing to their flammability.

  2. Preliminary design package for residential heating/cooling system: Rankine air conditioner redesign

    Science.gov (United States)

    1978-01-01

    A summary of the preliminary redesign and development of a marketable single family heating and cooling system is presented. The interim design and schedule status of the residential (3-ton) redesign, problem areas and solutions, and the definition of plans for future design and development activities were discussed. The proposed system for a single-family residential heating and cooling system is a single-loop, solar-assisted, hydronic-to-warm-air heating subsystem with solar-assisted domestic water heating and a Rankine-driven expansion air-conditioning subsystem.

  3. Panel cutting method: new approach to generate panels on a hull in Rankine source potential approximation

    Directory of Open Access Journals (Sweden)

    Hee-Jong Choi

    2011-12-01

    Full Text Available In the present study, a new hull panel generation algorithm, namely panel cutting method, was developed to predict flow phenomena around a ship using the Rankine source potential based panel method, where the iterative method was used to satisfy the nonlinear free surface condition and the trim and sinkage of the ship was taken into account. Numerical computations were performed to investigate the validity of the proposed hull panel generation algorithm for Series 60 (CB=0.60 hull and KRISO container ship (KCS, a container ship designed by Maritime and Ocean Engineering Research Institute (MOERI. The computational results were validated by comparing with the existing experimental data.

  4. Panel cutting method: new approach to generate panels on a hull in Rankine source potential approximation

    Science.gov (United States)

    Choi, Hee-Jong; Chun, Ho-Hwan; Park, Il-Ryong; Kim, Jin

    2011-12-01

    In the present study, a new hull panel generation algorithm, namely panel cutting method, was developed to predict flow phenomena around a ship using the Rankine source potential based panel method, where the iterative method was used to satisfy the nonlinear free surface condition and the trim and sinkage of the ship was taken into account. Numerical computations were performed to investigate the validity of the proposed hull panel generation algorithm for Series 60 (CB=0.60) hull and KRISO container ship (KCS), a container ship designed by Maritime and Ocean Engineering Research Institute (MOERI). The computational results were validated by comparing with the existing experimental data.

  5. Design and optimization of a novel organic Rankine cycle with improved boiling process

    DEFF Research Database (Denmark)

    Andreasen, Jesper Graa; Larsen, U.; Knudsen, Thomas

    2015-01-01

    to improve the boiling process. Optimizations are carried out for eight hydrocarbon mixtures for hot fluid inlet temperatures at 120 °C and 90 °C, using a genetic algorithm to determine the cycle conditions for which the net power output is maximized. The most promising mixture is an isobutane....../pentane mixture which, for the 90 °C hot fluid inlet temperature case, achieves a 14.5% higher net power output than an optimized organic Rankine cycle using the same mixture. Two parameter studies suggest that optimum conditions for the organic split-cycle are when the temperature profile allows the minimum...

  6. Evaluation of Rankine cycle air conditioning system hardware by computer simulation

    Science.gov (United States)

    Healey, H. M.; Clark, D.

    1978-01-01

    A computer program for simulating the performance of a variety of solar powered Rankine cycle air conditioning system components (RCACS) has been developed. The computer program models actual equipment by developing performance maps from manufacturers data and is capable of simulating off-design operation of the RCACS components. The program designed to be a subroutine of the Marshall Space Flight Center (MSFC) Solar Energy System Analysis Computer Program 'SOLRAD', is a complete package suitable for use by an occasional computer user in developing performance maps of heating, ventilation and air conditioning components.

  7. Applying the principles of thermoeconomics to the organic Rankine Cycle for low temperature waste heat recovery

    International Nuclear Information System (INIS)

    Xiao, F.; Lilun, Q.; Changsun, S.

    1989-01-01

    In this paper, thermoeconomic principle is used to study the selection of working fluids and the option of the cycle parameters in the organic Rankine cycle of low temperature waste heat recovery. The parameter ξ, the product of the ratio of waste heat recovery and real cycle thermal efficiency, is suggested as a unified thermodynamic criterion for the selection of the working fluids. The mathematical expressions are developed to determine the optimal boiling temperature and the optimal pin point temperature difference in the heat recovery exchanger by way of thermoeconomic principle

  8. A study of organic working fluids of an organic Rankine cycle for solar concentrating power plant

    International Nuclear Information System (INIS)

    Saifaoui, D.; Elmaanaoui, Y.; Faik, A.

    2014-01-01

    This work is a comparative study between four different configurations of an organic Rankine cycle (ORC) in order to find the configuration that gives the best performances. This study also made a comparison between seven organic fluids used as working fluids in the four ORC configurations. These fluids are all hydrocarbons. Then we made a parametric analysis of the results obtained in this first part. In a second part, we developed the binary mixtures of the seven pure hydrocarbons with the NIST software REFPROP 9 and we used them in our four ORC configurations. The obtained results are given and discussed. (author)

  9. Advanced Rankine and Brayton cycle power systems: Materials needs and opportunities

    Science.gov (United States)

    Grisaffe, S. J.; Guentert, D. C.

    1974-01-01

    Conceptual advanced potassium Rankine and closed Brayton power conversion cycles offer the potential for improved efficiency over steam systems through higher operating temperatures. However, for utility service of at least 100,000 hours, materials technology advances will be needed for such high temperature systems. Improved alloys and surface protection must be developed and demonstrated to resist coal combustion gases as well as potassium corrosion or helium surface degradation at high temperatures. Extensions in fabrication technology are necessary to produce large components of high temperature alloys. Long time property data must be obtained under environments of interest to assure high component reliability.

  10. Advanced Rankine and Brayton cycle power systems - Materials needs and opportunities

    Science.gov (United States)

    Grisaffe, S. J.; Guentert, D. C.

    1974-01-01

    Conceptual advanced potassium Rankine and closed Brayton power conversion cycles offer the potential for improved efficiency over steam systems through higher operating temperatures. However, for utility service of at least 100,000 hours, materials technology advances will be needed for such high temperature systems. Improved alloys and surface protection must be developed and demonstrated to resist coal combustion gases as well as potassium corrosion or helium surface degradation at high temperatures. Extensions in fabrication technology are necessary to produce large components of high temperature alloys. Long-time property data must be obtained under environments of interest to assure high component reliability.

  11. Model based control for waste heat recovery rankine cycle system in heavy duty trucks

    OpenAIRE

    Grelet, Vincent; Dufour, Pascal; Nadri, Madiha; Lemort, Vincent; Reiche, Thomas

    2015-01-01

    Driven by future emissions legislations and increase in fuel prices engine, gas heat recovering has recently attracted a lot of interest. In the past few years, a high number of studies have shown the interest of energy recovery Rankine based systems for heavy duty trucks engine compounding. Recent studies have brought a significant potential for such a system in a Heavy Duty (HD) vehicle, which can lead to a decrease in fuel consumption of about 5% [Wang et al. (2011)] and reduce engine emis...

  12. Experimental Comparison Of Working Fluids For Organic Rankine Cycle With Single-Screw Expander

    OpenAIRE

    Gusev, Sergei; Ziviani, Davide; Bell, Ian; De Paepe, Michel; van den Broek, Martijn

    2014-01-01

    This paper describes the behavior of an Organic Rankine Cycle (ORC) fed by a heat source with adaptable temperature and mass flow. For a suitable choice of working fluid, the setting of its evaporation pressure is crucial for the performance of an ORC installation. The higher the evaporation pressure, the higher the cycle efficiency on the one hand, but the lower the energy recovered from the heat source due to a higher outlet temperature on the other hand. An optimum has to be found to achie...

  13. A Novel Organic Rankine Cycle System with Improved Thermal Stability and Low Global Warming Fluids

    Directory of Open Access Journals (Sweden)

    Panesar Angad S

    2014-07-01

    Full Text Available This paper proposes a novel Organic Rankine Cycle (ORC system for long haul truck application. Rather than typical tail pipe heat recovery configurations, the proposed setup exploits the gaseous streams that are already a load on the engine cooling module. The system uses dual loops connected only by the Exhaust Gas Recirculation (EGR stream. A water blend study is conducted to identify suitable mixtures for the High Temperature (HT loop, while the Low Temperature (LT loop utilises a Low Global Warming (GWP Hydrofluoroether.

  14. Technology for industrial waste heat recovery by organic Rankine cycle systems

    Science.gov (United States)

    Cain, W. G.; Drake, R. L.; Prisco, C. J.

    1984-10-01

    The recovery of industrial waste heat and the conversion thereof to useful electric power by use of Rankine cycle systems is studied. Four different aspects of ORC technology were studied: possible destructive chemical reaction between an aluminum turbine wheel and R-113 working fluid under wheel-to-rotor rub conditions; possible chemical reaction between stainless steel or carbon steel and any of five different ORC working fluids under rotor-stator rub conditions; effects on electric generator properties of extended exposure to an environment of saturated R-113 vapor/fluid; and operational proof tests under laboratory conditions of two 1070 kW, ORC, R-113 hermetic turbogenerator power module systems.

  15. Conceptual design and analysis of a Dish-Rankine solar thermal power system

    Science.gov (United States)

    Pons, R. L.

    1980-08-01

    A Point Focusing Distributed Receiver (PFDR) solar thermal electric system which employs small Organic Rankine Cycle (ORC) engines is examined with reference to its projected technical/economic performance. With mass-produced power modules (about 100,000 per year), the projected life-cycle energy cost for an optimized no-storage system is estimated at 67 mills/kWh (Levelized Busbar Energy Cost) without the need for advanced development of any of its components. At moderate production rates (about 50 MWe/yr) system energy costs are competitive with conventional power generation systems in special remote-site types of applications.

  16. Thermal energy storage for organic Rankine cycle solar dynamic space power systems

    Science.gov (United States)

    Heidenreich, G. R.; Parekh, M. B.

    An organic Rankine cycle-solar dynamic power system (ORC-SDPS) comprises a concentrator, a radiator, a power conversion unit, and a receiver with a thermal energy storage (TES) subsystem which charges and discharges energy to meet power demands during orbital insolation and eclipse periods. Attention is presently given to the criteria used in designing and evaluating an ORC-SDPS TES, as well as the automated test facility employed. It is found that a substantial data base exists for the design of an ORC-SDPS TES subsystem.

  17. Preliminary design package for residential heating/cooling system--Rankine air conditioner redesign

    Energy Technology Data Exchange (ETDEWEB)

    1978-12-01

    This report contains a summary of the preliminary redesign and development of a marketable single-family heating and cooling system. The objectives discussed are the interim design and schedule status of the Residential (3-ton) redesign, problem areas and solutions, and the definition of plans for future design and development activities. The proposed system for a single-family residential heating and cooling system is a single-loop, solar-assisted, hydronic-to-warm-air heating subsystem with solar-assisted domestic water heating and a Rankine-driven expansion air-conditioning subsystem.

  18. Multi-Objective Optimization of Organic Rankine Cycle Power Plants Using Pure and Mixed Working Fluids

    DEFF Research Database (Denmark)

    Andreasen, Jesper Graa; Kærn, Martin Ryhl; Pierobon, Leonardo

    2016-01-01

    , which is beneficial for cycle performance. On the other hand, larger heat transfer surface areas are typically required for evaporation and condensation when zeotropic mixtures are used as working fluids. In order to assess the feasibility of using zeotropic mixtures, it is, therefore, important......For zeotropic mixtures, the temperature varies during phase change, which is opposed to the isothermal phase change of pure fluids. The use of such mixtures as working fluids in organic Rankine cycle power plants enables a minimization of the mean temperature difference of the heat exchangers...

  19. Multi-objective optimization of organic Rankine cycle power plants using pure and mixed working fluids

    DEFF Research Database (Denmark)

    Andreasen, Jesper Graa; Kærn, Martin Ryhl; Pierobon, Leonardo

    2015-01-01

    For zeotropic mixtures, the temperature varies during phase change, which is opposed to the isothermalphase change of pure fluids. The use of such mixtures as working fluids in organic Rankine cyclepower plants enables a minimization of the mean temperature difference of the heat exchangers whenthe...... minimum pinch point temperature difference is kept fixed. A low mean temperature differencemeans low heat transfer irreversibilities, which is beneficial for cycle performance, but it also results inlarger heat transfer surface areas. Moreover, the two-phase heat transfer coefficients for zeotropic...

  20. Cerebral oxygen transport failure?: decreasing hemoglobin and hematocrit levels after ischemic stroke predict poor outcome and mortality: STroke: RelevAnt Impact of hemoGlobin, Hematocrit and Transfusion (STRAIGHT)--an observational study.

    Science.gov (United States)

    Kellert, Lars; Martin, Evgenia; Sykora, Marek; Bauer, Harald; Gussmann, Philipp; Diedler, Jennifer; Herweh, Christian; Ringleb, Peter A; Hacke, Werner; Steiner, Thorsten; Bösel, Julian

    2011-10-01

    Although conceivably relevant for penumbra oxygenation, the optimal levels of hemoglobin (Hb) and hematocrit (Hct) in patients with acute ischemic stroke are unknown. We identified patients from our prospective local stroke database who received intravenous thrombolysis based on multimodal magnet resonance imaging during the years 1998 to 2009. A favorable outcome at 3 months was defined as a modified Rankin Scale score≤2 and a poor outcome as a modified Rankin Scale score≥3. The dynamics of Hemoglobin (Hb), Hematocrit (Hct), and other relevant laboratory parameters as well as cardiovascular risk factors were retrospectively assessed and analyzed between these 2 groups. Of 217 patients, 114 had a favorable and 103 a poor outcome. In a multivariable regression model, anemia until day 5 after admission (odds ratio [OR]=2.61; 95% CI, 1.33 to 5.11; P=0.005), Hb nadir (OR=0.81; 95% CI, 0.67 to 0.99; P=0.038), and Hct nadir (OR=0.93; 95% CI, 0.87 to 0.99; P=0.038) remained independent predictors for poor outcome at 3 months. Mortality after 3 months was independently associated with Hb nadir (OR=0.80; 95% CI, 0.65 to 0.98; P=0.028) and Hb decrease (OR=1.34; 95% CI, 1.01 to 1.76; P=0.04) as well as Hct decrease (OR=1.12; 95% CI, 1.01 to 1.23; P=0.027). Poor outcome and mortality after ischemic stroke are strongly associated with low and further decreasing Hb and Hct levels. This decrease of Hb and Hct levels after admission might be more relevant and accessible to treatment than are baseline levels.

  1. Sub-Coronal Inflatable Penile Prosthesis Placement With Modified No-Touch Technique: A Step-by-Step Approach With Outcomes.

    Science.gov (United States)

    Weinberg, Aaron C; Pagano, Matthew J; Deibert, Christopher M; Valenzuela, Robert J

    2016-02-01

    The surgical treatment of disorders of male sexual function requires specific exposure to correct the underlying problem safely and efficiently. Currently, sub-coronal exposure is used for treatment of phimosis, Peyronie's disease plaque (PDP), and semirigid penile prosthesis insertion. Infra-pubic and scrotal incisions are used for inflatable penile prosthesis (IPP) placement. However, men who present with several disorders might require multiple procedures and surgical incisions. To report a prospective review of our surgical experience and outcomes with a single sub-coronal incision for IPP placement with a modified no-touch technique. This approach allows for access to the entire corporal body for multiple reconstructive procedures. Two hundred men had IPPs placed through a sub-coronal incision using our modified no-touch technique. The penis was degloved to the level of the penoscrotal junction and the dartos muscle was everted and secured to the drapes. This allowed exclusion of the scrotal and penile skin from the operative field. After artificial erection, the patient's corpora were inspected for PDP and other abnormalities. Penoscrotal IPP models were placed in all cases with insertion proximal to the penoscrotal junction. After placement of the IPP, the abnormalities were repaired. Feasibility of the procedure, operative times, complication rate, utilization of accessory, reconstructive procedures, and post-operative penile length. Of the 200 men who had IPP placement, 92 had PDP that was treated, 106 (53%) consented to circumcision, 24 (12%) had their reservoir placed ectopically, and 31 (16%) had a prosthesis exchanged through the sub-coronal technique. Mean operative time was 73 minutes (39-161 minutes). Specialists in the surgical treatment of disorders of male sexual function can perform multiple procedures safely and easily through a modified no-touch single sub-coronal incision. This approach allows access to the entire corporal body, providing

  2. Thermodynamic analysis of an integrated gasification solid oxide fuel cell plant combined with an organic Rankine cycle

    DEFF Research Database (Denmark)

    Pierobon, Leonardo; Rokni, Masoud; Larsen, Ulrik

    2013-01-01

    into a fixed bed gasification plant to produce syngas which fuels the combined solid oxide fuel cells e organic Rankine cycle system to produce electricity. More than a hundred fluids are considered as possible alternative for the organic cycle using non-ideal equations of state (or state-of-the-art equations......A 100 kWe hybrid plant consisting of gasification system, solid oxide fuel cells and organic Rankine cycle is presented. The nominal power is selected based on cultivation area requirement. For the considered output a land of around 0.5 km2 needs to be utilized. Woodchips are introduced...... achieved by simple and double stage organic Rankine cycle plants and around the same efficiency of a combined gasification, solid oxide fuel cells and micro gas turbine plant. © 2013 Elsevier Ltd. All rights reserved....

  3. Thermodynamic performance analysis of a coupled transcritical and subcritical organic Rankine cycle system for waste heat recovery

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Xi Wu [Zhejiang Ocean University, Zhejian (China); Wang, Xiao Qiong; Li, You Rong; Wu, Chun Mei [Chongqing University, Chongqing (China)

    2015-07-15

    We present a novel coupled organic Rankine cycle (CORC) system driven by the low-grade waste heat, which couples a transcritical organic Rankine cycle with a subcritical organic Rankine cycle. Based on classical thermodynamic theory, a detailed performance analysis on the novel CORC system was performed. The results show that the pressure ratio of the expander is decreased in the CORC and the selection of the working fluids becomes more flexible and abundant. With the increase of the pinch point temperature difference of the internal heat exchanger, the net power output and thermal efficiency of the CORC all decrease. With the increase of the critical temperature of the working fluid, the system performance of the CORC is improved. The net power output and thermal efficiency of the CORC with isentropic working fluids are higher than those with dry working fluids.

  4. Does Kinesiophobia Modify the Effects of Physical Therapy on Outcomes in Patients With Sciatica in Primary Care? Subgroup Analysis From a Randomized Controlled Trial.

    Science.gov (United States)

    Verwoerd, Annemieke J H; Luijsterburg, Pim A J; Koes, Bart W; el Barzouhi, Abdelilah; Verhagen, Arianne P

    2015-09-01

    A higher level of kinesiophobia appears to be associated with poor recovery in patients with sciatica. The aim of this study was to investigate whether kinesiophobia modifies the effect of physical therapy on outcomes in patients with sciatica. This was a subgroup analysis from a randomized controlled trial. The study was conducted in a primary care setting. A total of 135 patients with acute sciatica participated. Patients were randomly assigned to groups that received (1) physical therapy plus general practitioners' care (intervention group) or (2) general practitioners' care alone (control group). Kinesiophobia at baseline was measured with the Tampa Scale for Kinesiophobia (TSK) and a single substitute question for kinesiophobia (SQK). Pain and recovery were assessed at 3- and 12-month follow-ups. Regression analysis was used to test for interaction between the level of kinesiophobia at baseline and treatment allocation. Subgroup results were calculated for patients classified with high fear of movement and for those classified with low fear of movement. Kinesiophobia at baseline interacted with physical therapy in the analysis with leg pain intensity at 12-month follow-up. Kinesiophobia at baseline did not interact with physical therapy regarding any outcome at 3-month follow-up or recovery at 12-month follow-up. When comparing both treatment groups in the subgroup of patients with high fear of movement (n=73), the only significant result was found for leg pain intensity difference from baseline at 12-month follow-up (intervention group: X̅=-5.0, SD=2.6; control group: X̅=-3.6, SD=2.7). The post hoc study design and relatively small sample size were limitations of the study. In 135 patients with sciatica, evidence shows that patients with a higher level of kinesiophobia at baseline may particularly benefit from physical therapy with regard to decreasing leg pain intensity at 12-month follow-up. © 2015 American Physical Therapy Association.

  5. A police education programme to integrate occupational safety and HIV prevention: protocol for a modified stepped-wedge study design with parallel prospective cohorts to assess behavioural outcomes

    Science.gov (United States)

    Strathdee, Steffanie A; Arredondo, Jaime; Rocha, Teresita; Abramovitz, Daniela; Rolon, Maria Luisa; Patiño Mandujano, Efrain; Rangel, Maria Gudelia; Olivarria, Horcasitas Omar; Gaines, Tommi; Patterson, Thomas L; Beletsky, Leo

    2015-01-01

    Introduction Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre–post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown. Objectives Proyecto ESCUDO (SHIELD) aims to evaluate the efficacy of the PEP on uptake of occupational safety procedures, as assessed through the incidence of needle stick injuries (NSIs) (primary outcome) and changes in knowledge of transmission, prevention and treatment of HIV and viral hepatitis; attitudes towards PWID, adverse behaviours that interfere with HIV prevention and protective behaviours (secondary outcomes). Methods/analysis ESCUDO is a hybrid type I design that simultaneously tests an intervention and an implementation strategy. Using a modified stepped-wedge design involving all active duty street-level police officers in Tijuana (N=∼1200), we will administer one 3 h PEP course to groups of 20–50 officers until the entire force is trained. NSI incidence and geocoded arrest data will be assessed from department-wide de-identified data. Of the consenting police officers, a subcohort (N=500) will be randomly sampled from each class to undergo pre-PEP and post-PEP surveys with a semiannual follow-up for 2 years to assess self-reported NSIs, attitudes and behaviour changes. The impact on PWIDs will be externally validated through a parallel cohort of Tijuana PWIDs. Ethics/dissemination Research ethics approval was obtained from the USA and Mexico. Findings will be disseminated through open access to protocol materials through the Law Enforcement and HIV Network. Trial registration number NCT02444403. PMID:26260350

  6. Tofacitinib in Combination With Conventional Disease-Modifying Antirheumatic Drugs in Patients With Active Rheumatoid Arthritis: Patient-Reported Outcomes From a Phase III Randomized Controlled Trial.

    Science.gov (United States)

    Strand, Vibeke; Kremer, Joel M; Gruben, David; Krishnaswami, Sriram; Zwillich, Samuel H; Wallenstein, Gene V

    2017-04-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We compared patient-reported outcomes (PROs) in patients with RA treated with tofacitinib or placebo in combination with conventional disease-modifying antirheumatic drugs (DMARDs). In a 12-month, phase III randomized controlled trial (ORAL Sync), patients (n = 795) with active RA and previous inadequate response to therapy with ≥1 conventional or biologic DMARD were randomized 4:4:1:1 to tofacitinib 5 mg twice daily (BID), tofacitinib 10 mg BID, placebo advanced to 5 mg BID, or placebo to 10 mg BID, in combination with stable background DMARD therapy. PROs included patient global assessment of arthritis (PtGA), patient assessment of arthritis pain (Pain), physical function (Health Assessment Questionnaire disability index [HAQ DI]), health-related quality of life (Short Form 36 health survey [SF-36]), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-F]), and sleep (Medical Outcomes Study Sleep [MOS Sleep]). At month 3, statistically significant improvements from baseline versus placebo were reported in PtGA, Pain, HAQ DI, all 8 SF-36 domains, FACIT-F, and MOS Sleep with tofacitinib 10 mg BID, and in PtGA, Pain, HAQ DI, 7 SF-36 domains, FACIT-F, and MOS Sleep with tofacitinib 5 mg BID. Improvements were sustained to month 12. Significantly more tofacitinib-treated patients reported improvements of greater than or equal to the minimum clinically important differences at month 3 versus placebo in all PROs, except the SF-36 role-emotional domain (significant for tofacitinib 10 mg BID). Patients with active RA treated with tofacitinib combined with background conventional DMARD therapy reported sustained, significant, and clinically meaningful improvements in PROs versus placebo. © 2016, The Authors. Arthritis Care & Research published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology.

  7. Early post-stroke cognition in stroke rehabilitation patients predicts functional outcome at 13 months.

    Science.gov (United States)

    Wagle, Jørgen; Farner, Lasse; Flekkøy, Kjell; Bruun Wyller, Torgeir; Sandvik, Leiv; Fure, Brynjar; Stensrød, Brynhild; Engedal, Knut

    2011-01-01

    To identify prognostic factors associated with functional outcome at 13 months in a sample of stroke rehabilitation patients. Specifically, we hypothesized that cognitive functioning early after stroke would predict long-term functional outcome independently of other factors. 163 stroke rehabilitation patients underwent a structured neuropsychological examination 2-3 weeks after hospital admittance, and their functional status was subsequently evaluated 13 months later with the modified Rankin Scale (mRS) as outcome measure. Three predictive models were built using linear regression analyses: a biological model (sociodemographics, apolipoprotein E genotype, prestroke vascular factors, lesion characteristics and neurological stroke-related impairment); a functional model (pre- and early post-stroke cognitive functioning, personal and instrumental activities of daily living, ADL, and depressive symptoms), and a combined model (including significant variables, with p value Stroke Scale; β = 0.402, p stroke cognitive functioning (Repeatable Battery of Neuropsychological Status, RBANS; β = -0.248, p = 0.001) and prestroke personal ADL (Barthel Index; β = -0.217, p = 0.002). Further linear regression analyses of which RBANS indexes and subtests best predicted long-term functional outcome showed that Coding (β = -0.484, p stroke cognitive functioning as measured by the RBANS is a significant and independent predictor of long-term functional post-stroke outcome. Copyright © 2011 S. Karger AG, Basel.

  8. Impact of early surgical evacuation of sylvian hematoma on clinical course and outcome after subarachnoid hemorrhage

    International Nuclear Information System (INIS)

    Mutoh, Tatsushi; Ishikawa, Tatsuya; Moroi, Junta; Suzuki, Akifumi; Yasui, Nobuyuki

    2010-01-01

    The present study aimed to evaluate the impact of early surgical evacuation of sylvian hematoma caused by ruptured middle cerebral artery (MCA) aneurysm on clinical outcome after subarachnoid hemorrhage. Hospital records and computed tomography scans for 26 patients with MCA aneurysm who underwent surgical clipping between June 2001 and January 2008 were retrospectively reviewed. All patients presented with sylvian hematoma associated with subarachnoid hemorrhage and received surgery at 7.9±3.6 (mean±standard deviation) hours of ictus. They were divided postoperatively into two groups, achievement (n=16) and non-achievement (n=10) of extensive hematoma evacuation, and their clinical course and functional outcomes were compared. The frequencies of delayed ischemic neurological deficit and vasospasm-related cerebral infarction were significantly less (p<0.05) in the achievement group. Better functional outcomes were obtained in patients with successful evacuation (p<0.05), as assessed by improvement of hemiparesis on manual muscle testing scale at postoperative 1-month follow up and by the modified Rankin scale at postoperative 3 and 6 months. Clinical outcomes were also better in the achievement group. These results suggest that better clinical course and outcome can be expected in patients who undergo early successful hematoma evacuation with surgical clipping of a ruptured MCA aneurysm. (author)

  9. Serum tenascin-C predicts severity and outcome of acute intracerebral hemorrhage.

    Science.gov (United States)

    Wang, Lin-Guo; Huangfu, Xue-Qin; Tao, Bo; Zhong, Guan-Jin; Le, Zhou-Di

    2018-06-01

    Tenascin-C is a matricellular protein related to brain injury. We studied serum tenascin-C in acute intracerebral hemorrhage (ICH) and examined the associations with severity and outcome following the acute event. Tenascin-C samples were obtained from 162 patients with acute hemorrhagic stroke and 162 healthy controls. Poor 90-day functional outcome was defined as modified Rankin Scale score > 2. Early neurological deterioration (END) and hematoma growth (HG) were recorded at 24 h. Patients had higher tenascin-C levels than controls. Tenascin-C levels were positively correlated with hematoma volume or National Institutes of Health Stroke Scale score at baseline. Elevated tenascin-C levels were independently associated with END, HG, 90-day mortality and poor functional outcome. Moreover, tenascin-C levels significantly predicted END, HG and 90-day outcomes under receiver operating characteristic curves. An increase in serum tenascin-C level is associated with an adverse outcome in ICH patients, supporting the potential role of serum tenascin-C as a prognostic biomarker for hemorrhagic stroke. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Evaluation of human sperm chromatin status after selection using a modified Diff-Quik stain indicates embryo quality and pregnancy outcomes following in vitro fertilization.

    Science.gov (United States)

    Tavares, R S; Silva, A F; Lourenço, B; Almeida-Santos, T; Sousa, A P; Ramalho-Santos, J

    2013-11-01

    Sperm chromatin/DNA damage can be measured by a variety of assays. However, it has been reported that these tests may lose prognostic value in Assisted Reproductive Technology (ART) cycles when assessed in post-prepared samples, possibly due to the normalizing effect promoted by sperm preparation procedures. We have recently implemented a modified version of the Diff-Quik staining assay that allows for the evaluation of human sperm chromatin status in native samples, together with standard sperm morphology assessment. However, the value of this parameter in terms of predicting in vitro fertilization (IVF) and Intracytoplasmic sperm injection (ICSI) outcomes after sperm selection is unknown. In this study, data from 138 couples undergoing in vitro fertilization (IVF) or Intracytoplasmic sperm injection (ICSI) treatments showed that sperm chromatin integrity was significantly improved after density gradient centrifugation and swim up (p embryo development rates (p > 0.05). However, sperm samples presenting lower percentages of damaged chromatin were associated with better quality (Grade I) embryos in both ART procedures (p selection may occur; but not in ICSI, where sperm selection is operator dependent. This quick and low-cost assay is suggested as an alternative method to detect sperm chromatin status in minimal clinical settings, when no other well-established and robust assays (e.g. Sperm chromatin structure assay, terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling) are available. © 2013 American Society of Andrology and European Academy of Andrology.

  11. Pretreatment Modified Glasgow Prognostic Score Predicts Clinical Outcomes After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kishi, Takahiro; Matsuo, Yukinori, E-mail: ymatsuo@kuhp.kyoto-u.ac.jp; Ueki, Nami; Iizuka, Yusuke; Nakamura, Akira; Sakanaka, Katsuyuki; Mizowaki, Takashi; Hiraoka, Masahiro

    2015-07-01

    Purpose: This study aimed to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with non-small cell lung cancer (NSCLC) who received stereotactic body radiation therapy (SBRT). Methods and Materials: Data from 165 patients who underwent SBRT for stage I NSCLC with histologic confirmation from January 1999 to September 2010 were collected retrospectively. Factors, including age, performance status, histology, Charlson comorbidity index, mGPS, and recursive partitioning analysis (RPA) class based on sex and T stage, were evaluated with regard to overall survival (OS) using the Cox proportional hazards model. The impact of the mGPS on cause of death and failure patterns was also analyzed. Results: The 3-year OS was 57.9%, with a median follow-up time of 3.5 years. A higher mGPS correlated significantly with poor OS (P<.001). The 3-year OS of lower mGPS patients was 66.4%, whereas that of higher mGPS patients was 44.5%. On multivariate analysis, mGPS and RPA class were significant factors for OS. A higher mGPS correlated significantly with lung cancer death (P=.019) and distant metastasis (P=.013). Conclusions: The mGPS was a significant predictor of clinical outcomes for SBRT in NSCLC patients.

  12. Preliminary thermodynamic study for an efficient turbo-blower external combustion Rankine cycle

    Science.gov (United States)

    Romero Gómez, Manuel; Romero Gómez, Javier; Ferreiro Garcia, Ramón; Baaliña Insua, Álvaro

    2014-08-01

    This research paper presents a preliminary thermodynamic study of an innovative power plant operating under a Rankine cycle fed by an external combustion system with turbo-blower (TB). The power plant comprises an external combustion system for natural gas, where the combustion gases yield their thermal energy, through a heat exchanger, to a carbon dioxide Rankine cycle operating under supercritical conditions and with quasi-critical condensation. The TB exploits the energy from the pressurised exhaust gases for compressing the combustion air. The study is focused on the comparison of the combustion system's conventional technology with that of the proposed. An energy analysis is carried out and the effect of the flue gas pressure on the efficiency and on the heat transfer in the heat exchanger is studied. The coupling of the TB results in an increase in efficiency and of the convection coefficient of the flue gas with pressure, favouring a reduced volume of the heat exchanger. The proposed innovative system achieves increases in efficiency of around 12 % as well as a decrease in the heat exchanger volume of 3/5 compared with the conventional technology without TB.

  13. High-Efficiency Small-Scale Combined Heat and Power Organic Binary Rankine Cycles

    Directory of Open Access Journals (Sweden)

    Costante Mario Invernizzi

    2018-04-01

    Full Text Available Small-CHP (Combined Heat and Power systems are generally considered a valuable technological option to the conventional boilers, in a technology developed context. If small-CHP systems are associated with the use of renewable energies (biomass, for example they could play an important role in distributed generation even in developing countries or, in any case, where there are no extensive electricity networks. Traditionally the considered heat engines for micro- or mini-CHP are: the gas engine, the gas turbine (with internal combustion, the steam engine, engine working according to the Stirling and to the Rankine cycles, the last with organic fluids. In principle, also fuel cells could be used. In this paper, we focus on small size Rankine cycles (10–15 k W with organic working fluids. The assumed heat source is hot combustion gases at high temperature (900–950 ∘ C and we assume to use only single stages axial turbines. The need to work at high temperatures, limits the choice of the right organic working fluids. The calculation results show the limitation in the performances of simple cycles and suggest the opportunity to resort to complex (binary cycle configurations to achieve high net conversion efficiencies (15–16%.

  14. Off-design performance analysis of a solar-powered organic Rankine cycle

    International Nuclear Information System (INIS)

    Wang, Jiangfeng; Yan, Zhequan; Zhao, Pan; Dai, Yiping

    2014-01-01

    Highlights: • Solar-powered organic Rankine cycle with CPC and thermal storage unit is studied. • Off-design performances encountering the changes of key parameters are examined. • Off-design performance is analyzed over a whole day and in different months. - Abstract: Performance evaluation of a thermodynamic system under off-design conditions is very important for reliable and cost-effective operation. In this study, an off-design model of an organic Rankine cycle driven by solar energy is established with compound parabolic collector (CPC) to collect the solar radiation and thermal storage unit to achieve the continuous operation of the overall system. The system off-design behavior is examined under the change in environment temperature, as well as thermal oil mass flow rates of vapor generator and CPC. In addition, the off-design performance of the system is analyzed over a whole day and in different months. The results indicate that a decrease in environment temperature, or the increases in thermal oil mass flow rates of vapor generator and CPC could improve the off-design performance. The system obtains the maximum average exergy efficiency in December and the maximum net power output in June or in September. Both the net power output and the average exergy efficiency reach minimum values in August

  15. An integrated optimization for organic Rankine cycle based on entransy theory and thermodynamics

    International Nuclear Information System (INIS)

    Li, Tailu; Fu, Wencheng; Zhu, Jialing

    2014-01-01

    The organic Rankine cycle has been one of the essential heat-work conversion technologies nowadays. Lots of effectual optimization methods are focused on the promotion of the system efficiency, which are mainly relied on engineering experience and numerical simulations rather than theoretical analysis. A theoretical integrated optimization method was established based on the entransy theory and thermodynamics, with the ratio of the net power output to the ratio of the total thermal conductance to the thermal conductance in the condenser as the objective function. The system parameters besides the optimal pinch point temperature difference were obtained. The results show that the mass flow rate of the working fluid is inversely proportional to the evaporating temperature. An optimal evaporating temperature maximizes the net power output, and the maximal net power output corresponds to the maximal entransy loss and the change points of the heat source outlet temperature and the change rates for the entropy generation and the entransy dissipation. Moreover, the net power output and the total thermal conductance are inversely proportional to the pinch point temperature difference, contradicting with each other. Under the specified condition, the optimal operating parameters are ascertained, with the optimal pinch point temperature difference of 5 K. - Highlights: • We establish an integrated optimization model for organic Rankine cycle. • The model combines the entransy theory with thermodynamics. • The maximal net power output corresponds to the maximal entransy loss. • The pinch point temperature difference is optimized to be 5 K

  16. Selecting working fluids in an organic Rankine cycle for power generation from low temperature heat sources

    Directory of Open Access Journals (Sweden)

    Fredy Vélez

    2014-01-01

    Full Text Available Este trabajo presenta un estudio termodinámico realizado sobre el uso de fuentes de calor de baja temperatura para la generaci ón de energía a través de un ciclo Rankin e subcrítico con fluidos de trabajo orgánicos. Un análisis d el estado del arte de esta tecn ología muestra como línea de investigación abierta, la selección del fluido de trabajo, pues hasta ahora, no existe un fluido que satisfaga t odos los aspectos medioambientales y técnicos a tener en cuenta en estos ciclos. Por ello, se ha desarrollado una serie de simulaciones que permiten estudiar el comportamiento del ciclo Rankine con difer entes configuraciones y fluidos (húmedo, seco e isoentrópico, permitiendo con ello observar de qué manera influyen cambios ta nto en esos tipos de fluidos utilizados (refrigerantes, hidroca rburos y agua, como de condiciones de temperatura, presión, flujo, etc. , sobre la eficiencia total del ciclo. Con el trabajo realizado se demuestra la viabilidad de este tipo de proceso en la recuperación de calore s en la industria y/o aprovechamiento de fuentes renovables de baja y media temperatura para la producción de energía eléctrica.

  17. Waste Heat Recovery of a PEMFC System by Using Organic Rankine Cycle

    Directory of Open Access Journals (Sweden)

    Tianqi He

    2016-04-01

    Full Text Available In this study, two systems are brought forward to recover the waste heat of a proton exchange membrane fuel cell (PEMFC, which are named the organic Rankine cycle (ORC, and heat pump (HP combined organic Rankine cycle (HPORC. The performances of both systems are simulated on the platform of MATLAB with R123, R245fa, R134a, water, and ethanol being selected as the working fluid, respectively. The results show that, for PEMFC where operating temperature is constantly kept at 60 °C, there exists an optimum working temperature for each fluid in ORC and HPORC. In ORC, the maximal net power can be achieved with R245fa being selected as the working fluid. The corresponding thermal efficiency of the recovery system is 4.03%. In HPORC, the maximal net power can be achieved with water being selected in HP and R123 in ORC. The thermal efficiency of the recovery system increases to 4.73%. Moreover, the possibility of using ORC as the cooling system of PEMFC is also studied. The heat released from PEMFC stack is assumed to be wholly recovered by the ORC or HPORC system. The results indicate that the HPORC system is much more feasible for the cooling system of a PEMFC stack, since the heat recovery ability can be promoted due to the presence of HP.

  18. Simulation of a passive house coupled with a heat pump/organic Rankine cycle reversible unit

    DEFF Research Database (Denmark)

    Dumont, Olivier; Carmo, Carolina; Randaxhe, François

    2014-01-01

    This paper presents a dynamic model of a passive house located in Denmark with a large solar absorber, a horizontal ground heat exchanger coupled with a HP/ORC unit. The HP/ORC reversible unit is a module able to work as an Organic Rankine Cycle (ORC) or as a heat pump (HP). There are 3 possible ...... presents a higher global COP because the heat produced on the roof can heat the storage directly.......This paper presents a dynamic model of a passive house located in Denmark with a large solar absorber, a horizontal ground heat exchanger coupled with a HP/ORC unit. The HP/ORC reversible unit is a module able to work as an Organic Rankine Cycle (ORC) or as a heat pump (HP). There are 3 possible...... modes that need to be chosen optimally depending on the weather conditions, the heat demand and the temperature level of the storage. The ORC mode is activated, as long as the heat demand of the house is covered by the storage to produce electricity based upon the heat generated by the solar roof...

  19. Review of organic Rankine cycles for internal combustion engine exhaust waste heat recovery

    International Nuclear Information System (INIS)

    Sprouse, Charles; Depcik, Christopher

    2013-01-01

    Escalating fuel prices and future carbon dioxide emission limits are creating a renewed interest in methods to increase the thermal efficiency of engines beyond the limit of in-cylinder techniques. One promising mechanism that accomplishes both objectives is the conversion of engine waste heat to a more useful form of energy, either mechanical or electrical. This paper reviews the history of internal combustion engine exhaust waste heat recovery focusing on Organic Rankine Cycles since this thermodynamic cycle works well with the medium-grade energy of the exhaust. Selection of the cycle expander and working fluid are the primary focus of the review, since they are regarded as having the largest impact on system performance. Results demonstrate a potential fuel economy improvement around 10% with modern refrigerants and advancements in expander technology. -- Highlights: ► This review article focuses on engine exhaust waste heat recovery works. ► The organic Rankine cycle is superior for low to medium exergy heat sources. ► Working fluid and expander selection strongly influence efficiency. ► Several authors demonstrate viable systems for vehicle installation

  20. Selection of Optimum Working Fluid for Organic Rankine Cycles by Exergy and Exergy-Economic Analyses

    Directory of Open Access Journals (Sweden)

    Kamyar Darvish

    2015-11-01

    Full Text Available The thermodynamic performance of a regenerative organic Rankine cycle that utilizes low temperature heat sources to facilitate the selection of proper organic working fluids is simulated. Thermodynamic models are used to investigate thermodynamic parameters such as output power, and energy efficiency of the ORC (Organic Rankine Cycle. In addition, the cost rate of electricity is examined with exergo-economic analysis. Nine working fluids are considered as part of the investigation to assess which yields the highest output power and exergy efficiency, within system constraints. Exergy efficiency and cost rate of electricity are used as objective functions for system optimization, and each fluid is assessed in terms of the optimal operating condition. The degree of superheat and the pressure ratio are independent variables in the optimization. R134a and iso-butane are found to exhibit the highest energy and exergy efficiencies, while they have output powers in between the systems using other working fluids. For a source temperature was equal to 120 °C, the exergy efficiencies for the systems using R134a and iso-butane are observed to be 19.6% and 20.3%, respectively. The largest exergy destructions occur in the boiler and the expander. The electricity cost rates for the system vary from 0.08 USD/kWh to 0.12 USD/kWh, depending on the fuel input cost, for the system using R134a as a working fluid.

  1. North American SOLITAIRE Stent-Retriever Acute Stroke Registry: choice of anesthesia and outcomes.

    Science.gov (United States)

    Abou-Chebl, Alex; Zaidat, Ossama O; Castonguay, Alicia C; Gupta, Rishi; Sun, Chung-Huan J; Martin, Coleman O; Holloway, William E; Mueller-Kronast, Nils; English, Joey D; Linfante, Italo; Dabus, Guilherme; Malisch, Timothy W; Marden, Franklin A; Bozorgchami, Hormozd; Xavier, Andrew; Rai, Ansaar T; Froehler, Micahel T; Badruddin, Aamir; Nguyen, Thanh N; Taqi, Muhammad; Abraham, Michael G; Janardhan, Vallabh; Shaltoni, Hashem; Novakovic, Roberta; Yoo, Albert J; Chen, Peng R; Britz, Gavin W; Kaushal, Ritesh; Nanda, Ashish; Issa, Mohammad A; Nogueira, Raul G

    2014-05-01

    Previous work that predated the availability of the safer stent-retriever devices has suggested that general anesthesia (GA) may have a negative impact on outcomes in patients with acute ischemic stroke undergoing endovascular therapy. We reviewed demographic, clinical, procedural (GA versus local anesthesia [LA], etc), and site-adjudicated angiographic and clinical outcomes data from consecutive patients treated with the Solitaire FR device in the investigator-initiated North American SOLITAIRE Stent-Retriever Acute Stroke (NASA) Registry. The primary outcomes were 90-day modified Rankin Scale, mortality, and symptomatic intracranial hemorrhage. A total of 281 patients from 18 centers were enrolled. GA was used in 69.8% (196/281) of patients. Baseline demographic and procedural factors were comparable between the LA and GA groups, except the former demonstrated longer time-to-groin puncture (395.4±254 versus 337.4±208 min; P=0.04), lower National Institutes of Health Stroke Scale (NIHSS; 16.2±5.8 versus 18.8±6.9; P=0.002), lower balloon-guide catheter usage (22.4% versus 49.2%; P=0.0001), and longer fluoroscopy times (39.5±33 versus 28±22.8 min; P=0.008). Recanalization (thrombolysis in cerebral infarction ≥2b; 72.94% versus 73.6%; P=0.9) and rate of symptomatic intracranial hemorrhage (7.1% versus 11.2%; P=0.4) were similar but modified Rankin Scale ≤2 was achieved in more LA patients, 52.6% versus 35.6% (odds ratio, 1.4 [1.1-1.8]; P=0.01). In multivariate analysis, hypertension, NIHSS, unsuccessful revascularization, and GA use (odds ratio, 3.3 [1.6-7.1]; P=0.001) were associated with death. When only anterior circulation and elective GA patients were included, there was a persistent difference in good outcomes in favor of LA patients (50.7% versus 35.5%; odds ratio, 1.3 [1.01-1.6]; P=0.04). The NASA Registry has demonstrated that clinical outcomes and survival are significantly better in patients treated with LA, without increased symptomatic

  2. Stroke outcomes in Malawi, a country with high prevalence of HIV: a prospective follow-up study.

    Directory of Open Access Journals (Sweden)

    Terttu Heikinheimo

    Full Text Available BACKGROUND: Stroke contributes significantly to disability and mortality in developing countries yet little is known about the determinants of stroke outcomes in such countries. 12% of Malawian adults have HIV/AIDS. It is not known whether having HIV-infection alters the outcome of stroke. The aim of this study was to document the functional outcome and mortality at 1 year of first-ever acute stroke in Malawi. Also to find out if the baseline variables, including HIV-infection, affect the outcome of stroke. METHODS AND FINDINGS: 147 adult patients with first-ever acute stroke were prospectively followed up for 12 months. Conventional risk factors and HIV-infection were assessed at baseline. Stroke severity was evaluated with modified National Institute of Health Stroke Scale (mNIHSS and functional outcome with modified Rankin scale (mRS. Fifty (34% of patients were HIV-seropositive. 53.4% of patients had a poor outcome (severe disability or death, mRS 4-6 at 1 year. Poor outcome was related to stroke severity and female gender but not to presence of HIV-infection. HIV-seropositive patients were younger and had less often common risk factors for stroke. They suffer more often ischemic stroke than HIV-seronegative patients. CONCLUSIONS: Mild stroke and male gender were associated with favourable outcome. HIV-infection is common in stroke patients in Malawi but does not worsen the outcome of stroke. However, it may be a risk factor for ischemic stroke for young people, who do not have the common stroke risk factors. Our results are significant, because stroke outcome in HIV-seropositive patients has not been studied before in a setting such as ours, with very limited resources and a high prevalence of HIV.

  3. Arterial stiffness and functional outcome in acute ischemic stroke.

    Science.gov (United States)

    Lee, Yeong-Bae; Park, Joo-Hwan; Kim, Eunja; Kang, Chang-Ki; Park, Hyeon-Mi

    2014-03-01

    Arterial stiffness is a common change associated with aging and can be evaluated by measuring pulse wave velocity (PWV) between sites in the arterial tree, with the stiffer artery having the higher PWV. Arterial stiffness is associated with the risk of stroke in the general population and of fatal stroke in hypertensive patients. This study is to clarify whether PWV value predicts functional outcome of acute ischemic stroke. ONE HUNDRED PATIENTS WERE ENROLLED WITH A DIAGNOSIS OF ACUTE ISCHEMIC STROKE AND CATEGORIZED INTO TWO GROUPS: large-artery atherosclerosis (LAAS) or small vessel disease (SVD) subtype of Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Each group was divided into two sub-groups based on the functional outcome of acute ischemic stroke, indicated by modified Rankin Scale (mRS) at discharge. Poor functional outcome group was defined as a mRS ≥ 3 at discharge. Student's t-test or Mann-Whitney U-test were used to compare maximal brachial-ankle PWV (baPWV) values. Twenty-four patients whose state was inadequate to assess baPWV or mRS were excluded. There were 38 patients with good functional outcome (mRS vs. 1,789.80 ± 421.91, p = 0.022), while there was no significant difference of baPWV among patients with LAAS subtype (2,071.76 ± 618.42 vs. 1,878.00 ± 365.35, p = 0.579). Arterial stiffness indicated by baPWV is associated with the functional outcome of acute ischemic stroke. This finding suggests that measurement of baPWV predicts functional outcome in patients with stroke especially those whose TOAST classification was confirmed as SVD subtype.

  4. Optimization of the ship type using waveform by means of Rankine source method; Rankine source ho ni yoru hakei wo mochiita funagata saitekika ni tsuite

    Energy Technology Data Exchange (ETDEWEB)

    Hirayama, A; Eguchi, T [Mitsui Engineering and Shipbuilding Co. Ltd., Tokyo (Japan)

    1996-04-10

    Among the numerical calculation methods for steady-state wave-making problems, the panel shift Rankine source (PSRS) method has the advantages of rather precise determination of wave pattern of practical ship types, and short calculation period. The wave pattern around the hull was calculated by means of the PSRS method. The waveform analysis was carried out for the wave, to obtain an amplitude function of the original ship type. Based on the amplitude function, a ship type improvement method aiming at the optimization of ship type was provided using a conditional calculus of variation. A Series 60 (Cb=0.6) ship type was selected for the ship type improvement, to apply this technique. It was suggested that optimum design can be made for reducing the wave making resistance by means of this method. For the improvement of Series 60 ship type using this method, a great degree of reduction in the wave making resistance was recognized from the results of numerical waveform analysis. It was suggested that the ship type improvement aiming at the reduction of wave-making resistance can be made in shorter period and by smaller labor compared with the method using a waveform analysis of cistern tests. 5 refs., 9 figs.

  5. The addition of voice prompts to audiovisual feedback and debriefing does not modify CPR quality or outcomes in out of hospital cardiac arrest--a prospective, randomized trial.

    Science.gov (United States)

    Bohn, Andreas; Weber, Thomas P; Wecker, Sascha; Harding, Ulf; Osada, Nani; Van Aken, Hugo; Lukas, Roman P

    2011-03-01

    Chest compression quality is a determinant of survival from out-of-hospital cardiac arrest (OHCA). ERC 2005 guidelines recommend the use of technical devices to support rescuers giving compressions. This prospective randomized study reviewed influence of different feedback configurations on survival and compression quality. 312 patients suffering an OHCA were randomly allocated to two different feedback configurations. In the limited feedback group a metronome and visual feedback was used. In the extended feedback group voice prompts were added. A training program was completed prior to implementation, performance debriefing was conducted throughout the study. Survival did not differ between the extended and limited feedback groups (47.8% vs 43.9%, p = 0.49). Average compression depth (mean ± SD: 4.74 ± 0.86 cm vs 4.84 ± 0.93 cm, p = 0.31) was similar in both groups. There were no differences in compression rate (103 ± 7 vs 102 ± 5 min(-1), p=0.74) or hands-off fraction (16.16% ± 0.07 to 17.04% ± 0.07, p = 0.38). Bystander CPR, public arrest location, presenting rhythm and chest compression depth were predictors of short term survival (ROSC to ED). Even limited CPR-feedback combined with training and ongoing debriefing leads to high chest compression quality. Bystander CPR, location, rhythm and chest compression depth are determinants of survival from out of hospital cardiac arrest. Addition of voice prompts does neither modify CPR quality nor outcome in OHCA. CC depth significantly influences survival and therefore more focus should be put on correct delivery. Further studies are needed to examine the best configuration of feedback to improve CPR quality and survival. ClinicalTrials.gov (NCT00449969), http://www.clinicalTrials.gov. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Joint unloading implant modifies subchondral bone trabecular structure in medial knee osteoarthritis: 2-year outcomes of a pilot study using fractal signature analysis

    Directory of Open Access Journals (Sweden)

    Miller LE

    2015-01-01

    Full Text Available Larry E Miller,1,2 Miki Sode,3 Thomas Fuerst,3 Jon E Block2 1Miller Scientific Consulting, Inc., Asheville, NC, USA; 2The Jon Block Group, San Francisco, CA, USA; 3Bioclinica, Newark, CA, USA Background: Knee osteoarthritis (OA is largely attributable to chronic excessive and aberrant joint loading. The purpose of this pilot study was to quantify radiographic changes in subchondral bone after treatment with a minimally invasive joint unloading implant (KineSpring® Knee Implant System.Methods: Nine patients with unilateral medial knee OA resistant to nonsurgical therapy were treated with the KineSpring System and followed for 2 years. Main outcomes included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC pain, function, and stiffness subscores and independent core laboratory determinations of joint space width and fractal signature of the tibial cortex.Results: WOMAC scores, on average, improved by 92% for pain, 91% for function, and 79% for stiffness over the 2-year follow-up period. Joint space width in the medial compartment of the treated knee significantly increased from 0.9 mm at baseline to 3.1 mm at 2 years; joint space width in the medial compartment of the untreated knee was unchanged. Fractal signatures of the vertically oriented trabeculae in the medial compartment decreased by 2.8% in the treated knee and increased by 2.1% in the untreated knee over 2 years. No statistically significant fractal signature changes were observed in the horizontally oriented trabeculae in the medial compartment or in the horizontal or vertical trabeculae of the lateral compartment in the treated knee.Conclusion: Preliminary evidence suggests that the KineSpring System may modify knee OA disease progression by increasing joint space width and improving subchondral bone trabecular integrity, thereby reducing pain and improving joint function. Keywords: disease modification, KineSpring, joint space, pain, trabecular

  7. Towards Tailored Patient’s Management Approach: Integrating the Modified 2010 ACR Criteria for Fibromyalgia in Multidimensional Patient Reported Outcome Measures Questionnaire

    Directory of Open Access Journals (Sweden)

    Yasser El Miedany

    2016-01-01

    Full Text Available Objectives. To assess the validity, reliability, and responsiveness to change of a patient self-reported questionnaire combining the Widespread Pain Index and the Symptom Severity Score as well as construct outcome measures and comorbidities assessment in fibromyalgia patients. Methods. The PROMs-FM was conceptualized based on frameworks used by the WHO Quality of Life tool and the PROMIS. Initially, cognitive interviews were conducted to identify item pool of questions. Item selection and reduction were achieved based on patients as well as an interdisciplinary group of specialists. Rasch and internal consistency reliability analyses were implemented. The questionnaire included the modified ACR criteria main items (Symptom Severity Score and Widespread Pain Index, in addition to assessment of functional disability, quality of life (QoL, review of the systems, and comorbidities. Every patient completed HAQ and EQ-5D questionnaires. Results. A total of 146 fibromyalgia patients completed the questionnaire. The PROMs-FM questionnaire was reliable as demonstrated by a high standardized alpha (0.886–0.982. Content construct assessment of the functional disability and QoL revealed significant correlation (p<0.01 with both HAQ and EQ-5D. Changes in functional disability and QoL showed significant (p<0.01 variation with diseases activity status in response to therapy. There was higher prevalence of autonomic symptoms, CVS risk, sexual dysfunction, and falling. Conclusions. The developed PROMs-FM questionnaire is a reliable and valid instrument for assessment of fibromyalgia patients. A phased treatment regimen depending on the severity of FMS as well as preferences and comorbidities of the patient is the best approach to tailored patient management.

  8. Tofacitinib with conventional synthetic disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis: Patient-reported outcomes from a Phase 3 randomized controlled trial.

    Science.gov (United States)

    Li, Zhanguo; An, Yuan; Su, Houheng; Li, Xiangpei; Xu, Jianhua; Zheng, Yi; Li, Guiye; Kwok, Kenneth; Wang, Lisy; Wu, Qizhe

    2018-02-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). We assess the effect of tofacitinib + conventional synthetic disease-modifying anti rheumatic drugs (csDMARDs) on patient-reported outcomes in Chinese patients with RA and inadequate response to DMARDs. This analysis of data from the Phase 3 study ORAL Sync included Chinese patients randomized 4 : 4 : 1 : 1 to receive tofacitinib 5 mg twice daily, tofacitinib 10 mg twice daily, placebo→tofacitinib 5 mg twice daily, or placebo→tofacitinib 10 mg twice daily, with csDMARDs. Placebo non-responders switched to tofacitinib at 3 months; the remaining placebo patients switched at 6 months. Least squares mean changes from baseline were reported for Health Assessment Questionnaire-Disability Index (HAQ-DI), patient assessment of arthritis pain (Pain), patient global assessment of disease activity (PtGA), physician global assessment of disease activity (PGA), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scores, Short Form 36 (SF-36), and Work Limitations Questionnaire (WLQ), using a mixed-effects model for repeated measures. Overall, 216 patients were included (tofacitinib 5 mg twice daily, n = 86; tofacitinib 10 mg twice daily, n = 86; placebo→tofacitinib 5 mg twice daily, n = 22; placebo→tofacitinib 10 mg twice daily, n = 22). At month 3, tofacitinib elicited significant improvements in HAQ-DI, Pain, PtGA, PGA and SF-36 Physical Component Summary scores. Improvements were generally maintained through 12 months. Tofacitinib 5 and 10 mg twice daily + csDMARDs resulted in improvements in health-related quality of life, physical function and Pain through 12 months in Chinese patients with RA. © 2018 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  9. Analysis of vehicle exhaust waste heat recovery potential using a Rankine cycle

    International Nuclear Information System (INIS)

    Domingues, António; Santos, Helder; Costa, Mário

    2013-01-01

    This study evaluates the vehicle exhaust WHR (waste heat recovery) potential using a RC (Rankine cycle ). To this end, both a RC thermodynamic model and a heat exchanger model have been developed. Both models use as input, experimental data obtained from a vehicle tested on a chassis dynamometer. The thermodynamic analysis was performed for water, R123 and R245fa and revealed the advantage of using water as the working fluid in applications of thermal recovery from exhaust gases of vehicles equipped with a spark-ignition engine. Moreover, the heat exchanger effectiveness for the organic working fluids R123 and R245fa is higher than that for the water and, consequently, they can also be considered appropriate for use in vehicle WHR applications through RCs when the exhaust gas temperatures are relatively low. For an ideal heat exchanger, the simulations revealed increases in the internal combustion engine thermal and vehicle mechanical efficiencies of 1.4%–3.52% and 10.16%–15.95%, respectively, while for a shell and tube heat exchanger, the simulations showed an increase of 0.85%–1.2% in the thermal efficiency and an increase of 2.64%–6.96% in the mechanical efficiency for an evaporating pressure of 2 MPa. The results confirm the advantages of using the thermal energy contained in the vehicle exhaust gases through RCs. Furthermore, the present analysis demonstrates that improved evaporator designs and appropriate expander devices allowing for higher evaporating pressures are required to obtain the maximum WHR potential from vehicle RC systems. -- Highlights: ► This study evaluates the vehicle exhaust waste heat recovery potential using Rankine cycle systems. ► A thermodynamic model and a heat exchanger model were developed. ► Experimental data obtained in a vehicle tested on a chassis dynamometer was used as models input. ► Thermodynamic analysis was performed for water, R123 and R245fa. ► Results confirm advantages of using the thermal energy

  10. Selection and optimization of pure and mixed working fluids for low grade heat utilization using organic Rankine cycles

    DEFF Research Database (Denmark)

    Andreasen, Jesper Graa; Larsen, Ulrik; Knudsen, Thomas

    2014-01-01

    We present a generic methodology for organic Rankine cycle optimization, where the working fluid is included as an optimization parameter, in order to maximize the net power output of the cycle. The method is applied on two optimization cases with hot fluid inlet temperatures at 120°C and 90°C. P...

  11. Design and optimisation of organic Rankine cycles for waste heat recovery in marine applications using the principles of natural selection

    DEFF Research Database (Denmark)

    Larsen, Ulrik; Pierobon, Leonardo; Haglind, Fredrik

    2013-01-01

    , boundary conditions, hazard levels and environmental concerns. A generally applicable methodology, based on the principles of natural selection, is presented and used to determine the optimum working fluid, boiler pressure and Rankine cycle process layout for scenarios related to marine engine heat...

  12. Outcomes of a contemporary cohort of 536 consecutive patients with acute ischemic stroke treated with endovascular therapy.

    Science.gov (United States)

    Abilleira, Sònia; Cardona, Pere; Ribó, Marc; Millán, Mònica; Obach, Víctor; Roquer, Jaume; Cánovas, David; Martí-Fàbregas, Joan; Rubio, Francisco; Alvarez-Sabín, José; Dávalos, Antoni; Chamorro, Angel; de Miquel, Maria Angeles; Tomasello, Alejandro; Castaño, Carlos; Macho, Juan M; Ribera, Aida; Gallofré, Miquel

    2014-04-01

    We sought to assess outcomes after endovascular treatment/therapy of acute ischemic stroke, overall and by subgroups, and looked for predictors of outcome. We used data from a mandatory, population-based registry that includes external monitoring of completeness, which assesses reperfusion therapies for consecutive patients with acute ischemic stroke since 2011. We described outcomes overall and by subgroups (age ≤ or >80 years; onset-to-groin puncture ≤ or >6 hours; anterior or posterior strokes; previous IV recombinant tissue-type plasminogen activator or isolated endovascular treatment/therapy; revascularization or no revascularization), and determined independent predictors of good outcome (modified Rankin Scale score ≤2) and mortality at 3 months by multivariate modeling. We analyzed 536 patients, of whom 285 received previous IV recombinant tissue-type plasminogen activator. Overall, revascularization (modified Thrombolysis In Cerebral Infarction scores, 2b and 3) occurred in 73.9%, 5.6% developed symptomatic intracerebral hemorrhages, 43.3% achieved good functional outcome, and 22.2% were dead at 90 days. Adjusted comparisons by subgroups systematically favored revascularization (lower proportion of symptomatic intracerebral hemorrhages and death rates and higher proportion of good outcome). Multivariate analyses confirmed the independent protective effect of revascularization. Additionally, age >80 years, stroke severity, hypertension (deleterious), atrial fibrillation, and onset-to-groin puncture ≤6 hours (protective) also predicted good outcome, whereas lack of previous disability and anterior circulation strokes (protective) as well as and hypertension (deleterious) independently predicted mortality. This study reinforces the role of revascularization and time to treatment to achieve enhanced functional outcomes and identifies other clinical features that independently predict good/fatal outcome after endovascular treatment/therapy.

  13. The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model

    Directory of Open Access Journals (Sweden)

    S. R. Belagaje

    2014-01-01

    Full Text Available Several devices and medications have been used to address poststroke spasticity. Yet, spasticity’s impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question “Did you have spasticity following your stroke?” on direct interview at 3 months from stroke onset. Patients who had expired by 90 days (n=30 or did not have spasticity data available (n=102 were excluded. Spasticity affected the 3-month functional status (β=0.420, 95 CI=0.194 to 0.645 after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model’s R2 changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors.

  14. National Institutes of Health Stroke Scale-Time Score Predicts Outcome after Endovascular Therapy in Acute Ischemic Stroke: A Retrospective Single-Center Study.

    Science.gov (United States)

    Todo, Kenichi; Sakai, Nobuyuki; Kono, Tomoyuki; Hoshi, Taku; Imamura, Hirotoshi; Adachi, Hidemitsu; Kohara, Nobuo

    2016-05-01

    Outcomes after successful endovascular therapy in acute ischemic stroke are associated with onset-to-reperfusion time (ORT) and the National Institutes of Health Stroke Scale (NIHSS) score. In intravenous recombinant tissue plasminogen activator therapy, the NIHSS-time score, calculated by multiplying onset-to-treatment time with the NIHSS score, has been shown to predict clinical outcomes. In this study, we assessed whether a similar combination of the ORT and the NIHSS score can be applied to predict the outcomes after endovascular therapy. We retrospectively reviewed the charts of 128 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy. We analyzed the association of the ORT, the NIHSS score, and the NIHSS-time score with good outcome (modified Rankin Scale score ≤ 2 at 3 months). Good outcome rates for patients with NIHSS-time scores of 84.7 or lower, scores higher than 84.7 up to 127.5 or lower, and scores higher than 127.5 were 72.1%, 44.2%, and 14.3%, respectively (P < .01). Multivariate logistic regression analysis revealed that the NIHSS-time score was an independent predictor of good outcomes (odds ratio, .372; 95% confidence interval, .175-.789) after adjusting for age, sex, internal carotid artery occlusion, plasma glucose level, ORT, and NIHSS score. The NIHSS-time score can predict good clinical outcomes after endovascular treatment. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  15. Working fluid selection for organic Rankine cycles - Impact of uncertainty of fluid properties

    DEFF Research Database (Denmark)

    Frutiger, Jerome; Andreasen, Jesper Graa; Liu, Wei

    2016-01-01

    of processmodels and constraints 2) selection of property models, i.e. Penge Robinson equation of state 3)screening of 1965 possible working fluid candidates including identification of optimal process parametersbased on Monte Carlo sampling 4) propagating uncertainty of fluid parameters to the ORC netpower output......This study presents a generic methodology to select working fluids for ORC (Organic Rankine Cycles)taking into account property uncertainties of the working fluids. A Monte Carlo procedure is described as a tool to propagate the influence of the input uncertainty of the fluid parameters on the ORC....... The net power outputs of all the feasible working fluids were ranked including their uncertainties. The method could propagate and quantify the input property uncertainty of the fluidproperty parameters to the ORC model, giving an additional dimension to the fluid selection process. In the given analysis...

  16. Organic Rankine cycle unit for waste heat recovery on ships (PilotORC)

    DEFF Research Database (Denmark)

    Haglind, Fredrik; Montagud, Maria E. Mondejar; Andreasen, Jesper Graa

    The project PilotORC was aimed at evaluating the technical and economic feasibility of the use of organic Rankine cycle (ORC) units to recover low-temperature waste heat sources (i.e. exhaust gases, scavenge air, engine cooling system, and lubricant oil system) on container vessels. The project...... included numerical simulations and experimental tests on a 125 kW demonstration ORC unit that utilizes the waste heat of the main engine cooling system on board one of Mærsk's container vessels. During the design of the demonstration ORC unit, different alternatives for the condenser were analyzed in order...... of using ORC units for maritime applications, and the relevance of this technology for new-building projects. Firstly, an evaluation of the waste heat resources available on board Mærsk containers fleet, and an estimation of the potential energy recovery by means of the ORC technology was performed...

  17. Uncertainty assessment of equations of state with application to an organic Rankine cycle

    DEFF Research Database (Denmark)

    Frutiger, Jerome; Bell, Ian; O’Connell, John P.

    2017-01-01

    Evaluations of equations of state (EoS) should include uncertainty. This study presents a genericmethod to analyse EoS from a detailed uncertainty analysis of the mathematical form and the dataused to obtain EoS parameter values. The method is illustrated by comparison of Soave–Redlich–Kwong (SRK......) cubic EoS with perturbed-chain statistical associating fluid theory (PC-SAFT) EoS for anorganic Rankine cycle (ORC) for heat recovery to power fromthe exhaust gas of a marine diesel engineusing cyclopentane as working fluid. Uncertainties of the EoS input parameters including......Evaluations of equations of state (EoS) should include uncertainty. This study presents a genericmethod to analyse EoS from a detailed uncertainty analysis of the mathematical form and the dataused to obtain EoS parameter values. The method is illustrated by comparison of Soave–Redlich–Kwong (SRK...

  18. Rankine cycle condenser pressure control using an energy conversion device bypass valve

    Science.gov (United States)

    Ernst, Timothy C; Nelson, Christopher R; Zigan, James A

    2014-04-01

    The disclosure provides a waste heat recovery system and method in which pressure in a Rankine cycle (RC) system of the WHR system is regulated by diverting working fluid from entering an inlet of an energy conversion device of the RC system. In the system, an inlet of a controllable bypass valve is fluidly coupled to a working fluid path upstream of an energy conversion device of the RC system, and an outlet of the bypass valve is fluidly coupled to the working fluid path upstream of the condenser of the RC system such that working fluid passing through the bypass valve bypasses the energy conversion device and increases the pressure in a condenser. A controller determines the temperature and pressure of the working fluid and controls the bypass valve to regulate pressure in the condenser.

  19. Control system to a Rankine cycle with a Tesla turbine using arduino

    International Nuclear Information System (INIS)

    Medeiros, Josenei G.; Guimaraes, Lamartine F.; Placco, Guilherme M.

    2013-01-01

    The thermal Rankine cycle is a thermodynamic cycle which converts heat in energy. This cycle occurs in steady state, in other words the cycle is a closed loop circuit with continuous feedback, which guarantees the reuse process one energy transformed in the various stages of the cycle. This cycle is used to drive a turbine type TESLA designed for the system. The objective of this work is to create the control and automation of this cycle using an micro-controlled system with Arduino that will hold the collection of sensors and the system will act to maintain the balance of the cycle causing it to behave continuously and with less interference from human operation for maintenance. Data will be collected and further processed, where it will display all the sensors and the situation of the actuators involved. Using Arduino system ensures the stability and reliability with a low cost of implementation

  20. Thermodynamic analysis of an integrated solid oxide fuel cell cycle with a rankine cycle

    International Nuclear Information System (INIS)

    Rokni, Masoud

    2010-01-01

    Hybrid systems consisting of solid oxide fuel cells (SOFC) on the top of a steam turbine (ST) are investigated. The plants are fired by natural gas (NG). A desulfurization reactor removes the sulfur content in the fuel while a pre-reformer breaks down the heavier hydro-carbons. The pre-treated fuel enters then into the anode side of the SOFC. The remaining fuels after the SOFC stacks enter a burner for further burning. The off-gases are then used to produce steam for a Rankine cycle in a heat recovery steam generator (HRSG). Different system setups are suggested. Cyclic efficiencies up to 67% are achieved which is considerably higher than the conventional combined cycles (CC). Both adiabatic steam reformer (ASR) and catalytic partial oxidation (CPO) fuel pre-reformer reactors are considered in this investigation.

  1. Working fluid selection for organic Rankine cycles - Impact of uncertainty of fluid properties

    DEFF Research Database (Denmark)

    Frutiger, Jerome; Andreasen, Jesper Graa; Liu, Wei

    2016-01-01

    This study presents a generic methodology to select working fluids for ORC (Organic Rankine Cycles)taking into account property uncertainties of the working fluids. A Monte Carlo procedure is described as a tool to propagate the influence of the input uncertainty of the fluid parameters on the ORC...... modeloutput, and provides the 95%-confidence interval of the net power output with respect to the fluid property uncertainties. The methodology has been applied to a molecular design problem for an ORCusing a low-temperature heat source and consisted of the following four parts: 1) formulation...... of processmodels and constraints 2) selection of property models, i.e. Penge Robinson equation of state 3)screening of 1965 possible working fluid candidates including identification of optimal process parametersbased on Monte Carlo sampling 4) propagating uncertainty of fluid parameters to the ORC netpower output...

  2. Parametric optimization and comparative study of organic Rankine cycle (ORC) for low grade waste heat recovery

    International Nuclear Information System (INIS)

    Dai Yiping; Wang Jiangfeng; Gao Lin

    2009-01-01

    Organic Rankine cycles for low grade waste heat recovery are described with different working fluids. The effects of the thermodynamic parameters on the ORC performance are examined, and the thermodynamic parameters of the ORC for each working fluid are optimized with exergy efficiency as an objective function by means of the genetic algorithm. The optimum performance of cycles with different working fluids was compared and analyzed under the same waste heat condition. The results show that the cycles with organic working fluids are much better than the cycle with water in converting low grade waste heat to useful work. The cycle with R236EA has the highest exergy efficiency, and adding an internal heat exchanger into the ORC system could not improve the performance under the given waste heat condition. In addition, for the working fluids with non-positive saturation vapor curve slope, the cycle has the best performance property with saturated vapor at the turbine inlet

  3. Development of a computer code for a regenerative Rankine cycle analysis

    International Nuclear Information System (INIS)

    Wi, Myung Hwan; Kim, Seong O; Choi, Seok Ki; Kim, Jin Hwan

    2005-01-01

    A regenerative Rankine cycle can increase the thermal efficiency of a steam system without increasing the steam pressure and temperature. The regenerative process involves heating the feedwater on its return trip to the steam generator by extracting steam at various stages of the turbine and transferring the energy to the feedwater via a feedwater heater. Some real plants use more than five feedwater heaters to enhance the cycle efficiency. However, the optimum number of feedwater heaters required is determined by balancing the efficiency improvement against the capital investment for a given cycle. In the present study, the computer code, TAOPCS, for the thermodynamic analysis of a regenerative steam cycle was developed to optimally design and accurately analyze the behavior of the power conversion system of Korea Advance Liquid Metal Reactor (KALIMER). In order to understand the functions and the characteristics of the code, the main features of the TAPCS were described and the example results are presented in this paper

  4. Space reactor/organic Rankine conversion - A near-term state-of-the-art solution

    Science.gov (United States)

    Niggemann, R. E.; Lacey, D.

    The use of demonstrated reactor technology with organic Rankine cycle (ORC) power conversion can provide a low cost, minimal risk approach to reactor-powered electrical generation systems in the near term. Several reactor technologies, including zirconium hydride, EBR-II and LMFBR, have demonstrated long life and suitability for space application at the operating temperature required by an efficient ORC engine. While this approach would not replace the high temperature space reactor systems presently under development, it could be available in a nearer time frame at a low and predictable cost, allowing some missions requiring high power levels to be flown prior to the availability of advanced systems with lower specific mass. Although this system has relatively high efficiency, the heat rejection temperature is low, requiring a large radiator on the order of 3.4 sq m/kWe. Therefore, a deployable heat pipe radiator configuration will be required.

  5. Potassium Rankine cycle power conversion systems for lunar-Mars surface power

    International Nuclear Information System (INIS)

    Holcomb, R.S.

    1992-01-01

    The potassium Rankine cycle has good potential for application to nuclear power systems for surface power on the moon and Mars. A substantial effort on the development of the power conversion system was carried out in the 1960's which demonstrated successful operation of components made of stainless steel at moderate temperatures. This technology could be applied in the near term to produce a 360 kW(e) power system by coupling a stainless steel power conversion system to the SP-100 reactor. Improved performance could be realized in later systems by utilizing niobium or tantalum refractory metal alloys in the reactor and power conversion system. The design characteristics and estimated mass of power systems for each of three technology levels are presented in the paper

  6. Control system to a Rankine cycle with a Tesla turbine using arduino

    Energy Technology Data Exchange (ETDEWEB)

    Medeiros, Josenei G., E-mail: joseneigodoi@yahoo.com.br [Faculdade de Tecnologia Sao Francisco (FATESF), Jacarei, SP (Brazil); Guimaraes, Lamartine F.; Placco, Guilherme M., E-mail: guimarae@ieav.cta.br, E-mail: placco@ieav.cta.br [Instituto de Estudos Avancados (ENU/IEAv/DCTA), Sao Jose dos Campos, SP (Brazil). Departamento de Energia Nuclear

    2013-07-01

    The thermal Rankine cycle is a thermodynamic cycle which converts heat in energy. This cycle occurs in steady state, in other words the cycle is a closed loop circuit with continuous feedback, which guarantees the reuse process one energy transformed in the various stages of the cycle. This cycle is used to drive a turbine type TESLA designed for the system. The objective of this work is to create the control and automation of this cycle using an micro-controlled system with Arduino that will hold the collection of sensors and the system will act to maintain the balance of the cycle causing it to behave continuously and with less interference from human operation for maintenance. Data will be collected and further processed, where it will display all the sensors and the situation of the actuators involved. Using Arduino system ensures the stability and reliability with a low cost of implementation.

  7. Performance analysis a of solar driven organic Rankine cycle using multi-component working fluids

    DEFF Research Database (Denmark)

    Baldasso, E.; Andreasen, J. G.; Modi, A.

    2015-01-01

    suitable control strategy and both the overall annual production and the average solar to electrical efficiency are estimated with an annual simulation. The results suggest that the introduction of binary working fluids enables to increase the solar system performance both in design and part-load operation....... cycle. The purpose of this paper is to optimize a low temperature organic Rankine cycle tailored for solar applications. The objective of the optimization is the maximization of the solar to electrical efficiency and the optimization parameters are the working fluid and the turbine inlet temperature...... and pressure. Both pure fluids and binary mixtures are considered as possible working fluids and thus one of the primary aims of the study is to evaluate whether the use of multi-component working fluids might lead to increased solar to electrical efficiencies. The considered configuration includes a solar...

  8. Uncertainty Assessment of Equations of State with Application to an Organic Rankine Cycle

    DEFF Research Database (Denmark)

    Frutiger, Jerome; Bell, Ian; O’Connell, John P.

    2017-01-01

    Evaluations of equations of state (EoS) with application to process systems should include uncertainty analysis. A generic method is presented for determining such uncertainties from both the mathematical formand the data for obtaining EoS parameter values. The method is implemented for the Soave......–Redlich–Kwong (SRK), the Peng-Robinson (PR) cubic EoS, and the perturbed-chain statistical associating fluid theory (PCSAFT) EoS, as applied to an organic Rankine cycle (ORC) power system to recover heat from the exhaust gas of a marine diesel engine with cyclopentane as the working fluid. Uncertainties of the Eo......S input parameters, including their corresponding correlation structure, are quantified from the data using a bootstrap method. A Monte Carlo procedure propagates parameter input uncertainties onto the process output. Regressions have been made of the three cubic EoS parameters from both critical point...

  9. Thermal Stability of Hexamethyldisiloxane (MM for High-Temperature Organic Rankine Cycle (ORC

    Directory of Open Access Journals (Sweden)

    Markus Preißinger

    2016-03-01

    Full Text Available The design of efficient Organic Rankine Cycle (ORC units for the usage of industrial waste heat at high temperatures requires direct contact evaporators without intermediate thermal oil circuits. Therefore, the thermal stability of high-temperature working fluids gains importance. In this study, the thermal degradation of hexamethyldisiloxane (MM is investigated in an electrically heated tube. Qualitative results concerning remarks on degradation products as well as quantitative results like the annual degradation rate are presented. It is shown that MM is stable up to a temperature of 300 °C with annual degradation rates of less than 3.5%. Furthermore, the break of a silicon–carbon bond can be a main chemical reaction that influences the thermal degradation. Finally, it is discussed how the results may impact the future design of ORC units.

  10. Thermodynamic analysis of an organic rankine cycle using a tubular solar cavity receiver

    International Nuclear Information System (INIS)

    Loni, R.; Kasaeian, A.B.; Mahian, O.; Sahin, A.Z.

    2016-01-01

    Highlights: • A non-regenerative Organic Rankine Cycle has been analyzed. • R113, R601, R11, R141b, Ethanol and Methanol were used as the working fluid. • A parabolic dish concentrator with a square prismatic cavity receiver was used. • Thermal efficiency, second law efficiency, and net power output were analyzed. - Abstract: In this study, a non-regenerative Organic Rankine Cycle (ORC) has been thermodynamically analyzed under superheated conditions, constant evaporator pressure of 2.5 MPa, and condenser temperature of 300 K. R113, R601, R11, R141b, Ethanol and Methanol were employed as the working fluid. A parabolic dish concentrator with a square prismatic tubular cavity receiver was used as the heat source of the ORC system. The effects of the tube diameter, the cavity depth, and the solar irradiation on the thermodynamic performance of the selected working fluid were investigated. Some thermodynamic parameters were analyzed in this study. These thermodynamic parameters included the thermal efficiency, second law efficiency, total irreversibility, availability ratio, mass flow rate, and net power output. The results showed that, among the selected working fluids, methanol had the highest thermal efficiency, net power output, second law efficiency, and availability ratio in the range of turbine inlet temperature (TIT) considered. On the other hand, methanol had the smallest total irreversibility in the same range of TIT. The results showed also that mass flow rate and consequently the net power output increased for higher solar irradiation, smaller tube diameter, and for the case of cubical cavity receiver (i.e. cavity depth h equal to the receiver aperture side length a).

  11. Analysis and optimization of the low-temperature solar organic Rankine cycle (ORC)

    International Nuclear Information System (INIS)

    Delgado-Torres, Agustin M.; Garcia-Rodriguez, Lourdes

    2010-01-01

    Solar thermal driven reverse osmosis desalination is a promising renewable energy-driven desalination technology. A joint use of the solar thermal powered organic Rankine cycle (ORC) and the desalination technology of less energy consumption, reverse osmosis (RO), makes this combination interesting in some scarce water resource scenarios. However, prior to any practical experience with any new process, a comprehensive and rigorous theoretical study must be done in order to assess the performance of the new technology or combination of existing technologies. The main objective of the present paper is the expansion of the theoretical analysis done by the authors in previous works to the case in which the thermal energy required by a solar ORC is supplied by means of stationary solar collectors. Twelve substances are considered as working fluids of the ORC and four different models of stationary solar collectors (flat plate collectors, compound parabolic collectors and evacuated tube collectors) are also taken into account. Operating conditions of the solar ORC that minimizes the aperture area needed per unit of mechanical power output of the solar cycle are determined for every working fluid and every solar collector. The former is done considering a direct vapour generation configuration of the solar cycle and also the configuration with water as heat transfer fluid flowing inside the solar collector. This work is part of the theoretical analysis of the solar thermal driven seawater and brackish water reverse osmosis desalination technology. Nevertheless, the supplied information can be also used for the assessment of different applications of the solar ORC. In that case, results presented in this paper can be useful in techno-economic analysis, selection of working fluids of the Rankine cycle, sizing of systems and assessment of solar power cycle configuration.

  12. Performance analyses of geothermal organic Rankine cycles with selected hydrocarbon working fluids

    International Nuclear Information System (INIS)

    Liu, Qiang; Duan, Yuanyuan; Yang, Zhen

    2013-01-01

    ORC (organic Rankine cycles) are promising systems for conversion of low temperature geothermal energy to electricity. The thermodynamic performance of the ORC with a wet cooling system is analyzed here using hydrocarbon working fluids driven by geothermal water from 100 °C to 150 °C and reinjection temperatures not less than 70 °C. The hydrocarbon working fluids are butane (R600), isobutane (R600a), pentane (R601), isopentane (R601a) and hexane. For each fluid, the ORC net power output first increases and then decreases with increasing turbine inlet temperature. The turbine inlet parameters are then optimized for the maximum power output. The ORC net power output increases as the condensation temperature decreases but the circulating pump power consumption increases especially for lower condensation temperatures at higher cooling water flow rates. The optimal condensation temperatures for the maximum plant power output are 29.45–29.75 °C for a cooling water inlet temperature of 20 °C and a pinch point temperature difference of 5 °C in the condenser. The maximum power is produced by an ORC using R600a at geothermal water inlet temperatures higher than 120 °C, followed by R245fa and R600 for reinjection temperatures not less than 70 °C. R600a also has the highest plant exergetic efficiency with the lowest turbine size factor. - Highlights: • ORC (organic Rankine cycles) using geothermal water from 100 to 150 °C and reinjection temperatures not less than 70 °C are analyzed. • Condensation temperatures optimized to maximize the plant power output. • An IHE (internal heat exchanger) gives higher plant power at low geothermal water temperatures and high reinjection temperatures. • ORC performance optimized considering the condensation and reinjection temperature. • R600a gives the best performance at the optimal turbine operating parameters

  13. Utilization of waste heat from GT-MHR for power generation in organic Rankine cycles

    International Nuclear Information System (INIS)

    Yari, Mortaza; Mahmoudi, S.M.S.

    2010-01-01

    The gas turbine-modular helium reactor (GT-MHR) is currently being developed by an international consortium. In this power plant, circulating helium that has to be compressed in a single or two successive stages cools the reactor core. For thermodynamic reasons, these compression stages require pre-cooling of the helium to about 26 deg. C through the use of intercooler and pre-cooler in which water is used to cool the helium. Considerable thermal energy (∼300 MWth) is thus dissipated in these components. This thermal energy is then rejected to a heat sink. For different designs, the temperature ranges of the helium in the intercooler and pre-cooler could be about 100 and 150 deg. C, respectively. These are ideal energy sources to be used in an organic Rankine cycles for power generation. This study examines the performance of a gas-cooled nuclear power plant with closed Brayton cycle (CBC) combined with two organic Rankine cycles (ORC). More attention was paid to the irreversibilities generated in the combined cycle. Individual models are developed for each component through applications of the first and second laws of thermodynamics. The effects of the turbine inlet temperature, compressor pressure ratio, evaporator temperature and temperature difference in the evaporator on the first- and second-law efficiencies and on the exergy destruction rate of the combined cycle were studied. Finally the combined cycle was optimized thermodynamically using the EES (Engineering Equation Solver) software. Based on identical operating conditions, a comparison between the GT-MHR/ORC and a simple GT-MHR cycle is also made. It was found that both the first- and second-law efficiencies of GT-MHR/ORC cycle are about 3%-points higher than that of the simple GT-MHR cycle. Also, the exergy destruction rate for GT-MHR/ORC cycle is about 5% lower than that of the GT-MHR cycle.

  14. Optimal design of compact organic Rankine cycle units for domestic solar applications

    Directory of Open Access Journals (Sweden)

    Barbazza Luca

    2014-01-01

    Full Text Available Organic Rankine cycle turbogenerators are a promising technology to transform the solar radiation harvested by solar collectors into electric power. The present work aims at sizing a small-scale organic Rankine cycle unit by tailoring its design for domestic solar applications. Stringent design criteria, i. e., compactness, high performance and safe operation, are targeted by adopting a multi-objective optimization approach modeled with the genetic algorithm. Design-point thermodynamic variables, e. g., evaporating pressure, the working fluid, minimum allowable temperature differences, and the equipment geometry, are the decision variables. Flat plate heat exchangers with herringbone corrugations are selected as heat transfer equipment for the preheater, the evaporator and the condenser. The results unveil the hyperbolic trend binding the net power output to the heat exchanger compactness. Findings also suggest that the evaporator and condenser minimum allowable temperature differences have the largest impact on the system volume and on the cycle performances. Among the fluids considered, the results indicate that R1234yf and R1234ze are the best working fluid candidates. Using flat plate solar collectors (hot water temperature equal to 75 °C, R1234yf is the optimal solution. The heat exchanger volume ranges between 6.0 and 23.0 dm3, whereas the thermal efficiency is around 4.5%. R1234ze is the best working fluid employing parabolic solar collectors (hot water temperature equal to 120 °C. In such case the thermal efficiency is around 6.9%, and the heat exchanger volume varies from 6.0 to 18.0 dm3.

  15. Exergy analysis of parabolic trough solar collectors integrated with combined steam and organic Rankine cycles

    International Nuclear Information System (INIS)

    Al-Sulaiman, Fahad A.

    2014-01-01

    Highlights: • As the solar irradiation increases, the exergetic efficiency increases. • The R134a combined cycle has best exergetic performance, 26%. • The R600a combined cycle has the lowest exergetic efficiency, 20%. • The main source of exergy destruction is the solar collector. • There is an exergetic improvement potential of 75% in the systems considered. - Abstract: In this paper, detailed exergy analysis of selected thermal power systems driven by parabolic trough solar collectors (PTSCs) is presented. The power is produced using either a steam Rankine cycle (SRC) or a combined cycle, in which the SRC is the topping cycle and an organic Rankine cycle (ORC) is the bottoming cycle. Seven refrigerants for the ORC were examined: R134a, R152a, R290, R407c, R600, R600a, and ammonia. Key exergetic parameters were examined: exergetic efficiency, exergy destruction rate, fuel depletion ratio, irreversibility ratio, and improvement potential. For all the cases considered it was revealed that as the solar irradiation increases, the exergetic efficiency increases. Among the combined cycles examined, the R134a combined cycle demonstrates the best exergetic performance with a maximum exergetic efficiency of 26% followed by the R152a combined cycle with an exergetic efficiency of 25%. Alternatively, the R600a combined cycle has the lowest exergetic efficiency, 20–21%. This study reveals that the main source of exergy destruction is the solar collector where more than 50% of inlet exergy is destructed, or in other words more than 70% of the total destructed exergy. In addition, more than 13% of the inlet exergy is destructed in the evaporator which is equivalent to around 19% of the destructed exergy. Finally, this study reveals that there is an exergetic improvement potential of 75% in the systems considered

  16. Analysis and assessment of a new organic Rankine based heat engine system with/without cogeneration

    International Nuclear Information System (INIS)

    Hogerwaard, Janette; Dincer, Ibrahim; Zamfirescu, Calin

    2013-01-01

    A low-temperature heat driven heat engine is proposed as a cost-effective system for power and heat production for small scale applications. The external heat source allows flexibility in the design; the system may be coupled with various available renewable sources including biomass/biofuel/biogas combustion, geothermal heat, concentrated solar radiation, and industrial waste heat, by selecting appropriate off-the-shelf components from the HVAC (heating, ventilation, and air conditioning), refrigeration, and automotive industries for use in an ORC (organic Rankine cycle). A theoretical analysis and an experimental study are carried out for an ORC with R134a as the working fluid, utilizing a low-temperature heat source (T source < 150 °C), with focus on the expansion and boiling processes. The complete ORC model is comprised of models for the expander, working fluid pump, boiler, and condenser. Thermodynamic and heat transfer models are developed to calculate the local and averaged heat transfer coefficient of the working fluid throughout the boiling process, based on the geometry of the selected heat exchanger. Data collected for the experimental ORC test bench are used to validate the expander and boiler models. A case study is performed for the proposed ORC, for cogeneration of power and heat in a residential application. The results of the case study analysis for the proposed ORC system indicate a cycle efficiency of 0.05, exergy efficiency of 0.17, and energy and exergy cogeneration efficiency of 0.87, and 0.35, respectively. - Highlights: • Development and investigation of a scroll based Rankine heat engine operating with R134a. • Thermodynamic analyses of the system and its components. • Heat transfer analyses of boiler and condenser. • Dynamic analysis of expander. • Model validation through performed experiments on an ORC test bench

  17. Potential of organic Rankine cycle using zeotropic mixtures as working fluids for waste heat recovery

    International Nuclear Information System (INIS)

    Li, You-Rong; Du, Mei-Tang; Wu, Chun-Mei; Wu, Shuang-Ying; Liu, Chao

    2014-01-01

    The performance of the ORC (organic Rankine cycle) systems using zeotropic mixtures as working fluids for recovering waste heat of flue gas from industrial boiler is examined on the basis of thermodynamics and thermo-economics under different operating conditions. In order to explore the potential of the mixtures as the working fluids in the ORC, the effects of various mixtures with different components and composition proportions on the system performance have been analyzed. The results show that the compositions of the mixtures have an important effect on the ORC system performance, which is associated with the temperature glide during the phase change of mixtures. From the point of thermodynamics, the performance of the ORC system is not always improved by employing the mixtures as the working fluids. The merit of the mixtures is related to the restrictive conditions of the ORC, different operating conditions results in different conclusions. At a fixed pinch point temperature difference, the small mean heat transfer temperature difference in heat exchangers will lead to a larger heat transfer area and the larger total cost of the ORC system. Compared with the ORC with pure working fluids, the ORC with the mixtures presents a poor economical performance. - Highlights: • Organic Rankine cycle system with the mixture working fluids for recovering waste heat is analyzed. • The performance of the mixture-fluid ORC is related to temperature glide in phase change of mixture working fluids. • The relative merit of the mixture working fluids depends on the restrictive operation conditions of the ORC. • The ORC with mixture working fluid presents a poor economical performance compared with the pure working fluid case

  18. Impact of collateral circulation status on favorable outcomes in thrombolysis treatment: A systematic review and meta-analysis.

    Science.gov (United States)

    Wufuer, Alimu; Wubuli, Atikaimu; Mijiti, Peierdun; Zhou, Jun; Tuerxun, Shabier; Cai, Jian; Ma, Jianhua; Zhang, Xiaoning

    2018-01-01

    Collateral circulation affects the prognosis of patients with acute ischemic stroke (AIS) treated by thrombolysis. The present study performed a systematic assessment of the impact of the collateral circulation status on the outcomes of patients receiving thrombolysis treatment. Relevant full-text articles from the Cochrane Library, Ovid, Medline, Embase and PubMed databases published from January 1, 2000 to November 1, 2016 were retrieved. The quality of the studies was assessed and data were extracted by 2 independent investigators. The random-effects model was used to estimate the impact of good vs. poor collateral circulation, as well as baseline characteristics, on the outcome within the series presented as risk ratios. Subgroup analyses explored the potential factors that may interfere with the effects of the collateral circulation status on the outcome. A total of 29 studies comprising 4,053 patients were included in the present meta-analysis. A good collateral circulation status was revealed to have a beneficial effect on favorable functional outcome (modified Rankin scale, 0-3 at 3-6 months; Pcollateral circulation. Good collateral circulation was also associated with a lower rate of symptomatic intracranial hemorrhage (Pcollateral circulation was demonstrated to have a favorable prognostic value regarding the outcome for patients with AIS receiving thrombolysis treatment. Assessment of collateral circulation and penumbra area during pre-treatment imaging within an appropriate time-window prior to thrombolytic therapy will therefore improve the identification of AIS patients who may benefit from thrombolysis treatment.

  19. Outcomes of emergent carotid artery stenting within 6 hours of symptom onset in patients with acute ischemic stroke

    International Nuclear Information System (INIS)

    Jeong, Won Gi; Yoon, Woong; Yim, Nam Yeol; Jung, Min Young; Jung, Se Hee; Kang, Heoung Keun

    2013-01-01

    To investigate clinical outcomes following the emergent carotid artery stenting for treatment of acute ischemic stroke. Twenty-eight consecutive patients with acute stroke due to atherosclerotic steno-occlusive diseases of extracranial internal carotid artery underwent emergent carotid artery stenting. Of these, 23 patients had tandem intracranial arterial occlusions. Extracranial carotid stenting was successful in all patients. From the 13 patients who underwent intracranial recanalization procedures, successful recanalization occurred in 84.6% (11/13). 57% of patients (16/28) had a good clinical outcome (modified Rankin Scale 0-2) after 3 months. Patients with successful intracranial/extracranial recanalization had a significantly higher rate of good outcome than those without recanalization after 3 months (75% vs. 33%, p = 0.027). Patients without intracranial tandem occlusions had a more favorable clinical outcome than those with intracranial tandem occlusions (100% vs. 48%, p = 0.033). Symptomatic intracerebral hemorrhage occurred in one patient (3.6%). Mortality rate was 0% (0/28) after 3 months. Emergent carotid artery stenting in setting of acute stroke was a safe and effective treatment modality. Successful recanalization (extracranial and intracranial) and absence of intracranial tandem occlusion are significantly associated with a good outcome for our cohort of patients whom undergone emergent carotid artery stenting.

  20. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

    International Nuclear Information System (INIS)

    Protto, Sara; Pienimäki, Juha-Pekka; Seppänen, Janne; Numminen, Heikki; Sillanpää, Niko

    2017-01-01

    BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

  1. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Protto, Sara, E-mail: sara.protto@pshp.fi; Pienimäki, Juha-Pekka; Seppänen, Janne [Tampere University Hospital, Medical Imaging Center (Finland); Numminen, Heikki [Tampere University Hospital, Department of Neurology (Finland); Sillanpää, Niko [Tampere University Hospital, Medical Imaging Center (Finland)

    2017-04-15

    BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

  2. Greater stroke severity predominates over all other factors for the worse outcome of cardioembolic stroke.

    Science.gov (United States)

    Hong, Keun-Sik; Lee, Juneyoung; Bae, Hee-Joon; Lee, Ji Sung; Kang, Dong-Wha; Yu, Kyung-Ho; Han, Moon-Ku; Cho, Yong-Jin; Song, Pamela; Park, Jong-Moo; Oh, Mi-Sun; Koo, Jaseong; Lee, Byung-Chul

    2013-11-01

    Cardioembolic (CE) strokes are more disabling and more fatal than non-CE strokes. Multiple prognostic factors have been recognized, but the magnitude of their relative contributions has not been well explored. Using a prospective stroke outcome database, we compared the 3-month outcomes of CE and non-CE strokes. We assessed the relative contribution of each prognostic factor of initial stroke severity, poststroke complications, and baseline characteristics with multivariable analyses and model fitness improvement using -2 log-likelihood and Nagelkerke R2. This study included 1233 patients with acute ischemic stroke: 193 CE strokes and 1040 non-CE strokes. Compared with the non-CE group, CE group had less modified Rankin Scale (mRS) 0-2 outcomes (47.2% versus 68.5%; odds ratio [95% confidence interval], .41 [.30-.56]), less mRS 0-1 outcomes (33.7% versus 53.5%; .44 [.32-.61]), more mRS 5-6 outcomes (32.1% versus 10.9%; 3.88 [2.71-5.56]), and higher mortality (19.2% versus 5.2%; 4.33 [2.76-6.80]) at 3 months. When adjusting either baseline characteristics or poststroke complications, the outcome differences between the 2 groups remained significant. However, adjusting initial National Institute of Health Stroke Scale (NIHSS) score alone abolished all outcome differences except for mortality. For mRS 0-2 outcomes, the decrement of -2 log-likelihood and the Nagelkerke R2 of the model adjusting initial NIHSS score alone approached 70.2% and 76.7% of the fully adjusting model. Greater stroke severity predominates over all other factors for the worse outcome of CE stroke. Primary prevention and more efficient acute therapy for stroke victims should be given top priorities to reduce the burden of CE strokes. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Improving the economy-of-scale of small organic rankine cycle systems through appropriate working fluid selection

    International Nuclear Information System (INIS)

    White, Martin; Sayma, Abdulnaser I.

    2016-01-01

    Highlights: • Novel system model coupling turbine and ORC system performance. • Contour plots to characterise working fluid and turbine performance. • Changing working fluid can expand pump and turbine operating envelope. • Possible to improve the economy-of-scale through optimal working fluid selection. - Abstract: Organic Rankine cycles (ORC) are becoming a major research area within the field of sustainable energy systems. However, a major challenge facing the widespread implementation of small and mini-scale ORC systems is the economy-of-scale. To overcome this challenge requires single components that can be manufactured in large volumes and then implemented into a wide variety of different applications where the heat source conditions may vary. The aim of this paper is to investigate whether working fluid selection can improve the current economy-of-scale by enabling the same system components to be used in multiple ORC systems. This is done through coupling analysis and optimisation of the energy process, with a performance map for a small-scale ORC radial turbine. The performance map, obtained using CFD, is adapted to account for additional loss mechanisms not accounted for in the original CFD simulation before being non-dimensionalised using a modified similitude theory developed for subsonic ORC turbines. The updated performance map is then implemented into a thermodynamic model, enabling the construction of a single performance contour that displays the range of heat source conditions that can be accommodated by the existing turbine whilst using a particular working fluid. Constructing this performance map for a range of working fluids, this paper demonstrates that through selecting a suitable working fluid, the same turbine can efficiently utilise heat sources between 360 and 400 K, with mass flow rates ranging between 0.5 and 2.75 kg/s respectively. This corresponds to using the same turbine in ORC applications where the heat available ranges

  4. Effect of aphasia on acute stroke outcomes

    Science.gov (United States)

    Boehme, Amelia K.; Martin-Schild, Sheryl; Marshall, Randolph S.

    2016-01-01

    Objective: To determine the independent effects of aphasia on outcomes during acute stroke admission, controlling for total NIH Stroke Scale (NIHSS) scores and loss of consciousness. Methods: Data from the Tulane Stroke Registry were used from July 2008 to December 2014 for patient demographics, NIHSS scores, length of stay (LOS), complications (sepsis, deep vein thrombosis), and discharge modified Rankin Scale (mRS) score. Aphasia was defined as a score >1 on question 9 on the NIHSS on admission and hemiparesis as >1 on questions 5 or 6. Results: Among 1,847 patients, 866 (46%) had aphasia on admission. Adjusting for NIHSS score and inpatient complications, those with aphasia had a 1.22 day longer LOS than those without aphasia, whereas those with hemiparesis (n = 1,225) did not have any increased LOS compared to those without hemiparesis. Those with aphasia had greater odds of having a complication (odds ratio [OR] 1.44, confidence interval [CI] 1.07–1.93, p = 0.0174) than those without aphasia, which was equivalent to those having hemiparesis (OR 1.47, CI 1.09–1.99, p = 0.0137). Controlling for NIHSS scores, aphasia patients had higher odds of discharge mRS 3–6 (OR 1.42 vs 1.15). Conclusion: Aphasia is independently associated with increased LOS and complications during the acute stroke admission, adding $2.16 billion annually to US acute stroke care. The presence of aphasia was more likely to produce a poor functional outcome than hemiparesis. These data suggest that further research is necessary to determine whether establishing adaptive communication skills can mitigate its consequences in the acute stroke setting. PMID:27765864

  5. Neurological outcomes in patients with ischemic stroke receiving enoxaparin or heparin for venous thromboembolism prophylaxis: subanalysis of the Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study.

    Science.gov (United States)

    Kase, Carlos S; Albers, Gregory W; Bladin, Christopher; Fieschi, Cesare; Gabbai, Alberto A; O'Riordan, William; Pineo, Graham F

    2009-11-01

    The Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study demonstrated that enoxaparin was superior to unfractionated heparin (UFH) in preventing venous thromboembolism in patients with ischemic stroke and was associated with a small but statistically significant increase in extracranial hemorrhage rates. In this PREVAIL subanalysis, we evaluate the long-term neurological outcomes associated with the use of enoxaparin compared with UFH. We also determine predictors of stroke progression. Acute ischemic stroke patients aged >or=18 years, who could not walk unassisted, were randomized to receive enoxaparin (40 mg once daily) or UFH (5000 U every 12 hours) for 10 days. Patients were stratified according to baseline stroke severity using the National Institutes of Health Stroke Scale score. End points for this analysis included stroke progression (>or=4-point increase in National Institutes of Health Stroke Scale score), neurological outcomes up to 3 months postrandomization (assessed using National Institutes of Health Stroke Scale score and modified Rankin Scale score), and incidence of intracranial hemorrhage. Stroke progression occurred in 45 of 877 (5.1%) patients in the enoxaparin group and 42 of 872 (4.8%) of those receiving UFH. Similar improvements in National Institutes of Health Stroke Scale and modified Rankin Scale scores were observed in both groups over the 90-day follow-up period. Incidence of intracranial hemorrhage was comparable between groups (20 of 877 [2.3%] and 22 of 872 [2.5%] in enoxaparin and UFH groups, respectively). Baseline National Institutes of Health Stroke Scale score, hyperlipidemia, and Hispanic ethnicity were independent predictors of stroke progression. The clinical benefits associated with use of enoxaparin for venous thromboembolism prophylaxis in patients with acute ischemic stroke are not associated with poorer long-term neurological outcomes or increased rates of symptomatic intracranial hemorrhage compared

  6. Leukoaraiosis predicts poor 90-day outcome after acute large cerebral artery occlusion.

    Science.gov (United States)

    Henninger, Nils; Lin, Eugene; Baker, Stephen P; Wakhloo, Ajay K; Takhtani, Deepak; Moonis, Majaz

    2012-01-01

    To date limited information regarding outcome-modifying factors in patients with acute intracranial large artery occlusion (ILAO) in the anterior circulation is available. Leukoaraiosis (LA) is a common finding among patients with ischemic stroke and has been associated with poor post-stroke outcomes but its association with ILAO remains poorly characterized. This study sought to clarify the contribution of baseline LA and other common risk factors to 90-day outcome (modified Rankin Scale, mRS) after stroke due to acute anterior circulation ILAO. We retrospectively analyzed 1,153 consecutive patients with imaging-confirmed ischemic stroke during a 4-year period (2007-2010) at a single academic institution. The final study cohort included 87 patients with acute ILAO subjected to multimodal CT imaging within 24 h of symptom onset. LA severity was assessed using the van Swieten scale on non-contrast CT. Leptomeningeal collaterals were graded using CT angiogram source images. Hemorrhagic transformation (HT) was determined on follow-up CT. Multivariate logistic regression controlling for HT, treatment modality, demographic, as well as baseline clinical and imaging characteristics was used to identify independent predictors of a poor outcome (90-day mRS >2). The median National Institutes of Health Stroke Scale (NIHSS) at baseline was 15 (interquartile range 9-21). Twenty-four percent of the studied patients had severe LA. They were more likely to have hypertension (p = 0.028), coronary artery disease (p = 0.015), poor collaterals (p Coexisting LA may predict poor functional outcome in patients with acute anterior circulation ILAO independent of other known important outcome predictors such as comorbid state, admission functional deficit, collateral status, hemorrhagic conversion, and treatment modality. Copyright © 2012 S. Karger AG, Basel.

  7. An experimental analysis of flow boiling and pressure drop in a brazed plate heat exchanger for organic Rankine cycle power systems

    DEFF Research Database (Denmark)

    Desideri, Adriano; Zhang, Ji; Kærn, Martin Ryhl

    2017-01-01

    Organic Rankine cycle power systems for low quality waste heat recovery applications can play a major role in achieving targets of increasing industrial processes efficiency and thus reducing the emissions of greenhouse gases. Low capacity organic Rankine cycle systems are equipped with brazed...... and pressure drop during vaporization at typical temperatures for low quality waste heat recovery organic Rankine cycle systems are presented for the working fluids HFC-245fa and HFO-1233zd. The experiments were carried out at saturation temperatures of 100°C, 115°C and 130°C and inlet and outlet qualities...

  8. Solving the relativistic Rankine-Hugoniot condition in the presence of a magnetic field in the astrophysical scenario of a neutron star

    International Nuclear Information System (INIS)

    Mallick, Ritam

    2011-01-01

    The Rankine-Hugoniot condition has been solved to study phase transition in an astrophysical scenario mainly in the case of phase transition from a neutron star (NS) to a quark star (QS). The equations of state and temperature play a huge role in determining the nature of the front propagation, which brings about the phase transition in a NS. The shock jump conditions can be solved analytically, but the situation changes drastically by the inclusion of the magnetic field. High magnetic fields, which are always associated with a NS play a huge role in determining the structure and evolution of a NS. So, a magnetic field has been introduced in the shock jump condition in the de Hoffmann-Teller frame. The modified conservation condition for the perpendicular and oblique shocks is obtained in this frame. Numerical solution of the perpendicular shock has been obtained, which shows considerable deviation from the nonmagnetic case. The results show that the magnetic field helps in shock generation. It also indirectly hints at the instability of the matter and thereby the NS for very high magnetic field, implying that NSs can only support a magnetic field of some finite strength.

  9. Could infarct location predict the long-term functional outcome in childhood arterial ischemic stroke?

    Directory of Open Access Journals (Sweden)

    Mauricio López-Espejo

    Full Text Available ABSTRACT Objective: To explore the influence of infarct location on long-term functional outcome following a first-ever arterial ischemic stroke (AIS in non-neonate children. Method: The MRIs of 39 children with AIS (median age 5.38 years; 36% girls; mean follow-up time 5.87 years were prospectively evaluated. Infarct location was classified as the absence or presence of subcortical involvement. Functional outcome was measured using the modified Rankin scale (mRS for children after the follow-up assessment. We utilized multivariate logistic regression models to estimate the odds ratios (ORs for the outcome while adjusting for age, sex, infarct size and middle cerebral artery territory involvement (significance < 0.05. Results: Both infarcts ≥ 4% of total brain volume (OR 9.92; CI 1.76 – 55.9; p 0.009 and the presence of subcortical involvement (OR 8.36; CI 1.76 – 53.6; p 0.025 independently increased the risk of marked functional impairment (mRS 3 to 5. Conclusion: Infarct extension and location can help predict the extent of disability after childhood AIS.

  10. Association between seizures after ischemic stroke and stroke outcome: A systematic review and meta-analysis.

    Science.gov (United States)

    Xu, Tao; Ou, Shu; Liu, Xi; Yu, Xinyuan; Yuan, Jinxian; Huang, Hao; Chen, Yangmei

    2016-07-01

    A systematic review and meta-analysis were performed to investigate a potential association between post-ischemic stroke seizures (PISS) and subsequent ischemic stroke (IS) outcome.A systematic search of two electronic databases (Medline and Embase) was conducted to identify studies that explored an association between PISS and IS outcome. The primary and secondary IS outcomes of interest were mortality and disability, respectively, with the latter defined as a score of 3 to 5 on the modified Rankin Scale.A total of 15 studies that were published between 1998 and 2015 with 926,492 participants were examined. The overall mortality rates for the patients with and without PISS were 34% (95% confidence interval [CI], 27-42%) and 18% (95% CI, 12-23%), respectively. The pooled relative ratio (RR) of mortality for the patients with PISS was 1.97 (95% CI, 1.48-2.61; I = 88.6%). The overall prevalence rates of disability in the patients with and without PISS were 60% (95% CI, 32-87%) and 41% (95% CI, 25-57%), respectively. Finally, the pooled RR of disability for the patients with PISS was 1.64 (95% CI, 1.32-2.02; I = 66.1%).PISS are significantly associated with higher risks of both mortality and disability. PISS indicate poorer prognoses in patients experiencing IS.

  11. Predictors of intracerebral hemorrhage severity and its outcome in Japanese stroke patients.

    Science.gov (United States)

    Hosomi, Naohisa; Naya, Takayuki; Ohkita, Hiroyuki; Mukai, Mao; Nakamura, Takehiro; Ueno, Masaki; Dobashi, Hiroaki; Murao, Koji; Masugata, Hisashi; Miki, Takanori; Kohno, Masakazu; Kobayashi, Shotai; Koziol, James A

    2009-01-01

    The aim of this investigation was to determine the factors influencing acute intracerebral hemorrhage severity on admission and clinical outcomes at discharge. Sixty acute stroke hospitals throughout Japan participated in the Japan Standard Stroke Registry Study (JSSRS), documenting the in-hospital course of 16,630 consecutive patients with acute stroke from January 2001 to March 2004. We identified 2,840 adult patients from the JSSRS who had intracerebral hemorrhage. Intracerebral hemorrhage severity on admission was strongly related to age, previous stroke history, and hemorrhage size in a monotone fashion [chi(2)(9) = 374.5, p < 0.0001]. Drinking history was also predictive of intracerebral hemorrhage severity on admission, but the association was not monotone. Interestingly, intracerebral hemorrhage severity on admission was increased in nondrinking and heavy drinking compared to mild drinking (p < 0.05). Unsuccessful outcome (modified Rankin scale score = 3-6) was related to age, previous stroke history, hemorrhage size, and intracerebral hemorrhage severity on admission [chi(2)(9) = 830.4, p < 0.0001]. Mortality was related to hemorrhage size, intraventricular hemorrhage, intracerebral hemorrhage severity on admission, and surgical operation [chi(2)(7) = 540.4, p < 0.0001]. We could find four varied factors associated with intracerebral hemorrhage severity and its outcomes. Interestingly, intracerebral hemorrhage severity tended to be greater in nondrinking and heavy drinking than mild drinking. Additionally, surgical operation decreased intracerebral hemorrhage mortality. Copyright 2008 S. Karger AG, Basel.

  12. Decannulation and Functional Outcome After Tracheostomy in Patients with Severe Stroke (DECAST): A Prospective Observational Study.

    Science.gov (United States)

    Schneider, Hauke; Hertel, Franziska; Kuhn, Matthias; Ragaller, Maximilian; Gottschlich, Birgit; Trabitzsch, Anne; Dengl, Markus; Neudert, Marcus; Reichmann, Heinz; Wöpking, Sigrid

    2017-08-01

    Tracheostomy is performed in ventilated stroke patients affected by persisting severe dysphagia, reduced level of consciousness, or prolonged mechanical ventilation. The study aim was to determine the frequency and predictors of successful decannulation and long-term functional outcome in tracheotomized stroke patients. A prospective single-center observational study recruited ventilated patients with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Follow-up visits were performed at hospital discharge, 3, and 12 months. Competing risk analyses were performed to identify predictors of decannulation. We included 53 ventilated stroke patients who had tracheostomy. One year after tracheostomy, 19 patients were decannulated (median [IQR] time to decannulation 74 [58-117] days), 13 patients were permanently cannulated, and 21 patients died without prior removal of the cannula. Independent predictors for decannulation in our cohort were patient age (HR 0.95 [95% CI: 0.92-0.99] per one year increase, p = 0.003) and absence of sepsis (HR 4.44 [95% CI: 1.33-14.80], p = 0.008). Compared to surviving patients without cannula removal, decannulated patients had an improved functional outcome after one year (median modified Rankin Scale score 4 vs. 5 [p tracheostomy and was associated with better functional outcome compared to patients without decannulation. Further prospective studies with larger sample sizes are needed to confirm our results.

  13. External validation of the ability of the DRAGON score to predict outcome after thrombolysis treatment.

    Science.gov (United States)

    Ovesen, C; Christensen, A; Nielsen, J K; Christensen, H

    2013-11-01

    Easy-to-perform and valid assessment scales for the effect of thrombolysis are essential in hyperacute stroke settings. Because of this we performed an external validation of the DRAGON scale proposed by Strbian et al. in a Danish cohort. All patients treated with intravenous recombinant plasminogen activator between 2009 and 2011 were included. Upon admission all patients underwent physical and neurological examination using the National Institutes of Health Stroke Scale along with non-contrast CT scans and CT angiography. Patients were followed up through the Outpatient Clinic and their modified Rankin Scale (mRS) was assessed after 3 months. Three hundred and three patients were included in the analysis. The DRAGON scale proved to have a good discriminative ability for predicting highly unfavourable outcome (mRS 5-6) (area under the curve-receiver operating characteristic [AUC-ROC]: 0.89; 95% confidence interval [CI] 0.81-0.96; pDRAGON scale provided good discriminative capability (AUC-ROC: 0.89; 95% CI 0.78-1.0; p=0.003) for highly unfavourable outcome. We confirmed the validity of the DRAGON scale in predicting outcome after thrombolysis treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. External validation of the MRI-DRAGON score: early prediction of stroke outcome after intravenous thrombolysis.

    Science.gov (United States)

    Turc, Guillaume; Aguettaz, Pierre; Ponchelle-Dequatre, Nelly; Hénon, Hilde; Naggara, Olivier; Leclerc, Xavier; Cordonnier, Charlotte; Leys, Didier; Mas, Jean-Louis; Oppenheim, Catherine

    2014-01-01

    The aim of our study was to validate in an independent cohort the MRI-DRAGON score, an adaptation of the (CT-) DRAGON score to predict 3-month outcome in acute ischemic stroke patients undergoing MRI before intravenous thrombolysis (IV-tPA). We reviewed consecutive (2009-2013) anterior circulation stroke patients treated within 4.5 hours by IV-tPA in the Lille stroke unit (France), where MRI is the first-line pretherapeutic work-up. We assessed the discrimination and calibration of the MRI-DRAGON score to predict poor 3-month outcome, defined as modified Rankin Score >2, using c-statistic and the Hosmer-Lemeshow test, respectively. We included 230 patients (mean ±SD age 70.4±16.0 years, median [IQR] baseline NIHSS 8 [5]-[14]; poor outcome in 78(34%) patients). The c-statistic was 0.81 (95%CI 0.75-0.87), and the Hosmer-Lemeshow test was not significant (p = 0.54). The MRI-DRAGON score showed good prognostic performance in the external validation cohort. It could therefore be used to inform the patient's relatives about long-term prognosis and help to identify poor responders to IV-tPA alone, who may be candidates for additional therapeutic strategies, if they are otherwise eligible for such procedures based on the institutional criteria.

  15. External validation of the MRI-DRAGON score: early prediction of stroke outcome after intravenous thrombolysis.

    Directory of Open Access Journals (Sweden)

    Guillaume Turc

    Full Text Available The aim of our study was to validate in an independent cohort the MRI-DRAGON score, an adaptation of the (CT- DRAGON score to predict 3-month outcome in acute ischemic stroke patients undergoing MRI before intravenous thrombolysis (IV-tPA.We reviewed consecutive (2009-2013 anterior circulation stroke patients treated within 4.5 hours by IV-tPA in the Lille stroke unit (France, where MRI is the first-line pretherapeutic work-up. We assessed the discrimination and calibration of the MRI-DRAGON score to predict poor 3-month outcome, defined as modified Rankin Score >2, using c-statistic and the Hosmer-Lemeshow test, respectively.We included 230 patients (mean ±SD age 70.4±16.0 years, median [IQR] baseline NIHSS 8 [5]-[14]; poor outcome in 78(34% patients. The c-statistic was 0.81 (95%CI 0.75-0.87, and the Hosmer-Lemeshow test was not significant (p = 0.54.The MRI-DRAGON score showed good prognostic performance in the external validation cohort. It could therefore be used to inform the patient's relatives about long-term prognosis and help to identify poor responders to IV-tPA alone, who may be candidates for additional therapeutic strategies, if they are otherwise eligible for such procedures based on the institutional criteria.

  16. Magnesium, hemostasis, and outcomes in patients with intracerebral hemorrhage.

    Science.gov (United States)

    Liotta, Eric M; Prabhakaran, Shyam; Sangha, Rajbeer S; Bush, Robin A; Long, Alan E; Trevick, Stephen A; Potts, Matthew B; Jahromi, Babak S; Kim, Minjee; Manno, Edward M; Sorond, Farzaneh A; Naidech, Andrew M; Maas, Matthew B

    2017-08-22

    We tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). Patients presenting with spontaneous ICH were enrolled in an observational cohort study that prospectively collected demographic, clinical, laboratory, radiographic, and outcome data. We performed univariate and adjusted multivariate analyses to assess for associations between serum magnesium levels and initial hematoma volume, final hematoma volume, and in-hospital hematoma growth as radiographic measures of hemostasis, and functional outcome measured by the modified Rankin Scale (mRS) at 3 months. We included 290 patients for analysis. Admission serum magnesium was 2.0 ± 0.3 mg/dL. Lower admission magnesium levels were associated with larger initial hematoma volumes on univariate ( p = 0.02), parsimoniously adjusted ( p = 0.002), and fully adjusted models ( p = 0.006), as well as greater hematoma growth ( p = 0.004, p = 0.005, and p = 0.008, respectively) and larger final hematoma volumes ( p = 0.02, p = 0.001, and p = 0.002, respectively). Lower admission magnesium level was associated with worse functional outcomes at 3 months (i.e., higher mRS; odds ratio 0.14, 95% confidence interval 0.03-0.64, p = 0.011) after adjustment for age, admission Glasgow Coma Scale score, initial hematoma volume, time from symptom onset to initial CT, and hematoma growth, with evidence that the effect of magnesium is mediated through hematoma growth. These data support the hypothesis that magnesium exerts a clinically meaningful influence on hemostasis in patients with ICH. © 2017 American Academy of Neurology.

  17. Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage.

    Science.gov (United States)

    Di Napoli, Mario; Zha, Alicia M; Godoy, Daniel A; Masotti, Luca; Schreuder, Floris H B M; Popa-Wagner, Aurel; Behrouz, Réza

    2016-01-01

    Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients. An analysis of an international, multicenter, observational database of consecutive patients with spontaneous ICH was conducted. We extracted the following characteristics on presentation: demographics, risk factors, antiplatelet or anticoagulant use, Glasgow Coma Scale, ICH score, neuroimaging parameters, and urine toxicology screen (UTS) results. Modified Rankin Scale (mRS) score was utilized for determination of outcome at discharge. Adjusted logistic ordinal regression was used as shift analysis to assess the impact of cannabis use on mRS score at discharge. The adjusted common OR measured the likelihood that cannabis use would lead to lower mRS scores. Within a cohort of 725 spontaneous ICH patients, UTS was positive for cannabinoids in 8.6%. Cannabinoids-positive (CB+) patients were more frequently Caucasian (p cannabis use was discovered in nearly 10% of patients with spontaneous ICH. Although there was no relationship between cannabis use and specific ICH characteristics, CB+ patients had milder ICH presentation and less disability at discharge. © 2016 S. Karger AG, Basel.

  18. Outcomes of basilar artery occlusion in patients aged 75 years or older in the Basilar Artery International Cooperation Study.

    Science.gov (United States)

    Vergouwen, Mervyn D I; Compter, Annette; Tanne, David; Engelter, Stefan T; Audebert, Heinrich; Thijs, Vincent; de Freitas, Gabriel; Algra, Ale; Jaap Kappelle, L; Schonewille, Wouter J

    2012-11-01

    Patients with an acute basilar artery occlusion (BAO) have a high risk of long-lasting disability and death. Only limited data are available on functional outcome in elderly patients with BAO. Using data from the Basilar Artery International Cooperation Study, we aimed to determine outcomes in patients ≥75 years. Primary outcome measure was poor functional outcome (modified Rankin scale score 4-6). Secondary outcomes were death, insufficient vessel recanalization (defined as thrombolysis in myocardial infarction score 0-1) and symptomatic intracranial hemorrhage (SICH). Patients were divided into four age-groups, based on quartiles: 18-54, 55-64, 65-74, and ≥75 years. Outcomes were compared between patients ≥75 years and patients aged 18-54 years. Risk ratios with corresponding 95 % confidence intervals (CI) were calculated and Poisson regression analyses were performed to calculate adjusted risk ratios (aRR). We included 619 patients [18-54 years n = 153 (25 %), 55-64 years n = 133 (21 %), 65-74 years n = 171 (28 %), and ≥75 years n = 162 (26 %)]. Compared with patients aged 18-54 years, patients ≥75 years were at increased risk of poor functional outcome [aRR 1.33 (1.14-1.55)] and death [aRR 2.47 (1.75-3.51)]. Nevertheless, 35/162 (22 %, 95 % CI 15-28 %) of patients ≥75 years had good functional outcome. No significant differences between age groups were observed for recanalization rate and incidence of SICH. Although patients ≥75 years with BAO have an increased risk of poor outcome compared with younger patients, a substantial group of patients ≥75 years survives with a good functional outcome.

  19. Comparison of Spot Sign, Blend Sign and Black Hole Sign for Outcome Prediction in Patients with Intracerebral Hemorrhage.

    Science.gov (United States)

    Sporns, Peter B; Schwake, Michael; Kemmling, André; Minnerup, Jens; Schwindt, Wolfram; Niederstadt, Thomas; Schmidt, Rene; Hanning, Uta

    2017-09-01

    Blend sign (BS) and black hole sign (BHS) on non-contrast computed tomography (NCCT) and spot sign (SS) on CT-angiography (CTA) are indicators of early hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, their independent contributions to outcome have not been well explored. In this retrospective study, inclusion criteria were: 1) spontaneous ICH and 2) NCCT and CTA performed on admission within 6 hours after onset of symptoms. Discharge outcome was dichotomized as good (modified Rankin Scale [mRS] 0-3) and poor (mRS 4-6) outcomes. The impacts of BHS, BS and SS on outcome were assessed in univariate and multivariable logistic regression models. Of 182 patients with spontaneous ICH, 26 (14.3%) presented with BHS, 37 (20.3%) with BS and 39 (21.4%) with SS. There was a substantial correlation between SS and BS (κ=0.701) and a moderate correlation between SS and BHS (κ=0.424). In univariable logistic regression, higher baseline hematoma volume ( P <0.001), intraventricular hemorrhage ( P =0.002) and the presence of BHS/BS/SS (all P <0.001) on admission CT scan were associated with poor outcome. Multivariable analysis identified intraventricular haemorrhage (odds ratio [OR] 2.22 per mL, P =0.022), baseline hematoma volume (OR 1.03 per mL, P <0.001) and SS on CTA (OR 11.43, P <0.001) as independent predictors of poor outcome, showing that SS compared to BS and BHS was more powerful to predict poor outcome. The NCCT BHS and BS are correlated with the CTA SS and are reliable predictors of poor outcome in patients with ICH. Of the CT variables indicating early hematoma expansion, SS on CTA was the most reliable outcome predictor. However, given their correlation with SS on CTA, BS and BHS on NCCT can be useful for predicting outcome if CTA is not obtainable.

  20. Paracetamol (Acetaminophen) in stroke 2 (PAIS 2): protocol for a randomized, placebo-controlled, double-blind clinical trial to assess the effect of high-dose paracetamol on functional outcome in patients with acute stroke and a body temperature of 36.5 °C or above.

    Science.gov (United States)

    de Ridder, Inger R; de Jong, Frank Jan; den Hertog, Heleen M; Lingsma, Hester F; van Gemert, H Maarten A; Schreuder, A H C M L Tobien; Ruitenberg, Annemieke; Maasland, E Lisette; Saxena, Ritu; Oomes, Peter; van Tuijl, Jordie; Koudstaal, Peter J; Kappelle, L Jaap; Algra, Ale; van der Worp, H Bart; Dippel, Diederik W J

    2015-04-01

    In the first hours after stroke onset, subfebrile temperatures and fever have been associated with poor functional outcome. In the first Paracetamol (Acetaminophen) in Stroke trial, a randomized clinical trial of 1400 patients with acute stroke, patients who were treated with high-dose paracetamol showed more improvement on the modified Rankin Scale at three-months than patients treated with placebo, but this difference was not statistically significant. In the 661 patients with a baseline body temperature of 37.0 °C or above, treatment with paracetamol increased the odds of functional improvement (odds ratio 1.43; 95% confidence interval: 1.02-1.97). This relation was also found in the patients with a body temperature of 36.5 °C or higher (odds ratio 1.31; 95% confidence interval 1.01-1.68). These findings need confirmation. The study aims to assess the effect of high-dose paracetamol in patients with acute stroke and a body temperature of 36.5 °C or above on functional outcome. The Paracetamol (Acetaminophen) In Stroke 2 trial is a multicenter, randomized, double-blind, placebo-controlled clinical trial. We use a power of 85% to detect a significant difference in the scores on the modified Rankin Scale of the paracetamol group compared with the placebo group at a level of significance of 0.05 and assume a treatment effect of 7%. Fifteen-hundred patients with acute ischemic stroke or intracerebral hemorrhage and a body temperature of 36.5 °C or above will be included within 12 h of symptom onset. Patients will be treated with paracetamol in a daily dose of six-grams or matching placebo for three consecutive days. The Paracetamol (Acetaminophen) In Stroke 2 trial has been registered as NTR2365 in The Netherlands Trial Register. The primary outcome will be improvement on the modified Rankin Scale at three-months as analyzed by ordinal logistic regression. If high-dose paracetamol will be proven effective, a simple, safe, and extremely cheap therapy will be

  1. Étude de la faisabilité des cycles sous-critiques et supercritiques de Rankine pour la valorisation de rejets thermiques

    OpenAIRE

    Le , Van Long

    2014-01-01

    This thesis concerns the feasibility study of subcritical and supercritical organic Rankine cycles for industrial waste heat recovery at relatively low temperature. Initially, a state of the art of ORCs (Organic Rankine Cycles) and their working fluids has been achieved. We conducted a preliminary comparison of several configurations from the scientific literature. In a second step, methods of energy and exergy analysis were applied to evaluate and optimize the performance of the ORCs. Indeed...

  2. Étude de la faisabilité des cycles sous-critiques et supercritiques de Rankine pour la valorisation de rejets thermiques

    OpenAIRE

    Le , Van Long

    2014-01-01

    This thesis concerns the feasibility study of subcritical and supercritical organic Rankine cycles for industrial waste heat recovery at relatively low temperature.Initially, a state of the art of ORCs (Organic Rankine Cycles) and their working fluids has been achieved. We conducted a preliminary comparison of several configurations from the scientific literature.In a second step, methods of energy and exergy analysis were applied to evaluate and optimize the performance of the ORCs. Indeed, ...

  3. Optimization of Cycle and Expander Design of an Organic Rankine Cycle Unit using Multi-Component Working Fluids

    DEFF Research Database (Denmark)

    Meroni, Andrea; Andreasen, Jesper Graa; Pierobon, Leonardo

    2016-01-01

    Organic Rankine cycle (ORC) power systems represent at-tractive solutions for power conversion from low temperatureheat sources, and the use of these power systems is gaining increasing attention in the marine industry. This paper proposesthe combined optimal design of cycle and expander...... for an organic Rankine cycle unit utilizing waste heat from low temperature heat sources. The study addresses a case where the minimum temperature of the heat source is constrained and a case where no constraint is imposed. The former case is the wasteheat recovery from jacket cooling water of a marine diesel...... engine onboard a large ship, and the latter is representative of a low-temperature geothermal, solar or waste heat recovery application. Multi-component working fluids are investigated, as they allow improving the match between the temperature pro-files in the heat exchangers and, consequently, reducing...

  4. Evaluation of ejector performance for an organic Rankine cycle combined power and cooling system

    International Nuclear Information System (INIS)

    Zhang, Kun; Chen, Xue; Markides, Christos N.; Yang, Yong; Shen, Shengqiang

    2016-01-01

    Highlights: • The performance of an ejector in an Organic Rankine Cycle and ejector refrigeration cycle (EORC) was evaluated. • The achieved entrainment ratio and COP of an EORC system is affected significantly by the evaporator conditions (such as temperature, pressure and flow rate). • An optimum distance of 6 mm nozzle position was found that ensures a maximum entrainment ratio, the best efficiency and lowest loss in the ejector. • A reduced total pressure loss between the nozzle inlet and exit leads to a lower energy loss, a higher entrainment ratio and better overall ejector performance. - Abstract: Power-generation systems based on organic Rankine cycles (ORCs) are well suited and increasingly employed in the conversion of thermal energy from low temperature heat sources to power. These systems can be driven by waste heat, for example from various industrial processes, as well as solar or geothermal energy. A useful extension of such systems involves a combined ORC and ejector-refrigeration cycle (EORC) that is capable, at low cost and complexity, of producing useful power while having a simultaneous capacity for cooling that is highly desirable in many applications. A significant thermodynamic loss in such a combined energy system takes place in the ejector due to unavoidable losses caused by irreversible mixing in this component. This paper focuses on the flow and transport processes in an ejector, in order to understand and quantify the underlying reasons for these losses, as well as their sensitivity to important design parameters and operational variables. Specifically, the study considers, beyond variations to the geometric design of the ejector, also the role of changing the external conditions across this component and how these affect its performance; this is not only important in helping develop ejector designs in the first instance, but also in evaluating how the performance may shift (in fact, deteriorate) quantitatively when the device

  5. Preliminary Design and Simulation of a Turbo Expander for Small Rated Power Organic Rankine Cycle (ORC

    Directory of Open Access Journals (Sweden)

    Roberto Capata

    2014-11-01

    Full Text Available Nowadays, the Organic Rankine Cycle (ORC system, which operates with organic fluids, is one of the leading technologies for “waste energy recovery”. It works as a conventional Rankine Cycle but, as mentioned, instead of steam/water, an organic fluid is used. This change allows it to convert low temperature heat into electric energy where required. Large numbers of studies have been carried out to identify the most suitable fluids, system parameters and the various configurations. In the present market, most ORC systems are designed and manufactured for the recovery of thermal energy from various sources operating at “large power rating” (exhaust gas turbines, internal combustion engines, geothermal sources, large melting furnaces, biomass, solar, etc.; from which it is possible to produce a large amount of electric energy (30 kW ÷ 300 kW. Such applications for small nominal power sources, as well as the exhaust gases of internal combustion engines (car sedan or town, ships, etc. or small heat exchangers, are very limited. The few systems that have been designed and built for small scale applications, have, on the other hand, different types of expander (screw, scroll, etc.. These devices are not adapted for placement in small and restricted places like the interior of a conventional car. The aim of this work is to perform the preliminary design of a turbo-expander that meets diverse system requirements such as low pressure, small size and low mass flow rates. The expander must be adaptable to a small ORC system utilizing gas of a diesel engine or small gas turbine as thermal source to produce 2–10 kW of electricity. The temperature and pressure of the exhaust gases, in this case study (400–600 °C and a pressure of 2 bar, imposes a limit on the use of an organic fluid and on the net power that can be produced. In addition to water, fluids such as CO2, R134a and R245fa have been considered. Once the operating fluids has been chosen

  6. An improved CO_2-based transcritical Rankine cycle (CTRC) used for engine waste heat recovery

    International Nuclear Information System (INIS)

    Shu, Gequn; Shi, Lingfeng; Tian, Hua; Li, Xiaoya; Huang, Guangdai; Chang, Liwen

    2016-01-01

    Highlights: • Propose an improved CTRC system (PR-CTRC) for engine waste heat recovery. • The PR-CTRC achieves a significant increase in thermodynamic performance. • The PR-CTRC possesses a strong coupling capability for high and low grade waste heat. • The PR-CTRC uses smaller turbine design parameters than ORC systems. • Total cooling load analysis of combined engine and recovery system was conducted. - Abstract: CO_2-based transcritical Rankine cycle (CTRC) is a promising technology for the waste heat recovery of an engine considering its safety and environment friendly characteristics, which also matchs the high temperature of the exhaust gas and satisfies the miniaturization demand of recovery systems. But the traditional CTRC system with a basic configuration (B-CTRC) has a poor thermodynamic performance. This paper introduces an improved CTRC system containing both a preheater and regenerator (PR-CTRC), for recovering waste heat in exhaust gas and engine coolant of an engine, and compares its performance with that of the B-CTRC system and also with that of the traditional excellent Organic Rankine Cycle (ORC) systems using R123 as a working fluid. The utilization rate of waste heat, total cooling load, net power output, thermal efficiency, exergy loss, exergy efficiency and component size have been investigated. Results show that, the net power output of the PR-CTRC could reach up to 9.0 kW for a 43.8 kW engine, which increases by 150% compared with that of the B-CTRC (3.6 kW). The PR-CTRC also improves the thermal efficiency and exergy efficiency of the B-CTRC, with increases of 184% and 227%, respectively. Compared with the ORC system, the PR-CTRC shows the significant advantage of highly recycling the exhaust gas and engine coolant simultaneously due to the special property of supercritical CO_2’s specific heat capacity. The supercritical property of CO_2 also generates a better heat transfer and flowing performances. Meanwhile, the PR

  7. Model of the expansion process for R245fa in an Organic Rankine Cycle (ORC)

    International Nuclear Information System (INIS)

    Luján, J.M.; Serrano, J.R.; Dolz, V.; Sánchez, J.

    2012-01-01

    An Organic Rankine Cycle (ORC) is considered as one of the most environmental-friendly ways to convert different kinds of low temperature energies, i.e. solar, geothermal, biomass and thermal energy of exhaust gases into electrical energy. Two important facts about the ORC must be considered: An organic fluid is selected as the working fluid and a high expansion ratio is usually presented in the machinery due to thermodynamic and efficiency factors. In the past, the pre-design of turbomachinery has been based on the usage of ideal fluid laws, but the real gas effects have a significant influence in the ORC working condition, due to its proximity to the saturation vapor line. In this article, the Equations of State (EoS) (Ideal gas, Redlich-Kwong-Soave and Peng–Robinson) have been evaluated in a typical ORC expansion in order to observe the inaccuracies of the ideal gas model with different thermodynamic variables. Finally an isothermal process followed by an isochoric process is proposed to reproduce the thermodynamic process of the organic fluid expansion by means of simpler equations. In the last point of this paper, several examples of this expansion process have been calculated, in order to analyze the proposed methodologies. It has been concluded that in typical expansion process of ORC (2.5 MPa-0.1 MPa and 1.6MPa-0.1 MPa), the PR and RKS equations show deviations between 6% and 8% in specific energy. These deviations are very low compared with the ideal gas equation whose deviations are above 100%. - Highlights: ► Evaluate the ideal gas behaviour of R245fa in typical working conditions of an Organic Rankine Cycle (ORC). ► Compare the ideal behaviour with other simple equations of state for real gas. ► Decide which equation of state has the highest precision in typical working conditions of an ORC. ► Derive the most important thermodynamic variables in each equation of state and decide the most accurate equation. ► Evaluate the speci c output

  8. Performance analysis of solar parabolic trough collectors driven combined supercritical CO2 and organic Rankine cycle

    Directory of Open Access Journals (Sweden)

    Harwinder Singh

    2018-06-01

    Full Text Available In this paper, attempts have been made on the detailed energy and exergy analysis of solar parabolic trough collectors (SPTCs driven combined power plant. The combination of supercritical CO2 (SCO2 cycle and organic Rankine cycle (ORC integrated with SPTCs has been used to produce power, in which SCO2 cycle and ORC are arranged as a topping and bottoming cycle. Five organic working fluids like R134a, R1234yf, R407c, R1234ze, and R245fa were selected for a low temperature bottoming ORC. Five key exergetic parameters such as exergetic efficiency, exergy destruction rate, fuel depletion ratio, irreversibility ratio, and improvement potential were also examined. It was revealed that exergetic and thermal efficiency of all the combined cycles enhances as the direct normal irradiance increases from 0.5 kW/m2 to 0.95 kW/m2. As can be seen, R407c combined cycle has the maximum exergetic as well as thermal efficiency which is around 78.07% at 0.95 kW/m2 and 43.49% at 0.95 kW/m2, respectively. Alternatively, the R134a and R245fa combined cycle yields less promising results with the marginal difference in their performance. As inferred from the study that SCO2 turbine and evaporator has a certain amount of exergy destruction which is around 9.72% and 8.54% of the inlet exergy, and almost 38.10% of the total exergy destruction in case of R407c combined cycle. Moreover, the maximum amount of exergy destructed by the solar collector field which is more than 25% of the solar inlet exergy and around 54% of the total destructed exergy. Finally, this study concludes that R407c combined cycle has a minimum fuel depletion ratio of 0.2583 for a solar collector and possess the highest power output of 3740 kW. Keywords: Supercritical CO2cycle, Organic Rankine cycle, Exergetic performance, SPTCs, Organic fluids

  9. Thermodynamic analysis of an Organic Rankine Cycle (ORC) based on industrial data

    International Nuclear Information System (INIS)

    Tumen Ozdil, N. Filiz; Segmen, M. Rıdvan; Tantekin, Atakan

    2015-01-01

    In this study, thermodynamic analysis of an Organic Rankine Cycle (ORC) is presented in a local power plant that is located southern of Turkey. The system that is analyzed includes an evaporator, a turbine, a condenser, a pump and a generator as components. System components are analyzed separately using actual plant data and performance cycle. The relationship between pinch point and exergy efficiency is observed. As the pinch point temperature decreases, the exergy efficiency increases due to low exergy destruction rate. The energy and exergy efficiencies of the ORC are calculated as 9.96% and 47.22%, respectively for saturated liquid form which is the real condition. In order to show the effect of the water phase of the evaporator inlet, exergy destruction and exergy efficiencies of components and overall system are calculated for different water phases. The exergy efficiency of the ORC is calculated as 41.04% for water mixture form which has quality 0.3. On the other hand, it is found as 40.29% for water mixture form which has quality 0.7. Lastly, it is calculated as 39.95% for saturated vapor form. Moreover, exergy destruction rates of the system are 520.01 kW for saturated liquid form, 598.39 kW for water mixture form which has quality 0.3, 609.5 kW for water mixture form which has quality 0.7 and 614.63 kW for saturated vapor form. The analyses show that evaporator has important effect on the system efficiency in terms of exergy rate. The evaporator is investigated particularly in order to improve the performance of the overall system. - Highlights: • Energy and exergy analysis of an Organic Rankine Cycle (ORC). • The main reasons of the irreversibility in the ORC. • Determination of exergy efficiency for the different water phases in the evaporator inlet. • Determination of the effect of the ambient temperature on ORC efficiency.

  10. Organic Rankine cycle saves energy and reduces gas emissions for cement production

    International Nuclear Information System (INIS)

    Wang, Huarong; Xu, Jinliang; Yang, Xufei; Miao, Zheng; Yu, Chao

    2015-01-01

    We investigated ORCs (organic Rankine cycles) integrated with typical China cement production line. The dry air at the kiln cooler outlet with the temperature of 220 °C was the waste heat. The fluids of hexane, isohexane, R601, R123 and R245fa were selected for ORCs based on the critical temperature criterion. The developed ORC verified the thermodynamics analysis. The NPV (net present value) and PBP (payback period) methods were applied to evaluate the economic performance. The LCA (life cycle assessment) was applied to evaluate the environment impacts. ORCs could generate 67,85,540–81,21,650 kWh electricity per year, equivalent to save 2035–2436 tons standard coal and reduce 7743–9268 tons CO 2 emission, for a 4000 t/d cement production line. ORCs reduced gas emissions of CO 2 by 0.62–0.74%, SO 2 by 3.83–4.59% and NO x by 1.36–1.63%. The PBP (payback period) was 2.74–3.42 years. The ORCs had the reduction ratios of EIL (environment impact load) by 1.49–1.83%, GWP (global warming potential) by 0.74–0.92%, AP (acidification potential) by 2.34–2.84%, EP (eutrophication potential) by 0.96–1.22% and HTP (human toxicity potential) by 2.38–2.89%. The ORC with R601 as the fluid had the best economic performance and significant gas emission reductions. ORCs had good economic performance and reduce the gas emissions. - Highlights: • Organic Rankine Cycles were integrated with the cement production line. • Five organic fluids were used as the working fluids for ORCs. • Thermal, economic and gas emission performances were analyzed. • R601 was the best fluid for ORC with the heat source temperature of 220 °C. • ORCs had good economic and gas emission reduction performances

  11. Analysis of a rotating spool expander for Organic Rankine Cycle applications

    Science.gov (United States)

    Krishna, Abhinav

    Increasing interest in recovering or utilizing low-grade heat for power generation has prompted a search for ways in which the power conversion process may be enhanced. Amongst the conversion systems, the Organic Rankine Cycle (ORC) has generated an enormous amount of interest amongst researchers and system designers. Nevertheless, component level technologies need to be developed and match the range of potential applications. In particular, technical challenges associated with scaling expansion machines (turbines) from utility scale to commercial scale have prevented widespread adoption of the technology. In this regard, this work focuses on a novel rotating spool expansion machine at the heart of an Organic Rankine Cycle. A comprehensive, deterministic simulation model of the rotating spool expander is developed. The comprehensive model includes a detailed geometry model of the spool expander and the suction valve mechanism. Sub-models for mass flow, leakage, heat transfer and friction within the expander are also developed. Apart from providing the ability to characterize the expander in a particular system, the model provides a valuable tool to study the impact of various design variables on the performance of the machine. The investigative approach also involved an experimental program to assess the performance of a working prototype. In general, the experimental data showed that the expander performance was sub-par, largely due to the mismatch of prevailing operating conditions and the expander design criteria. Operating challenges during the shakedown tests and subsequent sub-optimal design changes also detracted from performance. Nevertheless, the results of the experimental program were sufficient for a proof-of-concept assessment of the expander and for model validation over a wide range of operating conditions. The results of the validated model reveal several interesting details concerning the expander design and performance. For example, the match

  12. Combined Turbine and Cycle Optimization for Organic Rankine Cycle Power Systems—Part A: Turbine Model

    Directory of Open Access Journals (Sweden)

    Andrea Meroni

    2016-04-01

    Full Text Available Axial-flow turbines represent a well-established technology for a wide variety of power generation systems. Compactness, flexibility, reliability and high efficiency have been key factors for the extensive use of axial turbines in conventional power plants and, in the last decades, in organic Rankine cycle power systems. In this two-part paper, an overall cycle model and a model of an axial turbine were combined in order to provide a comprehensive preliminary design of the organic Rankine cycle unit, taking into account both cycle and turbine optimal designs. Part A presents the preliminary turbine design model, the details of the validation and a sensitivity analysis on the main parameters, in order to minimize the number of decision variables in the subsequent turbine design optimization. Part B analyzes the application of the combined turbine and cycle designs on a selected case study, which was performed in order to show the advantages of the adopted methodology. Part A presents a one-dimensional turbine model and the results of the validation using two experimental test cases from literature. The first case is a subsonic turbine operated with air and investigated at the University of Hannover. The second case is a small, supersonic turbine operated with an organic fluid and investigated by Verneau. In the first case, the results of the turbine model are also compared to those obtained using computational fluid dynamics simulations. The results of the validation suggest that the model can predict values of efficiency within ± 1.3%-points, which is in agreement with the reliability of classic turbine loss models such as the Craig and Cox correlations used in the present study. Values similar to computational fluid dynamics simulations at the midspan were obtained in the first case of validation. Discrepancy below 12 % was obtained in the estimation of the flow velocities and turbine geometry. The values are considered to be within a

  13. DRAGON score predicts functional outcomes in acute ischemic stroke patients receiving both intravenous tissue plasminogen activator and endovascular therapy.

    Science.gov (United States)

    Wang, Arthur; Pednekar, Noorie; Lehrer, Rachel; Todo, Akira; Sahni, Ramandeep; Marks, Stephen; Stiefel, Michael F

    2017-01-01

    The DRAGON score, which includes clinical and computed tomographic (CT) scan parameters, predicts functional outcomes in ischemic stroke patients treated with intravenous tissue plasminogen activator (IV tPA). We assessed the utility of the DRAGON score in predicting functional outcome in stroke patients receiving both IV tPA and endovascular therapy. A retrospective chart review of patients treated at our institution from February 2009 to October 2015 was conducted. All patients with computed tomography angiography (CTA) proven large vessel occlusions (LVO) who underwent intravenous thrombolysis and endovascular therapy were included. Baseline DRAGON scores and modified Rankin Score (mRS) at the time of hospital discharge was calculated. Good outcome was defined as mRS ≤3. Fifty-eight patients with LVO of the anterior circulation were studied. The mean DRAGON score of patients on admission was 5.3 (range, 3-8). All patients received IV tPA and endovascular therapy. Multivariate analysis demonstrated that DRAGON scores ≥7 was associated with higher mRS ( P DRAGON scores ≤6. Patients with DRAGON scores of 7 and 8 on admission had a mortality rate of 3.8% and 40%, respectively. The DRAGON score can help predict better functional outcomes in ischemic stroke patients receiving both IV tPA and endovascular therapy. This data supports the use of the DRAGON score in selecting patients who could potentially benefit from more invasive therapies such as endovascular treatment. Larger prospective studies are warranted to further validate these results.

  14. [Systolic blood pressure and functional outcome in patients with acute stroke: a Mexican registry of acute cerebrovascular disease (RENAMEVASC)].

    Science.gov (United States)

    Baños-González, Manuel; Cantú-Brito, Carlos; Chiquete, Erwin; Arauz, Antonio; Ruiz-Sandoval, José Luís; Villarreal-Careaga, Jorge; Barinagarrementeria, Fernando; Lozano, José Juan

    2011-01-01

    To analyze the association between the admission systolic blood pressure (SBP) and 30-day outcome in patients with acute cerebrovascular disease. The REgistro NAcional Mexicano de Enfermedad VAScular Cerebral (RENAMEVASC) is a hospital-based multicenter registry performed between November 2002 and October 2004. A total of 2000 patients with clinical syndromes of acute cerebrovascular disease confirmed by neuroimaging were registered. The modified Rankin scale was used for outcome stratification. We analyzed 1721 patients who had registered their SBP: 78 (4.5%) had transient ischemic attack, 894 (51.9%) brain infarction, 534 (30.9%) intracerebral hemorrhage, 165 (9.6%) subarachnoid hemorrhage and 50 (2.9%) cerebral venous thrombosis. Among 1036 (60.2%) patients with the antecedent of hypertension, only 32.4% had regular treatment. The 30-day case fatality rate presented a J pattern with respect to SBP, so that the risk of death was highest in 65 years (RR: 2.16, IC 95%: 1.74 - 2.67). Both hypotension and significant arterial hypertension at hospital admission are associated with an adverse outcome after acute cerebrovascular disease. Nevertheless, a good functional outcome can be attained in a wide range of SBP.

  15. Performance characterization of a power generation unit–organic Rankine cycle system based on the efficiencies of the system components

    International Nuclear Information System (INIS)

    Knizley, Alta; Mago, Pedro J.; Tobermann, James; Warren, Harrison R.

    2015-01-01

    Highlights: • Use of waste heat from a power generation unit to generate electricity is explored. • An organic Rankine cycle is used to recover the waste heat. • The system may lower cost, primary energy consumption, and carbon dioxide emission. • A parameter was established to show when the proposed system would provide savings. • The proposed system was evaluated in different locations in the US. - Abstract: This paper analyzes the potential of using the waste heat from a power generation unit to generate additional electricity using an organic Rankine cycle to reduce operational cost, primary energy consumption, and carbon dioxide emissions in different locations in the U.S. The power generation unit–organic Rankine cycle system is compared with a conventional system in terms of operational cost, primary energy consumption, and carbon dioxide emissions reduction. A parameter (R_m_i_n), which is based on system efficiencies, is established to determine when the proposed power generation unit–organic Rankine cycle system would potentially provide savings versus the conventional system in which electricity is purchased from the utility grid. The effect on the R_m_i_n parameter with variation of each system efficiency is also analyzed in this paper. Results indicated that savings in one parameter, such as primary energy consumption, did not imply savings in the other two parameters. Savings in the three parameters (operational cost, primary energy consumption, and carbon dioxide emissions) varied widely based on location due to prices of natural gas and electricity, source-to-site conversion factors, and carbon dioxide emissions conversion factors for electricity and natural gas. Variations in each system efficiency affected R_m_i_n, but varying the power generation unit efficiency had the most dramatic effect in the overall savings potential from the proposed system.

  16. Analisa Efisiensi Siklus Rankine Pada Sistem Pembangkit Tenaga Uap di PT. Pertamina (PERSERO) Refinery Unit IV Cilacap

    OpenAIRE

    Rahman, Fajril Ar

    2015-01-01

    Thermodynamic analysis was conducted to determine the thermal efficiency of the cycle Steam Power Plant. Rankine cycle is a thermodynamic basic principles that are commonly used to determine the performance and efficiency of a power plant. On Steam Generating System PT. Pertamina (Persero) RU IV Cilacap thermodynamic analysis has been conducted to determine the thermal efficiency and fuel use for different loading conditions. Thermodynamic analysis was done by determining the condition of the...

  17. Test results of an organic Rankine-cycle power module for a small community solar thermal power experiment

    Science.gov (United States)

    Clark, T. B.

    1985-01-01

    The organic Rankine-cycle (ORC) power conversion assembly was tested. Qualification testing of the electrical transport subsystem was also completed. Test objectives were to verify compatibility of all system elements with emphasis on control of the power conversion assembly, to evaluate the performance and efficiency of the components, and to validate operating procedures. After 34 hours of power generation under a wide range of conditions, the net module efficiency exceeded 18% after accounting for all parasitic losses.

  18. Part-Load Performance of aWet Indirectly Fired Gas Turbine Integrated with an Organic Rankine Cycle Turbogenerator

    Directory of Open Access Journals (Sweden)

    Leonardo Pierobon

    2014-12-01

    Full Text Available Over the last years, much attention has been paid to the development of efficient and low-cost power systems for biomass-to-electricity conversion. This paper aims at investigating the design- and part-load performance of an innovative plant based on a wet indirectly fired gas turbine (WIFGT fueled by woodchips and an organic Rankine cycle (ORC turbogenerator. An exergy analysis is performed to identify the sources of inefficiencies, the optimal design variables, and the most suitable working fluid for the organic Rankine process. This step enables to parametrize the part-load model of the plant and to estimate its performance at different power outputs. The novel plant has a nominal power of 250 kW and a thermal efficiency of 43%. The major irreversibilities take place in the burner, recuperator, compressor and in the condenser. Toluene is the optimal working fluid for the organic Rankine engine. The part-load investigation indicates that the plant can operate at high efficiencies over a wide range of power outputs (50%–100%, with a peak thermal efficiency of 45% at around 80% load. While the ORC turbogenerator is responsible for the efficiency drop at low capacities, the off-design performance is governed by the efficiency characteristics of the compressor and turbine serving the gas turbine unit.

  19. Research in Support of the Use of Rankine Cycle Energy Conversion Systems for Space Power and Propulsion

    Science.gov (United States)

    Lahey, Richard T., Jr.; Dhir, Vijay

    2004-01-01

    This is the report of a Scientific Working Group (SWG) formed by NASA to determine the feasibility of using a liquid metal cooled nuclear reactor and Rankine energy conversion cycle for dual purpose power and propulsion in space. This is a high level technical report which is intended for use by NASA management in program planning. The SWG was composed of a team of specialists in nuclear energy and multiphase flow and heat transfer technology from academia, national laboratories, NASA and industry. The SWG has identified the key technology issues that need to be addressed and have recommended an integrated short term (approx. 2 years) and a long term (approx. 10 year) research and development (R&D) program to qualify a Rankine cycle power plant for use in space. This research is ultimately intended to give NASA and its contractors the ability to reliably predict both steady and transient multiphase flow and heat transfer phenomena at reduced gravity, so they can analyze and optimize designs and scale-up experimental data on Rankine cycle components and systems. In addition, some of these results should also be useful for the analysis and design of various multiphase life support and thermal management systems being considered by NASA.

  20. Dual-objective optimization of organic Rankine cycle (ORC) systems using genetic algorithm: a comparison between basic and recuperative cycles

    Science.gov (United States)

    Hayat, Nasir; Ameen, Muhammad Tahir; Tariq, Muhammad Kashif; Shah, Syed Nadeem Abbas; Naveed, Ahmad

    2017-08-01

    Exploitation of low potential waste thermal energy for useful net power output can be done by manipulating organic Rankine cycle systems. In the current article dual-objectives (η_{th} and SIC) optimization of ORC systems [basic organic Rankine cycle (BORC) and recuperative organic Rankine cycle (RORC)] has been done using non-dominated sorting genetic algorithm (II). Seven organic compounds (R-123, R-1234ze, R-152a, R-21, R-236ea, R-245ca and R-601) have been employed in basic cycle and four dry compounds (R-123, R-236ea, R-245ca and R-601) have been employed in recuperative cycle to investigate the behaviour of two systems and compare their performance. Sensitivity analyses show that recuperation boosts the thermodynamic behaviour of systems but it also raises specific investment cost significantly. R-21, R-245ca and R-601 show attractive performance in BORC whereas R-601 and R-236ea in RORC. RORC, due to higher total investment cost and operation & maintenance costs, has longer payback periods as compared to BORC.

  1. Exergoeconomic assessment and parametric study of a Gas Turbine-Modular Helium Reactor combined with two Organic Rankine Cycles

    International Nuclear Information System (INIS)

    Mohammadkhani, F.; Shokati, N.; Mahmoudi, S.M.S.; Yari, M.; Rosen, M.A.

    2014-01-01

    An exergoeconomic analysis is reported for a combined system with a net electrical output of 299 MW in which waste heat from a Gas Turbine-Modular Helium Reactor (GT-MHR) is utilized by two Organic Rankine Cycles (ORCs). A parametric study is also done to reveal the effects on the exergoeconomic performance of the combined system of such significant parameters as compressor pressure ratio, turbine inlet temperature, temperatures of evaporators, pinch point temperature difference in the evaporators and degree of superheat at the ORC (Organic Rankine Cycle) turbines inlet. Finally the combined cycle performance is optimized from the viewpoint of exergoeconomics. The results show that the precooler, the intercooler and the ORC condensers exhibit the worst exergoeconomic performance. For the overall system, the exergoeconomic factor, the capital cost rate and the exergy destruction cost rate are determined to be 37.95%, 6876 $/h and 11,242 $/h, respectively. Also, it is observed that the unit cost of electricity produced by the GT-MHR turbine increases with increasing GT-MHR turbine inlet temperature but decreases as the other above mentioned parameters increase. - Highlights: • An exergoeconomic analysis is performed for the GT-MHR/ORC (Organic Rankine Cycle) combined cycle. • The effects of decision parameters on the exergoeconomic performance are studied. • The highest exergy destructions occur in the precooler, intercooler and condenser. • Superheating the working fluid at the ORC turbine inlet is not necessary. • Thermodynamic and exergoeconomic optimal conditions differ from each other

  2. Combining Spot Sign and Intracerebral Hemorrhage Score to Estimate Functional Outcome: Analysis From the PREDICT Cohort.

    Science.gov (United States)

    Schneider, Hauke; Huynh, Thien J; Demchuk, Andrew M; Dowlatshahi, Dar; Rodriguez-Luna, David; Silva, Yolanda; Aviv, Richard; Dzialowski, Imanuel

    2018-06-01

    The intracerebral hemorrhage (ICH) score is the most commonly used grading scale for stratifying functional outcome in patients with acute ICH. We sought to determine whether a combination of the ICH score and the computed tomographic angiography spot sign may improve outcome prediction in the cohort of a prospective multicenter hemorrhage trial. Prospectively collected data from 241 patients from the observational PREDICT study (Prediction of Hematoma Growth and Outcome in Patients With Intracerebral Hemorrhage Using the CT-Angiography Spot Sign) were analyzed. Functional outcome at 3 months was dichotomized using the modified Rankin Scale (0-3 versus 4-6). Performance of (1) the ICH score and (2) the spot sign ICH score-a scoring scale combining ICH score and spot sign number-was tested. Multivariable analysis demonstrated that ICH score (odds ratio, 3.2; 95% confidence interval, 2.2-4.8) and spot sign number (n=1: odds ratio, 2.7; 95% confidence interval, 1.1-7.4; n>1: odds ratio, 3.8; 95% confidence interval, 1.2-17.1) were independently predictive of functional outcome at 3 months with similar odds ratios. Prediction of functional outcome was not significantly different using the spot sign ICH score compared with the ICH score alone (spot sign ICH score area under curve versus ICH score area under curve: P =0.14). In the PREDICT cohort, a prognostic score adding the computed tomographic angiography-based spot sign to the established ICH score did not improve functional outcome prediction compared with the ICH score. © 2018 American Heart Association, Inc.

  3. The silver effect of admission glucose level on excellent outcome in thrombolysed stroke patients.

    Science.gov (United States)

    Rosso, Charlotte; Baronnet, Flore; Diaz, Belen; Le Bouc, Raphael; Frasca Polara, Giulia; Moulton, Eric Jr; Deltour, Sandrine; Leger, Anne; Crozier, Sophie; Samson, Yves

    2018-05-18

    Higher admission glucose levels (AGL) are associated with less favorable outcome in thrombolysis. But, could AGL's impact on outcome vary by onset-to-treatment (OTT) time? Is hyperglycemia associated with a shorter therapeutic time window for excellent outcome for thrombolysed stroke patients? We assessed predictive values of AGL, baseline NIHSS, age, and OTT time quartiles on excellent outcome (3-month modified Rankin score of 0-1) in 773 patients treated by rt-Pa. We added the AGL × OTT time quartile interaction in the model and separately analyzed the predictive values of AGL, age, and NIHSS for each OTT time quartile if the interaction was significant. AGL, baseline NIHSS, age, and OTT time quartiles were significant predictors. When added in the model, the AGL × OTT interaction was significant (OR: 0.96, 95% CI: 0.94-0.99, p: 0.0009). AGL was predictive only during the third OTT time quartile (181-224 min). During this period, the predicted rate of excellent outcome was 16% for AGL = 6.5 mmol/L and 8% for AGL = 8 mmol/L. The rate of excellent outcome was not decreased in hyperglycemic patients for OTT time ≤ 180 min (20 vs. 24.5% p: 0.37), but was decreased for OTT time > 180 min (9.6 vs. 26.7% p: 0.00001). Similar results were found in patients with MCA recanalization, but not in patients without recanalization. The therapeutic time window for excellent outcome is shortened in hyperglycemic patients. This would support the design of "freezing penumbra" randomized trials based on ultra-early AGL control.

  4. Temporal profile of body temperature in acute ischemic stroke: relation to infarct size and outcome.

    Science.gov (United States)

    Geurts, Marjolein; Scheijmans, Féline E V; van Seeters, Tom; Biessels, Geert J; Kappelle, L Jaap; Velthuis, Birgitta K; van der Worp, H Bart

    2016-11-21

    High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke. In 419 patients with acute ischemic stroke we assessed the relation between body temperature on admission and during the first 3 days with both infarct size and functional outcome. Infarct size was measured in milliliters on CT or MRI after 3 days. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Body temperature on admission was not associated with infarct size or poor outcome in adjusted analyses. By contrast, each additional 1.0 °C in body temperature on day 1 was associated with 0.31 ml larger infarct size (95% confidence interval (CI) 0.04-0.59), on day 2 with 1.13 ml larger infarct size(95% CI, 0.83-1.43), and on day 3 with 0.80 ml larger infarct size (95% CI, 0.48-1.12), in adjusted linear regression analyses. Higher peak body temperatures on days two and three were also associated with poor outcome (adjusted relative risks per additional 1.0 °C in body temperature, 1.52 (95% CI, 1.17-1.99) and 1.47 (95% CI, 1.22-1.77), respectively). Higher peak body temperatures during the first days after ischemic stroke, rather than on admission, are associated with larger infarct size and poor functional outcome. This suggests that prevention of high temperatures may improve outcome if continued for at least 3 days.

  5. Oxidation of mine tailings from Rankin Inlet, Nunavut, at subzero temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Meldrum, J. L.; Jamieson, H. E.; Dyke, L. D.

    2001-10-01

    An experiment was undertaken to determine if encapsulation in permafrost of acid-generating sulphidic tailings from a Ni-Cu mine on the shores of Hudson Bay in Nunavut will maintain the tailings and their saline pore water in a chemically inert state. The experiment involved collection of tailings material and pore water samples three years after burial, followed by long-term thermal monitoring. Tailings were studied at temperatures between +30 degrees C and -10 degrees C. Oxygen consumption was measured directly to determine the effect of low temperatures on oxidation rate. Significant oxidation was observed at +30 degrees C, which was substantially reduced at lower temperatures. At -10 degrees C oxygen consumption was below the detection limit. The highest measured oxygen flux correlated with a temperature increase of one degree C, which is consistent with exothermic sulphide oxidation reactions. The experiment showed that freezing in Rankin Inlet is progressing and tailings will be ice-bonded approximately 15 years after burial. 30 refs., 3 tabs. 6 figs.

  6. Evaluation of Working Fluids for Organic Rankine Cycle Based on Exergy Analysis

    Science.gov (United States)

    Setiawan, D.; Subrata, I. D. M.; Purwanto, Y. A.; Tambunan, A. H.

    2018-05-01

    One of the crucial aspects to determine the performance of Organic Rankine Cycle (ORC) is the selection of appropriate working fluids. This paper describes the simulative performance of several organic fluid and water as working fluid of an ORC based on exergy analysis with a heat source from waste heat recovery. The simulation was conducted by using Engineering Equation Solver (EES). The effect of several parameters and thermodynamic properties of working fluid was analyzed, and part of them was used as variables for the simulation in order to determine their sensitivity to the exergy efficiency changes. The results of this study showed that water is not appropriate to be used as working fluid at temperature lower than 130 °C, because the expansion process falls in saturated area. It was also found that Benzene had the highest exergy efficiency, i.e. about 10.49%, among the dry type working fluid. The increasing turbine inlet temperature did not lead to the increase of exergy efficiency when using organic working fluids with critical temperature near heat source temperature. Meanwhile, exergy efficiency decreasing linearly with the increasing condenser inlet temperature. In addition, it was found that working fluid with high latent heat of vaporization and specific heat exert in high exergy efficiency.

  7. Preliminary design and off-design performance analysis of an Organic Rankine Cycle for geothermal sources

    International Nuclear Information System (INIS)

    Hu, Dongshuai; Li, Saili; Zheng, Ya; Wang, Jiangfeng; Dai, Yiping

    2015-01-01

    Highlights: • A method for preliminary design and performance prediction is established. • Preliminary data of radial inflow turbine and plate heat exchanger are obtained. • Off-design performance curves of critical components are researched. • Performance maps in sliding pressure operation are illustrated. - Abstract: Geothermal fluid of 90 °C and 10 kg/s can be exploited together with oil in Huabei Oilfield of China. Organic Rankine Cycle is regarded as a reasonable method to utilize these geothermal sources. This study conducts a detailed design and off-design performance analysis based on the preliminary design of turbines and heat exchangers. The radial inflow turbine and plate heat exchanger are selected in this paper. Sliding pressure operation is applied in the simulation and three parameters are considered: geothermal fluid mass flow rate, geothermal fluid temperature and condensing pressure. The results indicate that in all considered conditions the designed radial inflow turbine has smooth off-design performance and no choke or supersonic flow are found at the nozzle and rotor exit. The lager geothermal fluid mass flow rate, the higher geothermal fluid temperature and the lower condensing pressure contribute to the increase of cycle efficiency and net power. Performance maps are illustrated to make system meet different load requirements especially when the geothermal fluid temperature and condensing pressure deviate from the design condition. This model can be used to provide basic data for future detailed design, and predict off-design performance in the initial design phase

  8. Comparison of different iterative schemes for ISPH based on Rankine source solution

    Directory of Open Access Journals (Sweden)

    Xing Zheng

    2017-07-01

    Full Text Available Smoothed Particle Hydrodynamics (SPH method has a good adaptability for the simulation of free surface flow problems. There are two forms of SPH. One is weak compressible SPH and the other one is incompressible SPH (ISPH. Compared with the former one, ISPH method performs better in many cases. ISPH based on Rankine source solution can perform better than traditional ISPH, as it can use larger stepping length by avoiding the second order derivative in pressure Poisson equation. However, ISPH_R method needs to solve the sparse linear matrix for pressure Poisson equation, which is one of the most expensive parts during one time stepping calculation. Iterative methods are normally used for solving Poisson equation with large particle numbers. However, there are many iterative methods available and the question for using which one is still open. In this paper, three iterative methods, CGS, Bi-CGstab and GMRES are compared, which are suitable and typical for large unsymmetrical sparse matrix solutions. According to the numerical tests on different cases, still water test, dam breaking, violent tank sloshing, solitary wave slamming, the GMRES method is more efficient than CGS and Bi-CGstab for ISPH method.

  9. Organic Rankine Cycle Analysis: Finding the Best Way to Utilize Waste Heat

    Directory of Open Access Journals (Sweden)

    Nadim Chakroun

    2012-01-01

    Full Text Available An Organic Rankine Cycle (ORC is a type of power cyclethat uses organic substances such as hydrocarbons orrefrigerants as the working fluid. ORC technology is usedto generate electricity in waste heat recovery applications,because the available heat is not at a high enoughtemperature to operate with other types of cycles. Theoptimum amount of working fluid required for the cycle(i.e., optimum charge level was investigated. Three chargelevels (13, 15, and 18 lbm were tested, and their effect onefficiency and performance of the system was analyzed.The heat source for the fluid was waste steam from thePurdue Power Plant, which had an average temperatureof 120oC. Regular city tap water at a temperature of 15oCwas used as the heat sink. For each charge level, multipletests were performed by measuring the temperaturesand pressures at all state points in the cycle, in order tounderstand any overarching patterns within the data.An important parameter that was analyzed is the 2nd lawefficiency. This efficiency is a measure of the effectivenessof the energy utilization compared to that of an idealcase. The peak efficiency increased from 24% to 27% asthe charge in the system decreased. Therefore, movingforward, this research suggests that a lower charge levelin the system will increase efficiency. However, testingbelow 13 lbm might cause mechanical complications inthe equipment as there may not be enough fluid to flowaround; thus, a compromise had to be made.

  10. Wave resistance calculation method combining Green functions based on Rankine and Kelvin source

    Directory of Open Access Journals (Sweden)

    LI Jingyu

    2017-12-01

    Full Text Available [Ojectives] At present, the Boundary Element Method(BEM of wave-making resistance mostly uses a model in which the velocity distribution near the hull is solved first, and the pressure integral is then calculated using the Bernoulli equation. However,the process of this model of wave-making resistance is complex and has low accuracy.[Methods] To address this problem, the present paper deduces a compound method for the quick calculation of ship wave resistance using the Rankine source Green function to solve the hull surface's source density, and combining the Lagally theorem concerning source point force calculation based on the Kelvin source Green function so as to solve the wave resistance. A case for the Wigley model is given.[Results] The results show that in contrast to the thin ship method of the linear wave resistance theorem, this method has higher precision, and in contrast to the method which completely uses the Kelvin source Green function, this method has better computational efficiency.[Conclusions] In general, the algorithm in this paper provides a compromise between precision and efficiency in wave-making resistance calculation.

  11. Performance estimation of Tesla turbine applied in small scale Organic Rankine Cycle (ORC) system

    International Nuclear Information System (INIS)

    Song, Jian; Gu, Chun-wei; Li, Xue-song

    2017-01-01

    Highlights: • One-dimensional model of the Tesla turbine is improved and applied in ORC system. • Working fluid properties and system operating conditions impact efficiency. • The influence of turbine efficiency on ORC system performance is evaluated. • Potential of using Tesla turbine in ORC systems is estimated. - Abstract: Organic Rankine Cycle (ORC) system has been proven to be an effective method for the low grade energy utilization. In small scale applications, the Tesla turbine offers an attractive option for the organic expander if an efficient design can be achieved. The Tesla turbine is simple in structure and is easy to be manufactured. This paper improves the one-dimensional model for the Tesla turbine, which adopts a non-dimensional formulation that identifies the dimensionless parameters that dictates the performance features of the turbine. The model is used to predict the efficiency of a Tesla turbine that is applied in a small scale ORC system. The influence of the working fluid properties and the operating conditions on the turbine performance is evaluated. Thermodynamic analysis of the ORC system with different organic working fluids and under various operating conditions is conducted. The simulation results reveal that the ORC system can generate a considerable net power output. Therefore, the Tesla turbine can be regarded as a potential choice to be applied in small scale ORC systems.

  12. Design and process integration of organic Rankine cycle utilizing biomass for power generation

    Science.gov (United States)

    Ependi, S.; Nur, T. B.

    2018-02-01

    Indonesia has high potential biomass energy sources from palm oil mill industry activities. The growing interest on Organic Rankine Cycle (ORC) application to produce electricity by utilizing biomass energy sources are increasingly due to its successfully used for generating electricity from rejected waste heat to the environment in industrial processes. In this study, the potential of the palm oil empty fruit bunch, and wood chip have been used as fuel for biomass to generate electricity based ORC with combustion processes. The heat from combustion burner was transfer by thermal oil heater to evaporate ORC working fluid in the evaporator unit. The Syltherm-XLT thermal oil was used as the heat carrier from combustion burner, while R245fa was used as the working fluid for ORC unit. Appropriate designs integration from biomass combustion unit to ORC unit have been analyzed and proposed to generate expander shaft-work. Moreover, the effect of recuperator on the total system efficiency has also been investigated. It was observed that the fuel consumption was increased when the ORC unit equipped recuperator operated until certain pressure and decreased when operated at high pressure.

  13. Operation of an organic Rankine cycle dependent on pumping flow rates and expander torques

    International Nuclear Information System (INIS)

    Yang, Xufei; Xu, Jinliang; Miao, Zheng; Zou, Jinghuang; Yu, Chao

    2015-01-01

    An ORC (organic Rankine cycle) was developed with R123 as the working fluid. The heat capacity is in ∼100 kW. The match between pump and expander is investigated. Lower pump frequencies (f 10 Hz) adapt low expander torques only, and cause unstable flow and pump cavitation for larger expander torques. Ultra-low expander torques generate sufficiently high vapor superheatings to decrease expander efficiencies. Ultra-high expander torques achieve saturation vapor at the expander inlet, causing liquid droplets induced shock wave to worsen expander performance. An optimal range of expander torques exists to have better expander performance. A liquid subcooling of 20 °C is necessary to avoid pump cavitation. Expander powers and efficiencies show parabola shapes versus expander torques, or vapor superheatings at the expander inlet. The optimal vapor superheating is 13 °C. The cavitation mechanisms and measures to avoid cavitation are analyzed. This paper notes the overestimation of ORC performance by equilibrium thermodynamic analysis. Assumptions should be dependent on experiments. Future studies are suggested on organic fluid flow, heat transfer and energy conversion in various components. - Highlights: • The match between pump and expander is investigated. • A liquid subcooling of 20 °C is needed at pump inlet. • A vapor superheating of 13 °C is necessary at expander inlet. • Cavitation in pumps and expanders are analyzed. • The equilibrium thermodynamics overestimate ORC performances.

  14. Analysis of zeotropic mixtures used in high-temperature Organic Rankine cycle

    International Nuclear Information System (INIS)

    Dong, Bensi; Xu, Guoqiang; Cai, Yi; Li, Haiwang

    2014-01-01

    Highlights: • Using mixtures leads to an efficiency increase compared to pure fluids. • MM/MDM (0.4/0.6) produces optimal cycle efficiency. • Lower temperature gradients of heat source and sink give rise to higher cycle efficiency. • Condensation step shows more effect than evaporation step on cycle efficiency. - Abstract: The paper investigates the performance of high-temperature Organic Rankine cycle (ORC) with zeotropic mixtures as working fluid. A numerical model, which has been validated by comparing with the published data, is developed to predict the first law thermal efficiency of the cycle. The effects of mixture concentration, temperature gradient of the heat transfer fluid, pinch temperature difference, pressure ratio, and condensation pressure on the first law efficiency are presented firstly using a purposely designed program, and then the suitable conditions for the described ORC are suggested based on the results of the simulation. It is demonstrated that the use of zeotropic mixtures leads to an efficiency increase compared to pure fluids

  15. Numerical optimization of Combined Heat and Power Organic Rankine Cycles – Part A: Design optimization

    International Nuclear Information System (INIS)

    Martelli, Emanuele; Capra, Federico; Consonni, Stefano

    2015-01-01

    This two-part paper proposes an approach based on state-of-the-art numerical optimization methods for simultaneously determining the most profitable design and part-load operation of Combined Heat and Power Organic Rankine Cycles. Compared to the usual design practice, the important advantages of the proposed approach are (i) to consider the part-load performance of the ORC at the design stage, (ii) to optimize not only the cycle variables, but also the main turbine design variables (number of stages, stage loads, rotational speed). In this first part (Part A), the design model and the optimization algorithm are presented and tested on a real-world test case. PGS-COM, a recently proposed hybrid derivative-free algorithm, allows to efficiently tackle the challenging non-smooth black-box problem. - Highlights: • Algorithm for the simultaneous optimization Organic Rakine Cycle and turbine. • Thermodynamic and economic models of boiler, cycle, turbine are developed. • Non-smooth black-box optimization problem is successfully tackled with PGS-COM. • Test cases show that the algorithm returns optimal solutions within 4 min. • Toluene outperforms MDM (a siloxane) in terms of efficiency and costs.

  16. Organic Rankine kilowatt isotope power system. First annual summary report, August 1, 1975--August 1, 1976

    International Nuclear Information System (INIS)

    1976-01-01

    Sundstrand Energy Systems is developing a Kilowatt Isotope Power System (KIPS) directed toward satisfying the higher power requirements of satellites of the 1980's. The KIPS is a plutonium oxide fueled organic Rankine cycle turbine power system which will provide design output power in the range of 500 to 2000 W(e) with a minimum of system changes. Research progress is reported on Phase I comprising: (1) flight system conceptual design and ground demonstration; (2) flight system design and ground qualification; and (3) flight system production, acceptance testing and delivery. The principal objectives of Phase I are to: (1) conceptually design the flight system, (2) based on the flight system concept, design and build the ground demonstration system (GDS), (3) conduct performance and endurance testing using electric heaters to simulate the radioisotope heat source, (4) identify and initiate long lead development efforts required to achieve the initial flight qualification hardware availability date of April 1981, and (5) finalize the flight concept design and prepare the program plan for the Phase II effort

  17. Performance analysis of low temperature heat source of organic Rankine cycle for geothermal application

    Science.gov (United States)

    Pintoro, A.; Ambarita, H.; Nur, T. B.; Napitupulu, F. H.

    2018-02-01

    Indonesia has a high potential energy resources from geothermal activities. Base on the report of Asian Development Bank and World Bank, the estimated of Indonesian hydrothermal geothermal resource considered to be the largest among the world. If it’s can be utilized to produce the electric power, it’s can contribute to increasing the electrification rates in Indonesia. In this study, an experimental studied of electric power generation, utilizing the Organic Rankine Cycle (ORC) system to convert the low level heat of hydrothermal as an energy source. The temperature of hydrothermal was modelled as hot water from water boiler which has a temperature range from 60 °C - 100 °C to heat up the organic working fluid of ORC system. The system can generated 1,337.7 watts of electricity when operated using R134A with hot water inlet temperature of 100 °C. Changing system working fluid to R245fa, the net power obtained increase to 1,908.9 watts with the same heat source condition. This study showed that the ORC system can be implemented to utilize low temperature heat source of hydrothermal in Indonesia.

  18. Computational modelling of an Organic Rankine Cycle (ORC waste heat recovery system for an aircraft engine

    Directory of Open Access Journals (Sweden)

    Saadon S.

    2018-01-01

    Full Text Available Escalating fuel prices and carbon dioxide emission are causing new interest in methods to increase the thrust force of an aircraft engine with limitation of fuel consumption. One viable means is the conversion of exhaust engine waste heat to a more useful form of energy or to be used in the aircraft environmental system. A one-dimensional analysis method has been proposed for the organic Rankine cycle (ORC waste heat recovery system for turbofan engine in this paper. The paper contains two main parts: validation of the numerical model and a performance prediction of turbofan engine integrated to an ORC system. The cycle is compared with industrial waste heat recovery system from Hangzhou Chinen Steam Turbine Power CO., Ltd. The results show that thrust specific fuel consumption (TSFC of the turbofan engine reach lowest value at 0.91 lbm/lbf.h for 7000 lbf of thrust force. When the system installation weight is applied, the system results in a 2.0% reduction in fuel burn. Hence implementation of ORC system for waste heat recovery to an aircraft engine can bring a great potential to the aviation industry.

  19. A new six stroke single cylinder diesel engine referring Rankine cycle

    International Nuclear Information System (INIS)

    Chen, Hao; Guo, Qi; Yang, Lu; Liu, Shenghua; Xie, Xuliang; Chen, Zhaoyang; Liu, Zengqiang

    2015-01-01

    Six stroke engine presented by Conklin and Szybist is an effective way to recover energy of exhaust gas by adding a partial exhaust stroke and steam expansion stroke. Characteristics of the engine are analyzed and its disadvantages are pointed out. A new six stroke diesel engine is presented here. It refers rankine cycle inside cylinder. Total exhaust gas is recompressed and at a relatively low back pressure in the fourth stroke water is injected to which maintains liquid phase until the piston moves to the TDC. At c′ 720 °CA (crank angle) the water becomes saturated. An ideal thermodynamics model of exhaust gas compression, water injection and expansion is constructed to investigate this modification. Properties at characteristic points are calculated to determine the increased indicated work. Results show that the work increases with the advance of water injection timing and the quality of water. The cycle is more efficient and the new engine has potential for saving energy. Moreover, it is forecasted that HC and PM emissions may reform with steam in reality and H 2 is produced which will react with NO X . - Highlights: • A new six stroke diesel engine is introduced and a new ideal cycle is constructed. • Increased indicated work of the cycle proves that the cycle is more efficient. • In reality steam may reform with HC and PM and produced H 2 may react with NO X emission. • The engine has the potential for energy saving and emission reducing

  20. Exergy optimization for a novel combination of organic Rankine cycles, Stirling cycle and direct expander turbines

    Science.gov (United States)

    Moghimi, Mahdi; Khosravian, Mohammadreza

    2018-06-01

    In this paper, a novel combination of organic Rankine cycles (ORCs), Stirling cycle and direct expander turbines is modeled and optimized using the genetic algorithm. The Exergy efficiency is considered as an objective function in the genetic algorithm. High efficiency is the main advantage of Stirling cycle, however, it needs nearly isothermal compressor and turbine. Therefore, an argon ORC and a R14 ORC are placed before and after the Striling cycle along with two expander turbines at the end of the line. Each component and cycle of the proposed plant in this article is verified by the previous works available in the literature and good agreement is achieved. The obtained results reveal that 27.98%, 20.86% and 12.90% of the total cold exergy are used by argon ORC, Stirling cycle and R14 ORC, respectively. Therefore, utilization of the Stirling cycle is a good idea for the LNG line cold exergy. The maximum exergy destruction occurs in the heat exchanger after the argon ORC (85.786 kJ/s per one kg/s LNG) due to the wasted cold exergy, which can be used for air conditioning systems in the plant. Finally, it would be shown that the maximum efficiency of the proposed plant is 54.25% and the maximum output power is 355.72 kW.

  1. Organic Rankine cycle – review and research directions in engine applications

    Directory of Open Access Journals (Sweden)

    Panesar Angad

    2017-01-01

    Full Text Available Waste heat to power conversion using Organic Rankine Cycles (ORC is expected to play an important role in CO2 reductions from diesel engines. Firstly, a review of automotive ORCs is presented focusing on the pure working fluids, thermal architectures and expanders. The discussion includes, but is not limited to: R245fa, ethanol and water as fluids; series, parallel and cascade as architectures; dry saturated, superheated and supercritical as expansion conditions; and scroll, radial turbine and piston as expansion machines. Secondly, research direction in versatile expander and holistic architecture (NOx + CO2 are proposed. Benefits of using the proposed unconventional approaches are quantified using Ricardo Wave and Aspen HYSYS for diesel engine and ORC modelling. Results indicate that, the implementation of versatile piston expander tolerant to two-phase and using cyclopentane can potentially increase the highway drive cycle power by 8%. Furthermore, holistic architecture offering complete utilisation of charge air and exhaust recirculation heat increased the performance noticeably to 5% of engine power at the design point condition.

  2. Optimization of low temperature solar thermal electric generation with Organic Rankine Cycle in different areas

    International Nuclear Information System (INIS)

    Jing, Li; Gang, Pei; Jie, Ji

    2010-01-01

    The presented low temperature solar thermal electric generation system mainly consists of compound parabolic concentrators (CPC) and the Organic Rankine Cycle (ORC) working with HCFC-123. A novel design is proposed to reduce heat transfer irreversibility between conduction oil and HCFC-123 in the heat exchangers while maintaining the stability of electricity output. Mathematical formulations are developed to study the heat transfer and energy conversion processes and the numerical simulation is carried out based on distributed parameters. Annual performances of the proposed system in different areas of Canberra, Singapore, Bombay, Lhasa, Sacramento and Berlin are simulated. The influences of the collector tilt angle adjustment, the connection between the heat exchangers and the CPC collectors, and the ORC evaporation temperature on the system performance are investigated. The results indicate that the three factors have a major impact on the annual electricity output and should be the key points of optimization. And the optimized system shows that: (1) The annual received direct irradiance can be significantly increased by two or three times optimal adjustments even when the CPC concentration ratio is smaller than 3.0. (2) Compared with the traditional single-stage collectors, two-stage collectors connected with the heat exchangers by two thermal oil cycles can improve the collector efficiency by 8.1-20.9% in the simultaneous processes of heat collection and power generation. (3) On the use of the market available collectors the optimal ORC evaporation temperatures in most of the simulated areas are around 120 C. (author)

  3. Organic Rankine Cycle recovering stage heat from MSF desalination distillate water

    International Nuclear Information System (INIS)

    Al-Weshahi, Mohammed A.; Anderson, Alexander; Tian, Guohong

    2014-01-01

    Highlights: • The ORC model is validated against measured performance of an existing ORC unit. • This ORC model highlights the importance of refrigerant choice (R245fa performs better than R134a for this specific application). • For heat recovery from desalination plant, ORC evaporator and cooling water temperatures significantly influence the performance. - Abstract: This investigation addresses the potential for heat recovery from Multi Stage Flash (MSF) desalination plant hot distillate water to power an Organic Rankine Cycle (ORC), comparing R134a and R245fa refrigerants as the working fluid. Using design characteristics of an existing ORC unit, the model was first validated against its measured output. The distillate hot water from MSF stages is utilised to provide heat to the ORC and performance is investigated for both working fluids and for the number of MSF stages for heat recovery. For the specific MSF plant investigated, the net produced ORC power is found the highest with extraction up to MSF powering stage 8, generating 359 kW when R245fa is used and 307 kW when R134a is used. Both refrigerants exhibit an increase of power output and decrease of energy efficiency as heat is recovered from more MSF stages. The influence of variation of the evaporator and cooling temperature on ORC performance is demonstrated to be significant for both refrigerants, with R245fa performing better in this specific application

  4. Investigation of the organic Rankine cycle (ORC) system and the radial-inflow turbine design

    International Nuclear Information System (INIS)

    Li, Yan; Ren, Xiao-dong

    2016-01-01

    Highlights: • The thermodynamic analysis of an ORC system is introduced. • A radial turbine design method has been proposed based on the real gas model. • A radial turbine with R123 is designed and numerically analyzed. - Abstract: Energy and environment issue set utilizing low-grade heat noticed. Organic Rankine Cycle (ORC) has been demonstrated to be a promising technology to recover waste heat. As a critical component of ORC system, the turbine selection has an enormous influence on the system performance. This paper carries out a study on the thermodynamic analysis of ORC system and the aerodynamic design of an organic radial turbine. The system performance is evaluated with various working fluids. The aerodynamic design of the organic radial-inflow turbine is focused due to the high molecule weight and the low sound speed of the organic working fluid. An aerodynamic and profile design system is developed. A radial-inflow turbine with R123 as the working fluid is designed and the numerical analysis is conducted. The simulation results indicate that the shock wave caused by the high expansion ratio in the nozzle is well controlled. Compared with the one-dimensional design results, the performance of the radial-inflow turbine in this paper reaches the design requirements.

  5. Reciprocating Expander for an Exhaust Heat Recovery Rankine Cycle for a Passenger Car Application

    Directory of Open Access Journals (Sweden)

    Osoko Shonda

    2012-06-01

    Full Text Available Nowadays, on average, two thirds of the fuel energy consumed by an engine is wasted through the exhaust gases and the cooling liquid. The recovery of this energy would enable a substantial reduction in fuel consumption. One solution is to integrate a heat recovery system based on a steam Rankine cycle. The key component in such a system is the expander, which has a strong impact on the system’s performance. A survey of different expander technologies leads us to select the reciprocating expander as the most promising one for an automotive application. This paper therefore proposes a steady-state semi-empirical model of the expander device developed under the Engineering Equation Solver (EES environment. The ambient and mechanical losses as well as internal leakage were taken into account by the model. By exploiting the expander manufacturer’s data, all the parameters of the expander model were identified. The model computes the mass flow rate, the power output delivered and the exhaust enthalpy of the steam. The maximum deviation between predictions and measurement data is 4.7%. A performance study of the expander is carried out and shows that the isentropic efficiency is quite high and increases with the expander rotary speed. The mechanical efficiency depends on mechanical losses which are quite high, approximately 90%. The volumetric efficiency was also evaluated.

  6. Experimental Investigation of the Performance of a Hermetic Screw-Expander Organic Rankine Cycle

    Directory of Open Access Journals (Sweden)

    Sung-Wei Hsu

    2014-09-01

    Full Text Available In this study, the authors experimentally investigate the performance of the organic Rankine cycle (ORC and screw expander under the influence of supply pressure and pressure ratio over the expander. Three tests were performed with expander pressure ratios of 2.4–3.5, 3.0–4.6, and 3.3–6.1, which cover the over-expansion and under-expansion operating modes. The test results show a maximum expander isentropic efficiency of 72.4% and a relative cycle efficiency of 10.5% at an evaporation temperature of 101 °C and condensation temperature of 45 °C. At a given pressure ratio over the expander, a higher supply pressure to the expander causes a higher expander isentropic efficiency and higher cycle efficiency in the over-expansion mode. However, in the under-expansion mode, the higher supply pressure results in a lower expander isentropic efficiency and adversely affects the cycle efficiency. The results also show that under the condition of operation at a given pressure ratio, a higher supply pressure yields a larger power output owing to the increased mass flow rate at the higher supply pressure. The study results demonstrate that a screw-expander ORC can be operated with a wide range of heat sources and heat sinks with satisfactory cycle efficiency.

  7. Performance analysis of an organic Rankine cycle with internal heat exchanger having zeotropic working fluid

    Directory of Open Access Journals (Sweden)

    Thoranis Deethayat

    2015-09-01

    Full Text Available In this study, performance of a 50 kW organic Rankine cycle (ORC with internal heat exchanger (IHE having R245fa/R152a zeotropic refrigerant with various compositions was investigated. The IHE could reduce heat rate at the ORC evaporator and better cycle efficiency could be obtained. The zeotropic mixture could reduce the irreversibilities during the heat exchanges at the ORC evaporator and the ORC condenser due to its gliding temperature; thus the cycle working temperatures came closer to the temperatures of the heat source and the heat sink. In this paper, effects of evaporating temperature, mass fraction of R152a and effectiveness of internal heat exchanger on the ORC performances for the first law and the second law of thermodynamics were considered. The simulated results showed that reduction of R245fa composition could reduce the irreversibilities at the evaporator and the condenser. The suitable composition of R245fa was around 80% mass fraction and below this the irreversibilities were nearly steady. Higher evaporating temperature and higher internal heat exchanger effectiveness also increased the first law and second law efficiencies. A set of correlations to estimate the first and the second law efficiencies with the mass fraction of R245fa, the internal heat exchanger effectiveness and the evaporating temperature were also developed.

  8. Energy analysis of a trigeneration plant based on solid oxide fuel cell and organic Rankine cycle

    International Nuclear Information System (INIS)

    Al-Sulaiman, F.A.; Dincer, I.; Hamdullahpur, F.

    2009-01-01

    In this paper, energy analysis of a trigeneration plant based on Solid Oxide Fuel cell (SOFC) and organic Rankine cycle (ORC) is carried out. The physical and thermodynamic elements of the plant include a SOFC, ORC, a heating process and a single-effect absorption chiller. The waste heat from the SOFC is used as an input heat to the ORC. In turn, the waste heat from the ORC is used to heat the inlet water, and to provide the heat needed for the single-effect absorption chiller. The results obtained from this study show that the highest cycle efficiency that can be attained under the proposed scheme is 48% and the highest SOFC efficiency is 43%. Furthermore, it is found that the highest net work rate is 435 kW and the highest SOFC-AC work rate is 337 kW. At a current density higher than 0.87 A/cm 2 , the SOFC and cycle efficiencies drop abruptly because of the sharp increase in the voltage losses of the SOFC. At a current density of 0.75 A/cm 2 , the highest SOFC efficiency of 41% is obtained at the inlet fuel cell temperature of 890 K. The change in the inlet pressure of the turbine has insignificant effect on the efficiencies of the ORC and overall cycle. The study shows the effect of both the current density and the inlet fuel cell temperature on the cell voltage and voltage loss. (author)

  9. Combined solar organic Rankine cycle with reverse osmosis desalination process: Energy, exergy, and cost evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Nafey, A.S.; Sharaf, M.A. [Department of Engineering Science, Faculty of Petroleum and Mining Engineering, Suez Canal University, Suez (Egypt)

    2010-11-15

    Organic Rankine cycles (ORC) have unique properties that are well suited to solar power generation. In this work design and performance calculations are performed using MatLab/SimuLink computational environment. The cycle consists of thermal solar collectors (Flat Plate Solar Collector (FPC), or Parabolic Trough Collector (PTC), or Compound Parabolic Concentrator (CPC)) for heat input, expansion turbine for work output, condenser unit for heat rejection, pump unit, and Reverse Osmosis (RO) unit. Reverse osmosis unit specifications used in this work is based on Sharm El-Shiekh RO desalination plant. Different working fluids such as: butane, isobutane, propane, R134a, R152a, R245ca, and R245fa are examined for FPC. R113, R123, hexane, and pentane are investigated for CPC. Dodecane, nonane, octane, and toluene are allocated for PTC. The proposed process units are modeled and show a good validity with literatures. Exergy and cost analysis are performed for saturation and superheated operating conditions. Exergy efficiency, total exergy destruction, thermal efficiency, and specific capital cost are evaluated for direct vapor generation (DVG) process. Toluene and Water achieved minimum results for total solar collector area, specific total cost and the rate of exergy destruction. (author)

  10. Evaluation of a solar-powered organic Rankine cycle using dry organic working fluids

    Directory of Open Access Journals (Sweden)

    Emily Spayde

    2015-12-01

    Full Text Available This paper presents a model to evaluate the performance of a solar-powered organic Rankine cycle (ORC. The system was evaluated in Jackson, MS, using five dry organic working fluids, R218, R227ea, R236ea, R236fa, and RC318. The purpose of this study is to investigate how hourly temperature change affects the electricity production and exergy destruction rates of the solar ORC, and to determine the effect of the working fluid on the proposed system. The system was also evaluated in Tucson, AZ, to investigate the effect of average hourly outdoor temperatures on its performance. The potential of the system to reduce primary energy consumption and carbon dioxide emissions is also investigated. A parametric analysis to determine how temperature and pressure of the organic working fluid, the solar collector area, and the turbine efficiency affect the electricity production is performed. Results show that the ORC produces the most electricity during the middle of the day, when the temperatures are the highest and when the solar collectors have the highest efficiency. Also, R-236ea is the working fluid that shows the best performance of the evaluated fluids. An economic analysis was performed to determine the capital cost available for the proposed system.

  11. Evaluation of external heat loss from a small-scale expander used in organic Rankine cycle

    International Nuclear Information System (INIS)

    Li Jing; Pei Gang; Li Yunzhu; Ji Jie

    2011-01-01

    With the scaling down of the Organic Rankine Cycle (ORC), the engine shaft power is not only determined by the enthalpy drop in the expansion process but also the external heat loss from the expander. Theoretical and experimental support in evaluating small-scale expander heat loss is rare. This paper presents a quantitative study on the convection, radiation, and conduction heat transfer from a kW-scale expander. A mathematical model is built and validated. The results show that the external radiative or convective heat loss coefficient was about 3.2 or 7.0 W/K.m 2 when the ORC operated around 100 o C. Radiative and convective heat loss coefficients increased as the expander operation temperature increased. Conductive heat loss due to the connection between the expander and the support accounted for a large proportion of the total heat loss. The fitting relationships between heat loss and mean temperature difference were established. It is suggested that low conductivity material be embodied in the support of expander. Mattress insulation for compact expander could be eliminated when the operation temperature is around 100 o C. - Highlights: → A close examination of external heat loss from a small expander is presented. → Theoretical analysis and experimental test were conducted. → The established formulas can be applied to other small ORC expanders. → The results are useful in further research of small-scale ORC.

  12. Exergetic Analysis of an Integrated Tri-Generation Organic Rankine Cycle

    Directory of Open Access Journals (Sweden)

    Ratha Z. Mathkor

    2015-08-01

    Full Text Available This paper reports on a study of the modelling, validation and analysis of an integrated 1 MW (electrical output tri-generation system energized by solar energy. The impact of local climatic conditions in the Mediterranean region on the system performance was considered. The output of the system that comprised a parabolic trough collector (PTC, an organic Rankine cycle (ORC, single-effect desalination (SED, and single effect LiBr-H2O absorption chiller (ACH was electrical power, distilled water, and refrigerant load. The electrical power was produced by the ORC which used cyclopentane as working fluid and Therminol VP-1 was specified as the heat transfer oil (HTO in the collectors with thermal storage. The absorption chiller and the desalination unit were utilize the waste heat exiting from the steam turbine in the ORC to provide the necessary cooling energy and drinking water respectively. The modelling, which includes an exergetic analysis, focuses on the performance of the solar tri-generation system. The simulation results of the tri-generation system and its subsystems were produced using IPSEpro software and were validated against experimental data which showed good agreement. The tri-generation system was able to produce about 194 Ton of refrigeration, and 234 t/day distilled water.

  13. Exergy optimization for a novel combination of organic Rankine cycles, Stirling cycle and direct expander turbines

    Science.gov (United States)

    Moghimi, Mahdi; Khosravian, Mohammadreza

    2018-01-01

    In this paper, a novel combination of organic Rankine cycles (ORCs), Stirling cycle and direct expander turbines is modeled and optimized using the genetic algorithm. The Exergy efficiency is considered as an objective function in the genetic algorithm. High efficiency is the main advantage of Stirling cycle, however, it needs nearly isothermal compressor and turbine. Therefore, an argon ORC and a R14 ORC are placed before and after the Striling cycle along with two expander turbines at the end of the line. Each component and cycle of the proposed plant in this article is verified by the previous works available in the literature and good agreement is achieved. The obtained results reveal that 27.98%, 20.86% and 12.90% of the total cold exergy are used by argon ORC, Stirling cycle and R14 ORC, respectively. Therefore, utilization of the Stirling cycle is a good idea for the LNG line cold exergy. The maximum exergy destruction occurs in the heat exchanger after the argon ORC (85.786 kJ/s per one kg/s LNG) due to the wasted cold exergy, which can be used for air conditioning systems in the plant. Finally, it would be shown that the maximum efficiency of the proposed plant is 54.25% and the maximum output power is 355.72 kW.

  14. Dynamic Simulation of an Organic Rankine Cycle—Detailed Model of a Kettle Boiler

    Directory of Open Access Journals (Sweden)

    Roberto Pili

    2017-04-01

    Full Text Available Organic Rankine Cycles (ORCs are nowadays a valuable technology to produce electricity from low and medium temperature heat sources, e.g., in geothermal, biomass and waste heat recovery applications. Dynamic simulations can help improve the flexibility and operation of such plants, and guarantee a better economic performance. In this work, a dynamic model for a multi-pass kettle evaporator of a geothermal ORC power plant has been developed and its dynamics have been validated against measured data. The model combines the finite volume approach on the tube side and a two-volume cavity on the shell side. To validate the dynamic model, a positive and a negative step function in heat source flow rate is applied. The simulation model performed well in both cases. The liquid level appeared the most challenging quantity to simulate. A better agreement in temperature was achieved by increasing the volume flow rate of the geothermal brine by 2% over the entire simulation. Measurement errors, discrepancies in working fluid and thermal brine properties and uncertainties in heat transfer correlations can account for this. In the future, the entire geothermal power plant will be simulated, and suggestions to improve its dynamics and control by means of simulations will be provided.

  15. Molecular Entropy, Thermal Efficiency, and Designing of Working Fluids for Organic Rankine Cycles

    Science.gov (United States)

    Wang, Jingtao; Zhang, Jin; Chen, Zhiyou

    2012-06-01

    A shortage of fossil energy sources boosts the utilization of renewable energy. Among numerous novel techniques, recovering energy from low-grade heat sources through power generation via organic Rankine cycles (ORCs) is one of the focuses. Properties of working fluids are crucial for the ORC's performance. Many studies have been done to select proper working fluids or to design new working fluids. However, no researcher has systematically investigated the relationship between molecular structures and thermal efficiencies of various working fluids for an ideal ORC. This paper has investigated the interrelations of molecular structures, molecular entropies, and thermal efficiencies of various working fluids for an ideal ORC. By calculating thermal efficiencies and molecular entropies, we find that the molecular entropy is the most appropriate thermophysical property of a working fluid to determine how much energy can be converted into work and how much cannot in a system. Generally speaking, working fluids with low entropies will generally have high thermal efficiency for an ideal ORC. Based on this understanding, the direct interrelations of molecular structures and entropies provide an explicit interrelation between molecular structures and thermal efficiencies, and thus provide an insightful direction for molecular design of novel working fluids for ORCs.

  16. Real-Time Optimization of Organic Rankine Cycle Systems by Extremum-Seeking Control

    Directory of Open Access Journals (Sweden)

    Andres Hernandez

    2016-05-01

    Full Text Available In this paper, the optimal operation of a stationary sub-critical 11 kW el organic Rankine cycle (ORC unit for waste heat recovery (WHR applications is investigated, both in terms of energy production and safety conditions. Simulation results of a validated dynamic model of the ORC power unit are used to derive a correlation for the evaporating temperature, which maximizes the power generation for a range of operating conditions. This idea is further extended using a perturbation-based extremum seeking (ES algorithm to identify online the optimal evaporating temperature. Regarding safety conditions, we propose the use of the extended prediction self-adaptive control (EPSAC approach to constrained model predictive control (MPC. Since it uses input/output models for prediction, it avoids the need for state estimators, making it a suitable tool for industrial applications. The performance of the proposed control strategy is compared to PID-like schemes. Results show that EPSAC-MPC is a more effective control strategy, as it allows a safer and more efficient operation of the ORC unit, as it can handle constraints in a natural way, operating close to the boundary conditions where power generation is maximized.

  17. Thermodynamic and heat transfer analysis of heat recovery from engine test cell by Organic Rankine Cycle

    Science.gov (United States)

    Shokati, Naser; Mohammadkhani, Farzad; Farrokhi, Navid; Ranjbar, Faramarz

    2014-12-01

    During manufacture of engines, evaluation of engine performance is essential. This is accomplished in test cells. During the test, a significant portion of heat energy released by the fuel is wasted. In this study, in order to recover these heat losses, Organic Rankine Cycle (ORC) is recommended. The study has been conducted assuming the diesel oil to be composed of a single hydrocarbon such as C12H26. The composition of exhaust gases (products of combustion) have been computed (and not determined experimentally) from the stoichiometric equation representing the combustion reaction. The test cell heat losses are recovered in three separate heat exchangers (preheater, evaporator and superheater). These heat exchangers are separately designed, and the whole system is analyzed from energy and exergy viewpoints. Finally, a parametric study is performed to investigate the effect of different variables on the system performance characteristics such as the ORC net power, heat exchangers effectiveness, the first law efficiency, exergy destruction and heat transfer surfaces. The results of the study show that by utilizing ORC, heat recovery equivalent to 8.85 % of the engine power is possible. The evaporator has the highest exergy destruction rate, while the pump has the lowest among the system components. Heat transfer surfaces are calculated to be 173.6, 58.7, and 11.87 m2 for the preheater, evaporator and superheater, respectively.

  18. Thermal analysis of a Phase Change Material for a Solar Organic Rankine Cycle

    Science.gov (United States)

    Iasiello, M.; Braimakis, K.; Andreozzi, A.; Karellas, S.

    2017-11-01

    Organic Rankine Cycle (ORC) is a promising technology for low temperature power generation, for example for the utilization of medium temperature solar energy. Since heat generated from solar source is variable throughout the day, the implementation of Thermal Energy Storage (TES) systems to guarantee the continuous operation of solar ORCs is a critical task, and Phase Change Materials (PCM) rely on latent heat to store large amounts of energy. In the present study, a thermal analysis of a PCM for a solar ORC is carried out. Three different types of PCMs are analyzed. The energy equation for the PCM is modeled by using the heat capacity method, and it is solved by employing a 1Dexplicit finite difference scheme. The solar source is modeled with a time-variable temperature boundary condition, with experimental data taken from the literature for two different solar collectors. Results are presented in terms of temperature profiles and stored energy. It has been shown that the stored energy depends on the heat source temperature, on the employed PCM and on the boundary conditions. It has been demonstrated that the use of a metal foam can drastically enhance the stored energy due to the higher overall thermal conductivity.

  19. Organic Rankine-cycle power systems working fluids study. Topical report No. 1: Fluorinol 85

    Science.gov (United States)

    Jain, M. L.; Demirgian, J. C.; Cole, R. L.

    1986-09-01

    The thermal stability limits and degradation rates of Fluorinol 85 as a function of maximum cycle temperatures are determined. Following the design and construction of a dynamic test loop capable of simulating the thermodynamic conditions of possible prototypical organic Rankine-cycle (ORC) power systems, several test runs were completed. The Fluorinol 85 test loop was operated for about 3800 h at a temperature range of 525 to 600 F. Both liquid and noncondensable vapor (gas) samples were drawn periodically and analyzed using capillary column gas chromatography, gas chromatography/mass spectrometry and mass spectrometry. Results indicate that Fluorinol 85 would not decompose significantly over an extended period, up to a maximum cycle temperature of 550 F. However, 506-h data at 575 F show initiation of significant degradation. The 770-h data at 600 F, using a fresh charge of Fluorinol 85, indicate an annual degradation rate of more than 17.2%. The most significant degradation product observed is hydrofluoric acid, which could cause severe corrosion in an ORC system. Removal of the hydrofluoric acid and prevention of temperature extremes are necessary for an ORC system using Fluorinol 85 as a working fluid.

  20. Thermo-Economic Evaluation of Organic Rankine Cycles for Geothermal Power Generation Using Zeotropic Mixtures

    Directory of Open Access Journals (Sweden)

    Florian Heberle

    2015-03-01

    Full Text Available We present a thermo-economic evaluation of binary power plants based on the Organic Rankine Cycle (ORC for geothermal power generation. The focus of this study is to analyse if an efficiency increase by using zeotropic mixtures as working fluid overcompensates additional requirements regarding the major power plant components. The optimization approach is compared to systems with pure media. Based on process simulations, heat exchange equipment is designed and cost estimations are performed. For heat source temperatures between 100 and 180 °C selected zeotropic mixtures lead to an increase in second law efficiency of up to 20.6% compared to pure fluids. Especially for temperatures about 160 °C, mixtures like propane/isobutane, isobutane/isopentane, or R227ea/R245fa show lower electricity generation costs compared to the most efficient pure fluid. In case of a geothermal fluid temperature of 120 °C, R227ea and propane/isobutane are cost-efficient working fluids. The uncertainties regarding fluid properties of zeotropic mixtures, mainly affect the heat exchange surface. However, the influence on the determined economic parameter is marginal. In general, zeotropic mixtures are a promising approach to improve the economics of geothermal ORC systems. Additionally, the use of mixtures increases the spectrum of potential working fluids, which is important in context of present and future legal requirements considering fluorinated refrigerants.

  1. Multi-objective optimization and grey relational analysis on configurations of organic Rankine cycle

    International Nuclear Information System (INIS)

    Wang, Y.Z.; Zhao, J.; Wang, Y.; An, Q.S.

    2017-01-01

    Highlights: • Pareto frontier is an effective way to make comprehensive comparison of ORC. • Comprehensive performance from energy and economics of basic ORC is the best. • R141b shows the best comprehensive performance from energy and economics. - Abstract: Concerning the comprehensive performance of organic Rankine cycle (ORC), comparisons and optimizations on 3 different configurations of ORC (basic, regenerative and extractive ORCs) are investigated in this paper. Medium-temperature geothermal water is used for comparing the influence of configurations, working fluids and operating parameters on different evaluation criteria. Different evaluation and optimization methods are adopted in evaluation of ORCs to obtain the one with the best comprehensive performance, such as exergoeconomic analysis, bi-objective optimization and grey relational analysis. The results reveal that the basic ORC performs the best among these 3 ORCs in terms of comprehensive thermodynamic and economic performances when using R245fa and driven by geothermal water at 150 °C. Furthermore, R141b shows the best comprehensive performance among 14 working fluids based on the Pareto frontier solutions without considering safe factors. Meanwhile, R141b is the best among all 14 working fluids with the optimal comprehensive performance when regarding all the evaluation criteria as equal by using grey relational analysis.

  2. Experimental and Thermoeconomic Analysis of Small-Scale Solar Organic Rankine Cycle (SORC System

    Directory of Open Access Journals (Sweden)

    Suresh Baral

    2015-04-01

    Full Text Available A small-scale solar organic Rankine cycle (ORC is a promising renewable energy-driven power generation technology that can be used in the rural areas of developing countries. A prototype was developed and tested for its performance characteristics under a range of solar source temperatures. The solar ORC system power output was calculated based on the thermal and solar collector efficiency. The maximum solar power output was observed in April. The solar ORC unit power output ranged from 0.4 kW to 1.38 kW during the year. The highest power output was obtained when the expander inlet pressure was 13 bar and the solar source temperature was 120 °C. The area of the collector for the investigation was calculated based on the meteorological conditions of Busan City (South Korea. In the second part, economic and thermoeconomic analyses were carried out to determine the cost of energy per kWh from the solar ORC. The selling price of electricity generation was found to be $0.68/kWh and $0.39/kWh for the prototype and low cost solar ORC, respectively. The sensitivity analysis was carried out in order to find the influencing economic parameters for the change in NPV. Finally, the sustainability index was calculated to assess the sustainable development of the solar ORC system.

  3. A Flow Rate Control Approach on Off-Design Analysis of an Organic Rankine Cycle System

    Directory of Open Access Journals (Sweden)

    Ben-Ran Fu

    2016-09-01

    Full Text Available This study explored effects of off-design heat source temperature (TW,in or flow rate (mW on heat transfer characteristics and performance of an organic Rankine cycle system by controlling the flow rate of working fluid R245fa (i.e., the operation flow rate of R245fa was controlled to ensure that R245fa reached saturation liquid and vapor states at the outlets of the preheater and evaporator, respectively. The results showed that the operation flow rate of R245fa increased with TW,in or mW; higher TW,in or mW yielded better heat transfer performance of the designed preheater and required higher heat capacity of the evaporator; heat transfer characteristics of preheater and evaporator differed for off-design TW,in and mW; and net power output increased with TW,in or mW. The results further indicated that the control strategy should be different for various off-design conditions. Regarding maximum net power output, the flow rate control approach is optimal when TW,in or mW exceeds the design point, but the pressure control approach is better when TW,in or mW is lower than the design point.

  4. Maintenance therapy is associated with better long-term outcomes in adult patients with primary angiitis of the central nervous system.

    Science.gov (United States)

    de Boysson, Hubert; Parienti, Jean-Jacques; Arquizan, Caroline; Boulouis, Grégoire; Gaillard, Nicolas; Régent, Alexis; Néel, Antoine; Detante, Olivier; Touzé, Emanuel; Aouba, Achille; Bienvenu, Boris; Guillevin, Loïc; Naggara, Olivier; Zuber, Mathieu; Pagnoux, Christian

    2017-10-01

    We aimed to analyse the effect of maintenance therapy after induction on the outcomes of adult patients with primary angiitis of the CNS (PACNS). We analysed long-term outcomes (relapse, survival and functional status) of patients enrolled in the French multicentre PACNS cohort who achieved remission after induction treatment and with ⩾12 months' follow-up, according to whether or not they received maintenance therapy. Good outcome was defined as relapse-free survival and good functional status (modified Rankin scale ⩽ 2) at last follow-up. Ninety-seven patients [46 (47%) female, median age: 46 (18-78) years at diagnosis] were followed up for a median of 55 (5-198) months. Induction treatment consisted of glucocorticoids in 95 (98%) patients, combined with an immunosuppressant in 80 (83%) patients, mostly CYC. Maintenance therapy was prescribed in 48 (49%) patients, following CYC in 42 of them. Maintenance therapy was started 4 (3-18) months after glucocorticoid initiation. At last follow-up, good outcomes were observed in 32 (67%) patients who had received maintenance therapy vs 10 (20%) who had not (P adults with PACNS is associated with better functional outcomes and lower relapse rates. Further studies are needed to confirm these findings. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  5. Impact of Bystander Automated External Defibrillator Use on Survival and Functional Outcomes in Shockable Observed Public Cardiac Arrests.

    Science.gov (United States)

    Pollack, Ross A; Brown, Siobhan P; Rea, Thomas; Aufderheide, Tom; Barbic, David; Buick, Jason E; Christenson, James; Idris, Ahamed H; Jasti, Jamie; Kampp, Michael; Kudenchuk, Peter; May, Susanne; Muhr, Marc; Nichol, Graham; Ornato, Joseph P; Sopko, George; Vaillancourt, Christian; Morrison, Laurie; Weisfeldt, Myron

    2018-02-26

    Background - Survival following out-of-hospital cardiac arrest (OHCA) with shockable rhythms can be improved with early defibrillation. Although shockable OHCA accounts for only ≈25% of overall arrests, ≈60% of public OHCAs are shockable, offering the possibility of restoring thousands of individuals to full recovery with early defibrillation by bystanders. We sought to determine the association of bystander automated external defibrillator use with survival and functional outcomes in shockable observed public OHCA. Methods - From 2011 to 2015, the Resuscitation Outcomes Consortium prospectively collected detailed information on all cardiac arrests at 9 regional centers. The exposures were shock administration by a bystander-applied automated external defibrillator in comparison with initial defibrillation by emergency medical services. The primary outcome measure was discharge with normal or near-normal (favorable) functional status defined as a modified Rankin Score ≤2. Survival to hospital discharge was the secondary outcome measure. Results -Among 49 555 OHCAs, 4115 (8.3%) observed public OHCAs were analyzed, of which 2500 (60.8%) were shockable. A bystander shock was applied in 18.8% of the shockable arrests. Patients shocked by a bystander were significantly more likely to survive to discharge (66.5% versus 43.0%) and be discharged with favorable functional outcome (57.1% versus 32.7%) than patients initially shocked by emergency medical services. After adjusting for known predictors of outcome, the odds ratio associated with a bystander shock was 2.62 (95% confidence interval, 2.07-3.31) for survival to hospital discharge and 2.73 (95% confidence interval, 2.17-3.44) for discharge with favorable functional outcome. The benefit of bystander shock increased progressively as emergency medical services response time became longer. Conclusions - Bystander automated external defibrillator use before emergency medical services arrival in shockable observed

  6. Influential factors of clinical outcome of local intra-arterial thrombolysis using urokinase in patients with hyperacute ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jae Min; Yoon, Woong; Kim, Jae Kyu; Seo, Jeong Jin; Heo, Sook Hee; Park, Jin Gyoon; Jeong, Yoon Yeon; Kang, Heoung Keun [Chonam University Hospital, Kwangju (Korea, Republic of)

    2002-10-01

    To evaluate the clinical outcome and other relevant factors in cases where local intra-arterial thrombolysis (LIT) is used for the treatment of hyperacute ischemic stroke. Forty-eight hyperacute ischemic stroke patients were treated by LIT, using urokinase, within six hours of ictus, and for evaluation of their neurological status, the national institutes of health stroke scale (NIHSS) score was used. Angiography recanalization was classified according to Mori recanalization grades. Three months after LIT, the outcome was assessed by clinical examination using the modified rankin scale (good outcome: RS=0-3; poor outcome: RS=4-6). In all patients, the findings of pre- and post- LIT CT, and angiography, as well as neurological status and hemorrhagic complications, were also analysed. Thirty-three patients had occlusions of the middle cerebral artery (MCA), and 15, of the internal carotid artery (ICA). The NIHSS score averaged 16.9 at the onset of therapy and 13.5 at 24 hours later. Successful recanalization (Mori grade 3,4) was achieved in 28 (58.3%) of 48 patients, but in 20 (41.7%) the attempt failed. Twenty-two (45.8%) of the 48 patients had a good outcome, but in (54.2%) the outcome was poor. Thirteen (40.6%) of 32 patients with MCA occlusions and 13 (81.2%) of 16 with ICA occlusions had a poor outcome. Eight patients (16.7%) died. Overall, hemorrhages occured in 20 (41.7%) of 48 patients, with symptomatic hemorrhage in ten. Five (50%) of these ten died. LIT using urokinase for hyperacute ischemic stroke is feasible; patients with MCA occlusions had better outcomes than those with ICA occlusions. Hemorrhagic complications of LIT were frequent, and in cases of symptomatic hemorrhage a fatal outcome may be expected.

  7. Worse stroke outcome in atrial fibrillation is explained by more severe hypoperfusion, infarct growth, and hemorrhagic transformation.

    Science.gov (United States)

    Tu, Hans T H; Campbell, Bruce C V; Christensen, Soren; Desmond, Patricia M; De Silva, Deidre A; Parsons, Mark W; Churilov, Leonid; Lansberg, Maarten G; Mlynash, Michael; Olivot, Jean-Marc; Straka, Matus; Bammer, Roland; Albers, Gregory W; Donnan, Geoffrey A; Davis, Stephen M

    2015-06-01

    Atrial fibrillation is associated with greater baseline neurological impairment and worse outcomes following ischemic stroke. Previous studies suggest that greater volumes of more severe baseline hypoperfusion in patients with history of atrial fibrillation may explain this association. We further investigated this association by comparing patients with and without atrial fibrillation on initial examination following stroke using pooled multimodal magnetic resonance imaging and clinical data from the Echoplanar Imaging Thrombolytic Evaluation Trial and the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution studies. Echoplanar Imaging Thrombolytic Evaluation Trial was a trial of 101 ischemic stroke patients randomized to intravenous tissue plasminogen activator or placebo, and Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution was a prospective cohort of 74 ischemic stroke patients treated with intravenous tissue plasminogen activator at three to six hours following symptom onset. Patients underwent multimodal magnetic resonance imaging before treatment, at three to five days and three-months after stroke in Echoplanar Imaging Thrombolytic Evaluation Trial; before treatment, three to six hours after treatment and one-month after stroke in Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution. Patients were assessed with the National Institutes of Health Stroke Scale and the modified Rankin scale before treatment and at three-months after stroke. Patients were categorized into definite atrial fibrillation (present on initial examination), probable atrial fibrillation (history but no atrial fibrillation on initial examination), and no atrial fibrillation. Perfusion data were reprocessed with automated magnetic resonance imaging analysis software (RAPID, Stanford University, Stanford, CA, USA). Hypoperfusion volumes were defined using time to maximum delays in two-second increments from >4 to

  8. Three dimensional optimization of small-scale axial turbine for low temperature heat source driven organic Rankine cycle

    International Nuclear Information System (INIS)

    Al Jubori, Ayad; Al-Dadah, Raya K.; Mahmoud, Saad; Bahr Ennil, A.S.; Rahbar, Kiyarash

    2017-01-01

    Highlights: • Three-dimensional optimization of axial turbine stage is presented. • Six organic fluids suitable for low-temperature heat source are considered. • Three-dimensional optimization has been done for each working fluid. • The results showed highlight the potential of optimization technique. • The performance of optimized turbine has been improved off-design conditions. - Abstract: Advances in optimization techniques can be used to enhance the performance of turbines in various applications. However, limited work has been reported on using such optimization techniques to develop small-scale turbines for organic Rankine cycles. This paper investigates the use of multi-objective genetic algorithm to optimize the stage geometry of a small-axial subsonic turbine. This optimization is integrated with organic Rankine cycle analysis using wide range of high density organic working fluids like R123, R134a, R141b, R152a, R245fa and isobutane suitable for low temperature heat sources <100 °C such as solar energy to achieve the best turbine design and highest organic Rankine cycle efficiency. The isentropic efficiency of the turbine in most of the reported organic Rankine cycle studies was assumed constant, while the current work allows the turbine isentropic efficiency to change (dynamic value) with both operating conditions and working fluids. Three-dimensional computational fluid dynamics analysis and multi-objective genetic algorithm optimization were performed using three-dimensional Reynolds-averaged Navier-Stokes equations with k-omega shear stress transport turbulence model in ANSYS"R"1"7-CFX and design exploration for various working fluids. The optimization was carried out using eight design parameters for the turbine stage geometry optimization including stator and rotor number of blades, rotor leading edge beta angle, trailing edge beta angle, stagger angle, throat width, trailing half wedge angle and shroud tip clearance. Results showed that

  9. Development of micro-scale axial and radial turbines for low-temperature heat source driven organic Rankine cycle

    International Nuclear Information System (INIS)

    Al Jubori, Ayad; Daabo, Ahmed; Al-Dadah, Raya K.; Mahmoud, Saad; Ennil, Ali Bahr

    2016-01-01

    Highlights: • One and three-dimensional analysis with real gas properties are integrated. • Micro axial and radial-inflow turbines configurations are investigated. • Five organic working fluids are considered. • The maximum total isentropic efficiency of radial-inflow turbine 83.85%. • The maximum ORC thermal efficiency based on radial-inflow turbine is 10.60%. - Abstract: Most studies on the organic Rankine cycle (ORC) focused on parametric studies and selection working fluids to maximize the performance of organic Rankine cycle but without attention for turbine design features which are crucial to achieving them. The rotational speed, expansion ratio, mass flow rate and turbine size have markedly effect on turbine performance. For this purpose organic Rankine cycle modeling, mean-line design and three-dimensional computational fluid dynamics analysis were integrated for both micro axial and radial-inflow turbines with five organic fluids (R141b, R1234yf, R245fa, n-butane and n-pentane) for realistic low-temperature heat source <100 °C like solar and geothermal energy. Three-dimensional simulation is performed using ANSYS"R"1"7-CFX where three-dimensional Reynolds-averaged Navier-Stokes equations are solved with k-omega shear stress transport turbulence model. Both configurations of turbines are designed at wide range of mass flow rate (0.1–0.5) kg/s for each working fluid. The results showed that n-pentane has the highest performance at all design conditions where the maximum total-to-total efficiency and power output of radial-inflow turbine are 83.85% and 8.893 kW respectively. The performance of the axial turbine was 83.48% total-to-total efficiency and 8.507 kW power output. The maximum overall size of axial turbine was 64.685 mm compared with 70.97 mm for radial-inflow turbine. R245fa has the lowest overall size for all cases. The organic Rankine cycle thermal efficiency was about 10.60% with radial-inflow turbine and 10.14% with axial turbine

  10. Combined Turbine and Cycle Optimization for Organic Rankine Cycle Power Systems—Part B: Application on a Case Study

    Directory of Open Access Journals (Sweden)

    Angelo La Seta

    2016-05-01

    Full Text Available Organic Rankine cycle (ORC power systems have recently emerged as promising solutions for waste heat recovery in low- and medium-size power plants. Their performance and economic feasibility strongly depend on the expander. The design process and efficiency estimation are particularly challenging due to the peculiar physical properties of the working fluid and the gas-dynamic phenomena occurring in the machine. Unlike steam Rankine and Brayton engines, organic Rankine cycle expanders combine small enthalpy drops with large expansion ratios. These features yield turbine designs with few highly-loaded stages in supersonic flow regimes. Part A of this two-part paper has presented the implementation and validation of the simulation tool TURAX, which provides the optimal preliminary design of single-stage axial-flow turbines. The authors have also presented a sensitivity analysis on the decision variables affecting the turbine design. Part B of this two-part paper presents the first application of a design method where the thermodynamic cycle optimization is combined with calculations of the maximum expander performance using the mean-line design tool described in part A. The high computational cost of the turbine optimization is tackled by building a model which gives the optimal preliminary design of an axial-flow turbine as a function of the cycle conditions. This allows for estimating the optimal expander performance for each operating condition of interest. The test case is the preliminary design of an organic Rankine cycle turbogenerator to increase the overall energy efficiency of an offshore platform. For an increase in expander pressure ratio from 10 to 35, the results indicate up to 10% point reduction in expander performance. This corresponds to a relative reduction in net power output of 8.3% compared to the case when the turbine efficiency is assumed to be 80%. This work also demonstrates that this approach can support the plant designer

  11. Modified cyanobacteria

    Science.gov (United States)

    Vermaas, Willem F J.

    2014-06-17

    Disclosed is a modified photoautotrophic bacterium comprising genes of interest that are modified in terms of their expression and/or coding region sequence, wherein modification of the genes of interest increases production of a desired product in the bacterium relative to the amount of the desired product production in a photoautotrophic bacterium that is not modified with respect to the genes of interest.

  12. Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery.

    Science.gov (United States)

    Reponen, Elina; Tuominen, Hanna; Hernesniemi, Juha; Korja, Miikka

    2015-11-01

    Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

  13. Outcome and periprocedural time management in referred versus directly admitted stroke patients treated with thrombectomy.

    Science.gov (United States)

    Weber, Ralph; Reimann, Gernot; Weimar, Christian; Winkler, Angela; Berger, Klaus; Nordmeyer, Hannes; Hadisurya, Jeffrie; Brassel, Friedhelm; Kitzrow, Martin; Krogias, Christos; Weber, Werner; Busch, Elmar W; Eyding, Jens

    2016-03-01

    After thrombectomy has shown to be effective in acute stroke patients with large vessel occlusion, the potential benefit of secondary referral for such an intervention needs to be validated. We aimed to compare consecutive stoke patients directly admitted and treated with thrombectomy at a neurointerventional centre with patients secondarily referred for such a procedure from hospitals with a stroke unit. Periprocedure times and mortality in 300 patients primarily treated in eight neurointerventional centres were compared with 343 patients referred from nine other hospitals in a prospective multicentre study of a German neurovascular network. Data on functional outcome at 3 months was available in 430 (76.4%) patients. In-hospital mortality (14.8% versus 11.7%, p = 0.26) and 3 months mortality (21.9% versus 24.1%, p = 0.53) were not statistically different in both patient groups despite a significant shorter symptom to groin puncture time in directly admitted patients, which was mainly caused by a longer interfacility transfer time. We found a nonsignificant trend for better functional outcome at 3 months in directly admitted patients (modified Rankin Scale 0-2, 44.0% versus 35.7%, p = 0.08). Our results show that a drip-and-ship thrombectomy concept can be effectively organized in a metropolitan stroke network. Every effort should be made to speed up the emergency interfacility transfer to a neurointerventional centre in stroke patients eligible for thrombectomy after initial brain imaging.

  14. Neurosurgical outcomes after intracerebral hemorrhage: results of the Factor Seven for Acute Hemorrhagic Stroke Trial (FAST).

    Science.gov (United States)

    Steiner, Thorsten; Vincent, Catherine; Morris, Stephen; Davis, Stephen; Vallejo-Torres, Laura; Christensen, Michael C

    2011-01-01

    The value of neurosurgical interventions after spontaneous intracerebral hemorrhage (SICH) is uncertain. We evaluated clinical outcomes in patients diagnosed with SICH within 3 hours of symptom onset who underwent hematoma evacuation or external ventricular drainage (EVD) of the hematoma in the Factor Seven for Acute Hemorrhagic Stroke Trial (FAST). FAST was a randomized, multicenter, double-blind, placebo-controlled trial conducted between May 2005 and February 2007 at 122 sites in 22 countries. Neurosurgical procedures (hematoma evacuation and external ventricular drainage) performed at any point after hospital admission were prospectively recorded. Clinical outcomes evaluated were post-SICH disability, as assessed by the modified Rankin Scale; neurologic impairment, as assessed by the National Institutes of Health Stroke Scale; and mortality at 90 days after SICH onset. The impact of neurosurgical procedures on clinical outcomes was evaluated using multivariate logistic regression analysis, controlling for relevant baseline characteristics. Fifty-five of 821 patients underwent neurosurgery. Patients who underwent hematoma evacuation or EVD were on average younger, had greater baseline neurologic impairment, and lower levels of consciousness compared with patients who did not undergo neurosurgery. After adjusting for these differences and other relevant baseline characteristics, we found that neurosurgery was generally associated with unfavorable outcomes at day 90. Among the patients who underwent hematoma evacuation, those with lobar ICH had less ICH expansion than those with deep gray matter ICH, and the smaller expansion was associated with lower mortality. ICH volume was substantially decreased in patients who underwent hematoma evacuation between 24 and 72 hours after hospital admission, and this was associated with better clinical outcome. In conclusion, a small number of patients who underwent neurosurgery in FAST exhibited no overall clinical benefit

  15. Duration of Agitation, Fluctuations of Consciousness, and Associations with Outcome in Patients with Subarachnoid Hemorrhage.

    Science.gov (United States)

    Reznik, Michael E; Mahta, Ali; Schmidt, J Michael; Frey, Hans-Peter; Park, Soojin; Roh, David J; Agarwal, Sachin; Claassen, Jan

    2018-01-08

    Agitation is common after subarachnoid hemorrhage (SAH) and may be independently associated with outcomes. We sought to determine whether the duration of agitation and fluctuating consciousness were also associated with outcomes in patients with SAH. We identified all patients with positive Richmond Agitation Sedation Scale (RASS) scores from a prospective observational cohort of patients with SAH from 2011 to 2015. Total duration of agitation was extrapolated for each patient using available RASS scores, and 24-h mean and standard deviation (SD) of RASS scores were calculated for each patient. We also calculated each patient's duration of substantial fluctuation of consciousness, defined as the number of days with 24-h RASS SD > 1. Patients were stratified by 3-month outcome using the modified Rankin scale, and associations with outcome were assessed via logistic regression. There were 98 patients with at least one positive RASS score, with median total duration of agitation 8 h (interquartile range [IQR] 4-18), and median duration of substantially fluctuating consciousness 2 days (IQR 1-3). Unfavorable 3-month outcome was significantly associated with a longer duration of fluctuating consciousness (odds ratio [OR] per day, 1.51; 95% confidence interval [CI], 1.04-2.20; p = 0.031), but a briefer duration of agitation (OR per hour, 0.94; 95% CI, 0.89-0.99; p = 0.031). Though a longer duration of fluctuating consciousness was associated with worse outcomes in our cohort, total duration of agitation was not, and may have had the opposite effect. Our findings should therefore challenge the intensity with which agitation is often treated in SAH patients.

  16. Vertebral artery stenosis in the Basilar Artery International Cooperation Study (BASICS): prevalence and outcome.

    Science.gov (United States)

    Compter, Annette; van der Hoeven, Erik J R J; van der Worp, H Bart; Vos, Jan Albert; Weimar, Christian; Rueckert, Christina M; Kappelle, L Jaap; Algra, Ale; Schonewille, Wouter J

    2015-02-01

    We assessed the prevalence of vertebral artery (VA) stenosis or occlusion and its influence on outcome in patients with acute basilar artery occlusion (BAO). We studied 141 patients with acute BAO enrolled in the Basilar Artery International Cooperation Study (BASICS) registry of whom baseline CT angiography (CTA) of the intracranial VAs was available. In 72 patients an additional CTA of the extracranial VAs was available. Adjusted risk ratios (aRRs) for death and poor outcome, defined as a modified Rankin Scale score ≥4, were calculated with Poisson regression in relation to VA occlusion, VA occlusion or stenosis ≥50 %, and bilateral VA occlusion. Sixty-six of 141 (47 %) patients had uni- or bilateral intracranial VA occlusion or stenosis ≥50 %. Of the 72 patients with intra- and extracranial CTA, 46 (64 %) had uni- or bilateral VA occlusion or stenosis ≥50 % and 9 (12 %) had bilateral VA occlusion. Overall, VA occlusion or stenosis ≥50 % was not associated with the risk of poor outcome. Patients with intra- and extracranial CTA and bilateral VA occlusion had a higher risk of poor outcome than patients without bilateral VA occlusion (aRR, 1.23; 95 % CI 1.02-1.50). The risk of death did not depend on the presence of unilateral or bilateral VA occlusion or stenosis ≥50 %. In conclusion, in patients with acute BAO, unilateral VA occlusion or stenosis ≥50 % is frequent, but not associated with an increased risk of poor outcome or death. Patients with BAO and bilateral VA occlusion have a slightly increased risk of poor outcome.

  17. Effects of edaravone on early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator.

    Science.gov (United States)

    Wada, Tomoki; Yasunaga, Hideo; Inokuchi, Ryota; Horiguchi, Hiromasa; Fushimi, Kiyohide; Matsubara, Takehiro; Nakajima, Susumu; Yahagi, Naoki

    2014-10-15

    We investigated whether edaravone could improve early outcomes in acute ischemic stroke patients treated with recombinant tissue plasminogen activator (rtPA). We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database. We identified patients admitted with a primary diagnosis of ischemic stroke from 1 July 2010 to 31 March 2012 and treated with rtPA on the same day of stroke onset or the following day. Thereafter, we selected those who received edaravone on the same day of rtPA administration (edaravone group), and those who received rtPA without edaravone (control group). The primary outcomes were modified Rankin Scale (mRS) scores at discharge. One-to-one propensity-score matching was performed between the edaravone and control groups. An ordinal logistic regression analysis for mRS scores at discharge was performed with adjustment for possible variables as well as clustering of patients within hospitals using a generalized estimating equation. We identified 6336 eligible patients for inclusion in the edaravone group (n=5979; 94%) and the control group (n=357; 6%) as the total population. In 356 pairs of the propensity-matched population, the ordinal logistic regression analysis showed that edaravone was significantly associated with lower mRS scores of patients at discharge (adjusted odds ratio: 0.74; 95% confidence interval: 0.57-0.96). Edaravone may improve early outcomes in acute ischemic stroke patients treated with rtPA. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Influence of statin therapy at time of stroke onset on functional outcome among patients with atrial fibrillation.

    Science.gov (United States)

    Ko, Darae; Thigpen, Jonathan L; Otis, James A; Forster, Kristen; Henault, Lori; Quinn, Emily; Tripodis, Yorghos; Berger, Peter B; Limdi, Nita; Hylek, Elaine M

    2017-01-15

    Statin pretreatment has been associated with reduced infarct volume in nonlacunar strokes. The effect of statins on functional outcomes of strokes related to atrial fibrillation (AF) is unknown. We aimed to define the influence of prestroke statin use on functional outcome in AF. We assembled a cohort of consecutive ischemic stroke patients from 2006 to 2010. All patients underwent CT or MRI and were adjudicated by site investigators. AF was confirmed by electrocardiogram in 100% of patients. Site neurologists blinded to the study hypothesis affirmed the type of stroke and assessed the severity of disability at the time of hospital discharge. The frequency of death at 30-days was calculated. Ischemic stroke (n=1030) resulted in a severe neurological deficit or death (modified Rankin scale ≥4) at 30days in 711 patients (69%). Using multivariable logistic regression models adjusting for factors associated with statin treatment and factors associated with functional outcome, prestroke statin use was associated with a 32% reduction in frequency of severe stroke (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.50-0.92; P=0.011). Other independent factors associated with severe stroke included older age, female sex, non-White race, diabetes mellitus, prior ischemic stroke, prior venous thromboembolism, and dementia. Ischemic strokes in AF are associated with high mortality and morbidity. Statin use at time of stroke onset among patients with AF was associated in this study with less severe stroke and warrant validation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. ECONOMICS AND FEASIBILITY OF RANKINE CYCLE IMPROVEMENTS FOR COAL FIRED POWER PLANTS

    Energy Technology Data Exchange (ETDEWEB)

    Richard E. Waryasz; Gregory N. Liljedahl

    2004-09-08

    ALSTOM Power Inc.'s Power Plant Laboratories (ALSTOM) has teamed with the U.S. Department of Energy National Energy Technology Laboratory (DOE NETL), American Electric Company (AEP) and Parsons Energy and Chemical Group to conduct a comprehensive study evaluating coal fired steam power plants, known as Rankine Cycles, equipped with three different combustion systems: Pulverized Coal (PC), Circulating Fluidized Bed (CFB), and Circulating Moving Bed (CMB{trademark}). Five steam cycles utilizing a wide range of steam conditions were used with these combustion systems. The motivation for this study was to establish through engineering analysis, the most cost-effective performance potential available through improvement in the Rankine Cycle steam conditions and combustion systems while at the same time ensuring that the most stringent emission performance based on CURC (Coal Utilization Research Council) 2010 targets are met: > 98% sulfur removal; < 0.05 lbm/MM-Btu NO{sub x}; < 0.01 lbm/MM-Btu Particulate Matter; and > 90% Hg removal. The final report discusses the results of a coal fired steam power plant project, which is comprised of two parts. The main part of the study is the analysis of ten (10) Greenfield steam power plants employing three different coal combustion technologies: Pulverized Coal (PC), Circulating Fluidized Bed (CFB), and Circulating Moving Bed (CMB{trademark}) integrated with five different steam cycles. The study explores the technical feasibility, thermal performance, environmental performance, and economic viability of ten power plants that could be deployed currently, in the near, intermediate, and long-term time frame. For the five steam cycles, main steam temperatures vary from 1,000 F to 1,292 F and pressures from 2,400 psi to 5,075 psi. Reheat steam temperatures vary from 1,000 F to 1,328 F. The number of feedwater heaters varies from 7 to 9 and the associated feedwater temperature varies from 500 F to 626 F. The main part of the

  20. Fuzzy Nonlinear Dynamic Evaporator Model in Supercritical Organic Rankine Cycle Waste Heat Recovery Systems

    Directory of Open Access Journals (Sweden)

    Jahedul Islam Chowdhury

    2018-04-01

    Full Text Available The organic Rankine cycle (ORC-based waste heat recovery (WHR system operating under a supercritical condition has a higher potential of thermal efficiency and work output than a traditional subcritical cycle. However, the operation of supercritical cycles is more challenging due to the high pressure in the system and transient behavior of waste heat sources from industrial and automotive engines that affect the performance of the system and the evaporator, which is the most crucial component of the ORC. To take the transient behavior into account, the dynamic model of the evaporator using renowned finite volume (FV technique is developed in this paper. Although the FV model can capture the transient effects accurately, the model has a limitation for real-time control applications due to its time-intensive computation. To capture the transient effects and reduce the simulation time, a novel fuzzy-based nonlinear dynamic evaporator model is also developed and presented in this paper. The results show that the fuzzy-based model was able to capture the transient effects at a data fitness of over 90%, while it has potential to complete the simulation 700 times faster than the FV model. By integrating with other subcomponent models of the system, such as pump, expander, and condenser, the predicted system output and pressure have a mean average percentage error of 3.11% and 0.001%, respectively. These results suggest that the developed fuzzy-based evaporator and the overall ORC-WHR system can be used for transient simulations and to develop control strategies for real-time applications.

  1. Energy and exergy analyses of a biomass trigeneration system using an organic Rankine cycle

    International Nuclear Information System (INIS)

    Al-Sulaiman, Fahad A.; Dincer, Ibrahim; Hamdullahpur, Feridun

    2012-01-01

    In this study, energy and exergy analyses of a biomass trigeneration system using an organic Rankine cycle (ORC) are presented. Four cases are considered for analysis: electrical-power, cooling-cogeneration, heating-cogeneration and trigeneration cases. The results obtained reveal that the best performance of the trigeneration system considered can be obtained with the lowest ORC evaporator pinch temperature considered, T pp = 20 K, and the lowest ORC minimum temperature, T 9 = 345 K. In addition, this study reveals that there is a significant improvement when trigeneration is used as compared to only electrical power production. This study demonstrates that the fuel utilization efficiency increases, in average, from 12% for electrical power to 88% for trigeneration. Moreover, the maximum exergy efficiency of the ORC is 13% and, when trigeneration is used, it increases to 28%. Furthermore, this study reveals that the electrical to cooling ratio can be controlled through changing the ORC evaporator pinch point temperature and/or the pump inlet temperature. In addition, the study reveals that the biomass burner and the ORC evaporator are the main two sources of exergy destruction. The biomass burner contributes to 55% of the total destructed exergy whereas the ORC evaporator contributes to 38% of the total destructed exergy. -- Highlights: ► The best performance can be obtained with the lowest ORC evaporator pinch temperature and the lowest ORC minimum temperature. ► There is, on average, 75 % gain in energy efficiency for trigeneration compared to electrical system. ► There is, on average, 17% gain in exergy efficiency when trigeneration is used as compared to electrical system. ► The electrical to cooling ratio is sensitive to the variation of the pinch point temperature and pump inlet temperature. ► The two main sources of the exergy destruction are the biomass burner with 55% and the ORC evaporator with 38%.

  2. Thermo-economic optimization of Regenerative Organic Rankine Cycle for waste heat recovery applications

    International Nuclear Information System (INIS)

    Imran, Muhammad; Park, Byung Sik; Kim, Hyouck Ju; Lee, Dong Hyun; Usman, Muhammad; Heo, Manki

    2014-01-01

    Highlights: • Thermo-economic optimization of regenerative ORC is performed. • Optimization is performed using multi objective genetic algorithm. • Objective function is maximum cycle efficiency and minimum specific investment. • Evaporation pressure, pinch point and superheat are decision variables. • Sensitivity analysis is performed to investigate effect of decision variables. - Abstract: Organic Rankine Cycle (ORC) is low grade and waste heat conversion technology. The current article deal with the thermo-economic optimization of basic ORC and regenerative ORC for waste heat recovery applications under constant heat source condition. Thermal efficiency and specific investment cost of basic ORC, single stage regenerative and double stage regenerative ORC has been optimized by using Non-dominated Sorting Genetic Algorithm-II (NSGA-II). Maximum thermal efficiency and minimum specific investment cost were selected as objective functions and relative increase in thermal efficiency and cost has been analyzed taking the basic ORC as base case. The constraint set consist of evaporation pressure, superheat, pinch point temperature difference in evaporator and condenser. The optimization was performed for five different working fluids. The optimization result show that R245fa is best working under considered conditions and basic ORC has low specific investment cost and thermal efficiency compared to regenerative ORC. R245fa is low boiling organic fluid, which has high degree of thermal stability and compatible with common construction materials of ORC. The average increase in thermal efficiency from basic ORC to single stage regenerative ORC was 1.01% with an additional cost of 187 $/kW while from basic ORC to double stage regenerative ORC was 1.45% with an average increase in cost of 297 $/kW. The sensitivity analysis was also performed to investigate the effect of operating conditions which show that evaporation pressure has promising effect on thermal

  3. Parametric design and off-design analysis of organic Rankine cycle (ORC) system

    International Nuclear Information System (INIS)

    Song, Jian; Gu, Chun-wei; Ren, Xiaodong

    2016-01-01

    Highlights: • A one-dimensional analysis method for ORC system is proposed. • The system performance under both design and off-design conditions are analyzed. • The working fluid selection is based on both design and off-design performance. • The system parameter determination are based on both design and off-design performance. - Abstract: A one-dimensional analysis method has been proposed for the organic Rankine cycle (ORC) system in this paper. The method contains two main parts: a one-dimensional aerodynamic analysis model of the radial-inflow turbine and a performance prediction model of the heat exchanger. Based on the present method, an ORC system for the industrial waste heat recovery is designed and analyzed. The net power output of the ORC system is 534 kW, and the thermal efficiency reaches 13.5%. System performance under off-design conditions is simulated and considered. The results show that the inlet temperatures of the heat source and the cooling water have a significant influence on the system. With the increment of the heat source inlet temperature, the mass flow rate of the working fluid, the net power output and the heat utilization ratio of the ORC system increase. While, the system thermal efficiency decreases with increasing cooling water inlet temperature. In order to maintain the condensation pressure at a moderate value, the heat source inlet temperature considered in this analysis should be kept within the range of 443.15–468.15 K, while the optimal temperature range of the cooling water is between 283.15 K and 303.15 K.

  4. Simulation of the parabolic trough solar energy generation system with Organic Rankine Cycle

    International Nuclear Information System (INIS)

    He, Ya-Ling; Mei, Dan-Hua; Tao, Wen-Quan; Yang, Wei-Wei; Liu, Huai-Liang

    2012-01-01

    Highlights: ► A parabolic trough solar power generation system with ORC is numerically simulated. ► The effects of key parameters on collector field and system performance are studied. ► Collector heat loss increases with small absorber and glass tube interlayer pressure. ► Heat collecting efficiency increases with initial increase of absorber HTO flow rate. ► Recommended thermal storage system volumes are different in year four typical days. -- Abstract: A model for a typical parabolic trough solar thermal power generation system with Organic Rankine Cycle (PT-SEGS–ORC) was built within the transient energy simulation package TRNSYS, which is formed by integrating several submodels for the trough collector system, the single-tank thermal storage system, the auxiliary power system and the heat-electricity conversion system. With this model, the effects of several key parameters, including the interlayer pressure between the absorber tube and the glass tube (p inter ), the flow rate of high temperature oil in the absorber tube (v), solar radiation intensity (I dn ) and incidence angle (θ), on the performance of the parabolic trough collector field based on the meteorological data of Xi’an city were examined. The study shows that the heat loss of the solar collector (q loss ) increases sharply with the increase in p inter at beginning and then reaches to an approximately constant value. The variation of heat collecting efficiency (η hc ) with v is quite similar to the variation of q loss with p inter . However, I dn and θ exhibit opposite effect on η hc . In addition, it is found that the optimal volume of the thermal storage system is sensitively dependent on the solar radiation intensity. The optimal volumes are 100, 150, 50, and 0 m 3 for spring equinox, summer solstice, autumnal equinox and winter solstice, respectively.

  5. Stand-Alone Solar Organic Rankine Cycle Water Pumping System and Its Economic Viability in Nepal

    Directory of Open Access Journals (Sweden)

    Suresh Baral

    2015-12-01

    Full Text Available The current study presents the concept of a stand-alone solar organic Rankine cycle (ORC water pumping system for rural Nepalese areas. Experimental results for this technology are presented based on a prototype. The economic viability of the system was assessed based on solar radiation data of different Nepalese geographic locations. The mechanical power produced by the solar ORC is coupled with a water pumping system for various applications, such as drinking and irrigation. The thermal efficiency of the system was found to be 8% with an operating temperature of 120 °C. The hot water produced by the unit has a temperature of 40 °C. Economic assessment was done for 1-kW and 5-kW solar ORC water pumping systems. These systems use different types of solar collectors: a parabolic trough collector (PTC and an evacuated tube collector (ETC. The economic analysis showed that the costs of water are $2.47/m3 (highest and $1.86/m3 (lowest for the 1-kW system and a 150-m pumping head. In addition, the cost of water is reduced when the size of the system is increased and the pumping head is reduced. The minimum volumes of water pumped are 2190 m3 and 11,100 m3 yearly for 1 kW and 5 kW, respectively. The payback period is eight years with a profitability index of 1.6. The system is highly feasible and promising in the context of Nepal.

  6. Simulation of a solar assisted combined heat pump – Organic rankine cycle system

    International Nuclear Information System (INIS)

    Schimpf, Stefan; Span, Roland

    2015-01-01

    Highlights: • Addition of an ORC to a solar thermal and ground source heat pump system. • Reverse operation of the scroll compressor in ORC mode. • Annual simulations for application in a single-family house at three locations. • By introducing the ORC the net electricity demand is reduced by 1–9%. • Over the lifetime of the system savings can cover additional investments. - Abstract: A novel solar thermal and ground source heat pump system that harnesses the excess heat of the collectors during summer by an Organic Rankine Cycle (ORC) is simulated. For the ORC the heat pump process is reversed. In this case the scroll compressor of the heat pump runs as a scroll expander and the working fluid is condensed in the ground heat exchanger. Compared to a conventional solar thermal system the only additional investments for the combined system are a pump, valves and upgraded controls. The goal of the study is to simulate and optimize such a system. A brief overview of the applied models and the evolutionary algorithm for the optimization is given. A system with 12 m 2 of flat plate collectors installed in a single family house is simulated for the locations Ankara, Denver and Bochum. The ORC benefits add up to 20–140 kW h/a, which reduces the net electricity demand of the system by 1–9%. Overall 180–520 € are saved over a period of 20 years, which can be enough to cover the additional investments

  7. The discussion of composition shift in organic Rankine cycle using zeotropic mixtures

    International Nuclear Information System (INIS)

    Zhou, Yaodong; Zhang, Fengyuan; Yu, Lijun

    2017-01-01

    Highlights: • The forming reasons of composition shift are well illuminated. • The influences of composition shift on ORC system are presented. • The influence factors of composition shift are well discussed. • The inner relation between temperature glide and composition shift is revealed. - Abstract: Zeotropic mixtures have been important candidates for working fluids in the organic Rankine cycle (ORC) because of the temperature glide characteristic. “Composition shift” is a widespread phenomenon for zeotropic mixtures’ application in thermodynamic systems and certainly needs to be considered in ORC. In this paper, the evaporator, condenser, expander and pump models are respectively developed and then the circulating composition is calculated. Based on that, the forming reasons of “composition shift” are well illuminated. The influences of composition shift on the system net power output and heat transfer process are presented and analysed. The influence factors including pressure, two-phase zone area, total charge mass and velocity difference between liquid and vapor phase are also carefully discussed. Besides, the inner relation between temperature glide and composition shift is also revealed at last. The results showed that the optimal charge concentration of the low boiling point component in practice should be a bit lower than the optimal concentration without considering composition shift. Besides, the local composition shift characteristic will affect the heat transfer process by altering the temperature along the heat exchanger. Reducing the two-phase zone area, increasing the total charge mass, increasing the evaporation pressure and reducing the slip ratio can mitigate the effect of composition shift. The simulation also reveals that the magnitudes of temperature glide and composition shift show a good linear relation by just altering the charge composition.

  8. Thermo-Economic Performance Analysis of a Regenerative Superheating Organic Rankine Cycle for Waste Heat Recovery

    Directory of Open Access Journals (Sweden)

    Zhonghe Han

    2017-10-01

    Full Text Available The Organic Rankine Cycle (ORC is a promising form of technology for recovering low-grade waste heat. In this study, a regenerative ORC system is established to recover the waste flue gas of 160 °C. Focusing on thermodynamic and economic performance while simultaneously considering the limitations of volume flow ratio (VFR and the effect of superheat, working fluid selection and parameter optimization have been investigated. The optimization of the evaporation temperature is carried out by analyzing the variation of net power output and specific investment cost (SIC. Then, the net power output, specific net power output, total exergy destruction rate, VFR, total capital cost, and levelized electricity cost (LEC are selected as criteria, and a fuzzy multi-criteria evaluation method is adopted to select a more suitable working fluid and determine the optimal degree of superheat. In addition, the preheating coefficient, latent heat coefficient, superheating coefficient, and internal heat coefficient were proposed to explore the effect of working fluid critical temperature on thermal efficiency. Research studies demonstrate that there is an optimal evaporation temperature, maximizing net power output and minimizing the SIC. Isohexane and butane have greater specific net power output due to greater latent heat. A suitable degree of superheat is not only conducive to improving the working capacity of working fluids, but also reduces the VFR, total capital cost, SIC, and LEC for different working fluids. Thus, the system’s thermodynamic and economic performance—as well as the operational stability—are improved. Among the six working fluids, butane exhibits the best comprehensive performance, and its optimal evaporation temperature and degree of superheat are 100 °C and 5 °C, respectively.

  9. Parametric optimization and range analysis of Organic Rankine Cycle for binary-cycle geothermal plant

    International Nuclear Information System (INIS)

    Wang, Xing; Liu, Xiaomin; Zhang, Chuhua

    2014-01-01

    Highlights: • Optimal level constitution of parameters for ORC system was obtained. • Order of system parameters’ sensitivity to the performance of ORC was revealed. • Evaporating temperature had significant effect on performance of ORC system. • Superheater had little effect on performance of ORC system. - Abstract: In this study, a thermodynamic model of Organic Rankine Cycle (ORC) system combined with orthogonal design is proposed. The comprehensive scoring method was adopted to obtain a comprehensive index to evaluate both of the thermodynamic performance and economic performance. The optimal level constitution of system parameters which improves the thermodynamic and economic performance of ORC system is provided by analyzing the result of orthogonal design. The range analysis based on orthogonal design is adopted to determine the sensitivity of system parameters to the net power output of ORC system, thermal efficiency, the SP factor of radial inflow turbine, the power decrease factor of the pump and the total heat transfer capacity. The results show that the optimal level constitution of system parameters is determined as the working fluid of R245fa, the super heating temperature of 10 °C, the pinch temperature difference in evaporator and condenser of 5 °C, the evaporating temperature of 65 °C, the isentropic efficiency for the pump of 0.75 and the isentropic efficiency of radial inflow turbine of 0.85. The order of system parameters’ sensitivity to the comprehensive index of orthogonal design is evaporating temperature > isentropic efficiency of radial inflow turbine > the working fluid > the pinch temperature difference of the evaporator and the condenser > isentropic efficiency of cycle pump > the super heating temperature. This study provides useful references for selecting main controlled parameters in the optimal design of ORC system

  10. Potential of organic Rankine cycle technology in India: Working fluid selection and feasibility study

    International Nuclear Information System (INIS)

    Sarkar, Jahar; Bhattacharyya, Souvik

    2015-01-01

    India has great potential to employ the ORC (organic Rankine cycle) technology for conversion of low temperature waste heat and renewable energy. In this study, available waste heat and relevant renewable heat sources in India are reviewed and suitable working fluids for ORC have been selected based on operational, environmental and safety criteria. A feasibility study and comparison of selected fluids for ORC is also presented for Indian climates along with discussions on component, operation and cost related aspects. A comprehensive review on available heat sources and sinks shows that India has plenty of waste heat and renewable energy sources for electricity generation by means of ORC; however, condenser operation may be challenging due to wide ambient temperature variation. Appropriate performance comparison among selected working fluids shows that ammonia is the best fluid in terms of net power generation and compactness of turbo-machineries, whereas n-Pentane is the best fluid in terms of thermal efficiency and heat exchanger compactness. Both are recommended as working fluids for ORC installations in India. The study reveals that there is a great opportunity to employ this technology in India provided we have to overcome some challenges related to component selection, finance and maintenance. - Highlights: • Available waste heat and renewable heat energies, and sinks in India are reviewed. • Suitable working fluids are selected by operational, environmental and safety criteria. • A feasibility study and comparison of selected fluids are presented for Indian climates. • Ammonia and n-Pentane are recommended for ORC installation in India. • Challenges related to plant component, operation and cost are discussed.

  11. Energetic and exergetic investigation of an organic Rankine cycle at different heat source temperatures

    International Nuclear Information System (INIS)

    Li, Jing; Pei, Gang; Li, Yunzhu; Wang, Dongyue; Ji, Jie

    2012-01-01

    The energetic and exergetic performance of an updated ORC (organic Rankine cycle) is investigated. The thermal efficiencies of the ORC at different heat source temperatures of about 100, 90, 80, and 70 °C are explored. The thermodynamic irreversibility that takes place in the evaporator, condenser, turbine, pump, and separator is revealed. The ORC feasibility for low-temperature applications is demonstrated. With a hot side temperature of around 80 °C, a thermal efficiency of 7.4% and a turbine isentropic efficiency of 0.68 can be achieved. The present research further indicates that exergy destruction caused by heat transfer through an appreciable temperature difference in the evaporator is the largest in the energy conversion process, followed by that in the condenser. The exergy destroyed in the heat exchangers amounts to 74% of the overall exergy loss. The total system exergy efficiency is approximately 40%; thus, ways to improve exergy efficiency are required. HCFC-123, a dry fluid, is experimentally confirmed to be highly superheated after expansion in this study. A regenerator should be used to preheat HCFC-123 prior to entering the evaporator. Meanwhile the heat-transfer configuration with two oil cycles can be a good solution to overcome the thermodynamic disadvantage of a one-stage evaporator. -- Highlights: ► An updated ORC system is introduced. ► The ORC feasibility for low-temperature applications is experimentally demonstrated. ► Thermodynamic irreversibility in ORC components is revealed. ► Suggestions are given to reduce the exergy destruction.

  12. The environmental impact of organic Rankine cycle for waste heat recovery through life-cycle assessment

    International Nuclear Information System (INIS)

    Liu, Chao; He, Chao; Gao, Hong; Xie, Hui; Li, Yourong; Wu, Shuangying; Xu, Jinliang

    2013-01-01

    The LCA (life-cycle assessment) was applied to evaluate EI (the environmental impact) of ORCPW (organic Rankine cycle power-plant for waste-heat-recovery) in this paper. The model of LCA on the ORCPW was established. The life-cycle of ORCPW was divided into construction, operation and decommissioning phases. The inventory of environmental emissions was listed for the ORCPW with 7 different working fluids. The GWP (global warming potential), AP (acidification potential), EP (eutrophication potential), HTP (human toxicity potential), SWP (solid waste potential) and SAP (soot and dust potential) were investigated. Some EIs of ORCPW were compared with the EIs of other power generation modes. The results show that the construction phase of ORCPW contributes mostly to the GWP and EP. GWP is the most serious EI followed by HTP among all the environmental impacts. The average pay back times of greenhouse gas discharged from ORCPW is calculated on the basis of five other power generation modes. For 7 different working fluids, it is 3–5 years for CO 2 , about one year for CH 4 and 3–6 years for NO x . But CO cannot be paid back during the life-cycle of ORCPW according to the average pay back time. - Highlights: • LCA was proposed to evaluate the environmental performance of ORC. • The ORC life cycle environmental emissions inventory was established. • GWP is the most serious environmental impact, followed by HTP. • The ORC with R113 exhibits the lowest environment impact load, followed by Pentane. • The total GWP of ORC could be paid back in 5 years

  13. Parametric analysis of a dual loop Organic Rankine Cycle (ORC) system for engine waste heat recovery

    International Nuclear Information System (INIS)

    Song, Jian; Gu, Chun-wei

    2015-01-01

    Highlights: • A dual loop ORC system is designed for engine waste heat recovery. • The two loops are coupled via a shared heat exchanger. • The influence of the HT loop condensation parameters on the LT loop is evaluated. • Pinch point locations determine the thermal parameters of the LT loop. - Abstract: This paper presents a dual loop Organic Rankine Cycle (ORC) system consisting of a high temperature (HT) loop and a low temperature (LT) loop for engine waste heat recovery. The HT loop recovers the waste heat of the engine exhaust gas, and the LT loop recovers that of the jacket cooling water in addition to the residual heat of the HT loop. The two loops are coupled via a shared heat exchanger, which means that the condenser of the HT loop is the evaporator of the LT loop as well. Cyclohexane, benzene and toluene are selected as the working fluids of the HT loop. Different condensation temperatures of the HT loop are set to maintain the condensation pressure slightly higher than the atmosphere pressure. R123, R236fa and R245fa are chosen for the LT loop. Parametric analysis is conducted to evaluate the influence of the HT loop condensation temperature and the residual heat load on the LT loop. The simulation results reveal that under different condensation conditions of the HT loop, the pinch point of the LT loop appears at different locations, resulting in different evaporation temperatures and other thermal parameters. With cyclohexane for the HT loop and R245fa for the LT loop, the maximum net power output of the dual loop ORC system reaches 111.2 kW. Since the original power output of the engine is 996 kW, the additional power generated by the dual loop ORC system can increase the engine power by 11.2%.

  14. Thermodynamic Optimization of a Geothermal- Based Organic Rankine Cycle System Using an Artificial Bee Colony Algorithm

    Directory of Open Access Journals (Sweden)

    Osman Özkaraca

    2017-10-01

    Full Text Available Geothermal energy is a renewable form of energy, however due to misuse, processing and management issues, it is necessary to use the resource more efficiently. To increase energy efficiency, energy systems engineers carry out careful energy control studies and offer alternative solutions. With this aim, this study was conducted to improve the performance of a real operating air-cooled organic Rankine cycle binary geothermal power plant (GPP and its components in the aspects of thermodynamic modeling, exergy analysis and optimization processes. In-depth information is obtained about the exergy (maximum work a system can make, exergy losses and destruction at the power plant and its components. Thus the performance of the power plant may be predicted with reasonable accuracy and better understanding is gained for the physical process to be used in improving the performance of the power plant. The results of the exergy analysis show that total exergy production rate and exergy efficiency of the GPP are 21 MW and 14.52%, respectively, after removing parasitic loads. The highest amount of exergy destruction occurs, respectively, in condenser 2, vaporizer HH2, condenser 1, pumps 1 and 2 as components requiring priority performance improvement. To maximize the system exergy efficiency, the artificial bee colony (ABC is applied to the model that simulates the actual GPP. Under all the optimization conditions, the maximum exergy efficiency for the GPP and its components is obtained. Two of these conditions such as Case 4 related to the turbine and Case 12 related to the condenser have the best performance. As a result, the ABC optimization method provides better quality information than exergy analysis. Based on the guidance of this study, the performance of power plants based on geothermal energy and other energy resources may be improved.

  15. Thermoeconomic analysis of configuration methods for modular Organic Rankine Cycle units in low-temperature applications

    International Nuclear Information System (INIS)

    Preißinger, Markus; Schatz, Sabrina; Vogl, Anne; König-Haagen, Andreas; Brüggemann, Dieter

    2016-01-01

    Highlights: • Two configuration methods for modular ORC design are presented. • Thermodynamic analysis cover the low-temperature range up to 190 °C. • Four commonly knows working fluids from two chemical classes are investigated. • Economic analysis cover payback period and cash flow under realistic boundary conditions. • Suggestions for ORC manufacturer are given concerning configuration method. - Abstract: Organic Rankine Cycle (ORC) is a promising technology for the utilization of low-grade waste heat. However, due to tailor-made power plants for different heat source temperatures, specific investment costs are still too high to be profitable. This study compares two different methods to configure a modular ORC in the temperature range of 373–463 K. The first method assumes a simple adaption of the mass flow rate within the ORC (mass flow method). In the second method, simultaneous adaption of mass flow rate and working pressure (combined method) take place. The common purpose of both methods is the optimization of the net power output for heat source temperatures lower and higher than the reference plant. Analyses are carried out for common fluorinated refrigerants (R227ea and R236ea) as well as for iso-alkanes (isobutane and isopentane). It is shown that within a wide range of temperatures the deviation in net power output between the simpler mass flow method and the more sophisticated combined method is below 10%. However, the deviation strongly depends on the location of the pinch point and on the choice of the working fluid. In general, it is shown that the mass flow method in combination with a working fluid, for which the pinch point is located at the beginning of the preheating, is thermodynamically favorable for plant manufacturers. Economic analyses subsequently compare both methods with respect to payback period and cash flow. Additional investment costs for the combined method are allowed to be up to 10% in order to reach higher

  16. Cost Engineering Techniques and Their Applicability for Cost Estimation of Organic Rankine Cycle Systems

    Directory of Open Access Journals (Sweden)

    Sanne Lemmens

    2016-06-01

    Full Text Available The potential of organic Rankine cycle (ORC systems is acknowledged by both considerable research and development efforts and an increasing number of applications. Most research aims at improving ORC systems through technical performance optimization of various cycle architectures and working fluids. The assessment and optimization of technical feasibility is at the core of ORC development. Nonetheless, economic feasibility is often decisive when it comes down to considering practical instalments, and therefore an increasing number of publications include an estimate of the costs of the designed ORC system. Various methods are used to estimate ORC costs but the resulting values are rarely discussed with respect to accuracy and validity. The aim of this paper is to provide insight into the methods used to estimate these costs and open the discussion about the interpretation of these results. A review of cost engineering practices shows there has been a long tradition of industrial cost estimation. Several techniques have been developed, but the expected accuracy range of the best techniques used in research varies between 10% and 30%. The quality of the estimates could be improved by establishing up-to-date correlations for the ORC industry in particular. Secondly, the rapidly growing ORC cost literature is briefly reviewed. A graph summarizing the estimated ORC investment costs displays a pattern of decreasing costs for increasing power output. Knowledge on the actual costs of real ORC modules and projects remains scarce. Finally, the investment costs of a known heat recovery ORC system are discussed and the methodologies and accuracies of several approaches are demonstrated using this case as benchmark. The best results are obtained with factorial estimation techniques such as the module costing technique, but the accuracies may diverge by up to +30%. Development of correlations and multiplication factors for ORC technology in particular is

  17. Bottoming organic Rankine cycle for a small scale gas turbine: A comparison of different solutions

    International Nuclear Information System (INIS)

    Clemente, Stefano; Micheli, Diego; Reini, Mauro; Taccani, Rodolfo

    2013-01-01

    Highlights: ► The ORC bottoming section for a commercial micro gas turbine has been studied. ► Six different organic working fluids have been considered and compared. ► The preliminary designs of both axial and radial turbines have been developed. ► Also scroll and reciprocating expanders have been analyzed for comparison. ► The best suited machine has to be selected after a detailed analysis in each case. - Abstract: Recently, several efforts have been devoted to the improvement of the thermal efficiency of small gas turbines, in order to approach the typical values of the internal combustion engines in the same range of power. One possibility is represented by a combined cycle, obtained coupling the gas turbine to a bottoming organic Rankine cycle (ORC). This paper deals with the definition of the main features of an ORC system aimed to recover heat from a 100 kWe commercial gas turbine with internal recuperator. After the optimization of the thermodynamic cycles, involving a comparison between six working fluids, different expanders are analyzed, with the aim of detecting, if possible, the best suited machine. First, single stage turbines, in both radial and axial flow configuration, are designed specifically for each considered fluid, in particular investigating the opportunity of mounting the ORC expander directly on the high-speed shaft of the gas turbine. Then, the performances of these dynamic machines are compared with those of positive displacement expanders, such as scroll devices, obtainable from commercial HVAC compressor with minor revisions, and reciprocating ones, here newly designed

  18. Development and a Validation of a Charge Sensitive Organic Rankine Cycle (ORC Simulation Tool

    Directory of Open Access Journals (Sweden)

    Davide Ziviani

    2016-05-01

    Full Text Available Despite the increasing interest in organic Rankine cycle (ORC systems and the large number of cycle models proposed in the literature, charge-based ORC models are still almost absent. In this paper, a detailed overall ORC simulation model is presented based on two solution strategies: condenser subcooling and total working fluid charge of the system. The latter allows the subcooling level to be predicted rather than specified as an input. The overall cycle model is composed of independent models for pump, expander, line sets, liquid receiver and heat exchangers. Empirical and semi-empirical models are adopted for the pump and expander, respectively. A generalized steady-state moving boundary method is used to model the heat exchangers. The line sets and liquid receiver are used to better estimate the total charge of the system and pressure drops. Finally, the individual components are connected to form a cycle model in an object-oriented fashion. The solution algorithm includes a preconditioner to guess reasonable values for the evaporating and condensing temperatures and a main cycle solver loop which drives to zero a set of residuals to ensure the convergence of the solution. The model has been developed in the Python programming language. A thorough validation is then carried out against experimental data obtained from two test setups having different nominal size, working fluids and individual components: (i a regenerative ORC with a 5 kW scroll expander and an oil flooding loop; (ii a regenerative ORC with a 11 kW single-screw expander. The computer code is made available through open-source dissemination.

  19. Performance Evaluation of a Solar-Powered Regenerative Organic Rankine Cycle in Different Climate Conditions

    Directory of Open Access Journals (Sweden)

    Emily Spayde

    2017-01-01

    Full Text Available A model to evaluate the performance of a solar powered regenerative Organic Rankine Cycle (R-ORC using five dry organic fluids: RC318, R227ea, R236ea, R236fa, and R218, is presented in this paper. The system is evaluated in two locations in the U.S.: Jackson, MS and Tucson, AZ. The weather data for each location is used to determine the heat available from the solar collector that could be used by the R-ORC to generate power. Results from the R-ORC performance are compared with a basic ORC using first and second law criteria as well as primary energy consumption (PEC and carbon dioxide emission (CDE savings for both locations. An economic analysis to determine the maximum capital cost for a desired payback period is presented in this paper. A parametric analysis is also performed to study the effect of the turbine efficiency as well as the open feed organic fluid heater intermediate pressure on the system performance. Results indicate that the R-ORC is able to generate more power than the basic ORC for some of the selected working fluids. For the R-ORC, R236ea is the working fluid that show the best performance among the evaluated fluids under the modeled conditions. On the other hand, the basic ORC with R236ea as the working fluid outperformed three of the fluids in the R-ORC. Also, the R-ORC evaluated in Tucson, AZ is able to generate more power, to provide more PEC and CDE savings, and had a higher available capital cost than the R-ORC evaluated in in Jackson, MS.

  20. Waste Heat-to-Power Using Scroll Expander for Organic Rankine Bottoming Cycle

    Energy Technology Data Exchange (ETDEWEB)

    Dieckmann, John [TIAX LLC, Lexington, MA (United States); Smutzer, Chad [TIAX LLC, Lexington, MA (United States); Sinha, Jayanti [TIAX LLC, Lexington, MA (United States)

    2017-05-30

    The objective of this program was to develop a novel, scalable scroll expander for conversion of waste heat to power; this was accomplished and demonstrated in both a bench-scale system as well as a full-scale system. The expander is a key component in Organic Rankine Cycle (ORC) waste heat recovery systems which are used to convert medium-grade waste heat to electric power in a wide range of industries. These types of waste heat recovery systems allow for the capture of energy that would otherwise just be exhausted to the atmosphere. A scroll expander has the benefit over other technologies of having high efficiency over a broad range of operating conditions. The speed range of the TIAX expander (1,200 to 3,600 RPM) enables the shaft power output to directly drive an electric generator and produce 60 Hz electric power without incurring the equipment costs or losses of electronic power conversion. This greatly simplifies integration with the plant electric infrastructure. The TIAX scroll expander will reduce the size, cost, and complexity of a small-scale waste heat recovery system, while increasing the system efficiency compared to the prevailing ORC technologies at similar scale. During this project, TIAX demonstrated the scroll expander in a bench-scale test setup to have isentropic efficiency of 70-75% and operated it successfully for ~200 hours with minimal wear. This same expander was then installed in a complete ORC system driven by a medium grade waste heat source to generate 5-7 kW of electrical power. Due to funding constraints, TIAX was unable to complete this phase of testing, although the initial results were promising and demonstrated the potential of the technology.

  1. Lower uric acid is associated with poor short-term outcome and a higher frequency of posterior arterial involvement in ischemic stroke.

    Science.gov (United States)

    Liu, Hanxiang; Reynolds, Gavin P; Wang, Wenmin; Wei, Xianwen

    2018-03-06

    Uric acid has neuroprotective properties in experimental and clinical studies of neurodegenerative disease. It is, however, associated with increased risk of stroke, yet, despite some inconsistent findings, increasing evidence suggests it may also be related to improved stroke outcomes. We have determined whether there is an effect of plasma uric acid on the short-term outcome of stroke patients in a general hospital setting using the modified Rankin Scale (mRS). We also investigated the relationship of uric acid with other clinical correlates. Plasma uric acid was determined in 108 acute ischemic stroke patients and their mRS scores measured. Patients with a poor outcome (mRS > 2) had significantly lower uric acid than those with a better outcome; this remained after correcting for the effect of sex on uric acid concentrations. There was no significant association with other epidemiological factors or with cognitive function determined by Mini-Mental State Examination. An association between uric acid and the cerebral circulation was also found in which lower uric acid occurs with posterior artery involvement. These findings demonstrate in a naturalistic cohort of patients the association of uric acid with short-term disability following ischemic stroke. They also raise the question of whether uric acid may influence the regional brain involvement in stroke.

  2. Effectiveness differences of ranitidine and omeprazole in prevention of stress ulcer and its effect on pneumonia occurrence and outcome of acute stroke patients

    Science.gov (United States)

    Batubara, C. A.; Ritarwan, K.; Rambe, A. S.

    2018-03-01

    Stress ulcer is one ofacute stroke complications. Giving ranitidine or omeprazole may prevent stress ulcer, but may increase the occurrence of pneumonia. Thus, it will affect the outcome of acute stroke. The method was experimental with a randomized control-group pretest - posttest design. This study divided the subjects into two groups, ranitidine 300mg and omeprazole 20mg group.We observed the patients whether stress ulcer or pneumonia occurred during hospitalization. Then, we measured the outcome by the National Institutes of Health Stroke Scaleand modified Rankin Scale. There were 32 subjects in this study. Only 1 (3.1%) subject suffered stress ulcer, and 3 (3.1%) suffered pneumonia in ranitidine group. Moreover, 2 (6.2%) subjects suffered pneumonia in omeprazole group. The differences were not significant between the two groups (p = 0.31 and p = 0.54). There was no significant effect and difference effect on the administration of both medications to the outcome at day 14. These results indicate that ranitidine and omeprazole have anequal effectiveness in the prevention of stress ulcer and also have equal effect on the occurrence of pneumonia, and both have no effect on the outcome of acute stroke patients.

  3. Thermodynamic analysis and optimization of an integrated Rankine power cycle and nano-fluid based parabolic trough solar collector

    International Nuclear Information System (INIS)

    Toghyani, Somayeh; Baniasadi, Ehsan; Afshari, Ebrahim

    2016-01-01

    Highlights: • The performance of an integrated nano-fluid based solar Rankine cycle is studied. • The effect of solar intensity, ambient temperature, and volume fraction is evaluated. • The concept of Finite Time Thermodynamics is applied. • It is shown that CuO/oil nano-fluid has the best performance from exergy perspective. - Abstract: In this paper, the performance of an integrated Rankine power cycle with parabolic trough solar system and a thermal storage system is simulated based on four different nano-fluids in the solar collector system, namely CuO, SiO_2, TiO_2 and Al_2O_3. The effects of solar intensity, dead state temperature, and volume fraction of different nano-particles on the performance of the integrated cycle are studied using second law of thermodynamics. Also, the genetic algorithm is applied to optimize the net output power of the solar Rankine cycle. The solar thermal energy is stored in a two-tank system to improve the overall performance of the system when sunlight is not available. The concept of Finite Time Thermodynamics is applied for analyzing the performance of the solar collector and thermal energy storage system. This study reveals that by increasing the volume fraction of nano-particles, the exergy efficiency of the system increases. At higher dead state temperatures, the overall exergy efficiency is increased, and higher solar irradiation leads to considerable increase of the output power of the system. It is shown that among the selected nano-fluids, CuO/oil has the best performance from exergy perspective.

  4. Estudio de un vórtice de Rankine con velocidad axial discontinua en un tubo infinito

    OpenAIRE

    Gonzalez, R; Vigh, C.D

    2016-01-01

    En este trabajo se muestra que un vórtice de Rankine confinado con flujo axial uniforme, posee sólo modos neutros aun cuando la velocidad axial sea discontinua en la interfase rotacional-irrotacional. Esta discontinuidad produce un curvamiento de las ramas inferiores de la relación de dispersión de tal forma que cortan al eje del número de onda con pendiente negativa, es decir velocidad de grupo negativa. Este resultado apoya la idea original de que el fenómeno de Vortex Breakdown se podría e...

  5. Dynamic behavior of Rankine cycle system for waste heat recovery of heavy duty diesel engines under driving cycle

    International Nuclear Information System (INIS)

    Xie, Hui; Yang, Can

    2013-01-01

    Highlights: • Waste heat recovery behavior of the RCS during driving cycle was investigated. • Four operating modes were defined to describe the operating process of the RCS under driving cycle. • The operating mode switching is the crucial reason for on-road inefficiency. • The dry and isentropic fluids are superior to the wet ones on the adaptability to unsteady ExGE. • The effects of the vapor parameters on RCT-E and power mode percentage are opposite. - Abstract: The RCS (Rankine cycle system) used to recover the WHE (waste heat energy) from engines has been regarded as one of the most potential ways of achieving higher efficiency. However, it is of great challenge to keep the RCS still in good performance under driving cycle. This paper tries to reveal and explain its on-road inefficiency. The operating process of the RCS under driving cycle was analyzed in advance. Afterwards, four basic operating modes were defined, including startup mode, turbine turning mode, power mode and protection mode. Then, a RCS model was established and operating performances of the RCS under an actual driving cycle were discussed based on this model. The results indicate that the on-road RCS-E (Rankine cycle system efficiency) is as low as 3.63%, which is less than half of the design RCS-E (7.77%) at the rated operating point. Despite the inevitable vapor state fluctuation, it is the operating mode switching during the driving cycle that leads to the on-road inefficiency. Further investigations indicate that the expander safety temperature and its safety margin affected by the working fluids, designed superheat degree and evaporating pressure are the main factors determining the operating mode switching. Finally, the effects of the working fluids, designed superheat degree and evaporating pressure on the operating mode switching and RC (Rankine cycle) efficiencies were profoundly investigated. The study shows that the dry and isentropic fluids are superior to the wet

  6. Sizing models and performance analysis of volumetric expansion machines for waste heat recovery through organic Rankine cycles on passenger cars

    OpenAIRE

    Guillaume, Ludovic; Legros, Arnaud; Quoilin, Sylvain; Declaye, Sébastien; Lemort, Vincent

    2013-01-01

    This paper aims at helping designers of waste heat recovery organic (or non-organic) Rankine cycles on internal combustion engines to best select the expander among the piston, scroll and screw machines, and the working fluids among R245fa, ethanol and water. The first part of the paper presents the technical constraints inherent to each machine through a state of the art of the three technologies. The second part of the paper deals with the modeling of such expanders. Finally, in the last pa...

  7. Solarstrom rund um die Uhr: Solarstrom mit Organic Rankine Cycle / erhöhte Solarausbeute / Fraunhofer UMSICHT

    OpenAIRE

    Schmidt, Mirjam; Hunstock, Björn; Bülten, Björn

    2013-01-01

    In einem Gastbeitrag beschäftigen sich die beiden Diplom-Ingenieure Björn Hunstock und Björn Bülten - beide wissenschaftliche Mitarbeiter des Fraunhofer-Instituts für Umwelt-, Sicherheits- und Energietechnik UMSICHT - mit solarthermisch angetriebenen Kraftwerken auf Basis der Organic Rankine Cycle (ORC) Technologie. Sie erläutern, in welchen Fällen und aus welchen Gründen diese als Alternative zu Photovoltaik-Anlagen in Betracht gezogen werden sollten. Sie wagen einen Vergleich der beiden Te...

  8. Altheim geothermal plant. Power generation by means of an ORC turbogenerator; Geothermieanlagen Altheim. Stromerzeugung mittels Organic-Rankine-Cycle Turbogenerator

    Energy Technology Data Exchange (ETDEWEB)

    Pernecker, G [Marktgemeindeamt Altheim (Austria)

    1997-12-01

    The report describes the project of the Austrian market town of Altheim to generate electricity by means of an ORC turbogenerator using low-temperature thermal water. The project is to improve the technical and economic situation of the existing industrial-scale geothermal project. (orig.) [Deutsch] Der Bericht beschreibt das Vorhaben der Marktgemeinde Altheim in Oberoesterreich, Strom mittels eines Organic-Rankine-Cycle-Turbogenerators unter Verwendung niedrig temperierten Thermalwassers zu produzieren. Ziel bzw. der Zweck des Projektes ist es, die technische und wirtschaftliche Situation der bestehenden Grossthermieanlage zu verbessern. (orig.)

  9. Integrated working fluid-thermodynamic cycle design of organic Rankine cycle power systems for waste heat recovery

    DEFF Research Database (Denmark)

    Cignitti, Stefano; Andreasen, Jesper Graa; Haglind, Fredrik

    2017-01-01

    recovery. Inthis paper, an organic Rankine cycle process and its pure working fluid are designed simultaneously forwaste heat recovery of the exhaust gas from a marine diesel engine. This approach can overcome designissues caused by the high sensitivity between the fluid and cycle design variables......Today, some established working fluids are being phased out due to new international regulations on theuse of environmentally harmful substances. With an ever-increasing cost to resources, industry wants toconverge on improved sustainability through resource recovery, and in particular waste heat...

  10. Multi-objective optimization of organic Rankine cycles for waste heat recovery: Application in an offshore platform

    DEFF Research Database (Denmark)

    Pierobon, Leonardo; Nguyen, Tuong-Van; Larsen, Ulrik

    2013-01-01

    This paper aims at finding the optimal design of MW-size organic Rankine cycles by employing the multi-objective optimization with the genetic algorithm as the optimizer. We consider three objective functions: thermal efficiency, total volume of the system and net present value. The optimization...... for acetone. Other promising working fluids are cyclohexane, hexane and isohexane. The present methodology can be utilized in waste heat recovery applications where a compromise between performance, compactness and economic revenue is required. © 2013 Elsevier Ltd. All rights reserved....

  11. Exergy and economic analysis of organic rankine cycle hybrid system utilizing biogas and solar energy in rural area of China

    DEFF Research Database (Denmark)

    Zhao, Chunhua; Zheng, Siyu; Zhang, Ji

    2017-01-01

    circuits. The cogeneration supplied the power to the air-condition in summer condition and hot water, which is heated in the condenser, in winter condition. The system performance under the subcritical pressures has been assessed according to the energy-exergy and economic analysis with the organic working......℃. The exergy efficiency of organic Rankine cycle (ORC) system increases from 35.2% to 38.2%. Moreover, an economic analysis of the system is carried out. The results demonstrate that the profits generated from the reduction of biogas fuel and electricity consumption can lead to a significant saving, resulting...

  12. Design and development of an automotive propulsion system utilizing a Rankine cycle engine (water based fluid). Final report

    Energy Technology Data Exchange (ETDEWEB)

    Demler, R.L.

    1977-09-01

    Under EPA and ERDA sponsorship, SES successfully designed, fabricated and tested the first federally sponsored steam powered automobile. The automobile - referred to as the simulator - is a 1975 Dodge Monaco standard size passenger car with the SES preprototype Rankine cycle automotive propulsion system mounted in the engine compartment. In the latter half of 1975, the simulator successfully underwent test operations at the facilities of SES in Watertown, Massachusetts and demonstrated emission levels below those of the stringent federally established automotive requirements originally set for implementation by 1976. The demonstration was accomplished during testing over the Federal Driving Cycle on a Clayton chassis dynamometer. The design and performance of the vehicle are described.

  13. Association between PTGS1 polymorphisms and functional outcomes in Chinese patients with stroke during aspirin therapy: Interaction with smoking.

    Science.gov (United States)

    Cai, Huan; Cai, Biyang; Sun, Lingli; Zhang, Hao; Zhou, Shuyu; Cao, Liping; Guo, Hongquan; Sun, Wen; Yan, Bernard; Davis, Stephen M; Zhang, Zhizhong; Liu, Xinfeng

    2017-05-15

    Prostaglandin-Endoperoxide Synthase 1 (PTGS1) and smoking may play important roles in aspirin nonresponsiveness, but the effect of their interaction on stroke outcomes remains largely unknown. We examined the effects of PTGS1 polymorphisms, smoking status, and their interaction on functional outcomes in a cohort of Chinese Han patients with stroke during aspirin therapy. A total of 617 ischemic stroke patients taking aspirin were enrolled. Three single nucleotide polymorphisms (SNPs) rs1330344, rs3842788, and rs5788 in PTGS1 were determined for genotyping. Poor functional outcomes were defined as a modified Rankin Scale (mRS) of 3-6 at 90-day follow-up. The influence of PTGS1 gene-smoking interaction on functional outcomes was examined. Poor functional outcomes occurred in 145 (23.5%) patients. When adjusting multiple factors by logistic regression, CC genotype of rs1330344 was associated with poor functional outcomes (risk ratio [RR]=1.73; 95% confidence interval [CI]: 1.17-2.37). A similar connection was found in the CGC haplotype (RR=1.40; 95% CI: 1.08-1.77). Furthermore, we found a significant interaction between rs1330344 and smoking status (P interaction =0.018); the interaction effect between the PTGS1 haplotype and smoking also showed statistical significance (P interaction =0.040). In Chinese Han stroke patients with aspirin therapy, the adverse effect of PTGS1 polymorphisms on functional outcomes may be modulated by the smoking status. PTGS1 gene-smoking interaction might in part reflect the heterogeneity in the prognosis of patients treated with aspirin. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Magnetic Resonance Imaging-DRAGON score: 3-month outcome prediction after intravenous thrombolysis for anterior circulation stroke.

    Science.gov (United States)

    Turc, Guillaume; Apoil, Marion; Naggara, Olivier; Calvet, David; Lamy, Catherine; Tataru, Alina M; Méder, Jean-François; Mas, Jean-Louis; Baron, Jean-Claude; Oppenheim, Catherine; Touzé, Emmanuel

    2013-05-01

    The DRAGON score, which includes clinical and computed tomographic scan parameters, showed a high specificity to predict 3-month outcome in patients with acute ischemic stroke treated by intravenous tissue plasminogen activator. We adapted the score for patients undergoing MRI as the first-line diagnostic tool. We reviewed patients with consecutive anterior circulation ischemic stroke treated ≤ 4.5 hour by intravenous tissue plasminogen activator between 2003 and 2012 in our center, where MRI is systematically implemented as first-line diagnostic work-up. We derived the MRI-DRAGON score keeping all clinical parameters of computed tomography-DRAGON (age, initial National Institutes of Health Stroke Scale and glucose level, prestroke handicap, onset to treatment time), and considering the following radiological variables: proximal middle cerebral artery occlusion on MR angiography instead of hyperdense middle cerebral artery sign, and diffusion-weighted imaging Alberta Stroke Program Early Computed Tomography Score (DWI ASPECTS) ≤ 5 instead of early infarct signs on computed tomography. Poor 3-month outcome was defined as modified Rankin scale >2. We calculated c-statistics as a measure of predictive ability and performed an internal cross-validation. Two hundred twenty-eight patients were included. Poor outcome was observed in 98 (43%) patients and was significantly associated with all parameters of the MRI-DRAGON score in multivariate analysis, except for onset to treatment time (nonsignificant trend). The c-statistic was 0.83 (95% confidence interval, 0.78-0.88) for poor outcome prediction. All patients with a MRI-DRAGON score ≤ 2 (n=22) had a good outcome, whereas all patients with a score ≥ 8 (n=11) had a poor outcome. The MRI-DRAGON score is a simple tool to predict 3-month outcome in acute stroke patients screened by MRI then treated by intravenous tissue plasminogen activator and may help for therapeutic decision.

  15. Effect of edaravone on favorable outcome in patients with acute cerebral large vessel occlusion: subanalysis of RESCUE-Japan Registry.

    Science.gov (United States)

    Miyaji, Yuki; Yoshimura, Shinichi; Sakai, Nobuyuki; Yamagami, Hiroshi; Egashira, Yusuke; Shirakawa, Manabu; Uchida, Kazutaka; Kageyama, Hirohito; Tomogane, Yusuke

    2015-01-01

    The data of the nationwide prospective registry of acute cerebral large vessel occlusion (LVO; RESCUE-Japan Registry) were analyzed to know the effect of edaravone, a free radical scavenger, on clinical outcome at 90 days after onset. In this registry, patients with acute cerebral LVO admitted within 24 h after onset were prospectively registered. The effect of various factors including endovascular treatment (EVT), intravenous recombinant tissue plasminogen activator (IV rt-PA), and other medication including edaravone on favorable outcome (modified Rankin scale 0-1) was analyzed. Of the 1,454 registered patients, 1,442 patients (99.2%) had the information of edaravone were analyzed. In total, edaravone group had more patients with favorable outcome compared to non-edaravone group (22.9% vs. 13.8%, p = 0.0006). Edaravone increased favorable outcome in patients treated with IV rt-PA (29.4% vs. 11.1%, p = 0.0107), but not with EVT (21.2% vs. 13.9%, p = 0.309). Logistic regression analysis revealed that higher National Institutes of Health Stroke Scale (NIHSS) score on admission [odds ratio (OR) 0.875, 95% confidence interval (CI) 0.858-0.894] and advanced age (OR 0.963, 95%CI 0.952-0.975) were significantly related to unfavorable outcome. In contrast, IV rt-PA (OR 2.489, 95%CI 1.867-3.319), EVT (OR 1.375, 95%CI 1.013-1.865), and edaravone (OR 1.483, 95%CI 1.027-2.143) were significantly associated with favorable outcome. This analysis indicated that IV rt-PA, EVT, and edaravone were effective to obtain favorable outcome in patients with acute LVO. Combination IV rt-PA with edaravone was more effective.

  16. 35% Good Outcome Rate in IV-tPA treated Patients with CTA Confirmed Severe Anterior Circulation Occlusive Stroke

    Science.gov (United States)

    González, R. Gilberto; Furie, Karen L.; Goldmacher, Gregory V.; Smith, Wade S.; Kamalian, Shervin; Payabvash, Seyedmehdi; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter J.; Camargo, Erica C. S.; Dillon, William P.; Lev, Michael H.

    2015-01-01

    BACKGROUND AND PURPOSE To determine the effect of IV-tPA on outcomes in patients with severe major anterior circulation ischemic stroke. METHODS Prospectively, 649 acute stroke patients had admission NIH stroke scale scores (NIHSS), non-contrast CT, CT angiography (CTA), and 6-month outcome assessed using modified Rankin scale (mRS). IV-tPA treatment decisions were made prior to CTA, at the time of non-contrast CT scanning, as per routine clinical protocol. Severe symptoms were defined as NIHSS>10. Poor outcome was defined as mRS>2. Major occlusions were identified on CTA. Univariate and multivariate stepwise-forward logistic regression analyses of the full cohort were performed. RESULTS Of 649 patients, 188 (29%) presented with NIHSS>10, and 64/188 (34%) of these received IV-tPA. Admission NIHSS, large artery occlusion, and IV-tPA all independently predicted good outcomes, however a significant interaction existed between IV-tPA and occlusion (p10 patients with anterior circulation occlusion, twice the percentage had good outcomes if they received IV-tPA (17/49, 35%), than if they did not (13/77, 17%; p=0.031). The “number needed to treat” was 7 (95% CI = 3–60). CONCLUSIONS IV-tPA treatment resulted in significantly more good outcomes in severely symptomatic stroke patients with major anterior circulation occlusions. The 35% good outcome rate was similar to rates found in endovascular therapy trials. Vascular imaging may help in patient selection and stratification for trials of IV-thrombolytic and endovascular therapies. PMID:24003051

  17. Exploration of time-course combinations of outcome scales for use in a global test of stroke recovery.

    Science.gov (United States)

    Goldie, Fraser C; Fulton, Rachael L; Dawson, Jesse; Bluhmki, Erich; Lees, Kennedy R

    2014-08-01

    Clinical trials for acute ischemic stroke treatment require large numbers of participants and are expensive to conduct. Methods that enhance statistical power are therefore desirable. We explored whether this can be achieved by a measure incorporating both early and late measures of outcome (e.g. seven-day NIH Stroke Scale combined with 90-day modified Rankin scale). We analyzed sensitivity to treatment effect, using proportional odds logistic regression for ordinal scales and generalized estimating equation method for global outcomes, with all analyses adjusted for baseline severity and age. We ran simulations to assess relations between sample size and power for ordinal scales and corresponding global outcomes. We used R version 2·12·1 (R Development Core Team. R Foundation for Statistical Computing, Vienna, Austria) for simulations and SAS 9·2 (SAS Institute Inc., Cary, NC, USA) for all other analyses. Each scale considered for combination was sensitive to treatment effect in isolation. The mRS90 and NIHSS90 had adjusted odds ratio of 1·56 and 1·62, respectively. Adjusted odds ratio for global outcomes of the combination of mRS90 with NIHSS7 and NIHSS90 with NIHSS7 were 1·69 and 1·73, respectively. The smallest sample sizes required to generate statistical power ≥80% for mRS90, NIHSS7, and global outcomes of mRS90 and NIHSS7 combined and NIHSS90 and NIHSS7 combined were 500, 490, 400, and 380, respectively. When data concerning both early and late outcomes are combined into a global measure, there is increased sensitivity to treatment effect compared with solitary ordinal scales. This delivers a 20% reduction in required sample size at 80% power. Combining early with late outcomes merits further consideration. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

  18. HLA-DRB1*03:01 and HLA-DRB1*04:01 modify the presentation and outcome in autoimmune hepatitis type-1.

    Science.gov (United States)

    van Gerven, N M F; de Boer, Y S; Zwiers, A; Verwer, B J; Drenth, J P H; van Hoek, B; van Erpecum, K J; Beuers, U; van Buuren, H R; den Ouden, J W; Verdonk, R C; Koek, G H; Brouwer, J T; Guichelaar, M M J; Vrolijk, J M; Coenraad, M J; Kraal, G; Mulder, C J J; van Nieuwkerk, C M J; Bloemena, E; Verspaget, H W; Kumar, V; Zhernakova, A; Wijmenga, C; Franke, L; Bouma, G

    2015-06-01

    The classical human leukocyte antigen (HLA)-DRB1*03:01 and HLA-DRB1*04:01 alleles are established autoimmune hepatitis (AIH) risk alleles. To study the immune-modifying effect of these alleles, we imputed the genotypes from genome-wide association data in 649 Dutch AIH type-1 patients. We therefore compared the international AIH group (IAIHG) diagnostic scores as well as the underlying clinical characteristics between patients positive and negative for these HLA alleles. Seventy-five percent of the AIH patients were HLA-DRB1*03:01/HLA-DRB1*04:01 positive. HLA-DRB1*03:01/HLA-DRB1*04:01-positive patients had a higher median IAIHG score than HLA-DRB1*03:01/HLA-DRB1*04:01-negative patients (P<0.001). We did not observe associations between HLA alleles and alanine transaminase levels (HLA-DRB1*03:01: P=0.2; HLA-DRB1*04:01; P=0.5); however, HLA-DRB1*03:01 was independently associated with higher immunoglobulin G levels (P=0.04). The HLA-DRB1*04:01 allele was independently associated with presentation at older age (P=0.03) and a female predominance (P=0.04). HLA-DRB1*03:01-positive patients received immunosuppressive medication and liver transplantation. In conclusion, the HLA-DRB1*03:01 and HLA-DRB1*04:01 alleles are both independently associated with the aggregate diagnostic IAIHG score in type-1 AIH patients, but are not essential for AIH development. HLA-DRB1*03:01 is the strongest genetic modifier of disease severity in AIH.

  19. Black Hole Sign Predicts Poor Outcome in Patients with Intracerebral Hemorrhage.

    Science.gov (United States)

    Li, Qi; Yang, Wen-Song; Chen, Sheng-Li; Lv, Fu-Rong; Lv, Fa-Jin; Hu, Xi; Zhu, Dan; Cao, Du; Wang, Xing-Chen; Li, Rui; Yuan, Liang; Qin, Xin-Yue; Xie, Peng

    2018-01-01

    In spontaneous intracerebral hemorrhage (ICH), black hole sign has been proposed as a promising imaging marker that predicts hematoma expansion in patients with ICH. The aim of our study was to investigate whether admission CT black hole sign predicts hematoma growth in patients with ICH. From July 2011 till February 2016, patients with spontaneous ICH who underwent baseline CT scan within 6 h of symptoms onset and follow-up CT scan were recruited into the study. The presence of black hole sign on admission non-enhanced CT was independently assessed by 2 readers. The functional outcome was assessed using the modified Rankin Scale (mRS) at 90 days. Univariate and multivariable logistic regression analyses were performed to assess the association between the presence of the black hole sign and functional outcome. A total of 225 patients (67.6% male, mean age 60.3 years) were included in our study. Black hole sign was identified in 32 of 225 (14.2%) patients on admission CT scan. The multivariate logistic regression analysis demonstrated that age, intraventricular hemorrhage, baseline ICH volume, admission Glasgow Coma Scale score, and presence of black hole sign on baseline CT independently predict poor functional outcome at 90 days. There are significantly more patients with a poor functional outcome (defined as mRS ≥4) among patients with black hole sign than those without (84.4 vs. 32.1%, p black hole sign independently predicts poor outcome in patients with ICH. Early identification of black hole sign is useful in prognostic stratification and may serve as a potential therapeutic target for anti-expansion clinical trials. © 2018 S. Karger AG, Basel.

  20. Collateral status affects the onset-to-reperfusion time window for good outcome.

    Science.gov (United States)

    Kim, Byung Moon; Baek, Jang-Hyun; Heo, Ji Hoe; Nam, Hyo Suk; Kim, Young Dae; Yoo, Joonsang; Kim, Dong Joon; Jeon, Pyoung; Baik, Seung Kug; Suh, Sang Hyun; Lee, Kyung Yol; Kwak, Hyo Sung; Roh, Hong Gee; Lee, Young-Jun; Kim, Sang Heum; Ryu, Chang-Woo; Ihn, Yon-Kwon; Kim, Byungjoon; Jeon, Hong Jun; Kim, Jin Woo; Byun, Jun Soo; Suh, Sangil; Park, Jeong Jin; Lee, Woong Jae; Roh, Jieun; Shin, Byoung-Soo; Bang, Oh Young

    2018-03-08

    To characterise the time window in which endovascular thrombectomy (EVT) is associated with good outcome, and to test the differential relationship between functional outcome and onset-to-reperfusion time (ORT), depending on collateral status. This was a retrospective analysis of clinical and imaging data of 554 consecutive patients, who had recanalisation success by EVT for anterior circulation large artery occlusion, from the prospectively maintained registries of 16 comprehensive stroke centres between September 2010 and December 2015. The patients were dichotomised into good and poor collateral groups, based on CT angiography. We tested whether the likelihood of good outcome (modified Rankin Scale, 0-2) by ORT was different between two groups. ORT was 298 min±113 min (range, 81-665 min), and 84.5% of patients had good collaterals. Age, diabetes mellitus, previous infarction, National Institutes of Health Stroke Scale, good collaterals (OR 40.766; 95% CI 10.668 to 155.78; pcollateral group (OR 0.305 for every 30 min; 95% CI 0.113 to 0.822) than in good collateral group (OR 0.926 for every 30 min; 95% CI 0.875 to 0.980). Earlier successful recanalisation was strongly associated with good outcome in poor collateral group; however, this association was weak during the tested time window in good collateral group. This suggests that the ORT window for good outcome can be adjusted according to collateral status. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Long-term outcome after arterial ischemic stroke in children and young adults.

    Science.gov (United States)

    Goeggel Simonetti, Barbara; Cavelti, Ariane; Arnold, Marcel; Bigi, Sandra; Regényi, Mária; Mattle, Heinrich P; Gralla, Jan; Fluss, Joel; Weber, Peter; Hackenberg, Annette; Steinlin, Maja; Fischer, Urs

    2015-05-12

    To compare long-term outcome of children and young adults with arterial ischemic stroke (AIS) from 2 large registries. Prospective cohort study comparing functional and psychosocial long-term outcome (≥2 years after AIS) in patients who had AIS during childhood (1 month-16 years) or young adulthood (16.1-45 years) between January 2000 and December 2008, who consented to follow-up. Data of children were collected prospectively in the Swiss Neuropediatric Stroke Registry, young adults in the Bernese stroke database. Follow-up information was available in 95/116 children and 154/187 young adults. Median follow-up of survivors was 6.9 years (interquartile range 4.7-9.4) and did not differ between the groups (p = 0.122). Long-term functional outcome was similar (p = 0.896): 53 (56%) children and 84 (55%) young adults had a favorable outcome (modified Rankin Scale 0-1). Mortality in children was 14% (13/95) and in young adults 7% (11/154) (p = 0.121) and recurrence rate did not differ (p = 0.759). Overall psychosocial impairment and quality of life did not differ, except for more behavioral problems among children (13% vs 5%, p = 0.040) and more frequent reports of an impact of AIS on everyday life among adults (27% vs 64%, p Stroke Scale/NIH Stroke Scale score was the most important predictor of favorable outcome (p young adults for mortality, disability, quality of life, psychological, or social variables. © 2015 American Academy of Neurology.

  2. Poor nutritional status on admission predicts poor outcomes after stroke: observational data from the FOOD trial.

    Science.gov (United States)

    2003-06-01

    Previous studies suggest that undernourished patients with acute stroke do badly. The data, however, are not robust. We aimed to reliably assess the importance of baseline nutritional status as an independent predictor of long-term outcome after stroke in a large prospective cohort enrolled in the Feed Or Ordinary Diet (FOOD) trial, a multicenter randomized trial evaluating various feeding policies. Patients admitted to hospital with a recent stroke were enrolled in the FOOD trial. Data on nutritional status and other clinical predictors of outcome were collected at trial entry. At 6 months, the coordinating center collected data on survival and functional status (modified Rankin Scale). Outcome assessment was done by researchers blinded to baseline assessments and treatment allocation. Between November 1996 and November 2001, 3012 patients were enrolled, and 2955 (98%) were followed up. Of the 275 undernourished patients, 102 (37%) were dead by final follow-up compared with only 445 (20%) of 2194 patients of normal nutritional status (odds ratio [OR], 2.32; 95% CI, 1.78 to 3.02). After adjustment for age, prestroke functional state, and stroke severity, this relationship, although weakened, still held (OR, 1.82; 95% CI, 1.34 to 2.47). Undernourished patients were more likely to develop pneumonia, other infections, and gastrointestinal bleeding during their hospital admission than other patients. These data provide reliable evidence that nutritional status early after stroke is independently associated with long-term outcome. It supports the rationale for the FOOD trial, which continues to recruit and aims to estimate the effect of different feeding regimes on outcome after stroke and thus determine whether the association observed in this study is likely to be causal.

  3. The impact of early specialist management on outcomes of patients with in-hospital stroke.

    Science.gov (United States)

    Manawadu, Dulka; Choyi, Jithesh; Kalra, Lalit

    2014-01-01

    Delays in treatment of in-hospital stroke (IHS) adversely affect patient outcomes. We hypothesised that early referral and specialist management of IHS patients will improve outcomes at 90 days. Baseline characteristics, assessment delays, thrombolysis eligibility, 90-day functional outcomes and all-cause mortality were compared between IHS patients referred for specialist stroke management within 3 hours of symptom onset (early referrals) and later referrals. Patients were identified from a prospective stroke registry between January 2009 and December 2010. Inclusion criteria were primary admission with a non-stroke diagnosis, onset of new neurological deficits after admission and early ischaemic changes on CT or MR imaging. Eighty four (4.6%) of 1836 stroke patients had IHS (mean age 74 year; 51% male, median NIHSS score 10). There were no significant differences in baseline characteristics between 53 (63%) early and 31 (37%) late referrals. Thrombolysis was performed in 29 (76%) of the 37/78 (47%) potentially eligible patients; 7 patients were excluded because specialist referral was delayed beyond 4.5 hours despite symptom recognition within 3 hours of onset. Early referral improved functional outcomes (modified Rankin Scale 0-2 at 90 days 40% v 7%, p = 0.001) and was an independent predictor of mRS 0-2 at 90 days after adjusting for age, pre-morbid function, primary cause for hospital admission and stroke severity [OR 1.13 (95% C.I.  = 1.10-1.27), p = 0.002]. Early referral and specialist management of IHS patients that includes thrombolysis is associated with better functional outcomes at 90 days.

  4. Glucose in prediabetic and diabetic range and outcome after stroke.

    Science.gov (United States)

    Osei, E; Fonville, S; Zandbergen, A A M; Koudstaal, P J; Dippel, D W J; den Hertog, H M

    2017-02-01

    Newly diagnosed disturbed glucose metabolism is highly prevalent in patients with stroke. Limited data are available on their prognostic value on outcome after stroke. We aimed to assess the association of glucose in the prediabetic and diabetic range with unfavourable short-term outcome after stroke. We included 839 consecutive patients with ischemic stroke and 168 patients with intracerebral haemorrhage. In all nondiabetic patients, fasting glucose levels were determined on day 2-4. Prediabetic range was defined as fasting glucose of 5.6-6.9 mmol/L, diabetic range as ≥7.0 mmol/L, pre-existent diabetes as the use of anti-diabetic medication prior to admission. Outcome measures were poor functional outcome or death defined as modified Rankin Scale (mRS) score >2 and discharge not to home. The association of prediabetic range, diabetic range and pre-existent diabetes (versus normal glucose) with unfavourable outcome was expressed as odds ratios, estimated with multiple logistic regression, with adjustment for prognostic factors. Compared with normal glucose, prediabetic range (aOR 1.8; 95%CI 1.1-2.8), diabetic range (aOR 2.5; 95%CI 1.3-4.9) and pre-existent diabetes (aOR 2.6; 95%CI 1.6-4.0) were associated with poor functional outcome or death. Patients in the prediabetic range (aOR 0.6; 95%CI 0.4-0.9), diabetic range (aOR 0.4; 95%CI 0.2-0.9) and pre-existent diabetes (aOR 0.6; 95%CI 0.4-0.9) were more likely not to be discharged to home. Patients with glucose in the prediabetic and diabetic range have an increased risk of unfavourable short-term outcome after stroke. These findings illustrate the potential impact of early detection and treatment of these patients. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. One-year outcome after first-ever stroke according to stroke subtype, severity, risk factors and pre-stroke treatment. A population-based study from Tartu, Estonia.

    Science.gov (United States)

    Vibo, R; Kõrv, J; Roose, M

    2007-04-01

    The aim of the current study was to evaluate the outcome at 1 year following a first-ever stroke based on a population-based registry from 2001 to 2003 in Tartu, Estonia. The outcome of first-ever stroke was assessed in 433 patients by stroke risk factors, demographic data and stroke severity at onset using the Barthel Index (BI) score and the modified Rankin Score (mRS) at seventh day, 6 months and 1 year. Female sex, older age, blood glucose value >10 mmol/l on admission and more severe stroke on admission were the best predictors of dependency 1 year following the first-ever stroke. At 1 year, the percentage of functionally dependent patients was 20% and the survival rate was 56%. The use of antihypertensive/antithrombotic medication prior to stroke did not significantly affect the outcome. The survival rate of stroke patients in Tartu is lower compared with other studied populations. The outcome of stroke was mainly determined by the initial severity of stroke and by elevated blood glucose value on admission. Patients with untreated hypertension had more severe stroke and trend for unfavourable outcome compared with those who were on treatment.

  6. Effect of Treatment Delay, Stroke Type, and Thrombolysis on the Effect of Glyceryl Trinitrate, a Nitric Oxide Donor, on Outcome after Acute Stroke: A Systematic Review and Meta-Analysis of Individual Patient from Randomised Trials

    Directory of Open Access Journals (Sweden)

    Philip M. Bath

    2016-01-01

    Full Text Available Background. Nitric oxide (NO donors are a candidate treatment for acute stroke and two trials have suggested that they might improve outcome if administered within 4–6 hours of stroke onset. We assessed the safety and efficacy of NO donors using individual patient data (IPD from completed trials. Methods. Randomised controlled trials of NO donors in patients with acute or subacute stroke were identified and IPD sought from the trialists. The effect of NO donor versus control on functional outcome was assessed using the modified Rankin scale (mRS and death, by time to randomisation. Secondary outcomes included measures of disability, mood, and quality of life. Results. Five trials (4,197 participants were identified, all involving glyceryl trinitrate (GTN. Compared with control, GTN lowered blood pressure by 7.4/3.3 mmHg. At day 90, GTN did not alter any clinical measures. However, in 312 patients randomised within 6 hours of stroke onset, GTN was associated with beneficial shifts in the mRS (odds ratio (OR 0.52, 95% confidence interval (CI 0.34–0.78 and reduced death (OR 0.32, 95% CI 0.14–0.78. Conclusions. NO donors do not alter outcome in patients with recent stroke. However, when administered within 6 hours, NO donors might improve outcomes in both ischaemic and haemorrhagic stroke.

  7. High blood pressure in acute ischemic stroke and clinical outcome.

    Science.gov (United States)

    Manabe, Yasuhiro; Kono, Syoichiro; Tanaka, Tomotaka; Narai, Hisashi; Omori, Nobuhiko

    2009-11-16

    This study aimed to evaluate the prognostic value of acute phase blood pressure in patients with acute ischemic stroke by determining whether or not it contributes to clinical outcome. We studied 515 consecutive patients admitted within the first 48 hours after the onset of ischemic strokes, employing systolic and diastolic blood pressure measurements recorded within 36 hours after admission. High blood pressure was defined when the mean of at least 2 blood pressure measurements was ≥200 mmHg systolic and/or ≥110 mmHg diastolic at 6 to 24 hours after admission or ≥180 mmHg systolic and/or ≥105 mmHg diastolic at 24 to 36 hours after admission. The high blood pressure group was found to include 16% of the patients. Age, sex, diabetes mellitus, hypercholesterolemia, atrial fibrillation, ischemic heart disease, stroke history, carotid artery stenosis, leukoaraiosis, NIH Stroke Scale (NIHSS) on admission and mortality were not significantly correlated with either the high blood pressure or non-high blood pressure group. High blood pressure on admission was significantly associated with a past history of hypertension, kidney disease, the modified Rankin Scale (mRS) on discharge and the length of stay. On logistic regression analysis, with no previous history of hypertension, diabetes mellitus, atrial fibrillation, and kidney disease were independent risk factors associated with the presence of high blood pressure [odds ratio (OR), 1.85 (95% confidence interval (CI): 1.06-3.22), 1.89 (95% CI: 1.11-3.22), and 3.31 (95% CI: 1.36-8.04), respectively]. Multi-organ injury may be presented in acute stroke patients with high blood pressure. Patients with high blood pressure had a poor functional outcome after acute ischemic stroke.

  8. Design and optimization of organic rankine cycle for low temperature geothermal power plant

    Science.gov (United States)

    Barse, Kirtipal A.

    Rising oil prices and environmental concerns have increased attention to renewable energy. Geothermal energy is a very attractive source of renewable energy. Although low temperature resources (90°C to 150°C) are the most common and most abundant source of geothermal energy, they were not considered economical and technologically feasible for commercial power generation. Organic Rankine Cycle (ORC) technology makes it feasible to use low temperature resources to generate power by using low boiling temperature organic liquids. The first hypothesis for this research is that using ORC is technologically and economically feasible to generate electricity from low temperature geothermal resources. The second hypothesis for this research is redesigning the ORC system for the given resource condition will improve efficiency along with improving economics. ORC model was developed using process simulator and validated with the data obtained from Chena Hot Springs, Alaska. A correlation was observed between the critical temperature of the working fluid and the efficiency for the cycle. Exergy analysis of the cycle revealed that the highest exergy destruction occurs in evaporator followed by condenser, turbine and working fluid pump for the base case scenarios. Performance of ORC was studied using twelve working fluids in base, Internal Heat Exchanger and turbine bleeding constrained and non-constrained configurations. R601a, R245ca, R600 showed highest first and second law efficiency in the non-constrained IHX configuration. The highest net power was observed for R245ca, R601a and R601 working fluids in the non-constrained base configuration. Combined heat exchanger area and size parameter of the turbine showed an increasing trend as the critical temperature of the working fluid decreased. The lowest levelized cost of electricity was observed for R245ca followed by R601a, R236ea in non-constrained base configuration. The next best candidates in terms of LCOE were R601a, R

  9. Performance evaluation of free piston compressor coupling organic Rankine cycle under different operating conditions

    International Nuclear Information System (INIS)

    Han, Yongqiang; Kang, Jianjian; Zhang, Guangpan; Liu, Zhongchang; Tian, Jing; Chai, Jiahong

    2014-01-01

    Highlights: • An ORC-FPC is proposed to recover the waste heat of exhaust gas. • The simulation model has been established in GT-Suite ver. 7.0. • Performances of ORC-FPC under different operating conditions have been evaluated. • Performances prediction of the ORC-FPC for real application has been made in the paper. - Abstract: An organic Rankine cycle coupling free piston compressor (ORC-FPC) system has been proposed, which is used in recovering the waste heat of exhaust gas from the stationary compressed nature gas (CNG) fueled internal combustion compressor. The free piston compressor functions as an expander in ORC and operates reciprocally to compress natural gas in compression cylinders to demanded pressure. After capturing the waste heat available and turning into vapor in evaporator, the working fluid R245ca can provide power to drive the free piston moving reciprocally in expander. The model of ORC-FPC built up in the GT-suite ver. 7.0 assists evaluating performances of this system under different operating conditions. In this paper, the operating condition includes two aspects: thermodynamic state of working fluid and input power. The purpose of simulation based on the model is to specify appropriate thermodynamic states of working fluid which yield high value of η (the ratio of work produced by the power piston to enthalpy reduction of working fluid in the power cylinder) and k (the ratio of output CNG’s mass to enthalpy reduction of working fluid in the power cylinder) value. Performances of the ORC-FPC under different input power, which determined by the operating frequency and injection quantity of the heated working fluid, have also been evaluated. Results show that when the heated working fluid is at 11.5 bar and 383 K, the system achieves better performances than other thermodynamic states, of which k is 601.1 mg/kJ and η is 44.3%. Based on the optimum thermodynamic state and the principle of obtaining the maximum k, the specific input

  10. Waste heat recovery from the exhaust of a diesel generator using Rankine Cycle

    International Nuclear Information System (INIS)

    Hossain, Shekh Nisar; Bari, Saiful

    2013-01-01

    Highlights: • Diesel engine exhaust contains 40% energy which can be used to produce extra power. • Extra 11% power gained with optimized heat exchangers using water as working fluid. • As a result brake specific fuel consumption improved by 12%. • Parallel arrangement of heat exchangers showed better performance than series. • Optimum working fluid pressure varies with the engine power. - Abstract: Exhaust heat from diesel engines can be an important heat source to provide additional power using a separate Rankine Cycle (RC). In this research, experiments were conducted to measure the available exhaust heat from a 40 kW diesel generator using two ‘off-the-shelf’ heat exchangers. The effectiveness of the heat exchangers using water as the working fluid was found to be 0.44 which seems to be lower than a standard one. This lower performance of the existing heat exchangers indicates the necessity of optimization of the design of the heat exchangers for this particular application. With the available experimental data, computer simulations were carried out to optimize the design of the heat exchangers. Two heat exchangers were used to generate super-heated steam to expand in the turbine using two orientations: series and parallel. The optimized heat exchangers were then used to estimate additional power considering actual turbine isentropic efficiency. The proposed heat exchanger was able to produce 11% additional power using water as the working fluid at a pressure of 15 bar at rated engine load. This additional power resulted into 12% improvement in brake-specific fuel consumption (bsfc). The effects of the working fluid pressure were also investigated to maximize the additional power production. The pressure was limited to 15 bar which was constrained by the exhaust gas temperature. However, higher pressure is possible for higher exhaust gas temperatures from higher capacity engines. This would yield more additional power with further improvements in

  11. Thermal energy storage for low grade heat in the organic Rankine cycle

    Science.gov (United States)

    Soda, Michael John

    Limits of efficiencies cause immense amounts of thermal energy in the form of waste heat to be vented to the atmosphere. Up to 60% of unrecovered waste heat is classified as low or ultra-low quality, making recovery difficult or inefficient. The organic Rankine cycle can be used to generate mechanical power and electricity from these low temperatures where other thermal cycles are impractical. A variety of organic working fluids are available to optimize the ORC for any target temperature range. San Diego State University has one such experimental ORC using R245fa, and has been experimenting with multiple expanders. One limitation of recovering waste heat is the sporadic or cyclical nature common to its production. This inconsistency makes sizing heat recovery ORC systems difficult for a variety of reasons including off-design-point efficiency loss, increased attrition from varying loads, unreliable outputs, and overall system costs. Thermal energy storage systems can address all of these issues by smoothing the thermal input to a constant and reliable level and providing back-up capacity for times when the thermal input is deactivated. Multiple types of thermal energy storage have been explored including sensible, latent, and thermochemical. Latent heat storage involves storing thermal energy in the reversible phase change of a phase change material, or PCM, and can have several advantages over other modalities including energy storage density, cost, simplicity, reliability, relatively constant temperature output, and temperature customizability. The largest obstacles to using latent heat storage include heat transfer rates, thermal cycling stability, and potentially corrosive PCMs. Targeting 86°C, the operating temperature of SDSU's experimental ORC, multiple potential materials were explored and tested as potential PCMs including Magnesium Chloride Hexahydrate (MgCl2˙6H2O), Magnesium Nitrate Hexahydrate (Mg(NO3)2˙6H 2O), montan wax, and carnauba wax. The

  12. Hybridisation of solar and geothermal energy in both subcritical and supercritical Organic Rankine Cycles

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Cheng

    2014-05-01

    Highlights: • Hybrid solar and geothermal energy conversion system was modelled using subcritical and supercritical ORCs. • Solar thermal and geothermal energy can be effectively hybridised. • Greater thermodynamic advantages and economic benefits can be achieved using the supercritical hybrid plant. • Hybrid plants can produce up to 19% more annual electricity than the two stand-alone plants. • Solar-to-electricity cost in the supercritical hybrid plant is about 4–19% less than in the subcritical plant. - Abstract: A supercritical Organic Rankine Cycle (ORC) is renowned for higher conversion efficiency than the conventional ORC due to a better thermal match (i.e. reduced irreversibility) presented in the heat exchanger unit. This improved thermal match is a result of the obscured liquid-to-vapor boundary of the organic working fluid at supercritical states. Stand-alone solar thermal power generation and stand-alone geothermal power generation using a supercritical ORC have been widely investigated. However, the power generation capability of a single supercritical ORC using combined solar and geothermal energy has not been examined. This paper thus investigates the hybridisation of solar and geothermal energy in a supercritical ORC to explore the benefit from the potential synergies of such a hybrid platform. Its performances were also compared with those of a subcritical hybrid plant, stand-alone solar and geothermal plants. All simulations and modelling of the power cycles were carried out using process simulation package Aspen HYSYS. The performances of the hybrid plant were then assessed using technical analysis, economic analysis, and the figure of merit analysis. The results of the technical analysis show that thermodynamically, the hybrid plant using a supercritical ORC outperforms the hybrid plant using a subcritical ORC if at least 66% of its exergy input is met by solar energy (i.e. a solar exergy fraction of >66%), namely producing 4–17

  13. Hybridisation of solar and geothermal energy in both subcritical and supercritical Organic Rankine Cycles

    International Nuclear Information System (INIS)

    Zhou, Cheng

    2014-01-01

    Highlights: • Hybrid solar and geothermal energy conversion system was modelled using subcritical and supercritical ORCs. • Solar thermal and geothermal energy can be effectively hybridised. • Greater thermodynamic advantages and economic benefits can be achieved using the supercritical hybrid plant. • Hybrid plants can produce up to 19% more annual electricity than the two stand-alone plants. • Solar-to-electricity cost in the supercritical hybrid plant is about 4–19% less than in the subcritical plant. - Abstract: A supercritical Organic Rankine Cycle (ORC) is renowned for higher conversion efficiency than the conventional ORC due to a better thermal match (i.e. reduced irreversibility) presented in the heat exchanger unit. This improved thermal match is a result of the obscured liquid-to-vapor boundary of the organic working fluid at supercritical states. Stand-alone solar thermal power generation and stand-alone geothermal power generation using a supercritical ORC have been widely investigated. However, the power generation capability of a single supercritical ORC using combined solar and geothermal energy has not been examined. This paper thus investigates the hybridisation of solar and geothermal energy in a supercritical ORC to explore the benefit from the potential synergies of such a hybrid platform. Its performances were also compared with those of a subcritical hybrid plant, stand-alone solar and geothermal plants. All simulations and modelling of the power cycles were carried out using process simulation package Aspen HYSYS. The performances of the hybrid plant were then assessed using technical analysis, economic analysis, and the figure of merit analysis. The results of the technical analysis show that thermodynamically, the hybrid plant using a supercritical ORC outperforms the hybrid plant using a subcritical ORC if at least 66% of its exergy input is met by solar energy (i.e. a solar exergy fraction of >66%), namely producing 4–17

  14. A novel cascade organic Rankine cycle (ORC) system for waste heat recovery of truck diesel engines

    International Nuclear Information System (INIS)

    Chen, Tao; Zhuge, Weilin; Zhang, Yangjun; Zhang, Lei

    2017-01-01

    Highlights: • A confluent cascade expansion ORC (CCE-ORC) system is proposed. • Cyclopentane is considered as the most suitable fluid for this system. • The CCE-ORC system performance under full operating conditions is analyzed. • The BSFC of diesel engine can be reduced by 9.2% with the CCE-ORC system. • Performance comparison of CCE-ORC and dual-loop ORC is conducted. - Abstract: Waste heat recovery (WHR) of engines has attracted increasingly more concerns recently, as it can improve engine thermal efficiency and help truck manufacturers meet the restrictions of CO_2 emission. The organic Rankine cycle (ORC) has been considered as the most potential technology of WHR. To take full advantage of waste heat energy, the waste heat in both exhaust gases and the coolant need to be recovered; however, conventional multi-source ORC systems are too complex for vehicle applications. This paper proposed a confluent cascade expansion ORC (CCE-ORC) system for engine waste heat recovery, which has simpler architecture, a smaller volume and higher efficiency compared with conventional dual-loop ORC systems. Cyclopentane is analyzed to be regarded as the most suitable working fluid for this novel system. A thermodynamic simulation method is established for this system, and off-design performance of main components and the working fluid side pressure drop in the condenser have been taken into consideration. System performance simulations under full engine operating conditions are conducted for the application of this system on a heavy-duty truck diesel engine. Results show that the engine peak thermal efficiency can be improved from 45.3% to 49.5% where the brake specific fuel consumption (BSFC) decreases from 185.6 g/(kW h) to 169.9 g/(kW h). The average BSFC in the frequently operating region can decrease by 9.2% from 187.9 g/(kW h) to 172.2 g/(kW h). Compared with the conventional dual-loop ORC system, the CCE-ORC system can generate 8% more net power, while the

  15. Applicability of entropy, entransy and exergy analyses to the optimization of the Organic Rankine Cycle

    International Nuclear Information System (INIS)

    Zhu, Yadong; Hu, Zhe; Zhou, Yaodong; Jiang, Liang; Yu, Lijun

    2014-01-01

    Graphical abstract: Fig. 3a. Variations of the evaluation parameters with evaporation temperature in the case of prescribed hot and cold streams for R123. Fig. 3(a) indicates that among the seven parameters, the minimum entropy generation rate, exergy destruction rate, entransy efficiency, revised entropy generation number and the maximum entransy loss rate are corresponding to the maximum output power. However, the minimum entransy dissipation rate does not associate with the output power variation, it can be explained as follow: the entransy dissipation is one part of the entransy loss rate besides entransy variation (work entransy) or does not consider the influence of work output on the change of entransy. - Highlights: • Theories of entropy, exergy and entransy are applied to the optimization of the ORC. • Two commonly utilized working fluids – R123 and N-pentane are chosen for comparison. • Variable evaporation temperature, hot stream temperature and mass flow rate are considered. • 3-D coordinates are utilized to observe the global variation of parameters. • The concept of entransy loss rate is appropriate for all the cases discussed in this paper. - Abstract: Based on the theories of entropy, entransy and exergy, the concepts of entropy generation rate, revised entropy generation number, exergy destruction rate, entransy loss rate, entransy dissipation rate and entransy efficiency are applied to the optimization of the Organic Rankine Cycle. Cycles operating on R123 and N-pentane have been compared in three common cases which are variable evaporation temperature, hot stream temperature and hot stream mass flow rate. The optimization goal is to produce maximum output power. Some numerical analyses and simulations are presented, and the results show that when both the hot and cold stream conditions are fixed, all the entropy principle, the exergy theory, the entransy loss rate and the entransy efficiency are applicable to the optimization of the

  16. Feasibility assessment of refinery waste heat-to-power conversion using an organic Rankine cycle

    International Nuclear Information System (INIS)

    Jung, H.C.; Krumdieck, Susan; Vranjes, Tony

    2014-01-01

    Highlights: • Kerosene enthalpies were estimated at different temperatures using samples and simulations. • Numerical ORC and financial models were developed to assess feasibility of waste heat-to-power conversion. • Six pure fluids and two mixtures were investigated for selecting optimum fluid. • It is technically and economically feasible to install a 250 kW ORC unit to capture kerosene waste heat. - Abstract: Industrial waste heat is a large potential resource for generation of carbon-free electricity. This study investigates the technical and economic feasibility of converting waste heat from a stream of liquid kerosene which must be cooled down to control the vacuum distillation temperature. The process conditions were determined for a simple 250 kW organic Rankine cycle (ORC) with a heat extraction loop. The pinch point technique was adopted to determine the optimum evaporation and condensation temperatures and assess the influence of the kerosene temperature at the evaporator exit on net power output. The operating conditions and performance of the ORC system were evaluated with eight potential refrigerants and refrigerant mixtures such as R123, R134a, R245fa, isobutane, butane, pentane, an equimolar mixture of butane and pentane, and a mixture of 40% isobutane and 50% butane on a mole basis. A financial model was established for the total plant cost. Results show that isobutane, of the pure fluids, yields the best plant efficiency of 6.8% with approximately half of the kerosene flow available, and the efficiency can be increased up to 7.6% using the butane/pentane mixture. The optimum kerosene temperature at the evaporator outlet is estimated to be 70 °C for all the fluid, except the butane/pentane mixture, which meets the design constraint not to disturb the existing distillation process. A capital cost target of $3000/kW could be achieved with a payback period of 6.8 years and the internal rate of return (IRR) of 21.8%. Therefore, if the detailed

  17. Long-Term Outcomes in Puerto Ricans with Rheumatoid Arthritis (RA) Receiving Early Treatment with Disease-Modifying Anti-Rheumatic Drugs using the American College of Rheumatology Definition of Early RA.

    Science.gov (United States)

    Varela-Rosario, Noemí; Arroyo-Ávila, Mariangelí; Fred-Jiménez, Ruth M; Díaz-Correa, Leyda M; Pérez-Ríos, Naydi; Rodríguez, Noelia; Ríos, Grissel; Vilá, Luis M

    2017-01-01

    Early treatment of rheumatoid arthritis (RA) results in better long-term outcomes. However, the optimal therapeutic window has not been clearly established. To determine the clinical outcome of Puerto Ricans with RA receiving early treatment with conventional and/or biologic disease-modifying anti-rheumatic drugs (DMARDs) based on the American College of Rheumatology (ACR) definition of early RA. A cross-sectional study was performed in a cohort of Puerto Ricans with RA. Demographic features, clinical manifestations, disease activity, functional status, and pharmacotherapy were determined. Early treatment was defined as the initiation of DMARDs (conventional and/or biologic) in less than 6 months from the onset of symptoms attributable to RA. Patients who received early (disease duration was 14.9 years and 337 (87.0%) patients were women. One hundred and twenty one (31.3%) patients received early treatment. In the multivariate analysis adjusted for age and sex, early treatment was associated with better functional status, lower probability of joint deformities, intra-articular injections and joint replacement surgeries, and lower scores in the physician's assessments of global health, functional impairment and physical damage of patients. Using the ACR definition of early RA, this group of patients treated with DMARDs within 6 months of disease had better long-term outcomes with less physical damage and functional impairment.

  18. J-ACT II. Differences in rate of valid recanalization and of a favorable outcome by site of MCA occlusion

    International Nuclear Information System (INIS)

    Hirano, Teruyuki

    2010-01-01

    The background and purpose of this study was to elucidate whether the effects of alteplase differ with occlusion site of the middle cerebral artery (MCA). An exploratory analysis was made of 57 patients enrolled on the Japan Alteplase Clinical Trial II (J-ACT II). The residual vessel length (mm), determined on pretreatment MR angiography (MRA), was used to reflect the occluded site. The proportions of patients with valid recanalization (modified Mori grade 2-3) at 6 and 24 hours, and a favorable outcome (modified Rankin scale 0-1 at 3 months) were compared between the groups dichotomized according to their lengths of residual vessel. Multiple logistic regression models were generated to elucidate the predictors of valid recanalization and a favorable outcome. Receiver operating characteristic (ROC) analysis revealed that 5 mm was the practical cutoff length for the dichotomization. In patients with M1 length <5 mm (n=12), the frequencies of valid recanalization at 6/24 hours (16.6%/25.0%) were significantly low compared with those (62.2%/82.2%) of 45 patients with a residual M1 length of ≥5 mm and M2 occlusions (p=0.008 for 6 hours, p<0.001 for 24 hours). The proportion of a favorable outcome was also small in patients with M1 length <5 mm (8.3%), as compared to the others (57.8%, p=0.004). In logistic regression models, the site of MCA occlusion (<5 mm) was the significant predictor of valid recanalization at 6/24 hours and of a favorable outcome. In patients with acute MCA occlusion, residual vessel length <5 mm on MRA can identify poor responders. (author)

  19. Performance Evaluation of a Helical Coil Heat Exchanger Working under Supercritical Conditions in a Solar Organic Rankine Cycle Installation

    Directory of Open Access Journals (Sweden)

    Marija Lazova

    2016-06-01

    Full Text Available Worldwide interest in low grade heat valorization using organic Rankine cycle (ORC technologies has increased significantly. A new small-scale ORC with a net capacity of 3 kW was efficiently integrated with a concentrated solar power technology for electricity generation. The excess heat source from Photovoltaic (PV collectors with a maximum temperature of 100 °C was utilized through a supercritical heat exchanger that uses R-404A as working medium. By ensuring supercritical heat transfer leads to a better thermal match in the heat exchanger and improved overall cycle efficiency. A helical coil heat exchanger was designed by using heat transfer correlations from the literature. These heat transfer correlations were derived for different conditions than ORCs and their estimated uncertainty is ~20%. In order to account for the heat transfer correlation uncertainties this component was oversized by 20%. Next, a prototype was built and installed in an integrated concentrated photovoltaic/thermal (CPV/T/Rankine system. The results from the measurements show that for better estimation of the sizing of the heat exchanger a more accurate correlation is required in order to design an optimal configuration and thus employ cheaper components.

  20. A Co-Powered Biomass and Concentrated Solar Power Rankine Cycle Concept for Small Size Combined Heat and Power Generation

    Directory of Open Access Journals (Sweden)

    Eileen Tortora

    2013-03-01

    Full Text Available The present work investigates the matching of an advanced small scale Combined Heat and Power (CHP Rankine cycle plant with end-user thermal and electric load. The power plant consists of a concentrated solar power field co-powered by a biomass furnace to produce steam in a Rankine cycle, with a CHP configuration. A hotel was selected as the end user due to its high thermal to electric consumption ratio. The power plant design and its operation were modelled and investigated by adopting transient simulations with an hourly distribution. The study of the load matching of the proposed renewable power technology and the final user has been carried out by comparing two different load tracking scenarios, i.e., the thermal and the electric demands. As a result, the power output follows fairly well the given load curves, supplying, on a selected winter day, about 50 GJ/d of thermal energy and the 6 GJ/d of electric energy, with reduced energy dumps when matching the load.

  1. Technology Development Program for an Advanced Potassium Rankine Power Conversion System Compatible with Several Space Reactor Designs

    Energy Technology Data Exchange (ETDEWEB)

    Yoder, G.L.

    2005-10-03

    This report documents the work performed during the first phase of the National Aeronautics and Space Administration (NASA), National Research Announcement (NRA) Technology Development Program for an Advanced Potassium Rankine Power Conversion System Compatible with Several Space Reactor Designs. The document includes an optimization of both 100-kW{sub e} and 250-kW{sub e} (at the propulsion unit) Rankine cycle power conversion systems. In order to perform the mass optimization of these systems, several parametric evaluations of different design options were investigated. These options included feed and reheat, vapor superheat levels entering the turbine, three different material types, and multiple heat rejection system designs. The overall masses of these Nb-1%Zr systems are approximately 3100 kg and 6300 kg for the 100- kW{sub e} and 250-kW{sub e} systems, respectively, each with two totally redundant power conversion units, including the mass of the single reactor and shield. Initial conceptual designs for each of the components were developed in order to estimate component masses. In addition, an overall system concept was presented that was designed to fit within the launch envelope of a heavy lift vehicle. A technology development plan is presented in the report that describes the major efforts that are required to reach a technology readiness level of 6. A 10-year development plan was proposed.

  2. Experimental and thermodynamic analysis of a bottoming Organic Rankine Cycle (ORC) of gasoline engine using swash-plate expander

    International Nuclear Information System (INIS)

    Galindo, J.; Ruiz, S.; Dolz, V.; Royo-Pascual, L.; Haller, R.; Nicolas, B.; Glavatskaya, Y.

    2015-01-01

    Highlights: • An experimental analysis of an ORC is presented and applied to a gasoline engine. • 28 Steady-state operating points have been tested to evaluate expander performance. • Optimum points have been used to analyze power balances and cycle efficiencies. - Abstract: This paper deals with the experimental testing of an Organic Rankine Cycle (ORC) integrate in a 2 liter turbocharged gasoline engine using ethanol as working fluid. The main components of the cycle are a boiler, a condenser, a pump and a swash-plate expander. Five engine operating points have been tested, they correspond to a nominal heat input into the boiler of 5, 12, 20, 25 and 30 kW. With the available bill of material based on prototypes, power balances and cycles efficiencies were estimated, obtaining a maximum improvement in the ICE mechanical power and an expander shaft power of 3.7% and 1.83 kW respectively. A total of 28 steady-state operating points were measured to evaluate performance of the swash-plate expander prototype. Operating parameters of the expander, such as expander speed and expansion ratio, were shifted. The objective of the tests is to master the system and understand physical parameters influence. The importance of each parameter was analyzed by fixing all the parameters, changing each time one specific value. In these sensitivity studies, maximum ideal and real Rankine efficiency value of 19% and 6% were obtained respectively

  3. Energy and exergy analysis of an organic Rankine for power generation from waste heat recovery in steel industry

    International Nuclear Information System (INIS)

    Kaşka, Önder

    2014-01-01

    Highlights: • Analysis of a waste heat driven Organic Rankine Cycle (ORC). • Irreversibility determination of subcomponents in ORC. • Using pinch point analysis in the evaporator of ORC. • Calculating energy and exergy efficiency for two different actual cases. • Optimum net power output for ORC. - Abstract: Energy, in conjunction with exergy, analysis of a waste heat driven Organic Rankine Cycle (ORC) is performed. Using actual plant data, performance of the cycle and pinpoint sites of primary exergy destruction are assessed. Furthermore, variations of energy and exergy efficiencies of the system with evaporator/condenser pressures, superheating and subcooling are illustrated. It is observed from the analysis that, the energy and exergy efficiencies of the system are 10.2%; 48.5% and 8.8%; 42.2%, respectively, for two different actual cases. Exergy destruction of subcomponents is also quantified. The components with greater exergy destructions to lower one can be listed as evaporator, turbine, condenser and pump. Evaporation pressure has significant effect on both energy and exergy efficiencies. Pinch-point analysis is, also performed to determine effects of heat exchange process, in the evaporator, on the net power production

  4. Comparative performance analysis of low-temperature Organic Rankine Cycle (ORC) using pure and zeotropic working fluids

    International Nuclear Information System (INIS)

    Aghahosseini, S.; Dincer, I.

    2013-01-01

    In this paper, a comprehensive thermodynamic analysis of the low-grade heat source Organic Rankine Cycle (ORC) is conducted and the cycle performance is analyzed and compared for different pure and zeotropic-mixture working fluids. The comparative performance evaluation of the cycle using a combined energy and exergy analysis is carried out by sensitivity assessment of the cycle certain operating parameters such as efficiency, flow rate, irreversibility, and heat input requirement at various temperatures and pressures. The environmental characteristics of the working fluids such as toxicity, flammability, ODP and GWP are studied and the cycle CO 2 emission is compared with different fuel combustion systems. R123, R245fa, R600a, R134a, R407c, and R404a are considered as the potential working fluids. Results from this analysis provide valuable insight into selection of the most suitable working fluids for power generating application at different operating conditions with a minimal environmental impact. -- Highlights: ► Combined energy and exergy analysis is conducted for Organic Rankine Cycle. ► Comparative assessment is performed for different pure and zeotropic working fluids. ► Exergy and energy efficiency, cycle irreversibility, and required external heat are analyzed. ► Toxicity, flammability, ODP and GWP of considered working fluids are studied. ► Environmental benefits of the renewable/waste heat-based ORC are investigated

  5. Exploring academics' views on designs, methods, characteristics and outcomes of inclusive health research with people with intellectual disabilities: a modified Delphi study

    Science.gov (United States)

    Frankena, T K; Naaldenberg, J; Cardol, M; Meijering, J V; Leusink, G; van Schrojenstein Lantman-de Valk, H M J

    2016-01-01

    Background The British Medical Journal's (BMJ's) patient revolution strives for collaboration with patients in healthcare and health research. This paper studies collaboration with people with intellectual disabilities (ID) in health research, also known as inclusive health research. Currently, transparency and agreement among academics is lacking regarding its main aspects, preventing upscaling of the patient revolution. Objective This study aims to gain agreement among academics on 3 aspects of inclusive health research for people with ID: (1) designs and methods, (2) most important characteristics and (3) outcomes. Design A Delphi study was conducted with academics with experience in inclusive (health) research and on people with ID. The study consisted of 2 sequential questionnaire rounds (n=24; n=17), followed by in-depth interviews (n=10). Results Academics agreed on (1) a collaborative approach to be most suitable to inclusive health research, (2) characteristics regarding the accessibility and facilitation of inclusive health research, and (3) several outcomes of inclusive health research for people with ID and healthcare. Other characteristics agreed on included: atmosphere, relationship, engagement, partnership and power. It was stressed that these characteristics ensure meaningful inclusion. Interviewed academics voiced the need for a tool supporting the facilitation and evaluation of inclusive health research. There was ambiguity as to what this tool should comprise and the extent to which it was possible to capture the complex process of inclusive health research. Discussion and conclusions This study underlines the need for transparency, facilitation and evaluation of inclusive health research. The need for in-depth interviews after 2 Delphi rounds underlines its complexity and context dependence. To increase process transparency, future research should focus on gaining insight into inclusive health research in its context. A tool could be developed

  6. Uric acid therapy improves the outcomes of stroke patients treated with intravenous tissue plasminogen activator and mechanical thrombectomy.

    Science.gov (United States)

    Chamorro, Ángel; Amaro, Sergio; Castellanos, Mar; Gomis, Meritxell; Urra, Xabier; Blasco, Jordi; Arenillas, Juan F; Román, Luis S; Muñoz, Roberto; Macho, Juan; Cánovas, David; Marti-Fabregas, Joan; Leira, Enrique C; Planas, Anna M

    2017-06-01

    Background Numerous neuroprotective drugs have failed to show benefit in the treatment of acute ischemic stroke, making the search for new treatments imperative. Uric acid is an endogenous antioxidant making it a drug candidate to improve stroke outcomes. Aim To report the effects of uric acid therapy in stroke patients receiving intravenous thrombolysis and mechanical thrombectomy. Methods Forty-five patients with proximal vessel occlusions enrolled in the URICO-ICTUS trial received intravenous recombinant tissue plasminogen activator within 4.5 h after stroke onset and randomized to intravenous 1000 mg uric acid or placebo (NCT00860366). These patients also received mechanical thrombectomy because a brain computed tomogaphy angiography confirmed the lack of proximal recanalization at the end of systemic thrombolysis. The primary outcome was good functional outcome at 90 days (modified Rankin Score 0-2). Safety outcomes included mortality, symptomatic intracerebral bleeding, and gout attacks. Results The rate of successful revascularization was >80% in the uric acid and the placebo groups but good functional outcome was observed in 16 out of 24 (67%) patients treated with uric acid and 10 out of 21 (48%) treated with placebo (adjusted Odds Ratio, 6.12 (95% CI 1.08-34.56)). Mortality was observed in two out of 24 (8.3%) patients treated with uric acid and one out of 21 (4.8%) treated with placebo (adjusted Odds Ratio, 3.74 (95% CI 0.06-226.29)). Symptomatic cerebral bleeding and gout attacks were similar in both groups. Conclusions Uric acid therapy was safe and improved stroke outcomes in stroke patients receiving intravenous thrombolysis followed by thrombectomy. Validation of this simple strategy in a larger trial is urgent.

  7. Reported Prestroke Physical Activity Is Associated with Vascular Endothelial Growth Factor Expression and Good Outcomes after Stroke.

    Science.gov (United States)

    López-Cancio, Elena; Ricciardi, Ana Clara; Sobrino, Tomás; Cortés, Jordi; de la Ossa, Natalia Pérez; Millán, Mónica; Hernández-Pérez, María; Gomis, Meritxell; Dorado, Laura; Muñoz-Narbona, Lucía; Campos, Francisco; Arenillas, Juan F; Dávalos, Antoni

    2017-02-01

    Physical activity (PhA) prior to stroke has been associated with good outcomes after the ischemic insult, but there is scarce data on the involved molecular mechanisms. We studied consecutive acute ischemic stroke patients admitted to a single tertiary stroke center. Prestroke PhA was evaluated with the International Physical Activity Questionnaire (metabolic equivalent of minutes/week). We studied several circulating angiogenic and neurogenic factors at different time points: vascular endothelial growth factor (VEGF), granulocyte colony-stimulating factor (G-CSF), and brain-derived neurotrophic factor (BDNF) at admission, day 7, and at 3 months. We considered good functional outcome at 3 months (modified Rankin scale  ≤ 2) as primary end point, and final infarct volume as secondary outcome. We studied 83 patients with at least 2 time point serum determinations (mean age 69.6 years, median National Institutes of Health Stroke Scale 17 at admission). Patients more physically active before stroke had a significantly higher increment of serum VEGF on the seventh day when compared to less active patients. This increment was an independent predictor of good functional outcome at 3 months and was associated with smaller infarct volume in multivariate analyses adjusted for relevant covariates. We did not find independent associations of G-CSF or BDNF levels neither with level of prestroke PhA nor with stroke outcomes. Although there are probably more molecular mechanisms by which PhA exerts its beneficial effects in stroke outcomes, our observation regarding the potential role of VEGF is plausible and in line with previous experimental studies. Further research in this field is needed. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. High urinary albumin/creatinine ratio at admission predicts poor functional outcome in patients with acute ischaemic stroke.

    Science.gov (United States)

    Watanabe, Yoko; Suda, Satoshi; Kanamaru, Takuya; Katsumata, Toshiya; Okubo, Seiji; Kaneko, Tomohiro; Mii, Akiko; Sakai, Yukinao; Katayama, Yasuo; Kimura, Kazumi; Tsuruoka, Shuichi

    2017-03-01

    Albuminuria and a low estimated glomerular filtration rate (eGFR) are widely recognized indices of kidney dysfunction and have been linked to cardiovascular events, including stroke. We evaluated albuminuria, measured using the urinary albumin/creatinine ratio (UACR), and the eGFR in the acute phase of ischaemic stroke, and investigated the clinical characteristics of ischaemic stroke patients with and those without kidney dysfunction. The study included 422 consecutive patients admitted between June 2010 and May 2012. General blood and urine examinations were performed at admission. Kidney dysfunction was defined as a low eGFR (high albuminuria (≥30 mg/g creatinine), or both. Neurological severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) at admission and the modified Rankin scale (mRS) at discharge. A poor outcome was defined as a mRS score of 3-5 or death. The impacts of the eGFR and UACR on outcomes at discharge were evaluated using multiple logistic regression analysis. Kidney dysfunction was diagnosed in 278 of the 422 patients (65.9%). The eGFR was significantly lower and UACR was significantly higher in patients with a poor outcome than in those with a good outcome. In multivariate analyses performed after adjusting for confounding factors, UACR >31.2 mg/g creatinine (OR, 2.58; 95% CI, 1.52-4.43; P = 0.0005) was independently associated with a poor outcome, while a low eGFR was not associated. A high UACR at admission may predict a poor outcome at discharge in patients with acute ischaemic stroke. © 2016 Asian Pacific Society of Nephrology.

  9. Ischemic Stroke in Young Adults with Moyamoya Disease: Prognostic Factors for Stroke Recurrence and Functional Outcome after Revascularization.

    Science.gov (United States)

    Zhao, Meng; Deng, Xiaofeng; Gao, Faliang; Zhang, Dong; Wang, Shuo; Zhang, Yan; Wang, Rong; Zhao, Jizong

    2017-07-01

    Stroke in young adults is uncommon and rarely described. Moyamoya disease is one of the leading causes of stroke in young adults. We aimed to study the prognostic factors for stroke recurrences and functional outcomes in young stroke patients with moyamoya disease after revascularization. We reviewed 696 consecutive patients with moyamoya disease admitted to our hospital from 2009-2015 and identified patients aged 18-45 years with first-ever stroke. Follow-up was conducted via face-to-face or structured telephone interviews. Outcome measures were recurrent stroke events and unfavorable functional outcomes (modified Rankin Scale >2). We included 121 young patients with moyamoya disease suffering from stroke (initial presentation age, 35.4 ± 7.5 years). All patients underwent revascularization after the acute phase of initial stroke events as the secondary prevention for recurrences. During follow-up (median, 40 months), 9 patients (7.4%) experienced recurrent strokes and 8 of them (6.6%) suffered unfavorable functional outcomes. In the multivariate analysis, diabetes was an independent predictor for stroke recurrences (hazard ratio 6.76; 95% confidence interval 1.30-35.11; P = 0.02) and was significantly associated with unfavorable functional outcomes (odds ratio 7.87; 95% confidence interval 1.42-38.74; P = 0.01). We identified diabetes as an independent risk factor for recurrent strokes and unfavorable functional outcomes after revascularization in young stroke patients with moyamoya disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Homeostasis model assessment of insulin resistance in relation to the poor functional outcomes in nondiabetic patients with ischemic stroke

    Science.gov (United States)

    Li, Siou; Yin, Changhao; Zhao, Weina; Zhu, Haifu; Xu, Dan; Xu, Qing; Jiao, Yang; Wang, Xue; Qiao, Hong

    2018-01-01

    Whether insulin resistance (IR) predicts worse functional outcome in ischemic stroke is still a matter of debate. The aim of the present study is to determine the association between IR and risk of poor outcome in 173 Chinese nondiabetic patients with acute ischemic stroke. This is a prospective, population-based cohort study. Insulin sensitivity, expressed by the homeostasis model assessment (HOMA) of insulin sensitivity (HOMA index = (fasting insulin × fasting glucose)/22.5). IR was defined by HOMA-IR index in the top quartile (Q4). Functional impairment was evaluated at discharge using the modified Rankin scale (mRS). The median (interquartile range) HOMA-IR was 2.14 (1.17–2.83), and Q4 was at least 2.83. There was a significantly positive correlation between HOMA-IR and National Institutes of Health Stroke Scale (r = 0.408; PIR group were associated with a higher risk of poor functional outcome (odds ratio (OR) = 3.23; 95% confidence interval (CI) = 1.75–5.08; P=0.001). In multivariate models comparing the third and fourth quartiles against the first quartile of the HOMA-IR, levels of HOMA-IR were associated with poor outcome, and the adjusted risk of poor outcome increased by 207% (OR = 3.05 (95% CI 1.70–4.89), P=0.006) and 429% (5.29 (3.05–9.80), PHOMA-IR to clinical examination variables (P=0.02). High HOMA-IR index is associated with a poor functional outcome in nondiabetic patients with acute ischemic stroke. PMID:29588341