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Power plant start-up, especially of cogeneration plants, demands good planning and a well organized, experienced start-up group. Guidelines will help During the early stages of engineering a power plant, it [...]

Introduction: Trapped lung, characterized by atelectatic lung unable to reexpand and fill the thoracic cavity due to a restricting fibrous visceral pleural peel, is occasionally seen in patients with end-stage liver disease complicated by hepatic hydrothorax. Limited data suggest that trapped lung prior to orthotopic liver transplantation may be associated with poor outcomes.Research Question: What is the clinical significance of trapped lung in patients receiving orthotopic liver transplantation?Design: We performed a retrospective analysis of patients who underwent liver transplantation over an 8-year period. Baseline clinical characteristics and postoperative outcomes of adult patients with trapped lung were analyzed and compared to the overall cohort of liver transplant recipients and controls matched 3:1 based on age, sex, Model for End-Stage Liver Disease (MELD) score, and presence of pleural effusion.Results: Of the 1193 patients who underwent liver transplantation, we identified 20 patients (1.68%) with trapped lung. The probability of 1 and 2-year survival were 75.0% and 57.1%, compared to 85.6% and 80.4% (p = 0.02) in all liver transplant recipients and 87.9% and 81.1% (p = 0.03) in matched controls respectively. Patients with trapped lung had a longer hospital length of stay compared to the total liver transplant population (geometric mean 54.9 ± 8.4 vs. 27.2 ± 0.7 days, p ≤ 0.001), when adjusted for age and MELD score.Discussion: Patients with trapped prior to orthotopic liver transplantation have increased probability of mortality as well as increased health care utilization. This is a small retrospective analysis, and further prospective investigation is warranted.

Start‐up activities at the Black Dog 130 MWe atmospheric fluidized bed combustor (AFBC) conversion began in February 1986 and ran concurrent with the construction schedule through June 1986. During this period, the boiler casing was air tested, and the water/steam circuitry was chemically cleaned. Forty‐six steam blows were made from drum pressures of 56.2 kg/cm2 (800 psig) to clean the boiler. The first fluidized‐bed coal fires were started on June 26, 1986, with the turbine on line and a maximum electrical power output of 45 MWe net. Gross power output as high as 95 MWe was achieved. Early in the Black Dog Unit 2 project, it was determined that only a bubbling fluidized bed combustor could be economically retrofit to the unit. Despite the limitations imposed by the project requirement to build a retrofit unit and not a completely new fluidized bed combustor (FBC), the Black Dog 2 retrofit provides operating flexibility that would be difficult to obtain with other designs. The paper describes what special design features make the operating flexibility possible and evaluate the economics of the design due to the process efficiency penalty when burning a hard Eastern coal.

Repurposing biological samples collected for required diagnostic purposes into suitable biobanking projects is a particularly useful method for enabling research in vulnerable populations. This approach is especially appropriate for the neonate in the neonatal intensive care unit (NICU), where blood volume reductions can quickly increase beyond minimal risk for adverse events, such as iatrogenic anemia, and proxy consent provided by parents or guardians is required. The method described in this study provides a framework to prospectively collect and store blood-derived clinical samples after all clinical and regulatory requirements are fulfilled. The consent approach incorporated a 30-day window to allow parents and guardians ample consideration time with follow-up involvement with NICU embedded study team members. The study enrolled 875 participants over a 3-year period. This established a critically needed biobank to support investigator-initiated research with explicit study aims requiring samples at defined day of life frequencies within the NICU and created a normative control reference bank for case comparisons for premature and full-term neonates with brain injury.