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The number of micro-scale spirit distilleries worldwide has grown considerably over the past decade. With an onus on the distillery sector to reduce its environmental impact, such as carbon emissions, opportunities for increasing energy efficiency need to be implemented. This study explores the potential environmental benefits and financial gains achievable through heat recovery from different process and by-product streams, exemplified for a Scotch whisky distillery, but transferrable to micro-distilleries worldwide. The eco-efficiency methodology is applied, taking into account both climate change and water scarcity impacts as well as economic performance of alcohol production with and without heat recovery. A Life Cycle Assessment, focusing on climate change and water scarcity, is combined with a financial assessment considering investment costs and the present value of the savings over the 20-year service life of the heat recovery system. The proposed heat recovery systems allow carbon emission reductions of 8-23% and water scarcity savings of 13-55% for energy and water provision for 1 L of pure alcohol (LPA). Financial savings are comparatively smaller, at 5-13%, due to discounting of the future savings - but offer a simple payback of the investment costs in under two years. The eco-efficiency of the distillery operations can be improved through all proposed heat recovery configurations, but best results are obtained when heat is recovered from mashing, distillations and by-products altogether. A sensitivity analysis confirmed that the methodology applied here delivers robust results and can help guide other micro-distilleries on whether to invest in heat recovery systems, and/or the heat recovery configuration. Uptake should be enhanced through increased information and planning support, and in cases where the distillery offers insufficient heat and water sinks to use all pre-warmed water, opportunities to link with a heat sink outside the distillery are encouraged. A 10% reduction in heating fuel use through heat recovery has the potential to save 47 kt of CO 2 eq. or £7.4 M per annum in United Kingdom malt whisky production alone, based on current fuel types used and current prices (2021)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Although the food service sector is a major user of water, the potential for heat recovery from commercial kitchens' drain water remains largely unexplored. For the first time, we compare the life cycle environmental burdens of producing and installing a heat recovery system with the environmental credits arising from energy savings for a restaurant case study, and for the entire UK food service sector. Life Cycle Assessment was applied to determine the impacts of heat recovery systems made from different materials and comprising a heat exchanger in the shape of a concentric double-walled pipe, pipework and fittings. The design option with the smallest environmental footprint combined a heat exchanger made out of polypropylene-graphite (PP-GR) with polyethylene pipework, exhibiting 80-99% less environmental impact compared with components made out of (35% recycled) copper. Contrasting the environmental impacts of two heat recovery set-ups with energy savings shows that a PP-GR based system pays back all burdens of the seven assessed environmental impact categories, within two years, while payback times for the copper-based system vary depending on the replaced energy source, and can exceed the 10 year operational lifetime of the system. When looking at typical flow-rates in UK food outlets, net environmental savings can be realised across all analysed impact categories above a threshold water consumption of 555 L/day, using current technology. Extrapolation to the UK food service sector indicates annual greenhouse gas emission mitigation potential of about 500 Gg CO 2 equivalent., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Object: In this paper, the authors' goal was to analyze the incidence, timing, and treatment of new metastases following initial treatment with 20-Gy Gamma Knife surgery (GKS) alone in patients with limited brain metastases without whole-brain radiation therapy (WBRT)., Methods: A retrospective analysis of 114 consecutive adults (75 women and 34 men; median age 61 years) with KPS scores of 60 or higher who received GKS for 1-3 brain metastases ≤ 2 cm was performed (median lesion volume 0.35 cm(3)). Five patients lacking follow-up data were excluded from analysis. After treatment, patients underwent MR imaging at 6 weeks and every 3 months thereafter. New metastases were preferentially treated with additional GKS. Indications for WBRT included development of numerous metastases, leptomeningeal disease, or diffuse surgical-site recurrence., Results: The median overall survival from GKS was 13.8 months. Excluding the 3 patients who died before follow-up imaging, 12 patients (11.3%) experienced local failure at a median of 7.4 months. Fifty-three patients (50%) developed new metastases at a median of 5 months. Six (7%) of 86 instances of new lesions were symptomatic. Most patients (67%) with distant failures were successfully treated using salvage GKS alone. Whole-brain radiotherapy was indicated in 20 patients (18.3%). Thirteen patients (11.9%) died of neurological disease., Conclusions: For patients with limited brain metastases and functional independence, 20-Gy GKS provides excellent disease control and high-functioning survival with minimal morbidity. New metastases developed in almost 50% of patients, but additional GKS was extremely effective in controlling disease. Using our algorithm, fewer than 20% of patients required WBRT, and only 12% died of progressive intracranial disease.

Background: Metastases to the brain occur in 20% to 30% of patients with cancer and have been identified on autopsy in as many as 50% of patients., Objective: To analyze the efficacy of 20-Gy Gamma Knife radiosurgery (GKR) as initial treatment in patients with 1 to 3 brain metastases ≤ 2 cm in greatest diameter., Methods: A retrospective analysis of 114 consecutive adults with Karnofsky performance status ≥ 60 who received GKR for 1 to 3 brain metastases ≤ 2 cm in size was performed. Five patients lacked detailed follow-up and were excluded, leaving 109 for outcome analysis (34 men and 75 women; median age, 61.2 years). All metastases received 20 Gy to the 50% isodose line., Results: One hundred nine patients underwent treatment of 164 metastases at initial GKR. Twenty-six patients (23.9%) were alive at last follow-up (median time, 29.9 months; range, 6.6 months to 7.8 years). The median overall survival was 13.8 months (range, 1 day to 7.6 years). Among the 52 patients with distant failure, 33 patients received 20 Gy to 95 new lesions. A total of 259 metastases received 20 Gy, and 4 patients lacked imaging follow-up secondary to death before posttreatment imaging. Local failure occurred in 17 of 255 treated lesions (6.7%), yielding an overall local control rate of 93.3%. Actuarial local control at 6, 12, 24, and 36 months was 96%, 93%, 89%, and 88%, respectively. Permanent neurological complications occurred in 3 patients (2.8%)., Conclusion: Among patients with 1 to 3 brain metastases ≤ 2 cm in size who have not received whole-brain radiation therapy, GKR with 20 Gy provides high rates of local control with low morbidity and excellent neurological symptom-free survival.

Object: Reports on resection of tumors in or near eloquent cortices have noted neurological complications in up to 30% of patients. This paper contains an analysis of symptom resolution and neurological morbidity following 20-Gy Gamma Knife surgery (GKS) for supratentorial brain metastases < or = 2 cm in greatest diameter., Methods: The authors performed a retrospective analysis of 98 consecutively treated adults (33 men and 65 women with a median age of 61.4 years at the time of GKS) with Karnofsky Performance Scale score > or = 60, who underwent GKS for supratentorial brain metastases < or = 2 cm in diameter. Lesion location was classified as noneloquent (Grade I), near eloquent (Grade II), or eloquent (Grade III), in accordance with the grading system developed by the group at M. D. Anderson Cancer Center. Following treatment, the patients underwent MR imaging and clinical examinations at 6 weeks and every 3 months thereafter., Results: Ninety-eight patients underwent 20-Gy GKS for 131 metastases at initial presentation and 31 patients underwent salvage 20-Gy GKS for 76 new lesions, for a total of 207 lesions (mean lesion volume 0.44 cm3). Lesions were classified as follows: Grade I, 96 (46.4%); Grade II, 51 (24.6%); and Grade III, 60 (29%). Fifteen patients (2 with Grade II and 13 with Grade III lesions) presented with deficits referable to their lesions, yielding pre-GKS deficit rates of 7.2% per lesion and 15.3% per patient. The pre-GKS deficits improved or resolved in 10 patients (66.7%) at a median time of 2.8 months and remained stable in 3 patients (20%). Two patients (13.3%) experienced worsened neurological deficits. One patient who was neurologically intact prior to treatment developed a new hemiparesis (1 of 83 patients [1.2%]). The rates of permanent neurological deterioration following GKS for Grades I, II, and III lesions were 0% (0 of 96 tumors), 2% (1 of 51), and 3.3% (2 of 60), respectively. The pre-GKS neurological deficits and larger lesions were the most significant risk factors for post-GKS neurological deterioration., Conclusions: Gamma Knife surgery performed using a 20-Gy dose provides amelioration of neurological deficits from brain metastases that are < or = 2 cm in diameter and located in or near eloquent cortices in nearly two-thirds of patients with a low incidence of morbidity. Consistent with the surgical literature, higher rates of neurological complications were observed as proximity to eloquent regions and lesion size increased. There was no neurological deterioration in patients harboring metastases in noneloquent areas.

We have developed an original method for global optimization of protein side-chain conformations, called the Fast and Accurate Side-Chain Topology and Energy Refinement (FASTER) method. The method operates by systematically overcoming local minima of increasing order. Comparison of the FASTER results with those of the dead-end elimination (DEE) algorithm showed that both methods produce nearly identical results, but the FASTER algorithm is 100-1000 times faster than the DEE method and scales in a stable and favorable way as a function of protein size. We also show that low-order local minima may be almost as accurate as the global minimum when evaluated against experimentally determined structures. In addition, the new algorithm provides significant information about the conformational flexibility of individual side-chains. We observed that strictly rigid side-chains are concentrated mainly in the core of the protein, whereas highly flexible side-chains are found almost exclusively among solvent-oriented residues., (Copyright 2002 Wiley-Liss, Inc.)

Background: Apparent life-threatening events in infants are a difficult and frequent problem in pediatric practice. The prognosis is uncertain because of risk of sudden infant death syndrome., Case Reports: Eight infants aged 2 to 15 months were admitted during a period of 6 years; they suffered from similar maladies in the bath: on immersion, they became pale, hypotonic, still and unreactive; recovery took a few seconds after withdrawal from the bath and stimulation. Two diagnoses were initially considered: seizure or gastroesophageal reflux but this was doubtful. The hypothesis of an equivalent of aquagenic urticaria was then considered; as for patients with this disease, each infant's family contained members suffering from dermographism, maladies or eruption after exposure to water or sun. All six infants had dermographism. We found an increase in blood histamine levels after a trial bath in the two infants tested. The evolution of these "aquagenic maladies" was favourable after a few weeks without baths. After a 2-7 year follow-up, three out of seven infants continue to suffer from troubles associated with sun or water., Conclusion: "Aquagenic maladies" could be a pediatric form of the aquagenic urticaria.