Optimizing refuse-derived fuel production from scheduled wastes through Aspen plus simulation.

This study aims to improve the quality of fuel with high calorific value namely Sfuel - a commercial high-quality refuse-derived fuel (RDF) from hazardous waste via modifying the process design and operating parameters of thermal conversion process. The study analyses key parameters of RDF quality, such as calorific value and heavy metal content, before and after process modifications based on the combination of experimental and simulation using Aspen Plus. In this study, the temperature and pressure of the simulation system are varied from 100 to 700 °C and from 1 to 5 bar, respectively. Findings indicate that there are a total of eleven heavy metals and 179 volatile compounds in the "Sfuels". The quality of the targeted product is greatly improved by the metal evaporation at high temperatures and pressures. However, the calorific value of RDF significantly decreases at 700 °C due to a large amount of the carbon content being evaporated. Although the carbon content at high temperatures is significantly lost, the heat from the vapour stream reactor outlet, which is reused to preheat the nitrogen gas stream supplied to the system, reduces energy consumption while improving the thermal conversion efficiency of the system. Besides, low pressure along with high temperature are not the optimal conditions for quality Sfuels improvement by thermal conversion. Results also indicate that electric heating is more economically efficient than natural gas heating.

Symptom Clusters' Content, Stability and Correlation with the Quality of Life in a Heterogeneous Group of Cancer Patients: A Large-Scale Longitudinal Study.

Cancer-related symptoms can negatively affect the quality of life, hinder or delay treatment, and increase suffering. This study aimed to explore symptom clusters among Jordanian cancer patients. A longitudinal survey design was used. The sample consisted of 1280 cancer patients treated in three selected hospitals. Two-thirds of the participants were female (63.5%) with a mean age of 52.7 SD 13.8 years and 40.3% had breast cancer. Five clusters were identified, the first was the psychological cluster of eight symptoms; the second was the treatment side-effects cluster consisting of ten symptoms; the third was the nausea and vomiting cluster comprising four symptoms; the fourth was the pain cluster comprising four symptoms; and last was the fatigue cluster, with three symptoms. Cancer patients through the journey of cancer treatment have several symptoms that tend to occur in five clusters which are negatively correlated with their quality of life.

Type-B lactic acidosis associated with progressive multiple myeloma.

We report a 64-year-old lady with stage II, Immunoglobulin-G lambda multiple myeloma (MM) (standard risk), who presented with type-B lactic acidosis (LA), and multi-organ dysfunction associating myeloma progression, and ending in imminent death. In the context of literature review of all previously reported similar cases, this report highlights and discusses the association of type-B LA and MM (especially progressive disease), and also emphasizes the poor outcome. Early recognition of this condition with intensive supportive care, and treatment of multiple myeloma may improve outcomes.