ABSTRACT
The application of mega complex projects in the heavy industrial sector have been growing globally for the last ten years. Given there is growth of mega complex projects, the failure rate of these types of projects has also increased. According the EY (who have analyzed 500 completed mega projects from the previous five years): “Of the projects analyzed, 60% experienced schedule delays, and 38% had cost overruns.” Based on research performed by McKinsey & Company, the construction industry needs to change to become more productive and as the industry changes it will look very different five to ten years from now. These changes will only be accelerated by the current COVID-19 pandemic. One solution is the application of smaller standard modular plants or trains that can be designed and constructed quicker and more efficiently. A product-based approach will lead to more of a manufacturing style approach to not only improve productivity but to reduce overall lifecycle costs and schedules and improve overall quality and safety. Further, in times of economic uncertainty, it will reduce the business risk for the project as the business can break the project down into “bite-sized pieces”. Companies will need to be innovative in order to be competitive and have a positive return on investment on their future programs and projects. In the current and future economic environment, an innovative way to execute projects is to utilize a product-based approach. This paper will focus on how to develop a standard modular plant using a product-based approach and provide a case study from a small-scale LNG plant. Copyright © 2021 by ASME.
ABSTRACT
This paper aims to describe the etiology of bloodstream infections in COVID-19, Papa Giovanni XXIII Hospital, Bergamo, Italy. Two periods were evaluated: February 22-May 21, 2019/2020. We considered: the number of patients and blood culture sets, species of isolates (bacteria, specifically those indicated by EARS criteria;CoNS;Candida albicans) and their antibiotic sensitivity. In 2020 Escherichia coli and Carbapenemase-producing Klebsiella pneumoniae disappeared. Candida albicans and MDR Pseudomonas aeruginosa, Enterococcus faecium and Acinetobacter baumannii were largely present. The analysis shows: 1. BSIs number was the same;2. In the first month of the COVID-19 period, BSIs were uncommon;3. Microbial etiologies were different;4. MDR isolates were less common.
ABSTRACT
Background: In December 2019, a new contagious disease, named COVID-19 caused by a novel coronavirus (SARSCov- 2) emerged in Wuhan City, China Since February 2020 this disease has also spread to Italy Bergamo, where one of the most active liver transplant (LT) Italian center is located, has been one of the most affected cities by COVID-19 This study aimed to evaluate the impact of COVID-19 in liver transplant patients Methods: From April 1st, 2020, to May 15th, 2020, 660 adult liver transplant recipients were contacted by phone by the medical staff of the Transplant Center at the ASST-Papa Giovanni XXIII-Bergamo The presence of COVID-19 symptoms (fever, cough, dyspnea, asthenia, dysgeusia, anosmia, gastrointestinal complaints and/or myalgia) and contact at risk were investigated Results of RX chest, SARS-Cov-2 nose-swab and hospitalizations, when occurred, were recorded in symptomatic patients Results: Seventy-seven patients (11 7%) reported symptoms related to SARS-Cov-2 infection;patients were primarily males (72 7%), with a median age of 62 9 years (IQR 57 1-69 0) and a median time from LT of 73 6 months (IQR 36 5-135 8) A chest x-rays was performed in 25/77 symptomatic patients (32 5%) and in 17/25 (68 0%) an interstitial pneumonia was found;swabs were performed in 21/77 patients (27 3%) and 17 of them (81 0%) resulted positive Among symptomatic patients, all reported at least two symptoms and in 14 (18 2%) five symptoms were present. Three patients (3.9%) had been hospitalized for transplant-related reasons and 11 patients needed hospitalization because of COVID-19 (14 9%) All hospitalized patients were treated with antibiotics;high dose steroids were added to 8 patients and antiviral therapy (lopinavir/ritonavir) to 4 patients Nine patients (11 7%) needed oxygen therapy One patient died for non-COVID-19 related condition, 2 patients died for COVID-19 (2/76;2 6%) Mortality in hospitalized patients was 21 4% (3/14), COVIDrelated mortality-rate was 15 4% (2/13) and both patients died within one month after LT Conclusion: COVID-19 can affect liver transplant patients, however, in our experience, both the need for hospitalization and deaths do not exceed those observed among the general population.