Application of a method for the sustainable planning and management of ground source heat pump systems in an urban environment, considering the effects of reciprocal thermal interference.

The "Most Easy, Efficient and Low Cost Geothermal Systems for Retrofitting Civil and Historical Buildings" (GEO4CIVHIC) project aims to accelerate the deployment of shallow geothermal systems for heating and cooling purposes when retrofitting existing and historical buildings. Analyzing the implementation process of borehole heat exchangers (BHEs), allows the understanding of how to promote the long-term sustainability of shallow geothermal energy systems. The thermal interference between BHE systems represents a problem, especially due to the increasing deployment of this technology and its spread in densely built-up areas. The main goal of this paper is to propose a conceptual model and to apply this to different case studies. The methodology includes phases to adopt an integrated approach for preventing long term thermal interference in neighbouring borehole heat exchangers, by providing management strategies and technical suggestions for design and operation. The method developed follows the following steps: 1) literature review to determine what are the main drivers for thermal interference between shallow geothermal systems, in the context of the GEO4CIVHIC project case study sites; 2) to create a conceptual model to limit thermal interference at both design and operational phases; 3) to apply the developed method to real and virtual case studies in countries with different regulatory frameworks and to test its main strengths and weaknesses. The application of this conceptual model to specific case studies provides evidence of critical planning and operational characteristics of GSHP systems and allows the identification of measures to mitigate impacts of thermal interference to be identified.

Impact of the 8th Edition of the AJCC-TNM Staging System on Estimated Cancer-Specific Survival in Patients Aged 45-54 Years at Diagnosis with Differentiated Thyroid Carcinoma: A Single Center Report.

BACKGROUND: The 8th edition of the American Joint Committee on Cancer (AJCC) staging system changed the age cutoff for risk stratification of differentiated thyroid carcinoma (DTC), downgrading patients between 45 and 54 years to stage I or II. The aim of our study was to assess cancer-specific survival (CSS) in patients aged 45-54 years, in order to document the prognostic capability of the last edition of the staging system. METHODS: We retrospectively reviewed the medical records of 172 patients that from January 1st, 2005, to May 31st, 2017, were diagnosed at our institution with DTC when aged 45-54 years. We restaged patients according to the 8th edition of the staging system and estimated CSS. RESULTS: 101 out of 172 patients (58.7%) were reallocated to a lower stage. Of the 101 downstaged patients, 88 (88.9%) showed a high or intermediate American Thyroid Association (ATA) risk of recurrence. We recorded no cancer-specific deaths. CONCLUSIONS: Risk of cancer-specific mortality in patients aged 45-54 years with DTC is low, supporting the prognostic capability of the 8th edition of the staging system. However, we recommend to consider carefully the significant proportion of patients at intermediate or high risk of recurrence in this group of patients.