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At least 19 records

Appendiceal endosalpingiosis: clinical presentation and imaging appearance of a rare condition of the appendix

Endosalpingiosis rarely affects the appendix but can be mistaken for acute appendicitis or appendiceal tumors. The medical literature regarding appendiceal endosalpingiosis is sparse; consisting of only four case reports which are primarily focused on the histopathology but provide little radiologic correlation. Endosalpingiosis is a rare condition characterized by the presence of benign fallopian tubal-like glandular epithelium derived from Mullerian ducts, usually affecting the serosal surfaces of the pelvis and peritoneum. It is histologically differentiated from endometriosis as endosalpingiosis lacks endometrial stroma. Endosalpingiosis tends to affect older women and has been associated with ovarian serous tumors of low malignant potential. After a retrospective review of a pathology database, we present pathologically proven cases of appendiceal endosalpingiosis with correlative imaging. We discuss the clinical presentation, illustrate the CT and MRI appearance, histologic characteristics, and review the current medical literature of appendiceal endosalpingiosis.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Obstruction-Free Survival Following Operative Intervention for Malignant Bowel Obstruction in Appendiceal Cancer

Background: Patients with peritoneal metastases from appendiceal cancer are at high risk of malignant bowel obstruction (MBO), which is associated with significant morbidity and mortality. There are no definitive treatment guidelines regarding operative intervention for MBO. We sought to evaluate the efficacy and safety of operative intervention in this population. Methods: We identified patients with peritoneal metastases from appendiceal cancer who underwent surgery for MBO at our institution between 2011 and 2018. Baseline characteristics, postoperative complications, and follow-up data were collected. The primary endpoint was obstruction-free survival (OFS). Other endpoints were postoperative recovery of bowel function, 60-day Clavien–Dindo (CD) morbidity, and overall survival (OS). Results: Twenty-six patients underwent operative treatment for MBO, of whom 14 had high-grade (HG) histology and 12 had low-grade (LG) histology. Seven (25.9%) patients had severe (CD grade 3 or higher) 60-day complications, including one (3.8%) postoperative death. All remaining patients had return of bowel function and resumed oral intake during hospitalization. Six (23.1%) patients had repeat admissions for MBO after surgery. Median OFS was 17.0 months (95% confidence interval [CI] 2.3–31.8), and median OS was 18.5 months (95% CI 3.6–33.3) following surgery. Conclusion: In this carefully selected group of patients with peritoneal metastases from appendiceal cancer, surgery for MBO provided durable palliation with acceptable morbidity.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Laparoscopic Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (L-CRS/HIPEC) for Perforated Low-Grade Appendiceal Mucinous Neoplasm (LAMN II)

Introduction: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is an established treatment for pseudomyxoma peritonei resulting from a perforated low-grade appendiceal mucinous neoplasm (LAMN II). In patients with localized disease, a laparoscopic procedure (L-CRS/HIPEC) can be undertaken. Methods: This video demonstrates L-CRS/HIPEC in a 66-year-old male who had previously undergone an appendicectomy for an LAMN II lesion. The preoperative computed tomography (CT) scan suggested disease localized to the right iliac fossa. However, laparoscopic assessment unexpectedly revealed disease in the pelvis and on the right hemidiaphragm and liver surface. Results: A technique for treating the thin film of mucin in the pelvis and on the right hemidiaphragm is demonstrated. The liver is mobilized to facilitate ablation of mucin on the serosal surface of the right lobe. Tips and tricks for starting the omentectomy, dealing with the vascular pedicle, and completing the dissection in the left upper quadrant are shown. The Peritoneal Cancer Index (PCI) score was 5 (3 for the right upper quadrant, 1 for the pelvis, 1 for the small bowel), and the cytoreduction score was CC-1. The operative duration was 8.5 h, and length of hospital stay was 5 days. The patient returned to work after 6 weeks. Discussion: L-CRS/HIPEC can be performed when patients are unexpectedly found to have disease, provided the appendiceal pathology is low grade and the PCI score is low. There are potential benefits to this approach, with a shorter length of hospital stay and faster functional recovery when compared with traditional open surgery.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Appendices for Geothermal Exploration Artificial Intelligence Report

The Geothermal Exploration Artificial Intelligence looks to use machine learning to spot geothermal identifiers from land maps. This is done to remotely detect geothermal sites for the purpose of energy uses. Such uses include enhanced geothermal system (EGS) applications, especially regarding finding locations for viable EGS sites. This submission includes the appendices and reports formerly attached to the Geothermal Exploration Artificial Intelligence Quarterly and Final Reports. The appendices below include methodologies, results, and some data regarding what was used to train the Geothermal Exploration AI. The methodology reports explain how specific anomaly detection modes were selected for use with the Geo Exploration AI. This also includes how the detection mode is useful for finding geothermal sites. Some methodology reports also include small amounts of code. Results from these reports explain the accuracy of methods used for the selected sites (Brady Desert Peak and Salton Sea). Data from these detection modes can be found in some of the reports, such as the Mineral Markers Maps, but most of the raw data is included the DOE Database which includes Brady, Desert Peak, and Salton Sea Geothermal Sites.

15 GEOTHERMAL ENERGY↗

WECC Variable Generation Planning Reference Book: Appendices

The document titled “WECC Variable Generation Planning Reference Book”. This book is divided into two volumes; one is the main document (volume 1)and the other is appendices (volume 2). The main document is a collection of the best practices and the information regarding the application and impact of variables generation on power system planning. This volume (appendices) has additional information on the following topics: Probabilistic load flow problems. 2. Additional useful indices. 3. high-impact low-frequency (HILF) events. 4. Examples of wide-area nomograms. 5. Transmission line ratings, types of dynamic rating methods. 6. Relative costs per MW-km of different electric power transmission technologies. 7. Ultra-high voltage (UHV) transmission. 8.High voltage direct current (VSC-HVDC). 9. HVDC. 10. Rewiring of existing transmission lines. 11. High-temperature low sag (HTLS) conductors. 12. The direct method and energy functions for transient stability analysis in power systems. 13.Blackouts caused by voltage instability. 14. Algorithm for parameter continuation predictor-corrector methods. 15. Approximation techniques available for security regions. 16. Impacts of wind power on power system small signals stability. 17. FIDVR. 18. FACTS. 19. European planning standard and practices. 20. International experience in wind and solar energy sources. 21. Western Renewable Energy Zones (WREZ). 22. various energy storage technologies. 23. demand response. 24. BA consolidation and cooperation options. 25. generator power management requirements and 26. European planning guidelines.

Makarov, Yuri V.↗

2020 natural gas LCA data appendices

This collection is the data-centric appendices for the report Life Cycle Analysis of Natural Gas Extraction and Power Generation: U.S. 2020 Emissions Profile. It consists of Appendix A: Additional Modeling Parameters [spreadsheet]; Appendix B: Water Burdens [spreadsheet]; Appendix D: Simulation of Liquids Unloading [python script and spreadsheet]; Appendix E: Detailed GHG Results for All Scenarios [spreadsheet]; Appendix F: Full Inventory Results [spreadsheet]; and Appendix I: Stage-Level Natural Gas Loss and Consumption Rates [spreadsheet].

Appendices↗

2020 natural gas LCA appendices Rev1

This collection is the data-centric appendices for the report Life Cycle Analysis of Natural Gas Extraction and Power Generation: U.S. 2020 Emissions Profile. It consists of Appendix A: Additional Modeling Parameters [spreadsheet]; Appendix B: Water Burdens [spreadsheet]; Appendix D: Simulation of Liquids Unloading [python script and spreadsheet]; Appendix E: Detailed GHG Results for All Scenarios [spreadsheet]; Appendix F: Full Inventory Results [spreadsheet]; and Appendix I: Stage-Level Natural Gas Loss and Consumption Rates [spreadsheet]. These results have been updated from the previous version (https://edx.netl.doe.gov/dataset/2020-natural-gas-lca-data-appendices) to correct a modeling error where the same post-processing natural gas composition was used instead of the intended regional compositions.

Appendices↗

Mucinous appendiceal neoplasms: classification, imaging, and HIPEC

Recent advances, specifically cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC), offer advantages compared to the traditional therapeutic approach of systemic chemotherapy in the treatment of peritoneal carcinomatosis from mucinous appendiceal neoplasms (MAN). This review provides an up-to-date, comprehensive summary of the histologic classification of MAN, reviews common imaging findings of mucoceles and pseudomyxoma peritonei, and describes the radiologist’s role in the multidisciplinary care team in quantifying disease and in helping select patients for definitive surgery.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Endovascular Repair of a Secondary Aorto-Appendiceal Fistula

Aortoenteric fistula (AEF) is an uncommon but serious complication occurring after aortic surgery and may occur at any site in the gastrointestinal tract, with the duodenum being the most common. Conventional surgical repair of secondary AEF has high mortality, whereas endovascular repair has emerged as an alternative treatment despite concerns about persistent or recurrent infection. We report the case of a 91-year old man who was admitted with rectal bleeding from an aorto-appendiceal fistula 9 years after open abdominal aortic aneurysm repair. This rare site for AEF was diagnosed on computed tomography, and we present the first case of endovascular treatment of this uncommon complication.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Percutaneous Radiofrequency Ablation of a Small Renal Mass Complicated by Appendiceal Perforation

Percutaneous radiofrequency ablation (RFA) has gained wide acceptance as nephron-sparing therapy for small renal masses in select patients. Generally, it is a safe procedure with minor morbidity and acceptable short-term oncologic outcome. However, as a result of the close proximity of vital structures, such as the bowel, ureter, and large vessels, to the ablative field, complications regarding these structures may occur. This is the first article describing appendiceal perforation as a complication of computed tomography-guided RFA despite hydrodissection. When performing this innovative and promising procedure one should be aware of the possibility of particular minor and even major complications.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

SunLine Transit Agency Advanced Technology Fuel Cell Bus Evaluation: Second Results Report and Appendices

This report describes operations at SunLine Transit Agency for their newest prototype fuel cell bus and five compressed natural gas (CNG) buses. In May 2010, SunLine began operating its sixth-generation hydrogen fueled bus, an Advanced Technology (AT) fuel cell bus that incorporates the latest design improvements to reduce weight and increase reliability and performance. The agency iscollaborating with the U.S. Department of Energy's (DOE) National Renewable Energy Laboratory (NREL) to evaluate the bus in revenue service. This is the second results report for the AT fuel cell bus since it was placed in service, and it focuses on the newest data analysis and lessons learned since the previous report. The appendices, referenced in the main report, provide the full backgroundfor the evaluation. They will be updated as new information is collected but will contain the original background material from the first report.

08 HYDROGEN↗

Preliminary Process and Market Evaluation: Better Buildings Neighborhood Program (Final Report Appendices)

This document was prepared as an account of work sponsored by an agency of the United States government. Neither the United States government nor any agency thereof, nor any of their employees, makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, usefulness, or any information, apparatus, product, or process disclosed, or represents that its use would not infringe privately owned rights. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, re commendation, or favoring by the United States government or any agency thereof. The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States government or any agency thereof.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗

H3 StingRAY Final Design and Technical Report - Section 13 Appendices

These documents are referenced in the public version of the H3 StingRAY Final Design and Technical Report (Linked Dataset can be found in Resources section, below), and are submitted separately to allow for public release of head document. The display names have the corresponding section number for easy reference.

16 TIDAL AND WAVE POWER↗

Smart Grid Status and Metrics Report Appendices

A smart grid uses digital power control and communication technology to improve the reliability, security, flexibility, and efficiency of the electric system, from large generation through the delivery systems to electricity consumers and a growing number of distributed generation and storage resources. To convey progress made in achieving the vision of a smart grid, this report uses a set of six characteristics derived from the National Energy Technology Laboratory Modern Grid Strategy. The Smart Grid Status and Metrics Report defines and examines 21 metrics that collectively provide insight into the grid’s capacity to embody these characteristics. This appendix presents papers covering each of the 21 metrics identified in Section 2.1 of the Smart Grid Status and Metrics Report. These metric papers were prepared in advance of the main body of the report and collectively form its informational backbone.

24 POWER TRANSMISSION AND DISTRIBUTION↗

Wind Vision. A New Era for Wind Power in the United States (Executive Summary, Full Report, and Appendices); U.S. Department of Energy (DOE), NREL (National Renewable Energy Laboratory)

The Wind Vision analysis demonstrates the economic value that wind power can bring to the nation, a value exceeding the costs of deployment. Wind’s environmental benefits can address key societal challenges such as climate change, air quality and public health, and water scarcity. Wind deployment can provide U.S. jobs, U.S. manufacturing, and lease and tax revenues in local communities to strengthen and support a transition of the nation’s electricity sector towards a low-carbon U.S. economy. The path needed to achieve 10% wind by 2020, 20% by 2030, and 35% by 2050 requires new tools, priorities, and emphases beyond those forged by the wind industry in growing to 4.5% of current U.S. electricity demand. Consideration of new strategies and updated priorities as identified in the Wind Vision could provide substantial positive outcomes for future generations.

17 WIND ENERGY↗

Test Protocols for Advanced Inverter Interoperability Functions - Appendices

Distributed energy resources (DER) such as photovoltaic (PV) systems, when deployed in a large scale, are capable of influencing significantly the operation of power systems. Looking to the future, stakeholders are working on standards to make it possible to manage the potentially complex interactions between DER and the power system. In 2009, the Electric Power Research Institute (EPRI), Sandia National Laboratories (SNL) with the U.S. Department of Energy (DOE), and the Solar Electric Power Association (SEPA) initiated a large industry collaborative to identify and standardize definitions for a set of DER grid support functions. While the initial effort concentrated on grid-tied PV inverters and energy storage systems, the concepts have applicability to all DER. A partial product of this on-going effort is a reference definitions document (IEC TR 61850-90-7, Object models for power converters in distributed energy resources (DER) systems) that has become a basis for expansion of related International Electrotechnical Commission (IEC) standards, and is supported by US National Institute of Standards and Technology (NIST) Smart Grid Interoperability Panel (SGIP). Some industry-led organizations advancing communications protocols have also embraced this work. As standards continue to evolve, it is necessary to develop test protocols to independently verify that the inverters are properly executing the advanced functions. Interoperability is assured by establishing common definitions for the functions and a method to test compliance with operational requirements. This document describes test protocols developed by SNL to evaluate the electrical performance and operational capabilities of PV inverters and energy storage, as described in IEC TR 61850-90-7. While many of these functions are not now required by existing grid codes or may not be widely available commercially, the industry is rapidly moving in that direction. Interoperability issues are already apparent as some of these inverter capabilities are being incorporated in large demonstration and commercial projects. The test protocols are intended to be used to verify acceptable performance of inverters within the standard framework described in IEC TR 61850-90-7. These test protocols, as they are refined and validated over time, can become precursors for future certification test procedures for DER advanced grid support functions.

14 SOLAR ENERGY↗

Final Report Feasibility Study for the California Wave Energy Test Center (CalWavesm) - Volume #2 - Appendices #16-17

The California Wave Energy Test Center (CalWave) Feasibility Study project was funded over multiple phases by the Department of Energy to perform an interdisciplinary feasibility assessment to analyze the engineering, permitting, and stakeholder requirements to establish an open water, fully energetic, grid connected, wave energy test center off the coast of California for the purposes of advancing U.S. wave energy research, development, and testing capabilities. Work under this grant included wave energy resource characterization, grid impact and interconnection requirements, port infrastructure and maritime industry capability/suitability to accommodate the industry at research, demonstration and commercial scale, and macro and micro siting considerations. CalWave Phase I performed a macro-siting and down-selection process focusing on two potential test sites in California: Humboldt Bay and Vandenberg Air Force Base. This work resulted in the Vandenberg Air Force Base site being chosen as the most favorable site based on a peer reviewed criteria matrix. CalWave Phase II focused on four siting location alternatives along the Vandenberg Air Force Base coastline and culminated with a final siting down-selection. Key outcomes from this work include completion of preliminary engineering and systems integration work, a robust turnkey cost estimate, shoreside and subsea hazards assessment, storm wave analysis, lessons learned reports from several maritime disciplines, test center benchmarking as compared to existing international test sites, analysis of existing applicable environmental literature, the completion of a preliminary regulatory, permitting and licensing roadmap, robust interaction and engagement with state and federal regulatory agency personnel and local stakeholders, and the population of a Draft Federal Energy Regulatory Commission (FERC) Preliminary Application Document (PAD). Analysis of existing offshore oil and gas infrastructure was also performed to assess the potential value and re-use scenarios of offshore platform infrastructure and associated subsea power cables and shoreside substations. The CalWave project team was well balanced and was comprised of experts from industry, academia, state and federal regulatory agencies. The result of the CalWave feasibility study finds that the CalWave Test Center has the potential to provide the most viable path to commercialization for wave energy in the United States.

16 TIDAL AND WAVE POWER↗