Search

Abstract Peer‐to‐peer (P2P) energy trading is expected to be emerged as a new energy management paradigm that allows the transaction of energy from one prosumer to another prosumer without any dependency on a central controller. In Malaysia, first pilot test of P2P trading has been conducted recently, which exclusively participated by industrial prosumers and commercial consumers only. In order to investigate the impact of P2P energy trading to Malaysia market, this paper proposes an auction‐based two‐stage P2P trading market‐clearing strategy, for multi‐cities and intra‐city in Malaysia. A motivational game theory‐based price scheme is presented to ensure an unbiased market operation, to maximize the saving and payoff for each prosumer, at the same time benefits the power utility company. The proposed two‐stage market clearing model is solved by Linear Programming optimization approach. A realistic representation of P2P trading in Malaysia is constructed and tested out under multi‐cities and intra‐city energy trading test cases. Comparison between the proposed P2P energy trading with existing solar generation net metering scheme is also presented. The numerical results indicate the viability and potential of motivational game theory based P2P trading in future Malaysia transactive energy market.

BackgroundWilson’s disease (WD) is a rare cause of acute liver failure (ALF) and has a high fatality rate. Rapid and accurate diagnosis is important for ALF because of WD (ALF-WD). Our objective was to establish a simple, rapid, and accurate diagnostic test to distinguish ALF-WD from non-WD ALF (NWDALF) in children.Materials and methodsThe data from all cases with pediatric ALF were retrospectively collected and analyzed. We performed receiver operator characteristics curve (ROC) analysis and confirmed the optimum cut-off points.ResultsFifty-eight patients with pediatric ALF (12 with WD, 46 with other etiologies) were included. Older age was observed in ALF-WD compared to NWDALF (11.16 ± 2.51 years vs. 3.34 ± 3.81 years, p < 0.001). An analysis based on routine biochemical testings revealed that total bilirubin (TBil), direct bilirubin, indirect bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST:ALT ratio, alkaline phosphatase (ALP), ALP:TBil ratio, serum albumin, gamma-glutamyl transferase, cholinesterase, hemoglobin, and platelet were statistically significant between the ALF-WD and NWDALF groups. The optimum cut-off points were obtained through ROC analysis. A scoring system was formed by assigning a score of 1 or 0 to patients who met the 13 cut-off points. Using ROC analysis, we determined a cut-off point of ≥ 6.5 for ALF-WD with 91.7% sensitivity and 97.8% specificity (p < 0.0001). In addition, a best cut-off point of ≥ 1.5 based on only five variables (ALT, AST, AST:ALT ratio, ALP, and ALP:TBil ratio), had 100% sensitivity and 91.3% specificity for ALF-WD (p < 0.0001). Based on this, when age was calculated as the sixth indicator, the best cut-off value of ≥ 2.5 had 100% sensitivity and 97.8% specificity (p < 00.0001).ConclusionOur study developed a new scoring system that consists of simple laboratory tests with good sensitivity and specificity and can be used by clinicians to quickly distinguish ALF-WD from NWDALF in children.

Citrus is an essential horticultural fruit whose yield and quality are affected by salinity all over the world. The recognition and adaptive regulation of citrus against salt stress are important areas for cultivar improvement, but the vascular system signal transduction mechanism of the plant response to salt stress remains elusive. In this study, we constructed a dodder (Cuscuta spp.) linked Hamlin sweet orange (Citrus sinensis) plant community in which deliver a vascular signal through the dodder in response to salt stress. RNA-seq technology was used to analyze the gene expression profile of citrus leaves after salt treatment. The results showed that a vascular signal was transmitted to a dodder-linked host plant, triggering a transcriptional response to salt stress. However, the phenotypic and transudative ability of the dodder changed after 24 h. The salt treatment group (Group S) and the dodder-linked group (Group D) respectively contained 1,472 and 557 differentially expressed genes (DEGs). 454 of which were common to both groups. The results of our analysis revealed that the gene expression categories in Group D represented a highly consistent trend compared to the group S plants, indicating that the dodder-bridged vascular signals activated the stress-response of citrus leaves for transcriptomic reconfiguration. The KEGG pathway database and an analysis of key drivers revealed that phenylpropanoid biosynthesis, photosynthesis-antenna proteins, starch and sucrose metabolism, plant hormone signal transduction, circadian rhythm, and MAPK signaling pathways were significantly enriched as the critical genes during salt stress. A systemic signal in the dodder-bridged host significantly regulated abiotic stress-related secondary metabolic pathways, including those for phenylpropanoids, lignin, and lignans. The physiological indexes of photosynthetic intensity, respiration, and attractiveness among communities supported the transcriptional changes. Thus, our results indicate that salt stress-induced vascular system signals can be transmitted through the vascular system of a dodder linking citrus plants, revealing the genetic regulation and physiological changes of citrus leaves responding to plant stress signal transmission.

Acupuncture treatment in local areas is commonly used to treat pain or soreness; however, acupuncture around the neck or shoulder may be a risk factor for pneumothorax. Herein, we report two cases of iatrogenic pneumothorax after acupuncture. These points indicate that physicians should be aware of these risk factors through history-taking before acupuncture. Chronic pulmonary diseases, such as chronic bronchitis, emphysema, tuberculosis, lung cancer, pneumonia, and thoracic surgery, may be associated with a higher risk of iatrogenic pneumothorax after acupuncture. Even if the incidence of pneumothorax should be low under caution and fully evaluated, it is still recommended to arrange further imaging examinations to rule out the possibility of iatrogenic pneumothorax.

Abstract Background Healthcare workers are usually the first responders during outbreaks and are instrumental in educating the populace about the prevention of different diseases and illnesses. The aim of this study was to assess the association between healthcare workers’ characteristics and knowledge, attitudes and practices toward Zika virus. Methods This was a cross-sectional study that collected data from healthcare workers at 3 medical facilities using a validated self-administered questionnaire between July 2017 – September 2017. Logistic regression models were used to examine the association between sociodemographic and knowledge, attitudes, and practices. Results A total of 190 healthcare workers were analyzed. Of these, 60, 72.6 and 64.7% had good knowledge, positive attitudes, and good practices toward Zika virus, respectively. Healthcare workers without a formal degree were less likely to have good knowledge of Zika virus (adjusted odds ratio (AOR) = 0:49; 95% confidence interval (CI) = 0.24–0.99) compared to those with a formal degree. Reduced odds for positive attitude towards Zika virus were observed in healthcare workers with low income as compared to those with high income (AOR = 0.31; 95% CI =0.13–0.75). Being younger than 40 years old was associated with poor Zika virus practices (AOR = 0:34; 95% CI = 0.15–0.79). Conclusions Significant association between healthcare workers’ sociodemographic characteristics and Zika virus knowledge, attitudes and practices were observed. Public health interventions that seek to increase Zika virus awareness should aim to train healthcare workers who are younger, without formal degree and those earning low income.

Abstract Potential mechanisms of depression involving herbal medicines and their specific compounds include elevated 5‐HT level and downstream BDNF pathway. To identify potentially new combined therapeutic strategies, 3,6'‐disinapoylsucrose (DISS) and tenuifoliside A (TFSA) have been observed to show antidepressant‐like effects and its related 5‐HT‐BDNF pathway. We have tried to investigate whether combined administration of DISS and TFSA exerted more effective in the treatment of depression, as assessed through tail suspension test (TST) and forced swimming test (FST). In addition, we also analyzed the expression of three important proteins, cyclic adenosine monophosphate (cAMP) response element binding (CREB), brain‐derived neurotrophic factor (BDNF), and cAMP‐regulated transcriptional coactivators (CRTC1), which have been shown to be involved in the regulation of the neurotrophic factors in the hippocampus. The DISS and TFSA separately, both at a dose of 5 mg/kg each, displayed small effect in the immobility time. However, combined treatment of these two in multiple doses exhibited better effect. Moreover, combined treatment of DISS and TFSA also demonstrated enhanced levels of 5‐hydroxytryptamine (5‐HT), and stronger increase in the phosphorylation levels of CREB, BDNF, and CRTC1 proteins in the hippocampus. Overall, our results indicated that coadministration of these two oligosaccharide esters at low dose may induce more pronounced antidepressant activity, in comparison with individual treatment even at high dosage. Thus, the antidepressant properties of both these compounds can be attributed to their ability to influence 5‐HT and BDNF pathway, and thereby suggesting that this combination strategy can definitely act as alternative therapy for depression disorder with very limited side effects.

Abstract Background To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection. Methods In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were included between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival (DSS) among different quality of neck dissection. Results Of the 1765 patients identified, 1108 (62.8%) had oral cancer, 1141 (64.6%) were men, and 1067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval [CI] 0.49–0.84) in those with

Abstract Background High quality lymph node (LN) yield could increase survival, however strategies to improve LN yield have been seldom reported. This study aimed to assess the multiple-step action to promote quality of neck dissection in oral cancer. Methods A total of 400 patients with oral cancer who underwent primary tumor resection and neck dissection, including elective and radical neck dissection, were recruited after propensity score matching by clinical T and N categories between January 2009 and September 2018. Patients were treated by two independent departments in our institute. A multiple-step action was initiated in October 2015 in one department, and another department was as a control group. The impact of multiple-step action on LN yield and regional recurrence were analyzed using multivariate analysis and difference-in-differences (DID) linear regression analysis. Results The mean patient age was 55.2 + 11.1 years, and 92% were male. A total of 180 (45%) patients had T3-4 disease, and 129 (32%) patients had N2-3 disease. The multivariate linear regression and DID analyses revealed that multiple-step action had a positive effect on LN yield. A net improvement of LN yield with a coefficient of 13.78 (p

Abstract Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC) patients. This study aims to determine whether combining radiotherapy with sorafenib administration increases its efficacy. The study cohort included 4763 patients with diagnosed advanced HCC who received sorafenib between January 2012 and December 2015, as reported in medical records in the Taiwan Cancer Registry database. The effect of sorafenib with or without radiotherapy on survival was calculated using the Kaplan–Meier method and compared using the log-rank test. A Cox proportional hazards model was used for multivariate analysis. Patients receiving sorafenib plus radiotherapy had greater 1-year survival than did those receiving sorafenib alone (P

We report enzymes from the berberine bridge enzyme (BBE) superfamily that catalyze the oxidative cyclization of the monoterpene moiety in cannabigerolic acid (CBGA) to form cannabielsoin (CBE). The enzymes are from a variety of organisms and are previously uncharacterized. Out of 232 homologues chosen from the enzyme superfamily, four orthologues were shown to accept CBGA as a substrate and catalyze the biosynthesis of CBE. The four enzymes discovered in this study were recombinantly expressed and purified in Pichia pastoris. These enzymes are the first report of heterologous expression of BBEs that did not originate from the Cannabis plant that catalyze the production of cannabinoids using CBGA as substrate. This study details a new avenue for discovering and producing natural and unnatural cannabinoids.

Zinc-copper alloy ash contains Cu, Zn, Al, Ni, Sn, Pb and other non-ferrous metals. In this paper, t he effective treatment of zmccopper ash in different particle size ranges ss realized by screening. The effects of sulfuric acid content, temperature, time, i iquid-soiid ratio, rotation speed, oxidant and roasting conditions on the selective eaching of different meta! were investigated. The resutts show that the zinccopper ash with partid size kss than 0. 15 mm ss caHned at 750 °C for 3 hours, and then leached at 85 °C, s uHunc acid content of 1. 2 g/g ash, iiquid-to-solid ratio of 5/1, sirring speed of 400 r/min, H202 0. 075 mL/g ash for 5 h. The removal rate of zinc ss 93. 40%, and the removal rate of copper ss 0. 23%. Compared with the initia1 copper ash, the ZnO n the copper ash after roasting and leaching ss greatly reduced. The leaching residue was mixed with copper slag with a particle size of 0. 15-0. 25 mm, roasted at 750 C for 4 hours, and then washed wI 2 mol/L suHurtc acid solution for 5 hours and washed wI water under the same condiions. The steps can remove a !arge number of impurtty metal e!ements inthe copper slag. The phase composition of the copper slag after pickling is mainly Cu, and the proportion of Cu elements reach 92. 52%. [ABSTRACT FROM AUTHOR]

Cohabitation has become more common in communities that have experienced demographic transitions, including in Taiwan, and hence it has become a research interest. However, our understanding of cohabitation in Taiwan has been limited to indirect estimations and cross-sectional analysis due to the lack of appropriate data. These analyses can provide a quick overview of the prevalence of cohabitation at specific periods, but they cannot portray the risk of cohabitation over the life course. Using recent panel data from the Taiwan Youth Project, we estimate cohabitation risk among young adults in their mid-20s to early-30s. We also examine the determinants of cohabitation. Results show that being a woman, not employed, living in emerging regions, not having varying residential locations, ever having sex (especially at an earlier age), and being more open to premarital intimacy were associated with higher odds of cohabitation. [ABSTRACT FROM AUTHOR]

Lightning strikes can cause equipment damage and power outages, so the distribution system's reliability in withstanding lightning strikes is crucial. This research paper presents a model that aims to optimise the configuration of a lightning protection system (LPS) in the power distribution system and minimise the System Average Interruption Frequency Index (SAIFI), a measure of reliability, and the associated cost investment. The proposed lightning electromagnetic transient model considers LPS factors such as feeder shielding, grounding design, and soil types, which affect critical current, flashover rates, SAIFI, and cost. A metaheuristic algorithm, PSOGSA, is used to obtain the optimal solution. The paper's main contribution is exploring grounding schemes and soil resistivity's impact on SAIFI. Using 4 grounding rods arranged in a straight line under the soil with 10 Ωm resistivity reduces grounding resistance and decreases SAIFI from 3.783 int./yr (no LPS) to 0.146 int./yr. Unshielded LPS has no significant effect on critical current for soil resistivity. Four test cases with different cost investments are considered, and numerical simulations are conducted. Shielded LPSs are more sensitive to grounding topologies and soil resistivities, wherein higher investment, with 10 Ωm soil resistivity, SAIFI decreases the most by 73.34%. In contrast, SAIFIs for 1 kΩm and 10 kΩm soil resistivities show minor decreases compared to SAIFIs with no LPS. The study emphasises the importance of considering soil resistivity and investment cost when selecting the optimal LPS configuration for distribution systems, as well as the significance of LPS selection in reducing interruptions to customers. [ABSTRACT FROM AUTHOR]

Background: The increasing rates of Caesarean section (CS) beyond the WHO standards (10–15%) pose a significant global health concern.Objective: Systematic review and meta-analysis to identify an association between CS history and maternal adverse outcomes for the subsequent pregnancy and delivery among women classified in Robson classification (RC).Search Strategy: PubMed/Medline, EbscoHost, ProQuest, Embase, Web of Science, BIOSIS, MEDLINE, and Russian Science Citation Index databases were searched from 2008 to 2018.Selection Criteria: Based on Robson classification, studies reporting one or more of the 14 adverse maternal outcomes were considered eligible for this review.Data Collection: Study design data, interventions used, CS history, and adverse maternal outcomes were extracted.Main Results: From 4,084 studies, 28 (n = 1,524,695 women) met the inclusion criteria. RC group 5 showed the highest proportion among deliveries followed by RC10, RC7, and RC8 (67.71, 32.27, 0.02, and 0.001%). Among adverse maternal outcomes, hysterectomy had the highest association after preterm delivery OR = 3.39 (95% CI 1.56–7.36), followed by Severe Maternal Outcomes OR = 2.95 (95% CI 1.00–8.67). We identified over one and a half million pregnant women, of whom the majority were found to belong to RC group 5.Conclusions: Previous CS was observed to be associated with adverse maternal outcomes for the subsequent pregnancies. CS rates need to be monitored given the prospective risks which may occur for maternal and child health in subsequent births.