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This paper presents a model for the optimization of a multi-area distribution grid considering the high penetration levels of photovoltaic (PV) resources and electric vehicle charging station (EVCSs) based on distributed flexible AC transmission system (D-FACTS) devices including on-load tap changer (OLTC) transformers and step voltage regulator (SVR) tap control and shunt capacitor (SC) and shunt reactor (ShR) to reduce losses and voltage deviation. The overarching research aim was to avoid the overvoltage caused by power injection by PV sources and the voltage drop caused by charging EVs in distribution grids. The proposed model was designed based on distribution network load flow and was optimized using a modified particle swarm optimization (M-PSO) algorithm. Two different test networks were tested under different scenarios to analyze the proposed model, revealing the efficiency of the proposed model.

Introduction Prescribing long-term opioid therapy is a nuanced clinical decision requiring careful consideration of risks versus benefits. Our goal is to understand patient, provider and context factors that impact the decision to prescribe opioids in patients with cancer.Methods We conducted a secondary analysis of the raw semistructured interview data gathered from 42 prescribers who participated in one of two aligned concurrent qualitative studies in the USA and Australia. We conducted a two-part analysis of the interview: first identifying all factors influencing long-term prescribing and second open coding-related content for themes.Results Factors that influence long-term opioid prescribing for cancer-related pain clustered under three key domains (patient-related, provider-related and practice-related factors) each with several themes. Domain 1: Patient factors related to provider–patient continuity, patient personality, the patient’s social context and patient characteristics including racial/ethnic identity, housing and socioeconomic status. Domain 2: Provider-related factors centred around provider ‘personal experience and expertise’, training and time availability. Domain 3: Practice-related factors included healthcare interventions to promote safer opioid practices and accessibility of quality alternative pain therapies.Conclusion Despite the differences in the contexts of the two countries, providers consider similar patient, provider and practice-related factors when long-term prescribing opioids for patients with cancer. Some of these factors may be categorised as cognitive biases that may intersect in an already disadvantaged patient and exacerbate disparities in the treatment of their pain. A more systematic understanding of these factors and how they impact the quality of care can inform appropriate interventions.

Abstract The objective of this study was to investigate the effects of corn processing index (CPI)—particularly at 70% and 85%—in starter feed in combination with the provision of forage, either alfalfa hay (AH) or wheat straw (WS), on feed intake, growth performance, rumen pH, and blood metabolites of dairy calves. Forty-eight male Holstein calves (43.0 ± 1.5 kg body weight) were randomly assigned (n = 12 calves per treatment) to one of four dietary treatments: (1) a textured starter diet containing 70% CPI and AH (70CPIAH), (2) a textured starter feed containing 70% CPI combined with WS (70CPIWS), (3) a textured starter feed containing 85% CPI and AH (85CPIAH), (4) a textured starter feed containing 85% CPI combined with WS (85CPIWS). Intake of starter feed (TMR) and milk was individually monitored and recorded daily, while body weight was measured weekly. On days 30 and 65, blood samples were collected from all calves 3 h after morning feeding. No interaction was detected between the CPI of starter feed diets and forage provision for starter intake, dry matter intake (DMI), metabolizable energy intake (MEI), feed efficiency (FE), average daily gain (ADG), and body weight (BW). The preweaning and overall DMI, preweaning, postweaning and overall FE and ADG, preweaning and overall starter intake, preweaning and overall ME intake, and postweaning and overall BW were greater for calves fed 85CPI than those fed 70CPI starter diets. Postweaning and overall ADG and postweaning FE were greater in calves fed WS than those fed AH. Body length and hip width were greater for calves offered 85CPI than in fed 70CPI. Wheat straw supplementation increased rumen pH at day 65 in calves fed 70CPI, but not in those fed 85CPI. No interaction was found between the CPI in the starter feed diet and the forage source for starter intake and DMI, MEI, FE, and BW. The results showed that including corn with 85% processing index in dairy calf starters improved their growth performance.

Background and Aim: Enuresis is one of the common problems among children. The present pilot study was conducted to investigate the effect of Rosa damascene on nocturnal enuresis in children. Materials and Methods: A randomized pilot study was performed from April 2017 to March 2018. The study participants were 40 children aged between 5-12 years with nocturnal enuresis. They were randomly divided to intervention and control groups using block randomization. The intervention group received R. damascena petals under the brand name Gole-Ghand (Barij- essence, Iran) as 5 cc orally, every 8 hours for one month. The control group received desmopressin as nasal spray (Sina Darou, Iran) 1-2 puffs for one month (maximum 20 mg daily). The primary outcome was complete or partial improvement in enuresis. The secondary outcome was frequency of side effects in patients. Results: Twenty-two out of 39 patients 22 (56.4%) were male and 17 patients (43.6%) were female with the average age of 7.3±1.86 years. There was no noticeable distinction between the groups in age, sex, urbanity, history of treatment, and primary or secondary enuresis (p>0.05). Complete improvement was observed in 14 patients (70%) in the control group. Partial improvement was observed in four patients (20%) in the control group and in six patients (31.5%) in the intervention group (p:0.001). No side effect was reported during the study in the intervention group. Conclusion: Based on the results of this pilot study, the use of R. damascena may lead to partial improvement against enuresis in some children. Further studies are required to evaluate this hypothesis.

Introduction: The necessity of a dynamic education in the field of medicine with the aim of improving the quality of education in order to train more efficient doctors has always led to the provision of new educational methods. The purpose of this study is to investigate the effect of the implementation of the selected educational program of pediatric outpatient drugs on the level of knowledge of interns. Methods: This study is a two-group semi-experimental interventional study of pre-test-post-test type with a control group, which included 70 people (through random assignment, 35 people were considered as the control group and 35 people were considered as the intervention group) from the medical internship students of the year 2016-2018 academic year of Mashhad University of Medical Sciences who were introduced to Imam Reza, Qaim and Dr. Sheikh hospitals of Mashhad were selected by available sampling method. The data collection tool was a structured test titled measuring the level of students' knowledge and awareness of pediatric outpatient drugs, based on the variables studied. Data analysis was done using descriptive statistical methods (mean and frequency of standard deviation) and analysis of covariance test. Results: The mean and standard deviation of the interns' knowledge in the pre-test was 5.93±0.57 in the control group and 5.93±0.57 in the intervention group, and in the post-test the mean and standard deviation of the interns' knowledge in the control group (13.89±1.28) and intervention group (16.82±1.34). The average scores of the two control and intervention groups in the post-test were significant (p=0.001), which indicates the effect of the complementary educational program of pediatric outpatient medicine in the intervention group. The test statistic was (F=85.407). Conclusion: The present study confirmed the effect of the selected educational program of pediatric outpatient drugs on the promotion of regular education and as an effective supplementary education. Therefore, it seems that the implementation of this educational program in medical sciences universities across the country should be considered in the coming years.

Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, with substantial cardiac complications. Cardiac involvement is frequently reported in MIS-C patients and includes arrhythmia, coronary artery aneurysm and dilation, conduction abnormalities, and ventricular dysfunction. Cardiogenic or vasodilatory shock may develop in patients with severe MIS-C, necessitating inotropic support, fluid resuscitation, mechanical ventilation, and extracorporeal membrane oxygenation. Empirical therapies have attempted to reverse the inflammatory response, and steroids or intravenous immunoglobulin have all been commonly used. Most children will survive with prompt diagnosis and appropriate treatment, but since the disease's outcomes are unclear, long-term follow-ups are necessary. This narrative review summarizes the available studies regarding cardiac involvement in MIS-C cases as well as clinical considerations for cardiac examination and follow-up.

This paper addresses the new type of backscatter communication based on motion-modulated chipless Radio Frequency IDentification (RFID) tags. To clearly explain the concept, the different methods of backscatter communication are classified from a system point of view based on the two fundamental properties of linearity and variation in time. The principle of classical chipless RFID technology, as a non-modulated backscatter method, and the motion-modulated chipless RFID are described with general mathematical demonstrations, while the performance of the two approaches is compared in terms of read range. Motion-modulated chipless RFID is presented as an effective backscatter communication method for identification and sensing of moving objects at large distances. Three different types of motion-induced modulation as phase (Doppler) modulation, polarization modulation, and directional modulation are addressed based on three specially designed moving resonant scatterers. The modulation process in each case is theoretically described, and the performance of the motion-modulated tag is experimentally verified in terms of identification capability and large read range.

Abstract The directional amplitude backscatter modulation with suppressed Doppler is demonstrated based on the scattering from a symmetrically rotating resonant loop. The concept is studied theoretically and experimentally with perfectly compatible results. The symmetrical rotation of the scatterer and the effect of radial resonance, as the two crucial points to realize the idea, are highlighted through the comparison between the symmetric and non-symmetric cases, and the results obtained for scatterers with and without radial resonance. The presented backscattering modulation technique provides an amplitude modulating waveform which is uniquely linked to the directional reradiation pattern of the rotating loop scatterer in a definite resonant mode. With the pure directional amplitude modulation (DAM) induced on the backscattered wave, the envelope waveform can be accurately retrieved form the received signal using the In-phase and Quadrature (IQ) representation. The contribution of the background in a real environment can be detected and removed to obtain the exact modulating waveform. This property of the proposed backscattering modulation method can be applied for sensing, localization, and identification purposes with high sensitivity, read range, and robustness.

The current study was conducted to evaluate the effects of a yeast cell wall product (YCWP) on the performance, the population of Lactobacillus and coliform bacteria and PGC-1α, TLR4, IL-10 and PPARγ genes expression in the intestine of broilers. Dietary treatments were as follows: basal diet (control), control diet + 0.3 g/kg colistin or 0.15, 0.3, 0.45 and 0.6 g/kg YCWP. Feed intake and feed conversion ratio were lower in the YCWP-fed birds compared to the control. Colistin and YCWP fed birds had higher Lactobacillus and lower coliform bacteria counts than control birds (p

Background: Pulmonary hypertension (PH) is a common finding in chronic kidney disease (CKD) and is associated with increased mortality and morbidity. The effect of kidney transplantation on PH is not yet well evaluated. This study aimed to compare pulmonary artery pressure (PAP) before and after kidney transplantation in CKD patients.Methods: This longitudinal study was conducted on 33 CKD patients who were candidates for kidney transplantation in a tertiary hospital in Mashhad, Iran. Pulmonary artery pressure and ejection fraction (EF) were assessed using trans-thoracic echocardiography (TTE). Demographic and clinical findings, including age, gender, and body mass index (BMI), as well as laboratory assessments, including hemoglobin, serum calcium and phosphorus level, and parathyroid hormone, were recorded before transplantation. TTE assessment was repeated one year after transplantation. Results: Mean age of the study patients (17 males and 16 females) was 30.42 ± 9.71 years. The majority of patients (85%) received hemodialysis before transplantation. Compared to before transplantation, PAP significantly decreased (from 33.67 ± 6.78 to 26.06 ± 5.78 mmHg, p

Background: Enuresis is a common problem that affects up to 15% of 5‐year‐old children and may have significant psychological, emotional, and social consequences for both the child and their family. Enuresis is the inability of toilet‐trained children to hold urine during the night. It can be classified as primary and secondary. Secondary enuresis occurs in children who have had a dry duration of more than six months; otherwise, it is called primary enuresis. Objectives: This narrative review aims to summarize the available data on the epidemiology, etiology, pathophysiology, evaluation, and treatment of children with enuresis. Methods: This study was conducted through a literature search with the keywords based on Medical Subject Headings (MESH) and were combined with other keywords, including enuresis, pediatric, incontinence, and treatment using PubMed, Embase, Web of Sciences, Scopus, and Cochrane databases. Results: The initial evaluation of enuresis needs a detailed medical history and a careful physical examination with no need for radiology and invasive procedures. The treatment’s mainstay is non‐pharmacological treatments, such as behavioral intervention followed by pharmacotherapy. The appropriate treatment chosen depends on the children's age, midnight voiding patterns, and family and child preferences. Conclusions: Enuresis is a common disorder that affects both the child and the family in many ways. Enuresis's etiology is complex, and it is still not well understood. The child and family must be included in the treatment process, and potential pathophysiological causes must be taken into account.

Complex spin textures in itinerant electron magnets hold promises for next-generation memory and information technology. The long-ranged and often frustrated electron-mediated spin interactions in these materials give rise to intriguing localized spin structures such as skyrmions. Yet, simulations of magnetization dynamics for such itinerant magnets are computationally difficult due to the need for repeated solutions to the electronic structure problems. We present a convolutional neural network (CNN) model to accurately and efficiently predict the electron-induced magnetic torques acting on local spins. Importantly, as the convolutional operations with a fixed kernel (receptive field) size naturally take advantage of the locality principle for many-electron systems, CNNs offer a scalable machine learning approach to spin dynamics. We apply our approach to enable large-scale dynamical simulations of skyrmion phases in itinerant spin systems. By incorporating the CNN model into Landau-Lifshitz-Gilbert dynamics, our simulations successfully reproduce the relaxation process of the skyrmion phase and stabilize a skyrmion lattice in larger systems. The CNN model also allows us to compute the effective receptive fields, thus providing a systematic and unbiased method for determining the locality of the original electron models.

Introduction[1] The provision of nutrients during the late gestation not only affects maternal status and reproductive performance, but also affects prenatal and postnatal litter growth and offspring’s health. Although trace elements are needed by the body in small amounts, they are essential nutrients for several metabolic functions such as growth, development, reproduction, and immunity. Copper (Cu) is often one of the most limiting trace elements for the fetus and neonate for normal development and copper play a major etiologic role in decrease of fetal growth and development. Deficiency of copper impairs fetal growth and causes serious consequences and can cause death. When intakes of Cu are deficient, maternal transfer of Cu to the fetus is insufficient for normal development, and abnormalities to the central nervous system, skeleton, and metabolism result. In ruminants, newborn animals are dependent on their dams for transferring nutrients via the placenta and mammary glands. To our knowledge, little information is available on the effects of maternal supplementation of copper via intra-ruminal administration of slow-release bolus at the late gestation on the copper status of ewes and their lambs. Because the slow-release ruminal bolus cannot be used in the newborn lambs until weaning, this study aimed to determine the effects of maternal supplementation of copper via intra-ruminal administration of slow-release boluses at the late gestation (8 weeks prepartum) on performance and some blood metabolites of ewes and their lambs until weaning.Materials and Methods To evaluate the performance and changes in some blood parameters of lambs born from ewes receiving slow-release boluses of copper, 80 Lori-Bakhtiari ewes (The fourth pregnancy with a body condition score 3 to 3.5) were divided into two groups of 40 heads each in a completely randomized design. Treatments were 1) control ewes and 2) ewes received slow-release boluses of copper, 60 days prepartum. After parturition, birth weight, sex, and the birth status of lambs (singlet or twin) were recorded. Lambs were weighed at birth and weaning at age 90 days. On the first day, days 10 and 60 postpartum, blood samples were taken from the ewes, while the blood samples of their lambs were taken at age 10 and 60 days. Serum samples were used to determine copper and ceruloplasmin concentrations in the ewes and their lambs, while iron, zinc, hematocrit, red blood and white cells, and hemoglobin were only determined in the born lambs.Results and Discussion The serum concentration of copper in the ewes were within the normal physiological range of 0.55 to 0.95 mg/l. Serum copper and ceruloplasmin concentrations of ewes at the first day of experiment were lower compared to days 10 and 60 postpartum (P0.05). Lambs born from ewes receiving slow-release bolus of copper had higher weaning weight, average daily weight gain, copper and ceruloplasmin concentrations, hematocrit percentage, red and white blood cell counts, and hemoglobin concentration compared to those born from control ewes (P

BackgroundSteroid resistant nephrotic syndrome (SRNS) represents a significant renal disease burden in childhood and adolescence. In contrast to steroid sensitive nephrotic syndrome (SSNS), renal outcomes are significantly poorer in SRNS. Over the past decade, extensive genetic heterogeneity has become evident while disease-causing variants are still only identified in 30% of cases in previously reported studies with proportion and type of variants identified differing depending on the age of onset and ethnical background of probands. A genetic diagnosis however can have implications regarding clinical management, including kidney transplantation, extrarenal disease manifestations, and, in some cases, even causal therapy. Genetic diagnostics therefore play an important role for the clinical care of SRNS affected individuals.Methodology and resultsHere, we performed NPHS2 Sanger sequencing and subsequent exome sequencing in 30 consanguineous Iranian families with a child affected by SRNS with a mean age of onset of 16 months. We identified disease-causing variants and one variant of uncertain significance in 22 families (73%), including variants in NPHS1 (30%), followed by NPHS2 (20%), WT1 (7%) as well as in NUP205, COQ6, ARHGDIA, SGPL1, and NPHP1 in single cases. Eight of these variants have not previously been reported as disease-causing, including four NPHS1 variants and one variant in NPHS2, ARHGDIA, SGPL1, and NPHP1 each.ConclusionIn line with previous studies in non-Iranian subjects, we most frequently identified disease-causing variants in NPHS1 and NPHS2. While Sanger sequencing of NPHS2 can be considered as first diagnostic step in non-congenital cases, the genetic heterogeneity underlying SRNS renders next-generation sequencing based diagnostics as the most efficient genetic screening method. In accordance with the mainly autosomal recessive inheritance pattern, diagnostic yield can be significantly higher in consanguineous than in outbred populations.

Abstract Algae are the main primary producers in aquatic environments and therefore of fundamental importance for the global ecosystem. Mid-infrared (IR) microspectroscopy is a non-invasive tool that allows in principle studying chemical composition on a single-cell level. For a long time, however, mid-infrared (IR) imaging of living algal cells in an aqueous environment has been a challenge due to the strong IR absorption of water. In this study, we employed multi-beam synchrotron radiation to measure time-resolved IR hyperspectral images of individual Thalassiosira weissflogii cells in water in the course of acclimation to an abrupt change of CO2 availability (from 390 to 5000 ppm and vice versa) over 75 min. We used a previously developed algorithm to correct sinusoidal interference fringes from IR hyperspectral imaging data. After preprocessing and fringe correction of the hyperspectral data, principal component analysis (PCA) was performed to assess the spatial distribution of organic pools within the algal cells. Through the analysis of 200,000 spectra, we were able to identify compositional modifications associated with CO2 treatment. PCA revealed changes in the carbohydrate pool (1200–950 cm $$^{-1}$$ - 1 ), lipids (1740, 2852, 2922 cm $$^{-1}$$ - 1 ), and nucleic acid (1160 and 1201 cm $$^{-1}$$ - 1 ) as the major response of exposure to elevated CO2 concentrations. Our results show a local metabolism response to this external perturbation.

Effects of milk feeding strategy and acidification on calf growth, metabolic traits, oxidative stress, and health were evaluated in the first 78 days of life. Holstein calves (N = 48; 12 calves/treatment) were assigned to 1 of the 4 treatments in a 2 × 2 factorial arrangement of milk feeding strategy [6 L/d (MOD) or 12 L/d (HIGH) of milk] and acidification [non-acidified milk (NAM) or acidified milk (ACM)] on day 2. Calves were bucket-fed milk as follows: 6 L/d from days 2 to 49 for MOD and 6 L/d from days 2 to 49, 12 L/d from days 7 to 42, and 8 L/d from days 43 to 49 for HIGH calves. All calves were then fed 4 L/d from days 50 to 56. Starter and water were available ad libitum, while hay was fed at 5% of starter from day 64. Calves were weighed, measured, and blood (except days 14, 42 and 56) sampled on days 2, 14, 28, 42, 49, 56, 63 and 78. Data were analyzed using Mixed PROC of SAS with time as repeated measurements. Fecal scores, checked daily, were examined by the logistic regression using a binomial distribution in GLIMMIX procedure. There were no three-way interactions observed for all the parameters. We detected a milk feeding strategy × time interaction for starter intake, body weight, ADG, ADG/ME, FE, structural measurements, and glucose. Although, overall (558.0 vs. 638.6 g/d), HIGH calves tended to consume less starter compared to MOD, significant differences were only observed in week 8. The HIGH calves had greater ADG during days 2–14 (1.12 vs. 0.75 kg/d) and tended to have greater ADG on days 15–28 (0.79 vs. 0.55) and 29–42 (0.86 vs. 0.60) and lower on days 57–63 (0.11 vs. 0.38) compared to MOD calves. The HIGH calves had greater BW from days 28 to 78 compared to MOD, while NAM were bigger compared to ACM calves from days 49 to 78. The HIGH calves had lower overall feed and metabolizable energy efficiencies compared to MOD. Except for BW and heart girth, no milk acidification × time interaction was observed for starter intake, ADG, FE, or ADG/ME. Blood glucose in calves fed NAM-HIGH and ACM-HIGH were greater compared to those fed moderate milk volumes on day 28 only. Albeit, feeding strategy had no effect, calves fed ACM had lower likelihood of experiencing diarrhea (odds ratio = 1.32; 95% confidence interval: 1.018–1.698) compared to those fed NAM. Overall milk feeding strategy had no effect on growth, while milk acidification reduced growth in calves, despite lowering the likelihood of experiencing diarrhea.

The aim of this study was to investigate interactions between milk feeding quantity (FL) and feeding frequency (FF) on intake, growth performance, rumen development and blood metabolites in dairy calves. A total of 48 Holstein calves (n = 12 calves per treatment: 6 males and 6 females) were randomly assigned to one of four treatments, including (1) two low plane of milk feeding (2 meals/d, LPM-2×; 3 meals/d, LPM-3×; total milk intake = 210 L) and two high plane of milk feeding (2 meals/d, HPM-2×; 3 meals/d, HPM-3×; total milk intake = 371 L). Calves fed HPM had higher BW, ADG, blood glucose and triglycerides concentration during the preweaning. Calves fed HPM received more ME, total DMI and ate less starter than LPM calves during preweaning. Regardless of the milk feeding quantity, with increasing FF, starter intake, total DMI and ME were reduced without a negative effect on ADG. Calves fed 3 times/d compared with 2 times/d had a lower final hip width. Calves fed HPM had higher ruminal pH and molar proportion of acetate and acetate to propionate ratio, but less molar proportion of propionate and butyrate and total VFA compared with calves fed LPM on d 35 of the study. Interaction between milk feeding level and feeding frequency was observed for plasma glucose concentration with HPM-3× calves having the greatest value at d 35 of study. In conclusion, at both levels of milk feeding, calves did not benefit from the increased feeding frequency, but calves benefitted from HPM.Highlights Calves did not benefit from increased milk feeding frequency at either low or high plane of milk feeding. The performance of calves on low plane of milk feeding was constrained by the low nutrient intake and not the feeding frequency. Regardless of plane of milk feeding, feeding 3 meals/d reduced total DM and starter intake with no detrimental effects on overall average daily gain.

Forty pregnant dairy goats were used in a 2 × 2 factorial arrangement of treatments to evaluate the effects of prepartum supplementation of selenium (Se) and iodine (I) as slow-release boluses. The boluses were administered four weeks prior to the expected kidding time to supply daily amounts of (1) 0 mg Se and 0 mg I, (2) 0 mg Se and 0.40 mg I, (3) 0.25 mg Se and 0 mg I and (4) 0.25 mg Se and 0.4 mg I. Milk production, milk fat percentage, daily production of milk components, milk selenium and iodine concentrations were greater in goats received 0.25 mg Se/day than no supplemental Se (p

A 2 × 3 factorial experiment was conducted to investigate the effects of silymarin-nanohydrogle (0, 500 free; 500 nano) and a mycotoxin (0; 2.2 mg/kg), silymarin contaminated diet on productive performance and certain serum biochemical parameters using 72 Japanese quail chicks in days 7–35 of age. Six experimental treatments consisting inclusion of 0 or 2.2 mg/kg aflatoxins in a basal diet fed to the birds receiving 0 or 500 mg/L silymarin in two free- or nanohydrogle forms via drinking water. Daily weight gain (DWG) and European production index (EPI) reduced by 6.7% and 13.6% while feed intake (FI) and FCR increased by 3.76% and 12% in the birds fed on the diet containing 2.2 mg/kg aflatoxin, respectively (p