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Food dyes with a diverse set of colorants stimulate appetite and enhance aesthetic charm of food on table but at the same time these dyes contaminate the aquatic and biological ecosystems due to their cytotoxic and carcinogenic potentials. Herein, we report magnetite catalyzed removal of sunset yellow dye from water through catalytic degradation and ozonation. The magnetite catalyst revealed about 83% catalytic degradation and 92% catalytic ozonation performance toward sunset yellow dye at 100 and 25 min, respectively. Furthermore, the persulphate/magnetite/O3 hybrid system revealed superior performance compared to the persulphate/magnetite under identical conditions. Kinetic studies revealed that the dye degradation data followed second-order kinetics, suggesting that the dye removal process is physicochemical in nature. This study further demonstrates that the persulfate/magnetite/O3 hybrid system can efficiently decompose sunset yellow dye in aqueous solution compared to the Fenton’s reagent and simple catalytic decomposition processes which is attributed to its unique structural features.

The study investigated the effects of grape seed extract (GSE) supplementation on laying hens aged 30–35 weeks. Hens were assigned to four groups: a control group with only basal diet and three experimental groups with basal diet supplemented with 250 (GSE 250), 500 (GSE 500) and 750 (GSE 750) mg/kg GSE. GSE-supplemented groups showed significantly lower feed intake in week 1 and 3 in GSE 750. No significant differences were observed in feed efficiency, egg weight, shell thickness, yolk weight, albumin weight, or Haugh Unit, suggesting GSE did not significantly impact these parameters. Egg production significantly increased in groups supplemented with 500 and 750 mg/kg GSE compared to the control group. Additionally, GSE-supplemented birds exhibited significantly lower levels of malondialdehyde (MDA), a marker of lipid peroxidation, indicating potential antioxidant effects. The study further revealed a significant increase in Lactobacillus at GSE500 and GSE 750 levels and a significant reduction in E. coli levels with GSE 750 supplementation, suggesting potential benefits on gut microbiota. In conclusion, GSE positively influenced egg production, promoted Lactobacillus growth, and reduced lipid peroxidation and E. coli populations. However, reproductive efficiency in golden laying hens was not significantly affected. These findings contribute valuable insights into the potential benefits of GSE in poultry nutrition.

Abstract Bacterial canker disease caused by Clavibacter michiganensis is a substantial threat to the cultivation of tomatoes, leading to considerable economic losses and global food insecurity. Infection is characterized by white raised lesions on leaves, stem, and fruits with yellow to tan patches between veins, and marginal necrosis. Several agrochemical substances have been reported in previous studies to manage this disease but these were not ecofriendly. Thus present study was designed to control the bacterial canker disease in tomato using green fabricated silver nanoparticles (AgNps). Nanosilver particles (AgNPs) were synthesized utilizing Moringa oleifera leaf extract as a reducing and stabilizing agent. Synthesized AgNPs were characterized using UV–visible spectroscopy, scanning electron microscopy (SEM), X-ray diffraction (XRD), energy-dispersive X-ray (EDX), and Fourier transform infrared spectrometry (FTIR). FTIR showed presence of bioactive compounds in green fabricated AgNPs and UV-visible spectroscopy confirmed the surface plasmon resonance (SPR) band in the range of 350 nm to 355 nm. SEM showed the rectangular segments fused together, and XRD confirmed the crystalline nature of the synthesized AgNPs. The presence of metallic silver ions was confirmed by an EDX detector. Different concentrations (10, 20, 30, and 40 ppm) of the green fabricated AgNPs were exogenously applied on tomato before applying an inoculum of Clavibacter michigensis to record the bacterial canker disease incidence at different day intervals. The optimal concentration of AgNPs was found to be 30 µg/mg that exhibited the most favorable impact on morphological (shoot length, root length, plant fresh and dry weights, root fresh and dry weights) and physiological parameters (chlorophyll contents, membrane stability index, and relative water content) as well as biochemical parameters (proline, total soluble sugar and catalase activity). These findings indicated a noteworthy reduction in biotic stress through the increase of both enzymatic and non-enzymatic activities by the green fabricated AgNPs. This study marks a first biocompatible approach in assessing the potential of green fabricated AgNPs in enhancing the well-being of tomato plants that affected with bacterial canker and establishing an effective management strategy against Clavibacter michiganensis. This is the first study suggests that low concentration of green fabricated nanosilvers (AgNPs) from leaf extract of Moringa oleifera against Clavibacter michiganensis is a promisingly efficient and eco-friendly alternative approach for management of bacterial canker disease in tomato crop.

Objective: To determine the outcome of early and late-onset Fontan operation in patients with univentricular heart repair. Study Design: Quasi-experimental study. Place and Duration of the Study: Department of Paediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi Pakistan, from Jan 2019 to Dec 2021. Methodology: During the study period, 121 patients of both genders, up to any age, with functionally univentricular hearts and who planned to undergo Fontan procedures were included. All cases were divided into two groups, Group-A had patients who underwent extra-cardiac Fontan at age ≤6 years, while Group B had patients who underwent extra-cardiac Fontan at age >6 years. Pre-procedure diagnosis, demographic, anatomic and hemodynamic characteristics, post-Fontan procedure morbidity and mortality were noted. Results: As per inclusion/exclusion criteria, 121 cases underwent Fontan surgery during the study period. There were 61(50.4%) male patients. Overall, the mean age was 7.02±4.6 years. Seventy-six 76(61.2%) cases were in Group-A and 45(38.8%) in Group-B. Mortality (within 30 days post-surgery) was reported in 11(9.1%) patients. Except for the mean duration of chest tube drainage ((0.010), there was no difference in terms of post-Fontan surgery outcomes between both study groups (p>0.05). Conclusion: The age of the patients at the time of the Fontan procedure did not affect the outcomes.

Abstract This research work investigates the axial stress versus strain responses of un-strengthened and carbon fiber reinforced polymer (CFRP) composites strengthened concrete specimens made with electronic waste coarse aggregates. For this purpose, 36 circular and non-circular 300 mm high concrete specimens constrained with CFRP sheets and partially replaced with E-waste coarse aggregates were prepared. The effect of cross-sectional geometry, 20% partial substitution of natural coarse aggregates with E-waste aggregates, corner effect of non-circular concrete specimens, confinement of specimens with CFRP sheets, and effect of the number of confinement sheets were also studied. In control concrete specimens, the coarse aggregates were 848 kg/m3 and E-waste aggregates were 212 kg/m3. The cement was 475 kg/m3 and fine aggregates were 655 kg/m3. Test results indicated that compressive strength is reduced by substituting natural coarse aggregates with E-waste aggregates. At the same time, compressive strength increased to 71%, 33%, and 25% for circular, square, and rectangular concrete specimens, respectively, by CFRP confinement. Whereas the axial strain increased to 1100%, 250%, and 133%, for circular, square, and rectangular concrete specimens, respectively, by CFRP confinement. CFRP sheets also enhanced the Poisson's ratio. Because of the greater confinement given by a double CFRP layer, it is more effective than a single layer. Furthermore, results also indicated that strength reduction in non-circular concrete specimens was greater than in circular concrete specimens for all studied cases. In the end, for theoretical calculations, strength and strain models for confined concrete suggested by different researchers were applied and compared with experimental results. In comparison to the experimental findings, theoretical data showed that most of the models were either on the higher or on the lower side, while only some model results matched well with the experimental data.

Water treatment sludge is a by-product of the drinking water treatment process, and it has been considered as a waste for water authorities around the world. This study aims to investigate the reuse of aluminium-based water treatment sludge (AS) as a soil replacement in road construction which can improve sustainable waste management practices for positive environmental outcomes. To evaluate the potential reuse of AS, a 50/50 mixture ratio of AS and clay (CL) was selected and tested for geotechnical engineering parameters through Odometer Tests, Unconfined Compression Strength Tests, Static triaxial, Cyclic triaxial and California Bearing Ratio. Detailed physical and chemical were also conducted with the water treatment sludge. Results suggest that combining AS with CL increases the optimal moisture content and decreases the dry density of the soil. Oedometer tests indicated that the CLAS mixture distributed stress better than CL and AS independently. In the UCS tests, CLAS enhanced the strength of the mixture from 74 kPa with only CL to 126 kPa with the introduction of AS. The shear strength of CLAS samples increased by 50% compared to CL. In the cyclic triaxial test, CLAS showed less cumulative strain than CL, and improved the CBR results of the mixture from 0.95% to 1.92%. Results indicate that AS can be beneficially reused as a low-cost soil replacement to contribute the Circular Economy and net-zero emission targets. Future research should examine the variability of AS, optimal ratios of AS to CL, and the levelized cost of AS in different environmental conditions.

Background and purpose: Autosegmentation techniques are emerging as time-saving means for radiation therapy (RT) contouring, but the understanding of their performance on different datasets is limited. The aim of this study was to determine agreement between rectal volumes by an existing autosegmentation algorithm and manually-delineated rectal volumes in prostate cancer RT. We also investigated contour quality by different-sized training datasets and consistently-curated volumes for retrained versions of this same algorithm. Materials and methods: Single-institutional data from 624 prostate cancer patients treated to 50–70 Gy were used. Manually-delineated clinical rectal volumes (clinical) and consistently-curated volumes recontoured to one anatomical guideline (reference) were compared to autocontoured volumes by a commercial autosegmentation tool based on deep-learning (v1; n = 891, multiple-institutional data) and retrained versions using subsets of the curated volumes (v32/64/128/256; n = 32/64/128/256). Evaluations included dose-volume histogram metrics, Dice similarity coefficients, and Hausdorff distances; differences between groups were quantified using parametric or non-parametric hypothesis testing. Results: Volumes by v1-256 (76–78 cm3) were larger than reference (75 cm3) and clinical (76 cm3). Mean doses by v1-256 (24.2–25.2 Gy) were closer to reference (24.2 Gy) than to clinical (23.8 Gy). Maximum doses were similar for all volumes (65.7–66.0 Gy). Dice for v1-256 and reference (0.87–0.89) were higher than for v1-256 and clinical (0.86–0.87) with corresponding Hausdorff comparisons including reference smaller than comparisons including clinical (5–6 mm vs. 7–8 mm). Conclusion: Using small single-institutional RT datasets with consistently-defined rectal volumes when training autosegmentation algorithms created contours of similar quality as the same algorithm trained on large multi-institutional datasets.

Abstract CNGCs are ligand-gated calcium signaling channels, which participate in important biological processes in eukaryotes. However, the CNGC gene family is not well-investigated in Brassica rapa L. (i.e., field mustard) that is economically important and evolutionary model crop. In this study, we systematically identified 29 member genes in BrCNGC gene family, and studied their physico-chemical properties. The BrCNGC family was classified into four major and two sub phylogenetic groups. These genes were randomly localized on nine chromosomes, and dispersed into three sub-genomes of B. rapa L. Both whole-genome triplication and gene duplication (i.e., segmental/tandem) events participated in the expansion of the BrCNGC family. Using in-silico bioinformatics approaches, we determined the gene structures, conserved motif compositions, protein interaction networks, and revealed that most BrCNGCs can be regulated by phosphorylation and microRNAs of diverse functionality. The differential expression patterns of BrCNGC genes in different plant tissues, and in response to different biotic, abiotic and hormonal stress types, suggest their strong role in plant growth, development and stress tolerance. Notably, BrCNGC-9, 27, 18 and 11 exhibited highest responses in terms of fold-changes against club-root pathogen Plasmodiophora brassicae, Pseudomonas syringae pv. maculicola, methyl-jasmonate, and trace elements. These results provide foundation for the selection of candidate BrCNGC genes for future breeding of field mustard.

With the growing cyber-infrastructure of smart grids, the threat of cyber-attacks has intensified, posing an increased risk of compromised communication links. Of particular concern is the false data injection (FDI) attack, which has emerged as a highly dangerous cyber-attack targeting smart grids. This paper addresses the limitations of the variable dummy value model proposed in the authors previous work and presents a novel defense methodology called the nonlinear function-based variable dummy value model for the AC power flow network. The proposed model is evaluated using the IEEE 14-bus test system, demonstrating its effectiveness in detecting FDI attacks. It has been shown that previous detection techniques are unable to detect FDI attacks, whereas the proposed method is shown to be successful in the detection of such attacks, guaranteeing the security of the smart grid’s measurement infrastructure.

Wheat stripe rust disease (WRD) is extremely detrimental to wheat crop health, and it severely affects the crop yield, increasing the risk of food insecurity. Manual inspection by trained personnel is carried out to inspect the disease spread and extent of damage to wheat fields. However, this is quite inefficient, time-consuming, and laborious, owing to the large area of wheat plantations. Artificial intelligence (AI) and deep learning (DL) offer efficient and accurate solutions to such real-world problems. By analyzing large amounts of data, AI algorithms can identify patterns that are difficult for humans to detect, enabling early disease detection and prevention. However, deep learning models are data-driven, and scarcity of data related to specific crop diseases is one major hindrance in developing models. To overcome this limitation, in this work, we introduce an annotated real-world semantic segmentation dataset named the NUST Wheat Rust Disease (NWRD) dataset. Multileaf images from wheat fields under various illumination conditions with complex backgrounds were collected, preprocessed, and manually annotated to construct a segmentation dataset specific to wheat stripe rust disease. Classification of WRD into different types and categories is a task that has been solved in the literature; however, semantic segmentation of wheat crops to identify the specific areas of plants and leaves affected by the disease remains a challenge. For this reason, in this work, we target semantic segmentation of WRD to estimate the extent of disease spread in wheat fields. Sections of fields where the disease is prevalent need to be segmented to ensure that the sick plants are quarantined and remedial actions are taken. This will consequently limit the use of harmful fungicides only on the targeted disease area instead of the majority of wheat fields, promoting environmentally friendly and sustainable farming solutions. Owing to the complexity of the proposed NWRD segmentation dataset, in our experiments, promising results were obtained using the UNet semantic segmentation model and the proposed adaptive patching with feedback (APF) technique, which produced a precision of 0.506, recall of 0.624, and F1 score of 0.557 for the rust class.

In this research, we propose an energy-management scheme for domestic users, which uses the load-shifting strategy of demand-side management (DSM). The research demonstrates that the energy sector’s circular debt problem from the viewpoint of a developing country can be solved by incorporating DSM. Circular debt is a chain reaction that arises when the balance between cost and energy supply collapses. Circular debt is an ongoing problem in Pakistan, where economic crises are continuously posing a threat to the energy sector. DSM is envisioned to address these concerns in a dynamic way thoroughly: introducing DSM can minimize circular debt, increase grid reliability, and smooth the supply–demand operation. Circular debt is directly linked with the subsidy offered by the government of Pakistan. As the cost of energy utilized by consumers increases, the subsidy also increases due to the direct link between the two entities. Therefore, the subsidy can be controlled by energy-consumption management with the adoption of DSM. This study addresses that by incorporating optimized cost solutions, circular debt can be regulated to improve the economy of the energy sector. A genetic algorithm is used as an optimization tool to manage demand and generate an optimal schedule under a dynamic electricity pricing signal. To support the utility, a solar system is used as a secondary energy source. Finally, the results show a curtailment in the payable costs at both the consumer and government ends, thus reducing the circular debt in the bigger picture. The reduction is 18% without and 41% with renewable energy support.

Due to an increase in penetration of intermittent distributed energy resources (DERs) in conjunction with load demand escalation, the electric power system will confront more and more challenges in terms of stability and reliability. Furthermore, the adoption of electric vehicles (EVs) is increasing day by day in the personal automobile market. The sudden rise in load demand due to EV load might cause overloading of the potential transformer, undue circuit faults and feeder congestion. The objective of this paper is to develop a strategy for distribution feeder management to support the implementation of emergency demand response (EDR) during contingency and overload conditions. The proposed methodology focuses on management of smart home appliances along with EVs by considering demand rebound and consumer convenience indices, in order to reduce network stress, congestion and demand rebound. The developed scheme ensures that the load profile is retained below a certain level during a demand response event while mitigating demand rebound impacts. Simultaneously, the mitigation of consumers’ convenience level violation, information of smart loads and homeowners’ objective of serving critical loads are also considered during the event. The effectiveness of the developed approach is assessed by simulating a node of a distribution network of 300kW, consisting of 9 distribution transformers serving the associated homes. In this study, the smart loads such as an air conditioner/heater, an EV, a clothes dryer, and a water heater are also modeled and simulated. Furthermore, the simulation results are compared with an already developed de-centralized approach, and a simple fair distribution approach to evaluate and validate the effectiveness of the designed methodology. It is exhibited by the analysis of the results that the developed approach reduced the demand rebound following a demand response event and minimized the congestion at distribution transformer during overloading condition while maintaining the consumers’ comfort.

The objective of this paper is to study the ordered $h$-regular semirings by the properties of their ordered $h$-ideals. It is proved that each $h$-regular ordered semiring is an ordered $h$-regular semiring but the converse does not follow. Important theorems relating to basic properties of the operator clousre and $h$-regular semirings are given. It is also proved that each regular ordered semiring is an ordered $h$-regular semiring but the converse does not hold. The classifications of the left and the right ordered $h$-regular semirings and the left and the right ordered $h$-weakly regular semirings are also presented.

Blastomycosis is a systemic fungal infection which primarily involves the lungs but can disseminate to involve extrapulmonary sites. Current testing that exists includes sputum, urine, serum, and pathological tissue analysis. Radiological testing is often non-specific and highly variable. Here we present five cases of pulmonary blastomycosis with challenging radiographic presentations.

A novel analytical approach for estimating the shear rate over the membrane surface and away from the membrane surface as a result of the membrane oscillation has been presented. The model was developed and modified according to our system using the Stokes boundary layer equation. Generation of the shear over the membrane surface is an important phenomenon that not only mitigates the fouling but also enhances the separation efficiency. It is investigated that membrane oscillating frequency, amplitude and viscosity of the souring fluid are important parameters that influence the intensity of the shear on the membrane surface and away from the surface. The model presented was tested with various set of frequencies, amplitudes and viscosities. While, keeping the amplitude constant and changing the frequencies, ahigherintensity of shear over the membrane surface was noticed. On the other hand, keeping the frequency constant and changing the amplitude, a lower shear on the membrane surface was observed. Similarly, as expected, a lower shear over the membrane surface was noticed when the viscosity of the surrounding fluid was increased. The model was supported with the experimental results where separation of oil drops from produced water was the focus of the experiments conducted. It was clear from the experimental results that membrane oscillation enhanced the separation efficiency of the membrane used and therefore, concentration of oil drops in the permeate decreased. Further, the application of the shear was greatly influenced by the pore blocking; higher the shear rate; lower was the pore blocking and vice versa.

Introduction There is growing interest in assessing the impact of health interventions, particularly when women are the focus of the intervention, on women’s empowerment. Globally, research has shown that interventions targeting nutrition, health and economic development can affect women’s empowerment. Evidence suggests that women’s empowerment is also an underlying determinant of nutrition outcomes. Depending on the focus of the intervention, different domains of women’s empowerment will be influenced, for example, an increase in nutritional knowledge, or greater control over income and access to resources.Objective This study evaluates the impact of the Shonjibon Cash and Counselling (SCC) Trial that combines nutrition counselling and an unconditional cash transfer, delivered on a mobile platform, on women’s empowerment in rural Bangladesh.Methods and analysis We will use a mixed-methods approach, combining statistical analysis of quantitative data from 2840 women in a cluster randomised controlled trial examining the impact of nutrition behaviour change communications (BCCs) and cash transfers on child undernutrition. Pregnant participants will be given a smartphone with a customised app, delivering nutrition BCC messages, and will receive nutrition counselling via a call centre and an unconditional cash transfer. This study is a component of the SCC Trial and will measure women’s empowerment using a composite indicator based on the Project-Level Women’s Empowerment in Agriculture Index, with quantitative data collection at baseline and endline. Thematic analysis of qualitative data, collected through longitudinal interviews with women, husbands and mothers-in-law, will elicit a local understanding of women’s empowerment and the linkages between the intervention and women’s empowerment outcomes. This paper describes the study protocol to evaluate women’s empowerment in a nutrition-specific and sensitive intervention using internationally validated, innovative tools and will help fill the evidence gap on pathways of impact, highlighting areas to target for future programming.Ethics and dissemination Ethical approval has been obtained from the International Centre for Diarrhoeal Disease Research (Ref. PR 17106) and The University of Sydney (Ref: 2019/840). Findings from this study will be shared in Bangladesh with dissemination sessions in-country and internationally at conferences, and will be published in peer-reviewed journals.

Photocatalytic conversion of CO2 using ZnO semiconductor is an effective, simple, economical and attractive way of combating energy problems resulting from anthropogenic emissions of CO2 i.e. greenhouse gases to the atmosphere. This article focuses on current advances in CO2 photoreduction by hydrothermal method. The fundamental photocatalytic CO2 reduction system by photocatalysts especially ZnO has been explicated. The synthetic protocol of ZnO and its growth mechanism in alkaline solution is elaborated with specific illustration of defect chemistry and its influence on CO2 reduction activity and selectivity. Conclusively, brief challenges of its current state and future prospects were also discussed

A new method is proposed to increase the rejection in microfiltration by applying membrane oscillation, using a new type of microfiltration membrane with slotted pores. The oscillations applied to the membrane surface result in reduced membrane fouling and increased separation efficiency. An exact mathematical solution of the flow in the surrounding solution outside the oscillating membrane is developed. The oscillation results in the appearance of a lift velocity, which moves oil particles away from the membrane. The latter results in both reduced membrane fouling and increased oil droplet rejection. This developed model was supported by the experimental results for oil water separation in the produced water treatment. It was proven that the oil droplet concentration was reduced notably in the permeate, due to the membrane oscillation, and that the applied shear rate caused by the membrane oscillation also reduced pore blockage. A four-times lower oil concentration was recorded in the permeate when the membrane vibration frequency was 25 Hz, compared to without membrane vibration. Newly generated microfiltration membranes with slotted pores were used in the experiments.

Abstract Integration of large number of electric vehicles (EVs) with distribution networks is devastating for conventional power system devices such as transformers and power lines etc. This paper proposes a methodology for management of responsive household appliances management and EVs with water-filling algorithm. With the proposed scheme, the load profile of a transformer is retained below its rated capacity while minimally affecting the associated consumers. When the instantaneous demand at transformer increases beyond its capacity, the proposed methodology dynamically allocates demand curtailment limit (DCL) to each home served by transformer. The DCL allocation takes convenience factors, load profile and information of flexible appliances into account to assure the comfort of all the consumers. The proposed scheme is verified by modeling and simulating five houses and a distribution transformer. The smart appliances such as an HVAC, a water heater, a cloth dryer and an EV are also modeled for the study. Results show that the proposed scheme performs to reduce overloading effects of the transformer efficiently and assures comfort of the consumers at the same time.

Extramedullary plasmacytoma is a type of plasma cell dyscrasia that can present as solitary tumor or secondary to multiple myeloma. We experienced a case of intramuscular plasmacytoma in the left thigh muscles of a patient secondary to multiple myeloma. A 73-year-old male with relapsed multiple myeloma and bilateral hip arthroplasty complained of lxeft lower limb weakness and hip pain 3 months after relapse. He underwent contrast-enhanced magnetic resonance imaging of lumbar spine and hip which was inconclusive. Subsequently, patient had multiple admissions for progressive lower limb weakness. His clinical course was complicated by a biopsy-proven plasmacytoma of the neck. He received localized radiation therapy to the neck in addition to a change in multiple myeloma chemotherapy regimen, resulting in resolution of the neck mass but his left lower extremity weakness continued to worsen. Repeat magnetic resonance imaging of hip and spine revealed an intramuscular mass in left thigh which was consistent with the diagnosis of extramedullary plasmacytoma on biopsy. Localized radiation to the thigh accompanied with a change in chemotherapy improved his symptoms and a significant reduction in size of plasmacytoma was observed. When an unexplained lower limb weakness is encountered with a history of multiple myeloma, secondary intramuscular plasmacytoma should be considered.

Vasculitis refers to inflammation of the systemic vessels. Eosinophilic granulomatosis with polyangiitis (EGPA) is a medium and small vessel vasculitis characterized by hypereosinophilia, pulmonary infiltrates, difficult to treat asthma and polyneuropathies. Diagnosis can often be challenging. In this article, we present a case of a young lady who was diagnosed ANCA negative EGPA.

Pulmonary malignancies carry a significant morbidity and mortality and are one of the leading causes of cancer-related deaths worldwide. Primary pulmonary lymphoma is a rare malignancy which should be considered in the differential of solitary pulmonary nodule or lung mass especially in a low-risk patient presenting with constitutional symptoms. Here, we describe a case of an elderly male who presented to our clinic with incidental pulmonary nodules and subsequent workup revealed low grade B cell non-Hodgkin's lymphoma consistent with diagnosis of primary pulmonary marginal zone lymphoma.

In this paper, a coordination method of multiple electric vehicle (EV) aggregators has been devised to flatten the system load profile. The proposed scheme tends to reduce the peak demand by discharging EVs and fills the valley gap through EV charging in the off-peak period. Upper level fair proportional power distribution to the EV aggregators is exercised by the system operator which provides coordination among the aggregators based on their aggregated energy demand or capacity. The lower level min max objective function is implemented at each aggregator to distribute power to the EVs. Each aggregator ensures that the EV customers’ driving requirements are not relinquished in spite of their employment to support the grid. The scheme has been tested on IEEE 13-node distribution system and an actual distribution system situated in Seoul, Republic of Korea whilst utilizing actual EV mobility data. The results show that the system load profile is smoothed by the coordination of aggregators under peak shaving and valley filling goals. Also, the EVs are fully charged before departure while maintaining a minimum energy for emergency travel.

Gram-negative infections are a rising concern faced by the medical community. Approximately 30% of nosocomial bloodstream infections in intensive care units in the United States are caused by these gram-negative species. Emergence of multidrug-resistant organisms further complicate this issue. In this article, we report a case of an 84-year-old Caucasian male who was diagnosed with Shewanella pneumonia treated with cefepime with minimal to no improvement in his symptoms. To the best of our knowledge, this is the third reported case of Shewanella putrefaciens nosocomial pneumonia and first case of bacteremia secondary to pneumonia by Shewanella putrefaciens .

Slipping rib syndrome is a rare cause of abdominal or lower chest pain that can remain undiagnosed for many years. Awareness among health care personnel of this rare but significant disorder is necessary for early recognition. Prompt treatment can avoid unnecessary testing, radiographic exposure, and years of debilitating pain. A 52-year-old female was evaluated for a 3-year history of recurrent abdominal and lower chest pain. Pain was sharp, primarily located in the lower chest and subcostal region left more than right, waxing and waning, nonradiating, and aggravates with specific movements. She underwent frequent physical therapies, treated with multiple muscle relaxants and analgesics with minimal improvement. Imaging modalities including CT scan, MRI, and X-rays performed on multiple occasions failed to signify any underlying abnormality. Complete physical examination was unremarkable except for positive hooking maneuver. Dynamic flow ultrasound of lower chest was performed which showed slipping of the lowest rib over the next lowest rib bilaterally left worse than right, findings consistent with slipping rib syndrome. Slipping rib syndrome is caused by hypermobility of the floating ribs (8 to 12) which are not connected to the sternum but attached to each other with ligaments. Diagnosis is mostly clinical, and radiographic tests are rarely necessary. Hooking maneuver is a simple clinical test to reproduce pain and can aid in the diagnosis. Reassurance and avoiding postures that worsen pain are usually helpful. In refractory cases, nerve block and surgical intervention may be required.

Sinking skin flap syndrome is rare phenomenon that occurs in patients with large craniectomies. Alteration in normal anatomy and pathophysiology can result in wide variety of symptoms including altered mental status, hemodynamic instability, and dysautonomias. Management is largely conservative. We here present a case of a patient with large craniectomy who was admitted to our hospital with pneumonia. Later on, he developed worsening mental status and CT head revealed sinking skin flap with significant midline shift. This is a very rare case of neurological deterioration after craniectomies, commonly known as sinking skin flap syndrome. To our knowledge, only few cases have been reported so far.

Sphingomonas paucimobilis is a nonfermentative gram-negative bacillus of low pathogenicity. The organism has been involved in causing a wide range of infections in community and hospital settings. Only 3 cases of meningitis caused by this organism have been reported so far. We report a rare case of S paucimobilis meningitis who presented with atypical symptoms. A 50-year-old female presented with headache, dizziness, chills, shakiness, and neck pain along with nuchal rigidity. On physical examination, severe neck rigidity along with decreased range of motion was noticed. Her cerebrospinal fluid showed gram-negative rods, and she was started on meropenem. The cerebrospinal fluid grew S paucimobilis sensitive to meropenem. She subsequently showed significant improvement and was discharged home on intravenous meropenem for 21 days and showed complete recovering in 5 weeks.

Idiopathic inflammatory myopathies are an unusual group of myopathies with annual incidence of 1 in 100 000 people in the United States. Necrotizing autoimmune myopathy comprises only 16% of this group. It usually presents with severe proximal weakness, lower extremity weakness, and severe fatigue while very rarely does it present with dysphagia and respiratory muscle weakness. Statin use, cancer, and connective tissue disorder are the usual associated risk factors. Anti-signal recognition particle and 3-hydroxy-3-methylglutaryl-coenzyme A reductase are the 2 most common autoantibodies associated with necrotizing autoimmune myopathy. In this article, we present a very rare case of a 66-year-old male who presented with shortness of breath and dysphagia requiring intubation and ventilator support. Creatine kinase was 23 000, myoglobin was 7000, and ANA was positive. All other autoimmune and infectious workup including Lyme disease was unremarkable. Muscle biopsy turned out remarkable for necrotizing myopathy. No evidence of statin use, active malignancy, or connective tissue disease was found. He was treated with high-dose corticosteroids and a short course of intravenous immunoglobulin with very mild improvement in symptoms. Anti-signal recognition particle and 3-hydroxy-3-methylglutaryl-coenzyme A reductase could not be performed as the patient refused to pursue further medical testing. This is a very rare case of idiopathic inflammatory myopathy presenting with bulbar and respiratory muscle weakness requiring ventilator support.

In this study, we focused on analysing and differentiating the determinants of conventional insurance and Takāful demand across ASEAN and Middle East Regions. We used panel data econometrics on a sample of 14 Asian countries having both conventional insurance and Takāful over the period 2005–2014. We applied fixed and random effect regression models to assess the impact of macroeconomic and demographic factors on conventional insurance and Takāful demand. Income and financial sector were found to have significant positive impact on insurance demand across all regions. On the other hand, dependency ratio was found to be negatively affecting Takāful demand across all regions while inflation shows positive impact. Urbanization was found to be significant positive impact on both conventional insurance and Takāful demand. Financial sector development positively triggers the insurance and Takāful demand across ASEAN region, while it triggers conventional insurance demand only in Middle East Region. Education shows negative impact on Takāful demand across both regions while it shows positive impact on insurance demand in Middle East. The study recognises the key role of urbanization and education in creating awareness to enhance Takāful demand in large populated countries of ASEAN and South Asia.

This paper attempts to investigate the factors that affect job satisfaction of sales agents from Islamic (Hereafter; Takāful) and conventional insurance of Pakistan using Herzberg two-factor motivation theory. Using multi-stage stratified random sampling, we received a total of 318 usable responses (185 from family Takāful and 133 from life insurance). A multiple regression and hierarchal regression model including 11 hygiene–motivational factors were used to examine job satisfaction in the presence of moderating factor Shari’ah perception. The outcomes regarding Herzberg two-factor theory were entirely distinctive between those two direct sales groups with the presence of moderating variable Shari’ah perception. Without moderating the effect of Shari’ah perception, family Takāful and conventional life insurance full-time direct sales agents demonstrated that hygiene factors and motivational factors were both more effective indicators of job satisfaction in Pakistani context. While checking the moderating effect in the presence of moderating variable Shari’ah perception, family Takāful sales agents are satisfied with hygiene factors where the motivators are not significantly affected by Shari’ah perception. On the other hand, conventional life insurance sales agents have no concern with Shari’ah perception.

Congenital absence of left circumflex artery is a rare occurrence and very few cases have been reported in literature. It is a benign incidental finding; however some patients present with sudden onset chest pain mimicking acute coronary syndrome often resulting in detection of this rare anatomy on coronary angiography. Coronary computed tomography angiography is a relatively new noninvasive imaging modality which can be used to confirm this suspicion and diagnose this unique morphology reliably.

Compelled by environmental and economic reasons and facilitated by modern technological advancements, the share of hybrid energy systems (HES) is increasing at modern smart house (SH) level. This work proposes an intelligent hybrid energy management system (IHEMS) for an SH connected to a power network that allows a bidirectional power flow. The SH has electrical and thermal power loops, and its main components include renewable energy from wind and photovoltaics, electric vehicle (EV), battery energy storage system, a fuel cell which serves as a micro-combined heat and power system, and a boiler. The proposed IHEMS models the components of the SH, defines their constraints, and develops an optimization model based on the real coded genetic algorithm. The key features of the developed IHEMS are highlighted under six simulation cases considering different configurations of the SH components. Moreover, the standard EV charging techniques are compared, and it is observed that the charging method which is flexible in timing and power injection to the EV is best suited for the economic operation of the SH. The simulation results reveal that the proposed IHEMS minimizes the 24-hour operational cost of the SH by optimally scheduling the energy resources and loads.

Ketoacidosis is a significant and often a life-threatening complication of diabetes mellitus seen mostly in type 1 diabetes mellitus as well as occasionally in type 2 diabetes mellitus. Diabetic ketoacidosis usually manifests with high blood glucose more than 250 mg/dL, but euglycemic diabetic ketoacidosis is defined as ketoacidosis associated with blood glucose level less than 250 mg/dL. Normal blood glucose in such patients results in significant delay in diagnosis and management of diabetic ketoacidosis, thus increasing mortality and morbidity. We present a case of euglycemic diabetic ketoacidosis secondary to canagliflozin in a type 2 diabetic patient.

Multidrug-resistant enterococcal nosocomial invasive infections are a rising concern faced by the medical community. Not many options are available to treat these highly virulent organisms. Risk factors for developing these highly resistant organisms include prolonged hospital stay, previous antibiotic use, and immunosuppression. In this article, we report a case of daptomycin-resistant enterococcal native infective endocarditis treated with off-label use of quinupristin-dalfopristin.

Gram-negative bacterial endocarditis causes 5% of all bacterial endocarditis. Among gram-negative bacteria, Klebsiella species are rare causes of native valve endocarditis. Klebsiella oxytoca is an extremely rare subspecies that can infrequently cause endocarditis and is associated with poor outcome. We report a case of Klebsiella oxytoca endocarditis in an elderly man who initially presented with stroke but later developed sepsis and heart block secondary to endocarditis.

The present environmental and economic conditions call for the increased use of hybrid energy resources and, concurrently, recent developments in combined heat and power (CHP) systems enable their use at a domestic level. In this work, the optimal scheduling of electric and gas energy resources is achieved for a smart home (SH) which is equipped with a fuel cell-based micro-CHP system. The SH energy system has thermal and electrical loops that contain an auxiliary boiler, a battery energy storage system, and an electrical vehicle besides other typical loads. The optimal operational cost of the SH is achieved using the real coded genetic algorithm (RCGA) under various scenarios of utility tariff and availability of hybrid energy resources. The results compare different scenarios and point-out the conditions for economic operation of micro-CHP and hybrid energy systems for an SH.

The provision of ancillary services by electric vehicles (EVs) such as load smoothing and renewable energy (RE) compensation in the form of an aggregated storage is more regulated in the smart grid context. As such, the presence of multiple EV aggregators in the distribution network requires adept supervision by the distribution system operator (DSO). In this paper, a coordination scheme of aggregators is proposed to smoothen the load profile of distribution networks by enacting EV discharging during peak load and off-peak charging, keeping in view the EV driving requirements. A bi-level on-line interaction procedure from the DSO to the aggregators and vice versa is devised to manage the aggregators based upon their energy capacity and requirements. The aggregators employ a water-filling algorithm in a two-step EV power allocation method. The proposed scheme operation is demonstrated on an medium voltage (MV) distribution feeder located in Seoul with its actual traffic density data. The results show the achievement of peak shaving and valley filling objectives under aggregator coordination and that the EVs are completely charged before departure. The effect of various EV penetration levels and adaptivity of the scheme to RE incorporation is also verified. Furthermore, a comparison with an existing peak shaving method shows the superior performance of the proposed scheme.

The increasing penetration of electric vehicles (EVs) in the distribution grid has established them as a prospective resource for ancillary services. These services require adequate control strategies for prompt and efficient operation. In this study, an energy management scheme (EMS) has been proposed to employ an off-board EV smart charger to support the grid during short-term variance of renewables and reactive load onset. The scheme operates by calculating power references for the charger instantaneously. The EMS incorporates a proportional power division methodology, proposed to allocate power references to the individual EVs connected to the charger DC-bus. This methodology considers the state-of-charge and battery sizes of the EVs, and it can aggregate energy from various types of EVs. The proposed scheme is compared with another power allocation method, and the entire EMS is tested under the scenarios of power mismatch and voltage sag/swell events. The results show that the proposed scheme achieves the goal of the aggregation of EVs at the charger level to support the grid. The EMS also fulfills the objectives of voltage regulation and four-quadrant operation of the smart charger.