With the increasing penetration of renewable energy, virtual power plants reduce the impact on the power grid by integrating massive distributed resources for unified management. However, the optimal scheduling of a large number of distributed resources in virtual power plants has become a new problem in recent years. Therefore, aiming at the real-time optimal scheduling problem in the optimal scheduling of virtual power plant, this letter regards the virtual power plant as a multi-agent system, and proposes a novel real-time active power dispatch scheme of virtual power plant based on distributed model predictive control, so that each agent can not only calculate its own optimization function relatively independently, but also fully refer to the neighbor information. Simulation results show the feasibility and effectiveness of the proposed method.

An improved time-frequency domain (TFD) method is proposed to reject interferences for Global Positioning System (GPS) receivers. The conditional TFD methods generally detect interferences through spectrum analysis, and reject them by filtering. Actually, the detection- rejection accuracy is always within the limit of the spectrum resolution. The present TFD method combines the FFT technique with an adaptive notch filter (ANF). Some initialized interference frequencies are detected first by FFT, and further updated by ANF. Numerical simulation results show that the present method could hence the anti- jamming capability of GPS receivers.

Purpose: Transcanal endoscopic ear surgery (TEES) avoids a postauricular incision, which has been shown to minimize pain and numbness. Our objective is to assess how much patients value minimizing pain and numbness relative to other postoperative otologic outcomes. Methods: Cross-sectional anonymous surveys were distributed to otolaryngology clinic patients in a tertiary care center. Patients were instructed to rate how much they value various outcomes when undergoing hypothetical ear surgery on a scale of 0 (not important) to 10 (very important). Linear regression was used to analyze demographic predictors of valued outcomes. Results: 102 patients responded (response rate 75%, 50% male). 51% presented for otologic complaints; other represented subspecialties included head & neck surgery, facial plastic surgery and rhinology. 10% of survey respondents were Spanish-speaking. Outcomes of highest importance included hearing (mean 9.3; SD 1.9), staff friendliness (8.9; 1.8), numbness (8.3; 2.4), and pain (8.1; 2.5). Outcomes of moderate importance included time spent under anesthesia (7.0; 3.2), scar visibility (6.3; 3.5), incision size (5.5; 3.4), incision hidden in the ear canal (5.4, 3.9), and surgery cost to the hospital (5.1; 3.9). In linear regression analysis, increasing age was associated with decreased value placed on size of incision (β=-0.06, p<0.001) and visibility of scar (β=-0.07, p<0.001). Conclusion: Patients placed very high value on minimizing pain and numbness after ear surgery, nearly as much as a good hearing outcome. This has implications for patient-driven interest in TEES, which has been previously shown to reduce pain and numbness compared to the postauricular approach.

It has been proposed that conservation laws might not be beneficial for accurate hydrological modeling due to errors in input (precipitation) and target (streamflow) data (particularly at the event time scale), and this might explain why deep learning models (which are not based on enforcing closure) can out-perform catchment-scale conceptual and process-based models at predicting streamflow. We test this hypothesis at the event and multi-year time scale using physics-informed (mass conserving) machine learning and find that: (1) enforcing closure in the rainfall-runoff mass balance does appear to harm the overall skill of hydrological models, (2) deep learning models learn to account for spatiotemporally variable biases in data (3) however this “closure” effect accounts for only a small fraction of the difference in predictive skill between deep learning and conceptual models.

A document by Zaixing Li. Click on the document to view its contents.

Nonspecific atrioventricular septal defect (AVSD) diagnosed at 5 months age, after cardiac arrest. Progressive dyspnea, peripheral cyanosis, with development of heart failure and pulmonary hypertension. At 18 years, confirmation of Eisenmenger´s sydrome, (complete AVSD: ASD - “ostium primum”; inlet ventricular septal defect and common AV valve).

NTM-infected CF patients may be at risk of being underdiagnosed or inappropriately treated when relying on culture and susceptibility results from non-specialized laboratories. Since this was a small study with convenience samples, a larger study needs to be carried out. If our findings are confirmed, the drivers should be elucidated for the discrepant results. Given the increasing prevalence of NTM in the population at large and not in the CF community alone[[13]](#ref-0013), elucidating any differences in testing to ensure the correct identification, including subspeciation and antimicrobial susceptibilities should be paramount

The transient receptor potential (TRP) superfamily of cation channels is divided into several subfamilies. The TRPV (vanilloid) subfamily is composed of proteins that undergo a closed-to-open gating transition in response to various physical and chemical stimuli, including heat transfer phenomena. TRPV1, the prototypical member of these thermo-TRP channels, is activated under physiological conditions by noxious high temperatures (>42°C), and by pungent chemicals including capsaicin and resiniferatoxin . Like TRPV1, TRPV2 is also activated at >52°C as well as 2-aminoethoxydiphenyl borate and cannabidiol. On the other hand, the main stimulus for Kv channels is the potential difference across the membrane. Notwithstanding these differences in their activation temperatures, ligand- or voltage-dependence, the gating mechanisms of these channels exhibit conformational transition pathways in common. Understanding these conformational changes in terms of the sequence determinants underlying these structural transitions helps to reveal residues with great functional relevance. This work examines the side-chain flexibility in regions undergoing peculiar helical transitions. We found that α-to-π helical transitions are associated with patterns of local rigidity whereas α-to-3 10 transitions are mainly associated with high local flexibility profiles. We also study the relationship between flexibility and protein order, both in these dynamic regions and in the rest of the transmembrane domains of these proteins. Our analysis shows that flexibility and protein disorder are two complementary parameters that could reveal conformational heterogeneity and the dynamic behavior of specific segments.

In regions of the world where anthrax is endemic, humans are at risk of infection from contact with infected animals and contaminated animal products. The World Health Organization proposed recommendations, based on then current evidence, for personal protective equipment (PPE) use when performing clinical, laboratory, and field work activities involving collection and handling of specimens from humans, animals, and environments potentially contaminated with Bacillus anthracis. However, it is often unclear how these recommendations apply under field settings in low-resource countries, leading to inadequate protection and subsequent exposures of veterinary, medical, and public health professionals investigating anthrax outbreaks. To illustrate how existing recommendations can be applied to reduce the risk of exposures in endemic regions with limited resources, while balancing access to PPE, CDC subject matter experts (field epidemiologists working on anthrax outbreak response, control and capacity building activities around the globe) reviewed current recommendations, existing data from human anthrax case reports and anthrax prevention studies, and discussed professional judgment based on years of personal field experiences. To develop a risk assessment for exposures to naturally occurring anthrax, the group evaluated exposure mechanisms in settings such as the laboratory, clinical practice (animal and human), environmental specimen collection, and foodborne exposures, and provided examples of simplified anthrax-exposure risk characterization scenarios and illustrations of post-exposure prophylaxis (PEP) practices. Although these practice-informed examples and risk exposure scenarios are most applicable in endemic regions with limited resources, they may be applied anywhere that B. anthracis occurs naturally, to assess whether PEP and monitoring are indicated.

Adapting the target dataset for a pre-trained model is still challenging. These adaptation problems result from a lack of adequate transfer of traits from the source dataset; this often leads to poor model performance resulting in trial and error in selecting the best performing pre-trained model. This paper introduces the conflation of source domain low-level textural features extracted using the first layer of the pretrained model. The extracted features are compared to the conflated low-level features of the target dataset to select a higher quality target dataset for improved pre-trained model performance and adaptation. From comparing the various probability distance metrics, Kullback-Leibler is adopted to compare the samples from both domains. We experiment on three publicly available datasets and two ImageNet pre-trained models used in past studies for results comparisons. This proposed approach method yields two categories of the target samples with those with lower Kullback-Leibler values giving better accuracy, precision and recall. The samples with the lower Kullback-Leibler values give a higher margin accuracy rate of 6.21% to 7.27%, thereby leading to better model adaptation for target transfer learning datasets and tasks

Our intention in writing this paper is to conduct a retrospective epidemiological analysis of foot and mouth disease (hereinafter referred to as FMD) outbreaks reported in livestock in the Russian Federation from 1991 to 2020. The paper provides space-time patterns of FMD outbreaks and describes risk factors, FMD prevention and control strategies. 97 FMD outbreaks caused by A, O and Asia-1 serotypes were reported in cattle, small ruminants and pigs in the Russian Federation in the study period. These outbreaks were mainly concentrated along the Russian-Chinese border. The analysis reveals a high incidence rate of A and O serotypes, which accounted for 79% of all outbreaks, as well as a trend towards forming time-space clusters in 2005 and in 2013-2019. Sufficient data were collected to identify 9 statistically significant time-space clusters formed by FMD outbreaks: 3 clusters (the FMDV serotype A) lasted 27 - 62 days, 4 clusters (the FMDV serotype O) lasted 6 - 27 days, one cluster (the FMDV serotype Asia-1) lasted 125 days, and a mixed cluster composed of A and O serotypes that lasted 552 days. Risk factors associated with pathogen introduction were underestimated and it undermined biosecurity and biosafety when keeping and moving animals. It has been argued that the underestimation of risk factors is the major cause of outbreaks. Due to it, direct and indirect contacts with carriers, including wild migrating [cloven-hoofed animal](https://www.multitran.com/m.exe?s=cloven-hoofed+animal&l1=1&l2=2)s, became possible. Based on the work carried out we have come to the conclusion that developing cross-border cooperation is urgently needed to prevent and control FMD.

We present two cases of general anesthesia in children with 18, 13 trisomy. One patient had difficulty with intubation and had to be reintubated postoperatively, another developed postoperative acute respiratory distress syndrome. The use of postoperative high-flow nasal cannula oxygen therapy to avoid reintubation is considered a feasible strategy.

This paper is devoted to the numerical treatment of time fractional diffusion equation with mixed boundary conditions. A new scheme based on the combination of the implicit finite difference method for Caputo derivative in time and the mimetic finite difference in space is considered for solving this problem. The stability analysis of the proposed scheme is given by using Von-Neumann method. The numerical results are provided to demonstrate the effectiveness of the proposed method as compared with other finite difference methods.

To explore the impacts of pulse vaccination on the dynamical behaviors of virus, the current paper investigates the threshold dynamics of a viral infection model with impulsive CTL immune response. We first discuss the existence of the infection-free steady state, and define the crucial CTL-activated viral infection reproduction number $R_0$. Then, the fundamental extinction and uniform persistence behaviors of virus are distinguished by various case of the threshold parameter $R_0$. Finally, we still devote to studying special global attractivity of the positive steady state by employing the Lyapunov function. Our results indicate that high vaccination rates stimulate the CTL response more effectively, and can eventually force the virus to eradicate.

Radial long cracks at bolt holes have been observed on steel brake discs used in high-speed rail systems. The crack propagation process is obviously different from traditional thermal fatigue propagation. Because the causes of the cracks and corresponding propagation mode are not well known, further study is warranted. In the present study, the microstructure evolution near the sliding surface of a cast steel brake disc was characterized. The variation in the mechanical properties of the disc material under the influence of microstructure evolution and temperature was analysed. Combining the establishment of the extended finite element model (XFEM) with changes in mechanical properties, the propagation mechanism of the radial long crack at the bolt hole on the brake disc sliding surface was analysed. The microanalysis and tensile test results showed that the grain size and the strength of material gradient increased from the sliding surface to the core of the disc. The simulation results showed that the interaction of strength decline and high-level stress concentration in the vicinity of the bolt hole led to rapid crack propagation along the radial direction of the disc. In addition, the formation of the radial long cracks was equivalent to the introduction of the fatigue crack source on the sliding surface, and the crack was very likely to continue to propagate to the core of the disc through fatigue propagation, which ultimately led to the failure of the brake disc. Based on the results of this study, recommendations regarding the presence of radial long cracks on the sliding surface and maintenance procedures for the cast steel brake disc are proposed.

An atypical coronary artery fistula originated from right coronary sinus of Valsalva with anomalous Left circumflex artery originZixin Xie1,2, Xiaojun Xie1,2, Banghui Lai1,2, Mingbin Deng1,2*1 Department of Cardiovascular Surgery, The Affiliated Hospital Of Southwest Medical University, 8 Kangcheng Road, Jiangyang District, Luzhou 646000, P.R. China.2Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou.*Corresponding author: Mingbin Deng, E-mail: mingbindeng@126.com.Telephone: +8613608288599A 14-year-old male was referred to our institution because of a continuous heart murmur diagnosed at another hospital. Physical examination revealed stable vital signs and a continuous murmur at the mid-left sternal border. The remainder of the examination was unremarkable. The electrocardiogram was normal with no ischemic changes. Cardiac markers were insignificant. Transthoracic echocardiography showed normal left ventricular motion and no valvular disease. Cardiac doppler showed a continuous turbulent flow into the right atrium(Panel A). Multidetector computed tomography(MDCT) revealed an abnormal marked dilation vessel originating from the right coronary sinus of Valsalva. The abnormal vessel developed into a 35 ×29 mm tortuosity aneurysm and eventually flowed into the posterior aspect of the right atrium(Panels B and D). The origin and diameter of the entire RCA were normal(Panel C). In addition, an anomalous origin of left circumflex artery(LCx) from the right coronary sinus of Valsalva was noted(Panels B and C). Because of the presence of a large fistulous tract and rupture risk, the patient was considered a surgical candidate. The fistula is identified from within the right atrium. The aneurysm wall was resected, and the stump was closed with direct sutures. The postoperative morphology of the sinus of Valsalva was excellent, and aortic regurgitation was not observed.Coronary artery fistula(CAF) is defined as a rare congenital or acquired abnormal communication between the coronary arteries and a cardiac chamber or a thoracic great vessel 1. The most common clinical presentation of CAF in children is a persistent heart murmur. Because CAF in children tends to increase with age, early surgical correction is required 2. Coronary artery fistulas can originate from any coronary artery branch 3. However, for this patient, the CAF originated from the right coronary sinus of Valsalva, which mimicking a Sinus of Valsalva aneurysm, there was no remarkable enlargement of right coronary sinus.

The outcomes of the arterial switch operation have improved over a period of time with the elimination of coronary artery anatomy as a risk factor for operative mortality in some series. However, cumulatively, when all the series published so far are analyzed, two coronary variations, namely the single sinus coronary artery origin and intramural type, persist as risk factors for an adverse operative outcome.

There are no solid evidence from literature that compare Cox-Maze with pulmonary vein isolation technique for atrial fibrillation in the context of concomitant mitral valve surgery. While the first is perhaps more effective and linked to higher freedom form atrial fibrillation, it is more invasive compared to the pulmonary isolation.

Cervical hibernoma is a rare, benign lipogenic tumor. Surgical removal of cervical hibernoma is needed when it causes symptoms such as dyspnea or dysphagia due to its mass effect, or when malignancy cannot be excluded. During surgery, en bloc resection is crucial to prevent hemorrhage and recurrence.

Aim: This study aimed to assess the cases of SARS-CoV-2 breakthrough infection and death among AZD1222, Sinopharm, Sputink V, Soberana, and COVAXIN vaccines receivers in Mazandaran. Methods: This retrospective cohort study was involving 320260 cases who received fully vaccinated (two doses) with five types of COVID-19 vaccine (ChAdOx1 nCoV-19, Sinopharm, Sputink V, Soberana, and COVAXIN) between February 2021 to August 2021 in the Mazandaran province. The outcomes of interest were SARS-CoV-2 breakthrough infection and death due to COVID-19 after vaccination. Data were analyzed using R software. Results: Among 320260 COVID-19 vaccine recipients, 712 (0.22%) cases of SARS-CoV-2 breakthrough infections were identified and 94 (0.029%) hospitalized patients died from COVID-19. The cases of SARS-CoV-2 breakthrough infections were in Sinopharm (0.26%), ChAdOx1 nCoV-19 (0.09%), Sputnik (0.21%) Soberana (0.01%) and Covaxin (0.38%), respectively. The cases of death in vaccine recipients in Sinopharm, AZD1222, Sputnik, Soberana, and Covaxin were 81, 11, 1, 1, and 0 cases, respectively. A significant difference was observed between COVID-19 vaccines in terms of death (P<0.05). Conclusion: Based on the findings, the most cases of SARS-CoV-2 breakthrough infection and death were observed in Sinopharm vaccine receivers.

The reported incidence rate of primary segmental omental torsion is 0.0016% to 0.37% and when compared with appendicitis, it is a ratio of less than 4 cases per 1000 cases of acute appendicitis.Almost 80% of cases present with right lower abdominal pain and may imitate acute appendicitis.

Parsonage Turner syndrome (PTS) is a peripheral inflammatory neuropathy of unknown etiology. We present a rare case of a patient with PTS post-covid-19 BNT162b2 mRNA vaccine. Symptoms occurred fifteen days after the second dose. The patient was treated with corticosteroids, analgesics and physical rehabilitation with a partial recovery.

Insulinomas are rare functioning neuroendocrine tumors. Up to 10% of insulinomas are associated with multiple endocrine neoplasia 1 . Several non-invasive and invasive techniques are used to localize the lesion. We present a case of insulinoma presenting with seizures episode , with negative non-invasive imaging results ,diagnosed with endoscopic ultrasound.

Background: IgE antibodies are involved in type-1 hypersensitivity. Cross-linking IgE bound to the high-affinity IgE receptor, FceRI on effector cells with an allergen can cause anaphylaxis. Recent studies have shown that IgE glycosylation significantly impacts the ability of IgE to bind to its high-affinity receptor FceRI and exert effector functions 1,2. We have recently shown that immunization of mice with IgE in complex with an allergen leads to a protective, glycan-dependent anti-IgE response 3. However, to what extent the glycans on IgE determine the induction of those antibodies and how they facilitate serum clearance is unclear. We investigated the role of glycan-specific IgG anti-IgE autoantibodies in regulating serum IgE levels and preventing systemic anaphylaxis by passive immunization. Methods: Mice were immunized using glycosylated or deglycosylated IgE-allergen-immune complexes (ICs) to induce anti-IgE IgG antibodies. The anti-IgE IgG antibodies were purified and used for passive immunization. Results: Glycosylated IgE-ICs induced a significantly higher anti-IgE IgG response and more IgG secreting plasma cells than deglycosylated IgE-ICs. Passive immunization of IgE sensitized mice with purified anti-IgE IgG increased the clearance of IgE and prevented systemic anaphylaxis upon allergen challenge. Anti-IgE IgG purified from the serum of mice immunized with deglycosylated IgE-ICs, led to a significantly reduced elimination and protection, confirming that the IgE glycans themselves are the primary drivers of the protectivity induced by the IgE-immune complexes. Conclusion: IgE glycosylation is essential for a robust anti-IgE IgG response and might be an important regulator of serum IgE level.