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The electricity production from Renewable Energy (RE) in isolated locations requires long-term energy storage systems. To that end, Hybrid Energy Storage Systems (HESS), through a combination of hydrogen and batteries, can benefit from the different advantages of both technologies. This paper presents a hybrid Power-to-Power (PtP) Optimal Power Dispatch (OPD) model for isolated systems with no electric grid access. Currently, the electricity supply in such cases is usually based on a mix of RE as the primary energy source sustained by a diesel genset acting as a backup generator. In this context, the model delivers the hourly energy flows between renewable production sources, energy storage devices and the electrical load, which minimises costs and Green House Gases (GHG) emissions. For validation purposes, the model was tested through its application to a case study in an isolated area in the Canary Islands, Spain. The results show that the algorithm calculates the hourly OPD successfully for a given plant sizing, considering the defined operational states of the different assets. These operational constraints showed a decrease in the PtP round-trip efficiency of 5.4% and a reduction of the hydrogen production of 9.7%. Finally, the techno-economic analysis of the results proves that the combination of hydrogen and batteries with RE production is a feasible alternative to phasing out fossil fuels for the selected case study – reducing the diesel generator usage down to 1.2% of the yearly energy supply. • Novel multi-state optimal power dispatch model for power-to-power energy systems. • Multi-year techno-economic evaluation of an off-grid case study. • Phasing out fossil fuels with renewable energy-based hybrid energy storage systems. • Hydrogen technology contributes to a lower levelized cost of energy. • High initial investment cost was a significant entry barrier to deploying hydrogen. [ABSTRACT FROM AUTHOR]

The use of hydrogen produced from renewable energy enables the reduction of greenhouse gas (GHG) emissions pursued in different international strategies. The use of power-purchase agreements (PPAs) to supply renewable electricity to hydrogen production plants is an approach that can improve the feasibility of projects. This paper presents a model applicable to hydrogen projects regarding the technical and economic perspective and applies it to the Spanish case, where pioneering projects are taking place via photovoltaic PPAs. The results show that PPAs are an enabling mechanism for sustaining green hydrogen projects. • Technical and economic feasibility assessment of green hydrogen projects. • An operational multi-state modeling of electrolyzers is proposed. • PPAs facilitate the decarbonization of hydrogen production facilities. • Sensitivity analysis to PPA prices, network tariffs exemption and public funding rates. [ABSTRACT FROM AUTHOR]

The production of green hydrogen from renewable energy by means of water electrolysis is a promising approach to support energy sector decarbonization. This paper presents a techno-economic model of plants with PV sources connected to electrolysis in self-consumption regime that considers the dynamics of electrolysis systems. The model calculates the optimal hourly dispatch of the electrolysis system including the operational states (production, standby, and idle), the load factor in production, and the energy imports and exports to the electricity grid. Results indicate that the model is a useful decision support tool to operate electrolysis plants connected to PV plants in self-consumption regimes with the target of reducing hydrogen production costs. • A techno-economic model of electrolysis plants with PV sources is formulated. • The model calculates the optimal hourly dispatch of the PV-electrolysis plant. • Forecast of solar PV production and market electricity prices are considered. • Environmental constraints are added to ensure solar PV is used to produce hydrogen. • A case study based on real data is used to test the model in a series of scenarios. [ABSTRACT FROM AUTHOR]

The production of hydrogen through water electrolysis is a promising pathway to decarbonize the energy sector. This paper presents a techno-economic model of electrolysis plants based on multiple states of operation: production, hot standby and idle. The model enables the calculation of the optimal hourly dispatch of electrolyzers to produce hydrogen for different end uses. This model has been tested with real data from an existing installation and compared with a simpler electrolyzer model that is based on two states. The results indicate that an operational strategy that considers the multi-state model leads to a decrease in final hydrogen production costs. These reduced costs will benefit businesses, especially while electrolysis plants grow in size to accommodate further increases in demand. • Multi-state model of electrolysis systems operating in dynamic conditions. • Mathematical formulation of the multi-state model. • Optimal hourly dispatch of grid connected electrolysis systems. • Testing of the model with a real case study against a two states model. • Sensitivity analysis for the case study including yearly results. [ABSTRACT FROM AUTHOR]

The use of hydrogen as energy carrier is a promising option to decarbonize both energy and transport sectors. This paper presents an advanced techno-economic model for calculation of optimal dispatch of large-scale multi MW electrolysis plants in order to obtain a more accurate evaluation of the feasibility of business cases related to the supply of this fuel for different end uses combined with grid services' provision. The model is applied to the Spanish case using different scenarios to determine the minimum demand required from the FCEV market so that electrolysis facilities featuring several MW result in profitable business cases. The results show that grid services contribute to the profitability of hydrogen production for mobility, given a minimum but considerable demand from FCEV fleets. • Techno-economic modelling of multi MW electrolysis to provide grid services. • Optimal economic dispatch of electrolysis units providing grid services. • Presentation of current and future key performance indicators for AWE and PEMWE. • Application of the model to a case study in Spain to supply fleets of FCEVs. • Sensitivity analysis of case study with different technologies and market prices. [ABSTRACT FROM AUTHOR]

Deploying renewable hydrogen presents a significant challenge in accessing off-takers who are willing to make long-term investments. To address this challenge, current projects focus on large-scale deployment to replace the demand for non-renewable hydrogen, particularly in ammonia synthesis for fertiliser production plants. The traditional process, involving Steam Methane Reformers (SMR) connected to Haber-Bosch synthesis, could potentially transition towards decarbonisation by gradually integrating water electrolysis. However, the coexistence of these processes poses limitations in accommodating the integration of renewable hydrogen, thereby creating operational challenges for industrial hubs. To tackle this issue, this paper proposes an optimal dispatch model for producing green hydrogen and ammonia while considering the coexistence of different processes. Furthermore, the objective is to analyse external factors that could determine the appropriate regulatory and pricing framework to facilitate the phase-out of SMR in favour of renewable hydrogen production. The paper presents a case study based in Spain, utilising data from 2018, 2022 and 2030 perspectives on the country's renewable resources, gas and electricity wholesale markets, pricing ranges, and regulatory constraints to validate the model. The findings indicate that carbon emissions taxation and the availability and pricing of Power Purchase Agreements (PPAs) will play crucial roles in this transition - the carbon emission price required for total phasing out SMR with water electrolysis would be around 550 EUR/ton CO 2. • Addressing the co-existence of steam methane reformers and electrolysers. • Novel power dispatch model addressing the flexibility of co-existential pathways. • PPA availability and pricing and ETS taxation as key enablers of renewable hydrogen. • Carbon intensity constraints heavily impact the project's sizing and feasibility. • Techno-environmental study of the carbon intensity of ammonia production. [ABSTRACT FROM AUTHOR]

Ketamine, a dissociative anesthetic drug, has gained popularity as a recreational substance, particularly among young adults. However, chronic ketamine abuse can lead to various complications including ketamine-induced cystitis. We present the case of a 46-year-old Caucasian male with a history of HIV infection and daily recreational ketamine use for 7 months, who was admitted to the emergency room with hypogastric pain and hematuria. Laboratory examinations and contrast-enhanced abdominal CT tomography revealed significant irregular circumferential thickening of both ureters, substantial bilateral pyeloureteral ectasia, and a bladder with markedly thickened walls. Bilateral flexible ureteropyeloscopy, bladder transurethral resection, and bladder fulguration were performed, and pathology confirmed the diagnosis of ketamine-induced cystitis. Treatment consisted of ketamine withdrawal, pain relief, and support from psychiatrists and urologists. The patient's symptoms improved and he was discharged without complications. This case highlights the importance of recognizing the potential adverse effects of recreational ketamine use and the need for a multidisciplinary approach to managing ketamine-induced cystitis. Further research is necessary to elucidate the precise mechanisms underlying this condition and develop effective prevention and treatment strategies., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Invasive lobular carcinoma (ILC) represents the second most common subtype of breast cancer (BC), accounting for up to 15% of all invasive BC. Loss of cell adhesion due to functional inactivation of E-cadherin is the hallmark of ILC. Although the current world health organization (WHO) classification for diagnosing ILC requires the recognition of the dispersed or linear non-cohesive growth pattern, it is not mandatory to demonstrate E-cadherin loss by immunohistochemistry (IHC). Recent results of central pathology review of two large randomized clinical trials have demonstrated relative overdiagnosis of ILC, as only ~60% of the locally diagnosed ILCs were confirmed by central pathology. To understand the possible underlying reasons of this discrepancy, we undertook a worldwide survey on the current practice of diagnosing BC as ILC. A survey was drafted by a panel of pathologists and researchers from the European lobular breast cancer consortium (ELBCC) using the online tool SurveyMonkey®. Various parameters such as indications for IHC staining, IHC clones, and IHC staining procedures were questioned. Finally, systematic reporting of non-classical ILC variants were also interrogated. This survey was sent out to pathologists worldwide and circulated from December 14, 2020 until July, 1 2021. The results demonstrate that approximately half of the institutions use E-cadherin expression loss by IHC as an ancillary test to diagnose ILC and that there is a great variability in immunostaining protocols. This might cause different staining results and discordant interpretations. As ILC-specific therapeutic and diagnostic avenues are currently explored in the context of clinical trials, it is of importance to improve standardization of histopathologic diagnosis of ILC diagnosis., (© 2022. The Author(s).)

Desmoplastic small round cell tumor (DSRCT) is a rare malignancy, of uncertain differentiation, which more commonly affects adolescents and young adult males; it usually has an intra-abdominal location. We describe the case of a 35-year-old male who presented initially with occasional abdominal pain, and subsequently with abdominal mass sensation, without any other associated symptoms. Imaging studies reported an intra-abdominal mass located in mesogastrium, right hypochondrium, and right lumbar region, without clear evidence of infiltration to secondary structures, but with clear peritoneal spread to greater omentum and pelvis. Definitive diagnosis of DSRCT is based on histologic and immunohistochemical findings. Standard treatment includes intensive neoadjuvant chemotherapy, surgical cytoreduction, and radiotherapy. Despite this multidisciplinary approach, DSRCT has a poor prognosis and a high mortality rate at five years., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Matute et al.)

Tall cell carcinoma with reversed polarity (TCCRP) of the breast is a rare entity with low potential for malignancy that exhibits some morphological similarities to the tall cell variant of papillary thyroid carcinoma. Immunohistochemical and molecular studies help establish the mammary origin of this neoplasm. Here, we describe the case of a 63-year-old woman with a finding of a nodular lesion during a screening mammogram, whose morphological findings and immunohistochemical studies confirmed the diagnosis of papillary high cell carcinoma with the reverse polarity of the mammary gland., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Matute et al.)

A hibernoma is an uncommon benign soft tissue tumor composed of brown adipose cells; the mediastinal location as presentation is scarce, with only six cases previously reported. The diagnosis of hibernoma is challenging and must be made based on the clinical, radiographic, and cytologic features. Here we present a 33-year-old woman without any relevant medical history presented for outpatient evaluation of a dry cough persisting for three months, and the X-rays revealed a dense well-defined mass with smooth borders in the left upper posterior mediastinum.  Posterior mediastinal lesions represent a relatively small proportion of patient loads in thoracic surgery and account for a total of 25% of the cases, with neurogenic tumors among the most frequently seen in adults. Of these, the nerve sheath tumors (schwannoma, neurofibroma, paraspinal ganglioneuroma) are the most seen. Other differential diagnoses of paravertebral masses are the paraspinal abscess, metastases, hematoma, descending aortic aneurysm, among others. The patient underwent surgical resection via left posterolateral thoracotomy, without complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Muñoz-Palacio et al.)

In this research, the detection and quantification of adulterants in one of the most common varieties of extra virgin olive oil (EVOO) have been successfully carried out. Visible absorption information was collected from binary mixtures of Picual EVOO with one of four adulterants: refined olive oil, orujo olive oil, sunflower oil, and corn oil. The data gathered from the absorption spectra were used as input to create an artificial neural network (ANN) model. The designed mathematical tool was able to detect the type of adulterant with an identification rate of 96% and to quantify the volume percentage of EVOO in the samples with a low mean prediction error of 1.2%. These significant results make ANNs coupled with visible spectroscopy a reliable, inexpensive, user-friendly, and real-time method for difficult tasks, given that the matrices of the different adulterated oils are practically alike.

The estimation of the density and refractive index of ternary mixtures comprising the ionic liquid (IL) 1-butyl-3-methylimidazolium tetrafluoroborate, 2-propanol, and water at a fixed temperature of 298.15 K has been attempted through artificial neural networks. The obtained results indicate that the selection of this mathematical approach was a well-suited option. The mean prediction errors obtained, after simulating with a dataset never involved in the training process of the model, were 0.050% and 0.227% for refractive index and density estimation, respectively. These accurate results, which have been attained only using the composition of the dissolutions (mass fractions), imply that, most likely, ternary mixtures similar to the one analyzed, can be easily evaluated utilizing this algorithmic tool. In addition, different chemical processes involving ILs can be monitored precisely, and furthermore, the purity of the compounds in the studied mixtures can be indirectly assessed thanks to the high accuracy of the model.

Aim. Our aim was (1) to determine the frequency of insulin resistance (IR) in patients with Duchenne/Becker muscular dystrophy (DMD/BMD), (2) to identify deleted exons of DMD gene associated with obesity and IR, and (3) to explore some likely molecular mechanisms leading to IR. Materials and Methods. In 66 patients with DMD/BMD without corticosteroids treatment, IR, obesity, and body fat mass were evaluated. Molecules involved in glucose metabolism were analyzed in muscle biopsies. Results show that 18.3%, 22.7%, and 68% were underweight, overweight, or obese, and with high adiposity, respectively; 48.5% and 36.4% presented hyperinsulinemia and IR, respectively. Underweight patients (27.3%) exhibited hyperinsulinemia and IR. Carriers of deletions in exons 45 (OR = 9.32; 95% CI = 1.16-74.69) and 50 (OR = 8.73; 95% CI = 1.17-65.10) from DMD gene presented higher risk for IR than noncarriers. We observed a greater staining of cytoplasmic aggregates for GLUT4 in muscle biopsies than healthy muscle tissue. Conclusion. Obesity, hyperinsulinemia, and IR were observed in DMD/BMD patients and are independent of corticosteroids treatment. Carriers of deletion in exons 45 or 50 from DMD gene are at risk for developing IR. It is suggested that alteration in GLUT4 in muscle fibers from DMD patients could be involved in IR.

A wide variety of olive oil samples from different origins and olive types has been chemically analyzed as well as evaluated by trained sensory panelists. Six chemical parameters have been obtained for each sample (free fatty acids, peroxide value, two UV absorption parameters (K232 and K268), 1,2-diacylglycerol content, and pyropheophytins) and linked to their quality using an artificial neural network-based model. Herein, the nonlinear algorithms were used to distinguish olive oil quality. Two different methods were defined to assess the statistical performance of the model (a K-fold cross-validation (K = 6) and three different blind tests), and both of them showed around a 95-96% correct classification rate. These results support that a relationship between the chemical and the sensory analyses exists and that the mathematical tool can potentially be implemented into a device that could be employed for various useful applications.

Statistical models have been used to estimate the refractive index of 72 imidazolium-based ionic liquids using the electronic polarisability of their ions as the data for two different mathematical approaches: artificial neural networks, in the form of multi-layer perceptrons, and multiple linear regression models. Although the artificial neural networks and linear models have been able to accomplish this task, the multi-layer perceptron model has been shown to be a more accurate method, thanks to its ability of determining non-linear relationships between different dependent variables. Additionally, it is clear that the multiple linear regression presents a systematic deviation in the estimated refractive index values, which confirms that it is an inappropriate model for this system.

Tumor necrosis factor alpha antagonists (TNFA) are biological agents to treat chronic inflammatory and autoimmune diseases. However, their use is associated with an increased rate of tuberculosis, endemic mycoses, and intracellular bacterial infections. Since tuberculosis is moderately to highly endemic in Colombia, the risk of these infections in patients treated with TNFAs may be higher than previously reported in Colombia. Recently, four patients have developed tuberculosis during TNFA therapy. Tuberculosis appeared between 3 to 24 months after initiation of TFNA therapy and was independent of previous tuberculin skin test status. A review of the relevant literature and recommendations are presented as guides for surveillance and prophylaxis on a country-wide basis.

A cross-sectional and multicenter study was undertaken to analyze the clinical and immunological characteristics at diagnosis associated with nephritis in northwestern Colombian patients with systemic lupus erythematosus (SLE). Thirty-nine patients with lupus nephritis were included and were compared to 100 SLE patients without nephritis. A multivariate analysis was performed. The patients who developed nephritis had a higher frequency of oral ulcers (41% vs. 21%, OR = 3.1, 95% CI: 1.3-7.5 p = 0.01) and malar erythema (77% vs. 45%, OR = 4.4, 95% CI: 1.8-10.8 p = 0.001). Lupus nephritis was observed in 77% of cases during the first year of the disease. The frequency of anti-DNA antibodies was higher in patients with nephritis, however, differences were not statistically significant (83% vs 64%, OR = 2.6, 95% CI: 1.03-6.41, p = 0.06). The presence of other autoantibodies (anti-Ro, anti-La, anti-RNP, anti-Sm and anticardiolipin) at diagnosis was similar in both groups. This autoantibody profile remained unchanged throughout the evolution of the disease. Patients with lupus nephritis had a higher prevalence of arterial hypertension (60% vs 10%, OR = 13.7, 95% IC: 5-37, p = 0.00001) and hyperlipidemia (30% vs 7%, OR = 8.1, 95% IC: 2.5-27, p = 0.0006) at onset. Finally, patients with lupus nephritis required more hospitalizations (> 1) over the course of disease (89% vs 60%, OR = 7.8, 95% CI: 2.1-29, p = 0.002). In conclusion, lupus nephritis appears early during the course of SLE. Malar erythema, oral ulcers, hypertension and hyperlipidemia at onset of disease are associated factors. Lupus nephritis is a major risk factor leading to repeated hospitalizations. This study may help to assist in public health policies in our population in order to improve patient outcomes while simultaneously reducing disease costs.

Objective: To describe the epidemiology of iron, zinc and iodide deficiencies in a probabilistic sample of Mexican women and children and explore its association with some dietary and socio-demographic variables., Material and Methods: We carried out in 1999 an epidemiological description of iron (percent transferrin saturation, PTS, < 16%), serum zinc (< 65 ug/dl) and iodide (< 50 ug/l urine) deficiencies in a probabilistic sample of 1,363 Mexican children under 12 years and of 731 women of child-bearing age. Serum iron, Total Iron Binding Capacity (TIBC) and zinc were measured by atomic absorption spectrometry, and urinary iodide by a colorimetric method. Logistic regression models explored determinants for such micromineral deficiencies., Results: Iron deficiency was higher (67%) in infants < 2 years of age. Prevalence declined (34-39%) at school age. The prevalence for iron deficiency in women was 40%. Zinc deficiency was higher in infants < 2 years of age (34%) than in school-age children (19-24%). Prevalence in women was 30%, with no rural/urban difference. In women the likelihood of iron deficiency decreased as SEL improved (p = 0.04) and increased with the intake of cereals (p = 0.01). The likelihood of low serum zinc levels was greater in women and children of low socioeconomic level (SEL) (p < 0.02 and p = 0.001) iodide deficiency was negligible in both children and women., Conclusions: The data shows high prevalence of iron deficiency-specially in infants 12 to 24 months of age. It is suggested that in older children and women 12 to 49 years of age that iron bioavailability is low. The prevalence of zinc deficiency was also very high. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.