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The volume of end-of-life automotive batteries is increasing rapidly as a result of growing electric vehicle adoption. Most automotive lithium-ion batteries (LIBs) are recycled but could be repurposed as second-life batteries (SLBs) since they have 70-80% residual capacity, which can be adequate for stationary applications. SLBs have been proposed as potential, inexpensive, low-carbon energy storage for residential and utility-level applications, with or without photovoltaics (PV). However, it is unknown whether SLBs will be better than new batteries and whether SLBs will provide similar cost and carbon emission reduction for the different stationary applications in all locations. This work compared the levelized cost of electricity and life-cycle carbon emissions associated with using SLBs and new LIBs in the US for three energy storage applications: (1) residential energy storage with rooftop PV, (2) utility-level PV firming, and (3) utility-level peak-shaving, leading to a total of 41 scenarios. SLBs reduced the levelized cost of electricity by 12-57% and carbon emissions by 7-31% compared to new LIBs in the considered applications, with higher reductions for utility-level applications. SLBs still provided benefits at the residential level when compared to rooftop PV alone by reducing the levelized cost by 15-25% and carbon emissions by 22-51%, making SLBs attractive to residential consumers as well. SLBs offer an opportunity to utilize an end-of-life product for energy storage applications, provided the uncertainty in SLB quality and availability is addressed.

Hydatid cysts can be found in almost any organ of the body with the most common sites being liver, lung, spleen, and kidney. A pancreatic hydatid cyst is rare but an isolated pancreatic hydatid cyst is even rarer. Cysts in the head of pancreas usually present with jaundice, whereas cysts located in the body and tail are usually asymptomatic. We present a rare case of isolated pancreatic hydatid cyst that presented with acute pancreatitis and mimicked a pancreatic fluid collection.

Background Microscopic colitis (MC) remains an elusive cause of chronic diarrhea. Histopathology is a gold standard with variable yield. The OCTT and concomitant lactose intolerance in these cases may aid to understand the complex symptoms. We used Hydrogen(H2) breath tests (H2BT) for detecting SIBO (Small Intestinal Bacterial Overgrowth), Lactose intolerance and calculation of oro-cecal transit time (OCTT). Methods 43 MC patients [mean age - 45.83(±15.92] and 10 controls were studied. Among these, 37(86%) patients with MC & 9 (90%) controls underwent breath tests. SIBO was diagnosed with glucose H2BT. For confirmation, we took rise ≥12 ppm over fasting value in H2 concentration within 2hours of glucose ingestion Lactulose H2BT was done to calculate OCTT. Time taken for rising in breath hydrogen by ≥12ppm over baseline value in two consecutive readings was considered as OCTT. For lactose breath test, 15 minutes samples were taken up to 4 hours. A ≥20 ppm rise over fasting value in H2concentration in two consecutive readings was considered intolerance Results Four(9.5%) patients of SIBO in Glucose H2BT were enrolled in controls. Mean (+ SD) OCTT in cases of MC vs controls was 130.38±47.95 mins and 97.14±48.55 mins (p= 0.109) respectively. Thus OCTT increased in 73% cases of MC vs 43% controls. Also, in the MC group, 9(28.1%) patients were lactose intolerant while vs 3(42.9%) controls (p= 0.654). Thus a significant 28% MC patients were lactose intolerant possibly aggravating symptoms Conclusions Lactose intolerance has lesser prevalence in cases of microscopic colitis. These patients were also detected to have paradoxically prolonged OCTT excluding the role of small bowel in diarrheal symptoms

Background Chronic diarrhea due to Microscopic colitis (MC) is often overlooked. Restriction of disease to the colon is still unclear, and on drawing analogies from Idiopathic Ulcerative Colitis any proximal disease extension may have bearing on treatment regimes. We evaluated terminal ileum using narrow band imaging (NBI), high definition white light endoscopy (HDWLE) and histopathological findings on biopsy Methods 53 adults with suspected MC were enrolled. All underwent colonoscopy with ileal intubation. Segmental colonic and terminal ileum biopsies were obtained using HDWLE and NBI. Same were analysed by expert gastrointestinal histopathologist Results In 43 patients of confirmed MC, HDWLE of ileum was normal. On NBI, intravillous capillary network was regular unbranched with semi-circular pattern in 41(95.4%) of patients of MC and in all controls. It was sparse and irregular in 2(4.7%) cases. Peyer’s patch domes were indistinct in 5(9.4%), normal in 38(88.4%) cases and normal in all controls (p = 0.570). Peyer’s patch vessels were regular and unbranched in 38(88.4%) cases and all controls. They were sparse and irregular in 5 cases (11.6%) (p = 0.570). Ileal histopathology revealed normal villi in 39 (90.6%) cases, 4 had partial villous atrophy. The crypt villous ratio was grouped as 1:1.5, 1:3, 1:4 and 1:5 in 2 (4.6), 26 (60.4),11 (25.5%) and 4 (9.3) respectively. Lymphoplasmacytic infiltrate was grouped as mild, moderate and severe, and observed in 10 (23.2%), 2 (4.6%) and 1 (2.3%) patient respectively Conclusions Ileal NBI findings in MC are hitherto unreported, with up to 12% showing abnormalities. Histologically up to 23% showed abnormalities in ileal biopsies. Ileal pathology may contribute to certain symptoms in MC

The economic and environmental performance of residential rooftop photovoltaics (PVs) with Second Life Batteries (SLBs) was evaluated in five US cities. The annualized system cost and global warming potential (GWP) of SLB with PV were compared with those of grid-connected PV. Adding SLBs provided cost reduction relative to the grid-connected PV if excess electricity generated by the PV is not sold back to the grid; otherwise, adding SLBs increased the cost. The combination of SLBs with PV had the lowest GWP for all scenarios considered. Time-of-use pricing structure showed similar trends as well.

Background Ileo-cecal ulcers could result from a number of conditions including intestinal tuberculosis and Crohn’s disease. We report the use of GeneXpert Mtb/Rif in the diagnosis of ITB in patients with ileo-cecal ulcers. Methods One year retrospective study involving patients with ileo-cecal ulcers who underwent GeneXpert Mtb/Rif from the intestinal biopsies taken from ulcers. The results of the test were compared with the final diagnosis. We divided the patients into two groups: those with a final diagnosis of ITB and those with a final diagnosis other than ITB (OTH). Results Of the 40 patients with ileo-cecal ulcers included, 23 (57.5%) were females and the mean age was 32.92±12.78 years. Abdominal pain was present in 33 (88.5%) patients and diarrhea in 12 (30%). Out of 40 patients, 25 had ITB and 15 patients were in the OTH group. The sensitivity, specificity, negative predictive value, the positive predictive value and accuracy of GeneXpert-Mtb/Rif for diagnosis of ITB was 32% (CI: 14.95–53.50%), 100% (78.2–100), 46.88% (40.27–53.59%), 100 & 57.50 (40.89–72.89)% respectively. Conclusions A positive GeneXpert-Mtb/Rif is helpful in the diagnosis of ITB but the sensitivity is low.

This work evaluates the energy benefit of transparent photovoltaics (TPV) for window application for two different donor materials. TPVs made of chloroaluminum phthalocyanine and heptamethine harvest energy from the near-infrared region of the spectrum and have the potential to reduce cooling energy. Due to the absorption property of the TPV material, energy-saving changes with location in the United States (U.S.). This work quantifies the energy savings using two types of TPVs in five types of commercial buildings and four different locations.

Subdural haematoma (SDH) is the collection of blood below the inner layer of the dura but external to the brain and the arachnoid membrane. It is the most common type of traumatic intracranial mass lesion seen. Chronic subdural haematoma (CSDH) usually presents with headache, fluctuating level of consciousness, falls, seizures, focal or transient neurological deficits and hemiparesis1 (Table 1). Isolated third nerve palsy is a common presentation of intracranial aneurysms, diabetes mellitus, trauma and in chronic lymphocytic meningeal infiltration. Subdural haematomas presenting with an isolated unilateral oculomotor paralysis, without any other notable signs or symptoms, except for mild headache, however, are very unusual. To the best of our knowledge it has been reported only thrice earlier in literature.2–4 Table 1 Presentations of chronic subdural haematoma.1 Here we report one such rare case of CSDH in a relatively young individual who presented with unilateral complete third nerve palsy as the only presenting sign and a normal level of consciousness.

Growth of wireless technologies with its increased user demands of applications makes this area more vulnerable for attackers and intruders. The attacker continuously trying to affects the communication and getting the benefits from gamming the network with higher data drop rates. Among them, the most famous and dangerous attacks is blackhole by which a node starts dropping a data and behaving as a normal node. During the last few years various solutions are provided for overcoming the active and passive blackhole detection and termed as malicious node detections. Any node, affecting the actual performance or operation of network will be termed as malicious node and blackhole is its one category. The existing mechanism only detects the static blackhole attacks but is not capable to detect sudden change in the behavior of node from legitimate to malicious. Thus this paper proposes a CTV (Consistent Trust Value) mechanism based on some of the performance parameter analysis such as PDR, throughput, delays and TTL values by which timely triggered and normal blackhole node is detected with higher accuracy. By regular analysis those improper behaviour is detected in timely manner and reduces the probability of data drops. At the initial level of evaluation the approach is proving its strong presence among the existing methods. Index Terms: MANET (Mobile Ad-Hoc Network), AODV, Routing, Attacks, Timely Triggered Blackhole, CTV (Consistent Trust Value), Reliable Path

Introduction: Data on the use of Xpert Mtb/Rif for the diagnosis of intestinal tuberculosis is sparse. We report on the utility of Xpert Mtb/Rif testing for diagnosis of intestinal tuberculosis (ITB) in patients with ileocecal ulcers Methodology: We performed a retrospective analysis of patients with ileocecal ulcers and suspected to have ITB and in whom testing of intestinal tissue for Xpert Mtb/Rif was performed. The patients were divided into two groups: those with a final diagnosis of intestinal tuberculosis and those with other diagnosis. These patients were compared for clinical features and presentation. The sensitivity, specificity, positive predictive value, and negative predictive value of Xpert Mtb/Rif for the diagnosis of ITB were calculated. Results: Of the 40 patients studied, 23 were women and the mean age was 32.92 ± 12.78 years. Abdominal pain was present in 33 (88.5%) patients and diarrhea in 12 (30%). A total of 25 patients had underlying ITB whereas 15 patients had other diagnoses (Crohn’s disease, amebiasis, nonspecific ileitis, etc.). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of GeneXpert-Mtb/Rif was 32% (CI: 14.95–53.50%), 100% (78.2–100), 46.88% (40.27–53.59%), 100 & 57.50 (40.89–72.89%) respectively. Conclusion: A positive GeneXpert-Mtb/Rif helps in the diagnosis of ITB, but the sensitivity is low.

Dengue fever is the most prevalent form of flavivirus infection in humans. Borne by the Aedes mosquito, the infection is endemic in more than 100 countries mostly in the developing world and those around the tropics and the warm temperate regions of the world. The highest incidence occurs in Southeast Asia, India, and the American tropics. Worldwide more than 100 million people are infected annually.1 Recent studies indicate that the clinical profile of dengue is changing, and that neurological manifestations are now being reported more frequently, though their exact incidence is uncertain.2 Ocular findings in dengue fever were also considered rare previously. However now, a wide spectrum of ocular manifestations ranging from mild non-specific symptoms to severe retinal hemorrhages, are being regularly reported.3,4 However, abducens nerve involvement, manifesting with lateral rectus paralysis following dengue is so rare that it has only been reported once, earlier in literature.5