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Objective: Young migraine patients often present with white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI). This study aimed to analyze whether synthetic (Syn) T2-FLAIR and Syn double inversion recovery (DIR) can reveal WMHs more clearly and sensitively than conventional T2-FLAIR. Materials and Methods: Conventional MRI and Syn MRI data from 50 young migraine patients were analyzed prospectively. WMHs in each anatomical region (periventricular, deep white matter, and juxtacortical) were recorded separately. The differences in the clarity of lesion boundaries and the number of lesions displayed in the three sequences in the same anatomical region were analyzed. Results: A total of 80 (periventricular area, 15; deep white matter, 31; juxtacortical area, 34), 163 (17, 50, 96), and 134 (18, 42, 74) lesions were observed with conventional T2-FLAIR, Syn T2-FLAIR, and Syn DIR, respectively. Syn T2-FLAIR and Syn DIR can show lesions more clearly than conventional T2-FLAIR (all P < 0.001). There was no significant difference in the number of lesions observed in the periventricular white matter among the three sequences (P = 0.159, 0.083, 0.322). Syn T2-FLAIR and Syn DIR can detect more lesions in the deep white matter than conventional T2-FLAIR (P < 0.001, P = 0.006). Syn T2-FLAIR revealed more lesions in the juxtacortical white matter than Syn DIR and conventional T2-FLAIR imaging (all P < 0.001), and conventional T2-FLAIR revealed the fewest lesions (P < 0.001). Conclusion: Syn T2-FLAIR and Syn DIR sequences can clearly and sensitively detect WMHs, especially in deep and juxtacortical white matter areas. [ABSTRACT FROM AUTHOR]

Introduction: The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a rare condition caused by an immune response associated with over-reactivity of the immune system, triggered by adjuvants. The most common adjuvants are aluminium salts but can also be bioimplants or infectious agents. It may lead to the development of various autoimmunologic diseases. Case Report: In the following article, we present the case of a 26-year-old woman who developed SLE likely induced by ASIA syndrome after the aesthetic medicine procedures. The patient was admitted because of arthralgia and fever. She also presented with a butterfly-shaped erythema on her face and erythematous and infiltrative skin lesions on the posterior surface of the thighs and buttocks. We performed numerous diagnostic tests, including laboratory tests, immunological tests, imaging diagnostics such as chest X-ray and USG of the abdomen and joints, and the biopsy of the skin lesion on the left thigh. The results of the diagnostic process led us to diagnose SLE. The patient fulfilled the ACR/EULAR 2019 classification criteria of the SLE. Laboratory results also led to the diagnosis of autoimmune haemolytic anaemia. Due to exposure to numerous adjuvants like tattoo ink, hyaluronic acid, and piercing and the development of the delayed inflammatory reaction (DIR) to hyaluronic acid (HAF), the patient also fulfilled the criteria of ASIA. In the treatment process we applied antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, hydroxychloroquine, and cyclosporine. The treatment resulted in an improvement in the general condition, resolution of swelling and joint pain, and improvement in skin lesions. Conclusions: ASIA syndrome after bioimplantation is still underdiagnosed, probably due to ignorance or diagnostic difficulties, as symptoms are uncharacteristic and there is no immunological marker for this syndrome. In addition, as in the presented case, it can develop several years after the procedure, and it is difficult for both patient and physician to become aware of the connection. Early diagnosis requires a multidisciplinary approach and may require immunosuppressive treatment in specific cases. [ABSTRACT FROM AUTHOR]

Purpose: Deformable image registration (DIR) has been increasingly used in radiation therapy (RT). The accuracy of DIR algorithms and how it impacts on the RT plan dosimetrically were examined in our study for abdominal sites using biomechanically modeled deformations. Methods: Five pancreatic cancer patients were enrolled in this study. Following the guidelines of AAPM TG‐132, a patient‐specific quality assurance (QA) workflow was developed to evaluate DIR for the abdomen using the TG‐132 recommended virtual simulation software ImSimQA (Shrewsbury, UK). First, the planning CT was deformed to simulate respiratory motion using the embedded biomechanical model in ImSimQA. Additionally, 5 mm translational motion was added to the stomach, duodenum, and small bowel. The original planning CT and the deformed CT were then imported into Eclipse and MIM to perform DIR. The output displacement vector fields (DVFs) were compared with the ground truth from ImSimQA. Furthermore, the original treatment plan was recalculated on the ground‐truth deformed CT and the deformed CT (with Eclipse and MIM DVF). The dose errors were calculated on a voxel‐to‐voxel basis. Results: Data analysis comparing DVF from Eclipse versus MIM show the average mean DVF magnitude errors of 2.8 ± 1.0 versus 1.1 ± 0.7 mm for stomach and duodenum, 5.2 ± 4.0 versus 2.5 ± 1.0 mm for small bowel, and 4.8 ± 4.1 versus 2.7 ± 1.1 mm for the gross tumor volume (GTV), respectively, across all patients. The mean dose error on stomach+duodenum and small bowel were 2.3 ± 0.6% for Eclipse, and 1.0 ± 0.3% for MIM. As the DIR magnitude error increases, the dose error range increase, for both Eclipse and MIM. Conclusion: In our study, an initial assessment was conducted to evaluate the accuracy of DIR and its dosimetric impact on radiotherapy. A patient‐specific DIR QA workflow was developed for pancreatic cancer patients. This workflow exhibits promising potential for future implementation as a clinical workflow. [ABSTRACT FROM AUTHOR]

This article analyses how and why the northwest borderland region of Pakistan has become one of the world’s most heavily militarised regions. Before 9/11, the area was a historical colonial frontier, experiencing significant militarism and violence during the Cold War. After the 9/11 attacks and the American and allied forces’ invasion and occupation of Afghanistan, however, the Pakistani military undertook a massive intervention and deployment in the region and established a chain of checkpoints aimed at filtering and disciplining the local population. Consequently, local inhabitants have endured severe treatment from the military and other coercive apparatuses. Using an ethnographic method, this article documents the daily experiences of the local people amidst pervasive militarisation. It contends that recent instances of state violence and militarisation cannot solely be attributed to 9/11 but are deeply rooted in the region’s historical treatment as a buffer zone during colonial times. In this context, Pakistan’s postcolonial state has heavily relied on its violent methods and securitised infrastructure to regulate both the region and its people. [ABSTRACT FROM AUTHOR]

Using deep learning models like Convolutional Neural Networks (CNN), Recurrent Neural Networks (RNN), Deep Neural Networks (DNN), and Random Multimodel Deep Learning (RMDL), this review paper provides an extensive examination of Document Information Retrieval (DIR). The study carefully analyses and assesses the accuracy of these individual models and ensemble strategies in DIR tasks, drawing on a close reading of more than 25 research papers. [ABSTRACT FROM AUTHOR]

Dissimilatory iron reduction (DIR) can drive the release of organic carbon (OC) as carbon dioxide (CO2) by mediating electron transfer between organic compounds and microbes. However, DIR is also crucial for carbon sequestration, which can affect inorganic‐carbon redistribution via iron abiotic–phase transformation. The formation conditions of modern carbonate‐bearing iron minerals (ICFe) and their potential as a CO2 sink are still unclear. A natural environment with modern ICFe, such as karst lake sediment, could be a good analog to explore the regulation of microbial iron reduction and sequential mineral formation. We find that high porosity is conducive to electron transport and dissimilatory iron‐reducing bacteria activity, which can increase the iron reduction rate. The iron‐rich environment with high calcium and OC can form a large sediment pore structure to support rapid DIR, which is conducive to the formation and growth of ICFe. Our results further demonstrate that the minimum DIR threshold suitable for ICFe formation is 6.65 μmol g−1 dw day−1. DIR is the dominant pathway (average 66.93%) of organic anaerobic mineralization, and the abiotic‐phase transformation of Fe2+ reduces CO2 emissions by ~41.79%. Our findings indicate that as part of the carbon cycle, DIR not only drives mineralization reactions but also traps carbon, increasing the stability of carbon sinks. Considering the wide geographic distribution of DIR and ICFe, our findings suggest that the "iron mesh" effect may become an increasingly important vector of carbon sequestration. [ABSTRACT FROM AUTHOR]

This is a very first attempt to study various parameters of a medicinal plant, Delphinium suave Huth. The plant is erect, geophytic, herbaceous, with tuberous root, trifid in a palmatipartite, strigose cuneate leaf and white spurred zygomorphic flower. The root was isodiametric phellem with single non‐glandular trichomes. The stem revealed single‐layered cuticle, multiseriate epidermis, cortex, pith ray and uniserate bowed non‐glandular trichomes. The leaf was amphistomatic, showed tapering trichomes, prismatic crystals and ranunculaceous stomata with circumference 144.66–182.67 μm. Pollen grains in Light Microscopy (LM), were prolate, spheroidal trizonocolpate, isopolar, radiosymmetric, scabrate, elliptic and monads. Scanning Electron Microscope (SEM) pollen surface was scabrate, monad, size varied from 18.06 to 16.67 μm, colpus to inaperturate, tricolpate, ornamented, echinus, isopolar, isodiametric and circular. SEM roots showed sclerenchymatic tissues, stellate, glandular, non‐glandular trichomes and crystals. The stem showed scalariform, pitted vessels, warty protuberances, unicellular, silicified, non‐glandular trichomes. Leaves powder revealed, simple, unicellular, tapered headed, uniseriate, sessile, capitate, unbranched glandular, non‐glandular, trichomes with crystals. Capitate, stellate, circular, unicellular, branchy trichomes were observed for the first time through SEM. Powder drug study of root, stem leaves through LM revealed different tissues. Preliminary phytochemical revealed alkaloids, anthocyanins, anthraquinones, coumarins, flavones, mucilages, saponins, steroids, terpenoids, volatile oils and proteins. GC/MS showed 36 compounds in roots, 33 in stem while 40 in leaves. Fluorescence analysis of roots, stem and leaves showed variations in color when treated with chemicals. This study will assist pharmacognostic exploration, authentication from adulterants/allied species for consistent quality, resulting in safe use, preservation and efficacy. Research Highlights: This was first attempt on pharmacognostic study on D. suave Huth. which could be used as a foundation for identifying and authenticating the specie from other allied species by these morphological, anatomical, GC/MS profiling, phytochemical analysis and fluorescence analysis. [ABSTRACT FROM AUTHOR]

Background. There is a rising concern about multiple sclerosis (MS) lesions that occur in the cortical gray matter (GM), owing to its direct relationship with the disability and cognition dysfunction that occur during the MS course. Two magnetic resonance imaging (MRI) sequences that aid in the precise identification of these lesions are the Double Inversion Recovery (DIR) and Fluid Attenuation Inversion Recovery (FLAIR) sequences. Objective. To study the importance of the DIR for brain lesion detection and the various cortical subtypes distinction in MS-diagnosed patients and its correlations to the level of patient disability by comparing it to FLAIR. Patients and Methods: Thirty MS patients participated in this retrospective cross-sectional study, who had been previously diagnosed with MS and were routinely followed up at the Radiology Department at Ain-Shams University. Results. Comparing the DIR sequence to FLAIR, the overall MS lesion detection enhanced by 8% (p

Abstract This study was designed to assess the ichthyofaunal diversity of River Panjkora, Khyber Pakhtunkhwa, Pakistan. For this purpose, a total of 1189 fish from six different sites were collected along the river and identified using standard keys. The fish collected and identified were representing 38 species, belonging to 7 families. The investigation spanned a year, from July 2021 to May 2022. The most dominant family was Cyprinidae 76% (n=906/1189), followed by Nemacheilidae 5.8% (n=69/1189), Channidae 5.2% (n=62/1189), Sisoridae 5.1% (n=61/1189), Mastacembelidae 4.9% (n=58/1189), Salmonidae 2.6% (n=31/1189) and least was Bagridae 0.17 (n=2/1189). The most abundant speices was Schizothorax plagiostomus with relative density of 16.8. Family Cyprinidae was represented by 21 species, Sisoridae by 7 species, Nemacheilidae by 5 species, Channidae by 2 species, while Bagridae, Salmonidae and Mastacembelidae, were each represented by a single species. PAST 3, XLSTAT and EXCEL 2019 were used for principal component analysis to study correlation of fish diversity and richness. Eigenvalue obtained from Kumrat to Busaq were 3.32, 1.01, 0.80, 0.44, 0.31 and 0.10 respectively. The higher value at Kumrat shows higher diversity. The water quality assessment showed average value of water temperature 10.4 ͦC, pH 7.0, electrical conductivity 184 mg/L, dissolved oxygen 7.9 mg/L, turbidity 43.73 mg/L, total dissolved solids 101 mg/L, total suspended solids 34.72 mg/L, total solids 135.53 mg/L, total alkalinity 75.77 mg/L, total hardness 58.37 mg/L, ammonia 0.46 mg/L, sulphate 26.03 mg/L, chloride 14.67 mg/L, calcium 69.11 mg/L, chromium 0.18 mg/L, copper 0.03, cobalt mg/L 0.04, nickel 0.039 mg/L, lead 0.02 mg/L and Zinc 0.35 mg/L. The findings of this study indicated that most of the physicochemical parameters remained within the acceptable limits throughout the study period. Analysis of fish gut contents included; nymphs, insect larvae, the presence of algae, protozoans and macroinvertebrates in the river ecosystem.

The double inversion recovery (DIR) technique suppresses two types of tissue signals with different T1 values by applying two inversion recovery (IR) pulses with different inversion times (TI). In contrast, the double tissue suppression with multi-echo acquisition and single TI combining HIRE (DOMUST-HIRE) method, is a technique enabling the white-matter-attenuated inversion recovery (WAIR) images by setting one inversion time (TI) in a sequence based on the multi-echo method and subtracting the second echo image from the first echo image. Here, we propose a new sequence that can provide the gray-matter-attenuated inversion recovery image based on the DOMUST-HIRE method. In this small clinical study, we performed determination of optimal TI and physical evaluation by imaging a subject's head with T1WI and our proposed method for GAIR images. Our proposed method could increase the contrast ratio and the contrast-to-noise ratio between white matter (WM) and gray matter (GM), whereas the signal-to-noise ratio WM and GM decreased than with T1WI method. Our proposed method can be used to suppress GM and CSF signals. The use of our proposed method in low-field MRI systems could provide GAIR image. [ABSTRACT FROM AUTHOR]

Accurate information on potential evapotranspiration (PET) is mandatory for arid regions (such as Egypt) to assess crop water requirements. Such precision is limited by the dynamical downscaling options and the physical settings used in regional climate models (like the RegCM4). To address these issues, four simulations were run as part of the current study. The first two simulations take direct (DIR) and one-way nesting (NEST) into account, while the other two use two boundary layer techniques (HOLTSLAG; HOLT) and (the University of Washington; UW). All simulations were driven via an ERA-Interim reanalysis of 1.5 degrees. The simulated PET was evaluated for the high-resolution reanalysis gridded derived product of ERA5-Land (hereafter ERA5). The findings revealed no discernible difference between DIR and NEST regarding global incident solar radiation (RSDS). Also, NEST had a higher mean air temperature (TMP) than DIR. Additionally, UW had a lower TMP than HOLT, but switching between HOLT and UW did not significantly impact the simulated RSDS. Concerning PET, it is neither affected by DIR and NEST nor HOLT and UW. Such results suggest that the RSDS is the main driver in controlling PET variability, followed by TMP. Therefore, by using the DIR downscaling option and UW boundary layer scheme throughout the period of 1990–2020, as recommended by the World Meteorological Organization, the RegCM4 can be used to develop a regional PET map of Egypt. [ABSTRACT FROM AUTHOR]

Cortical lesions (CLs) detected with double inversion recovery (DIR) magnetic resonance imaging (MRI) are very helpful in differentiating multiple sclerosis (MS) from other neuroinflammatory diseases of the central nervous system (CNS), that is, neuromyelitis optica spectrum disorders (NMOSDs). Furthermore, CLs are closely related to motor and cognitive impairment. We report a case of a 48-year-old female MS patient who developed several CLs during anti-CD20 therapy. Some CLs disappeared during follow-up MRIs. In the suspicion of a treatment failure, the screening for the autologous hematopoietic stem cell transplant (AHSCT) was performed with the evidence of an atrial myxoma. In MS patients with new CLs, a comorbid ischemic pathology should be considered and carefully investigated. [ABSTRACT FROM AUTHOR]

The dirigent (DIR) gene is a key player in environmental stress response and has been identified in many multidimensional tube plant species. However, there are few studies on the StDIR gene in potato. In this study, we used genome-wide identification to identify 31 StDIR genes in potato. Among the 12 potato chromosomes, the StDIR gene was distributed on 11 chromosomes, among which the third chromosome did not have a family member, while the tenth chromosome had the most members with 11 members. 22 of the 31 StDIRs had a classical DIR gene structure, with one exon and no intron. The conserved DIR domain accounts for most of the proteins in the 27 StDIRs. The structure of the StDIR gene was analyzed and ten different motifs were detected. The StDIR gene was divided into three groups according to its phylogenetic relationship, and 22 duplicate genes were identified. In addition, four kinds of cis-acting elements were detected in all 31 StDIR promoter regions, most of which were associated with biotic and abiotic stress. The findings demonstrated that the StDIR gene exhibited specific responses to cold stress, salt stress, ABA, and drought stress. This study provides new candidate genes for improving potato's resistance to stress. [ABSTRACT FROM AUTHOR]

Background and purpose: Adaptive radiotherapy (ART) decision-making benefits from dosimetric information to supplement image inspection when assessing the significance of anatomical changes. This study evaluated a dosimetry-based clinical decision workflow for ART utilizing deformable registration of the original planning computed tomography (CT) image to the daily Cone Beam CT (CBCT) to replace the need for a replan CT for dose estimation. Materials and methods: We used 12 retrospective Head & Neck patient cases having a ground truth – a replan CT (rCT) in response to anatomical changes apparent in the daily CBCT – to evaluate the accuracy of dosimetric assessment conducted on synthetic CTs (sCT) generated by deforming the original planning CT Hounsfield Units to the daily CBCT anatomy.The original plan was applied to the sCT and dosimetric accuracy of the sCT was assessed by analyzing plan objectives for targets and organs-at-risk compared to calculations on the ground-truth rCT. Three commercial DIR algorithms were compared. Results: For the best-performing algorithms, the majority of dose metrics calculated on the sCTs differed by less than 4 Gy (5.7% of 70 Gy prescription dose). An uncertainty of ±2.5 Gy (3.6% of 70 Gy prescription) is recommended as a conservative tolerance when evaluating dose metrics on sCTs for head and neck. Conclusions: Synthetic CTs present a valuable addition to the adaptive radiotherapy workflow, and synthetic CT dose estimates can be effectively used in addition to the current practice of visually inspecting the overlay of the planning CT and CBCT to assess the significance of anatomical change.

This study examines the profiles of combatants who participated in the post-9/11 Afghan 'jihad' from Dir, Pakistan and explores the associated psychological and economic conditions affecting their families. Using a qualitative approach, data were collected through unstructured interviews and analyzed thematically. The research includes detailed tables profiling combatants based on age, education, sect affiliation, and family structure. Key findings reveal that a majority of combatants were illiterate, unemployed, and affiliated with the Deobandi sect. The study also highlights that most combatants' families remain uncertain about their loved ones' status, leading to unresolved grief and psychological distress. Additionally, the research provides insights into the economic hardships faced by the families, such as high unemployment rates and large family sizes. This comprehensive profiling of combatants, coupled with the examination of family conditions, offers valuable insights into the socio-economic and psychological dimensions of the post-9/11 Afghan Jihad's impact on the local population. [ABSTRACT FROM AUTHOR]

Accurate information on potential evapotranspiration (PET) is mandatory for arid regions (such as Egypt) to assess crop water requirements. Such precision is limited by the dynamical downscaling options and the physical settings used in regional climate models (like the RegCM4). To address these issues, four simulations were run as part of the current study. The first two simulations take direct (DIR) and one-way nesting (NEST) into account, while the other two use two boundary layer techniques (HOLTSLAG; HOLT) and (the University of Washington; UW). All simulations were driven via an ERA-Interim reanalysis of 1.5 degrees. The simulated PET was evaluated for the high-resolution reanalysis gridded derived product of ERA5-Land (hereafter ERA5). The findings revealed no discernible difference between DIR and NEST regarding global incident solar radiation (RSDS). Also, NEST had a higher mean air temperature (TMP) than DIR. Additionally, UW had a lower TMP than HOLT, but switching between HOLT and UW did not significantly impact the simulated RSDS. Concerning PET, it is neither affected by DIR and NEST nor HOLT and UW. Such results suggest that the RSDS is the main driver in controlling PET variability, followed by TMP. Therefore, by using the DIR downscaling option and UW boundary layer scheme throughout the period of 1990–2020, as recommended by the World Meteorological Organization, the RegCM4 can be used to develop a regional PET map of Egypt.

PurposeTo investigate high contrast imaging of short T2 tissues with a three-dimensional double adiabatic inversion recovery prepared ultrashort echo time Cones (3D DIR-UTE-Cones) sequence.MethodsThe sequence used two sequential adiabatic inversion pulses to suppress signals from long T2 tissues, followed by multispoke UTE acquisition to detect signals from short T2 tissues. The two adiabatic inversion pulses are identical with a center frequency located at the water peak, but the spectral width is broad enough to cover both water and fat frequencies. The feasibility of this technique was demonstrated through numerical simulation and phantom studies. Finally, DIR-UTE-Cones was applied to three healthy volunteers to image cortical bone, patellar tendon, and Achilles tendon. T2* was also measured via single-component exponential fitting.ResultsNumerical simulation suggests that the DIR technique provides perfect nulling of muscle and fat as well as efficient suppression of other long T2 tissues with T1 values between fat and water or those above water. Excellent image contrast can be achieved with DIR-UTE-Cones for the short T2 tissues, with fitted T2* values of 0.28-0.38 ms for cortical bone, 0.56 ± 0.07 ms for the patella tendon, and 0.45 ± 0.06 ms for the Achilles tendon, respectively.ConclusionThe 3D DIR-UTE-Cones sequence provides robust suppression of long T2 tissues and allows selective imaging as well as T2* measurement of short T2 tissues such as cortical bone, patellar tendon, and the Achilles tendon. Magn Reson Med 79:2555-2563, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

The red blood cell membrane (RBCm) provides tight protection, lowers the immunogenicity, and prolongs the circulation time of drugs in vivo when acting as the coating of drug delivery systems. However, the cellular uptake and release of drugs are hindered by RBCm. Docetaxel (DTX) is the first‐line medicine for treating triple‐negative breast cancer (TNBC), but it induces tumor metastasis. To solve these dilemmas, in this study, the photosensitizer 1,1‐dioctadecyl‐3,3,3,3‐tetramethylindotricarbocyanine iodide (DiR)‐modified RBCm (DM) is prepared, which is coated onto a hybrid micelle consisting of the prodrugs of DTX and the anti‐metastasis agent calcitriol (CTL), obtaining a nanoparticle, named HDC‐DM. In a 4T1 tumor‐bearing mouse model, after injecting HDC‐DM, the intratumoral DTX and CTL concentrations are increased by 1.7 and 2.5 times compared with the free drug groups. After irradiating tumors with near‐infrared laser, DiR elicits the photothermal effect, triggering the rupture of RBCm and drug release, promoting drug penetration in tumors, and inducing immunogenic cell death. The tumor growth inhibition rate is 77%, and the formation of lung metastases is reduced by 82%, with good biocompatibility. It is suggested that the combination of phototherapy, chemotherapy, and anti‐metastatic therapy using HDC‐DM is expected to be a powerful strategy for treating TNBC. [ABSTRACT FROM AUTHOR]

In this article, Special Trans Functions Theory (STFT) is used to obtain exact solutions of the transcendental equation that describes Dimensionless Injection Rate (DIR) for CO 2 storage. The obtained results were compared with DIR values calculated by a sequential asymptotic formula (SAF) based on the Lambert W function. The proposed exact analytical approach to determining DIR solutions implies considerable qualitative improvement compared to the conventional analytical and numerical methods. Determining STFT DIR solution for CO 2 storage is novel and precise, while the computations are simple, practical and do not require significant computation time. Note that the formulas derived within STFT in applied physics and engineering domains are characterized by structural robustness and complexity. It is a kind of “genetic characteristic” of STFT formulas, which does not affect the efficiency and simplicity of their applications. This paper additionally analyzes the importance of choosing an exact analytical solution for transcendent functional equations that describe the phenomenon of CO 2 storage, since these above-mentioned nonlinear forms describe many other significantly different physical phenomena. This implies the generalization of STF Theory. [ABSTRACT FROM AUTHOR]

Abstract Background A number of magnetic resonance imaging studies have shown that a significant proportion of multiple sclerosis (MS) lesions are located in the cerebral cortex and correlate with the patient's disability level. Double inversion recovery (DIR) has a higher sensitivity to detect cortical lesions and their different types. The aim of our study was to assess the superiority of 3D DIR as compared to FLAIR in detecting the different cortical subtypes and to enhance its role as a test for the clinical disability of the patient. Results The current study included 82 MS patients (60 female and 22 male with mean age of 34.5 ± 8.2 years); 59 cases having relapsing–remitting MS, 5 having secondary progressive MS, and 4 having primary progressive MS, as well as eight clinically isolated syndrome cases, and six radiologically isolated syndrome cases. DIR was superior to FLAIR in MS plaque number detection of cortical plaque-types 1, 2, 3 and 4 with a p value

Cassava is an important tropical cash crop. Severe drought stresses affect cassava productivity and quality, and cause great economic losses in agricultural production. Enhancing the drought tolerance of cassava can effectively improve its yield. Long non-coding RNAs (lncRNAs) are present in a wide variety of eukaryotes. Recently, increasing evidence has shown that lncRNAs play a critical role in the responses to abiotic stresses. However, the function of cassava lncRNAs in the drought response remains largely unknown. In this study, we identified a novel lncRNA, DROUGHT-INDUCED INTERGENIC lncRNA (DIR). Gene expression analysis showed that DIR was significantly induced by drought stress treatment, but did not respond to abscisic acid (ABA) or jasmonic acid (JA) treatments. In addition, overexpression of the DIR gene enhanced proline accumulation and drought tolerance in transgenic cassava. RNA-seq analysis revealed that DIR preferentially affected drought-related genes that were linked to transcription and metabolism. Moreover, RNA pull-down mass spectrometry analysis showed that DIR interacted with 325 proteins. A protein–protein interaction (PPI) analysis found a marked enrichment in proteins associated with the mRNA export and protein quality control pathways. Collectively, these results suggest that DIR and its interacting proteins that regulate mRNA or protein metabolism are involved in mediating the drought stress response. Thus, regulating DIR expression has potential for improving cassava yield under drought conditions.

An increased number of healthcare providers across the continuum of care share responsibility for providing treatment and care to the patient. Treatment is often provided at community-based facilities and not necessarily at the hospital that performed the imaging. As a result, there is an increased dependency on readily available access to a patient's longitudinal imaging records. The ways in which diagnostic images and results are exchanged among providers within a patient's circle of care have expanded. This article explores three varieties of image exchange. First, we examine image exchange patterns within a regional Diagnostic Imaging Repository and identify missed sharing opportunities. Secondly, we explore the use of a regional clinical viewer widely used in southwestern Ontario, called ClinicalConnect™, and examine the adoption of the viewer by providers. Finally, the paper provides a high-level look at how patients can leverage patient portals to view their imaging data to empower their healthcare experience. [ABSTRACT FROM AUTHOR]

Dirigent proteins (DIR) play important roles in the biosynthesis of lignins and lignans, defensive responses, secondary metabolism, and disease resistance in plants. The DIR gene family has been identified and studied in many plants. However, the identification of DIR gene family in eggplant has not been conducted yet. Therefore, in this study, based on the available genome information of eggplant, the DIR family genes in eggplant were identified with bioinformatics methods. The expression pattern analyses of eggplant DIR family genes in different organs and stresses were also conducted to understand their biological functions. The results showed that a total of 24 DIR genes were identified in the eggplant, which were divided into three subfamilies (DIR-a, DIR-b/d, and DIR-e). Synteny analysis of DIR genes among eggplant, Arabidopsis, and rice showed that 15 eggplant DIR genes were colinear with 18 Arabidopsis DIR genes, and 16 eggplant DIR genes were colinear with 15 rice DIR genes. Phylogenetic tree analysis showed that 19 pairs of orthologous genes were identified between eggplant and pepper. The cis-acting elements analysis implied that the eggplant DIR genes contained a lot of cis-elements associated with stress and hormone response. The organ-specific expression analysis of eggplant DIR family genes revealed that only the SmDIR3 gene was highly expressed in all the 19 organs of eggplant. Some SmDIR genes, including SmDIR7, SmDIR8, SmDIR11, SmDIR14, SmDIR18, SmDIR19, SmDIR20, and SmDIR23, were not or were lowly expressed in the eggplant organs, while the other eggplant DIR family genes showed an organ-specific expression pattern. Furthermore, 19 of 24 SmDIR genes were differentially expressed in response to abiotic and biotic stresses. 5 SmDIR genes, including SmDIR3, SmDIR5, SmDIR6, SmDIR12, and SmDIR22, were differentially expressed under multiple types of abiotic and biotic stresses. Especially notable, the SmDIR22 gene was differentially expressed under three types of abiotic stresses and two types of biotic stresses, which indicated that the SmDIR22 gene plays an important role in the response to abiotic and biotic stresses. These results provide valuable evidence for a better understanding of the biological role of DIR genes in eggplant. [ABSTRACT FROM AUTHOR]

AbstractBackground This study evaluated the correlation between radiation-induced lung injury (RILI) and dosimetric parameters on computed tomography (CT) images of stage I non-small cell lung cancer (NSCLC) patients undergoing intensity-modulated radiotherapy (IMRT).Materials and methods Sixty-three stage I NSLC patients who underwent IMRT were enrolled in the study. The patients underwent CT within 6 months (acute phase) and 1.5 years (late phase) after radiotherapy. These were fused with the planned irradiation CT. The range of RILI was measured from 10% to 100%, with an IC in 10% increments.Results The median interval from completion of radiotherapy to acute and late phase CT was 92 and 440 days, respectively. The median RILI ranges of the acute and late phases were in the 80% (20–100%) and 70% dose regions (20–100%), respectively. The significantly narrower range of RILI when lung V20 in the acute phase was less than 19.2% and that of V5 in the late phase was less than 27.6% at the time of treatment planning.Conclusions This study showed that RILI occurred in a localized range in stage I NSCLC patients who underwent IMRT. The range of RILI was correlated with V20 in the acute phase and V5 in the late phase.KEY MESSAGESRILI correlated with V20 in acute and V5 in late phase.The shadow of RILI occurred in 80% dose region in acute and 70% in late phase.No relationship exists between radiographic changes in RILI and PTV volume.

Background: Umbilical cord mesenchymal stem cell transplantation can treat metabolic syndrome, but the tracing of cells in the body after transplantation has always been a problem. Tree shrew umbilical cord mesenchymal stem cells were labeled with the dark red fluorescent dye DIR and a metabolic syndrome model in tree shrew was generated. The migration, distribution, colonization and survival of the cells were observed. Methods: Tree shrew umbilical cord mesenchymal stem cells were labeled with the dark red fluorescent dye DIR. Three days after the tree shrew model was generated, the pancreas, kidney and liver were placed in a small animal live imager to observe the distribution of the labeled cells. Result: The labeled cells showed deep red fluorescence in the live imager. After treatment with the transplanted cells, dark red fluorescent signals were observed in the liver, kidney and pancreas of the tree shrews but not in the untreated group and no dark red fluorescent signal was observed in the cell distribution. [ABSTRACT FROM AUTHOR]

Abstract Background Multiple sclerosis (MS) is a common chronic inflammatory demyelinating disorder more common in young adults. MS is characterized mainly with white matter (WM) affection; however, considerable gray matter (GM) involvement is also noted in many patients. MRI is used for diagnosis and follow up of the disease using different pulse sequences; FLAIR imaging provides the highest sensitivity in the detection of supratentorial, juxtacortical, and the periventricular lesions but is less sensitive in the posterior fossa. A double inversion recovery (DIR) pulse sequence was recently introduced to improve the visibility of GM lesions and especially cortical lesions. The aim of this study is to assess the role of DIR sequence in the detection of brain lesions in patients with MS compared to FLAIR sequence. Results DIR showed a significantly higher number of MS lesions in infratentorial region (2.9 ± 0.4 compared to 2.25 ± 0.3 in FLAIR) with a statistically significant difference (p = 0.002) and also in supratentorial periventricular regions (11.84 ± 8.07 in DIR and 11.31 ± 8.07 in FLAIR, p < 0.001). DIR imaging also demonstrated significantly more intracortical lesions (7.12 ± 1.2 compared to 1.4 ± 0.9 in FLAIR imaging) with a statistically significant difference (p < 0.001). On the other hand, corpus callosum lesions were significantly higher on FLAIR (0.84 ± 0.1) with respect to DIR imaging (0.68 ± 0.1) with a statistically significant difference in between (p = 0.025). Conclusion DIR is a powerful conventional MRI sequence for visualization of brain lesions in patients with MS and is superior to FLAIR sequence in detecting lesions in different locations, namely cortical, periventricular, and infratentorial regions; hence, DIR can be added to the MRI protocol of MS patients or even can replace FLAIR which would be of a good diagnostic value with only 80 s added to the scan time.

Background: A number of magnetic resonance imaging studies have shown that a significant proportion of multiple sclerosis (MS) lesions are located in the cerebral cortex and correlate with the patient's disability level. Double inversion recovery (DIR) has a higher sensitivity to detect cortical lesions and their different types. The aim of our study was to assess the superiority of 3D DIR as compared to FLAIR in detecting the different cortical subtypes and to enhance its role as a test for the clinical disability of the patient. Results: The current study included 82 MS patients (60 female and 22 male with mean age of 34.5 ± 8.2 years); 59 cases having relapsing–remitting MS, 5 having secondary progressive MS, and 4 having primary progressive MS, as well as eight clinically isolated syndrome cases, and six radiologically isolated syndrome cases. DIR was superior to FLAIR in MS plaque number detection of cortical plaque-types 1, 2, 3 and 4 with a p value < 0.001. DIR was superior to FLAIR for detection of overall cortical types, juxtacortical and juxtacortical extended MS plaques with p = < 0.001, 0.010 and < 0.001, respectively. DIR was significantly better than FLAIR for MS plaque number detection in the periventricular white matter, subcortical white matter, infratentorial region and the overall MS plaques burden with a p < 0.001, 0.038, < 0.001, < 0.001, respectively. No significant difference was noted between both sequences for plaques number detection in deep white matter and deep gray matter. A significant correlation between MS disease duration, number of attacks and EDSS and the overall cortical MS plaques types and the overall MS plaque burden. Conclusion: 3D DIR is a reliable tool and provides superior delineation in detecting cortical subtypes. In addition, DIR is of value in assessing the degree of clinical and cognitive impairment of MS affected patients. [ABSTRACT FROM AUTHOR]

This study evaluated the correlation between radiation-induced lung injury (RILI) and dosimetric parameters on computed tomography (CT) images of stage I non-small cell lung cancer (NSCLC) patients undergoing intensity-modulated radiotherapy (IMRT). Sixty-three stage I NSLC patients who underwent IMRT were enrolled in the study. The patients underwent CT within 6 months (acute phase) and 1.5 years (late phase) after radiotherapy. These were fused with the planned irradiation CT. The range of RILI was measured from 10% to 100%, with an IC in 10% increments. The median interval from completion of radiotherapy to acute and late phase CT was 92 and 440 days, respectively. The median RILI ranges of the acute and late phases were in the 80% (20–100%) and 70% dose regions (20–100%), respectively. The significantly narrower range of RILI when lung V20 in the acute phase was less than 19.2% and that of V5 in the late phase was less than 27.6% at the time of treatment planning. This study showed that RILI occurred in a localized range in stage I NSCLC patients who underwent IMRT. The range of RILI was correlated with V20 in the acute phase and V5 in the late phase. RILI correlated with V20 in acute and V5 in late phase. The shadow of RILI occurred in 80% dose region in acute and 70% in late phase. No relationship exists between radiographic changes in RILI and PTV volume. [ABSTRACT FROM AUTHOR]

Dirigent proteins (DIR) play important roles in the biosynthesis of lignins and lignans, defensive responses, secondary metabolism, and disease resistance in plants. The DIR gene family has been identified and studied in many plants. However, the identification of DIR gene family in eggplant has not been conducted yet. Therefore, in this study, based on the available genome information of eggplant, the DIR family genes in eggplant were identified with bioinformatics methods. The expression pattern analyses of eggplant DIR family genes in different organs and stresses were also conducted to understand their biological functions. The results showed that a total of 24 DIR genes were identified in the eggplant, which were divided into three subfamilies (DIR-a, DIR-b/d, and DIR-e). Synteny analysis of DIR genes among eggplant, Arabidopsis, and rice showed that 15 eggplant DIR genes were colinear with 18 Arabidopsis DIR genes, and 16 eggplant DIR genes were colinear with 15 rice DIR genes. Phylogenetic tree analysis showed that 19 pairs of orthologous genes were identified between eggplant and pepper. The cis-acting elements analysis implied that the eggplant DIR genes contained a lot of cis-elements associated with stress and hormone response. The organ-specific expression analysis of eggplant DIR family genes revealed that only the SmDIR3 gene was highly expressed in all the 19 organs of eggplant. Some SmDIR genes, including SmDIR7, SmDIR8, SmDIR11, SmDIR14, SmDIR18, SmDIR19, SmDIR20, and SmDIR23, were not or were lowly expressed in the eggplant organs, while the other eggplant DIR family genes showed an organ-specific expression pattern. Furthermore, 19 of 24 SmDIR genes were differentially expressed in response to abiotic and biotic stresses. 5 SmDIR genes, including SmDIR3, SmDIR5, SmDIR6, SmDIR12, and SmDIR22, were differentially expressed under multiple types of abiotic and biotic stresses. Especially notable, the SmDIR22 gene was differentially expressed under three types of abiotic stresses and two types of biotic stresses, which indicated that the SmDIR22 gene plays an important role in the response to abiotic and biotic stresses. These results provide valuable evidence for a better understanding of the biological role of DIR genes in eggplant.

Fluid attenuated inversion recovery (FLAIR) MRI sequences have become an indispensible tool for defining the malignant boundary in patients with brain tumors by nulling the signal contribution from cerebrospinal fluid allowing both regions of edema and regions of non-enhancing, infiltrating tumor to become hyperintense on resulting images. In the current study we examined the utility of a three-dimensional double inversion recovery (DIR) sequence that additionally nulls the MR signal associated with white matter, implemented either pre-contrast or post-contrast, in order to determine whether this sequence allows for better differentiation between tumor and normal brain tissue. T1- and T2-weighted, FLAIR, dynamic susceptibility contrast (DSC)-MRI estimates of cerebral blood volume (rCBV), contrast-enhanced T1-weighted images (T1+C), and DIR data (pre- or post-contrast) were acquired in 22 patients with glioblastoma. Contrast-to-noise (CNR) and tumor volumes were compared between DIR and FLAIR sequences. Line profiles across regions of tumor were generated to evaluate similarities between image contrasts. Additionally, voxel-wise associations between DIR and other sequences were examined. Results suggested post-contrast DIR images were hyperintense (bright) in regions spatially similar those having FLAIR hyperintensity and hypointense (dark) in regions with contrast-enhancement or elevated rCBV due to the high sensitivity of 3D turbo spin echo sequences to susceptibility differences between different tissues. DIR tumor volumes were statistically smaller than tumor volumes as defined by FLAIR (Paired t test, P = 0.0084), averaging a difference of approximately 14 mL or 24 %. DIR images had approximately 1.5× higher lesion CNR compared with FLAIR images (Paired t test, P = 0.0048). Line profiles across tumor regions and scatter plots of voxel-wise coherence between different contrasts confirmed a positive correlation between DIR and FLAIR signal intensity and a negative correlation between DIR and both post-contrast T1-weighted image signal intensity and rCBV. Additional discrepancies between FLAIR and DIR abnormal regions were also observed, together suggesting DIR may provide additional information beyond that of FLAIR.

Swat and Dir valleys in Pakistan have seen the brunt of post 9/11 violent extremism in the recent past. Because this extremism was generated and exploited by a few religiously motivated violent organizations, a popular perception emerged that all religious leaders of the society were involved in terrorism. Therefore, this research focuses on the role played by those religious leaders who involved themselves in mobilizing local communities against violent extremism. Employing a mixed-method research approach and sequential analysis strategy our data shows that most of the common local religious leaders played positive role in building community resilience to countering violent extremism during the early phase of the War on Terrorism in these two valleys. [ABSTRACT FROM AUTHOR]

Renewable generation in power systems has proved to be challenging for system operators owing to the increasing levels of penetration. The operation of power systems currently requires additional flexibility and reserves due to the intermittency and unpredictability of renewable generators. However, it is difficult to precisely predict and control the stochastic nature of renewable sources; nevertheless, its capacity continues to increase. To monitor and control renewable generators efficiently, the entire system needs to be established in a hierarchical order. This study proposed the concept of a substation that is uniquely designed for renewable interconnection. The purpose of this substation is simple: to make the renewable generators dispatchable to operators such that each group of renewable generators is sufficiently stable to be considered as conventional generators. For this purpose, methods for sizing and controlling energy storage system are proposed based on forecasts and error distributions. [ABSTRACT FROM AUTHOR]

The fluorescence dye-loaded nanoparticles are widely used as bioimaging agents in the field of nanotheranostics. However, the nanoparticles for nanotheranostics usually consist of synthetic materials, such as metal, silica, and organic polymers, which are often biologically incompatible and may arouse toxicity issues. Herein, the potential of near-infrared probe DiR-containing solid lipid nanoparticle suspensions (DiR-SLNS) as the bioimaging agent, which was prepared by lipids and surfactants with excellent biocompatibility, was investigated in this study. The nanostructure of DIR-SLNS system and the distribution of DiR were studied by dissipative particle dynamics (DPD) simulations. The stability of physicochemical properties and fluorescence spectra of DIR-SLNS system were investigated using dynamic laser scattering (DLS), nanoparticle tracking analysis (NTA), and fluorescence spectra. The fluorescence intensity-concentration correlation of DIR-SLNS was also evaluated. As a result, DiR-SLNS demonstrated a "core-shell"-like nanostructure and DiR was mainly distributed in the cetyl palmitate (CP) core rather than the surface of SLNS, which was beneficial to its potential applications in bioimaging. DiR-SLNS exhibited remarkable physicochemical stability as the nanoparticles maintained ~ 90% fluorescence intensity during the 10-day storage time. The correlation between fluorescence intensity and concentration was established and validated using a linear regression model. This study proposed a type of promising candidates in nano-scale with higher safety and fluorescence stability for bioimaging. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the impact of fractional dose and the number of arcs on interplay effects when volumetric modulated arc therapy (VMAT) is used to treat lung tumors with large respiratory motions. A three (fractional dose of 4, 7.5 or 12.5 Gy) by two (number of arcs, one or two) VMAT plan was created for 10 lung cancer cases. The median 3D tumor motion was 17.9 mm (range: 8.2–27.2 mm). Ten phase-specific subplans were generated by calculating the dose on each respiratory phase computed tomography (CT) scan using temporally assigned VMAT arcs. We performed temporal assignment of VMAT arcs using respiratory information obtained from infrared markers placed on the abdomens of the patients during CT simulations. Each phase-specific dose distribution was deformed onto exhale phase CT scans using contour-based deformable image registration, and a 4D plan was created by dose accumulation. The gross tumor volume dose of each 4D plan (4D GTV dose) was compared with the internal target volume dose of the original plan (3D ITV dose). The near-minimum 4D GTV dose (D 99%) was higher than the near-minimum 3D internal target volume (ITV) dose, whereas the near-maximum 4D GTV dose (D 1%) was lower than the near-maximum 3D ITV dose. However, the difference was negligible, and thus the 4D GTV dose corresponded well with the 3D ITV dose, regardless of the fractional dose and number of arcs. Therefore, interplay effects were negligible in VMAT-based stereotactic body radiation therapy for lung tumors with large respiratory motions. [ABSTRACT FROM AUTHOR]

Background: Optic nerve involvement is not considered in dissemination in space (DIS) or time (DIT) of multiple sclerosis (MS) lesions. Objectives: To evaluate frequency of optic nerve involvement using three-dimensional (3D)-double inversion recovery (DIR) sequence in clinically isolated syndrome (CIS) and to measure its relationship with DIS and DIT (2010 and 2017 McDonald criteria). Methods: From November 2013 to August 2016, 57 CIS patients underwent 3T-magnetic resonance imaging (3T-MRI) including 3D-DIR sequence and optical coherence tomography (OCT) at 3 months after CIS. We assessed signal abnormalities of the optic nerves on DIR sequence and collected data for DIS and DIT criteria according to 2010 and 2017 McDonald criteria. Results: Among the 57 recruited patients, the presence of ⩾1 DIR hypersignal in optic nerve was observed in 36 (63%; 48 optic nerves) including asymptomatic hypersignal in 22 (38.5%; 25 optic nerves). Optic nerve involvement was significantly associated with DIT (p = 0.006) and MS according to 2010 criteria (p = 0.01) but was not significantly associated with presence of DIS criteria according to 2010 and 2017 McDonald criteria. We identified a significant (p < 0.001) temporal peripapillary retinal nerve fiber layer thinning on eyes with optic nerve involvement versus healthy controls. Conclusions: Optic nerve involvement is very frequent at the earliest clinical stage of MS. It is associated with the presence of asymptomatic gadolinium-enhancement and retinal axonal loss and may reflect the inflammatory disease activity level. [ABSTRACT FROM AUTHOR]

The genus Hygrophorus is poorly studied from Asia. From Pakistan, only one species has been reported so far. Two new species in the genus have been collected from Himalayan oak forests of Pakistan. Hygrophorus alboflavescens (section Pudorini, subgenus Colorati) is characterised by its pure white, centrally depressed pileus, occurrence of white stipe with yellow patches at lower half and broader (4.98 μm) basidiospores. Hygrophorus scabrellus (section Hygrophorus, subgenus Hygrophorus) is characterised by its yellowish-green stipe with white apex that has fine scales on the entire stipe, an off-white pileus with dark green and greyish fibrils, ovoid to ellipsoid basidiospores and clavate 4-spored basidia. Macro- and micromorphological descriptions have revealed that both these taxa are not yet described. Phylogenetic estimation based on DNA sequences from the internal transcribed spacer (ITS) region and large subunit (LSU) of the nuclear ribosomal DNA (rDNA) genes, is congruent with the morphological characters that help to delimit these as new species of Hygrophorus. Allied taxa are also compared. [ABSTRACT FROM AUTHOR]

Double inversion-recovery (DIR) imaging has the potential to improve the detection of subcortical lesions through the use of voxel-based morphometry (VBM) analysis. The aim of this study was to clarify the characteristics of detectable lesions by performing a VBM analysis on DIR images of simulated lesions. Twenty healthy volunteers underwent magnetic resonance imaging using a head three-dimensional DIR sequence. The images were processed using SPM12; then, the selected images with simulated lesions were analyzed via VBM. The VBM results were evaluated using free-response receiver-operating characteristic curves and a receiver-operating characteristic analysis. The sensitivity was 100% (5/5), with 5.6 false-positive objects per case, in simulated lesions with a contrast of 0.6 and a size of 2.4 mm. The sensitivity was 80% (4/5), with 5.4 false-positive objects per case, in simulated lesions with a contrast of 0.5 and a size of 2.4 mm. The mean area under the curve value was increased from 0.783 to 0.883 using VBM, with a statistically significant difference (p < 0.01). The VBM analysis of the DIR images using SPM alone showed the potential to detect subcortical microscopic lesions. Early detection of Alzheimer's disease may be possible by adapting VBM in the clinical setting. [ABSTRACT FROM AUTHOR]

Using a white-matter selective double inversion recovery sequence (WM-DIR) that suppresses both grey matter (GM) and cerebrospinal fluid (CSF) signals, some white matter (WM) lesions appear surrounded by a dark rim. These dark rim lesions (DRLs) seem to be specific for multiple sclerosis (MS). They could be of great usefulness in clinical practice, proving to increase the MRI diagnostic criteria specificity. The aims of this study are the identification of DRLs on 1.5 T MRI, the exploration of the relationship between DRLs and disease course, the characterization of DRLs with respect to perilesional normal-appearing WM using magnetization transfer imaging, and the investigation of possible differences in the underlying tissue properties by assessing WM-DIR images obtained at 3.0 T MRI. DRLs are frequent in primary progressive MS (PPMS) patients. Amongst relapsing-remitting MS (RRMS) patients, DRLs are associated with a high risk of the disease worsening and secondary progressive MS (SPMS) conversion after 15 years. The mean magnetization transfer ratio (MTR) of DRLs is significantly different from the lesion without the dark rim, suggesting that DRLs correspond to more destructive lesions.

Renewable generation in power systems has proved to be challenging for system operators owing to the increasing levels of penetration. The operation of power systems currently requires additional flexibility and reserves due to the intermittency and unpredictability of renewable generators. However, it is difficult to precisely predict and control the stochastic nature of renewable sources; nevertheless, its capacity continues to increase. To monitor and control renewable generators efficiently, the entire system needs to be established in a hierarchical order. This study proposed the concept of a substation that is uniquely designed for renewable interconnection. The purpose of this substation is simple: to make the renewable generators dispatchable to operators such that each group of renewable generators is sufficiently stable to be considered as conventional generators. For this purpose, methods for sizing and controlling energy storage system are proposed based on forecasts and error distributions.