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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.

Recurrent aphthous stomatitis consists on recurring oral ulcers of unknown etiology. Oral ulcers may be different in number and size depending on the clinical presentation, which also determines the time needed for healing. Moreover, there are factors associated to outbreaks but not implicated in its etiopathogenesis. When oral aphthosis has a known etiology, it is not considered as recurrent aphthous stomatitis. The severity and the clinical presentation helps in the differential diagnosis. Treatment is symptomatic in recurrent aphthous stomatitis while, if there is an underlying systemic disease, the treatment of such disease is need in addition to topical treatment., (Copyright © 2011 Elsevier España, S.L. All rights reserved.)

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.