Some advanced parametric methods for assessing waveform distortion in a smart grid with renewable generation

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New advanced methods for the spectral analysis of time-varying waveforms in power systems

This thesis presents new advanced methods for the spectral analysis of time-varying waveforms in power systems. First, the main non-parametric, parametric and hybrid methods are presented in details under an analytical review of the state of the art, stressing both their advantages and their weaknesses. Then, a new advanced modified parametric method and three new advanced hybrid methods are presented in this thesis. All of the proposed methods guarantee an accuracy typical of the parametric methods, though with a significantly lower computational efforts

Distributed Energy Resources to Improve the Power Quality and to Reduce Energy Costs of a Hybrid AC/DC Microgrid

This chapter deals with microgrids (μGs), i.e., a group of interconnected loads and distributed energy resources that act as a single controllable entity with respect to the grid. The μGs can be classified into AC and DC μGs depending on the characteristics of the supply voltage, with both solutions characterized by advantages and challenges. Recently, hybrid AC/DC μGs have been developed with the aim to exploit the advantages of both AC and DC solutions. Hybrid μGs require being properly controlled to guarantee their optimal behavior, in both grid-connected and islanding mode. In this chapter, we propose an optimal control strategy for a hybrid μG to be realized in an actual Italian industrial facility. The control strategy operates with the aim to simultaneously minimize the energy costs and to compensate waveform distortions. The key result of the chapter consists in evidencing the technical and economic advantages of the proposed solution by means of real-time simulations of the hybrid μG performed through Matlab/Simulink development tool in the different conditions (grid-connected and islanding mode)

Autofluorescence image reconstruction and virtual staining for in-vivo optical biopsying

Modern photonic technologies are emerging, allowing the acquisition of in-vivo endoscopic tissue imaging at a microscopic scale, with characteristics comparable to traditional histological slides, and with a label-free modality. This raises the possibility of an ‘optical biopsy’ to aid clinical decision making. This approach faces barriers for being incorporated into clinical practice, including the lack of existing images for training, unfamiliarity of clinicians with the novel image domains and the uncertainty of trusting ‘black-box’ machine learned image analysis, where the decision making remains inscrutable. In this paper, we propose a new method to transform images from novel photonics techniques (e.g. autofluorescence microscopy) into already established domains such as Hematoxilyn-Eosin (H-E) microscopy through virtual reconstruction and staining. We introduce three main innovations: 1) we propose a transformation method based on a Siamese structure that simultaneously learns the direct and inverse transformation ensuring domain back-transformation quality of the transformed data. 2) We also introduced an embedding loss term that ensures similarity not only at pixel level, but also at the image embedding description level. This drastically reduces the perception distortion trade-off problem existing in common domain transfer based on generative adversarial networks. These virtually stained images can serve as reference standard images for comparison with the already known H-E images. 3) We also incorporate an uncertainty margin concept that allows the network to measure its own confidence, and demonstrate that these reconstructed and virtually stained images can be used on previously-studied classification models of H-E images that have been computationally degraded and de-stained. The three proposed methods can be seamlessly incorporated on any existing architectures. We obtained balanced accuracies of 0.95 and negative predictive values of 1.00 over the reconstructed and virtually stained image-set on the detection of color-rectal tumoral tissue. This is of great importance as we reduce the need for extensive labeled datasets for training, which are normally not available on the early studies of a new imaging technology.The authors would like to thank all pathologists that generated the BIOPOOL dataset (FP7-ICT-296162) that has been used for this work and specially to M. Saiz, A. Gaafar, S. Fernandez, A. Saiz, E. de Miguel, B. Catón, J. J. Aguirre, R. Ruiz, Ma A. Viguri, and R. Rezola

Critical Competences for the Management of Post-Operative Course in Patients with Digestive Tract Cancer: The Contribution of MADIT Methodology for a Nine-Month Longitudinal Study

There is a high postoperative morbidity rate after cancer surgery, that impairs patients' self-management, job condition and economic strength. This paper describes the results of a peculiar psychological intervention on patients undergoing surgery for esophageal, gastric and colorectal cancer. The intervention aimed to enhance patients' competences in the management of postoperative daily life. A narrative approach (M.A.D.I.T.-Methodology for the Analysis of Computerised Text Data) was used to create a questionnaire, Health and Employment after Gastro-Intestinal Surgery-Dialogical Questionnaire, HEAGIS-DQ, that assesses four competences. It was administered to 48 participants. Results were used as guidance for specific intervention, structured on patients' competence profiles. The intervention lasted nine months after surgery and was structured in weekly to monthly therapeutic sessions. Quality of Life questionnaires were administered too. At the end of the intervention, 94% of patients maintained their job and only 10% of patients asked for financial support. The mean self-perception of health-related quality of life was 71.2. The distribution of three of four competences increased after nine months (p < 0.05). Despite economic difficulties due to lasting symptoms after surgery, and to the current pandemic scenario, a structured intervention with patients let them to resume their jobs and continue activities after surgery

Managing the Consequences of Oncological Major Surgery: A Short- and Medium-Term Skills Assessment Proposal for Patient and Caregiver through M.A.D.I.T. Methodology

The effects of cancer surgery and treatment harm patients' life and working ability: major causes of this can be intensified by the postoperative symptoms. This study, the first part of the HEAGIS project (Health and Employment after Gastrointestinal Surgery), proposes a method to assess patients and caregivers' competences in dealing with postoperative course and the related needs to improve the adequate competences. In this observational study, an ad hoc structured interview was conducted with 47 patients and 15 caregivers between the third and fifteenth postoperative day. Oesophageal (38%), esophagogastric junction (13%), gastric (30%), colon (8%) and rectum (11%) cancer patients were considered. Computerized textual data analysis methodology was used to identify levels of competences. Text analysis highlighted three different levels (low, medium and high) of four specific types of patients and caregivers' competences. In particular, the overall trend of the preview of future scenarios and use of resource competences was low. Less critical were situation evaluation and preview repercussion of own actions' competences. Caregivers' trends were similar. The Kruskal-Wallis test did not distinguish any differences in the level of competences related to the characteristics of the participants. Patients and caregivers are not accurate in planning the future after surgery, using personal beliefs rather than referring to physicians, and not recognizing adequate resources. The medium-low competences' trend leads to unexpected critical situations, and patients could not deal with them in a maximally effective way. Both patients and caregivers should be taken over by healthcare professionals to improve patients' competences and make the curative surgery effective in daily life

Pre-treatment risk factors to predict early cisplatin-related nephrotoxicity in locally advanced head and neck cancer patients treated with chemoradiation: A single Institution experience

Objectives: Cisplatin is essential in the curative treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) patients. The assessment of risk factors to predict an early cisplatin-induced nephrotoxicity could help in better managing one of the most relevant cisplatin-related dose-limiting factors. Material and methods: We retrospectively collected data of LA-HNSCC patients treated at our Institution from 2008 to 2019. Patients received cisplatin in a curative setting concurrently with radiation. Acute Kidney Injury (AKI) was assessed as a dichotomous variable (CreaIncr) based on pre-treatment values, and values recorded at days 6-20 post-first cycle of cisplatin. Univariable logistic regression models were performed to investigate associations between CreaIncr and clinical characteristics. A multivariable logistic model on a priori selected putative covariates was performed. Results: Of the 350 LA-HNSCC treated patients, 204 were analyzed. Ninety (44 %) suffered from any grade AKI (grade I 51.1 %): out of them, 84.4 % received high-dose cisplatin (100 mg/m2 q21). On the univariable logistic regression model, male sex, age, serum uric acid, creatinine, concomitant drugs, and cisplatin schedule were significantly associated with a higher rate of AKI. At multivariable model, age (p = 0.034), baseline creatinine (p = 0.027), concomitant drugs (p = 0.043), and cisplatin schedule (one-day bolus or fractionated high-dose vs. weekly; p = 0.001) maintained their significant association. Conclusions: Identifying pre-treatment risk factors in LA-HNSCC patients may improve decision-making in a setting where cisplatin has a curative significance. A strict monitoring of AKI could avoid cisplatin dose adjustments, interruptions, and treatment delays, thus limiting a negative impact on outcomes

IGF1 Is a Common Target Gene of Ewing's Sarcoma Fusion Proteins in Mesenchymal Progenitor Cells

The EWS-FLI-1 fusion protein is associated with 85-90% of Ewing's sarcoma family tumors (ESFT), the remaining 10-15% of cases expressing chimeric genes encoding EWS or FUS fused to one of several ets transcription factor family members, including ERG-1, FEV, ETV1 and ETV6. ESFT are dependent on insulin-like growth factor-1 (IGF-1) for growth and survival and recent evidence suggests that mesenchymal progenitor/stem cells constitute a candidate ESFT origin. To address the functional relatedness between ESFT-associated fusion proteins, we compared mouse progenitor cell (MPC) permissiveness for EWS-FLI-1, EWS-ERG and FUS-ERG expression and assessed the corresponding expression profile changes. Whereas all MPC isolates tested could stably express EWS-FLI-1, only some sustained stable EWS-ERG expression and none could express FUS-ERG for more than 3-5 days. Only 14% and 4% of the total number of genes that were respectively induced and repressed in MPCs by the three fusion proteins were shared. However, all three fusion proteins, but neither FLI-1 nor ERG-1 alone, activated the IGF1 promoter and induced IGF1 expression. Whereas expression of different ESFT-associated fusion proteins may require distinct cellular microenvironments and induce transcriptome changes of limited similarity, IGF1 induction may provide one common mechanism for their implication in ESFT pathogenesis

Acute Delta Hepatitis in Italy spanning three decades (1991–2019): Evidence for the effectiveness of the hepatitis B vaccination campaign

Updated incidence data of acute Delta virus hepatitis (HDV) are lacking worldwide. Our aim was to evaluate incidence of and risk factors for acute HDV in Italy after the introduction of the compulsory vaccination against hepatitis B virus (HBV) in 1991. Data were obtained from the National Surveillance System of acute viral hepatitis (SEIEVA). Independent predictors of HDV were assessed by logistic-regression analysis. The incidence of acute HDV per 1-million population declined from 3.2 cases in 1987 to 0.04 in 2019, parallel to that of acute HBV per 100,000 from 10.0 to 0.39 cases during the same period. The median age of cases increased from 27 years in the decade 1991-1999 to 44 years in the decade 2010-2019 (p &lt; .001). Over the same period, the male/female ratio decreased from 3.8 to 2.1, the proportion of coinfections increased from 55% to 75% (p = .003) and that of HBsAg positive acute hepatitis tested for by IgM anti-HDV linearly decreased from 50.1% to 34.1% (p &lt; .001). People born abroad accounted for 24.6% of cases in 2004-2010 and 32.1% in 2011-2019. In the period 2010-2019, risky sexual behaviour (O.R. 4.2; 95%CI: 1.4-12.8) was the sole independent predictor of acute HDV; conversely intravenous drug use was no longer associated (O.R. 1.25; 95%CI: 0.15-10.22) with this. In conclusion, HBV vaccination was an effective measure to control acute HDV. Intravenous drug use is no longer an efficient mode of HDV spread. Testing for IgM-anti HDV is a grey area requiring alert. Acute HDV in foreigners should be monitored in the years to come