Impact of loading capability on optimal location of renewable energy systems distribution networks

Copyright © 2023 The Authors. A distribution system's network reconfiguration is the process of altering the open/closed status of sectionalizing and tie switches to change the topological structure of distribution feeders. For the last two decades, numerous heuristic search evolutionary algorithms have been used to tackle the problem of network reconfiguration for time-varying loads, which is a very difficult and highly non-linear efficiency challenge. This research aims to offer an ideal solution for addressing network reconfiguration difficulties in terms of a system for power distribution, to decrease energy losses, and increase the voltage profile. A hybrid Genetic Archimedes optimization technique (GAAOA) has also been developed to size and allocate three types of DGs, wind turbine, fuel cell and PV considering load variation. This approach is quite useful and may be used in many situations. This technique is evaluated for loss reduction and voltage profile on a typical 33-bus radial distribution system and a 69-bus radial distribution system. The system has been simulated using MATLAB software. The findings suggest that this approach is effective and acceptable for real-time usage

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Alternative eradication regimens for Helicobacter pylori infection in Indonesian regions with high metronidazole and levofloxacin resistance

Muhammad Miftahussurur,1,2 Langgeng Agung Waskito,2,3 Ari Fahrial Syam,4 Iswan Abbas Nusi,1 Gontar Siregar,5 Marselino Richardo,6 Achmad Fuad Bakry,7 Yudith Annisa Ayu Rezkitha,2,8 I Dewa Nyoman Wibawa,9 Yoshio Yamaoka3,10,11 1Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60131, Indonesia; 2Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia; 3Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; 4Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia; 5Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, University of Sumatera Utara, Medan 20136, Indonesia; 6Department of Internal Medicine, Merauke City General Hospital, Merauke 99656, Indonesia; 7Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, Sriwijaya University, Palembang 30126, Indonesia; 8Department of Internal Medicine, Muhammadiyah University of Surabaya, Surabaya 60113, Indonesia; 9Division of Gastroentero-hepatology, Department of Internal Medicine, Faculty of Medicine, University of Udayana, Denpasar 80232, Indonesia; 10Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX 77030, USA; 11Global Oita Medical Advanced Research Center for Health, Yufu 879-5593, Japan Background: The prevalence of Helicobacter pylori resistance to metronidazole and clarithromycin is high in Indonesia. Moreover, the increasing levofloxacin resistance rates in the absence of bismuth treatment in Indonesia has led to the use of other antibiotics as alternative regimens. Methods: We determined the minimum inhibitory concentrations (MICs) of five alternative antibiotics for H. pylori (rifaximin, rifabutin, furazolidone, garenoxacin, and sitafloxacin) using the agar dilution method and assessed mutations associated with antibiotic resistance using next-generation sequencing. Result: Analysis of 106 strains isolated from 1039 adult dyspeptic patients revealed that none of the strains were furazolidone-resistant. All strains were also sensitive to rifabutin and sitafloxacin. In contrast, the rates of resistance to rifaximin and garenoxacin were high (38.9% and 6.7%, respectively). The strains isolated from patients on Java Island had the highest resistance rates to garenoxacin and rifaximin. In addition, the resistance was distributed evenly among the ethnic groups, ranging between 25.0% and 69.2%. Except for rifaximin, for which the resistance rate was 38.9%, the other four antibiotics could be successfully employed to eradicate levofloxacin- and metronidazole-resistant H. pylori infections in vitro. Interestingly, garenoxacin-sensitive strains were found in regions with high clarithromycin resistance rates such as Bali and Papua Islands. In contrast, rifaximin might not be considered as an alternative antibiotic in regions with high clarithromycin resistance. There was an inconsistent association between gyrA and gyrB mutations and garenoxacin resistance. We confirmed that the I837V (replacement of isoleucine at position 837 with valine), A2414T/V, Q2079K and K2068R were the predominant rpoB point mutations. There was an association between vacA genotypes of H. pylori and rifaximin resistance (P = 0.048). Conclusion: furazolidone-, rifabutin-, and sitafloxacin-based therapies might be considered as alternative regimens to eradicate H. pylori in Indonesia, including regions with high metronidazole and clarithromycin resistance rates. Moreover, sitafloxacin but not garenoxacin should be considered for eradication of levofloxacin-resistant strains. Keywords: Indonesia; drug resistance; Helicobacter pylori; antibiotic

Molluscicidal activity of four Apiaceae essential oils against the freshwater snail Radix peregra

Snails of the family Lymnaeidae are an essential link in the transmission of zoonotic diseases. Radix peregra is a European freshwater snail and a susceptible intermediate host of Fasciola hepatica, the causing agent of fascioliasis. Essential oils (EOs) extracted from Anethum graveolens (dill), Cuminum cyminum (cumin), Foeniculum vulgare var. vulgare (bitter fennel) and Petroselinum crispum (plain leaf parsley) were characterized by GC and GC-MS. Seven EOs and 11 constituents were first screened through a single-dose bioassay against R. peregra (10 mg L-1 for juveniles and 50 mg L-1 for egg masses and mature snails). EOs from parsley, cumin and bitter fennel (leaves plus stems) were highly active towards eggs and adults at 50 mg L-1. Subsequently, dose and time-lethality bioassays were performed against adults to determine lethal parameters (LC50;90 and LT50;90). Estimated 48 h LC50s varied from 13.7 to 46.5 mg L-1, with P. crispum fruits EO exhibiting the most significant activity. EOs from cumin fruits and bitter fennel infrutescences, and cuminaldehyde, were the most time-effective treatments when assessed by continuous exposure (LT50 for a 50 mg L-1 dose = 15.1, 19.3 and 19.5 h, respectively). A short-time exposure (8 h) to bitter fennel EOs was effective for the control of adults (LT50 <= 25 h). The present study uncovers the potential of four well-known Apiaceae species as natural sources of biomolluscicides.This work was supported by national funds (FCT-Portuguese Foundation for Science and Technology) under the project UID/AGR/04033/2013. RM Sousa was financially supported by the FCT through a PhD grant SFRH/BD/66041/2009. Authors are grateful to S. Chaves for the English language revision.info:eu-repo/semantics/publishedVersio