Analysis of spatial fixed PV arrays configurations to maximize energy harvesting in BIPV applications

This paper presents a new approach for efficient utilization of building integrated photovoltaic (BIPV) systems under partial shading conditions in urban areas. The aim of this study is to find out the best electrical configuration by analyzing annual energy generation of the same BIPV system, in terms of nominal power, without changing physical locations of the PV modules in the PV arrays. For this purpose, the spatial structure of the PV system including the PV modules and the surrounding obstacles is taken into account on the basis of virtual reality environment. In this study, chimneys which are located on the residential roof-top area are considered to create the effect of shading over the PV array. The locations of PV modules are kept stationary, which is the main point of this paper, while comparing the performances of the configurations with the same surrounding obstacles that causes partial shading conditions. The same spatial structure with twelve distinct PV array configurations is considered. The same settling conditions on the roof-top area allow fair comparisons between PV array configurations. The payback time analysis is also performed with considering local and global maximum power points (MPPs) of PV arrays by comparing the annual energy yield of the different configurationsPeer ReviewedPostprint (author’s final draft

Coordinated Home Energy Management in Community Microgrids with Energy Sharing Among Smart Homes

International audienceThis paper presents a coordination mechanism for smart homes in community microgrids (smart neighborhoods) whether photovoltaics (PV), home battery storage and electric vehicles (EV) are available. The objective of the proposed method is to reduce the electricity cost of the users, as well as the aggregated peak load of the area by establishing an energy sharing ability among neighbors. A decentralized control algorithm deployed by the smart homes is used for battery control and appliance scheduling. It is assumed that the users are the owners of these resources and that they are selfish decision-makers who focus on increasing own benefit. For the neighborhood, a dynamic price model is used, where the price is associated to the aggregated consumption of the neighborhood area. Numerical results show that proposed coordination mechanism with energy sharing provides benefits for both the users and the utility

Depression and sickness behavior are Janus-faced responses to shared inflammatory pathways

It is of considerable translational importance whether depression is a form or a consequence of sickness behavior. Sickness behavior is a behavioral complex induced by infections and immune trauma and mediated by pro-inflammatory cytokines. It is an adaptive response that enhances recovery by conserving energy to combat acute inflammation. There are considerable phenomenological similarities between sickness behavior and depression, for example, behavioral inhibition, anorexia and weight loss, and melancholic (anhedonia), physio-somatic (fatigue, hyperalgesia, malaise), anxiety and neurocognitive symptoms. In clinical depression, however, a transition occurs to sensitization of immuno-inflammatory pathways, progressive damage by oxidative and nitrosative stress to lipids, proteins, and DNA, and autoimmune responses directed against self-epitopes. The latter mechanisms are the substrate of a neuroprogressive process, whereby multiple depressive episodes cause neural tissue damage and consequent functional and cognitive sequelae. Thus, shared immuno-inflammatory pathways underpin the physiology of sickness behavior and the pathophysiology of clinical depression explaining their partially overlapping phenomenology. Inflammation may provoke a Janus-faced response with a good, acute side, generating protective inflammation through sickness behavior and a bad, chronic side, for example, clinical depression, a lifelong disorder with positive feedback loops between (neuro)inflammation and (neuro)degenerative processes following less well defined triggers

Stressful life events and catechol-O-methyl-transferase (COMT) gene in bipolar disorder

GlaxoSmithKline Research and Development

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mécanismes de coordination pour la gestion de l'énergie électrique dans un quartier intelligent : planification de l'utilisation des ressources et partage local d'énergie

Grid modernization through philosophies as the Smart Grid has the potential to help meet the expected world increasing demand and integrate new distributed generation resources at the same time. Using advanced communication and computing capabilities, the Smart Grid offers a new avenue of controlling end-user assets, including small units such as home appliances. However, with such strategies, decisions taken independently can cause undesired effects such as rebound peaks, contingencies, and instabilities in the network. Therefore, the interaction between the energy management actions of multiple smart homes is a challenging issue in the Smart Grid. Under this purpose, in this work, the potential of coordination mechanisms established among residential customers at the neighborhood level is evaluated through three studies. Firstly, coordinative home energy management is presented, with the aim to increase local renewable energy usage in the neighborhood area by establishing energy trading among smart homes, which are compensated by incentives. The control algorithm is realized in both centralized and decentralized manners by deploying a multi-agent system, where neighborhood entities are modeled as agents. Simulations results show that both methods are effective on increasing local renewable energy usage and decreasing the daily electricity bills of customers. However, while the decentralized approach gives results in shorter time, the centralized approach shows a better performance regarding costs. Secondly, two decentralized energy management algorithms are proposed for day-ahead energy management in the neighborhood area. A dynamic pricing model is used, where price is associated to the aggregated consumption and grid time-of-use scheme. The objective of the study is to establish a more advanced coordination mechanism (compared to previous work) with residual renewable energy is shared among smart homes. In this study, the performance of the algorithms is investigated with daily and annual analyses, with and without considering forecasting errors. According to simulations results, both coordinative control models show better performance compared to baseline and selfish (no coordination) control cases, even when considering forecasting errors. Lastly, the impact of photovoltaic systems on a residential aggregator performance (in a centralized approach) is investigated in a neighborhood area. In the proposed model, the aggregator interacts with the spot market and the utility, and proposes a novel pricing scheme to influence customers to control their loads. Simulation results show that when the penetration level of residential photovoltaics (PV) is increased, the aggregator profit decreases due to self-consumption ability with PV in the neighborhood.La modernisation des réseaux électriques via ce que l'appelle aujourd'hui les réseaux intelligents (ou smart grids) promet des avancées pour permettre de faire face à une augmentation de la demande mondiale ainsi que pour faciliter l'intégration des ressources décentralisées. Grâce à des moyens de communication et de calcul avancés, les smart grids offrent de nouvelles possibilités pour la gestion des ressources des consommateurs finaux, y compris pour de petits éléments comme de l'électroménager. Cependant, ce type de gestion basée sur des décisions prises indépendamment peuvent causer des perturbations tels qu'un rebond de consommation, ou des instabilités sur le réseau. La prise en compte des interactions entre les décisions de gestion énergétique de différentes maisons intelligentes est donc une problématique naissante dans les smart grids. Cette thèse vise à évaluer l'impact potentiel de mécanismes de coordination entre consommateurs résidentiels au niveau de quartiers, et ce à travers trois études complémentaires. Tout d'abord, une première stratégie pour la gestion coordonnée de maisons est proposée avec l'objectif d'augmenter l'utilisation locale d'énergie renouvelable à travers la mise en place d'échanges d'énergie électrique entre voisins. Les participants reçoivent en échange une compensation financière. L'algorithme de gestion est étudié dans une configuration centralisée et une configuration décentralisée en faisant appel au concept de système multi-agents, chaque maison étant représentée par un agent. Les résultats de simulation montrent que les deux approches sont efficaces pour augmenter la consommation locale d'énergie renouvelable et réduire les coûts énergétiques journaliers des consommateurs. Bien que l'approche décentralisée retourne des résultats plus rapidement, l'approche centralisée a une meilleure performance concernant les coûts. Dans une seconde étude, deux algorithmes de gestion énergétiques à J-1 sont proposés pour un quartier résidentiel. Un modèle de tarification dynamique est utilisé, où le prix dépend de la consommation agrégée du quartier ainsi que d'une forme de tarification heures creuses-heures pleines. L'objectif est ici de concevoir un mécanisme de coordination plus avancé (par rapport au précédent), en permettant des échanges d'énergie renouvelable résiduelle au sein du quartier. La performance des algorithmes est étudiée sur une période d'une journée puis d'une année, en prenant ou non en compte les erreurs de prévision. D'après les résultats de simulation, les deux algorithmes proposés montrent de meilleurs performances que les méthodes de référence (sans contrôle, et algorithme égoïste), même en considérant les erreurs de prévision. Enfin, dans une troisième étude, l'impact de l'introduction de production photovoltaïque résidentielle sur la performance d'un agrégateur est évaluée, dans une configuration centralisée. L'agrégateur interagit avec le marché spot et le gestionnaire de réseau, de façon à proposer un nouveau modèle de tarification permettant d'influencer les consommateurs à agir sur leur consommation. Les résultats de simulation montrent quand le taux de pénétration de photovoltaïque résidentiel augmente, le profit de l'agrégateur diminue, du fait de l'autoconsommation dans le quartier