Photospheric and chromospheric magnetic activity of seismic solar analogs. Observational inputs on the solar/stellar connection from Kepler and Hermes

We identify a set of 18 solar analogs among the seismic sample of solar-like stars observed by the Kepler satellite rotating between 10 and 40 days. This set is constructed using the asteroseismic stellar properties derived using either the global oscillation properties or the individual acoustic frequencies. We measure the magnetic activity properties of these stars using observations collected by the photometric Kepler satellite and by the ground-based, high-resolution Hermes spectrograph mounted on the Mercator telescope. The photospheric (Sph) and chromospheric (S index) magnetic activity levels of these seismic solar analogs are estimated and compared in relation to the solar activity. We show that the activity of the Sun is comparable to the activity of the seismic solar analogs, within the maximum-to-minimum temporal variations of the 11-year solar activity cycle 23. In agreement with previous studies, the youngest stars and fastest rotators in our sample are actually the most active. The activity of stars older than the Sun seems to not evolve much with age. Furthermore, the comparison of the photospheric, Sph, with the well-established chromospheric, S index, indicates that the Sph index can be used to provide a suitable magnetic activity proxy which can be easily estimated for a large number of stars from space photometric observations.Comment: Accepted for publication in A&

X chromosome inactivation does not necessarily determine the severity of the phenotype in Rett syndrome patients

Rett syndrome (RTT) is a severe neurological disorder usually caused by mutations in the MECP2 gene. Since the MECP2 gene is located on the X chromosome, X chromosome inactivation (XCI) could play a role in the wide range of phenotypic variation of RTT patients; however, classical methylation-based protocols to evaluate XCI could not determine whether the preferentially inactivated X chromosome carried the mutant or the wild-type allele. Therefore, we developed an allele-specific methylation-based assay to evaluate methylation at the loci of several recurrent MECP2 mutations. We analyzed the XCI patterns in the blood of 174 RTT patients, but we did not find a clear correlation between XCI and the clinical presentation. We also compared XCI in blood and brain cortex samples of two patients and found differences between XCI patterns in these tissues. However, RTT mainly being a neurological disease complicates the establishment of a correlation between the XCI in blood and the clinical presentation of the patients. Furthermore, we analyzed MECP2 transcript levels and found differences from the expected levels according to XCI. Many factors other than XCI could affect the RTT phenotype, which in combination could influence the clinical presentation of RTT patients to a greater extent than slight variations in the XCI pattern

Multi-Objective Optimization of PV and Energy Storage Systems for Ultra-Fast Charging Stations

The installation of ultra-fast charging stations (UFCSs) is essential to push the adoption of electric vehicles (EVs). Given the high amount of power required by this charging technology, the integration of renewable energy sources (RESs) and energy storage systems (ESSs) in the design of the station represents a valuable option to decrease its impact on the grid and the environment. Therefore, this paper proposes a multi-objective optimization problem for the optimal sizing of photovoltaic (PV) system and battery ESS (BESS) in a UFCS of EVs. The proposed multi-objective function aims to minimize, on one side, the annualized cost of the station, and on the other side, the produced pollutant emissions. The decision variables are the number of PV panels and the capacity of the ESS to be installed. The optimization problem is reduced to a single-objective problem by applying the linear scalarization method. Then the equivalent single-objective function is optimized through a genetic algorithm (GA). The proposed optimization framework is applied to a study case and the results prove that PV and ESS could lead to a significant reduction of both the annualized cost and the pollutant emissions. Finally, a sensitivity analysis is also presented to validate the effectiveness of the proposed solution

Optimal online battery power control of grid-connected energy-stored quasi-impedance source inverter with PV system

This study presents an optimal online control that implements a biogeography-based optimization (BBO) algorithm on a battery energy system (BES) integrated into an energy-stored quasi-impedance source inverter (qZSI) that connects a photovoltaic (PV) power plant to the grid. The BBO algorithm was used to tune the PI regulator in the BES current control loop by minimizing the integral time absolute error (ITAE). Two different options for the BBO are compared in this application:1) a PI controller with online self-tuning based on BBO, and 2) a PI controller with offline tuning using BBO. Moreover, the BBO-based PI controllers were compared with a third controller tuned online using the particle swarm optimization (PSO) algorithm. To evaluate and compare the controllers, a PV power plant with a battery energy-stored qZSI was simulated under different operating conditions, such as step changes in the BES current reference, different sun irradiance, and a grid voltage sag. The results demonstrate better control of the BES current with the online tuning techniques (BBO and PSO) than with the offline tuning procedure, and similar results between the two online tuning algorithms. Nevertheless, throughout the simulation, the time of use of the BBO algorithm was almost 2.5 times smaller than the PSO algorithm. Therefore, the online BBO-based PI controller is considered the most suitable option

. Climate change adaptability and mitigation with Conservation Agriculture

The status quo of agriculture based on soil tillage is unacceptable from a climate point of view. To reverse agriculture’s field performance from that of a net GHG emitter to a GHG mitigator requires a new paradigm. CA is a holistic agricultural system that is able to mitigate and adapt to climate change. The three interlinked principles of CA enable the system to deliver many benefits in terms of carbon sequestration and climate adaptation, especially with regards to soil, water, nutrient, and energy management

A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study

Background: The benefit of pharmacogenetic testing before starting drug therapy has been well documented for several single gene–drug combinations. However, the clinical utility of a pre-emptive genotyping strategy using a pharmacogenetic panel has not been rigorously assessed. Methods: We conducted an open-label, multicentre, controlled, cluster-randomised, crossover implementation study of a 12-gene pharmacogenetic panel in 18 hospitals, nine community health centres, and 28 community pharmacies in seven European countries (Austria, Greece, Italy, the Netherlands, Slovenia, Spain, and the UK). Patients aged 18 years or older receiving a first prescription for a drug clinically recommended in the guidelines of the Dutch Pharmacogenetics Working Group (ie, the index drug) as part of routine care were eligible for inclusion. Exclusion criteria included previous genetic testing for a gene relevant to the index drug, a planned duration of treatment of less than 7 consecutive days, and severe renal or liver insufficiency. All patients gave written informed consent before taking part in the study. Participants were genotyped for 50 germline variants in 12 genes, and those with an actionable variant (ie, a drug–gene interaction test result for which the Dutch Pharmacogenetics Working Group [DPWG] recommended a change to standard-of-care drug treatment) were treated according to DPWG recommendations. Patients in the control group received standard treatment. To prepare clinicians for pre-emptive pharmacogenetic testing, local teams were educated during a site-initiation visit and online educational material was made available. The primary outcome was the occurrence of clinically relevant adverse drug reactions within the 12-week follow-up period. Analyses were irrespective of patient adherence to the DPWG guidelines. The primary analysis was done using a gatekeeping analysis, in which outcomes in people with an actionable drug–gene interaction in the study group versus the control group were compared, and only if the difference was statistically significant was an analysis done that included all of the patients in the study. Outcomes were compared between the study and control groups, both for patients with an actionable drug–gene interaction test result (ie, a result for which the DPWG recommended a change to standard-of-care drug treatment) and for all patients who received at least one dose of index drug. The safety analysis included all participants who received at least one dose of a study drug. This study is registered with ClinicalTrials.gov, NCT03093818 and is closed to new participants. Findings: Between March 7, 2017, and June 30, 2020, 41 696 patients were assessed for eligibility and 6944 (51·4 % female, 48·6% male; 97·7% self-reported European, Mediterranean, or Middle Eastern ethnicity) were enrolled and assigned to receive genotype-guided drug treatment (n=3342) or standard care (n=3602). 99 patients (52 [1·6%] of the study group and 47 [1·3%] of the control group) withdrew consent after group assignment. 652 participants (367 [11·0%] in the study group and 285 [7·9%] in the control group) were lost to follow-up. In patients with an actionable test result for the index drug (n=1558), a clinically relevant adverse drug reaction occurred in 152 (21·0%) of 725 patients in the study group and 231 (27·7%) of 833 patients in the control group (odds ratio [OR] 0·70 [95% CI 0·54–0·91]; p=0·0075), whereas for all patients, the incidence was 628 (21·5%) of 2923 patients in the study group and 934 (28·6%) of 3270 patients in the control group (OR 0·70 [95% CI 0·61–0·79]; p <0·0001). Interpretation: Genotype-guided treatment using a 12-gene pharmacogenetic panel significantly reduced the incidence of clinically relevant adverse drug reactions and was feasible across diverse European health-care system organisations and settings. Large-scale implementation could help to make drug therapy increasingly safe. Funding: European Union Horizon 2020

coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit

Background/objectives: Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. Methods: All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Results: Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P < 0.00001), early enteral feeding (33.2%, χ2 11.51, P = 0.009), and the implementation of early cholecystectomy strategies (29%, χ2 354.64, P < 0.00001), with wide variability based on the admitting speciality. Conclusions: The results of this study showed an overall poor compliance with evidence-based guidelines in the management of ABP, with wide variability based on the admitting speciality. Study protocol registered in ClinicalTrials.Gov (ID Number NCT04747990)

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090–6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286–5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912–7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138–0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143–0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990). Graphical abstract: [Figure not available: see fulltext.]