Influence of atmospheric conditions on the power production of utility-scale wind turbines in yaw misalignment

The intentional yaw misalignment of leading, upwind turbines in a wind farm, termed wake steering, has demonstrated potential as a collective control approach for wind farm power maximization. The optimal control strategy, and resulting effect of wake steering on wind farm power production, are in part dictated by the power degradation of the upwind yaw misaligned wind turbines. In the atmospheric boundary layer, the wind speed and direction may vary significantly over the wind turbine rotor area, depending on atmospheric conditions and stability, resulting in freestream turbine power production which is asymmetric as a function of the direction of yaw misalignment and which varies during the diurnal cycle. In this study, we propose a model for the power production of a wind turbine in yaw misalignment based on aerodynamic blade elements which incorporates the effects of wind speed and direction changes over the turbine rotor area in yaw misalignment. A field experiment is performed using multiple utility-scale wind turbines to characterize the power production of yawed freestream operating turbines depending on the wind conditions, and the model is validated using the experimental data. The resulting power production of a yaw misaligned variable speed wind turbine depends on a nonlinear interaction between the yaw misalignment, the atmospheric conditions, and the wind turbine control system.Comment: 37 pages, 15 figure

Black Holes in Ho\v{r}ava Gravity with Higher Derivative Magnetic Terms

We consider Horava gravity coupled to Maxwell and higher derivative magnetic terms. We construct static spherically symmetric black hole solutions in the low-energy approximation. We calculate the horizon locations and temperatures in the near-extremal limit, for asymptotically flat and (anti-)de Sitter spaces. We also construct a detailed balanced version of the theory, for which we find projectable and non-projectable, non-perturbative solutions.Comment: 17 pages. v2: Up to date with published version; some minor remarks and more reference

Potentially inappropriate medication in older participants of the Berlin Aging Study II (BASE-II) - Sex differences and associations with morbidity and medication use

INTRODUCTION: Multimorbidity in advanced age and the need for drug treatment may lead to polypharmacy, while pharmacokinetic and pharmacodynamic changes may increase the risk of adverse drug events (ADEs). OBJECTIVE: The aim of this study was to determine the proportion of subjects using potentially inappropriate medication (PIM) in a cohort of older and predominantly healthy adults in relation to polypharmacy and morbidity. METHODS: Cross-sectional data were available from 1,382 study participants (median age 69 years, IQR 67-71, 51.3% females) of the Berlin Aging Study II (BASE-II). PIM was classified according to the EU(7)-PIM and German PRISCUS (representing a subset of the former) list. Polypharmacy was defined as the concomitant use of at least five drugs. A morbidity index (MI) largely based on the Charlson Index was applied to evaluate the morbidity burden. RESULTS: Overall, 24.1% of the participants were affected by polypharmacy. On average, men used 2 (IQR 1-4) and women 3 drugs (IQR 1-5). According to PRISCUS and EU(7)-PIM, 5.9% and 22.6% of participants received at least one PIM, while use was significantly more prevalent in females (25.5%) compared to males (19.6%) considering EU(7)-PIM (p = 0.01). In addition, morbidity in males receiving PIM according to EU(7)-PIM was higher (median MI 1, IQR 1-3) compared to males without PIM use (median MI 1, IQR 0-2, p<0.001). CONCLUSION: PIM use occurred more frequently in women than in men, while it was associated with higher morbidity in males. As expected, EU(7)-PIM identifies more subjects as PIM users than the PRISCUS list but further studies are needed to investigate the differential impact of both lists on ADEs and outcome. KEY POINTS: We found PIM use to be associated with a higher number of regular medications and with increased morbidity. Additionally, we detected a higher prevalence of PIM use in females compared to males, suggesting that women and people needing intensive drug treatment are patient groups, who are particularly affected by PIM use

C3-Cloud personalised care plan development platform for addressing the needs of multi-morbidity and managing poly-pharmacy : protocol for a pilot technology trial

Background: There is an increasing need to organise the care around the patient and not the disease, as well as taking into account the complex realities of multiple physical, psycho-social conditions and polypharmacy. Integrated patient-centred care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced ICT solutions. Objective: The C3-Cloud project has developed two collaborative computer platforms for patients and members of the Multi-Disciplinary Team and deployed these in three different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients, informal caregivers, healthcare professionals and, in extend, healthcare systems. Methods: This paper describes the protocol for conducting an evaluation of the user-centred design, user experience, acceptability, and usefulness of the platforms. For this, four ‘testing and evaluation’ phases have been defined, involving multiple qualitative methods, and advanced impact modelling. Results: The technology trial in this 4-year funded project (2016-2020) is currently in its execution phase. The testing and evaluation phase 1 and 2 have been completed with satisfying results on system component tests, and promising results on application and usability tests. The pilot technology trial for evaluation phase 3 and 4 was launched in August 2019. Data collection for these phases is underway and results are forthcoming, approximately in April 2020. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product. Conclusions: Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalised care plan platforms for patients and collaboration platforms for members of Multi-Disciplinary Teams can help to tackle the specific challenges of clinical guideline reconciliation for multimorbid patients and improved the management of poly-pharmacy. The initial evaluative phases have indicated promising results of platform usability. The phased methodology has shown useful results in the first two phases, while results of phase 3 and 4 are pending. Clinical Trial: https://www.clinicaltrials.gov/ct2/show/NCT0383420

Perturbative instabilities in Horava gravity

We investigate the scalar and tensor perturbations in Horava gravity, with and without detailed balance, around a flat background. Once both types of perturbations are taken into account, it is revealed that the theory is plagued by ghost-like scalar instabilities in the range of parameters which would render it power-counting renormalizable, that cannot be overcome by simple tricks such as analytic continuation. Implementing a consistent flow between the UV and IR limits seems thus more challenging than initially presumed, regardless of whether the theory approaches General Relativity at low energies or not. Even in the phenomenologically viable parameter space, the tensor sector leads to additional potential problems, such as fine-tunings and super-luminal propagation.Comment: 21 pages, version published at Class. Quant. Gra

Farmacogen\ue9tica de la Tuberculosis: Nuevo modelo de predicci\uf3n de hepatotoxicidad inducida por f\ue1rmacos antituberculosis

Introducci\uf3n: La hepatotoxicidad inducida por f\ue1rmacos antituberculosis (HIFA) es una reacci\uf3n adversa grave y potencialmente fatal del tratamiento de la tuberculosis (TB). Tres de los cuatro f\ue1rmacos utilizados como terapia de primera l\uednea (isoniacida, rifampicina, pirazinamida), han sido asociados a HIFA. Estudios sobre farmacogen\ue9tica de la TB han asociado el desarrollo de HIFA con variaciones en genes de enzimas que metabolizan estos f\ue1rmacos. Objetivos: Debido a que en Argentina la TB es una enfermedad re-emergente y a la elevada prevalencia de HIFA encontrada en pacientes internados, nos propusimos evaluar la posible asociaci\uf3n de factores ambientales y variantes gen\ue9ticas en enzimas que metabolizan f\ue1rmacos anti-TB con el desarrollo de HIFA. Tambi\ue9n, investigar las posibles interacciones gen-gen y gen-ambiente y su asociaci\uf3n con el desarrollo de HIFA, en una poblaci\uf3n de pacientes con TB hospitalizados de la Ciudad de Buenos Aires. M\ue9todos: Se estudiaron 345 pacientes con TB tratados con f\ue1rmacos anti-TB (96 con HIFA). Se analizaron variables cl\uednicas y demogr\ue1ficas tomadas en fichas de datos. Las variaciones gen\ue9ticas en las enzimas N-acetiltransferasa 2 (NAT2), citocromo P450 2E1 (CYP2E1), glutathione S-transferasa theta 1 (GSTT1) y glutathione S-transferasa mu 1 fueron detectadas por reacci\uf3n en cadena de polimerasa (PCR), secuenciaci\uf3n o PCR-RFLP. Para comparar las posibles variables predictoras entre pacientes con y sin HIFA se utiliz\uf3 un an\ue1lisis de regresi\uf3n log\uedstica binaria. Para estudiar las interacciones gen\ue9ticas y ambientales en asociaci\uf3n con HIFA se utiliz\uf3 el m\ue9todo de reducci\uf3n de la dimensionalidad multifactorial (MDR). Resultados: Este estudio mustra que ser acetilador lento (AL) de NAT-2 [OR (IC95%) = 3,02 (1,82-5,00); p&lt;0,001], ser portador de la variante c2 [OR (IC95%) = 2,16 (1,33-3,51); p = 0,002] o ser portador de la variante A4 de CYP2E1 [OR (IC95%) = 2,13 (1,06-4,29); p = 0,049], y ser mujer [OR (IC95%) = 1,94 (1,20 - 3,14); p = 0,006] resultaron variables predictoras independientes para HIFA. Aquellos pacientes AL que adem\ue1s eran portadores de la variante c2 de CYP2E1 tienen un riesgo mayor [OR (IC95%) = 7.07 (3.34-14.95); p &lt;0,001]. Por primera vez, se identific\uf3 una interacci\uf3n sin\ue9rgica (epistasis) entre GSTT1 y CYP2E1 con mayor riesgo de HIFA. A su vez, se describe por primera vez una significativa interacci\uf3n gen (NAT2 y CYP2E1) - ambiente (sexo) con riesgo aumentado de HIFA [TBA = 0,675, (p = 0,001) y CVC = 10/10]. Es decir que el mejor modelo de predicci\uf3n (67,5%) de HIFA contempla las variables NAT2, CYP2E1 y sexo. Conclusiones: HIFA es una reacci\uf3n adversa potencialmente fatal y prevalente (11% de los pacientes tratados) que conduce a la interrupci\uf3n del f\ue1rmaco. En nuestro estudio, se obtuvo un modelo de predicci\uf3n que clasifica adecuadamente al 67,5% de los pacientes con TB en su riesgo de desarrollar HIFA. Dado el n\ufamero considerable de TB en nuestro pa\ueds, las pruebas farmacogen\ue9ticas y una historia cl\uednica completa podr\uedan ser \ufatiles para reconocer a los pacientes con alto riesgo de sufrir hepatotoxicidad. Estos representan datos nacionales e internacionales in\ue9ditos relacionados a HIFA

Treatment challenges in and outside a specialist network setting: Pancreatic neuroendocrine tumours

Pancreatic Neuroendocrine Neoplasms comprise a group of rare tumours with special biology, an often indolent behaviour and particular diagnostic and therapeutic requirements. The specialized biochemical tests and radiological investigations, the complexity of surgical options and the variety of medical treatments that require individual tailoring, mandate a multidisciplinary approach that can be optimally achieved through an organized network. The present study describes currents concepts in the management of these tumours as well as an insight into the challenges of delivering the pathway in and outside a Network

Testicular germ-cell tumours and penile squamous cell carcinoma: Appropriate management makes the difference

Germ-cell tumours (GCT) of the testis and penile squamous cell carcinoma (PeSCC) are a rare and a very rare uro-genital cancers, respectively. Both tumours are well defined entities in terms of management, where specific recommendations - in the form of continuously up-to-dated guide lines-are provided. Impact of these tumour is relevant. Testicular GCT affects young, healthy men at the beginning of their adult life. PeSCC affects older men, but a proportion of these patients are young and the personal consequences of the disease may be devastating. Deviation from recommended management may be a reason of a significant prognostic worsening, as proper treatment favourably impacts on these tumours, dramatically on GCT and significantly on PeSCC. RARECAREnet data may permit to analyse how survivals may vary according to geographical areas, histology and age, leading to assume that non-homogeneous health-care resources may impact the cure and definitive outcomes. In support of this hypothesis, some epidemiologic datasets and clinical findings would indicate that survival may improve when appropriate treatments are delivered, linked to a different accessibility to the best health institutions, as a consequence of geographical, cultural and economic barriers. Finally, strong clues based on epidemiological and clinical data support the hypothesis that treatment delivered at reference centres or under the aegis of a qualified multi-institutional network is associated with a better prognosis of patients with these malignancies. The ERN EURACAN represents the best current European effort to answer this clinical need