Tailored Pre-Operative Antibiotic Prophylaxis to Prevent Post-Operative Surgical Site Infections in General Surgery

The average American today undergoes three inpatient and two outpatient surgical procedures during one’s life, each of which carries with it a risk of post-operative infection. It has long been known that post-operative infections cause significant morbidity in the immediate peri-operative period, but recent evidence suggests that they can have long-term consequences as well, increasing a patient’s risk of infectious complications in unrelated surgeries performed months or even years later. While there are several theories on the origin of this association, including bacterial colonization of a post-operative infectious wound site, antimicrobial resistance from curative courses of antibiotics, subclinical immunosuppression, or the creation of an inflammatory “pathobiome” following an infectious insult, it is ultimately still unclear why patients who experience a single post-operative infection seem to be at a significantly higher risk of experiencing subsequent ones. Regardless, this association has significant implications for the routine use of pre-operative antibiotic prophylaxis. Indeed, while the prescription of antibiotics pre-operatively has dramatically reduced the rate of post-operative infections, the chosen prophylaxis regimens are typically standardized according to national guidelines, are facing increasing antimicrobial resistance patterns, and have been unable to reduce the risk of post-operative infection to acceptably low levels for certain surgeries. As a result, some clinicians have speculated that tailoring pre-operative antibiotic prophylaxis according to a patient’s prior infectious and operative history could improve efficacy and further reduce the rate of post-operative infections. The purpose of this review is to describe the evidence for the link between multiple post-operative infections and explore the efficacy of individualized pre-operative prophylaxis

Online Recursive Detection and Adaptive Fuzzy Mitigation of Cyber-Physical Attacks Targeting Topology of IMG: An LFC Case Study

Due to the low inertia of inverter-based islanded microgrids (IMGs), these systems require a delicate and accurate load frequency control (LFC) scheme. The deployment of such a control scheme, which preserves the balance between the load and generation, needs a cyber layer on top of the physical system that makes IMGs an appealing target for a variety of cyber-physical attacks (CPAs). Among these CPAs, there is a family of malicious CPAs whose aim is to compromise the LFC scheme by changing the topology of IMG and its parameters. On this basis, an online system identification method is developed to estimate the parameters of IMG using the recursive least square forgetting factor (RLS-FF) approach. Then, based on the estimated parameters, an anomaly-based intrusion detection system (IDS) is developed to identify CPAs and distinguish them from the uncertainties in the normal operation of IMG. Following anomaly detection, a mitigation scheme is proposed to regulate the IMG’s frequency using an adaptive interval type-2 fuzzy logic controller (IT2FLC). The proposed IT2FLC uses different types of distributed energy resources (DERs)—i.e., tidal power plants and solar panels which are, respectively, equipped with inertia emulation and droop-based controllers—to improve the frequency excursion resulting from CPAs. The simulation results verify the performance of the developed detection and mitigation schemes, particularly when the RLS-FF parameters, i.e., forgetting factor, covariance matrix, and reset parameter, are obtained through the grey wolf optimization (GWO) algorithm. Furthermore, the designed mitigation scheme is corroborated by comparing its performance with several well-known attack-resilient control frameworks in LFC studies, e.g., linear quadratic regulator (LQR) and H∞, using real-time simulations.©2023 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.fi=vertaisarvioitu|en=peerReviewed

Investigation of the battery degradation impact on the energy management of a fuel cell hybrid electric vehicle

This paper studies the influence of battery degradation over the performance of a fuel cell hybrid electric vehicle (FCHEV). For this purpose, an optimized fuzzy strategy based on the costs of battery and fuel cell degradations as well as fuel consumption and battery recharging is employed. Simulations are done by two driving cycles for three scenarios based on battery state of health (SOH) and validity of feedback signal. Simulation results prove that battery aging has a considerable impact on the total cost of a FCHEV. Moreover, tuning of the EMS parameters according to the battery SOH decreases the defined cost

Online energy management of a hybrid fuel cell vehicle considering the performance variation of the power sources

This study investigates the impact of battery and fuel cell (FC) degradation on energy management of a FC hybrid electric vehicle. In this respect, an online energy management strategy (EMS) is proposed considering simultaneous online adaptation of battery and FC models. The EMS is based on quadratic programming which is integrated into an online battery and proton exchange membrane FC (PEMFC) parameters identification. Considering the battery and PEMFC states of health, three scenarios have been considered for the EMS purpose, and the performance of the proposed EMS has been examined under two driving cycles. Numerous test scenarios using standard driving cycles reveal that the ageing of battery and PEMFC has a considerable impact on the hydrogen consumption. Moreover, the proposed EMS can successfully tackle the model uncertainties owing to the performance drifts of the power sources at the mentioned scenarios

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe

Techno-Economic Analysis of Biofuel Production from Macroalgae (Seaweed)

A techno-economic evaluation of bioenergy production from macroalgae was carried out in this study. Six different scenarios were examined for the production of different energy products and by-products. Seaweed was produced either via the longline method or the grid method. Final products of these scenarios were either ethanol from fermentation, or electricity from anaerobic digestion (AD). By-products were digestate for AD, and animal feed, or electricity and digestate, for the fermentation pathway. Bioenergy breakeven selling prices were investigated according to the cost components and the feedstock supply chain, while suggestions for potential optimization of costs were provided. The lowest production level of dry seaweed to meet 0.93 ($/L) for ethanol fuel and 0.07$/kW-h for electricity was found to be 0.68 and 3.7 million tonnes (dry basis), respectively. At the moment, biofuel production from seaweed has been determined not to be economically feasible, but achieving economic production may be possible by lowering production costs and increasing the area under cultivation

Techno-Economic Analysis of Biofuel Production from Macroalgae (Seaweed)

A techno-economic evaluation of bioenergy production from macroalgae was carried out in this study. Six different scenarios were examined for the production of different energy products and by-products. Seaweed was produced either via the longline method or the grid method. Final products of these scenarios were either ethanol from fermentation, or electricity from anaerobic digestion (AD). By-products were digestate for AD, and animal feed, or electricity and digestate, for the fermentation pathway. Bioenergy breakeven selling prices were investigated according to the cost components and the feedstock supply chain, while suggestions for potential optimization of costs were provided. The lowest production level of dry seaweed to meet 0.93 ($/L) for ethanol fuel and 0.07$/kW-h for electricity was found to be 0.68 and 3.7 million tonnes (dry basis), respectively. At the moment, biofuel production from seaweed has been determined not to be economically feasible, but achieving economic production may be possible by lowering production costs and increasing the area under cultivation.This article is published as Soleymani, Mohsen, and Kurt A. Rosentrater. "Techno-Economic Analysis of Biofuel Production from Macroalgae (Seaweed)." Bioengineering 4, no. 4 (2017): 92. DOI: 10.3390/bioengineering4040092. Posted with permission.</p

Evaluation the Phytoremediation of Oil-contaminated Soils Around Isfahan Oil Refinery

Petroleum compounds are pollutants that most commonly occur in soils around oil refineries and that often find their ways into groundwater resources. Phytoremediation is a cost-effective alternative to physicochemical methods for oil-contaminated soil remediation, where feasible. In this study, a greenhouse experiment was conducted to evaluate the phytoremediation of oil-contaminated soils around Isfahan Oil Refinery. Four different plants (namely, sorghum, barley, agropyron, and festuca) were initially evaluated in terms of their germinability in both contaminated and control (non-contaminated) soils. Sorghum and barley (recording the highest germinability values) were chosen as the species for use in the phytoremediation experiments. Shoot and root dry weights, total and oil-degrading bacteria counts, microbial activity, and total concentrations of petroleum hydrocarbons (TPHs) were determined at harvest 120 days after planting. A significant difference was observed in the bacterial counts (total and oil-degrading bacteria) between the planted soils and the control. In contaminated soils, a higher microbial activity was observed in the rhizosphere of the sorghum soil than in that of barley. TPHs concentration decreased by 52%‒64% after 120 days in contaminated soil in which sorghum and barley had been cultivated. This represented an improvement of 30% compared to the contaminated soil without plants. Based on the results obtained, sorghum and barley may be recommended for the removal of petro-contaminants in areas close to Isfahan Oil Refinery. Nevertheless, caution must be taken as such cultivated lands may need to be protected against grazing animals

Impact of negative links on the structural balance of brain functional network during emotion processing

Abstract Activation of specific brain areas and synchrony between them has a major role in process of emotions. Nevertheless, impact of anti-synchrony (negative links) in this process still requires to be understood. In this study, we hypothesized that quantity and topology of negative links could influence a network stability by changing of quality of its triadic associations. Therefore, a group of healthy participants were exposed to pleasant and unpleasant images while their brain responses were recorded. Subsequently, functional connectivity networks were estimated and quantity of negative links, balanced and imbalanced triads, tendency to make negative hubs, and balance energy levels of two conditions were compared. The findings indicated that perception of pleasant stimuli was associated with higher amount of negative links with a lower tendency to make a hub in theta band; while the opposite scenario was observed in beta band. It was accompanied with smaller number of imbalanced triads and more stable network in theta band, and smaller number of balanced triads and less stable network in beta band. The findings highlighted that inter regional communications require less changes to receive new information from unpleasant stimuli, although by decrement in beta band stability prepares the network for the upcoming events