Treatment of alopecia totalis/universalis/focalis with vitamin D and analogs: Three case reports and a literature review

BACKGROUND: Alopecia areata (AA) is an inflammatory disease with autoimmune, environmental, and inherited components directed at the hair follicle, either limited to patchy hair loss over the scalp (Focalis, AF), total loss of scalp hair (Totalis, AT), or total loss of both scalp and body hair (Universalis, AU). Despite multiple treatment modalities, no therapy exists. Vitamin D deficiency in patients with AA/AT/AF influences disease severity and duration, inversely correlating with inflammation histologically. CASE SUMMARY: Three girls presented with AT (P1), AU (P2), and AF (P3) at the ages of 1, 5, and 5 years, respectively. For P1-P2, all available treatments implemented for 2 years had failed. We started an initial 6-mo repletion with oral cholecalciferol 2000/4000 IU/d, with no apparent effect. Then we attempted immunomodulation using oral calcitriol and its analog paricalcitol. On calcitriol, 0.5 mcg/d P1 regrew hair within 6 mo. After 4 years, a relapse with loss of eyebrow hair was resolved after doubling the calcitriol dose to 0.5 mcg × 2/d; the results have been maintained for 6 years to date. On calcitriol, 0.25 mcg × 3/d P2 led to the development of asymptomatic hypercalcemia-hypercalciuria, which was immediately resolved by switching to paricalcitol 2 mcg × 3/d; mild tolerable hypercalciuria was maintained. Hair regrowth was observed at 6 mo, stabilizing only as fur at 12 mo. AF in P3 was resolved completely within 3 mo on a daily high dose (8000 IU) of cholecalciferol. CONCLUSION: Vitamin D may have immunomodulating therapeutic impact on AT/AU/AF, which needs to be explored with further pilot clinical trials

Development of Smart Grid Standards in View of Energy System Functionalities

A range of technologies must be developed and deployed for achieving a decarbonised energy system. A smart grid aims to integrate these different technologies into a single, over-arching system that is at the same time both complex and interoperable, which cannot be achieved without standardisation. Moreover, standardisation is a method of transferring research into successful processes and products. Without this, existing conventional energy systems will not change much longer, as it is more difficult to achieve significant market penetration of new technologies and deployment of new functions and applications. It seems that standardisation issues are not sufficiently addressed in scientific publications and are treated as a very specific topic by community of researchers despite the fact that standards may serve as a knowledge base for further research and improvement of emerging technologies and approaches. This paper presents a bird's-eye smart grid standardisation review based on a unique functionality - technology approach developed within Horizon 2020 project PANTERA.acceptedVersio

Communication Among Multidisciplinary Team Members Treating Patients with Disorders of Consciousness Following Traumatic Brain Injury

The purpose of this research is to understand how clinicians who work with patients with disorders of consciousness (DoC) following traumatic brain injury (TBI) communicate about patients’ behavior regarding changes in consciousness. Communication and collaboration among multidisciplinary teams is central for person-centered rehabilitation and clinical progress. A deficiency in person-centeredness may decrease the quality of care a patient receives (Epstein & Street, 2007). This process is more complicated in patients with DoC since these patients are unable to participate in the dialog (Papadimitriou & Cott, 2015). This qualitative analysis explores unique challenges clinicians face communicating with team members when treating patients with DoC following TBI in inpatient rehabilitation. A grounded theory interview study explored how clinician’s perceive they communicate patients’ changes in consciousness with team members (Green & Thorogood, 2014). Three hospital systems recruited twenty-one clinicians who have experience working with DoC patients. Clinicians participated in semi-structured interviews with two trained interviewers. Interviews were audio-recorded, transcribed verbatim, and NVivo 11 Plus software was used for open coding. The team developed a codebook using thematic analysis and constant comparative strategies to finalize the codebook (Glaser, 1965). Three major themes emerged: 1) clinicians’ difficulty interpreting patients’ behaviors of change in consciousness, 2) a lack of confidence when selecting a treatment, and 3) an uncertainty of how to leverage caregivers’ interpretation of patients’ behaviors. For example, the data describes challenges clinical teams face in discharge planning. A social worker perceives the caregiver to agree on what it takes to bring their family member home while the occupational therapist did not share this perception. The social worker tried to convey to the team that the caregiver was equipped to take the patient home, “I was turning blue in the face communicating to the team that I did strongly feel that his [caregiver] had a reasonable expectation and an understanding of the severity of his deficit”. This exemplifies how each discipline has a different vantage point surrounding a complex task such as discharge planning. Communication challenges for clinicians treating patients with DoC were grounded within the three themes, which conveyed uncertainty with interpreting patients’ behaviors and linking it to clinical progress, a lack of research to support interventions, and being cautious when talking to family. Uncovering how clinicians make sense of patient’s behaviors and how they communicate these behaviors can aide in creating a foundation for improving the exchange of information and person-centered rehabilitation

Development of Energy Communities in Europe

This paper presents a review study of energy communities (ECs) in Europe, and discusses the future development of such communities in Europe – both related to energy technologies, energy carriers, regional conditions (North, Central and South of Europe), emerging regulatory development etc. From the analysis, it emerged that the future ECs in Europe will focus on utilizing local renewable energy sources (sun, wind, run of river, biogas, biomass), for covering all or part of the energy consumption for end-use customers. The ECs can be a sustainable alternative to large power plants based on fossil fuels. This is also linked to the emerging regulatory developments started when European Commission introduced such concepts in the “Clean Energy for all Europeans” package. The main goal of eNeuron H2020 project is to develop innovative tools for the optimal design and operation of ECs, integrating distributed energy resources and multiple energy carriers at different scales.Development of Energy Communities in EuropeacceptedVersio

Abdominal obesity, blood glucose and apolipoprotein B levels are the best predictors of the incidence of hypercholesterolemia (2001–2006) among healthy adults: the ATTICA Study

<p>Abstract</p> <p>Objective</p> <p>In this work we evaluated the 5-year incidence of hypercholesterolemia, in a sample of cardiovascular disease free adult men and women from Greece. We also evaluated the association of several socio-demographic, dietary and lifestyle habits on the incidence of this disorder.</p> <p>Methods</p> <p>1514 men and 1528 women (>18 y) without any clinical evidence of cardiovascular disease, living in Attica area, Greece, were enrolled in the ATTICA study from May 2001 to December 2002. The sampling was random, multi-stage, and included information about various socio-demographic, lifestyle (diet, exercise, smoking etc), biological (lipids, and inflammatory markers), and clinical characteristics of the participants. In 2006, a group of experts performed the 5-year follow-up through telephone calls or personal visits (941 of the 3042 (31%) participants were lost to follow-up). Hypercholesterolemia, among people who had normal blood lipids at initial examination, was defined as fasting total cholesterol levels > 200 mg/dl or use of lipids lowering agents (NCEP ATPIII).</p> <p>Results</p> <p>The 5-year incidence of hypercholesterolemia was 23.7% (n = 127) in men and 17.7% (n = 110) in women (p for gender differences < 0.001). Multi-adjusted logistic regression analysis which revealed that increased age (odds ratio = 1.05, p < 0.001), waist circumference (odds ratio = 1.02, p = 0.03), fasting blood glucose (odds ratio = 1.01, p = 0.08) and apolipoprotein B (odds ratio = 1.02, p = 0.001) levels, were the most significant baseline predictors of developing hypercholesterolemia within a 5-year period.</p> <p>Conclusion</p> <p>Incidence of hypercholesterolemia was high in both genders, emphasizing the burden of this disorder at population level. Aging, increased waist circumference, fasting blood glucose and apolipoprotein B levels were the most significant baseline predictors of hypercholesterolemia.</p

Comparative Value of Simple Inflammatory Markers in the Prediction of Left Ventricular Systolic Dysfunction in Postacute Coronary Syndrome Patients

Objectives. We sought to assess the comparative value of inflammatory markers on the occurrence of left ventricular systolic dysfunction (LVSD) after an acute coronary syndrome (ACS). Methods. During 2006–2008, 760 patients with an ACS were enrolled. C-reactive protein (CRP) and white blood cell (WBC) count were measured during the first 12 hours of hospital admission. Results. CRP levels and WBC count were significantly higher in those who developed LVSD compared to those who did not. The analysis revealed that a 10 mg/dL increase of CRP levels and a 1000/μL increase in WBC are associated with a 6% and a 7% increase in the likelihood of developing LVSD, respectively. Furthermore, WBC count at entry and CRP have almost the same predictive value for development of LVSD after an ACS (R2 = 0.109 versus R2 = 0.093). Conclusions. Serum CRP levels and WBC count at entry are almost equally powerful independent predictors of LVSD, after an ACS

Scoping review and descriptive thematic analysis

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This study aims to synthesize the literature on any disproportionate health risks or consequences of a COVID-19 infection for people with disabilities. Scoping review with a descriptive thematic analysis was carried out. Up to mid-September 2020, seven scientific databases and three preprint servers were searched to identify empirical or perspective papers. Snowballing searches and expert’ consultations also took place. Two independent reviewers were used for the screenings and data extractions. Of 1027 references, 58 were included, 15 of which were empirical articles. The thematic analysis showed that: (1) People with disabilities living in residential or long-term care facilities were more likely to have greater infection rates; (2) Intersecting mediators of greater infection risks were multiple (e.g., lack of accessible information); (3) People with disabilities often face greater health problems when infected; and (4) Unethical disadvantages in the rationing of lifesaving and critical care can be experienced by people with disabilities. Conclusions: Beyond any health-related vulnerabilities (e.g., comorbidity rates), multiple yet modifiable environmental factors can provide disproportionate health risks and consequences of a COVID-19 infection for people with disabilities. Public health and policy measures must prevent or reduce modifiable environmental risks.publishersversionpublishe

Photovoltaic grid-forming control strategy investigation using hardware-in-the-loop experiments

The frequency stability of a power system is of paramount importance, as a fast frequency swings in the system can lead to oscillatory instability, and thereby blackouts. A grid-connected microgrid, that can operate in the islanded mode can also possess such deteriorating effect due to the higher share of converter-based sources. In this paper, a coordinated frequency control within a distribution network is discussed, with a higher share of Photovoltaics (PV). The main objective of this paper is to test the grid-forming capabilities of PVs, without the requirement of an energy storage in the network. The tests were carried out with the help of the Typhoon Hardware-in-the-loop (HIL) platform using a real Cypriot network feeder. The real-time results confirm the efficacy of the PV as a grid-forming inverter, provided it has sufficient input (irradiance) to provide for the loads within the system of interest. The grid-forming PV also possesses the capability of reconnection with the utility grid through a synchronizer switch that requires minimal communication, makes the overall control independent of any other power source, subject to certain irradiance and loading conditions.Comment: 13th Mediterranean Conference on Power Generation, Transmission, Distribution and Energy Conversion (MEDPOWER 2022