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Optical coherence tomography angiography (OCT-A) allows the detection of retinal vessel density (VD) loss, which is a reflection of brain vascular pathology. We aimed to investigate differences in macular VD in the superficial plexus in a large cohort of individuals cognitively unimpaired (CU), with mild cognitive impairment due to Alzheimer´s disease (MCI-AD), MCI due to cerebrovascular pathology (MCI-Va), probable Alzheimer´s disease dementia (ADD) and Vascular Dementia (VaD). Clinical, demographical, ophthalmological and OCT-A data from the Neuro-ophthalmology Research at Fundació ACE (NORFACE) project were analyzed. Differences of macular VD in four quadrants (superior, nasal, inferior and temporal) among the five diagnostic groups were assessed in a multivariate regression model, adjusted by age, sex, education, hypertension, diabetes mellitus, heart disease and stroke. The study cohort comprised 672 participants: 128 CU, 120 MCI-AD, 111 MCI-Va, 257 ADD and 56 VaD. Regression analysis showed a significantly higher VD in the temporal quadrant in MCI-AD compared to CU participants (49.05 ± 4.91 vs 47.27 ± 4.17, p  = 0.02, d = 0.40), and a significantly lower VD in the inferior quadrant in MCI-Va compared to CU participants (48.70 ± 6.57 vs 51.27 ± 6.39, p  = 0.02, d = 0.40). Individuals with heart disease presented significantly lower VD in the inferior quadrant than those without ( p  = 0.01). The interaction of sex and diagnosis had no effect in differentiating VD. Mini-Mental State Examination (MMSE) scores were not correlated to VD (all r < 0.16; p  > 0.07). In conclusion, our study showed that the MCI-AD and MCI-Va groups had significant differences in macular VD in opposite directions in the temporal and inferior quadrants, respectively, compared to CU participants, suggesting that macular VD might be able to differentiate two pathogenic pathways (AD- and cerebrovascular-related) in early stages of cognitive decline.

Hybrid microgrids constitute a promising solution for filling the electricity access gap that currently exists in rural areas; however, there is still relatively little information about their reliability and costs based on measured data in real working conditions. This article analyzes data obtained from the operation of a 9 kW hybrid microgrid in the fishermen’s cove of Laguna Grande, Paracas, in the Ica region of Perú, which has been running for 5 years. This microgrid has been equipped with data acquisition systems that measure and register wind speed, solar radiation, temperatures, and all the relevant electric parameters. Battery dynamics considerations are used to determine the depth of discharge in a real-time operative situation. The collected data are used to optimize the design using the specialized software HOMER, incorporating state-of-the-art technology and costs as a possible system upgrade. This work aims to contribute to better understanding the behavior of hybrid rural microgrids using data collected under field conditions, analyzing their reliability, costs, and corresponding sensitivity to battery size as well as solar and wind installed power, as a complement to a majority of studies based on simulations.

Background Several studies have reported a relationship between retinal thickness and dementia. Therefore, optical coherence tomography (OCT) has been proposed as an early diagnosis method for Alzheimer’s disease (AD). In this study, we performed a genome-wide association study (GWAS) aimed at identifying genes associated with retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thickness assessed by OCT and exploring the relationships between the spectrum of cognitive decline (including AD and non-AD cases) and retinal thickness. Methods RNFL and GCIPL thickness at the macula were determined using two different OCT devices (Triton and Maestro). These determinations were tested for association with common single nucleotide polymorphism (SNPs) using adjusted linear regression models and combined using meta-analysis methods. Polygenic risk scores (PRSs) for retinal thickness and AD were generated. Results Several genetic loci affecting retinal thickness were identified across the genome in accordance with previous reports. The genetic overlap between retinal thickness and dementia, however, was weak and limited to the GCIPL layer; only those observable with all-type dementia cases were considered. Conclusions Our study does not support the existence of a genetic link between dementia and retinal thickness.

A microgrid is a group of interconnected loads and distributed energy resources that can fill the gap between the dependence on a bulk power grid and the transition to renewable energies. The islanded mode presents itself as the most interesting scenario, when local controllers should maintain the power quality standards based on several parameters. A tool specifically focused on the process of parameter tuning of the secondary consensus-based control for inverter-based islanded microgrids was proposed in this paper. One often-quoted drawback in this process is the great number of parameters that must be tuned, even for a very simple microgrid structure. To manage such a large number of parameters, the design of experiments was used in this study. The main motivation for this work was to present an optimized way to define the correct parameters for the secondary consensus control for inverter-based islanded microgrids. The study shows how experimental design methodology can be an efficient tool to tune microgrid parameters, which are typically multi-objective-based experiments. From the results, it is correct to state that the design of experiments is able to reach the optimal setting with a minimal number of experiments, which would be almost impossible to obtain with the trial-and-error method.

Background Ultrasonographic evaluation of thyroid nodules is challenging due to their high frequency and low malignancy rate. The risk stratification system developed by the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) focuses on addressing the primary contemporary objectives for these lesions, aiming to decrease unnecessary biopsies while maintaining a similar specificity compared with other risk stratification systems. Generally, when indicative of malignancy by ultrasound findings, the next best step in management is an evaluation by fine needle aspiration biopsy (FNAB) and cytological analysis with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) results that determine further evaluation requirements, actions that are based on the risk of malignancy (ROM) of the assigned category, which could include surgical intervention. Objectives To validate and analyze the individual impact of each ultrasonographic finding indicative of malignancy in the ACR TI-RADS guidelines based on their respective correlation with results obtained by TBSRTC. Materials and method Reports for 212 thyroid ultrasound-guided FNABs from 2018 to 2020 were assessed. Only 117 had both ACR TI-RADS and TBSRTC reports available and were analyzed. Nodules were divided into two groups: ROM < 5% (Bethesda 1, 2; n = 58), and ROM > 5% (Bethesda 3, 4, 5, 6; n = 59). Statistical analysis was performed using the x test and bivariate logistic regression model for each characteristic included in ACR TI-RADS. Results Individual ultrasound characteristics with a more pronounced distribution towards the Bethesda > 5% malignancy group were: solid or almost completely solid composition (n=53, 62.3%), very hypoechoic echogenicity (n=3, 75%), wider-than-tall shape (n=50, 50.5%), lobulated or irregular margin (n=23, 65.7%), punctate echogenic foci (n=18, 72%), and thyroid isthmus location (n=6, 75%). Statistically significant individual ultrasonographic characteristics indicative of malignancy included solid or almost completely solid (p = 0.005), very hypoechoic echogenicity (p = 0.046), margin lobulated or irregular (p = 0.031), and punctate echogenic foci (p = 0.015). No significant association was found in the taller-than-wide shape for differentiating malignant from benign lesions (p = 0.969). Conclusions Specific ultrasound characteristics identified in the ACR TI-RADS system demonstrate a stronger correlation with an increased risk of malignancy when compared with cytologic evaluation results. These characteristics include a solid composition, lobulated or irregular margins, punctate echogenic foci, and very hypoechoic echogenicity. Our findings revealed that the scale points for the taller-than-wide characteristic do not adequately represent its true influence on the risk of malignancy.

Purpose. To present the outcomes of hybrid multifocal and monofocal intraocular lenses (IOLs) and to compare with refractive and diffractive multifocal IOLs (MFIOLs). Methods. Three hundred twenty eyes (160 patients) underwent cataract surgery with randomized IOLs bilateral implantation. Changes in uncorrected and distance-corrected logMAR distance, intermediate and near (UNVA and DCNVA) visual acuity (VA), contrast sensitivity (CS), presence of dysphotopsia, spectacle independence, and patient satisfaction were analyzed. Results. Postoperative VA in the hybrid (OptiVis) group was improved in all distances (p<0.001). OptiVis acted superiorly to monofocal IOLs in UNVA and DCNVA (p<0.001 for both) and to refractive ones in DCNVA (p<0.005). Distance, mesopic, without glare CS in OptiVis was lower than in the monofocal group and similar to other MFIOLs. No differences in dysphotopsia pre- and postoperatively and spectacle independence in near for OptiVis and refractive MFIOLs were detected. OptiVis patients were more satisfied than those with monofocal IOLs (p=0.015). Conclusions. After cataract surgery, patients with OptiVis improved VA in all distances. Near and intermediate VA was better than monofocal, and DCNVA was better than the refractive group. CS was lower in OptiVis than in the monofocal group, but there was no difference between MFIOLs. Patient satisfaction was higher in OptiVis than in the monofocal group. This trial is registered with NCT03512626.

Purpose: To evaluate visual function of three types of multifocal intraocular lenses (IOLs) and one monofocal IOL (as the control group) after cataract surgery. Methods: One hundred fourteen patients participated in a prospective, randomized, controlled clinical study and received monofocal Tecnis Z9000 (AMO) (n=24, 48 eyes); symmetric diffractive multifocal Tecnis ZM900 (AMO) (n=26, 52 eyes); zonal refractive multifocal ReZoom (AMO) (n=32, 64 eyes); and asymmetric diffractive multifocal TwinSet (Acri.Tec) (n=32, 64 eyes) IOLs. Results: Mean binocular distance best spectacle-corrected visual acuity (BSCVA) (logMAR) was 0.05 for controls, 0.08 for ZM900, 0.07 for ReZoom, and 0.11 for TwinSet, with mean binocular distance BSCVA at near of 0.49, 0.06, 0.22, and 0.11, respectively. Mean contrast sensitivity was better for the monofocal IOL group than for the multifocal IOLs. Patients assigned to TwinSet had less favorable contrast sensitivity scores. Patients with monofocal IOLs had more frequently recommended near addition (74%) than those with multifocal IOLs. Patients with refractive ReZoom had also recommended near addition more frequently than the two diffractive groups. The percentage of dysphotopsia phenomena was 81% in patients with diffractive multifocal ZM900 compared with 48% in patients with mono-focal IOLs, 53% with refractive ReZoom, and 47% with diffractive TwinSet. Conclusions: The monofocal IOL showed better visual function and lesser photic phenomena than multifocal IOLs but patients were spectacle dependent. ReZoom provided better distance BSCVA than the TwinSet diffractive model. Patients with Tecnis and TwinSet diffractive multifocal IOLs were more spectacle independent than patients with ReZoom. Patients with TwinSet had the worst visual function. Patients implanted with the Tecnis diffractive ZM900 were those reporting more photic phenomena. [J Refract Surg. 2008;24:257–264.]

In this paper, the finite control set model predictive control is combined with the vector operation technique to be applied in the control of a three-phase active power filter. Typically, in the finite control set technique applied to three-phase power converters, eight different vectors are considered in order to obtain the optimum control signal by minimizing a cost function. On the other hand, the vector operation technique is based on dividing the grid voltage period into six different regions. The main advantage of combining both techniques is that for each region the number of possible voltage vectors to be considered can be reduced to a half, thus reducing the computational load employed by the control algorithm. Besides, in each region, only two phase-legs are switching at high frequency while the remaining phase-leg is maintained to a constant dc-voltage value during this interval. Accordingly, a reduction of the switching losses is obtained. Unlike the typical model predictive control methods which make use of the discrete differential equations of the converter, this method considers a Kalman filter in order to improve the behavior of the closed-loop system in noisy environments. Selected experimental results are exposed in order the demonstrate the validity of the control proposal.

The zeta potential of soils is an electric potential in the double-layer interface and is a physical property exhibited by any particle related to electrochemical attractive forces. On the other hand, the chemical aging phenomenon is seen as the chief mechanism of the aging of sands due to the dissolution and precipitation of minerals, resulting in the development of the cementation of particles in granular mediums. The present investigation focuses on determining whether granular materials can generate cementation due to electrokinetic forces, and if the zeta potential could be related as a measure of the potential of chemical aging. X-ray fluorescence and diffraction tests were performed to characterize four representative fractions of one kind of sand, and zeta potential studies were carried out to determine the electrical potential on the mineral surfaces of each one. Zeta potential analysis showed both dependence on the mineralogical content and the variation in the pH of the colloidal solution fluid because the increase in OH- ion concentrations increases the thickness of the diffuse double layer and the electrokinetic forces of attraction. Moreover, the zeta potential showed an increase in the thickness of the diffuse double layer, due to the electrokinetic forces, which can be associated with the development of cohesive forces with a dependence on the mineralogy of sands.

Microgrids are a feasible path to deploy smart grids, an intelligent and highly automated power system. Their operation demands a dedicated communication infrastructure to manage, control and monitor the intermittent sources of energy and loads. Therefore, smart devices will be connected to support the growth of grid smartness increasing the dependency on communication networks, which consumes a high amount of power. In an energy-limited scenario, one of the main issues is to enhance the power supply time. Therefore, this paper proposes a hybrid methodology for microgrid energy management, integrated with a communication infrastructure to improve and to optimize islanded microgrid operation at maximum energy efficiency. The hybrid methodology applies some control management rules, such as intentional load shedding, priority load management, and communication energy saving. These energy saving rules establish a trade-off between increasing microgrid energy availability and communication system reliability. To achieve a compromised solution, a continuous time Markov chain model describes the impact of energy saving policies into system reliability. The proposed methodology is simulated and tested with the help of the modified IEEE 34 node test-system.