bluuebunny/crossref_metadata_2025_split huggingface dataset:
Centralized optimal management of a smart distribution system considering the importance of load reduction based on prioritizing smart home appliances
Authors: Sanaei Salman , Haghifam Mahmud‐Reza , Safdarian Amir 
Published: August 2022

AbstractThe distribution system's economic operation is significantly impacted by the management of distributed generation (DG) resources, energy storage (ES), and controllable loads. The paper employs a smart distribution system that incorporates dispatchable and non‐dispatchable DG resources, as well as battery storage, in addition to the demand response (DR) scheme. New modelling was performed in hourly steps to achieve the optimal unit commitment. In smart homes, appliances are prioritized and classified into four types: adjustable, interruptible, shiftable, and uncontrollable loads. Load reduction in smart homes is also considered based on load prioritization and customer participation in the DR scheme to achieve the proposed scheme's objectives. The proposed method considers costs associated with microturbines (MTs), including manufacturing, start‐up, shutdown, and pollution. Additionally, planning is conducted to purchase or sell electricity to the upstream network. The simulation is run on an IEEE 33‐bus system to demonstrate the proposed method's effectiveness. The system is assumed to be capable of operation in both island and grid‐connected modes. The results demonstrate the proposed approach's efficacy in load reduction, operation cost, and execution time.
An integral backstepping controller design for compensated distribution networks with rapid earth fault current limiters in bushfire prone areas
Authors: Roy Tushar Kanti , Mahmud Md Apel , Roy Naruttam Kumar 
Published: August 2022

AbstractThis paper presents a nonlinear integral backstepping controller (I‐BSC) design scheme for a T‐type residual current compensation (RCC) inverter used in compensated distribution networks with rapid earth fault current limiters (REFCLs). The major control task for the proposed scheme is to reduce the fault current to a value suitable for the mitigation of powerline bushfires due to single phase‐to‐ground faults in compensated distribution networks. The key distinct feature of the proposed I‐BSC over the traditional backstepping controller (T‐BSC) is that it introduces an integral action for analyzing the dynamic of the tracking error which minimizes its steady‐state value and ensures better dynamic performance. In order to prove the global asymptotic stability of the RCC inverter with the proposed integral backstepping controller (I‐BSC), the Lyapunov function‐based theory is used. Finally, the performance of the I‐BSC is analyzed on the MATLAB/Simulink environment and compared with a T‐BSC. The performance of both I‐ and T‐BSCs is assessed in terms of transient behaviors of the injected current to the neutral, fault current, and line‐to‐ground voltage of the faulty phase to ensure the standard operational criteria for self‐extinguishing powerline bushfires. Simulation results clearly demonstrate that both controllers fulfill operational standards for REFCL‐compensated networks though the I‐BSC archives better transient behaviors while comparing with the T‐BSC. Results from the processor‐in‐loop (PIL) validations are also included to further justify the applicability of the newly proposed scheme in the real‐time environment.
Opportunistic offloading scheme for content delivery service using electro‐mobility networks
Authors: Kyung Yeunwoong , Kim Eunchan , Song Taewon 
Published: August 2022

AbstractVehicular caching (VC) in electro‐mobility networks has become promising for supporting the needs of low end‐to‐end service delays and reducing the load of networks (i.e. edge caching [EC]) for content delivery service. However, since VCs are available only when they are in the vicinity of the user, intermittent connectivity should be considered. In this paper, the opportunistic offloading scheme for content delivery service is proposed, and a decision is made regarding whether to use VC or EC for the content delivery service. In the proposed scheme, when VC is not available, the user determines whether to choose VC or EC for the content download. If VC is chosen, the user delays the content download to increase the VC utilization according to the expectation of VC contacts. This results in the delayed service completion but can reduce the EC load (i.e. offloading gain). If EC is chosen, the user can download the content without any delay or service interruption. To find the optimal policy, this paper formulates a Markov decision process (MDP) problem and uses the value iteration algorithm to solve the problem. The evaluation results show that the proposed scheme outperforms the comparison schemes based on the expected reward.
Hidden Cardiovascular Anatomy in “Saint John the Baptist” by Leonardo da Vinci
Authors: Keshelava Grigol 
Published: August 2022

AbstractLeonardo da Vinci conducted many anatomical studies during his life. Today, almost the complete set of these anatomical drawings and comments is owned by the British Crown and resides in the Royal Library at Windsor Castle, United Kingdom.Through the program Paint X, we moved two details on the painting “Saint John the Baptist.” The moving details are circled along the faint contour by Leonardo da Vinci himself. We obtained heart and aortic arch imaging.
Homograft Versus Valves and Valved Conduits for Extensive Aortic Valve Endocarditis with Aortic Root Involvement/Destruction: A Systematic Review and Meta-Analysis
Authors: Williams Michael L. , Brookes John D. L. , Jaya Joseph S. , Tan Eren 
Published: August 2022

AbstractAortic valve infective endocarditis is a life-threatening condition. Patients frequently present profoundly unwell and extensive surgery may be required to correct the underlying anatomical deficits and control sepsis. Periannular involvement occurs in more than 10% of patients with aortic valve endocarditis. Complex aortic valve endocarditis has a mortality rate of 10 to 40%. Longstanding surgical dogma suggests homografts represent the optimal replacement option in complex aortic valve endocarditis; however, there is a paucity of evidence and lack of consensus on the optimal replacement choice. A systematic review and meta-analysis was performed utilizing EMBASE, PubMed, and the Cochrane databases to review articles describing homografts versus aortic valve replacement and/or valved conduit graft implantation for complex aortic valve endocarditis. The outcomes of interest were mortality, reinfection, and reoperation. Eleven studies were included in this meta-analysis, contributing 810 episodes of complex aortic valve endocarditis. All included reports were cohort studies. There was no statistically significant difference in overall mortality (risk ratio [RR] 0.99; 95% confidence interval [CI], 0.61–1.59; p = 0.95), reinfection (RR 0.89; 95% CI, 0.45–1.78; p = 0.74), or reoperation (RR 0.91; 95% CI, 0.38–2.14; p = 0.87) between the homograft and valve replacement/valved conduit graft groups. Overall, there was no difference in mortality, reinfection, or reoperation rates between homografts and other valve or valved conduits in management of complex aortic endocarditis. However, there is a paucity of high-quality evidence in the area, and comparison of valve types warrants further investigation.
Multiple Parallel Grafts for Urgent Endovascular Repair of a Ruptured Mycotic Aortic Aneurysm
Authors: Xodo Andrea , Piazza Michele , Taglialavoro Jacopo , Zavatta Marco , Grego Franco , Antonello Michele 
Published: August 2022

AbstractA 73-year-old woman underwent urgent endovascular repair of a ruptured mycotic aortic aneurysm. A thoracic stent graft was employed as the main endograft, while the celiac trunk and superior mesenteric artery were revascularized by the chimney technique and the renal arteries through the periscope technique. Postoperative computed tomography revealed a Type A1 gutter, treated by detachable coils and peripheral occlusion devices. Six-month follow-up revealed patency of the stent grafts, without endoleak or stent graft infection signs.
Geometric Analysis of Complex Endovascular Treatment of a Successfully Completed Residual Post-Type A Aortic Dissection
Authors: Finotello Alice , Pane Bianca , Di Bartolo Mauro , Del Pizzo Rachele , Mambrini Simone , Pratesi Giovanni , Spinella Giovanni 
Published: August 2022

AbstractWe describe a case of complex multistep endovascular treatment of a post-Type A thoracoabdominal dissected aneurysm. Volume analysis documents true and false lumen improvements during follow-up. Centerline tortuosity of the aorta and of the iliac arteries straightens after endovascular treatment completion. In addition, analysis of stent-graft remodeling reveals the stent-graft tendency to spring back to its original status together with a caudal migration of the fenestrated body.
Clinical Experience with “Stand-Alone” Elephant Trunk Procedure for Descending Aortic Aneurysms
Authors: Kumbasar Ulas , Zafar Mohammad A. , Ziganshin Bulat A. , Elefteriades John A. 
Published: August 2022

Abstract
Background Both open and endovascular treatments of descending thoracic aortic aneurysms require a secure proximal landing zone. This may be difficult to achieve when the dilatation extends proximally to the left subclavian level. Clamping above the aneurysm may be difficult. In the case of an endovascular approach, achieving a suitable landing zone may require extensive extra-anatomic debranching, which is not without complications and limitations.
Methods We describe a modification of the traditional elephant trunk procedure that represents a “stand-alone” elephant trunk. Under deep hypothermic circulatory arrest, the aorta is transected between the left carotid and left subclavian arteries. A simple, noninverted elephant trunk is placed through the distal cut aorta. The two ends are sewn back together, incorporating the lip of the elephant trunk in the anastomosis. We review our experience in five patients who underwent this procedure.
Results All 5 patients (4 males, 1 female) aged 41 to 68 (mean, 57 years) tolerated the Stage 1 stand-alone elephant trunk procedure well, without mortality, stroke, or bleeding. The Stage 2 descending aortic replacements were performed at a mean of 6.7 months after Stage 1. There was no Stage 2 mortality, stroke, or bleeding. One patient died 8 years later of cardiac cause, and the remaining are alive and well.
Conclusion A stand-alone elephant trunk procedure is safe and straightforward and provides an excellent proximal foundation for subsequent open (or potentially endovascular) descending aortic replacement.
Differences in Aortic Histopathology in Patients Undergoing Valve Reimplantation Surgery for Various Clinical Syndromes
Authors: Tucker Nicholas J. , Eitan Tal , Yoon Justin G. , Rosinski Bradley F. , Rodriguez E. Rene , Tan Carmela D. , Svensson Lars G. 
Published: August 2022

Abstract
Objectives The study aims to investigate aortic histopathologic differences among patients undergoing aortic valve reimplantation, suggest different mechanisms of aortic root aneurysm pathogenesis, and identify factors associated with long-term success of reimplantation.
Methods From 2006 to 2017, 568 adults who underwent reimplantation for repair of aortic root aneurysm, including patients with tricuspid aortic valves with no connective tissue disease (TAV/NoCTD, n = 314/568; 55.3%), bicuspid aortic valves (BAVs, n = 86/568; 15.1%), or connective tissue disease (CTD, n = 177/568; 31.2%), were compiled into three comparison groups. Patients with both BAV and CTD (n = 9/568; 1.6%) were omitted to increase study power. Patient records were analyzed retrospectively, focusing on pathology reports, which were available for 98.42% of patients, and were classified based on their descriptions of aortic tissue samples, primarily from the noncoronary sinus. Mean follow-up time available for patients was 2.97 years.
Results Aortitis, medial fibrosis, and smooth muscle loss were more common histopathologic findings in patients with TAV/NoCTD than in patients with BAV and CTD (p < 0.05). Cystic medial degeneration was most often found in patients with CTD, then TAV/NoCTD, and least in BAV (p < 0.01). Increases in mucopolysaccharides were found more often in the BAV group than in the TAV/NoCTD and CTD groups (p < 0.01). There were no differences in the frequency of elastic laminae fragmentation/loss across these three groups. Among all patients, 1.97% (n = 11/559) had an unplanned reintervention on the aortic valve after reimplantation, but no significant demographic or histopathologic differences were identified.
Conclusion Despite some common histopathologic features among patients undergoing aortic valve reimplantation, there were enough distinguishing features among aortic tissue samples of TAV/NoCTD, BAV, and CTD patients to suggest that these groups develop root aneurysms by different mechanisms. No histopathologic features were able to predict the need for late reintervention on the aortic valve.
Comparison of Outcomes of Patients Undergoing Reimplantation versus Bentall Root Procedure
Authors: Svensson Lars G. , Rosinski Brad F. , Tucker Nicholas J. , Gillinov A. Marc , Rajeswaran Jeevanantham , Roselli Eric E. , Johnston Douglas R. , Desai Milind Y. , Griffin Brian P. , Blackstone Eugene H. 
Published: August 2022

Abstract
Background A bioprosthesis- or mechanical-prosthesis–containing polyester graft (composite graft) is standard surgical management for aortic root aneurysms (Bentall procedure), but particularly in the young patient in whom a bioprosthesis is likely to deteriorate and a mechanical prosthesis mandates life-long anticoagulation, valve-sparing procedures have been devised. One such procedure involves reimplantation of the native aortic valve in the polyester graft. With focus on selecting the optimum procedure for young relatively asymptomatic patients, we compared outcomes of reimplantation of the aortic valve versus the Bentall procedure and identified factors influencing outcomes.
Methods From January 2000 to January 2017, 643 adults age ≤ 70 with tricuspid aortic valves underwent elective aortic root replacement with either reimplantation (n = 448/70%) or a composite valve graft (Bentall) procedure (n = 195/30%). Outcomes were compared in 100 propensity-matched pairs.
Results Patients with fewer symptoms, less aortic regurgitation (AR), higher left ventricular ejection fraction, and smaller cross-sectional aortic area/height ratio had a higher likelihood of valve repair with reimplantation (all p < 0.02) versus receiving a Bentall procedure. Operative mortality was 0.16% (reimplantation, 1/448, 0.22%; Bentall 0/195, 0%). After reimplantation, 8-year freedom from severe AR was 95% and 10-year freedom from reintervention was 98%. Ten-year survival was 95%. Higher preoperative AR grade (p < 0.0001) but not larger root diameter (p = 0.3) was associated with higher grade of late regurgitation after a reimplantation procedure. Among propensity-matched patients, reimplantation compared with a Bentall was associated with similar 10-year survival (89% vs. 94%), but more late AR (8-year freedom from severe AR: 93% vs. 99.9%) and greater early reduction in, but similar late, left ventricular mass (104 vs. 105 g•m–2 at 8 years).
Conclusion Excellent aortic valve reimplantation results versus Bentall lead us to recommend reimplantation more often in patients who present with even moderately severe or severe AR and significantly enlarged aortic roots.
Effect of Emotional Valence on Working Memory of Psychogenic Non-Epileptic Seizures (PNES) Patients
Authors: Singh Priyesh K. , Chaurasia Rameshwar Nath , Pratap Sujeet , Tiwari Trayambak , Mishra Vijay N. , Singh Tara 
Published: August 2022

AbstractBackground The present study investigated how emotional valence influenced the working memory of patients with psychogenic non-epileptic seizures (PNES) as compared to healthy individuals.Methods Emotional-N-Back task (E-N-back task) was administered to 15 PNES patients and equal number of healthy individuals. A 2 × 3 one-way analysis of variance (ANOVA) was used. Correct detection (accuracy) and reaction (RT) time were recorded as behavioral performance measures.Results The ANOVA result of correct detection (accuracy) measure revealed significant difference in the performance of patients with PNES as compared with healthy individual,F(2, 48) = 17.08,p = 0.001. However, on the measure of reaction time (RT), both groups performed equally and there was no significant difference,F(2, 48) = 1.13,p = 0.33. Also the results of present study showed that patients with PNES are quicker in identifying unpleasant picture stimuli, which is evident from their mean comparison: unpleasant (M = 65.55,SD = 15.66), pleasant (M = 58.22,SD = 20.03), and neutral (M = 45.11,SD = 23.13).Conclusion Conclusively, the finding of the present study shows a significant effect of emotional valence on working memory of patients with PNES on the measure of correct detection (accuracy), but not for second measure, i.e., reaction time this clearly reveals that patients with PNES are poor at emotional–cognitive integration, specifically at working memory level.
A Sporadic Cisternal Cystic Oculomotor Schwannoma—Case Report and Review of Literature
Authors: Murali Sanjay Honavalli , Gohil Jaypalsinh , Easwer H. V. 
Published: August 2022

Abstract
Schwannoma arising from a pure motor cranial nerve in sporadic cases is a rare finding. We report adult female patient presented with a seizure without oculomotor palsy. On evaluation, she was diagnosed with cystic oculomotor schwannoma and underwent surgery. She developed oculomotor palsy postoperatively. Here, we describe a rare sporadic cystic oculomotor schwannoma.
Effect of Preanesthetic Fluid Loading on Postinduction Hypotension and Advanced Cardiac Parameters in Patients with Chronic Compressive Cervical Myelopathy: A Randomized Controlled Trial
Authors: Paul Anto , Sriganesh Kamath , Chakrabarti Dhritiman , Reddy K. R. Madhusudan 
Published: August 2022

Abstract

Purpose Hypotension during the early intraoperative phase is common and can lead to adverse perioperative outcomes. Fluid preloading is one of the methods to limit its occurrence. Patients with chronic compressive cervical myelopathy may have autonomic dysfunction, which can aggravate hemodynamic alterations during anesthesia. This study compared the occurrence of postinduction hypotension and changes in cardiac dynamic indices in patients with and without crystalloid preloading undergoing decompressive cervical spine surgery.

Methods This randomized controlled trial was conducted over 15 months after obtaining patient consent, approval of the institute ethics committee, and trial registration. We compared preanesthetic fluid loading with Ringer's lactate (20 mL/kg over 30 minutes) with no preloading (2 mL/kg/h maintenance) in 60 consecutive patients undergoing cervical spine surgery. The ANSiscope was used to determine baseline cardiac autonomic function. Noninvasive cardiac output monitor was used to assess changes in heart rate, mean arterial pressure, cardiac index (CI), stroke volume variation (SVV), and total peripheral resistance index during study intervention, anesthetic induction, tracheal intubation, and change in position from supine to prone.

Results The incidences of postinduction hypotension were 26.7% (8/30) and 86.7% (26/30) and the median doses of mephentermine used were 0 and 6 mg, respectively, in patients with and without fluid preloading (both p < 0.001). Preloading resulted in improvement in CI, reduction in SVV, and lesser vasopressor use.

Conclusion Preloading reduced the occurrence of postinduction hypotension and vasopressor use, improved CI, and reduced SVV during the early intraoperative period.

Registration number of Clinical Trial The trial was registered with Clinical Trial Registry of India (CTRI/2018/07/014970 on 19/07/2018).
Determinants and Characteristics of the Violent Incidents in a Tertiary-Level Mental Health Care Center
Authors: Chongtham Virtu , Sharma Nitasha , Parashar Kantadorshi , Pandey Chandani 
Published: August 2022

Abstract

Background The Mental Health Care Act of India, 2017 has for the first time focused on violence management interventions, especially restraint and seclusion in psychiatric settings, and recommended important guidelines in this aspect.

Objective This situation has created a strong need to review the prevalence of violence in inpatient settings, associated clinical and social correlates keeping a preventive model in context. Hence, this study was undertaken to fulfill this need. Methods: A retrospective matched case–control chart review design was employed. All patients who exhibited at least one violent incident during their ward stay were included. For each case, the control was selected by individual matching based on age ± 2 years and gender from patients who were admitted during the study period but did not exhibit any violent incident. The information about the characteristics of violent incidents and management was also collected.

Results 8.80% of patients exhibited at least one incident of violence and a total of 186 violent incidents were recorded during the study period. Variables including involuntary admission, history of the previous admission, history of violence, impulsivity, lack of insight, and irritability at the time of admission significantly predicted the likelihood of violent incidents. The use of chemical restraining was the most common method of management of violent incidents.

Conclusion Violent incidents in psychiatric inpatient settings are still common. Efforts should be made to understand the risk as well as antecedent factors well in time. Verbal de-escalation should be employed and chemical and physical restraint should be used only as a last resort after exhausting the least restrictive interventions.
Nuances of Septal Deviation Repair
Authors: Abrol Anish , Lu G. Nina 
Published: August 2022

AbstractSeptoplasty is one of the most common procedures performed by facial plastic surgeons. Surgical decision-making surrounding septal deviation repair centers around the location of deviation and need for dorsal and/or caudal septal correction. Endonasal approaches are often adequate and external approaches are utilized for significant L-strut involvement. For severe deformities, extracorporeal septoplasty and anterior septal reconstruction can be utilized. We present an overview of septal deviation repair with technical nuances and advanced reconstruction techniques.
Embolization of the Middle Meningeal Artery for the Treatment of Chronic Subdural Hematoma: A Path Less Travelled So Far
Authors: Sarma Pragyan , Garg Manish , Prem Prashant , Gupta Rahul 
Published: August 2022

Abstract

Introduction Chronic subdural hematoma (CSDH) is relatively common and usually encountered in elderly population. With steady increase in life expectancy, incidence of CSDH also is bound to increase proportionately. Though surgery is the treatment of choice and relatively a simpler procedure, recurrence is a cause of concern. Embolization of the middle meningeal artery (MMA) is a newly evolving treatment modality in CSDH and offers hope in some of the recently published case series.

Materials and Methods Five cases of CSDH were subjected to embolization of MMA over a period from October 2019 to July 2020. Among them, it was employed for treatment in four cases after at least two recurrences following surgery, and in one case, it was done as the patient was not fit for surgery. All procedures were done under general anesthesia and polyvinyl alcohol (PVA) particles were used for embolization. Follow-up of the patients were done with computed tomography brain at 4 weeks and after 6 months of the procedure.

Results There was no incidence of recurrence in our series. Furthermore, embolization per se did not cause any complication or side effect which could be directly attributable to the procedure itself.

Conclusion In carefully selected patients based on clinical profile and angiographic findings, MMA embolization can be an effective modality for the treatment in CSDH.