Flavonoid intake and kidney stones: An exposome-based cross-sectional study.

BackgroundSeptic shock is commonly associated with reduction in vasomotor tone, mainly due to vascular hyporesponsiveness to norepinephrine (NE). Although the diastolic arterial pressure (DAP)/heart rate (HR) ratio reflects vasomotor tone, it cannot be a reliable index of vascular responsiveness to NE (VNERi). We hypothesized that adjusting DAP/HR for the NE dose could yield a VNERi value (VNERi = DAP/(NE dose x HR)), knowledge of which can help guiding therapeutic strategies in cases of persistent hypotension despite NE (e.g., increasing NE doses vs. introducing additional vasopressors). For our hypothesis be valid, at least VNERi should demonstrate a stronger association with patient outcome than DAP, DAP/HR or mean arterial pressure (MAP)/NE dose, a global marker of NE responsiveness.MethodsWe conducted a post-hoc analysis of the ANDROMEDA-SHOCK database. Hemodynamic variables and initial NE doses were recorded at the randomization time-point, within 4 h of septic shock diagnosis. NE doses were expressed in µg/kg/min (using the bitartrate NE formulation). A multivariate model was employed to compare the associations between these variables and key clinical outcomes, including in-hospital mortality, numbers of vasopressor-free days and of renal replacement therapy (RRT)-free days up to day 28.ResultsThe ANDROMEDA-SHOCK database included 424 patients with septic shock receiving NE. The median DAP was 52 mmHg [IQR: 45–50] and the median NE dose at inclusion was 0.2 µg/kg/min [IQR: 01-0.4]. In-hospital mortality was 43%. VNERi demonstrated the strongest association with in-hospital mortality compared to DAP, DAP/HR, and MAP/NE dose, emerging as the most significant covariate in the multivariate model. Similar findings were found for the associations with numbers of vasopressor-free days and RRT-free days up to day 28. The model revealed an inverted J-shaped relationship between in-hospital mortality and VNERi, with a nadir point at 6.7, below which mortality increased.ConclusionsIn patients receiving NE during early septic shock, VNERi demonstrated the strongest association with outcome compared to DAP, DAP/HR, and MAP/NE dose. Due to its physiological basis and robust association with outcomes, VNERi may serve as a valuable bedside marker of the vascular responsiveness to NE. This index could potentially be integrated into decision-making of early septic shock.

Abstract Equipping sensors on the lunar surface would enable the capture of Earth’s outgoing longwave radiation (OLR) from nearly an entire hemisphere. However, the Earth’s nonsphericity would profoundly impact the observational solid angle, thereby influencing the disk-integrated Earth OLR estimation. This study analyzes the impact of the Earth’s ellipsoidal shape on the OLR estimation by examining the effects of the observational solid angle. In particular, an expansion-series-based method is proposed for calculating the observational solid angle, avoiding complex numerical integration. Three critical issues are analyzed. (1) Comparing the observational solid angles calculated by using an Earth ellipsoidal model versus those obtained by adjusting the Earth’s radius. We find that adjusting the Earth’s radius can approximate the results based on an Earth ellipsoidal model, offering insights into parameterizing the observational solid angle. (2) Parameterizing the observational solid angle through series expansion, which is validated by comparing the associated results to those from numerical integrations. The observational solid angle is parameterized into two components: one is attributable to a variable Earth radius and another is related to the nadir point’s latitude and the Earth–Moon distance. (3) Guiding parameter selection for observational solid angle estimation. These findings enhance our understanding of disk-integrated Earth OLR estimates and provide a unique tool for establishing benchmarks for the Earth samples needed in the study of habitable planets, thereby contributing to sustainable development.

This paper presents a decision support approach to enable decision-makers to identify no-preference solutions in multi-objective optimization for factory layout planning. Using a set of trade-off solutions for a battery production assembly station, a decision support method is introduced to select three solutions that balance all conflicting objectives, namely, the solution closest to the ideal point, the solution furthest from the nadir point, and the one that is best performing along the ideal nadir vector. To further support decision-making, additional analyses of system performance and worker well-being metrics are integrated. This approach emphasizes balancing operational efficiency with human-centric design, aligning with human factors and ergonomics (HFE) principles and Industry 4.0–5.0. The findings demonstrate that objective decision support based on Pareto front analysis can effectively guide stakeholders in selecting optimal solutions that enhance both system performance and worker well-being. Future work could explore applying this framework with alternative multi-objective optimization algorithms.

Optimal blood pressure (BP) for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear. This study aims to identify the optimal BP by investigating the association between average office BP and future clinical events in patients undergoing PCI. Consecutive patients undergoing PCI from 2012 to 2016 were included. They were divided into five groups according to the average follow-up BP after discharge. The co-primary outcomes were net adverse clinical events (NACE) and major adverse cardiac and cerebrovascular events (MACCE) up to 5 years. NACE was defined as a composite of MACCE (all-cause death, non-fatal myocardial infarction (MI), non-fatal stroke, or any revascularization) or major bleeding. A total of 2845 patients were included, and among them, 787 (27.7%) experienced the NACE during the follow-up period. Patients in the highest SBP group (adjusted hazard ratio [HR] 1.495, confidence interval [CI] 1.189–1.880) and lowest SBP group (adjusted HR 1.625, CI 1.214–2.176) had a significantly higher risk of 5-year NACE. Similar associations were observed between SBP and the risk of MACCE, and similar results based on DBP categories were also observed. There was a J-curve relationship between SBP and DBP with respect to 5-year NACE and MACCE. The nadir point of risk for NACE and MACCE was found at 121.4/74.8 and 120.4/73.7 mmHg. In patients underwent PCI, there is a significant correlation between office BP level and clinical events, indicates the importance of efforts for optimal BP control to reduce ischemic and bleeding events.Trial registration: HanYang University Medical Center (HYUMC) Registry, NCT05935397.

Trochlear Dysplasia Is Associated With Increased Sagittal Tibial Tubercle Trochlear-Groove Distance in Patients With Patellar Instability

Objective: The optimal blood pressure (BP) target for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear. This study aimed to identify the optimal BP target by investigating the association between average office BP and future clinical events after PCI in patients with CAD. Design and method: Consecutive patients undergoing PCI from 2012 to 2016 were included. They were divided into five groups according to the average follow-up BP after discharge. The co-primary outcome was major adverse cardiac and cerebrovascular event (MACCE: all-cause death, non-fatal myocardial infarction, non-fatal stroke, or any revascularization) and net adverse clinical events (NACE: MACCE, or major bleeding) up to 5 years. Results: A total of 2,845 patients were included in the analyses, and among them, 787 (27.7%) experienced the NACE during the follow-up period. Patients in the highest SBP group (adjusted hazard ratio [HR] 1.495, confidence interval [CI] 1.189–1.880) and lowest SBP group (adjusted HR 1.625, CI 1.214–2.176) had a significantly higher risk of 5-year NACE. Similar associations were observed between SBP and the risk of MACCE, and similar results based on DBP categories were also observed. There was a J-curve relationship observed between SBP and DBP with respect to 5-year NACE and MACCE. The nadir point of risk for NACE and MACCE was found at 121.4/74.8 and 120.4/73.7 mmHg. Conclusions: In patients underwent PCI, there is a significant correlation between office BP level and clinical events, which indicates the importance of efforts for optimal BP control to reduce ischemic and bleeding events.

Investigating normalization in preference-based evolutionary multi-objective optimization using a reference point

Most existing multi-objective evolutionary algorithms relying on fixed reference vectors originating from an ideal or a nadir point may fail to perform well on multi- and many-objective optimization problems with various convexity or shapes of Pareto fronts. A possible reason could be the inaccurate measurement of the diversity of solutions or the failure of the fixed reference vectors in guiding the rapidly changing population. To meet this challenge, this work develops an adaptive normal reference vector-based decomposition strategy for guiding the search process, which is able to handle various convexity and shapes of Pareto fronts. Specifically, the normal vector passing through the center of each cluster in a constructed hyperplane is adopted as the reference vector for guiding the search process. Then, a selection strategy is put forward based on the positions of solutions in the current population and the normal vectors for the environmental selection. Based on the adaptive normal vectors, the proposed algorithm can not only rapidly adapt to the changing population but also alleviate the influence of the convexity of Pareto fronts on the measurement of diversity. Experimental results show that the proposed algorithm performs consistently well on various types of multi-/many-objective problems having regular or irregular Pareto fronts. In addition, the proposed algorithm is shown to perform well in the optimization of the polyester fiber esterification process.

The unceasing quest for a profound comprehension of the Earth system propels the continuous evolution of novel methods for Earth observation. Of these, the Lagrange points situated in the cislunar space proffer noteworthy prospects for space-based Earth observation. Although extant research predominantly centers on Moon-based Earth observation and the L1 point within the Sun-Earth system, the realm of cislunar space remains relatively unexplored. This paper scrutinizes the overarching characteristics of the L1 point within the Earth-Moon system concerning Earth observation. A pivotal enhancement is introduced through the incorporation of the halo orbit. This research comprehensively analyzes the relative motion between the halo orbiter and the Earth, achieved via orbit determination within a rotating coordinate system, followed by a transformation into the Earth coordinate system. Subsequently, numerical simulations employing ephemeris data unveil the observing geometry and Earth observation characteristics, encompassing the distribution of nadir points, viewing angles, and the spatiotemporal ground coverage. As a point of reference, we also present a case study involving a Moon-based platform. Our findings reveal that the motion of the halo orbit, perpendicular to the lunar orbital plane, results in a broader range of nadir point latitudes, which can extend beyond 42°N/S, contingent upon the orbit’s size. Additionally, it manifests a more intricate latitude variation, characterized by the bimodal peaks of the proposed temporal complexity curve. The viewing angles and the spatiotemporal ground coverage closely resemble those of Moon-based platforms, with a marginal enhancement in coverage frequency for polar regions. Consequently, it can be deduced that the Earth observation characteristics of the L1 point within the Earth-Moon system bear a close resemblance to those of Moon-based platforms. Nevertheless, considering the distinct advantages of Moon-based platforms, the lunar surface remains the paramount choice, boasting the highest potential for Earth observation within cislunar space. In summation, this study demonstrates the Earth observation characteristics of the L1 point within the Earth-Moon system, emphasizing the distinctions between this and Moon-based platforms.

The issue of transport in underground hard coal mines is very rarely described in the literature. The financial aspects of this issue are even less often analyzed. Publications in this area focus on technical issues and the safety of mining crews. More attention is paid to transport in open-pit mines. The above premises and practical needs imply the need to conduct economic analyses of transport systems in underground hard coal mines. This paper is a scientific communication, which presents the concept of a multi-criteria cost analysis as a tool to support the selection of the optimal transportation option in an underground hard coal mine. Considerations in this area have not been carried out in the relevant literature, and the problem of selecting a transportation option is a complex and necessary issue in the practice of underground mines with extensive mine workings. The methodology presented includes five cost criteria (costs of carrying out the transportation task; route expansion costs; rolling stock maintenance costs; depreciation costs; and additional personnel costs). The simultaneous application of criteria relating to utility properties in addition to cost criteria makes it possible to adopt a specific technical and organizational model of the transportation system based on the indication of the optimal solution, resulting from the mathematical construction of functions of objectives relating to utility and cost. The optimal variant of the designed system and configuration of the material transportation system in underground workings takes into consideration the following: (1) seven utility criteria (KU1—transportation task completion time; KU2—compatibility of transportation systems; KU3—continuous connectivity; KU4—co-use with other transportation tasks; KU5—safety; KU6—inconvenience; KU7—operation under overplanning conditions) and (2) five cost criteria (KK1—costs of implementing the transportation task; KK2—costs of route expansion; KK3—rolling stock maintenance costs; KK4—depreciation costs; KK5—additional personnel costs). Based on the aforementioned criteria, two objective functions are built for each option: utility and cost. They present divergent goals; therefore, they are non-cooperative functions. Both utility and costs strive for the maximum. In the developed methodology, an ideal point is usually a fictitious solution representing a set of maximum values among all the achievable values in a set of solutions, but it is impossible to achieve this simultaneously based on all the criteria. This point illustrates the maximum utility and lowest cost among the alternatives considered, which is obviously impossible for any of the variants to meet at the same time, although it indicates the possibilities of the technique and the range of costs. For the developed method, a so-called “PND” nadir point is also determined, representing the least-preferred level of achievement of all goals simultaneously, determined from the set of optimal points in the Pareto sense. The originality of the conceptual considerations undertaken stems from: filling the gap in the economic methodology of complex transportation systems evaluation; embedding considerations in the trend concerning complex transportation systems of underground mines; and focusing considerations on the pre-investment phase, making it possible to optimize costs before expenditures are incurred.

Objectives: Osteoarthritis (OA) stands as the prevailing progressive musculoskeletal disease, serving as the primary cause of chronic pain and activity limitations among adults over 40. Flavan-3-ols, common polyphenolic compounds, are believed to harbor anti-inflammatory and anti-aging properties. This study explores the relationship between flavan-3-ol intake and osteoarthritis risk in individuals over the age of 40 in the US. Methods: This study included 7452 participants over the age of 40 from three cycles (2007-2008, 2009-2010, and 2017-2018) of the National Health and Nutrition Examination Survey. Information on OA history was obtained via home surveys. Information on flavan-3-ol monomers intake was obtained using a survey from the Food and Nutrient Database for Dietary Studies. We used a logistic regression model and restricted cubic spline to analyze the relationships between flavan-3-ol monomers and OA. Stratified analyses were also conducted in this study. Results: There were 1056 participants with OA and 6396 without OA. Compared to the first tertile (T1) group, the adjusted odds ratio with a 95% confidence interval (CI) of logistic regression model 2 for the flavan-3-ol T2 group was 1.296 (0.979-1.715) (p = 0.068), the OR for (-)-epigallocatechin was 1.292 (1.025-1.629) (p = 0.032), and the OR for (-)-epicatechin 3-gallate was 1.348 (1.013, 1.793) (p = 0.042). A dose-response curve indicated a non-linear association (p for non-linearity <0.05) between OA and total flavan-3-ol monomers (nadir point: 483.29 mg, 95% CI: 0.61-0.90). No interaction effects were found in the subgroup analysis. Conclusions: In individuals over 40 in the US, the average daily dietary intake of flavan-3-ol monomers manifests a J-shaped relationship with OA risk.

The impact of circular economy indicators in the optimal planning of energy systems

Decomposition methods have been widely employed in evolutionary algorithms for tackling multiobjective optimization problems (MOPs) due to their good mathematical explanation and promising performance. However, most decomposition methods only use a single ideal or nadir point to guide the evolution, which are not so effective for solving MOPs with extremely convex/concave Pareto fronts (PFs). To solve this problem, this article proposes an effective method to adapt decomposed directions (ADDs) for solving MOPs. Instead of using one single ideal or nadir point, each weight vector has one exclusive ideal point in our method for decomposition, in which the decomposed directions are adapted during the search process. In this way, the adapted decomposed directions can evenly and entirely cover the PF of the target MOP. The effectiveness of our method is analyzed theoretically and verified experimentally when embedding it into three representative multiobjective evolutionary algorithms (MOEAs), which can significantly improve their performance. When compared to seven competitive MOEAs, the experiments also validate the advantages of our method for solving 39 artificial MOPs with various PFs and one real-world MOP.

The practicality of Pareto-dominance in solving many-objective optimization problems becomes questionable due to its inability to factor the critical Human Decision-making (HDM) elements, including, the number of better objectives, the degree of betterment in objectives, and objectives&#x2019; relative preference. Relevant dominance principles are recently proposed to incorporate the first two HDM elements, often with the need for new tunable parameters. This paper proposes a high-fidelity-dominance principle, that factors all the three HDM elements, explicitly and simultaneously, and without requiring tuning of any parameter. This principle has been implemented in a reference vector based framework, leading to a computationally efficient many-objective Evolutionary Algorithm (MaOEA), namely localized high-fidelity-dominance based EA (LHFiD). Critically, LHFiD also has an inbuilt mechanism for on-the-fly determination of the timing for: (a) intermittent nadir point estimation that enables faster convergence, and (b) its self-termination that bears practically utility. This paper is based on an extensive study involving 41,912 experiments, in which the proposed LHFiD approach is compared with existing competitive MaOEAs. The paper reports statistically better performance in about 60% instances, making it practical and worthy of further investigation and application.

Multi-objective two-stage stochastic unit commitment model for wind-integrated power systems: A compromise programming approach

The variable-speed DFIM system is a next-generation energy storage technology in which a rotor is connected to a back-to-back converter to adjust the active and reactive power of the device to compensate for the output variability of renewable energy sources. However, general DFIM has less inertia than synchronous generators to support the system when a disturbance occurs in the system, and requires an active technology to assist it. In this paper, a steam turbine governor with droop characteristics was modeled to explain the power control of the existing variable speed DFIM and simulate the drop in system frequency, and a virtual inertia controller was used for the variable speed DFIM system. The current and active power of the DFIM and the frequency change is compared by distinguishing the before and after using the virtual inertia. DFIM, which operates as a variable load after using virtual inertia, reduces the rotor current and reduces the active power absorbed from the system from 1p.u to 0.78p.u by using the virtual inertial active power. Accordingly, it was confirmed that the rotor speed was variable, and it was confirmed that the virtual inertia loop using kinetic energy operated effectively. When disturbance occurs in the system frequency due to the dropout of the power source of the system, the frequency nadir point drops to 48.5Hz. When the system frequency inertia was supported using virtual inertia, the frequency nadir increased from 48.5Hz to 48.76Hz, confirming that the system frequency nadir was improved by mimicking the inertial characteristics of the synchronous generator even during pump operation.

UAV-based images are now widely used to generate large-scale orthophoto mosaics. The generation of an orthophoto mosaic is divided into two stages: image registration and image stitching. Using the DSM associated with each image, orthophotos are generated throughout the image registration. The single orthophotos generated are then joined to each other step by step in the second stage, utilizing various methods of image stitching. Image stitching methods depend on the complex and challenging processes of image matching and seamline determination. In addition, the registration and stitching of images in UAV-based mapping projects with a significant number of images is a time-consuming process. In this study, a straightforward method is provided for creating large-scale true orthophoto mosaics from UAV-based images without the requirement to generate single orthophotos, image registration and seamline network determination. Instead of registrating the images and then stitching them step-by-step, this method processes the DSM of the entire area and all of the images simultaneously. First, for each DSM point, the optimal image is determined from among all the visible images based on an optimization procedure. Optimization is based on two criteria: distance from nadir point and distance from the projection center. Using the determined optimal images, the differential rectification procedure is then run, and the orthophoto mosaic cells are filled. The results of this investigation demonstrated that the proposed method yielded a mosaic with minimal changes along the seamline. In addition, the proposed method is compared with the conventional orthophoto mosaic production method, which is based on image matching and determination of seamlines. Evaluations indicate that the proposed method is able to increase the production rate of orthophoto mosaic by 39% and 45% in dataset 1 and 2 respectively. Additionally, the geometric accuracy calculated using the checkpoints in the orthophoto mosaic generated by the suggested method has decreased by an average of 2 cm, indicating more precise results.

A Pareto Front grid guided multi-objective evolutionary algorithm

This paper deals with the issue of frequency regulation in a small insulated low inertia grid with a large participation of renewable energy sources (RESs). A strong decentralized control strategy is used, allowing various RESs such as batteries, supercapacitors, and fuel cells to provide additional frequency recovery service. A small grid with a synchronous machine, photovoltaic cells, and fuel cells was developed as generation units to test the effectiveness of the suggested technique. Furthermore, the battery and supercapacitors were added to the system to give additional service to suppliers. Simulating the system response to numerous uncertainty is used to evaluate the controller's performance.&nbsp; the controller's efficiency is displayed in Graphical form. This paper will show how a decentralized method that allows all units to provide active power supports not only adjusts frequency nadir points but also minimizes the amount of active power required in the process. As a result, the electrical pressure on each element that supports the network against the heavy usage of RESs is reduced.