The luminescent solar concentrator (LSC) is a promising concept for the integration of photovoltaic (PV) generators into the building envelope. Having the form of semitransparent plates, LSCs offer a ...high degree of flexibility and can be used as windows or facades, as part of the of building-integrated photovoltaic (BIPV) industry. Existing performance characterizations of LSC devices focus almost exclusively on electric power generation. However, when used as window components, the transmitted spectrum can alter the color, potentially affecting the visual comfort of the occupants by altering the properties of the sunlight. In this study, eight different state-of-the-art nanocrystals are evaluated as potential candidates for LSC window luminophores, using Monte Carlo simulations. The transparency of each LSC window varies between 90% and 50%, and the color-rendering properties are assessed with respect to the color rendering index (CRI) and the correlated color temperature (CCT). It is found that luminophores with a wide absorption bandwidth in the visible spectrum can maintain a high CRI value (above 85) and CCT values close to the Planckian locus, even for high luminophore concentrations. In contrast, luminophores that only absorb partly in the visible spectrum suffer from color distortion, a situation characterized by low CCT and CRI values, even at high transmittance.
This paper proposes two novel strategies for determining the bilateral trading preferences of households participating in a fully Peer-to-Peer (P2P) local energy market. The first strategy matches ...between surplus power supply and demand of participants, while the second is based on the distance between them in the network. The impact of bilateral trading preferences on the price and amount of energy traded is assessed for the two strategies. A decentralized fully P2P energy trading market is developed to generate the results in a day-ahead setting. After that, a permissioned blockchain-smart contract platform is used for the implementation of the decentralized P2P trading market on a digital platform. Actual data from a residential neighborhood in the Netherlands, with different varieties of distributed energy resources, is used for the simulations. Results show that in the two strategies, the energy procurement cost and grid interaction of all participants in P2P trading are reduced compared to a baseline scenario. The total amount of P2P energy traded is found to be higher when the trading preferences are based on distance, which could also be considered as a proxy for energy efficiency in the network by encouraging P2P trading among nearby households. However, the P2P trading prices in this strategy are found to be lower. Further, a comparison is made between two scenarios: with and without electric heating in households. Although the electrification of heating reduces the total amount of P2P energy trading, its impact on the trading prices is found to be limited.
Aims
Phosphohistone H3 (PhH3) has been proposed as a novel proliferation marker in breast cancer. This study compares the interobserver agreement for assessment of the mitotic activity index (MAI), ...Ki67 expression, and PhH3 in a cohort of oestrogen receptor (ER)‐positive breast cancer patients.
Methods and results
Tumour samples of 159 luminal breast cancer patients were collected. MAI and PhH3 scores were assessed by three breast cancer pathologists. Ki67 scores were assessed separately by two of the three pathologists. PhH3‐positive cells were counted in an area of 2 mm2, with a threshold of ≥13 positive cells being used to discriminate between low‐proliferative and high‐proliferative tumours. Ki67 expression was assessed with the global scoring method. Ki67 percentages of <20% were considered to be low. The intraclass correlation coefficient (ICC) and Cohen's κ statistics were used to evaluate interobserver agreement. The impact on histological grading of replacing the MAI with PhH3 was assessed. Counting PhH3‐positive cells was highly reproducible among all three observers (ICC of 0.86). The κ scores for the categorical PhH3 count (κ = 0.78, κ = 0.68, and κ = 0.80) reflected substantial agreement among all observers, whereas agreement for the MAI (κ = 0.38, κ = 0.52, and κ = 0.26) and Ki67 (κ = 0.55) was fair to moderate. When PhH3 was used to determine the histological grade, agreement in grading increased (PhH3, κ = 0.52, κ = 0.48, and κ = 0.52; MAI, κ = 0.43, κ = 0.35, and κ = 0.32), and the proportion of grade III tumours increased (14%, 18%, and 27%).
Conclusion
PhH3 seems to outperform Ki67 and the MAI as a reproducible means to measure tumour proliferation in luminal‐type breast cancer. Variation in the assessment of histological grade might be reduced by using PhH3, but would result in an increase in the proportion of high‐grade cancers.
To assess the pathologic and radiologic response in patients with low-risk breast cancer treated with magnetic resonance (MR) guided neoadjuvant partial breast irradiation (NA-PBI) and to evaluate ...toxicity and patient-reported outcomes (PROs).
For this single-arm prospective trial, women with unifocal, non-lobular tumors with a maximum diameter of 20 mm (age, 50-70 years) or 30 mm (age, ≥70 years) and tumor-negative sentinel node(s) were eligible. Patients were treated with a single ablative dose of NA-PBI followed by breast-conserving surgery after an interval of 6 to 8 months. Target volumes were defined on radiation therapy planning computed tomography scan and additional magnetic resonance imaging. Prescribed doses to gross tumor volume and clinical target volume (gross tumor volume plus 20 mm margin) were 20 Gy and 15 Gy, respectively. Primary outcome was pathologic complete response (pCR). Secondary outcomes were radiologic response (on magnetic resonance imaging), toxicity (Common Terminology Criteria for Adverse Events), PROs (European Organisation for Research and Treatment of Cancer QLQ-BR23, Hospital Anxiety and Depression Scale), and cosmesis (assessed by patient, radiation oncologist, and BCCT.core software).
Thirty-six patients were treated with NA-PBI, and pCR was reported in 15 patients (42%; 95% confidence interval, 26%-59%). Radiologic complete response was observed in 15 patients, 10 of whom had pCR (positive predictive value, 67%; 95% confidence interval, 39%-87%). After a median follow-up of 21 months (range, 12-41), all patients experienced grade 1 fibrosis in the treated breast volume. Transient grade 2 and 3 toxicity was observed in 31% and 3% of patients, respectively. Local recurrences were absent. No deterioration in PROs or cosmetic results was observed.
NA-PBI has the potential to induce pCR in a substantial proportion of patients, with acceptable toxicity. This treatment seems a feasible alternative to standard postoperative irradiation and could even result in postponement or omission of surgery if pCR can be accurately predicted in selected low-risk patients.
Digital pathology with whole-slide imaging (WSI) has a large potential to make the process of expert consultation and expert panel diagnosis more rapid and more efficient. However, comparison with ...the current methods is necessary for validation of the technique. In this study, we determined if digital assessment of whole-slide images of hematopathology specimens with a focus on the assessment of lymphoma can be used for consultation and panel diagnostics. Ninety-three histological specimens with a suspicion for lymphoma were assessed both with conventional microscopy and digital microscopy with a wash out period between assessments. A consensus diagnosis was based on full concordance between the pathologists or, in case of discordances, was reached at a joint session at a multi-headed microscope. In 81% of the cases, there was a full concordance between digital and light microscopical assessment for all three pathologists. Discordances between conventional microscopy and digital pathology were present in 3% of assessments. In comparison with the consensus diagnosis, discordant diagnoses were made in 5 cases with digital microscopy and in 3 cases with light microscopy. The reported level of confidence and need for additional investigations were similar between assessment by conventional and by digital microscopy. In conclusion, the performance of assessment by digital pathology is in general comparable with that of conventional light microscopy and pathologists feel confident using digital pathology for this subspecialty.
•Optimal power flow and trading are combined in a single optimization problem.•A real dataset from a prosumer community in Amsterdam is used.•The role of a smart contract as a virtual aggregator is ...described in a detailed manner.•Import cost reductions of up to 34.9% are found for the combined model.•The combined model shows 50% reduced peak energy imports.
In this paper, an integrated blockchain-based energy management platform is proposed that optimizes energy flows in a microgrid whilst implementing a bilateral trading mechanism. Physical constraints in the microgrid are respected by formulating an Optimal Power Flow (OPF) problem, which is combined with a bilateral trading mechanism in a single optimization problem. The Alternating Direction Method of Multipliers (ADMM) is used to decompose the problem to enable distributed optimization and a smart contract is used as a virtual aggregator. This eliminates the need for a third-party coordinating entity. The smart contract fulfills several functions, including distribution of data to all participants and executing part of the ADMM algorithm. The model is run using actual data from a prosumer community in Amsterdam and several scenarios of the model are tested to evaluate the impact of combining physical constraints and trading on social welfare of the community and scheduling of energy flows. The scenario variants are trade-only, where only a trading mechanism is implemented, grid-only where only OPF optimization is implemented and a combined scenario where both are implemented. Results are compared with a baseline scenario. Simulation results show that import costs of the whole community are reduced by 34.9% as compared to a baseline scenario, and total energy import quantities are reduced by 15%. Total social welfare is found to be highest without a trading mechanism, however this platform is only viable when all costs are equally shared between all households. Furthermore, peak imports are reduced by over 50% in scenarios including grid constraints.
Preoperative partial breast irradiation (PBI) has the potential to induce tumor regression. We evaluated the differences in the numbers of preirradiation tumor infiltrating lymphocytes (TILs) between ...responders and nonresponders after preoperative PBI in low-risk patients with breast cancer. Furthermore, we evaluated the change in number of TILs before and after irradiation.
In the prospective ABLATIVE study, low-risk patients with breast cancer underwent treatment with single-dose preoperative PBI (20 Gy) to the tumor and breast-conserving surgery after 6 or 8 months. In the preirradiation diagnostic biopsy and postirradiation resection specimen, numbers of TILs in 3 square regions of 450 × 450 μm were counted manually. TILs were visualized with CD3, CD4, and CD8 immunohistochemistry. Differences in numbers of preirradiation TILs between responders and nonresponders were tested using Mann-Whitney U test. Responders were defined as pathologic complete or near-complete response, and nonresponders were defined “as all other response.” Changes in numbers of TILs after preoperative PBI was evaluated with the Wilcoxon signed rank test.
Preirradiation tissue was available from 28 patients, postirradiation tissue from 29 patients, resulting in 22 pairs of preirradiation and postirradiation tissue. In these 35 patients, 15 had pathologic complete response (43%), 11 had a near-complete response (31%), 7 had a partial response (20%), and 2 had stable disease (6%). The median numbers of CD3+ TILs, CD4+ TILs, and CD8+ TILs in the preirradiation tumor tissue were 49 (interquartile range IQR, 36-80), 45 (IQR, 28-57), and 19 (IQR, 8-35), respectively. The number of preirradiation TILs did not differ significantly between responders and nonresponders. The median numbers of CD3+ TILs, CD4+ TILs, and CD8+ TILs in postirradiation tumor tissue were 17 (IQR, 13-31), 26 (IQR, 16-35), and 7 (IQR, 5-11), respectively.
After preoperative PBI in this limited cohort, the number of TILs in tumor tissue decreased. No differences in numbers of preirradiation TILs between responders and nonresponders were observed.
Abstract Background Primary cardiac diffuse large B-cell lymphoma (CDLBCL) is an exceptionally rare entity, estimated to represent less than 1% of all primary cardiac tumours. In this case report, we ...emphasize the diagnostic importance of multimodality imaging and the need for additional procedures, such as tissue biopsy, in a case with a primary cardiac lymphoma presenting with cardiac tamponade. Case summary An 80-year-old male was admitted to the emergency department with a life-threatening tamponade demanding immediate sternotomy. Pre-operative echocardiography unveiled pericardial effusion and a thickened apex. While computed tomography ruled out an aortic dissection, surgery revealed an unexpected vascular-rich mass at the right ventricle and apex, too perilous for biopsy. Post-operative imaging misinterpreted this mass as a benign haematoma. Subsequently, the patient was admitted to the intensive care unit, but after a conservative treatment strategy, the patient died. An autopsy revealed a primary CDLBCL. Discussion This case demonstrates the deceptive nature of primary CDLBCL, often complicated by cardiac tamponade. It underscores the pivotal role of pathologic assessment, even amidst the perils of sternotomy, to determine the origin of abnormal cardiac masses. A heightened awareness among physicians is imperative, for such elusive diagnoses may slip by, with potentially fatal outcomes.
We aimed to evaluate changes in dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) magnetic resonance imaging (MRI) scans acquired before and after single-dose ablative neoadjuvant partial ...breast irradiation (NA-PBI), and explore the relation between semiquantitative MRI parameters and radiologic and pathologic responses.
We analyzed 3.0T DCE and DW-MRI of 36 patients with low-risk breast cancer who were treated with single-dose NA-PBI, followed by breast-conserving surgery 6 or 8 months later. MRI was acquired before NA-PBI and 1 week, 2, 4, and 6 months after NA-PBI. Breast radiologists assessed the radiologic response and breast pathologists scored the pathologic response after surgery. Patients were grouped as either pathologic responders or nonresponders (<10% vs ≥10% residual tumor cells). The semiquantitative MRI parameters evaluated were time to enhancement (TTE), 1-minute relative enhancement (RE1min), percentage of enhancing voxels (%EV), distribution of washout curve types, and apparent diffusion coefficient (ADC).
In general, the enhancement increased 1 week after NA-PBI (baseline vs 1 week median – TTE: 15s vs 10s; RE1min: 161% vs 197%; %EV: 47% vs 67%) and decreased from 2 months onward (6 months median – TTE: 25s; RE1min: 86%; %EV: 12%). Median ADC increased from 0.83 × 10−3 mm2/s at baseline to 1.28 × 10−3 mm2/s at 6 months. TTE, RE1min, and %EV showed the most potential to differentiate between radiologic responses, and TTE, RE1min, and ADC between pathologic responses.
Semiquantitative analyses of DCE and DW-MRI showed changes in relative enhancement and ADC 1 week after NA-PBI, indicating acute inflammation, followed by changes indicating tumor regression from 2 to 6 months after radiation therapy. A relation between the MRI parameters and radiologic and pathologic responses could not be proven in this exploratory study.
Up to 30% of stage II patients with curatively resected colorectal cancer (CRC) will develop disease recurrence. We evaluated whether examination of lymph nodes by multilevel sectioning and ...immunohistochemical staining can improve prognostication. Lymph nodes (n = 780) from 36 CRC patients who had developed disease recurrence (cases) and 72 patients who showed no recurrence of disease for at least 5 years (controls) were analyzed. Sections of 4 levels at 200‐μm interval were immunohistochemically stained for cytokeratin expression. The first level was analyzed by conventional and automated microscopy, and the 3 following levels were analyzed by automated microscopy for the presence of tumor cells. Overall, cases showed more micrometastases (3 patients) than controls (1 patient). Analysis of a second level led to the additional detection of 1 patient with micrometastases (case) and 1 patient with macrometastasis (case). Examining more levels only led to additional isolated tumor cells, which were equally divided between cases and controls. Likewise, automated microscopy resulted only in detection of additional isolated tumor cells when compared with conventional microscopy. In multivariate analysis, micrometastases odds ratio (OR) 26.3, 95% confidence interval (CI) 1.9–364.8, p = 0.015, T4 stage (OR 4.8, 95% CI 1.4–16.7, p = 0.013) and number of lymph nodes (OR 0.9, 95% CI 0.8–1.0, p = 0.028) were independent predictors for disease recurrence. Lymph node analysis of 2 levels and immunohistochemical staining add to the detection of macrometastases and micrometastases in CRC. Micrometastases were found to be an independent predictor of disease recurrence. Isolated tumor cells were of no prognostic significance.
PDF
