446 research outputs found

    Characterisation of large changes in wind power for the day-ahead market using a fuzzy logic approach

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    Wind power has become one of the renewable resources with a major growth in the electricity market. However, due to its inherent variability, forecasting techniques are necessary for the optimum scheduling of the electric grid, specially during ramp events. These large changes in wind power may not be captured by wind power point forecasts even with very high resolution Numerical Weather Prediction (NWP) models. In this paper, a fuzzy approach for wind power ramp characterisation is presented. The main benefit of this technique is that it avoids the binary definition of ramp event, allowing to identify changes in power out- put that can potentially turn into ramp events when the total percentage of change to be considered a ramp event is not met. To study the application of this technique, wind power forecasts were obtained and their corresponding error estimated using Genetic Programming (GP) and Quantile Regression Forests. The error distributions were incorporated into the characterisation process, which according to the results, improve significantly the ramp capture. Results are presented using colour maps, which provide a useful way to interpret the characteristics of the ramp events

    Effectiveness of dolutegravir-based regimens as either first-line or switch antiretroviral therapy: data from the Icona cohort

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    Introduction: Concerns about dolutegravir (DTG) tolerability in the real-life setting have recently arisen. We aimed to estimate the risk of treatment discontinuation and virological failure of DTG-based regimens from a large cohort of HIV-infected individuals. Methods: We performed a multicentre, observational study including all antiretroviral therapy (ART)-naïve and virologically suppressed treatment-experienced (TE) patients from the Icona (Italian Cohort Naïve Antiretrovirals) cohort who started, for the first time, a DTG-based regimen from January 2015 to December 2017. We estimated the cumulative risk of DTG discontinuation regardless of the reason and for toxicity, and of virological failure using Kaplan–Meier curves. We used Cox regression model to investigate predictors of DTG discontinuation. Results: About 1679 individuals (932 ART-naïve, 747 TE) were included. The one- and two-year probabilities (95% CI) of DTG discontinuation were 6.7% (4.9 to 8.4) and 11.5% (8.7 to 14.3) for ART-naïve and 6.6% (4.6 to 8.6) and 7.6% (5.4 to 9.8) for TE subjects. In both ART-naïve and TE patients, discontinuations of DTG were mainly driven by toxicity with an estimated risk (95% CI) of 4.0% (2.6 to 5.4) and 2.5% (1.3 to 3.6) by one year and 5.6% (3.8 to 7.5) and 4.0% (2.4 to 5.6) by two years respectively. Neuropsychiatric events were the main reason for stopping DTG in both ART-naïve (2.1%) and TE (1.7%) patients. In ART-naïve, a concomitant AIDS diagnosis predicted the risk of discontinuing DTG for any reason (adjusted relative hazard (aRH) = 3.38, p = 0.001), whereas starting DTG in combination with abacavir (ABC) was associated with a higher risk of discontinuing because of toxicity (aRH = 3.30, p = 0.009). TE patients starting a DTG-based dual therapy compared to a triple therapy had a lower risk of discontinuation for any reason (adjusted hazard ratio (aHR) = 2.50, p = 0.037 for ABC-based triple-therapies, aHR = 3.56, p = 0.012 for tenofovir-based) and for toxicity (aHR = 5.26, p = 0.030 for ABC-based, aHR = 6.60, p = 0.024 for tenofovir-based). The one- and two-year probabilities (95% CI) of virological failure were 1.2% (0.3 to 2.0) and 4.6% (2.7 to 6.5) in the ART naïve group and 2.2% (1.0 to 3.3) and 2.9% (1.5 to 4.3) in the TE group. Conclusions: In this large cohort, DTG showed excellent efficacy and optimal tolerability both as first-line and switching ART. The low risk of treatment-limiting toxicities in ART-naïve as well as in treated individuals reassures on the use of DTG in everyday clinical practice

    Impact of social determinants on antiretroviral therapy access and outcomes entering the era of universal treatment for people living with HIV in Italy

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    Background: Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. Methods: All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA < 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test. Results: A total of 8023 HIV+ pts (82% males, median age at first pos anti-HIV test 36 years, IQR: 29-44) were included: 6214 (77.5%) started ART during the study period. Women, people who inject drugs (PWID) and residents in Southern Italy presented the lowest levels of education and the highest rate of unemployment compared to other groups. Females, pts aged > 50 yrs., unemployed vs employed, and people with lower educational levels presented the lowest CD4 count at ART initiation compared to other groups. The overall median time to ART initiation was 0.6 years (yrs) (IQR 0.1-3.7), with a significant decrease over time [2002-2006 = 3.3 yrs. (0.2-9.4); 2007-2011 = 1.0 yrs. (0.1-3.9); 2012-2016 = 0.2 yrs. (0.1-2.1), p < 0.001]. By multivariate analysis, females (p < 0.01) and PWID (p < 0.001), presented a longer time to ART initiation, while older people (p < 0.001), people with higher educational levels (p < 0.001), unemployed (p = 0.02) and students (p < 0.001) were more likely to initiate ART. Moreover, PWID, unemployed vs stable employed, and pts. with lower educational levels showed a lower 1-year probability of achieving HIV-RNA suppression, while females, older patients, men who have sex with men (MSM), unemployed had higher 1-year risk of first-line ART discontinuation. Conclusions: Despite median time to ART start decreased from 2002 to 2016, socio-demographic factors still contribute to disparities in ART initiation, outcome and durability

    Comparative genomics of drug resistance in <i>Trypanosoma brucei rhodesiense</i>

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    Trypanosoma brucei rhodesiense is one of the causative agents of human sleeping sickness, a fatal disease that is transmitted by tsetse flies and restricted to Sub-Saharan Africa. Here we investigate two independent lines of T. b. rhodesiense that have been selected with the drugs melarsoprol and pentamidine over the course of 2 years, until they exhibited stable cross-resistance to an unprecedented degree. We apply comparative genomics and transcriptomics to identify the underlying mutations. Only few mutations have become fixed during selection. Three genes were affected by mutations in both lines: the aminopurine transporter AT1, the aquaporin AQP2, and the RNA-binding protein UBP1. The melarsoprol-selected line carried a large deletion including the adenosine transporter gene AT1, whereas the pentamidine-selected line carried a heterozygous point mutation in AT1, G430R, which rendered the transporter non-functional. Both resistant lines had lost AQP2, and both lines carried the same point mutation, R131L, in the RNA-binding motif of UBP1. The finding that concomitant deletion of the known resistance genes AT1 and AQP2 in T. b. brucei failed to phenocopy the high levels of resistance of the T. b. rhodesiense mutants indicated a possible role of UBP1 in melarsoprol-pentamidine cross-resistance. However, homozygous in situ expression of UBP1-Leu(131) in T. b. brucei did not affect the sensitivity to melarsoprol or pentamidine

    Estimating Ionospheric Height From Amplitude Scintillation Signatures in SAR Images

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    In this letter, we discuss the estimation of the location of ionospheric irregularities exploiting the appearance of intensity scintillations in ALOS-2 images, as they are semifocused at different heights. The intensity scintillations (stripes) are not always visible in the single-look complex (SLC) images. However, they start to be visible, as the image is semifocused at different heights with a peak of contrast where electron density irregularities are found (ionospheric height). The slant range between the satellite and the ionospheric plane can be estimated and converted directly into the ionospheric height by autofocusing the stripes. The observations show good agreement with the height of maximum ionization estimated by the International Reference Ionosphere (IRI). Furthermore, we perform an alternative geometric validation based on feature tracking by comparing the shifts between azimuth sublooks. With both methods for the presented dataset, the height of the ionospheric irregularities was estimated to be 330 km

    EU2030 biodiversity strategy: Unveiling gaps in the coverage of ecoregions and threatened species within the strictly protected areas of Italy

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    About 19 % of the Italian territory is covered by protected areas (PAs), 5.1 % of which fall in IUCN categories Ia and II, which can be considered strictly protected areas (StPAs). The 2030 EU Biodiversity Strategy sets a target of 30 % coverage for PAs (of which 10 % should be StPAs). We assessed the area coverage of StPAs, for the territory of Italy, with respect to biogeographical regions, ecoregions, elevation range, habitats, and the distribution of species threatened with extinction according to the IUCN Red List (Vulnerable, VU; Endangered, EN; or Critically Endangered, CR). We found that most of the StPAs are located in the Mediterranean biogeographical region, followed by the Alpine and Continental regions, and that the spatial distribution of such protected areas is biased towards higher elevation. Moreover, we found that three of the fourteen terrestrial ecoregions of Italy are not protected at all by StPAs (i.e., Illyrian, Ligurian-Provencal, and Central-Adriatic), while the Po Plain and the Sicilia Sections are only marginally protected. Moreover, nine habitats are not covered by any StPAs including one priority habitat (Inland salt meadows). Finally, we found unprotected species among freshwater fish (21), amphibians (3 VU, 3 CR), reptiles (1 CR), birds (2 NE), mammals (1 VU), and plants (20 VU, 14 EN, 21 CR). Our findings suggest that the current amount and spatial distribution of StPAs of Italy are far from the targets of the EU Biodiversity Strategy and needs improvements
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