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Operations Research System Tora Software Free 467 __TOP__

The Feature Paper can be either an original research article, a substantial novel research study that often involvesseveral techniques or approaches, or a comprehensive review paper with concise and precise updates on the latestprogress in the field that systematically reviews the most exciting advances in scientific literature. This type ofpaper provides an outlook on future directions of research or possible applications.

Operations Research System Tora Software Free 467

Abstract:A battery/supercapacitor hybrid energy storage system is developed to mitigate the battery degradation for electric vehicles. By coordinating the battery and supercapacitor, the proposed system avoids using the large bidirectional DC/DC. Through the improved topology and two added controlled switches, the battery current can be managed flexibly. Based on the battery and supercapacitor voltage, seven operation modes of battery and capacitor cooperation are designed. The control strategy is redesigned to match the modes, in which the key control parameters are calibrated based on three standard driving cycles. During driving, the proposed system calls the predefined parameter set by the cycle recognition technique. The objective of the cycle-related control is to maximize the harvest of the braking energy and minimize battery degradation in various driving styles. Taking the battery case solely as a benchmark and the infinite supercapacitors case as the largest battery degradation mitigation scenario, the battery degradation quantification of the proposed energy storage system shows more than 80% mitigation of the maximum theoretical battery degradation mitigation on urban dynamometer driving schedule (UDDS), highway fuel economy cycle (HWFET), and high-speed (US06) driving cycle, respectively. During the tested driving cycles, the simulation result indicates the battery degradation reduced by 30% more than the battery solely scenario, which proves the benefit of the proposed system.Keywords: electric vehicles; hybrid energy storage system; supercapacitor; battery life; electric vehicles

Adler et al (2009) stated that although stereotactic radiosurgery is an established procedure for treating TN, the likelihood of a prompt and durable complete response is not assured. Moreover, the incidence of facial numbness remains a challenge. To address these limitations, a new, more anatomic radiosurgical procedure was developed that uses the CyberKnife (Accuray, Inc., Sunnyvale, CA) to lesion an elongated segment of the retro-Gasserian cisternal portion of the trigeminal sensory root. Because the initial experience with this approach resulted in an unacceptably high incidence of facial numbness, a gradual dose and volume de-escalation was performed over several years. In this single-institution prospective study, these researchers assessed clinical outcomes in a group of TN patients who underwent lesioning with seemingly optimized non-isocentric radiosurgical parameters. A total of 46 patients with intractable idiopathic TN were treated between January 2005 and June 2007. Eligible patients were either poor surgical candidates or had failed previous microvascular decompression or destructive procedures. During a single radiosurgical session, a 6-mm segment of the affected nerve was treated with a mean marginal prescription dose of 58.3 Gy and a mean maximal dose of 73.5 Gy. Monthly neurosurgical follow-up was performed until the patient became pain-free. Longer-term follow-up was performed both in the clinic and over the telephone. Outcomes were graded as excellent (pain-free and off medication), good (greater than 90 % improvement while still on medication), fair (50 to 90 % improvement), or poor (no change or worse). Facial numbness was assessed using the Barrow Neurological Institute Facial Numbness Scale score. Symptoms disappeared completely in 39 patients (85 %) after a mean latency of 5.2 weeks. In most of these patients, pain relief began within the first week. Trigeminal neuralgia recurred in a single patient after a pain-free interval of 7 months; all symptoms abated after a second radiosurgical procedure. Four additional patients underwent a repeat rhizotomy after failing to respond adequately to the first operation. After a mean follow-up period of 14.7 months, patient-reported outcomes were excellent in 33 patients (72 %), good in 11 patients (24 %), and poor/no improvement in 2 patients (4 %). Significant ipsilateral facial numbness (Grade III on the Barrow Neurological Institute Scale) was reported in 7 patients (15 %). The authors concluded that optimized non-isocentric CyberKnife parameters for TN treatment resulted in high rates of pain relief and a more acceptable incidence of facial numbness than reported previously. Moreover, they stated that longer follow-up periods will be needed to establish whether or not the durability of symptom relief after lesioning an elongated segment of the trigeminal root is superior to isocentric radiosurgical rhizotomy.

Qureshi and colleagues (2018) stated that nerves and nerve ganglions are supplied by segmental arteries and the vasa nervorum, but the intra-arterial route has not been used for diagnostic or therapeutic purposes. These investigators presented the results of intra-arterial delivery of medication for modulating trigeminal nerve ganglion function in patients with refractory TN. They administered intra-arterial lidocaine in doses up to 50 mg in the middle meningeal artery territory adjacent to the arterial branch that supplies the trigeminal nerve ganglion. These researchers performed electrophysiologic monitoring to serially assess the latency and amplitude of R1 and R2 responses in the blink reflex before and concurrent with each incremental dose of lidocaine. Clinical outcome assessment included a 10-point numeric rating, 4-point severity grading, and the pain-free time interval pre- and post-treatment. Intra-arterial lidocaine was administered to 3 patients with TN (35-year old woman, 57-year old man, and 34-year old woman). In all patients, there was a latency prolongation and amplitude reduction of R1 or R2 responses or both that was evident after 5 to 10 mg of lidocaine administration; a more pronounced effect was seen with increasing doses. The 2nd and 3rd patients reported improvement in pain severity on all scales with pain-free intervals of 5 and 3 days, respectively. There was improvement in facial hyperalgesia in all 3 patients in all dermatomes. All 3 patients' symptoms had returned to baseline severity 1 month later. The authors found that modulation of trigeminal nerve activity via the intra-arterial route is possible based on consistent intra-procedural electrophysiologic suppression and short-term clinical improvement in patients with refractory TN. Moreover, they stated that this procedure needs more investigation and should only be considered for patients with therapy-refractory TN, due to the risk profile of the procedure and the short duration of pain relief.

Yuvaraj and colleagues (2019) stated that of the many chronic painful conditions, TN affecting the oro-facial region needs the particular attention of physicians and surgeons, especially those specializing in the maxilla-facial region. Therapeutic protocols for the management of classic TN include pharmacology and surgical intervention. Oral and maxilla-facial surgeons have traditionally employed the peripheral neurectomy in the surgical management of TN. These researchers examined the efficacy of peripheral neurectomy in the management of TN with regard to the relief of symptoms in comparison with standard neurosurgical procedures, and the duration of pain relief and complications observed compared to standard neurosurgical procedures. The review of the literature was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and included randomized controlled trials (RCTs), reviews and prospective clinical studies involving surgical procedures for the management of TN. The primary outcomes evaluated were initial relief of pain, duration of relief of pain, complications observed with ablative procedures and recurrence of symptoms. A total of 43 studies met the inclusion criteria. A total of 7,913 patients from the 43 studies, central procedures were found to have best results for both quality and duration of pain relief. Percutaneous and peripheral procedures were associated with increased recurrence rates. The consolidated rates of complication for peripheral, percutaneous and central procedures were 39.46 %, 65.42%, and 10.41 %, respectively. The use of peripheral neurectomy alone in the management of classic TN was observed in 10 studies. The authors concluded that peripheral neurectomy in TN was associated with lesser quality of pain relief in comparison with central neurosurgical procedures. It also provided only short- to medium-term pain relief. Most studies with the use of peripheral neurectomy involved only a small group of patients with short follow-up periods. These investigators stated that oral and maxilla-facial surgeons must not consider the peripheral neurectomy as the 1st surgical option in the management of classic TN. Long-term results could be better-achieved with appropriate central neurosurgical procedures and pharmacotherapy.

Patra and colleagues (2019) noted that GKRS has emerged as a promising treatment modality for patients with classical TN; however, considering that almost 50 % of the patients experience post-GKRS failure or lesion recurrence, a repeat treatment is typically necessary. The existing literature does not offer clear evidence to establish which treatment modality, repeat GKRS or microvascular decompression (MVD), is superior. These researchers compared the overall outcome of patients who have undergone either repeat GKRS or MVD after failure of their primary GKRS; they did so by conducting a systematic review and meta-analysis of the literature and analysis of data from their own institution. These investigators conducted a systematic review and meta-analysis of the PubMed, Cochrane Library, Web of Science, and CINAHL databases to identify studies describing patients who underwent either repeat GKRS or MVD after initial failed GKRS for TN. The primary outcomes were complete pain relief (CPR) and adequate pain relief (APR) at 1 year. The secondary outcomes were rate of post-operative facial numbness and the re-treatment rate. The pooled data were analyzed with R software. Bias and heterogeneity were assessed using funnel plots and I2 tests, respectively. A retrospective analysis of a series of patients treated by the authors who underwent repeat GKRS or MVD after post-GKRS failure or relapse was presented. A total of 22 studies met the selection criteria and were included for final data retrieval and meta-analysis. The search did not identify any study that had directly compared outcomes between patients who had undergone repeat GKRS versus those who had undergone MVD. Thus, the authors' final analysis included 2 groups: studies describing outcome after repeat GKRS (n = 17) and studies describing outcome after MVD (n = 5). The authors' institutional study was the only study with direct comparison of the 2 cohorts. The pooled estimates of primary outcomes were APR in 83 % of patients who underwent repeat GKRS and 88 % of those who underwent MVD (p = 0.49), and CPR in 46 % of patients who underwent repeat GKRS and 72 % of those who underwent MVD (p = 0.02). The pooled estimates of secondary outcomes were facial numbness in 32 % of patients who underwent repeat GKRS and 22 % of those who underwent MVD (p = 0.11); the re-treatment rate was 19 % in patients who underwent repeat GKRS and 13 % in those who underwent MVD (p = 0.74). The authors' institutional study included 42 patients (repeat GKRS in 15 and MVD in 27), and the outcomes 1 year after re-treatment were APR in 80 % of those who underwent repeat GKRS and 81 % in those who underwent MVD (p = 1.0); CPR was achieved in 47 % of those who underwent repeat GKRS and 44 % in those who underwent MVD (p = 1.0). There was no difference in the rate of post-operative facial numbness or re-treatment. The authors concluded that the current meta-analysis failed to identify any superiority of one treatment over the other with comparable outcomes in terms of APR, post-operative facial numbness, and re-treatment rates. However, MVD was shown to provide a better chance of CPR compared with repeat GKRS.


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