This paper proposes a virtual tool for load flow analysis in energy distribution systems of micro-grids. The solution is based on a low-cost measurement architecture, which entails low-voltage power measurements in each secondary substation and a voltage measurement at the beginning of the medium voltage (MV) feeder. The proposed virtual tool periodically queries these instruments to acquire the measurements. Then, it implements a backward–forward load flow algorithm, to evaluate the power flow in each branch and the voltage at each node. The virtual tool performances are validated using power measurements acquired at the beginning of each MV feeder. The uncertainties on each calculated quantity are also evaluated starting from the uncertainties due to the used measurement instruments. Moreover, the influence of the line parameter uncertainties on the evaluated quantities is also considered. The validated tool is useful for the online analysis of power flows and also for planning purposes, as it allows verifying the influence of future distributed generator power injection. In fact, the tool is able to off-line perform the load flow calculation in differently distributed generation scenarios. The micro-grid of Favignana Island was used as a case study to test the developed virtual tool.
Introduction: Osteoarthritis (OA) is a common chronic joint disease characterized by pain, deformity, instability, reduction of motion and function. It is one of the main causes of disability in older adults, affecting about 10% of men and 18% of women over the age of sixty. There are several Guidelines that support the general clinical decision-making process. However, it is necessary to define an integrated management model for patients with OA to ensure an appropriate and quality healthcare. Methods: The objective of the analysis is to determine the economic burden linked to the prevalence and incidence of OA in the acute and chronic phases from the perspective of the National Health Service (NHS) and the entire society. A comparison was made between the management according to the clinical practice and the appropriate management according to National and International Guidelines, determining for each scenario the level of resources absorbed. Results: Patients who started a nonsteroidal anti-inflammatory drug (NSAID)-based therapy in clinical practice resulted in a higher absorption of resources of €363.87 than the same patient managed by referring to National and International Guidelines. Conclusions: OA is associated with a high economic burden and it is a priority problem for public health internationally. The savings resulting from our research, if generalized to the entire Italian population, would lead to a significant reduction of OA economic burden, thus allowing a reallocation of the available resources to other NHS’ sectors.
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BackgroundChronic myelogenous leukaemia (CML) is a pathological clinical condition with a yearly incidence between 10 and 15 cases per million people, 14 in Italy. Its incidence increases with age, reaching 20–25 yearly cases per million individuals in people over 70 years. A growing importance has been given to the need of a multidisciplinary approach (MDA) for the management of patients with CML.ObjectiveTo analyse the importance of MDA as compared with the current Italian standard of care for the management of CML patients based on the involvement of several health professional figures.MethodsA group of healthcare professionals from several healthcare structures were gathered in a first Advisory Board (AB) and divided into as many groups as the number of belonging health structures representative of the Italian provision of therapeutic approaches for CML. In a second AB, the results were validated by the same panel of experts.ResultsThe number of dedicated health professionals within the dedicated ward ranged from 1 to 13. Most structures rely on several professionals intervening only in case of necessity. Only one centre provides a booking service based on clinical needs to avoid waiting times. Most centres report there is basically no disagreement in the definition of the clinical pathway and there is a high adherence to national and international CML guidelines.ConclusionsThe development of forms of interorganisational and interprofessional coordination to improve the diagnosis and the treatment of CML patients have been for long on the agenda of policy makers, managers and professionals for more than 20 years. This analysis represents a starting reference to consider for the evaluation of an MDA in the Italian context.
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