3 Technical RepoRT New Opportunities Offered by the ESRF to the Cultural and Natural Heritage Communities Marine Cotte,1,2 Kathleen DollMan,1 VinCent FernanDez,1 ViCtor Gonzalez,3 FreDeriK VanMeert,4,5 letizia MoniCo,6,7,4 Catherine Dejoie,1 ManFreD BurGhaMMer,1 loïC huDer,1 Stuart FiSher,1 Wout De nolF,1 iDa FazliC,1,8 hiraM CaStillo-MiChel,1 Murielle SaloMé,1 Marta GhirarDello,9 Daniela CoMelli,9 oliVier Mathon,1 anD Paul taFForeau1 1European Synchrotron Radiation Facility (ESRF), Grenoble, France 2Sorbonne Université, CNRS, Laboratoire d’Archéologie Moléculaire et Structurale (LAMS), Paris, France 3Université Paris-Saclay, ENS Paris-Saclay, CNRS, PPSM, Gif-sur-Yvette, France 4Antwerp X-ray Imaging and Spectroscopy Laboratory (AXIS) Research Group, NANOLab Centre of Excellence, University of Antwerp, Antwerp, Belgium 5Paintings Laboratory, Royal Institute for Cultural Heritage (KIK-IRPA), Brussels, Belgium 6CNR-SCITEC, Perugia, Italy 7Centre of Excellence SMAArt, University of Perugia, Perugia, Italy 8Science Department, Rijksmuseum, Amsterdam, The Netherlands 9Physics Department, Politecnico di Milano, Milano, Italy Introduction For the past 20 years, the community of heritage scientists has frequently exploited the synchrotron radiation-based techniques offered at the European Synchrotron Radiation Facility (ESRF), Grenoble, France [1]. X-ray imaging techniques (in particular, micro computedtomography, μCT) are regularly employed to probe non-destructively the inner structure of objects and materials. In paleontology, this can offer information on the functioning and evolution of organs and organisms. In addition, analytical techniques such as X-ray fluorescence (XRF), X-ray powder diffraction (XRPD), and X-ray absorption spectroscopy (XAS) are often used, alone or combined, for the chemical analysis of micro-fragments of historical manufactured materials. This can give clues about both the early days of objects (physical and chemical processes used in the production of artworks and the evolution of these skills in time and space) as well as the evolution/alteration of objects (nature of degradation products and environmental factors contributing to these degradations). The limited size of samples and their high heterogeneity often require access to micro and nano-probes. The new capabilities offered by the ESRF upgrade “EBS” (Extremely Brilliant Source), as well as instrumental developments at new and strongly refurbished beamlines, have motivated the organization of a dedicated “EBS-workshop” about cultural and natural heritage, which was held in January 2020 at the ESRF, attracting more than 150 participants, among which were 90 new ESRF users. Most of the talks were broadcast on the ESRF YouTube Channel and are still available (https:// youtube.com/playlist?list=PLsWatK2_NAmyyA0n03OMJMAKobVIvow2D). Through scientific presentations, tutorials, and discussions, the objectives of the workshop were: 1. To illustrate to expert and non-expert users the many capabilities offered by synchrotron radiation-based techniques for the study of natural and cultural heritage materials/objects; 2. To present EBS and the related instrumental developments, highlighting the ground-breaking capabilities that will be offered through the ESRF upgrade phase 2 (thanks to the new source, new beamlines, and new instruments); 3. To present and discuss the upstream and downstream challenges associated with these new instruments (e.g., access models and data analysis, data management...), which are fundamental for making the experiments a success. This was notably a very good opportunity to discuss the implementation of new beamtime access modes.

A search is performed for delayed and nonpointing photons originating from the displaced decay of a neutral long-lived particle (LLP). The analysis uses the full Run 2 data set of proton-proton collisions delivered by the LHC at a center-of-mass energy of $\sqrt{s}=13$ TeV between 2015 and 2018 and recorded by the ATLAS detector, corresponding to an integrated luminosity of 139 fb$^{-1}$. The capabilities of the ATLAS electromagnetic calorimeter are exploited to precisely measure the arrival times and trajectories of photons. The results are interpreted in a scenario where the LLPs are pair-produced in exotic decays of the 125 GeV Higgs boson, and each LLP subsequently decays into a photon and a particle that escapes direct detection, giving rise to missing transverse momentum. No significant excess is observed above the expectation due to Standard Model background processes. The results are used to set upper limits on the branching ratio of the exotic decay of the Higgs boson. A model-independent limit is also set on the production of photons with large values of displacement and time delay.

A pandemic caused by the coronavirus affects all aspects of life of an individual and a society as a whole. It is not only a question of the medical profession, but also of other areas, and especially the need for fundamental human rights. The measures adopted by state bodies are primarily aimed at protecting human health, but the effects and implications they cause limit other rights, so it raises the question of their adequacy. The basic and most important question is how to access health care in such conditions. Therefore, the main aim of the paper is to try to answer the question through PESTEL (P-Political, E-Economic, S-Social, T-Technological, E-Environmental, L-Legal) analysis of the healthcare system of the local community of Pale. Thirty factors of PESTEL analysis were quantified by using the Improved Fuzzy Stepwise Weight Assessment Ratio Analysis (IMF SWARA) method. The results obtained through the total of 70 formed models show that the current state of the observed local community is marked by social and legal factors. This analysis should present a diagnostic test of the current situation and provide a good basis for future actions.

Out of all benign tumors of the ceruminous glands, syringocystadenoma papilliferum is the rarest and represents only 2% of cases. It is an extremely rare benign tumor that originates from modified apocrine sweat glands. The aim of this paper was to present, according to our findings, the 18th case of syringocystadenoma papilliferum in the external auditory canal, with a detailed review of its clinical, radiological and histomorphological characteristics. A 59-year-old man reported to our clinic due to a 5×5 mm papillomatous growth at the entrance to the right external auditory canal. Histopathology indicated, after an excisional biopsy, that it was a syringocystadenoma papilliferum. The resection lines were free of tumor tissue, and the patient has no signs of tumor recurrence. Although rare, it should be considered as a differential diagnosis of lesions in this region. Complete excision is mandatory in order to avoid recurrence and potential malignant alteration.

This study aimed to examine the impact of personality on glycemic regulation in adult patients with type 1 diabetes mellitus (T1DM). The study group consisted of subjects with T1DM, who were ≥ 18 years of age. The study was conducted in two phases: At baseline, subjects completed the Croatian version of the International Personality Item Pool scale (IPIP50s) and a questionnaire designed to gather socioeconomic data, duration of diabetes, presence of chronic complications, presence of cardiovascular risk factors, frequency, and type of pre-existing hypoglycemic episodes per week. Blood and urine samples were collected and body mass index (BMI) was calculated. Each participant was provided with the intermittently scanned glucose monitoring system (isCGM) Freestyle Libre. During the second visit (3 months from the start of the trial), glycemic parameters were collected from the reports generated from the Freestyle Libre system. Estimated glycated hemoglobin (HbA1c) values were significantly lower after three months compared to baseline HbA1c (Wilcoxon test, p < 0.001). An inverse correlation between the number of daily scans and degree of extraversion among subjects was observed, e.g., higher degrees of extraversion resulted in lower numbers of daily scans, while lower degrees of extraversion, i.e., introvertedness, resulted in higher numbers of daily scans (Rho = −0.238 p = 0.009). There was a positive correlation between emotional stability and time spent in hypoglycemia (Rho = 0.214; p = 0.02). In addition, a shorter duration of diabetes was associated with higher percentages of TIR and vice versa (p = 0.02). Investigating personality traits can be a useful tool for identifying patients predisposed to hypoglycemia and lower scanning frequency. Patients with a longer history of T1DM require closer follow-up and should be re-educated when necessary.

Due to higher requirements for achieving sustainable development goals, current challenging sociopolitical climate and internationalization, business models remain problematic, resulting in a more complex global competition among firms and the need for sustainability incorporation. Throughout this study, a conceptual model based on the systematic literature review was applied as the methodology, with the study's purpose to propose the new Model of Continuous Enterprise Sustainability, which is designed to facilitate and enhance enterprise management in today's demanding and complex business environment by providing concise steps for effectively incorporating sustainability into day‐to‐day business activities. Five essential components, through their interconnectedness, form the Model of Continuous Enterprise Sustainability, which smooth the path of sustainable management in a dynamic environment, which are as follows: (1) situational factors, (2) creating factors/processes, (3) triple‐sustainable results, (4) organizational results, and (5) continuous stakeholder communication, optimization, innovation and learning. This conceptual model contributes in the first line to advancement and detail explanation of how to achieve sustainable human, financial and natural resources management within enterprises. In addition to directions for sustainable internal resources management, this model also involves clarification how to strategically manage with external resources and prime stakeholders in order to integrate meaningful sustainability matters in firm's business core and create continuously greater value for firm and its prime interested parties.

Introduction Healthcare utilisation requires knowing one’s entitlements and how to access them (navigation) and having access to grievance redressal when entitlements are denied. To ensure citizen access to and use of health insurance entitlements, the Health Insurance Fund established an initiative called the Protector of Patients’ Health Insurance Entitlements (PPHIE). PPHIEs are supposed to provide patient navigation and grievance redressal services. This paper explores to what extent this initiative meets its objectives and is used by the elderly in rural areas. Methods This study employed a mixed methods approach. We conducted in-depth interviews with elderly patients in rural areas, PPHIEs, health providers and health insurance managers (N=39), as well as focus groups (N=5) and a household survey (N=715) with elderly rural patients. Qualitative data were analysed using content analysis, and the household survey results were analysed using descriptive statistics. Results The majority of elderly patients were not aware of the PPHIE initiative and instead received patient navigation support from their healthcare providers. The PPHIE programme was poorly publicised among the population. Although PPHIEs had a mandate to pursue grievance redressal they rarely did so, and their role in the system was more symbolic than functional. Conclusion While healthcare providers have (by default) filled the navigation role left by inactive PPHIEs, the grievance redressal role remains unfilled. Information about health insurance entitlements and access to grievance redressal must be provided through visible, accessible and efficient mechanisms that should be continuously monitored and improved.

Introduction Various side effects and complications in the perioperative period can occur with the use of hyperbaric lidocaine and bupivacaine. Goal Comparative presentation of the occurrence of side effects and complications of hyperbaric lidocaine and bupivacaine during spinal anesthesia in our patients. Methods The study was retrospective and included 178 patients of both sexes. Patients were divided into two groups. In Group I (n-98) hyperbaric lidocaine 5% was used for spinal block. Group II (n-80) was divided into 2 subgroups, A- where hyperbaric Markain 0.5% was used (n-51), and B (n-29) where hyperbaric Sensorkain 0.75% was used. In the study, we analyzed gender, age, block onset, and complications. Results There were 98 patients in Group I, 79 males and 19 females. There were 80 patients in Group II, 69 males and 11 females. The mean age of patients in Group I was 44.96 and in Group II 48.16 years. There was no statistically significant difference in the age of patients in both groups p> 0.05 (p = 0.2321). The occurrence of spinal block occurred significantly faster in Group I compared to group II (p <0.0001), and in subgroup B faster than in subgroup A (p <0.005). The clinical occurrence of complications and side effects during spinal anesthesia is somewhat more common in spinal block with 5% lidocaine. Conclusion The compared incidence of adverse perioperative clinical effects and complications after administration of hyperbaric lidocaine and bupivacaine in spinal anesthesia was not statistically significant.

High-voltage direct current (HVDC) circuit breaker development and deployment strongly depend on the testing process, which ensures that the HVDC circuit breakers will satisfy design requirements. This article presents an HVDC circuit breaker test bench circuit configuration that can provide controllable large output currents to simulate different fault conditions for the current breaking test and high output voltage for the dielectric withstand test. The current breaking test circuit is based on multiple cascaded power converters connected in parallel to provide the necessary output current capability. Each cascaded power converter is composed of multiple cells that are operated by a phase-shifted pulsewidth-modulated signal for greater controllability and higher quality of the output waveform. The dielectric withstand test circuit is a simple high-voltage source with a low power rating that can also be used to charge the test bench and the internal circuitry of the circuit breaker that is to be tested. The proposed test bench ensures that fault conditions can be replicated accurately and offers greater flexibility by being able to test mechanical, semiconductor-based, or hybrid HVDC circuit breakers with different current and voltage ratings on the same hardware without any changes. The idea and the operating principle of the proposed test bench are verified experimentally on a downscaled system that consists of three cascaded power converters connected in parallel with three cells per cascaded power converter and with a total equivalent switching frequency of 92.5 kHz.

Objective. To identify the type of the non-invasive ventilatory treatment for patients diagnosed with chronic obstructive pulmonary disease (COPD), with respiratory status deteriorated by COVID-19 pneumonia, and in need of treatment in the Intensive Care Unit (ICU). Materials and Methods. This cross-sectional study was conducted over a one-year period in the medical intensive care units of two hospitals. As the patients’ clinical condition deteriorated and the parameters of the arterial blood gas (ABG) analysis worsened, oxygen support was applied via a high flow nasal cannula (HFNC) or by non-invasive positive pressure ventilation (NPPV). According to the control values of the arterial oxygen saturation (SaO2) and the parameters of ABG, the patients were enabled to be transferred between the two types of non-invasive ventilatory support. The primary outcome was the length of hospital stay, while secondary outcomes were the rate of intubation, the mortality rate, and respiratory support-free days. Results. Out of 21 critical patients with COPD and COVID-19, 11 (52.4%) were initially treated with NPPV and 10 (47.6%) with HFNC. The ages (67±9.79 in NPPV group vs. 70.10±10.25 in HFNC group) and severity of illness (SOFA score 5 (3.5) in NPPV group vs. 5 (2.8) in HFNC group) were similar between the two groups. Switching the mode of respiratory support was more common in NPPV (58.3% in survivor group vs. 41.7% in non-survivor group). Patients treated with NPPV compared to HFNC had a nominally longer length of stay (15 (11) vs. 11.5 (4.25)), and higher risk of intubation (66.7% vs. 33.3%) and mortality (66.7% vs. 33.3%), but the comparisons did not reach statistical significance. Survivors had significantly longer Medical Intensive Care Unit and hospital stays, but significantly lower FiO2 (0.60 vs.1) and higher values of PaO2/FiO2 (78(32.4) vs. 56.3(17.8)) than non-survivors. All patients were treated with corticosteroids, and the duration of treatment was similar between groups. Conclusion. In critically ill patients with COPD and COVID-19, both HFNC and NPPV were commonly used as the initial mode of ventilation. Switching to a different mode and adverse patient outcomes were more frequent in patients initially treated with NPPV. Survivors had higher values of PaO2/FiO2 than non-survivors.

The integration of renewable generation in electrical power systems is exponentially increasing for multiple reasons. First, a fast decarbonization of the electrical energy system is a critical milestone to slow climate change and facilitate the decarbonization of other energy sectors, such as transportation and heat. Second, renewable generation from wind and solar have become much cheaper compared to conventional sources like gas, coal, and nuclear. Third, renewable generation is in many cases decentralized, which increases the resilience of the energy system, for example, in the face of natural disasters.

Reliable power system operation with 100% inverter-based resources (IBRs) is an unsolved and challenging problem. One of the most challenging factors is ensuring power system stability after N-1 contingencies. This paper presents a promising solution using an operator support system (OSS) to enable stable operation of power system with up to 100% IBR generation. The OSS consists of two components. First is dynamic security assessment to evaluate the system resiliency, and identify critical N-1 contingencies that could endanger the system. The second component, as the key technology behind the OSS, is dynamic security optimization (DSO). The DSO optimizes the control parameters of generators and inverters to improve the stability of the system towards the identified N-1 contingencies. The key to system with 100% IBRs, as emphasized in many recent studies, is to establish the grid frequency reference using grid-forming (GFM) inverters. We show through high-fidelity Electro-Magnetic-Transient (EMT) simulations of the future generation models of Hawai‘i Island system with 100% IBR capacity that a system with 100% IBRs can be operated stably with the help of GFM inverters, and appropriate controller parameters can be found by DSO for the inverters. The DSO is verified via 28 critical N-1 contingencies of Hawai‘i Island system identified by Hawaiian Electric. The simulation results verify the effectiveness of DSO, and show significant stability improvement from DSO.