While postpartum depression is a well-researched disorder in mothers, there is growing evidence indicating that some fathers also develop depressive symptoms . A recent meta-analysis revealed a total prevalence of paternal depression during pregnancy and up to one year postpartum of 8.4%, with significant heterogeneity observed among prevalence rates. International studies suggest that PPD is characterized by additional symptoms compared to maternal postpartum depression. Furthermore, various risk factors of PPD have been identified. However, the prevalence, symptomatology, risk factors and healthcare situation of fathers affected by PPD in Germany are unknown.This study comprises a controlled, cross-sectional epidemiological survey administered via postal questionnaires. The primary objective is to compare the prevalence of depressive symptoms in fathers with a 0–12-month-old infant to the prevalence of depressive symptoms in men without recent paternity. Two structurally differing regions  will be included. A random sample of 4600 fathers (2300 in each region) in the postpartum period and 4600 men without recent paternity matched by age, nationality and marital status will be assessed regarding depressive symptoms using the PHQ-9. Contact data will be extracted from residents’ registration offices. As secondary objectives, the study aims to provide insights into symptoms and risk factors of PPD in fathers and to assess the current healthcare situation of fathers with PPD in Germany. In an add-on study, genetic and epigenetic mechanisms of PPD will be explored.This study will conduct the first direct comparison between fathers in the postpartum period of one year after childbirth and a matched sample of men without a newborn child. Besides closing this research gap, the findings will provide prevalence estimates as well as insights into specific symptomatology, risk factors, and the current healthcare situation regarding fathers with PPD in Germany. The results will identify low-threshold approaches as a relevant issue for healthcare. Moreover, the findings should inform the development of PPD-specific screening instruments and healthcare offers addressing fathers with PPD.DRKS00013339; Trial registration date: August 20, 2018; Universal Trial Number (UTN): U1111–1218-8185.German Clinical Trials Register (DRKS):  While postpartum depression in mothers is a well-researched and recognized mental illness , growingFor Germany, there is currently only one longitudinal study by Gawlik et al. 2014), which examined paternal depressive symptoms over the second and third trimester of pregnancy up to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale , which e. The stuIt might be assumed that PPD is characterized by male-specific symptoms –17. TypiA starting point to ensure adequate care for fathers is to identify risk factors influencing the emergence and maintenance of PPD. A review by Wee et al. 2006) revealed that PPD is correlated with depressive symptoms in the partner, low relationship quality, and lack of social support  revealed. FurtherA limitation of all existing studies is that findings on prevalence, symptomatology, and risk factors of PPD focus solely on fathers in the first year after childbirth in comparison to historical control data on depressive symptoms. So far, no study has directly compared fathers in the postpartum period of one year after childbirth to a matched sample of men without a newborn child. A simultaneous investigation of depressive symptoms using the same instruments ensures the direct comparability of prevalence estimates between fathers of an infant and men without recent paternity. It provides the benefit of counteracting the risk of over- or underestimation of the relative frequency of depressive symptoms after childbirth, and thus safeguards the scientific quality of the findings. To determine whether having a newborn increases fathers’ likelihood of developing depressive symptoms (compared to not having a newborn), a valid study including a control group is necessary.The described findings suggest that PPD is a clinically relevant problem for fathers, their families, and the healthcare system, which might currently be under-diagnosed and under-treated . Both inIn sum, current international research lacks an exhaustive overview of PPD, as it failed to compare the prevalence rate, symptomatology, and risk factors of fathers within one year after childbirth with a matched control group using the same instruments. For Germany, there is no research investigating PPD throughout the entire period of one year after childbirth. Taking into account the international research gaps, this study also closes existing gaps in prevalence, symptomatology and risk factors with a particular focus on Germany. Additionally, knowledge about the healthcare situation of affected fathers can lead to the identification of low-threshold service access in the healthcare system.The aim of our study is to examine the prevalence of PPD in fathers within the first year after childbirth compared to the prevalence of depressive symptoms in a matched sample of men without recent paternity. We hypothesize that the prevalence of PPD in fathers within one year after childbirth is higher than the prevalence of depressive symptoms in a matched sample of men without recent childbirth. As one of the secondary objectives, we take a closer look at the group of fathers within one year after childbirth to assess differences in PPD prevalence in different time periods. Other secondary objectives are to identify specific symptoms and risk factors of PPD. Furthermore, service utilization regarding PPD is considered as a secondary objective on a healthcare level. In an exploratory add-on study, genetic and epigenetic mechanisms of PPD will be explored.A controlled, cross-sectional epidemiological survey in men with new paternity within one year prior to this survey (group 1: fathers of an infant) and a matched sample of men without a newborn child within one year prior to this survey (group 2: control group) will be conducted via postal questionnaires. The aim is to compare the prevalence of PPD in fathers within the first year after childbirth to the prevalence of depressive symptoms in a matched sample of men without a newborn child. As study regions, we chose two cities in Southwestern Germany with varying populations regarding birthrate, employment status, socioeconomic structure, and nationality of inhabitants: Freiburg and Mannheim, with 228,000 and 320,000 inhabitants, respectively. As social factors may influence the development of PPD in fathers and of depressive symptoms in men without new paternity, the use of two structurally different cities as study regions allows the generalizability of the results to be investigated.As primary measure, the Patient Health Questionnaire (PHQ-9) will be used  as well as men from the same regions without a newborn child within one year prior to this survey (group 2: control group). The two groups will be matched by age, nationality and marital status. To ensure a high external validity of our results, no exclusion criteria have been established, with the exception of insufficient German language proficiency due to the nature of the survey.Contact details of potential study participants for both groups will be obtained from the residents’ registration offices of the chosen study regions of Freiburg and Mannheim, which will enable a random sample of fathers of an infant to be drawn. Due to the random selection of fathers of an infant, a balanced distribution of the children’s age between 0 and 12 months can be expected. Since a request for a sample from the residents’ registration offices takes two days to process, it is guaranteed that all included fathers of an infant will have become a father of a newborn within 12 months prior to this survey. At the same time, the residents’ registration offices of Freiburg and Mannheim will draw the matched control group. The information provided by the residents’ registration offices will include contact details as well as descriptions of the men in the samples according to the variables age, nationality and marital status. After obtaining these sample descriptions, information about the study and a consent form as well as a questionnaire will be sent by post to both groups. The questionnaire is reduced to central variables and a prepaid return envelope will be attached, as these measures are associated with an increased response rate .The primary objective is to assess the prevalence of PPD in fathers within the first year after childbirth (group 1: fathers of an infant) compared to the prevalence of depressive symptoms in a matched sample without recent paternity (group 2: control group). This will enable the relative frequency of depressive symptoms after childbirth to be calculated. For prevalence estimates regarding PPD in fathers of an infant and regarding depressive symptoms in the control group, respectively, the Patient Health Questionnaire (PHQ-9) will be used as a measurement instrument in both groups. With sensitivity and specificity both lying at 88% , the PHQSecondary objectives will be addressed regarding the prevalence of PPD in different periods after childbirth, male-specific symptomatology, and risk factors of PPD. On a healthcare level, service utilization regarding PPD in fathers is considered as a secondary objective.The prevalence in different time periods after childbirth will be measured as a secondary objective, assessed using the PHQ-9. The age of the child in weeks will be recorded by calculating the time between the date of childbirth and the date on which the questionnaire is completed.The identification of specific depressive symptoms will be considered as a secondary objective. The presence of male-specific depressive symptoms will be recorded using the Gotland Scale for Male Depression , 49, whiTo identify risk factors of PPD, various secondary objectives will be evaluated. The course of disease was chosen as a secondary objective, as numerous studies have demonstrated its moderating influence on the development of depressive symptoms. The course of disease is not recorded in the PHQ-9 and will therefore be assessed using additional items regarding the duration of the current episode and previous episodes.P < .001) [To detect present anxiety symptoms, the Adult Separation Anxiety Questionnaire  and the < .001) . The ASI < .001) .Global assessments of the subjective judgment of the child’s and of the mother’s health status as possible influencing variables will be recorded using self-constructed items. Additionally, it will be asked whether a diagnosis of maternal postpartum depression is present.The normative gender role orientation of the study participants will be evaluated using the Questionnaire of Normative Gender Role Attitudes . The NSocial support will be measured using the standardized German short form of the Social Support Questionnaire , a uniConcerning pregnancy and birth, it is relevant to record whether the pregnancy was planned, unplanned or unwanted, whether artificial insemination was used and whether the birth was premature or involved multiple births. Furthermore, perinatal variables such as caesarean section delivery will be collected. The father should also indicate whether or not he is the child’s biological father.The involvement of the father in the child’s care will be assessed using self-constructed items. These items cover, for example, the nighttime care, the inclusion and effectiveness of the father in the child’s upbringing and the use of paternity leave. The extent of perceived self-efficacy will be assessed using the General Self-Efficacy Scale , which The socio-demographic data collection will be based on the recommendations for epidemiological studies  as well The utilization of medical services will be assessed based on scales of the health questionnaire of the study on Adult Health in Germany (DEGS ), the GeBased on the data of the residents’ registration offices, it will be possible to describe differences in the composition of the population and the respondents of the two samples (fathers of an infant and control group) in terms of marital status, nationality, and age. The influence of these covariates on the response behavior can be controlled using logistic regressions. If there are significant differences between the population and the respondents of the two samples, a statistical adjustment of these differences will be made in the evaluation.In psychometrically tested instruments, missing values are handled according to the instructions in the respective manual. If there are no recommendations, up to 30% of the missing data is replaced by the expectation-maximization algorithm method .Relative frequencies will be calculated for nominal-scaled variables. For ordinal-scaled and non-normally distributed interval-scaled measurements, the median is used as the preferred measure of central tendency. For interval-scaled variables, the arithmetic mean and standard deviations will be calculated. The choice of the respective statistical method for group comparisons depends on the scale level of the dependent variable. Although a matched sampling will be performed, this information cannot be used in the evaluation due to the anonymity of the survey. The evaluation therefore requires the use of independent samples techniques. Nominal distributions will be compared using Chi-square and Fisher’s exact tests. Parametric tests  will be used for interval-scaled measurements. The effect of socio-demographic and other influencing factors will be calculated using logistic regressions.The study will investigate whether a significant difference can be observed between the prevalence of PPD in fathers within the first year after childbirth and the prevalence of depressive symptoms in a matched sample of men without recent paternity. The a priori calculation of statistical power is based on a point prevalence of 5.3% in the control group , which corresponds to the incidence of depressive symptoms in men according to the PHQ-9 standard data . Comparen = 4600; 2300 per city) matched according to age, nationality, and marital status will be generated. Thus, a total of 9200 potential participants will be contacted. Based on response rates from other anonymized postal surveys, a dropout rate of about 75% is expected for this study. Already included in these dropout calculations are those men who cannot participate due to incorrect address information. However, the obtained sample size will be sufficiently large to reveal small differences in the prevalence of depressive symptoms among the fathers of an infant (ω = 0.1) for each month after birth with a power > 80% using the Chi-square test.In Freiburg and Mannheim together, about 5500 children are born each year , 62. OutEnrolment for the trial began in September 2018. Recruitment and data collection continued until March 2019. As of August 2019, data management and data analysis is ongoing.First results indicate the relevance of genetic and epigenetic factors in PPD, which show a complex interaction with psychosocial and environmental aspects , 64. EpiOur controlled cross-sectional epidemiological study aims to compare the prevalence of PPD in fathers within the first year after childbirth with the prevalence of depressive symptoms in a matched sample of men without new paternity. Furthermore, our study should reveal differences regarding the prevalence of PPD in fathers in different time periods within one year after childbirth. Additionally, potential male-specific symptoms and risk factors of PPD in fathers will be investigated. A further goal is to assess the current healthcare situation of fathers with PPD in Germany. Our findings will contribute to closing the above-mentioned research gaps and offer possibilities to refine healthcare options for fathers with PPD. Compared to previous studies, our study has several methodological strengths. A central advantage is the direct comparison of the prevalence of PPD in fathers of an infant with the prevalence of depressive symptoms in a matched group of men without recent paternity from the general population. The simultaneous detection of depressive symptoms using the same measurement instrument will minimize the risk of producing an estimation bias of the relative prevalence of PPD and thus increase the external validity of the results. The large sample size compared to previous studies will allow us to perform a variety of subgroup analyses. Furthermore, the large sample size and the recording of the date of childbirth and the date of responding to our questionnaire will allow us to examine prevalence differences for several time periods within one year after childbirth and to analyze specific symptoms of PPD and risk factors. A further advantage of our study lies in the consideration of the healthcare situation of fathers with PPD in Germany – an issue that has not been considered in the research so far. By examining these aspects, low-threshold service access can be revealed, enabling important hints to be derived for the development of adequate care options for fathers with PPD. The identification of risk factors for the development of PPD in fathers will allow an early and specific treatment for these men through the utilization of adequate healthcare offers. Finally, genetic and epigenetic risk patterns of PPD to be identified in the exploratory add-on study might serve as future biomarkers for early interventions or even personalized preventive measures in men at risk of PPD.A potential limitation lies in the method of recruitment, which could produce a selection bias in the sample and thus restrict the external validity of the results. A further limitation is that study participants have to self-administer a high number of measurement instruments. This might hinder the feasibility of the trial and reduce the response rate. We have tried to address this issue by naming a contact person from the study team in case of questions, by giving examples on how to answer the questionnaire, and by reducing the questionnaire to relevant aspects. As we will also assess the general health status and other diagnoses such as anxiety, it will be possible to detect some of the potential confounding factors.Our study will provide insights into the issue of PPD in fathers. Currently, there is no study on PPD using a matched control group. Studies conducted to date compared their results with historical control data, which carries the risk of over- or underestimation of the relative frequency of depressive symptoms after childbirth. A simultaneous detection of depressive symptoms, of symptomatology, and of risk factors using the same instruments will enhance the comparability of the results and thus ensure the scientific quality of the concluding statements. Surveying the healthcare situation will provide opportunities for the practice-oriented design of current care and thus information on the development of screening methods and healthcare concepts. Based on the findings of our study, further studies should address the standardization of measurement methods to identify PPD as well as male-specific healthcare interventions in fathers.


Continuous renal replacement therapy (CRRT) is an essential procedure for patients with acute kidney injury in intensive care. It is important to maintain an adequate blood flow rate during CRRT. Several previous studies have reported the relationships between blood flow rate and filter lifespan, or circuit life, in CRRT. Here, we aim at elucidating the incidence and factors associated with a decreased blood flow rate in CRRT.  This is a retrospective observational study. From January 2014 to June 2017, 119 patients who underwent CRRT in the intensive care unit were enrolled. The definition of a decreased blood flow rate included situations in which the medical staff needed to decrease the blood flow volume. We statistically analyzed the association of the decreased blood flow rate with patients' clinical characteristics.  Of 119 patients, 52 required a decreased blood flow rate during CRRT. Almost half of the cases occurred within one day of starting CRRT. None of the clinical factors  score, catheter position, systemic infection, albumin, hemoglobin, and activating coagulation time) were significantly associated with decreased blood flow rate.  A decreased blood flow rate often occurs during CRRT. Clinical factors significantly associated with the occurrence of the decreased blood flow rate were not detected in the current study. Further investigation regarding the occurrence of a decreased blood flow is warranted. In intensive care units, the frequency of acute kidney injury is approximately 30–40% , and conThis is a retrospective observational study that occurred in a single center in Japan. Patients underwent CRRT in the intensive care unit of Nagano Red Cross Hospital from January 2014 to June 2017. The exclusion criteria consisted of patients whose clinical data were not fully obtained or patients younger than 20 years old. The study protocol was approved by the institutional review board of the ethical committee at Nagano Red Cross Hospital and was conducted in accordance with the principles of the Declaration of Helsinki, as revised in 2013. The patients' data were obtained from medical records.After insertion of the vascular access catheter, the position of the catheter tip was checked by X-ray, and we confirmed that the position was appropriate in all cases. The catheter tip was placed at the superior vena cava when the vascular access catheter was inserted in the left or right jugular vein, at the inferior vena cava when it was inserted in the right femoral vein, or at the inferior vena cava or left common iliac vein when it was inserted in the left femoral vein.All patients were treated with continuous venovenous hemodialysis (CVVHD) or continuous venovenous hemodiafiltration (CVVHDF). All CVVHDF procedures were performed using the postdilution protocol. For the setup of CRRT, the blood flow rate at the start of CRRT and the type of anticoagulant were uniform in all patients. The blood flow rate at the start time of CRRT was 100 mL/min, and nafamostat mesylate was used as an anticoagulant in all patients. The amount of the nafamostat mesylate was determined by the clinical physician according to the patient's medical chart and activated coagulation time. Nafamostat mesylate was administered from the CRRT machine before blood entered the hemofilter. The vascular access catheter used in the current study was also uniform for all patients. The clinical physician who inserted the vascular access catheter decided whether to double or triple the lumen catheter. The urokinase-coated temporary vascular access catheter  was used universally in all patients. The size (gauge) of the catheters was 11.5 Fr. The CRRT machines used in this study were the JUN-505 , JUN55X , or AcuFil Multi 55X-II . These machines perform CRRT in a similar manner and require the same blood circuits.A decreased blood flow rate from the vascular access catheter was defined as an adequate blood flow rate that could not be continuously sustained  and/or required intervention by medical staff (changing the connection of the catheter or inserting a new vascular access catheter). We collected data on the decrease in the blood flow rate according to the following situations: the alarm raised due to inadequate blood flow rate continues and the rate does not improve for at least 10 minutes despite the administration of relevant interventions. The decrease in the blood flow rate due to the elevation of transmembrane pressure (TMP) and the arterial or venous side pressure was not considered. These decisions (10% reduction of blood flow rate) were made by medical or nursing staff. Catheter-related bloodstream infections were defined when clinicians diagnosed infections caused by the vascular access catheter whether or not bacteria were detected in blood cultures.n) and frequency (%). Clinical data between two groups of patients were compared, with group 1 being patients' with a decreased blood flow rate in the therapeutic course of CRRT and group 2 being patients' with a preserved blood flow rate. Continuous variables between both groups were compared using the Mann–Whitney U test, and categorical variables were compared using the Fisher exact probability test. Factors considered to be associated with the occurrence of decreased blood flow rate from the vascular access catheter were investigated by performing Cox hazard regression analyses. We performed multivariate analyses of six models composed of the following factors: age, gender, height, sequential organ failure assessment (SOFA) score, serum albumin level, hemoglobin, activated coagulation time, sepsis or severe infectious diseases, heart failure, CVVHDF, and catheter position. In addition, we evaluated the clinicians who inserted the vascular access catheter. A p value of <0.05 was considered to indicate statistical significance. Analyses were performed using EZR , a graphical user interface for R  [Continuous variables are presented as the median and interquartile range. Categorical variables are presented as number (Austria) .The current study included 119 patients. Patients' characteristics are presented in Almost half of the patients died during hospitalization. Age, height, body weight, BMI, SOFA score, hemoglobin, albumin, C-reactive protein levels, and activated coagulation time were not significantly different regardless of whether the patients developed a decrease in the blood flow rate . In addiThe univariate Cox hazard regression analysis indicated that there was no significant association between the development of a decreased blood flow rate from the vascular access catheter and catheter position, age, gender, height, SOFA score, sepsis or severe infectious diseases, heart failure, mode of CRRT (CVVHDF), serum albumin level, hemoglobin level, or activated coagulation time . In addiMultivariate Cox regression analyses demonstrated that there were no significant associations between the occurrence of a decreased blood flow rate and the clinical characteristics of the patient  when adjusted for general confounding factors, such as age, gender, height, and SOFA score .Duration between catheter insertion and the occurrence of a decreased blood flow rate data is presented in The incidence of a decreased blood flow rate was high, at 43.7% in patients who required CRRT, and in most cases developed within one day after the start of CRRT. There were no significant associations between the development of a decreased blood flow from the vascular access catheter and general clinical factors, including catheter position.In regard to catheter-related problems, catheter-related bloodstream infections, complications accompanying the insertion of the central venous catheter, and venous thrombosis have been previously reported , 5. ReceInadequate blood flow rate or decrease in the blood flow rate in CRRT is a noticeable and serious problem. Its incidence may be higher than that considered by us. The reason for the inadequate blood flow rate or decrease in the blood flow rate may be that most medical centers, except for those in Japan, adopted a higher blood flow rate in CRRT. The patients who receive CRRT where the blood flow rate is low are less likely to develop an inadequate flow rate than those who receive CRRT where the blood flow rate is high. In our study, a decrease in the blood flow rate was noted in 43.7% of the patients; therefore, an inadequate blood flow rate is more likely to develop frequently in patients in foreign medical centers than those in centers in Japan.In the clinical setting, a decrease in the blood flow rate in CRRT is an undesirable situation because this may shorten the filter or circuit life and decrease CRRT efficiency and ultrafiltration. Therefore, once the blood flow rate decreases, the vascular access catheter should be ideally reinserted or the central vein in which the vascular access catheter was inserted should be changed. However, for patients with severe physiological conditions often complicated with remarkable thrombocytopenia or coagulation disorder, the insertion of the vascular access catheter is accompanied by the risk of bleeding. Thus, in some cases, the decrease in the blood flow rate may be allowed in clinical settings.This study had several limitations. It was a retrospective observational study, with a small sample size. Although we investigated the clinical factors that were associated with decreased blood flow volume from the vascular access catheter, we could not investigate the position of the tip of the catheter in the central vein. There are several studies that have discussed the optimal positioning of the central venous catheter tip , 20. AltThe size of the inferior vena cava and central venous pressure is an important marker for evaluating the volume status. However, we did not obtain complete data for these parameters. The marker of volume status may be the predictive marker of the occurrence of a decreased blood flow rate. Prospective studies must be conducted to assess this. There was no unified protocol for the evaluation of catheter function . In the present study, identification of catheter function at the time of catheter insertion depended on the physician who inserted the catheter. This may be a limitation of our study.We attempted to obtain the data on the circuit or filter lives of these circuits. However, we could not obtain the complete data. In addition, CRRT was interrupted in some patients because of examinations  or therapeutic interventions . Therefore, it was difficult to evaluate the substantial filter life in CRRT. This was also a limitation of the current retrospective study.Due to the retrospective nature of this study, we cannot clearly define the algorithm for blood flow reduction, and it was challenging to clarify the trigger for the decrease in the blood flow rate. This is a limitation of our study. However, all events (occurrence of a decrease in the blood flow rate) counted were defined as an inadequate blood flow rate from the time of insertion of the vascular access catheter. The decrease in the blood flow rate due to the elevation of transmembrane pressure (TMP) and the arterial or venous side pressure was not considered. In addition, the alarm raised due to inadequate blood flow rate continues and the rate does not improve for at least 10 minutes despite the administration of relevant interventions.For statistical analyses, in order to investigate the factors associated with the occurrence of a decreased blood flow rate, we planned to perform Cox hazard regression analyses after adjusting for four general confounding factors . Finally, as a decrease in the blood flow rate was noted in 52 patients, we could perform the statistical analyses, as planned. We did not completely calculate the required sample size before the commencement of data collection because the current study was a single-center study and the patient number was originally limited. This is a statistical limitation of the study.Almost half of the patients who required CRRT experienced a decreased blood flow rate, and inadequate blood flow rate or decreased blood flow rate in CRRT is a noticeable and serious problem. Although it is useful to predict the occurrence of decreased blood flow from the vascular access catheter in CRRT, factors that could help in this regard could not be uncovered in the current study. In particular, evaluation of volume status using central venous pressure or type of vascular access catheter may be one of the promising factors associated with the occurrence of a decrease in the blood flow rate. Therefore, further investigations and prospective studies on the occurrence of the decreased blood flow rate from the vascular access catheter are warranted.


The role of dietary patterns in the prevention of unipolar depression has been analyzed in several epidemiological studies. The primary aims of this study are to determine the effectiveness of an extra-olive oil-enriched Mediterranean diet in reducing the recurrence of depression and improving the symptoms of this condition.https://predidep.es/participantes/) or by phone. Recurrence of depression is assessed by psychiatrists and clinical psychologists through clinical evaluations . Depressive symptoms are assessed with the Beck Depression Inventory. Information on quality of life, level of physical activity, dietary habits, and blood, urine and stool samples are collected after the subject has agreed to participate in the study and once a year.Multicenter, two-arm, parallel-group clinical trial. Arm 1, extra-virgin olive oil Mediterranean diet; Arm 2, control group without nutritional intervention. Dieticians are in charge of the nutritional intervention and regular contact with the participants. Contacts are made through our web platform  with NCT number: NCT03081065.The study has been prospectively registered in the U.S. National Library of Medicine (The online version of this article (10.1186/s12888-019-2036-4) contains supplementary material, which is available to authorized users. Unipolar depression is one of the leading global causes of disability-adjusted life years (DALYs)  and, in Prevention of depression recurrence is an essential goal in the management of depressive patients. Pharmacological treatment strategies are common to help prevent the risk of recurrence, as well as other alternatives, e.g., psychological interventions, which have shown promising outcomes .Besides pharmacological and psychotherapeutic approaches, other interventions based on lifestyle changes, e.g., diet, physical activity, or alcohol and drug limitations, can be helpful can be helpful as part of the treatment of these patients. A body of research suggests the beneficial role of these factors in the etiopathogenesis of the condition and their potential utility for its management , 5.Over the last years, several epidemiological studies have analyzed the role of dietary patterns, foods, food groups and nutrients, as factors that can help prevent unipolar depression. A recent systematic review and dose-response meta-analysis of prospective studies shows that higher quality diets associate with lower risks of developing depressive symptoms, although the authors believe that this hypothesis has to be further tested with prospective studies and randomized controlled trials . Being aTo our knowledge there are not clinical trials specifically designed to assess the role of a nutritional intervention based on the Mediterranean diet in the prevention of depression recurrence.The primary objective of this study, the PREDI-DEP trial, is to investigate the effectiveness of following an extra-virgin olive oil-enriched Mediterranean diet with the risk of depression recurrence and improvement of residual depressive symptoms in participants with previous episodes of mayor depression. The secondary objectives are to analyze the effect of the Mediterranean nutritional intervention in the quality of life, various biochemical parameters and changes on the microbiota of the participants. We also aim to test the relationship between the nutritional intervention with an extra-virgin olive oil Mediterranean diet with the reduction in the risk of medical and psychiatric comorbidities in patients with a previous diagnosis of unipolar depressive disorder.Multicenter, two-arm, parallel-group clinical trial. One group of patients (arm 1) is assigned to a Mediterranean diet supplemented with extra-virgin olive oil and the second group (control) (arm 2) has no nutritional intervention. The participants are recruited from four centers across Spain: Hospital Dr. Negrín , Clínica Universidad de Navarra (Pamplona), Hospital Universitario (Vitoria), and Clínica Dr. Chiclana (Madrid). The intervention period lasted two years.The inclusion criteria were established after an exhaustive review of the scientific literature and consensus among all participating psychiatric and clinical psychologists. Study subjects are aged ≥18 years, has had a previous major depressive episode within the last five years and are in a stage of total or partial remission within the last six months, based on DSM-5 criteria. One participant who has undergone a single depression episode is included for every three participants who had undergone two or more episodes.Table In a first phase of the selection process, we extract names of potential participants from the clinical records of the hospitals or health centers who are willing to collaborate with the study. Next, the participating psychologists and psychiatrists review the clinical records individually to identify the subjects that comply with the inclusion criteria. The potential participants are contacted by phone or during a clinical visit. When a candidate agrees to participate, a face-to-face interview with the specialist is carried out to exclude participants who do not meet the criteria. Besides the semi-structured clinical interview (Spanish SCID-I) , particiStudy participants are randomly assigned to one of two groups (Mediterranean diet or control) once their data are included in a centralized computer system by the specialists. Various stratification factors are considered for the randomization, sex, age group (< 65 years or ≥ 65 years) and recruitment center. At baseline, psychiatrists and clinical psychologists are blinded to the allocation of the participants, following the CONSORT guidelines for randomized trials to prevent selection biases.Full-time registered dietitians with experience in the PREDIMED trial are responsible for the dietary intervention in the PREDI-DEP study. The PREDIMED trial is a landmark trial of intervention with a Mediterranean diet in participants at high risk of cardiovascular disease , 18. TheParticipants allocated to the Mediterranean diet receive intensive training on Mediterranean diet and supplemental foods Table , as wellAt the beginning of the trial, the dieticians thoroughly explain the reasons to follow a Mediterranean diet to each participant and negotiate changes in his/her diet, working with the subject to determine what he or she considers an attainable goal. The dietician does this every three months by calling the participant over the phone. To assess adherence to the Mediterranean diet and enhance future adherence  is updated monthly with news related to the Mediterranean diet and its health effects. The dieticians take into account any doubt or suggestion made by the participants at any time of the intervention period.The website developed for this study , phone calls, or email. When a participant is not familiarized with these technologies, the dieticians use postal mail to send all the information.The dieticians are in charge of the nutritional interventions (Mediterranean diet), as well as for the regular contact and follow-up of the participants. Contacts are made using current technologies such as our web platform  a general questionnaire; 2) a physical activity questionnaire; 3) a semi-quantitative food frequency questionnaire (FFQ); 3) the 14-Item Mediterranean Diet Adherence Screener (MEDAS), and 4) the Short Form-36 Quality of Life Questionnaire (SF-36).Diet is assessed with a semi-quantitative FFQ validated in Spain . The queChanges in adherence to the Mediterranean diet is assessed through the MEDAS questionnaire at baseline and yearly in the control group and every three months in the Mediterranean diet group.Physical activity is assessed using a validated physical activity questionnaire with seventeen activities . LeisureInformation regarding socioeconomic , anthropometric , life-style , and medical characteristics of the participants, including medication, family history of mental disorders or the use of psychotherapy or relaxation techniques are obtained from the general questionnaire at baseline. This information is updated on a yearly basis using follow-up questionnaires.The clinical evaluations by specialists are limited to yearly follow-up visits that consist of the same examinations performed at baseline. If any suspicion of depression is detected through the Beck depression inventory or the subject him/herself communicates it, the specialist arranges an appointment with the participant. Specialists review the clinical records of participants lost to follow-up in order to assess possible cases of recurrence of depression not reported by the participants or detected by their specialists at follow-up.Depressive symptoms are assessed using the Beck Depression Inventory validated in Spain, which includes 21 questions with four possible answers sorted according to symptom severity .Every four months, the participants complete this questionnaire over the phone with the aid of the dietitians or by themselves through the website. Exceptionally, at the beginning of the study or once a year the inventory is completed in the psychiatrist’s consulting room.Quality of life is assessed at baseline and yearly (over the phone or through the website) with the Spanish version of the SF-36 , a generBlood, urine and stool samples are collected at baseline and yearly during medical visits. EDTA plasma tubes, buffy coat, and serum are collected and aliquots are kept at − 80 °C. All the samples are correctly identified and labeled with an alphanumeric code.Biological compliance markers  will be measured randomly in participants from the two arms of the trial at baseline and at the end of the study.The original sample size calculation indicated that 250 people per group were required (assuming an attrition of 5%) to provide a statistical power of 80% for detecting a relative risk reduction of 30% in the Mediterranean diet group versus the control group for a two-year follow-up period. The assumed recurrence rate was 50% for the control group and 35% for the group assigned to the Mediterranean diet. The relative risk reduction of 30% was slightly lower than the observed in the SUN cohort study. In this latter study, we found a 40% risk reduction of depression comparing extreme quintiles of adherence to the Mediterranean Diet Score  and the A researcher blinded to the conditions of the intervention will carry out the analysis of the data. Intention-to-treat analysis will be done. For each participant we will compute person-years of follow-up from the study inclusion date to the date of recurrence of the depression or study termination, whichever comes first.Log Rank analysis will be used to assess the effect of the intervention on the risk of depression recurrence. If distribution differences of baseline characteristics are detected, the Cox proportional-hazards regression models will be used to check by recruitment center, age group and sex, and adjusting for possible confounding factors . Hazard ratios (HR) and 95% confidence intervals (CI) will be calculated considering the control group as reference.We will also carry out a protocol analysis . CategorChanges in residual depressive symptoms, quality of life or biochemical parameters were evaluated through Generalized Estimating Equation (GEE) models and will be adjusted for possible confounding factors and baseline values of depressive symptoms, quality of life or each biochemical parameter, respectively.P values for the interaction will be calculated using the log-likelihood ratio test.Subgroup and sensitivity analyses will be done under different assumptions. To assess a possible interaction between the intervention and some variables , product terms will be introduced in the multivariable models. Multiple imputation will be employed for handling missing data , 31.Three independent clinical trial experts in Nutrition, Psychiatry and Statistics made up the data monitoring committee (DMC). They will hold an annual meeting to review the implementation of the protocol, monitor trial progress, and recommend the continuation or termination of the study based on safety, outstanding benefit, or futility criteria.https://predidep.es/participantes/), from where authorized investigators and the coordinator of the trial can download forms and datasets. For privacy and security, an ID and password are required to access the data and the forms.A web-based system of data access was created . However, it does not examine the effect of a Mediterranean diet intervention in preventing depression in subjects with overweight and have elevated depressive symptoms, but with no current -or in the last six months- criteria for an episode of major depressive disorder .Therefore, to the best of our knowledge, the PREDI-DEP clinical trial is the first randomized clinical trial designed to assess the role of a MDP in the prevention of recurrent depression. Preventing recurrence of depression is one of the priorities in the management of patients with depression, particularly when the number of relapses is high. Whereas the risk of recurrence is approximately 40–60% in patients with a unique depression episode, this risk raises to 90% in patients with three or more previous episodes , 34. OurAdditional file 1:14-Item Mediterranean Diet Adherence Screener (MEDAS). Description of the MEDAS questionnaire. (DOCX 14 kb)


The paper proposes a sensors platform to control a barrier that is installed for vehicles entrance. This platform is automatized by image-based license plate recognition of the vehicle. However, in situations where standardized license plates are not used, such image-based recognition becomes non-trivial and challenging due to the variations in license plate background, fonts and deformations. The proposed method first detects the approaching vehicle via ultrasonic sensors and, at the same time, captures its image via a camera installed along with the barrier. From this image, the license plate is automatically extracted and further processed to segment the license plate characters. Finally, these characters are recognized with the help of a standard optical character recognition (OCR) pipeline. The evaluation of the proposed system shows an accuracy of 98% for license plates extraction, 96% for character segmentation and 93% for character recognition. The security sensitive areas of a country, such as classified defense areas, government buildings and military installations, are under constant surveillance to avoid potential threats. Such surveillance also extends to the vehicles that constantly access these areas. A vast majority of the currently installed systems use barrier gates that are either manually operated  or use vAn automatic license plate recognition (ALPR) system is instrumental in identifying a vehicle from the image of its LP. As a common rule in various parts of the world, the government issues LPs with fixed aspect ratios, fonts and backgrounds. However, arbitrarily designed LPs is an ever growing problem in countries like Pakistan, where the ALPR becomes a challenging task for a few reasons. First, the position of an LP is not fixed on the front side of the vehicle. Second, there exists a huge variation in the aspect ratios of the LPs. Third, the backgrounds of the LPs vary from on to the other. Finally, variations are also found due to non-uniform font styles and font sizes. Some of these variations are depicted in Image capturing device acquires an image or extract an image from a videoLocalization and extraction of license plate in the acquired imageCharacter segmentation and recognition OCR in the extracted LPA typical ALPR system mainly consists of the following steps ,4:ImageDevelopment of a prototype for barrier access control and then deploying it in a real world scenario.An image dataset of challenging number plates commonly used in Pakistan with variations in background, position on vehicle, fonts and font styles.Development of an algorithm for character extraction and segmentation of LPs having different background, position on vehicle, fonts and font styles.An extensive performance evaluation of classifiers for optical character recognition.A performance evaluation of the proposed system on two different hardware environments to select the one which is favorable for real-time application.The ALPR process begins with LP localization and extraction from the vehicle image. LP localization techniques extract the rectangular bounding box or the text regions directly from the image . WithoutThe rest of this paper is structured as follows: In this section, we briefly introduce the related work about LP Localization in vehicle images, characters segmentation and characters recognition.In an ALPR system, the starting step is LP detection and extraction. If the LP is not properly extracted, then the LP segmentation will be severely affected . As a coCharacter segmentation divides the LP into individual characters and digits. Character segmentation becomes challenging due to multi-color background and foreground of an LP. Tabrizi et al.  proposedOne of the main components of ALPR is the automatic recognition of characters. Chen et al.  proposedR engine  with modR engine  for LP cR engine  proposedR engine  comparedR engine  proposedR engine  proposedVehicle arrival detection and image acquisitionImage pre-processing and edge image generationImage segmentation based on detected edgesLP extraction via the count of connected componentsCharacter segmentation and features calculationOptical character recognitionVehicle authorization and barrier control systemThis section explains the proposed architecture including the main functions from vehicle detection to the barrier control mechanism. These steps are further explained in the following subsections.S is the distance, V is the speed of sound: .034 m/t is the time in In the proposed ALPR method, we convert the captured image into grayscale. It reduces the processing complexity and processing time and is robust to color changes due to different lighting conditions. A canny edge detector is applied to this image to detect all the edges. The Canny edge detector is a combination of a Gaussian filter for smoothing and a Sobel filter for edge detection. Equation  shows thAfter the Gaussian filter, we apply the Sobel masks  to detecOn the generated edge image, we perform various morphological operations such as dilation, horizontal erosion, vertical erosion and hole filling. Dilation adds the pixels to the boundary of edges to complete the boundary and increases the efficiency of LP extraction. Mathematically, Equation  shows thEquation .(6)IholWe use vertical and horizontal erosion to remove those pixels, which makes it difficult to extract the LP. All the unnecessary lines and parts connected to the LP area create problems for the LP extraction. Equation  shows thWe find the 8-connectivity components based rectangular bounding box objects in the eroded image. In addition to the LP, there are other rectangular objects such as headlights, radiators, grille and bumper. Therefore, it is likely that these objects are also segmented along with the LP. Due to this reason, we use the count of connected components in each segment as a clue to differentiate between the LP and other rectangular objects. To this end, for a segment to be considered an LP, the number of objects inside that segment should be more than five. This is due to the fact that the Pakistani LP consists of at least five characters as shown in Once the LP region is extracted, character segmentation is employed to extract the LP characters. For this purpose, as a first step, the LP region is binarized using the algorithm shown in Zoning: It divides the character image into various sub-images. Mathematical it can be calculated by Equation .(8)zoniPerimeter: The set of interior boundary pixels of a connected component (character image (C)) [age (C)) . We consExtent: It is the ratio of white pixels in an image to the total number of pixel in the binary image. Equation sumEccentricity: Finds how close an object is to being a circle. It is ratio of the linear eccentricity to the semi-major axis.Orientation: The major axis of an ellipse around the object and then finding the angle which the major axis made with the x-axis.In this paper, we focus on the features-based approach for character recognition. We extract the following features of a character.In this paper, we evaluated various supervised learning algorithms (classifiers) to recognize characters on the LP. The real-time system for vehicle detection and authorization is implemented on a Raspberry Pi. The ultrasonic sensors interfaced to the Raspberry Pi detect the approaching vehicle on entrance. The LP of this vehicle is then verified using its image. If the vehicle is permitted then the Raspberry Pi sends a command to open the barrier. PC(Intel(R), Core(TM) i3-4010U CPU 1.70GHz,RAM: 4.00GB) running Matlab running Python with OpenCV. The Raspberry Pi-based system had low computational time, a smaller size, and low power consumption, due to which it was used in the real-time application. In future, we are working to increase the dataset of handwritten LP characters to improve accuracy and laser beam-based vehicle detection to increase the detection range.


The different approaches led to a range of estimates. The weighted sum method using worldwide RRs generated the lowest (0.9%) while the adjusted CRA approach using 2013 RRs generated the highest estimate (1.5%). Using European-specific RRs instead of worldwide RRs resulted in higher estimates. Most of the approaches revealed an increasing OAMF over the period 1981 to 2013 especially from 1993 onwards except for the adjusted CRA approach among women. Estimates of OAMF levels and trends differed depending on the method applied. Given the limited available data, we recommend using the weighted-sum method to compare obesity-attributable mortality across European countries over time.The available methodologies to estimate the obesity-attributable mortality fraction (OAMF) affect the levels found and hamper the construction of time series. Our aim was to assess the impact of using different techniques to estimate the levels and the trends in obesity-attributable mortality for The Netherlands between 1981 to 2013. Using Body Mass Index (BMI), all-cause and cause-specific mortality data, and worldwide and European relative risks (RRs), we estimated OAMFs using three all-cause approaches  and one cause-of-death approach . We adjusted the CRA approach to purely capture obesity (BMI ≥ 30 kg/m Over the past three decades, the prevalence of obesity has risen tremendously across the globe  to the pIn quantifying the health burden of obesity at the population level, the population attributable fraction (PAF) is commonly used . The PAF2 . In. In24]. For women, the adjusted CRA approach clearly resulted in different trends compared to the other approaches with a decline over the period 1990 to 2013. Since these differences were not observed for men, the reason for this finding seems to lie less in the methodology that was applied than in the sex-specific data that were used. Since the RRs do not change over time and are fairly similar for men and women see , the treWhen aiming to compare the different methodologies to estimate obesity-attributable mortality and their estimates concerning Europe, data availability is a major restricting factor. Related to this, we chose a practical and rather straightforward evaluation strategy where we compared the methodologies that can practically be applied with the available data and their point estimates.Each available method requires a different level of detail with regard to the RRs . Unfortunately, a dataset providing all the RRs needed is not available. Instead, we, like previous studies, had to rely on RRs from different data sources/meta-analyses for each method , which iIn addition, we chose not to estimate confidence intervals surrounding the RRs. First, due to using secondary data , we do not possess the covariance matrix of the relevant variables. Hence, a formal comparison of levels or trends cannot be made unless untestable assumptions—which will affect the comparisons—are also made . Second,Although we used a fairly simple evaluation approach, it is still the first time that the influence of the chosen method (and the related RRs) on obesity-attributable mortality trends for a European country has been assessed. In doing so, our study provided valuable insights into the pros and cons of the different methods and highlighted as well the urgency for additional data in Europe.We applied methodologies that, based on their data requirements, enabled us to construct time series of the OAMF. We included three all-cause approaches: the partially adjusted method, the weighted sum method, and a combined all-cause method. The partially adjusted method requires the least amount of detailed data. However, because of the scarcity of unadjusted RRs, most studies that have applied this method (including our study) used adjusted RRs instead ,11, whicIn addition, we applied the CRA approach, which we adjusted to estimate the share of mortality due to obesity only. An advantage of the CRA approach is that it has the potential to provide more reliable estimates because it takes more information into account such as information on the obesity-related causes of death. One disadvantage of the CRA approach is that it requires the BMI distribution and data on (detailed) causes of death, which are not readily available for European countries. This issue is especially salient when aiming to study time trends. In addition, the changes in the ICD classification over time  make it Given these considerations, we recommend the use of the weighted sum method for the study of trends in OAMFs for the European context and ideally the provision of confidence intervals. Estimates of both the levels of, and the trends in, obesity-attributable mortality fractions in The Netherlands differed depending on the method applied as well as on the underlying data and the relative risks (RRs) used. Since obesity prevalence is relatively low in The Netherlands, we would expect to find even larger differences for countries with higher obesity prevalence. In quantifying the health burden of obesity at the population level, it is, therefore, essential to compare different methodologies and different RRs. Comparisons of obesity-attributable mortality between countries and over time can only be performed accurately by using the same methodology as well as comparable data and RRs. Since the data that are currently available for Europe are limited, we recommend using the weighted-sum method and European RRs to compare obesity-attributable mortality across European countries and over time.


We propose a video deblurring method by combining motion compensation with spatiotemporal constraint for restoring blurry video caused by camera shake. The proposed method makes effective full use of the spatiotemporal information not only in the blur kernel estimation, but also in the latent sharp frame restoration. Firstly, we estimate a motion vector between the current and the previous blurred frames, and introduce the estimated motion vector for deriving the motion-compensated frame with the previous restored frame. Secondly, we proposed a blur kernel estimation strategy by applying the derived motion-compensated frame to an improved regularization model for improving the quality of the estimated blur kernel and reducing the processing time. Thirdly, we propose a spatiotemporal constraint algorithm that can not only enhance temporal consistency, but also suppress noise and ringing artifacts of the deblurred video through introducing a temporal regularization term. Finally, we extend Fast Total Variation de-convolution (FTVd) for solving the minimization problem of the proposed spatiotemporal constraint energy function. Extensive experiments demonstrate that the proposed method achieve the state-of-the-art results either in subjective vision or objective evaluation. B, k, L and N denote the observed blurry video frame, the blur kernel, the latent sharp frame and additive noise, respectively, and L from B, and the problem can be converted into a blind deconvolution operation while the blur kernel is unknown.The videos captured by hand-hold cameras often suffer from inevitable blur because of camera shake. As it is easy to generate global motion blur when using a tracking shot, and this type of blur widely exists in the field of mobile video surveillance, how to deblur the uniform motion blurred videos is a problem worth studying. In general, a video frame with camera shake can be modeled by a motion blur kernel, which can describes the motion blur of each video frame captured by camera in the assumption that the motion blur of each video frame is shift-invariant. Mathematically, the relationship between an observed blurry video frame and the latent sharp frame can be modeled according as follows:A straightforward idea for this problem is to apply existing single or multiple image deblurring methods to each blurry frame ,13,14,15Considering that more information will be conducive to the deblurring process, some other methods make the deblurring problem more tractable by leveraging additional input and joint multiple blurry images ,18,19,20Because the temporal information of video is ignored and only the spatial prior information of an image is utilized, the performance of both single and multiple image methods is unsatisfactory while applying them to restore videos. The phenomena of artifacts, noise and inconsistencies often can be seen in the restored videos. In order to solve these problems, several video deblurring methods are explored in recent years. Takeda et al.  and ChanOther methods take into account the temporal coherence between video frames in the blur kernel estimation or the latent sharp frame restoration ,31,32,33In order to solve the above-mentioned problems, we proposed a removing camera shake method for restoring the blurred videos with no sharp frames. In the proposed method, except for the spatial information, we also make full use of the temporal information for both blur kernel estimation and latent sharp frame restoration considering that the temporal information between neighboring frames can accelerate the precise estimation of blur kernel, suppress the ringing artifacts and maintain the temporal consistency of restoration. We derive a motion-compensated frame by performing motion estimation and compensation on two adjacent frames. The derived motion-compensated frame has sharp edges and little noise because it is a predictor of current sharp frame. Therefore, we apply it to a regularization model after processed for efficiently getting an accurate blur kernel. Our improved blur kernel estimation method can improve more effective restored quality than the method proposed by Lee et al.  in avoid(1)We propose a blur kernel estimation strategy by applying the derived motion-compensated frame to an improved regularization model for enhancing the quality of the estimated blur kernel and reducing the processing time.(2)We propose a spatiotemporal constraint algorithm that introduces a temporal regularization term for obtaining latent sharp frame.(3)We extend the computationally efficient FTVd for solving the minimization problem of the proposed spatiotemporal constraint energy function.The contributions of this paper can be summarized as follows:The rest of this paper is organized as follows: t-th observed blurry frame B could be related to the latent sharp frame L as:x, y) and t are the coordinate in space and time, respectively. Given a blurry video, as illustrated in L from the blurry frame B. Here, we focus on the uniform blur caused by camera motion, so the blur kernel is assumed to be shift-invariant. However, the blur kernel may be different from each other along the time direction, i.e., the blur kernel is spatially-invariant, meanwhile, may be temporally variant.According to model (1), the n-th blurry frame in a video, our method consists of three steps and the outline of the proposed method is shown in A detailed description of the proposed video deblurring method is given in this section. Because there may be no sharp frame in the video, we employ a frame grouping strategy for deblurring the video. The first frame of each group is restored by a single image deblurring method, and the remaining frames of the group can be deblurred by the proposed video deblurring method with the first restored frame. For deblurring the nB−1 and nB, and derive the motion-compensated frame nI by performing motion compensation on the previous restored frame nL−1. In the second step, we estimate the accurate blur kernel by the regularization algorithm with the current blurry frame nB and the preprocessed motion-compensated frame PI. In the third step, we obtain the deblurred frame nL by using the spatiotemporal constraint algorithm with the blur kernel k from the second step and the motion-compensated frame nI from the first step. The deblurred frame nL in the third step will be used as one of input for estimating the motion compensation and the motion-compensated frame in the next loop.As shown in The pseudocode of the proposed video deblurring method is summarized as follows (Algorithm 1):Algorithm 1: Overview of the proposed video deblurring method.Input: The blurry video.Divide the video into M groups that have N frames in a group. Set the group ordinal of the video m = 1 and the frame ordinal of this group n = 2.Repeat Repeat(1)L1 of this group by utilizing an image deblurring method.Obtain the first deblurred frame (2)nB−1 and nB, and using it to derive the motion-compensated frame nI from the previous deblurred frame nL−1.Perform motion estimation algorithm to get the motion vector between the blurry frames (3)PI by preprocessing nI, and then estimate the blur kernel k with PI and nB by the regularization method.Obtain the preprocessing motion-compensated frame (4)nL by the spatiotemporal constraint algorithm with k and nI.Estimate the deblurred frame (5)n ← n + 1. Untiln > Nm ← m + 1Untilm > MOutput: The deblurred video.n-th blurry frame nB, for example. Because the accuracy of the motion-compensated frame nI affects the overall performance of our method, an accurate motion vector between the current and the previous blurry frames is needed. In this paper, for generating a sufficient correct motion-compensated frame nI, according to whether the blur kernel is temporally invariant, we introduce two different matching methods that are block matching method and feature extraction method respectively.We first estimate the motion-compensated frame by the motion vector of the blurry frame and the previous frame for obtaining the blur kernel. We still take the w × w and the searched area is constrained up to p pixels on all four sides of the corresponding macro block in the previous frame as shown in w = 16 and p = 7 as a default.The block matching method divides the current blurry frame into a matrix of macro block and then searches the corresponding block with the same content in the previous blurry frame. The macro block size is As for temporally variant blur kernels, video frames are deblurred with the blur kernels that have different sizes and directions. Consequently, we introduce a feature extraction method to track the feature points across the adjacent blurry frames due to it is robust to image blur and noise. As the Oriented Fast and Rotated BRIEF (ORB) method  is much nB−1 and nB, the motion-compensated frame nI, i.e., the initial estimation of the current sharp frame can be derived by performing motion compensation on the previous deblurred frame nL−1, which is estimated in the previous loop. It should be noted that the first deblurred frame L1 of each group can be achieved by an image deblurring method.After obtaining the motion vector between the adjacent blurry frames B is the current blurry frame, namely, nB, I is the latent sharp frame, and α is a weight for the regularization term We estimate the blur kernel by edge information after obtained the motion-compensated frame. Cho and Lee  estimateI has to be obtained firstly through the prior information of the current frame. Considering that it takes a great deal of time if a coarse-to-fine scheme or an alternating iterative optimization scheme is employed, Cho and Lee used a simple de-convolution method to estimate the latent sharp frame I and formulated the optimization function using image derivatives rather than pixel values to accelerate the blur kernel estimation. However, the method needs to estimate the latent sharp frame without the inter-frame information of the video, and the estimated one is of enough sharp edges.In energy function (3), the blurry frame is used to estimate the blur kernel, the latent sharp frame nI to the data term of (3) for nI is pretty close to the current latent sharp frame. However, there may exist error of nI, and as illustrated in , respectively, where mu is set to the experience value 120 and n is the ordinal of the frame in a group. The penalty parameter γ is set to β2/mu, where β2 is set to the experience values 100.In order to demonstrate the effectiveness of the proposed method, some artificially and naturally uniform blurred videos are implemented to make a series of experiments. We also perform comparison with the several representative image and video deblurring methods, such as Shan’s method , Cho’s mstockholm and shield are quite similar and undergo translational motion and that which captures the video old town cross has depth variance motion. The videos city and tu berlin include both translational and rotation motion, but the former has more details. The video mobile & calendar is a dynamic scene, whose blur is caused by the camera with depth variance motion and the objects with complex motion. The above videos are artificially blurred by the different methods with the blur kernels as shown in For verifying the effectiveness of the proposed method when restoring artificially blurred videos, we perform comparative experiments on six grayscale videos with several motion types and the results are shown in We first consider the class of temporally invariant blur, which assumes that the blur kernels are identical for all frames. Thus, the exhaustive search block matching method is utilized for motion estimation. The artificially blurred videos are generated by the same linear blur kernel convolute the all frames of a video. We test the proposed method on three sample videos with the different linear blur kernels in For illustrating the accuracy of the improved blur kernel estimation method, the blur kernels of stockholm and tu berlin. In video mobile & calendar, the accuracy of our method is similar to method [The blur kernels by our method have the least errors in videos o method . Table 2o method  also is o method .The six videos in shields and city randomly. Then, these frames are blurred with the blur kernels in shields and city. From Method  uses a sshield and the random blur kernels, such as The proposed method can be used to remove temporally variant motion blur as shown in book which are captured by a SONY HDR-PJ510E hand-held camera with translation motion in the horizontal direction and slight camera rotation. The original color videos are transformed into grayscale. In addition to some artificially blurred videos, we also apply the proposed method to naturally blurry videos to further demonstrate the effectiveness of our method. book by the different methods. book, such as the frame in books and bridge provided by Cho et al. [books and bridge which have uniform motion blur are chosen to make the comparison experiments. Our method is compared not only with the previous uniform image and video deblurring methods, but also with the patch-based method [The widely used videos o et al.  are usedd method  and the d method . The expIn For objectively evaluating the accuracy of the proposed video deblurring method on naturally blurry video, a no-reference sharpness metric base on the local gradients distribution to quantify the blur amount  is used book, books and bridge by different methods. From mobile & calendar are artificially blurred with the blur kernel shown in Effects of the restored first frame and the motion-compensated frame on the final restored results are evaluated in objective evaluation and subjective vision respectively. In order to illustrate the effect of the restored first frame on the final restored results, the randomly adjacent frames of the video stockholm and mobile & calendar, respectively. For the temporal-invariant blur, the blur kernels used for degradation are linear motion blurs, such as To illustrate the influence of the motion-compensated frame on the final restored result, we execute the experiments on the static and dynamic scene videos In this paper, we proposed a video deblurring method by combining motion compensation with spatiotemporal constraint. A blur kernel estimation strategy is proposed by applying the derived motion-compensated frame to an improved regularization model for enhancing the quality of the estimated blur kernel and reducing the processing time. We also proposed a spatiotemporal constraint algorithm which introduces a temporal regularization term for obtaining the latent sharp frame. We extend FTVd for solving the minimization problem of the proposed spatiotemporal constraint energy function. Because it makes effective use of the relationship between the current frame and the motion-compensated frames, our method can more accurately estimate the blur kernel without expensive computation, and more effectively suppress the ringing artifacts and maintain the spatiotemporal consistencies of the deblurred video.The artificially and naturally experimental results illustrated that no matter whether the blur kernel is temporally variant or not, our method could effectively restore the latent sharp frame with details and without noticeable artifacts. Moreover, the quantitative comparison results on a publicly available datasets demonstrated that the proposed method surpass the state-of-the-art methods.


This paper presents a data-driven approach that leverages reinforcement learning to manage the optimal energy consumption of a smart home with a rooftop solar photovoltaic system, energy storage system, and smart home appliances. Compared to existing model-based optimization methods for home energy management systems, the novelty of the proposed approach is as follows: (1) a model-free Q-learning method is applied to energy consumption scheduling for an individual controllable home appliance (air conditioner or washing machine), as well as the energy storage system charging and discharging, and (2) the prediction of the indoor temperature using an artificial neural network assists the proposed Q-learning algorithm in learning the relationship between the indoor temperature and energy consumption of the air conditioner accurately. The proposed Q-learning home energy management algorithm, integrated with the artificial neural network model, reduces the consumer electricity bill within the preferred comfort level (such as the indoor temperature) and the appliance operation characteristics. The simulations illustrate a single home with a solar photovoltaic system, an air conditioner, a washing machine, and an energy storage system with the time-of-use pricing. The results show that the relative electricity bill reduction of the proposed algorithm over the existing optimization approach is 14%. With the advent of the Internet of Things (IoT) technology, smart sensors, and advanced communication and control methods in electric energy systems, increasing amounts of electric energy-related data are being produced and utilized for the reliable and efficient operation of electric energy system. Machine learning (ML) is a core technology for handling such big data effectively, and various ML-based applications are currently under development for the prediction of solar photovoltaic (PV) generation, load forecasting, energy control and cost optimization, peak load management, and the design of dynamic energy pricing using various ML models, such as the artificial neural network (ANN), support vector machine, and deep learning . This stOwing to the increasing home energy consumption  along wiThe HEMS is a key solution for residential energy management in future smart grids. The HEMS has two major functions: (1) monitoring the real-time energy use of consumers using smart meters and smart plugs, and (2) scheduling the optimal energy consumption of home appliances to reduce consumer electricity bills in their comfortable and preferred environments. A traditional core technology in HEMSs is the optimization method for economic load reduction and load shifting. In general, the HEMS algorithm is formulated as an optimization problem, in which the objective functions (consumer electricity bill and discomfort cost) are minimized while satisfying the equality and inequality constraints .We present an RL-based HEMS model that manages the optimal energy consumption of a smart home with a rooftop PV system, ESS, and smart home appliances. In the HEMS model, the Q-learning method is applied to the energy consumption scheduling of different home appliances , whereby the agent of each appliance determines the optimal policy independently to reduce its own electric cost within the consumer comfort level and the appliance operation characteristics. Furthermore, we propose an ANN model to learn the relationship between the indoor temperature and energy consumption of the air conditioner more accurately, which is integrated into the Q-learning module to achieve improved performance of the air conditioner agent.The simulation results confirm that the proposed RL method with the ANN can successfully reduce both the consumer electricity bill and dissatisfaction cost . Moreover, we compare the performance of the proposed RL-based HEMS algorithm to that of the conventional mixed-integer linear programming (MILP)-based HEMS algorithm, and verify that the proposed approach can achieve greater energy savings than the conventional approach under various penalty parameter settings in the reward function of the appliance agent.Compared to the existing model-based HEMS optimization approaches, we propose a HEMS algorithm using a model-free reinforcement learning (RL). The remainder of this paper is organized as follows. Over the past decade, various studies have been conducted on the HEMS optimization formulation in different types of optimization models and performance assessment ,14,15,16echnique , load scechnique ,9,10, LPechnique , the natechnique , robust echnique  and the echnique . Previouechnique . In addiechnique .In recent years, compared to the aforementioned model-based HEMS optimization approaches, data-driven approaches using ML methods have gained popularity owing to their more efficient residential energy management because the existing model-based approach is limited to deterministic decision-making under an uncertain environment and approximated energy system models, thereby leading to undesired energy consumption scheduling. In , an operMore recently, reinforcement learning (RL), also known as the model-free control approach, has received attention as a promising ML method for electric energy management. A pioneering work in RL-based energy management is Google DeepMind, which was developed using the RL method and has been proved to decrease the electricity bill by cooling the data center by approximately 40%. Deep RL (DRL)  was applied to the control of HVAC in a building to reduce the energy cost while maintaining a comfortable consumer level in terms of the indoor temperature , as wellAlthough extensive research has been conducted on residential energy management using the RL method, to the best of the authors’ knowledge, no study has proposed an energy consumption scheduling algorithm yet considering the operation of various home appliances, including the ESS, and the consumer comfort level simultaneously. Previous studies have been limited to the energy consumption scheduling problem for controlling only the HVAC ,28 or onControllable appliance  tariff:A general HEMS algorithm that determines the optimal operating schedule of household appliances and DERs is formulated as an MILP optimization problem, consisting of the objective function and constraints as follows:The objective function  for the t. Furthermore, In Equation , J1EtnetEquation  is the cEquation  is decomt (For a reducible appliance Equation  is the cEquations –(9) ensuEquation , (ii) fot in terms of the SOE at the previous time Equation  illustraFinally, the MINLP-based HEMS optimization problem above can be converted into an MILP optimization problem by means of the linearization of the nonlinear objective function RL is one of the main ML techniques for optimal decision-making in a non-deterministic environment. As illustrated in t and updates the Q-value towards the maximum total rewards using the following Bellman equation:Q-learning is one of the representative RL techniques for determining the optimal policy In Equation , based ot, t, and the element  in the Q-value table associated with the selected pair of state and action is updated using the following Bellman equation:Whenever the Q-value In Equation , θ∈Equation , the Q-vIn this study, the aforementioned Q-learning method is applied to an individual appliance  to calculate the optimal operation schedule of appliances in a smart home with a PV system and an ESS, which consequently results in the reduction of the consumer electricity bill within the consumer preferred appliance scheduling and comfort level. A detailed illustration of the state, action, and reward for the proposed Q-learning approach is provided in the following three subsections.t.We consider the situation in which the proposed Q-learning algorithm is executed for 24 h with a 1 h scheduling resolution. For The optimal action for each appliance depends on the environment of the agent, including the present state, as defined in In Equation , the WM The reward function for each appliance agent is formulated as the sum of the negative electric cost and negative dissatisfaction cost associated with the consumer preferred comfort and appliance operation characteristics. The comprehensive reward In Equation , the thrFirstly, the reward function for the WM agent is expressed asThe reward function for the AC agent is defined asFinally, the reward function for the ESS agent consists of a negative electric cost and negative energy underutilization cost, as follows:In this study, we consider the situation in which the HEMS schedules the AC energy consumption based on the indoor and outdoor temperature with the consumer preferred thermal conditions. Traditionally, the HEMS calculates the current indoor temperature using an approximated equation  model Equation  in Sectif that illustrates the relationship between the indoor temperature and AC energy consumption, as follows:In the proposed ANN model, the AC agent learns the extent to which the AC energy consumption affects the current indoor temperature, which implies the estimation of the function As illustrated in function . Moreovefunction  is emploThe temperature prediction function approximated by the proposed ANN is fed into the Q-learning module for the AC agent, as illustrated in Finally, the HEMS with the PV system, ESS, and home appliances learn the energy management policies that optimize the electricity bill and consumer comfort level using Algorithm 1. The HEMS receives the hour-ahead indoor temperature, consumer preferred indoor temperature range, predicted outdoor temperature, and AC energy consumption , and an ESS that can be controlled by the HEMS under the TOU tariff, as illustrated in In this subsection, we present the simulation of the algorithm for the proposed RL-based HEMS, and verify the energy consumption schedule of the controllable appliances and ESS charging/discharging schedule. In the Q-learning process for the AC agent, a higher penalty t given an outdoor temperature In this subsection, we investigate the effects of the different penalties In this subsection, we study the effect of the indoor temperature prediction using the ANN model proposed in Equation ) for theIn this subsection, we compare the performance of the proposed RL-based HEMS algorithm with that of the MILP-based HEMS algorithm. p represents a parameter including the preferred operating time interval of the WM, ESS capacity, and penalty for the consumers preferred indoor thermal conditions associated with the AC operation. It can be observed from these figures that the RL method could achieve greater energy savings than the MILP model under the situation with varying parameters.The results from Finally, In this study, the proposed HEMS algorithm is executed under the TOU pricing tariff. However, in electric power system operations, there is another pricing tariff such as real-time pricing (RTP). RTP, namely locational marginal pricing, is the core variable to conduct the congestion management in the wholesale and retail electricity markets ,37. ReceRecent studies have investigated the joint optimization of electric vehicle (EV) and home energy consumption scheduling . HoweverA lifetime of the residential ESS is an important constraint for the HEMS problem, and it is expressed as the SOE range in terms of the number of the limited charging and discharging cycles of ESS . A key pWe have proposed a machine learning-based smart home energy management algorithm using reinforcement learning and an artificial neural network. The proposed algorithm can minimize the electricity bill through the energy consumption scheduling of two controllable home appliances (an air conditioner and a washing machine) and the charging and discharging of the energy storage system, while maintaining the consumer comfort level and appliance operation characteristics. In the proposed Q-learning framework, the agents for a washing machine, an air conditioner, and an energy storage system independently learn their actions through the interaction of an environment until they maximize the total cumulative rewards received from the environment. The washing machine agent schedules the energy consumption of the washing machine within the consumer preferred operation period. The energy storage system agent calculates the charging and discharging energy while preventing the overcharging and undercharging of the energy storage system. In the indoor temperature prediction model constructed by an artificial neural network, the air conditioner agent performs the scheduling for the energy consumption of the air conditioner while satisfying the consumer preferred indoor temperature. The performance of the proposed algorithm was validated in the simulation study, and the results confirm the economical advantages of the proposed approach compared to the existing optimization approach using mixed-integer linear programming.In future work, we plan to develop a multi-agent reinforcement learning algorithm that schedules the energy consumption of multiple smart homes with distributed energy resources and smart home appliances. A key challenge lies in how to design the efficient communication scheme between multiple smart homes for achieving the energy savings and maintaining the consumer comfort level. In addition, the practical implementation of the developed algorithm should be tested in large-scale realistic electric power networks. Last but not least, we plan to integrate advanced neural network models such as recurrent neural networks and long short-term memory in the proposed framework to improve the prediction accuracy of the indoor temperature.