The Association of Skin-Intrinsic Fluorescence With Type 1 Diabetes Complications in the DCCT/EDIC Study

OBJECTIVESTo determine whether skin-intrinsic fluorescence (SIF) is associated with long-term complications of type 1 diabetes (T1D) and, if so, whether it is independent of chronic glycemic exposure and previous intensive therapy.RESEARCH DESIGN AND METHODSWe studied 1,185 (92%) of 1,289 active Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) participants from 2010 to 2011. SIF was determined using a fluorescence spectrometer and related cross-sectionally to recently determined measures of retinopathy (stereo fundus photography), cardiac autonomic neuropathy (CAN; R-R interval), confirmed clinical neuropathy, nephropathy (albumin excretion rate [AER]), and coronary artery calcification (CAC).RESULTSOverall, moderately strong associations were seen with all complications, before adjustment for mean HbA1c over time, which rendered these associations nonsignificant with the exception of sustained AER >30 mg/24 h and CAC, which were largely unaffected by adjustment. However, when examined within the former DCCT treatment group, associations were generally weaker in the intensive group and nonsignificant after adjustment, while in the conventional group, associations remained significant for CAN, sustained AER >30 mg/24 h, and CAC even after mean HbA1c adjustment.CONCLUSIONSSIF is associated with T1D complications in DCCT\EDIC. Much of this association appears to be related to historical glycemic exposure, particularly in the previously intensively treated participants, in whom adjustment for HbA1c eliminates statistical significance.

Non-pharmacological interventions for cognitive impairment due to systemic cancer treatment (Review)

Background

It is estimated that up to 75% of cancer survivors may experience cognitive impairment as a result of cancer treatment and given the increasing size of the cancer survivor population, the number of affected people is set to rise considerably in coming years. There is a need, therefore, to identify effective, non-pharmacological interventions for maintaining cognitive function or ameliorating cognitive impairment among people with a previous cancer diagnosis.
Objectives

To evaluate the cognitive effects, non-cognitive effects, duration and safety of non-pharmacological interventions among cancer patients targeted at maintaining cognitive function or ameliorating cognitive impairment as a result of cancer or receipt of systemic cancer treatment (i.e. chemotherapy or hormonal therapies in isolation or combination with other treatments).
Search methods

We searched the Cochrane Centre Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PUBMED, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PsycINFO databases. We also searched registries of ongoing trials and grey literature including theses, dissertations and conference proceedings. Searches were conducted for articles published from 1980 to 29 September 2015.
Selection criteria

Randomised controlled trials (RCTs) of non-pharmacological interventions to improve cognitive impairment or to maintain cognitive functioning among survivors of adult-onset cancers who have completed systemic cancer therapy (in isolation or combination with other treatments) were eligible. Studies among individuals continuing to receive hormonal therapy were included. We excluded interventions targeted at cancer survivors with central nervous system (CNS) tumours or metastases, non-melanoma skin cancer or those who had received cranial radiation or, were from nursing or care home settings. Language restrictions were not applied.
Data collection and analysis

Author pairs independently screened, selected, extracted data and rated the risk of bias of studies. We were unable to conduct planned meta-analyses due to heterogeneity in the type of interventions and outcomes, with the exception of compensatory strategy training interventions for which we pooled data for mental and physical well-being outcomes. We report a narrative synthesis of intervention effectiveness for other outcomes.
Main results

Five RCTs describing six interventions (comprising a total of 235 participants) met the eligibility criteria for the review. Two trials of computer-assisted cognitive training interventions (n = 100), two of compensatory strategy training interventions (n = 95), one of meditation (n = 47) and one of physical activity intervention (n = 19) were identified. Each study focused on breast cancer survivors. All five studies were rated as having a high risk of bias. Data for our primary outcome of interest, cognitive function were not amenable to being pooled statistically. Cognitive training demonstrated beneficial effects on objectively assessed cognitive function (including processing speed, executive functions, cognitive flexibility, language, delayed- and immediate- memory), subjectively reported cognitive function and mental well-being. Compensatory strategy training demonstrated improvements on objectively assessed delayed-, immediate- and verbal-memory, self-reported cognitive function and spiritual quality of life (QoL). The meta-analyses of two RCTs (95 participants) did not show a beneficial effect from compensatory strategy training on physical well-being immediately (standardised mean difference (SMD) 0.12, 95% confidence interval (CI) -0.59 to 0.83; I2= 67%) or two months post-intervention (SMD - 0.21, 95% CI -0.89 to 0.47; I2 = 63%) or on mental well-being two months post-intervention (SMD -0.38, 95% CI -1.10 to 0.34; I2 = 67%). Lower mental well-being immediately post-intervention appeared to be observed in patients who received compensatory strategy training compared to wait-list controls (SMD -0.57, 95% CI -0.98 to -0.16; I2 = 0%). We assessed the assembled studies using GRADE for physical and mental health outcomes and this evidence was rated to be low quality and, therefore findings should be interpreted with caution. Evidence for physical activity and meditation interventions on cognitive outcomes is unclear.
Authors' conclusions

Overall, the, albeit low-quality evidence may be interpreted to suggest that non-pharmacological interventions may have the potential to reduce the risk of, or ameliorate, cognitive impairment following systemic cancer treatment. Larger, multi-site studies including an appropriate, active attentional control group, as well as consideration of functional outcomes (e.g. activities of daily living) are required in order to come to firmer conclusions about the benefits or otherwise of this intervention approach. There is also a need to conduct research into cognitive impairment among cancer patient groups other than women with breast cancer.

The control of wave energy converters using active bipolar damping

A novel method for controlling wave energy converters using active bipolar damping is described and compared with current control methods. The performance of active bipolar damping is modelled numerically for two distinct types of wave energy converter and it is found that in both cases the power capture can be significantly increased relative to optimal linear damping. It is shown that this is because active bipolar damping has the potential for providing a quasi-spring or quasi-inertia, which improves the wave energy converter's tuning and amplitude of motion, resulting in the increase in power capture observed. The practical implementation of active bipolar damping is also discussed. It is noted that active bipolar damping does not require a reactive energy store and thereby reduces the cost and eliminates losses due to the cycling of reactive energy. It is also noted that active bipolar damping could be implemented using a single constant pressure double-acting hydraulic cylinder and so potentially represents a simple, efficient, robust and economic solution to the control of wave energy converters.

Tight junctional abnormality in multiple sclerosis white matter affects all calibres of vessel and is associated with blood-brain barrier leakage and active demyelination

Blood-brain barrier (BBB) hyperpermeability in multiple sclerosis (MS) is associated with lesion pathogenesis and has been linked to pathology in microvascular tight junctions (TJs). This study quantifies the uneven distribution of TJ pathology and its association with BBB leakage. Frozen sections from plaque and normal-appearing white matter (NAWM) in 14 cases were studied together with white matter from six neurological and five normal controls. Using single and double immunofluorescence and confocal microscopy, the TJ-associated protein zonula occludens-1 (ZO-1) was examined across lesion types and tissue categories, and in relation to fibrinogen leakage. Confocal image data sets were analysed for 2198 MS and 1062 control vessels. Significant differences in the incidence of TJ abnormalities were detected between the different lesion types in MS and between MS and control white matter. These were frequent in oil-red O (ORO)+ active plaques, affecting 42% of vessel segments, but less frequent in ORO- inactive plaques (23%), NAWM (13%), and normal (3.7%) and neurological controls (8%). A similar pattern was found irrespective of the vessel size, supporting a causal role for diffusible inflammatory mediators. In both NAWM and inactive lesions, dual labelling showed that vessels with the most TJ abnormality also showed most fibrinogen leakage. This was even more pronounced in active lesions, where 41% of vessels in the highest grade for TJ alteration showed severe leakage. It is concluded that disruption of TJs in MS, affecting both paracellular and transcellular paths, contributes to BBB leakage. TJ abnormality and BBB leakage in inactive lesions suggests either failure of TJ repair or a continuing pathological process. In NAWM, it suggests either pre-lesional change or secondary damage. Clinically inapparent TJ pathology has prognostic implications and should be considered when planning disease-modifying therapy

Damping torque analysis for DC bus implemented damping control

Damping torque analysis is a well-developed technique for understanding and studying power system oscillations. This paper presents the applications of damping torque analysis for DC bus implemented damping control in power transmission networks in two examples. The first example is the investigation of damping effect of shunt VSC (Voltage Source Converter) based FACTS voltage control, i.e., STATCOM (Static Synchronous Compensator) voltage control. It is shown in the paper that STATCOM voltage control mainly contributes synchronous torque and hence has little effect on the damping of power system oscillations. The second example is the damping control implemented by a Battery Energy Storage System (BESS) installed in a power system. Damping torque analysis reveals that when BESS damping control is realized by regulating exchange of active and reactive power between the BESS and power system respectively, BESS damping control exhibits different properties. It is concluded by damping torque analysis that BESS damping control implemented by regulating active power is better with less interaction with BESS voltage control and more robust to variations of power system operating conditions. In the paper, all analytical conclusions obtained are demonstrated by simulation results of example power systems.

Robustness of Damping Control Implemented by Energy Storage Systems Installed in Power Systems

An energy storage system (ESS) installed in a power system can effectively damp power system oscillations through controlling exchange of either active or reactive power between the ESS and power system. This paper investigates the robustness of damping control implemented by the ESS to the variations of power system operating conditions. It proposes a new analytical method based on the well-known equal-area criterion and small-signal stability analysis. By using the proposed method, it is concluded in the paper that damping control implemented by the ESS through controlling its active power exchange with the power system is robust to the changes of power system operating conditions. While if the ESS damping control is realized by controlling its reactive power exchange with the power system, effectiveness of damping control changes with variations of power system operating condition. In the paper, an example power system installed with a battery ESS (BESS) is presented. Simulation results confirm the analytical conclusions made in the paper about the robustness of ESS damping control. Laboratory experiment of a physical power system installed with a 35kJ/7kW SMES (Superconducting Magnetic Energy Storage) was carried out to evaluate theoretical study. Results are given in the paper, which demonstrate that effectiveness of SMES damping control realized through regulating active power is robust to changes of load conditions of the physical power system.

Neural network controlled three-phase four-wire shunt active powerfilter

A three-phase four-wire shunt active power filter for harmonic mitigation and reactive power compensation in power systems supplying nonlinear loads is presented. Three adaptive linear neurons are used to tackle the desired three-phase filter current templates. Another feedforward three-layer neural network is adopted to control the output filter compensating currents online. This is accomplished by producing the appropriate switching patterns of the converter's legs IGBTs. Adequate tracking of the filter current references is obtained by this method. The active filter injects the current required to compensate for the harmonic and reactive components of the line currents, Simulation results of the proposed active filter indicate a remarkable improvement in the source current waveforms. This is reflected in the enhancement of the unified power quality index defined. Also, the filter has exhibited quite a high dynamic response for step variations in the load current, assuring its potential for real-time applications

Salt-bridge dynamics control substrate-induced conformational change in the membrane transporter GlpT.

Active transport of substrates across cytoplasmic membranes is of great physiological, medical and pharmaceutical importance. The glycerol-3-phosphate (G3P) transporter (GlpT) of the E. coli inner membrane is a secondary active antiporter from the ubiquitous major facilitator superfamily that couples the import of G3P to the efflux of inorganic phosphate (Pi) down its concentration gradient. Integrating information from a novel combination of structural, molecular dynamics simulations and biochemical studies, we identify the residues involved directly in binding of substrate to the inward-facing conformation of GlpT, thus defining the structural basis for the substrate-specificity of this transporter. The substrate binding mechanism involves protonation of a histidine residue at the binding site. Furthermore, our data suggest that the formation and breaking of inter- and intradomain salt bridges control the conformational change of the transporter that accompanies substrate translocation across the membrane. The mechanism we propose may be a paradigm for organophosphate:phosphate antiporters.

Vasoactivity of AG014699, a clinically active small molecule inhibitor of poly(ADP-ribose) polymerase: a contributory factor to chemopotentiation in vivo?

Purpose: Poly(ADP-ribose) polymerase (PARP) plays an important role in DNA repair, and PARP inhibitors can enhance the activity of DNA-damaging agents in vitro and in vivo. AG014699 is a potent PARP inhibitor in phase II clinical development. However, the range of therapeutics with which AG014699 could interact via a DNA-repair based mechanism is limited. We aimed to investigate a novel, vascular-based activity of AG014699, underlying in vivo chemosensitization, which could widen its clinical application.

Experimental Design: Temozolomide response was analyzed in vitro and in vivo. Vessel dynamics were monitored using “mismatch” following the administration of perfusion markers and real-time analysis of fluorescently labeled albumin uptake in to tumors established in dorsal window chambers. Further mechanistic investigations used ex vivo assays of vascular smooth muscle relaxation, gut motility, and myosin light chain kinase (MLCK) inhibition.

Results: AG014699 failed to sensitize SW620 cells to temozolomide in vitro but induced pronounced enhancement in vivo. AG014699 (1 mg/kg) improved tumor perfusion comparably with the control agents nicotinamide (1 g/kg) and AG14361 (forerunner to AG014699; 10 mg/kg). AG014699 and AG14361 relaxed preconstricted vascular smooth muscle more potently than the standard agent, hydralazine, with no impact on gut motility. AG014699 inhibited MLCK at concentrations that relaxed isolated arteries, whereas AG14361 had no effect.

Conclusion: Increased vessel perfusion elicited by AG014699 could increase tumor drug accumulation and therapeutic response. Vasoactive concentrations of AG014699 do not cause detrimental side effects to gut motility and may increase the range of therapeutics with which AG014699 could be combined with for clinical benefit.

Thermochemistry of Ionic Liquid-Catalyzed Reactions: Theoretical and Experimental Study of the Beckmann Rearrangement-Kinetic or Thermodynamic Control?

A thermodynamic analysis of the experimental conditions of the Beckmann rearrangement reaction of oximes into amides has been undertaken to examine whether the reaction is under thermodynamic or kinetic control. To answer this question, the thermodynamic properties of the typical Beckmann rearrangement reactions in the ideal gaseous state-cyclohexanone oxime to caprolactam and 2-butanone oxime to N-methylpropanarnide-were studied by using the quantum mechanical method. Gibbs energy and equilibrium constants of the Beckmann rearrangement have been assessed in the gaseous and the liquid phases. Results of the thermodynamic analysis have shown that Beckmann rearrange ments are kinetically controlled. Thus, a search for possible active ionic liquid based catalysts for the mild reaction conditions has been performed.

Coordinated control of DFIG’s rotor and grid side converters during network unbalance

This paper proposes a coordinated control of the rotor and grid side converters (RSC & GSC) of doubly-fed induction generator (DFIG) based wind generation systems under unbalanced voltage conditions. System behaviors and operations of the RSC and GSC under unbalanced voltage are illustrated. To provide enhanced operation, the RSC is controlled to eliminate the torque oscillations at double supply frequency under unbalanced stator supply. The oscillation of the stator output active power is then cancelled by the active power output from the GSC, to ensure constant active power output from the overall DFIG generation system. To provide the required positive and negative sequence currents control for the RSC and GSC, a current control strategy containing a main controller and an auxiliary controller is analyzed. The main controller is implemented in the positive (dq)+ frame without involving positive/negative sequence decomposition whereas the auxiliary controller is implemented in the negative sequence (dq)? frame with negative sequence current extracted. Simulation results using EMTDC/PSCAD are presented for a 2MW DFIG wind generation system to validate the proposed control scheme and to show the enhanced system operation during unbalanced voltage supply.