A rare breed: Wild-type braf and ighv expression in a 29 year old lady with classical hairy cell leukemia

The V600 BRAF mutation has been described as a key mutation in the pathogenesis of classical hairy cell leukemia (c-HCL) cases without expression of a mutant immunoglobulin heavy chain (IgHV). Here we present a rare case of c-HCL with neither V600 BRAF mutation nor the aforementioned IgHV variant successfully treated with cladribine and review the current literature on its use in women of childbearing age/pregnancy

Optimal network reconfiguration in active distribution networks with soft open points and distributed generation

Copyright © 2019 by the authors. In this study, we allocated soft open points (SOPs) and distributed generation (DG) units simultaneously with and without network reconfiguration (NR), and investigate the contribution of SOP losses to the total active losses, as well as the effect of increasing the number of SOPs connected to distribution systems under different loading conditions. A recent meta-heuristic optimization algorithm called the discrete-continuous hyper-spherical search algorithm is used to solve the mixed-integer nonlinear problem of SOPs and DGs allocation, along with new NR methodology to obtain radial configurations in an efficient manner without the possibility of getting trapped in local minima. Further, multi-scenario studies are conducted on an IEEE 33-node balanced benchmark distribution system and an 83-node balanced distribution system from a power company in Taiwan. The contributions of SOP losses to the total active losses, as well as the effect of increasing the number of SOPs connected to the system, are investigated to determine the real benefits gained from their allocation. It was clear from the results obtained that simultaneous NR, SOP, and DG allocation into a distribution system creates a hybrid configuration that merges the benefits offered by radial distribution systems and mitigates drawbacks related to losses, power quality, and voltage violations, while offering a far more efficient and optimal network operation. Also, it was found that the contribution of the internal loss of SOPs to the total loss for different numbers of installed SOPs is not dependent on the number of SOPs and that loss minimization is not always guaranteed by installing more SOPs or DGs along with NR. One of the findings of the paper demonstrates that NR with optimizing tie-lines could reduce active losses considerably. The results obtained also validate, with proper justifications, that SOPs installed for the management of constraints in LV feeders could further reduce losses and efficiently address issues related to voltage violations and network losses

Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches

<p>Abstract</p> <p>Background</p> <p>Research suggests that food intolerance may be a precipitating factor for migraine like headaches.</p> <p>Aim</p> <p>To evaluate the effectiveness of the ELISA (Enzyme Linked Immuno-Sorbent Assay) Test and subsequent dietary elimination advice for the prevention of migraine like headaches.</p> <p>Design</p> <p>Randomised controlled trial.</p> <p>Setting</p> <p>Community based volunteers in the UK.</p> <p>Participants</p> <p>Volunteers who met the inclusion criteria for migraine like headaches and had one or more food intolerance were included in the study. Participants received either a true diet (n = 84) or a sham diet (n = 83) sheet. Participants were advised to remove the intolerant foods from their diet for 12 weeks.</p> <p>Main outcome measures</p> <p>Number of headache days over a 12 week period (item A MIDAS questionnaire). Other measures includes the total MIDAS score and total HIT-6 score.</p> <p>Results</p> <p>The results indicated a small decrease in the number of migraine like headaches over 12 weeks, although this difference was not statistically significant (IRR 1.15 95% CI 0.94 to 1.41, p = 0.18). At the 4 week assessment, use of the ELISA test with subsequent diet elimination advice significantly reduced the number of migraine like headaches (IRR 1.23 95%CI 1.01 to 1.50, p = 0.04). The disability and impact on daily life of migraines were not significantly different between the true and sham diet groups.</p> <p>Conclusions</p> <p>Use of the ELISA test with subsequent diet elimination advice did not reduce the disability or impact on daily life of migraine like headaches or the number of migraine like headaches at 12 weeks but it did significantly reduce the number of migraine like headaches at 4 weeks.</p> <p>Trial registration number</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRTCN89559672">ISRTCN89559672</a></p

A continuous-variable quantum-inspired algorithm for classical image segmentation

The probabilistic nature of quantum particles, state space, and the superposition principle are among the important concepts in quantum mechanics. A framework was previously developed by the authors that allowed to take advantage of these quantum aspects in the field of image processing. This was done by modeling each image’s pixel by a two-state quantum system which allowed efficient single-object segmentation. However, the extension of the framework to multi-object segmentation would be highly complex and computationally expensive. In this paper, we propose a classical image segmentation algorithm inspired by the continuous-variable quantum theory that overcomes the challenges in extending the framework to multi-object segmentation. By associating each pixel with a quantum harmonic oscillator, the space of coherent states becomes continuous. Thus, each pixel can evolve from an initial state to any of the continuous coherent states under the influence of an external resonant force. The Hamiltonian operator is designed to account for this force and is derived from the features extracted at the pixel. Therefore, the system evolves from an initial ground state to a final coherent state depending on the image features. Finally by calculating the fidelity between the final state and a set of reference states representing the objects in the image, the state with the highest fidelity is selected. The collective states of all pixels produce the final segmentation. The proposed method is tested on a database of synthetic and natural images, and compared with other methods. Average sensitivity and specificity of 97.86% and 99.61% were obtained respectively indicating the high segmentation accuracy of the algorithm

Analysis and characterisation of extreme wind gust hazards in New South Wales, Australia

Extreme wind gusts cause major socioeconomic damage, and the rarity and localised nature of those events make their analysis challenging by either modelling or empirical approaches. A 23-year long data record from 29 automatic weather stations located in New South Wales (eastern Australia) is used to study the distribution, frequency and average recurrence intervals (ARIs) of extreme gusts via a peaks-over-threshold approach. We distinguish between gust events generated by synoptic phenomena (e.g. cyclones and frontal systems), hereafter called “synoptic events”, and convective phenomena (i.e. thunderstorms), hereafter called “convective events”, using the wind time series. For synoptic events the frequency of gusts > 25 m/s decreases systematically inland from the coast, in contrast to convective gusts which are more uniformly distributed geographically and occur more often than synoptic gusts at nearly all inland locations. At inland locations the most extreme wind gusts are likewise dominated by convective events, whereas at coastal stations both gust types have similar intensities at low ARIs but convective events again dominate at the highest ARIs. Extreme gust directions were found to be predominantly westerly at inland locations and southerly at coastal ones, with more variable direction for convective than synoptic events. This study confirms the dominant role of thunderstorms in producing the most extreme gusts in the region, and shows that wind risk varies strongly with distance from the coast

A novel graphically based network reconfiguration for power loss minimization in large distribution systems

Distribution network reconfiguration (DNR) is the optimized change in the topological structure of distribution systems without violating its radial configuration. DNR has been of interest in applied mathematics and engineering because of its importance in modern power systems. In literature, various optimization techniques that constitute a large area of applied mathematics were proposed to obtain optimized radial configurations; however, most of them were tested in small distribution systems. In this paper, a novel graphically-based DNR is proposed to obtain the optimized radial configurations for power loss minimization. The proposed DNR is based on the graphical representation of the distribution system without any need for a radiality check. Case studies were conducted on 16-, 33-, 70-, 83-, 136-, 415-, 880-, 1760-, and 4400-node distribution systems in order to minimize the total power loss. Results have proven the ability of the proposed graphical DNR for power loss minimization by obtaining fast radial configurations in comparison with previous studies and also its ability to deal with large distribution systems efficiently. The proposed DNR succeeded in minimizing the total losses for large distribution systems as the 880-, 1760-, and 4400-node distribution systems by 69.45%, 72.51%, and 74.35%, respectively

Enhancement of hosting capacity with soft open points and distribution system reconfiguration: Multi-objective bilevel stochastic optimization

Copyright © 2020 by the authors. Soft open points (SOPs) are power electronic devices that replace the normal open points in active distribution systems. They provide resiliency in terms of transferring electrical power between adjacent feeders and delivering the benefits of meshed networks. In this work, a multi-objective bilevel optimization problem is formulated to maximize the hosting capacity (HC) of a real 59-node distribution system in Egypt and an 83-node distribution system in Taiwan, using distribution system reconfiguration (DSR) and SOP placement. Furthermore, the uncertainty in the load is considered to step on the real benefits of allocating SOPs along with DSR. The obtained results validate the effectiveness of DSR and SOP allocation in maximizing the HC of the studied distribution systems with low cost