Grid Connected Distributed Generation System with High Voltage Gain Cascaded DC-DC Converter Fed Asymmetric Multilevel Inverter Topology

The paper presents distributed generation (DG) system in grid connected mode of operation with asymmetric multi-level inverter (AMLI) topology. Cascaded type DC-DC converter is employed to feed proposed AMLI topology. The DG output voltage (generally low voltage) is stepped up to the required level of voltage using high-gain DC-DC converter. Proposed AMLI topology consists of capacitors at the primary side. The output of high-gain DC-DC converter is fed to split voltage balance single-input multi-output (SIMO) circuit to maintain voltage balance across capacitors of AMLI topology. Cascaded DC-DC converters (both high-gain converter and SIMO circuit) are operated in closed-loop mode. The proposed AMLI feeds active power to grid converting DC type of power generated from DG to AC type to feed the grid. PWM pattern to trigger power switches of AMLI is also presented. The inverting circuit of MLI topology is controlled using simplified Id-Iq control strategy in this paper. With the proposed control theory, the active power fed to grid from DG is controlled and power factor is maintained at unity. The proposed system of DG integration to grid through cascaded DC-DC converters and AMLI structure is validated from fixed active power to grid from DG condition. The proposed system is developed and results are obtained using MATLAB/SIMULINK software

Low copy numbers of complement C4 and C4A deficiency are risk factors for myositis, its subgroups and autoantibodies

Background Idiopathic inflammatory myopathies (IIM) are a group of autoimmune diseases characterised by myositis-related autoantibodies plus infiltration of leucocytes into muscles and/or the skin, leading to the destruction of blood vessels and muscle fibres, chronic weakness and fatigue. While complement-mediated destruction of capillary endothelia is implicated in paediatric and adult dermatomyositis, the complex diversity of complement C4 in IIM pathology was unknown. Methods We elucidated the gene copy number (GCN) variations of total C4, C4A and C4B, long and short genes in 1644 Caucasian patients with IIM, plus 3526 matched healthy controls using real-time PCR or Southern blot analyses. Plasma complement levels were determined by single radial immunodiffusion. Results The large study populations helped establish the distribution patterns of various C4 GCN groups. Low GCNs of C4T (C4T=2+3) and C4A deficiency (C4A=0+1) were strongly correlated with increased risk of IIM with OR equalled to 2.58 (2.28-2.91), p=5.0×10 -53 for C4T, and 2.82 (2.48-3.21), p=7.0×10 -57 for C4A deficiency. Contingency and regression analyses showed that among patients with C4A deficiency, the presence of HLA-DR3 became insignificant as a risk factor in IIM except for inclusion body myositis (IBM), by which 98.2% had HLA-DR3 with an OR of 11.02 (1.44-84.4). Intragroup analyses of patients with IIM for C4 protein levels and IIM-related autoantibodies showed that those with anti-Jo-1 or with anti-PM/Scl had significantly lower C4 plasma concentrations than those without these autoantibodies. Conclusions C4A deficiency is relevant in dermatomyositis, HLA-DRB1∗03 is important in IBM and both C4A deficiency and HLA-DRB1∗03 contribute interactively to risk of polymyositis

Transforming Growth Factor β Receptor Type 1 Is Essential for Female Reproductive Tract Integrity and Function

The transforming growth factor β (TGFβ) superfamily proteins are principle regulators of numerous biological functions. Although recent studies have gained tremendous insights into this growth factor family in female reproduction, the functions of the receptors in vivo remain poorly defined. TGFβ type 1 receptor (TGFBR1), also known as activin receptor-like kinase 5, is the major type 1 receptor for TGFβ ligands. Tgfbr1 null mice die embryonically, precluding functional characterization of TGFBR1 postnatally. To study TGFBR1–mediated signaling in female reproduction, we generated a mouse model with conditional knockout (cKO) of Tgfbr1 in the female reproductive tract using anti-Müllerian hormone receptor type 2 promoter-driven Cre recombinase. We found that Tgfbr1 cKO females are sterile. However, unlike its role in growth differentiation factor 9 (GDF9) signaling in vitro, TGFBR1 seems to be dispensable for GDF9 signaling in vivo. Strikingly, we discovered that the Tgfbr1 cKO females develop oviductal diverticula, which impair embryo development and transit of embryos to the uterus. Molecular analysis further demonstrated the dysregulation of several cell differentiation and migration genes (e.g., Krt12, Ace2, and MyoR) that are potentially associated with female reproductive tract development. Moreover, defective smooth muscle development was also revealed in the uteri of the Tgfbr1 cKO mice. Thus, TGFBR1 is required for female reproductive tract integrity and function, and disruption of TGFBR1–mediated signaling leads to catastrophic structural and functional consequences in the oviduct and uterus

Current management of the gastrointestinal complications of systemic sclerosis.

Systemic sclerosis is a multisystem autoimmune disorder that involves the gastrointestinal tract in more than 90% of patients. This involvement can extend from the mouth to the anus, with the oesophagus and anorectum most frequently affected. Gut complications result in a plethora of presentations that impair oral intake and faecal continence and, consequently, have an adverse effect on patient quality of life, resulting in referral to gastroenterologists. The cornerstones of gastrointestinal symptom management are to optimize symptom relief and monitor for complications, in particular anaemia and malabsorption. Early intervention in patients who develop these complications is critical to minimize disease progression and improve prognosis. In the future, enhanced therapeutic strategies should be developed, based on an ever-improving understanding of the intestinal pathophysiology of systemic sclerosis. This Review describes the most commonly occurring clinical scenarios of gastrointestinal involvement in patients with systemic sclerosis as they present to the gastroenterologist, with recommendations for the suggested assessment protocol and therapy in each situation

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

In Memoriam: C.R. Rao (1920-2023)

This is the author accepted manuscriptLast year, the scientific world lost one of its preeminent statisticians, Calyampudi Radhakrishna Rao. Much has already been written about his more famous results, the Cramér-Rao lower bound, the Rao-Blackwell Theorem, and information geometry. (The August 2021 issue of the International Statistical Review provides a good primer.) Instead, this memorial column will connect two applied publications Rao worked on early in his career to modern data science: (1) “Anthropometric survey of the United Provinces, 1941: A statistical study” by P.C. Mahalanobis, D.N. Majumdar, M.W.M Yeatts, and C.R. Rao published in Sankhyā in 1949; and (2) The Ancient Inhabitants of Jebel Moya by R. Mukherjee, C.R. Rao, and J.C. Trevor, published in 1955. Both works offer the contemporary reader excellent examples of following a modern collaborative data science framework, from study design to data stewardship. We will focus on three themes integrated within such frameworks: replicability, reproducibility, and incorporating data context. (Replicability is the idea that a new study can repeat the results of the old one. It implies, however, that the initial study provide sufficient details so that someone else can "replicate" it, starting from data collection. This differs from reproducibility, where researchers supply enough information, including the raw data, so that the existing results can be independently generated. That said, especially given that these are historical data sets, replicability can only be discussed as a theoretical possibility.