Search

Distributed generation systems and microgrids are instrumental for a greater penetration of renewables to achieve a substantial reduction on carbon emissions. However, microgrids performances and reliability strongly depend on the continuous interaction between power generation, storage and load requirements, highlighting the importance in developing a proper energy management strategy and the relative control system. In this work a Model predictive Control (MPC) strategy, based on a Mixed Linear Integer Programming framework, has been applied to a residential microgrid case. Theoretical results obtained confirm that grid connected microgrids have potential capabilities in grid balancing allowing for a larger penetration of fluctuating renewable energy sources and thus producing economic benefits for both end-user and grid operators. A microgrid test bench to reproduce previous microgrid model is also presented in the paper. The experimental setup has been used to validate results obtained from simulation. Results obtained confirm the potential of this solution and its real applicability. [ABSTRACT FROM AUTHOR]

In this paper a Model Predictive Control (MPC) logic, based on weather forecasts, has been applied to the analysis of power management in a domestic off-grid system composed by: Photovoltaic panel (PV), Fuel Cells (FC) and a battery pack. The controller has the simultaneous objectives of maintaining environmental comfort in the house and minimizing costs, thus optimizing the use of primary energy sources. A theoretical model of the system has been developed and simulations have been carried out for winter and summer seasons. MPC performances have been evaluated in comparison with a standard Ruled Based Control (RBC) logic. [ABSTRACT FROM AUTHOR]

Abstract: Background: Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a potential treatment for Parkinson's disease (PD). H-coils, inducing deeper and wider magnetic fields compared to traditional coils, may be potentially useful in PD, characterized by widespread, bilateral involvement of cortico-subcortical circuits. Objective: To evaluate the safety of repetitive deep TMS (rDTMS) with H-coil as add-on treatment of motor symptoms in PD. Methods: Twenty-seven PD patients (aged 60.1 ± 6.8 y; PD-duration: 6.3 ± 2.8 y; motor-UPDRS: 39.6 ± 10.1) underwent 12 rDTMS sessions over 4 weeks at excitatory (10 Hz) frequency over primary motor (M1) and bilateral prefrontal (PF) regions. Motor UPDRS off therapy was assessed before and after the last rDTMS session, together with safety records at each treatment session. Results: No drop-outs or adverse events were recorded. Motor UPDRS significantly improved after rDTMS (10.8 points average reduction; P < 0.0001). Conclusions: High-frequency rDTMS might be a safe treatment for PD motor symptoms. Further placebo-controlled, randomized studies are warranted. [Copyright &y& Elsevier]

Abstract: Deep brain stimulation (DBS) can be complicated by adverse events, which are generally classified as surgical-hardware or stimulation-related. Here we report the onset of a painful cervical dystonia probably triggered by the extension wire of a subthalamic nucleus (STN)–DBS device in a woman suffering from advanced Parkinson’s disease (PD). Two months after implantation of the STN–DBS device, our patient developed a painful cervical dystonia, which was not responsive to neurostimulation or to medication. No sign of infections or fibrosis was detected. A patch test with the components of the device was performed, revealing no hypersensibility. The patient was referred back to surgery to reposition the pulse generator in the contralateral subclavian region. A deeper channeling of the wire extensions produced a complete remission of the painful dystonia. [Copyright &y& Elsevier]

To evaluate the effect of repetitive deep transcranial magnetic stimulation—rDTMS on motor symptoms in Parkinson’s Disease—PD in a randomized, placebo controlled study. Sixty patients underwent 12 sessions (3 sessions/week) of 10 Hz rDTMS, after randomization into 3 groups: Group 1 (real rDTMS on primary motor—M1 and prefrontal—PF areas); Group 2 (M1-real/PF-sham), Group 3 (M1-sham/PF-sham). Primary outcome was percent reduction of Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) part III, OFF therapy. Secondary outcomes were: changes in UPDRSIII sub-scores; improvement in timed tests (Hand Tapping—HT, Foot Tapping—FT, Walking Time—WT, Nine Hole Peg Test—NHPT). Statistical analysis was performed using Mann–Whitney or t -test. Outcomes were tested in hierarchical order, by comparing the two real groups (1–2) only if their pooled data significantly differed from sham. No drop-outs or serious adverse effects were recorded. Both real groups improved significantly more than sham in UPDRSIII ( p = .010 and p = .045, respectively), while they did not significantly differ between them. Pooled real groups showed a significant improvement vs sham in UPDRSIII ( p = .007), tremor ( p = .011) and lateralized sub-scores ( p = .042 and p = .012 for worse and better side, respectively). Timed tests significantly improved more in the real group vs sham on the worse side (HT p = .041, FT p = .012, NHPT p = .003). rDTMS with H-coil appeared safe and effective on motor symptoms as add-on treatment in PD. [ABSTRACT FROM AUTHOR]

Our aim was to evaluate safety and clinico-neurophysiological effects of repetitive Deep Transcranial Magnetic Stimulation (DTMS) in Parkinson’s Disease (PD), using the novel H-COIL. Fourteen PD-patients underwent 12 sessions 10 Hz-DTMS (4weeks) over primary motor area opposite to their most affected side (W-M1) and prefrontal cortices. Clinical assessment (UPDRSIII; timed-tests including arm/foot tapping-AT/FT) and neurophysiological evaluation (Resting Motor Threshold-RMT, input–output curves-IO, Cortical Silent Period-CSP, intracortical inhibition-ICI/facilitation-ICF) were performed for worse (WS) and less affected (BS) sides. Patients were evaluated OFF therapy at baseline (T0) and before the last DTMS-session (T1). We found significant clinical improvements in UPDRSIII (41.9±9.4 vs. 31.4±7.9; p <0.001), lateralized scores (p <0.001 for both sides) and timed-test (p <0.05 for AT and FT in both sides). Neurophysiological measures disclosed modifications in M1 excitability only in the worse hemisphere. RMT lowered from 36.5±6.7 to 34.3±6.4 (p =0.04), MEP amplitude (120%RMT) increased (p =0.04); ICI and ICF paralleled these modifications (3 and 15ms; p =0.05 and p =0.04 respectively); CSP shortened (p =0.05). No changes were observed for IO curves. Despite the lack of blindness, DTMS appears as a safe and promising new therapeutic perspective for non-invasive stimulation in PD. Neurophysiological changes on the worse side motor excitability paralleled clinical findings. [ABSTRACT FROM AUTHOR]

Our aim was to investigate, in a pilot study, the clinical and neurophysiological effects of non-invasive, deep repetitive transcranial magnetic stimulation (DrTMS) in Parkinson’s disease (PD), using the H coil. Twenty patients (3F; 63±9 y.o.; PD duration: 6±3y) underwent 12 DrTMS sessions in 4weeks. Excitatory 10Hz DrTMS was applied over the primary motor cortex contralateral to the patient’s worse side (WS) and the bilateral prefrontal cortices. Motor control was assessed before and after DrTMS, OFF medication, using clinical (UPDRSIII, lateralized scores, timed arm tapping, and Nine-Hole Peg Test) and neurophysiological measurements (Event-Related Desynchronization (ERD) of the mu and beta sensorimotor rhythms during self-paced WS wrist extensions). No drop-outs or adverse events were recorded. UPDRSIII (global and subscores) and timed tests significantly improved after treatment (p <0.001). Mu and beta ERD latency onsets were significantly increased after treatment (Mu: −1237±177ms before, and −2024±215ms after; beta: −1247±151ms before, and −2229±179ms after; p <0.01). DrTMS is a safe treatment for PD. It improved motor symptoms and significantly modulated the cerebral activity related to motor planning. Further placebo controlled, randomized studies are needed to assess the therapeutic efficacy DrTMS and its consequences on cortical motor control. [ABSTRACT FROM AUTHOR]

Abstract: Background: Despite its large clinical application, our understanding about the mechanisms of action of deep brain stimulation of the subthalamic nucleus is still limited. Aim of the present study was to explore cortical and subcortical metabolic modulations measured by Positron Emission Tomography associated with improved motor manifestations after deep brain stimulation in Parkinson disease, comparing the ON and OFF conditions. Patients and methods: Investigations were performed in the stimulator off- and on-conditions in 14 parkinsonian patients and results were compared with a group of matched healthy controls. The results were also used to correlate metabolic changes with the clinical effectiveness of the procedure. Results: The comparisons using Statistical parametric mapping revealed a brain metabolic pattern typical of advanced Parkinson disease. The direct comparison in ON vs OFF condition showed mainly an increased metabolism in subthalamic regions, corresponding to the deep brain stimulation site. A positive correlation exists between neurostimulation clinical effectiveness and metabolic differences in ON and OFF state, including the primary sensorimotor, premotor and parietal cortices, anterior cingulate cortex. Conclusion: Deep brain stimulation seems to operate modulating the neuronal network rather than merely exciting or inhibiting basal ganglia nuclei. Correlations with Parkinson Disease cardinal features suggest that the improvement of specific motor signs associated with deep brain stimulation might be explained by the functional modulation, not only in the target region, but also in surrounding and remote connecting areas, resulting in clinically beneficial effects. [Copyright &y& Elsevier]

The need to increase renewable energy sources deployment and to reduce consumption of fossil fuels has led to the diffusion of small-scale DG (Distributed Generation) systems, which may be effectively integrated in micro-grids. The role of control logic in defining microgrid performances and reliability is predominant and can be improved by using advanced control logics such as the ones based on MPC (Model Predictive Control). In a previous paper, a MPC logic, based on the use of weather forecasts to improve the performances, has been applied to the analysis of power management in a domestic micro-grid system composed by: PV (Photovoltaic panels), FC (Fuel Cells) and a battery pack; in that case, the system was not affected by real uncertainties. In this paper the same system has been considered for domestic microgrid applications. The system control logic has been implemented by assuming real weather forecast as input data. DMPC and SMPC (Deterministic and Stochastic Model Predictive Control) concepts have been applied to the system and results have been compared to both MPC and to a standard RBC (Rule Based Control) logic. The impact of forecast uncertainties has been evaluated showing the advantages of a stochastic approach. In that case, the SMPC showed encouraging performances compared to standard control logics, primarily in terms of primary energy savings and downsizing potential of the power-delivering sub-systems using programmable energy sources. [ABSTRACT FROM AUTHOR]

Background: Clinical responses to ipilimumab are variable in terms of onset, magnitude and duration. Upfront identification of patients who are more likely or unlikely to benefit from treatment is a major need. Patients and methods: Prospectively collected data from 720 advanced melanoma patients treated with ipilimumab 3 mg/kg within the Italian expanded access program were analyzed. The derived neutrophil-to-lymphocyte ratio (dNLR) was calculated from baseline peripheral blood cell counts, and receiver operating characteristic curve was used to evaluate the best cutoff for this marker. Patients were stratified according to dichotomized baseline absolute neutrophil counts (ANC), dNLR and their combination. The prognostic values of ANC and dNLR for survival were assessed using multivariate Cox proportional hazard models. A subgroup analysis including LDH in the models was also carried out. Results: The median follow-up was 16.5 months. The optimal cutoff for dNLR was 3. Baseline ANC and dNLR were significantly associated with the outcome of ipilimumab-treated melanoma patients, in terms of disease progression and death (P < 0.0001 for all). Furthermore, for each elevated variable, prognosis worsened. Patients with both ANC ≥ 7500 and dNLR ≥ 3 had a significantly and independently increased risk of death [hazard ratio(HR) = 5.76; 95% confidence interval (CI) 4.29-7.75] and of progression (HR = 4.10; 95% CI 3.08-5.46) compared with patients with both lower ANC and dNLR. Patients with one of the two factors elevated displayed an intermediate risk of progression and death. The 1- and 2-year survival rates were 2% and 0%, respectively, for patients with ANC ≥ 7500 and dNLR ≥ 3, and 43% and 24%, respectively, for patients with both lower ANC and dNLR. Conclusions: Although these findings need to be confirmed and validated, we suggest that a neutrophil-based index may help risk-group stratification and assist disease-management strategies. Furthermore, the potential predictive value of this index for response to ipilimumab should be investigated in randomized clinical trials. [ABSTRACT FROM AUTHOR]

In this paper a Model Predictive Control (MPC) logic, based on weather forecasts, has been applied to the analysis of power management in a domestic off-grid system. The system is laid out as the integration of renewable energy conversion devices (Photovoltaic, PV), a high efficiency energy conversion programmable system (a Fuel Cell, FC) and an electrochemical energy storage (batteries). The control strategy has the objective of minimizing energy costs, while maintaining the optimal environmental comfort in the house, thus optimizing the use of renewable sources. To that aim, a validated numerical model of the whole system has been developed, and simulations have been carried out for winter and summer periods. Performances attainable with a MPC-based logic have been evaluated in comparison with a standard Rule Based Control logic, by means of costs and efficiency parameters of the micro-grid. Temperature violations have been taken into account to represent the impact of the control on comfort. Results show an improvement of the house comfort conditions and a lower use (on average 14.5%) of primary fossil energy. This is due both to a reduction of required energy, and to an increased use of renewable energy sources. Moreover, the modulation of the HVAC load and of the FC operation gives a reduction of requested power by approximately 40%. Smoother battery pack charge and discharge processes are also obtained. As a main positive effect, a reduction of the FC powerplant size and an increase of its durability seems feasible, leading to an overall reduction of capital costs. [ABSTRACT FROM AUTHOR]

Several functional studies suggest a more bilateral movement-related recruitment of motor areas during voluntary movement associated with physiological aging. To investigate the changes of motor cortical excitatory and inhibitory balance during physiological aging, using transcranial magnetic stimulation (TMS). We recruited right-handed 31 healthy volunteers, divided into two groups: one younger group (15 subjects, 6 females, age 25.4 ± 1.9 y) and one older group (16 subjects, 7 females, age 61.1 ± 5.1 y). Motor abilities were tested using Nine Hole Peg Test (NHPT) and finger tapping (FT). Surface electromyography (EMG) of the bilateral abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles was recorded. TMS was delivered with a Magstim 200 simulator connected to a figure-of-eight coil (Magstim 2nd generation, 70 mm of external diameter). Resting motor threshold (RMT) on each side and cortical mapping of APB and ADM muscles were analyzed. We also registered ipsilateral silent period (ISP) in both APB muscles, during maximal contraction. Older subjects showed worse motor performances (in terms of NHPT and FT of both hands) than younger ones ( p < 0.001). RMT did not significantly differ between groups but had a significant SIDE effect (lower on the left hemisphere, p < 0.001). In younger group, APB had a greater map representation than ADM on both hemispheres ( p = 0.03). In older group, APB map on the right hemisphere was significantly reduced vs the younger group ( p = 0.021) and vs its homologous ( p = 0.042). For ADM, no significant map differences were found between elderly and young subjects, even on the right hemisphere. ISP was significantly reduced in the elderly on both sides, in terms of duration ( p = 0.025), peak ( p = 0.033) and area ( p = 0.008). Physiological aging is associated with disruption of interemispheric specialization both concerning motor cortical representation and interhemispheric interactions. This may have consequences on recovery from pathological processes and suggests that age has to be taken into account when planning therapeutic intervention aimed at restoring hand motor function. [ABSTRACT FROM AUTHOR]

Repetitive transcranial magnetic stimulation (rTMS) has been recognized as a promising intervention for treatment of stroke patients. The purpose of this double-blind placebo-controlled crossover study was to assess the efficacy of 20Hz rTMS delivered with H-coil on lower limb (LL) motor function in patients with chronic (>6months) subcortical stroke. Nine patients received both real and sham rTMS in a random sequence. rTMS treatments were composed of 11 sessions (administered over 3-weeks) and were separated by a 4-week wash-out period. LL functions were assessed by the Fugl-Meyer LL scale (FM-LL), the 10-meters walking test (10MWT) and the six minutes walking test (6MWT), before and 1day after the end of each treatment period, as well as at a 4-week follow-up. Real rTMS treatments were associated with a significant improvement in FM-LL scores. This effect persisted at follow-up and was significantly greater than that observed with sham stimulation. A significant increase in walking speed was also found after real rTMS but this effect did not reach statistical significance in comparison with the sham stimulation. These data demonstrated that 3-weeks of high-frequency deep rTMS could induce long-term improvements in LL functions in the chronic post-stroke period. [Copyright &y& Elsevier]

Neuroimaging studies have reported mirroring motor activation to music listening in musicians. Actual corticospinal modulation remains to be clarified. We tested the motor cortex modulation in pianists while listening to well-known, predictable melodic sequences, using Transcranial Magnetic Stimulation (TMS) and electroencephalography (EEG). Two groups of subjects were studied: pianists (n =10) and controls (n =10). Participants listened to a melodic sequence containing the alternating repetition of a scale in two different octaves. Using a circular coil on the vertex, Motor Evoked Potentials (MEP) were recorded bilaterally on both hands at different time points, with 32 channels EEG monitoring. EEG event-related desynchronization (ERD) of the mu rhythm was assessed by comparing its spectral power during listening vs rest. Pianists, not controls, showed modulation of MEPs amplitude of right hand muscles according to the timing of their activation during actual performance. Left sensori-motor frontal mu ERD to the melodic sequence played with the right hand was present in 9 pianists vs 4 control. The dynamic auditory induced motor resonance to music listening observed in pianists suggests the presence of an audio-motor mirror system that can be related to the ability of musician to confer a gestural meaning to well-known melodies. [Copyright &y& Elsevier]