RESUMO
Maturity-onset diabetes of the young (MODY) is part of the heterogeneous group of monogenic diabetes (MD) characterized by the non-immune dysfunction of pancreatic ß-cells. The diagnosis of MODY still remains a challenge for clinicians, with many cases being misdiagnosed as type 1 or type 2 diabetes mellitus (T1DM/T2DM), and over 80% of cases remaining undiagnosed. With the introduction of modern technologies, important progress has been made in deciphering the molecular mechanisms and heterogeneous etiology of MD, including MODY. The aim of our study was to identify genetic variants associated with MODY in a group of patients with early-onset diabetes/prediabetes in whom a form of MD was clinically suspected. Genetic testing, based on next-generation sequencing (NGS) technology, was carried out either in a targeted manner, using gene panels for monogenic diabetes, or by analyzing the entire exome (whole-exome sequencing). GKC-MODY 2 was the most frequently detected variant, but rare forms of KCNJ11-MODY 13, specifically, HNF4A-MODY 1, were also identified. We have emphasized the importance of genetic testing for early diagnosis, MODY subtype differentiation, and genetic counseling. We presented the genotype-phenotype correlations, especially related to the clinical evolution and personalized therapy, also emphasizing the particularities of each patient in the family context.
Assuntos
Diabetes Mellitus Tipo 2 , Aconselhamento Genético , Testes Genéticos , Humanos , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/diagnóstico , Testes Genéticos/métodos , Masculino , Feminino , Adulto , Medicina de Precisão/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Adolescente , Canais de Potássio Corretores do Fluxo de Internalização/genética , Adulto Jovem , Criança , Fator 4 Nuclear de Hepatócito/genética , Sequenciamento do Exoma/métodos , Predisposição Genética para Doença , MutaçãoRESUMO
From 2007 in US and from 2022 in EU it is mandatory to use TPMS monitoring in new cars. Sensors mounted in tires require a continuous power supply, which currently only is from batteries. Piezoelectric energy harvesting is a promising technology to harvest energy from tire movement and deformation to prolong usage of batteries and even avoid them inside tires. This study presents a simpler method to simultaneous model the tire deformation and piezoelectric harvester performance by using a new simulation approach - dynamic bending zone. For this, angular and initial velocities were used for rolling motion, while angled polarization was introduced in the model for the piezoelectric material to generate correct voltage from tire deformation. We combined this numerical simulation in COMSOL Multiphysics with real-life measurements of electrical output of a piezoelectric energy harvester that was mounted onto a tire. This modelling approach allowed for 10 times decrease in simulation time as well as simpler investigation of systems parameters influencing the output power. By using experimental data, the simulation could be fine-tuned for material properties and for easier extrapolation of tire deformation with output harvested energy from simulations done at low velocity to the high velocity experimental data.