Goal-directed fluid management based on pulse pressure variation monitoring during high-risk surgery: a pilot randomized controlled trial

Abstract Introduction Several studies have shown that maximizing stroke volume (or increasing it until a plateau is reached) by volume loading during high-risk surgery may improve post-operative outcome. This goal could be achieved simply by minimizing the variation in arterial pulse pressure (ΔPP) induced by mechanical ventilation. We tested this hypothesis in a prospective, randomized, single-centre study. The primary endpoint was the length of postoperative stay in hospital. Methods Thirty-three patients undergoing high-risk surgery were randomized either to a control group (group C, n = 16) or to an intervention group (group I, n = 17). In group I, ΔPP was continuously monitored during surgery by a multiparameter bedside monitor and minimized to 10% or less by volume loading. Results Both groups were comparable in terms of demographic data, American Society of Anesthesiology score, type, and duration of surgery. During surgery, group I received more fluid than group C (4,618 ± 1,557 versus 1,694 ± 705 ml (mean ± SD), P < 0.0001), and ΔPP decreased from 22 ± 75 to 9 ± 1% (P < 0.05) in group I. The median duration of postoperative stay in hospital (7 versus 17 days, P < 0.01) was lower in group I than in group C. The number of postoperative complications per patient (1.4 ± 2.1 versus 3.9 ± 2.8, P < 0.05), as well as the median duration of mechanical ventilation (1 versus 5 days, P < 0.05) and stay in the intensive care unit (3 versus 9 days, P < 0.01) was also lower in group I. Conclusion Monitoring and minimizing ΔPP by volume loading during high-risk surgery improves postoperative outcome and decreases the length of stay in hospital. Trial registration NCT00479011

A Systematic Mapping on the Role-Permission Relationship in Role Based Access Control Models

Access control is a key component of security in any computer system. In the last two decades, the research on Role Basead Access Control Models was intense. One of the most important components of a Role Based Model is the Role-Permission Relationship. In this paper, the technique of systematic mapping is used to identify, extract and analyze many approaches applied to establish the Role-Permission Relationship. The main goal of this mapping is pointing directions of significant research in the area of Role Based Access Control Models.

A novel self consistent calculation approach for the capacitance-voltage characteristics of semiconductor quantum wire transistors based on a split-gate configuration

Purpose - The purpose of this paper is to develop an efficient numerical algorithm for the self-consistent solution of Schrodinger and Poisson equations in one-dimensional systems. The goal is to compute the charge-control and capacitance-voltage characteristics of quantum wire transistors. Design/methodology/approach - The paper presents a numerical formulation employing a non-uniform finite difference discretization scheme, in which the wavefunctions and electronic energy levels are obtained by solving the Schrodinger equation through the split-operator method while a relaxation method in the FTCS scheme ("Forward Time Centered Space") is used to solve the two-dimensional Poisson equation. Findings - The numerical model is validated by taking previously published results as a benchmark and then applying them to yield the charge-control characteristics and the capacitance-voltage relationship for a split-gate quantum wire device. Originality/value - The paper helps to fulfill the need for C-V models of quantum wire device. To do so, the authors implemented a straightforward calculation method for the two-dimensional electronic carrier density n(x,y). The formulation reduces the computational procedure to a much simpler problem, similar to the one-dimensional quantization case, significantly diminishing running time.

Towards automated first-order abduction: the cut-based approach

Traditional abduction imposes as a precondition the restriction that the background information may not derive the goal data. In first-order logic such precondition is, in general, undecidable. To avoid such problem, we present a first-order cut-based abduction method, which has KE-tableaux as its underlying inference system. This inference system allows for the automation of non-analytic proofs in a tableau setting, which permits a generalization of traditional abduction that avoids the undecidable precondition problem. After demonstrating the correctness of the method, we show how this method can be dynamically iterated in a process that leads to the construction of non-analytic first-order proofs and, in some terminating cases, to refutations as well.

In-Flight Collision Avoidance Controller Based Only on OS4 Embedded Sensors

The major goal of this research was the development and implementation of a control system able to avoid collisions during the flight for a mini-quadrotor helicopter, based only on its embedded sensors without changing the environment. However, it is important to highlight that the design aspects must be seriously considered in order to overcome hardware limitations and achieve control simplification. The controllers of a UAV (Unmanned Aerial Vehicle) robot deal with highly unstable dynamics and strong axes coupling. Furthermore, any additional embedded sensor increases the robot total weight and therefore, decreases its operating time. The best balance between embedded electronics and robot operating time is desired. This paper focuses not only on the development and implementation of a collision avoidance controller for a mini-robotic helicopter using only its embedded sensors, but also on the mathematical model that was essential for the controller developing phases. Based on this model we carried out the development of a simulation tool based on MatLab/Simulink that was fundamental for setting the controllers' parameters. This tool allowed us to simulate and improve the OS4 controllers in different modeled environments and test different approaches. After that, the controllers were embedded in the real robot and the results proved to be very robust and feasible. In addition to this, the controller has the advantage of being compatible with future path planners that we are developing.

Designing piezoresistive plate-based sensors with distribution of piezoresistive material using topology optimization

Piezoresistive sensors are commonly made of a piezoresistive membrane attached to a flexible substrate, a plate. They have been widely studied and used in several applications. It has been found that the size, position and geometry of the piezoresistive membrane may affect the performance of the sensors. Based on this remark, in this work, a topology optimization methodology for the design of piezoresistive plate-based sensors, for which both the piezoresistive membrane and the flexible substrate disposition can be optimized, is evaluated. Perfect coupling conditions between the substrate and the membrane based on the `layerwise' theory for laminated plates, and a material model for the piezoresistive membrane based on the solid isotropic material with penalization model, are employed. The design goal is to obtain the configuration of material that maximizes the sensor sensitivity to external loading, as well as the stiffness of the sensor to particular loads, which depend on the case (application) studied. The proposed approach is evaluated by studying two distinct examples: the optimization of an atomic force microscope probe and a pressure sensor. The results suggest that the performance of the sensors can be improved by using the proposed approach.

Development of paper based electrodes: From air-breathing to paintable enzymatic cathodes

This work presents the results from the development of bio-cathodes for the application on paper-based biofuel cells. Our main goal here is to demonstrate the possibility of using different designs of air-breathing bio-cathodes and ink-based bio-cathodes for this new type of paper based electrochemical cell. The electrochemical performance for the bio-electrocatalytic oxygen reduction reaction was studied by using open circuit voltage and amperometry measurements, as well as polarization curves to probe the four-electron reduction reaction of ambient oxygen catalyzed by bilirubin oxidase (BOx). The electrochemical measurements showed that all procedures allowed the direct electron transfer from the active site of the bilirubin oxidase to the electrode surface with a limiting current density of almost 500 mu A cm(-2) for an air-breathing BOx cathode and 150 mu A cm(-2) for an ink based BOx cathode. Under a load of 300 mV a stable current density was obtained for 12 h of continuous operation. (C) 2012 Elsevier Ltd. All rights reserved.