The VAD connection : connecting ventricular assist devices to the aorta in silico

Les systèmes d'assistance ventriculaire sont apparus durant la dernière décade comme une approche thérapeutique efficace du traitement de l'insuffisance cardiaque terminale, en particulier dans le contexte de manque de donneurs d'organes. Néanmoins, et ceci malgré les progrès techniques majeurs, les taux de complications restent élevés et sont en partie liés à la configuration géométrique, en particulier le site d'implantation de la cannule de sortie à l'aorte thoracique. Bien que l'anastomose à l'aorte descendante permette une chirurgie moins invasive, les bénéfices de cette technique sont toujours controversés, comparée à la méthode standard de l'aorte ascendante, en raison du risque thrombo-embolique possiblement augmenté et des modifications hémodynamiques induites au niveau de l'arc aortique. Dans ce travail, nous comparons in silico en terme de débit et pression les deux possibilités anastomotiques. Nous développons un réseau de modèles mathématiques unidimensionnels, et l'appliquons à diverses situations cliniques, pour différents stades d'insuffisance cardiaque et de vitesses de rotation de la machine. Les données initiales sont obtenues grâce à un modèle OD (c'est-à-dire qui dépend uniquement du temps mais pas de l'espace) du système cardiovasculaire comprenant une assistance circulatoire, validé avec des données cliniques. Les simulations réalisées montrent que les deux méthodes sont similaires, en terme de débit et courbes de pression, ceci pour tous les cas cliniques étudiés. Ces résultats numériques soutiennent la possibilité d'utiliser la technique d'anastomose à l'aorte thoracique descendante, permettant une chirurgie moins invasive. Sur un plan plus fondamental, le système cardiovasculaire peut être simulé par le biais de multiples modèles de niveau de complexité différents, au prix d'un coût computationnel toujours plus élevé. Nous évaluons les avantages de modèles géométriques à plusieurs échelles (uni- et tridimensionnelle) avec données provenant de patients, comparés à des modèles simplifiés. Les résultats montrent que ces modèles de dimensions hétérogènes apportent un bénéfice important en terme de ressources de calcul, tout en conservant une précision acceptable. En conclusion, ces résultats encourageant montrent la relevance des études numériques dans le domaine médical, tant sur le plan fondamental et la compréhension des mécanismes physiopathologiques, que sur le plan applicatif et le développement de nouvelles thérapeutiques.

Guidelines for Removal of Traffic Control Devices in Rural Areas, TR-527, 2005

It is commonly regarded that the overuse of traffic control devices desensitizes drivers and leads to disrespect, especially for low-volume secondary roads with limited enforcement. The maintenance of traffic signs is also a tort liability concern, exacerbated by unnecessary signs. The Federal Highway Administration’s (FHWA) Manual on Uniform Traffic Control Devices (MUTCD) and the Institute of Transportation Engineer’s (ITE) Traffic Control Devices Handbook provide guidance for the implementation of STOP signs based on expected compliance with right-of-way rules, provision of through traffic flow, context (proximity to other controlled intersections), speed, sight distance, and crash history. The approach(es) to stop is left to engineering judgment and is usually dependent on traffic volume or functional class/continuity of system. Although presently being considered by the National Committee on Traffic Control Devices, traffic volume itself is not given as a criterion for implementation in the MUTCD. STOP signs have been installed at many locations for various reasons which no longer (or perhaps never) met engineering needs. If in fact the presence of STOP signs does not increase safety, removal should be considered. To date, however, no guidance exists for the removal of STOP signs at two-way stop-controlled intersections. The scope of this research is ultra-low-volume (< 150 daily entering vehicles) unpaved intersections in rural agricultural areas of Iowa, where each of the 99 counties may have as many as 300 or more STOP sign pairs. Overall safety performance is examined as a function of a county excessive use factor, developed specifically for this study and based on various volume ranges and terrain as a proxy for sight distance. Four conclusions are supported: (1) there is no statistical difference in the safety performance of ultra-low-volume stop-controlled and uncontrolled intersections for all drivers or for younger and older drivers (although interestingly, older drivers are underrepresented at both types of intersections); (2) compliance with stop control (as indicated by crash performance) does not appear to be affected by the use or excessive use of STOP signs, even when adjusted for volume and a sight distance proxy; (3) crash performance does not appear to be improved by the liberal use of stop control; (4) safety performance of uncontrolled intersections appears to decline relative to stop-controlled intersections above about 150 daily entering vehicles. Subject to adequate sight distance, traffic professionals may wish to consider removal of control below this threshold. The report concludes with a section on methods and legal considerations for safe removal of stop control.

Small access (30F) clinical central venous smart cannulation: is it adequate?

OBJECTIVES: To assess the performance of 45F vs. 36F smartcanula in CPB with gravity drainage alone. METHODS: Twenty patients were randomly assigned to two groups receiving for venous drainage a smartcanula which is collapsed over a mandrel for trans-atrial insertion into the inferior vena cava and expanded in situ to either 45F or 36F. RESULTS: Valve replacement/repair was realized in 7/10 and/or CABG in 6/10 for 36F (69+/-13 years) vs. 5/10 and 5/10, respectively, for 45F (63+/-11 years: NS). Body weight and surface area (BSA) were 83+/-9 kg (1.9+/-0.2 m2, max 2.2 m2) for 36F vs. 79+/-6 kg: NS (1.9+/-0.1 m2 (NS), max 2.1 m2) for 45F. Insertion and access orifice diameter (area) was 6 mm and 10 mm (78.5 mm2) for the 36F vs. 6 mm and 13 mm (132 mm2) for the 45F (+69%). Calculated target pump flow (2.4 l/min/m2) was 4.7+/-0.4 l/min for 36F vs. 4.5+/-0.3 l/min for 45F. Achieved pump flow accounted for 5.0+/-0.3 l/min for 36F (8% above target) vs. 4.8+/-0.3 l/min for 45F (8% above target): NS. The water balance during the pump run (clear volume added minus hemofilter and urine output) was 2.2+/-0.3 l for 36F vs. 2.0 l for 45F: NS. CONCLUSION: Due to its 'open' wall (the vena cava provides the seal), its reduced wall thickness (range: 0.0-0.4 mm), and its self-expanding design, the 36F smartcanula requiring a 30F access orifice has sufficient drainage capacity by gravity alone for full CPB in adults with a BSA up to 2.2 mm2.

Selective ablation of photovoltaic materials with UV laser sources for monolithic interconnection of devices based on a-Si:H

Lasers are essential tools for cell isolation and monolithic interconnection in thin-film-silicon photovoltaic technologies. Laser ablation of transparent conductive oxides (TCOs), amorphous silicon structures and back contact removal are standard processes in industry for monolithic device interconnection. However, material ablation with minimum debris and small heat affected zone is one of the main difficulty is to achieve, to reduce costs and to improve device efficiency. In this paper we present recent results in laser ablation of photovoltaic materials using excimer and UV wavelengths of diode-pumped solid-state (DPSS) laser sources. We discuss results concerning UV ablation of different TCO and thin-film silicon (a-Si:H and nc-Si:H), focussing our study on ablation threshold measurements and process-quality assessment using advanced optical microscopy techniques. In that way we show the advantages of using UV wavelengths for minimizing the characteristic material thermal affection of laser irradiation in the ns regime at higher wavelengths. Additionally we include preliminary results of selective ablation of film on film structures irradiating from the film side (direct writing configuration) including the problem of selective ablation of ZnO films on a-Si:H layers. In that way we demonstrate the potential use of UV wavelengths of fully commercial laser sources as an alternative to standard backscribing process in device fabrication.

The role of embolic protection devices during carotid stenting prior to cardiac surgery in asymptomatic patients: Empty filters?

Objectives: The purpose of this study was to analyze the debris captured in the distal protection filters used during carotid artery stenting (CAS). Background: CAS is an option available to high-risk patients requiring revascularization. Filters are suggested for optimal stroke prevention during CAS. Methods: From May 2005 to June 2007, filters from 59 asymptomatic patients who underwent CAS were collected and sent to a specialized laboratory for light-microscope and histological analysis. Peri- and postprocedural outcomes were assessed during 1-year follow-up. Results: On the basis of biomedical imaging of the filter debris, the captured material could not be identified as embolized particles from the carotid plaque. On histological analysis the debris consisted mainly of red blood cell aggregates and/ or platelets, occasionally accompanied by granulocytes. We found no consistent histological evidence of embolized particles originating from atherosclerotic plaques. Post-procedure, three neurological events were reported: two (3.4%) transient ischemic attacks (TIA) and one (1.7%) ipsilateral minor stroke. Conclusion: The filters used during CAS in asymptomatic patients planned for cardiac surgery often remained empty. These findings may be explained by assuming that asymptomatic patients feature a different atherosclerotic plaque composition or stabilization through antiplatelet medication. Larger, randomized trials are clearly warranted, especially in the asymptomatic population. © 2012 Wiley Periodicals, Inc.

Remote Control of Mobile Devices in Android Platform

Remote control systems are a very useful element to control and monitor devices quickly and easily. This paper proposes a new architecture for remote control of Android mobile devices, analyzing the different alternatives and seeking the optimal solution in each case. Although the area of remote control, in case of mobile devices, has been little explored, it may provide important advantages for testing software and hardware developments in several real devices. It can also allow an efficient management of various devices of different types, perform forensic security tasks, etc ... The main idea behind the proposed architecture was the design of a system to be used as a platform which provides the services needed to perform remote control of mobile devices. As a result of this research, a proof of concept was implemented. An Android application running a group of server programs on the device, connected to the network or USB interface, depending on availability. This servers can be controlled through a small client written in Java and runnable both on desktop and web systems.

Computational and Energy Costs of Cryptographic Algorithms on Handheld Devices

Networks are evolving toward a ubiquitous model in which heterogeneousdevices are interconnected. Cryptographic algorithms are required for developing securitysolutions that protect network activity. However, the computational and energy limitationsof network devices jeopardize the actual implementation of such mechanisms. In thispaper, we perform a wide analysis on the expenses of launching symmetric and asymmetriccryptographic algorithms, hash chain functions, elliptic curves cryptography and pairingbased cryptography on personal agendas, and compare them with the costs of basic operatingsystem functions. Results show that although cryptographic power costs are high and suchoperations shall be restricted in time, they are not the main limiting factor of the autonomyof a device.

JXTA security in mobile constrained devices

JXME is the JXTA protocols implementation formobile devices using J2ME. Two different flavors of JXME have been implemented, each one specific for a particular set of devices, according to their capabilities. The main value of JXME is its simplicity to create peer-to-peer (P2P) applications in limited devices. In addition to assessing JXME functionalities, it is also important to realize the default security level provided. This paper presents a brief analysis of the current state of security in JXME, focusing on the JXME-Proxied version, identifies existing vulnerabilities and proposes further improvements in this field.

Smart antennas in software radio base stations

The application of adaptive antenna techniques to fixed-architecture base stations has been shown to offer wide-ranging benefits, including interference rejection capabilities or increased coverage and spectral efficiency.Unfortunately, the actual implementation ofthese techniques to mobile communication scenarios has traditionally been set back by two fundamental reasons. On one hand, the lack of flexibility of current transceiver architectures does not allow for the introduction of advanced add-on functionalities. On the other hand, theoften oversimplified models for the spatiotemporal characteristics of the radio communications channel generally give rise toperformance predictions that are, in practice, too optimistic. The advent of software radio architectures represents a big step toward theintroduction of advanced receive/transmitcapabilities. Thanks to their inherent flexibilityand robustness, software radio architecturesare the appropriate enabling technology for theimplementation of array processing techniques.Moreover, given the exponential progression ofcommunication standards in coexistence andtheir constant evolution, software reconfigurabilitywill probably soon become the only costefficientalternative for the transceiverupgrade. This article analyzes the requirementsfor the introduction of software radio techniquesand array processing architectures inmultistandard scenarios. It basically summarizesthe conclusions and results obtained withinthe ACTS project SUNBEAM,1 proposingalgorithms and analyzing the feasibility ofimplementation of innovative and softwarereconfigurablearray processing architectures inmultistandard settings.

Smart antennas: state of the art

Aim of this contribution is to illustrate the state of the art of smart antenna research from several perspectives. The bow is drawn from transmitter issues via channel measurements and modeling, receiver signal processing, network aspects, technological challenges towards first smart antenna applications and current status of standardization. Moreover, some future prospects of different disciplines in smart antenna research are given.

GTK+ toolkit on mobile Linux devices

Linux -käyttöjärjestelmä on laajasti käytössä palvelin- ja työpöytätietokoneissa. Linux on lisäämässä suosiotaan kuitenkin myös sulautetuissa laitteissa, kuten PDA:issa, kännyköissä sekä erilaisissateollisuusjärjestelmissä. Näytön koko, suorituskyky ja käytettävyys asettavat omia erityisiä tarpeitaan laitteiden graafiselle käyttöliittymälle. Linux -käyttöjärjestelmälle on olemassa useita käyttöliittymäkirjastoja, joista GTK+ on yksi yleisimmin käytetyistä. Tämä diplomityö esittelee sulautetun Linux -käyttöjärjestelmän ja GTK+ käyttöliittymäkirjaston, selvittäen miten hyvin ne soveltuvat mobiileihin päätelaitteisiin. Yksi suurimmista esteistä työpöytäkäyttöön suunnattujen teknologioiden, kuten GTK+, muokkaamisessa mobiileihin päätelaitteisiin on suorituskyky. Osana tätä työtä kehitettiin GtkPerf -niminen työkalu, jolla GTK+:n suorituskykyä eri alustoilla pystytään helposti mittaamaan ja havaitsemaan mahdollisia pullonkauloja. Tämän työn johtopäätöksenä on, että pienillä muokkailuilla ja optimoinneilla GTK+ soveltuu myös mobiileihin päätelaitteisiin. Ensimmäinen kaupallisesti saatavilla oleva GTK+ -pohjainen päätelaite, Nokia 770 Internet Tablet, on tästä osoituksena.

Prediction of hip fracture risk by quantitative ultrasound in more than 7000 Swiss women > or =70 years of age: comparison of three technologically different bone ultrasound devices in the SEMOF study.

To compare the prediction of hip fracture risk of several bone ultrasounds (QUS), 7062 Swiss women > or =70 years of age were measured with three QUSs (two of the heel, one of the phalanges). Heel QUSs were both predictive of hip fracture risk, whereas the phalanges QUS was not. INTRODUCTION: As the number of hip fracture is expected to increase during these next decades, it is important to develop strategies to detect subjects at risk. Quantitative bone ultrasound (QUS), an ionizing radiation-free method, which is transportable, could be interesting for this purpose. MATERIALS AND METHODS: The Swiss Evaluation of the Methods of Measurement of Osteoporotic Fracture Risk (SEMOF) study is a multicenter cohort study, which compared three QUSs for the assessment of hip fracture risk in a sample of 7609 elderly ambulatory women > or =70 years of age. Two QUSs measured the heel (Achilles+; GE-Lunar and Sahara; Hologic), and one measured the heel (DBM Sonic 1200; IGEA). The Cox proportional hazards regression was used to estimate the hazard of the first hip fracture, adjusted for age, BMI, and center, and the area under the ROC curves were calculated to compare the devices and their parameters. RESULTS: From the 7609 women who were included in the study, 7062 women 75.2 +/- 3.1 (SD) years of age were prospectively followed for 2.9 +/- 0.8 years. Eighty women reported a hip fracture. A decrease by 1 SD of the QUS variables corresponded to an increase of the hip fracture risk from 2.3 (95% CI, 1.7, 3.1) to 2.6 (95% CI, 1.9, 3.4) for the three variables of Achilles+ and from 2.2 (95% CI, 1.7, 3.0) to 2.4 (95% CI, 1.8, 3.2) for the three variables of Sahara. Risk gradients did not differ significantly among the variables of the two heel QUS devices. On the other hand, the phalanges QUS (DBM Sonic 1200) was not predictive of hip fracture risk, with an adjusted hazard risk of 1.2 (95% CI, 0.9, 1.5), even after reanalysis of the digitalized data and using different cut-off levels (1700 or 1570 m/s). CONCLUSIONS: In this elderly women population, heel QUS devices were both predictive of hip fracture risk, whereas the phalanges QUS device was not.

Suitability of Ultra Wideband for Mobile Devices

Mobiililaitteet ovat kehittyneet merkittävästi viimeisen vuosikymmenen aikana. Ne eivät enää ole pelkästään puhelimia tai kämmentietokoneita, vaan multimediatietokoneita, jotka pystyvät tuottamaan korkealaatuisia elämyksiä käyttäjälleen.Sisällön laadun paraneminen johtaa väistämättä myös siirrettävän tietomäärän kasvamiseen. Siksi uusia, nopeampia tiedonsiirtomenetelmiä on otettava käyttöön. Ultra Wideband (UWB) on uusi radioaaltotekniikka, jokamahdollistaa korkeat tiedonsiirtonopeudet lyhyillä etäisyyksillä. Tekniikka operoi erittäin leveällä 3.1 - 10.6 gigahertsin taajuuskaistalla.UWB on suunnattu nopeaan, langattomaan tiedonsiirtoon personal area networkin (PAN) laitteiden välillä. Tämän diplomityön tarkoituksena on arvioida UWBn soveltuvuutta mobiililaitteisiin. Arviointi tehdään teoreettiselta pohjalta, sillä UWBtä ei vielä ole implementoitu kaupallisiin laitteisiin. Ensin esitellään UWBn tekniikka ja ominaisuudet, jonka jälkeen sen soveltuvuutta arvioidaan esimerkkikäyttötapausten valossa. Esimerkkikäyttötapauksiksi on valittu kolme tyypillistä mutta erilaista toimintoa, jotka mahdollisimman hyvin kuvaavat mobiililaitteiden käyttöä.

Security in RFID devices

Aquest projecte inclou una aproximació als conceptes de RFID i targetes contactless centrant-se en l’ampliament usat MIFARE Classic chip. L’objectiu principal es mostrar el seu funcionament i les seves vulnerabilitats, així com alguns exemples pràctics fent una anàlisi de diferents serveis que les utilitzen.

Long-term continuous-flow left ventricular assist devices (LVAD) as bridge to heart transplantation.

Heart transplantation (HTx) is the treatment of choice for end-stage heart failure but the limited availability of heart's donors still represents a major issue. So long-term mechanical circulatory support (MCS) has been proposed as an alternative treatment option to assist patients scheduled on HTx waiting list bridging them for a variable time period to cardiac transplantation-the so-called bridge-to-transplantation (BTT) strategy. Nowadays approximately 90% of patients being considered for MCS receive a left ventricular assist device (LVAD). In fact, LVAD experienced several improvements in the last decade and the predominance of continuous-flow over pulsatile-flow technology has been evident since 2008. The aim of the present report is to give an overview of continuous-flow LVAD utilization in the specific setting of the BTT strategy taking into consideration the most representative articles of the scientific literature and focusing the attention on the evolution, clinical outcomes, relevant implications on the HTx strategy and future perspectives of the continuous-flow LVAD technology.