Automated low flow pump system for the treatment of refractory ascites: A multi-center safety and efficacy study

BACKGROUND & AIMS: Refractory ascites (RA) affects 10% of patients with advanced cirrhosis and ascites. Usual therapy includes large volume paracentesis, and in selected patients, a transjugular portosystemic shunt (TIPS). These therapies may be associated with increased morbidity: paracentesis may induce circulatory dysfunction and impair quality of life and TIPS may induce encephalopathy and is associated with increased mortality in patients with severe liver dysfunction. We present the results of a multicenter, non-randomized trial to assess the safety and efficacy of a new automated pump system for treatment of RA. METHODS: Forty patients at 9 centers (February 2010-June 2011) received an implanted pump for the automated removal of ascites from the peritoneal cavity into the bladder, from where it was eliminated through normal urination. Patients were followed-up for 6months. The primary study outcome was safety. Secondary outcomes included recurrence of tense ascites and pump performance. RESULTS: Surgical complications occurred early in the study and became less frequent. The pump system removed 90% of the ascites and significantly reduced the median number of large volume paracentesis per month [3.4 (range 1-6) vs. 0.2 (range 0-4); p <0.01]. Cirrhosis-related adverse events decreased along follow-up. CONCLUSIONS: The automated pump seems an efficacious tool to move out ascites from the peritoneal cavity to the bladder. Its safety is still moderate, but a broad use in different countries will improve the surgical technique as well as the medical surveillance. A prospective randomized clinical trial vs. large volume paracentesis is underway to confirm these preliminary results.

Digital multi-text editions from scratch to electronic performance. Transcription and collation routines transformed in a flexible database system

The poster demonstrates the preparatory steps of a digital multi-text edition that are abstracted from the experiences made in the Parzival Project, based at the University of Bern, the Berlin-Brandenburg Academy of Sciences and the University of Erlangen. This edition of Wolfram von Eschenbach’s German Grail novel, written shortly after 1200 and transmitted during several centuries in ca. hundred witnesses, has now been completed by more than a half of the textual corpus.

Novel emboli protection system during cardiac surgery: a multi-center, randomized, clinical trial.

BACKGROUND Stroke is a major cause of morbidity and mortality during open-heart surgery. Up to 60% of intraoperative cerebral events are emboli induced. This randomized, controlled, multicenter trial is the first human study evaluating the safety and efficacy of a novel aortic cannula producing simultaneous forward flow and backward suction for extracting solid and gaseous emboli from the ascending aorta and aortic arch upon their intraoperative release. METHODS Sixty-six patients (25 females; 68±10 years) undergoing elective aortic valve replacement surgery, with or without coronary artery bypass graft surgery, were randomized to the use of the CardioGard (CardioGard Medical, Or-Yehuda, Israel) Emboli Protection cannula ("treatment") or a standard ("control") aortic cannula. The primary endpoint was the volume of new brain lesions measured by diffusion-weighted magnetic resonance imaging (DW-MRI), performed preoperatively and postoperatively. Device safety was investigated by comparisons of complications rate, namely neurologic events, stroke, renal insufficiency and death. RESULTS Of 66 patients (34 in the treatment group), 51 completed the presurgery and postsurgery MRI (27 in the treatment group). The volume of new brain lesion for the treatment group was (mean±standard error of the mean) 44.00±64.00 versus 126.56±28.74 mm3 in the control group (p=0.004). Of the treatment group, 41% demonstrated new postoperative lesions versus 66% in the control group (p=0.03). The complication rate was comparable in both groups. CONCLUSIONS The CardioGard cannula is safe and efficient in use during open-heart surgery. Efficacy was demonstrated by the removal of a substantial amount of emboli, a significant reduction in the volume of new brain lesions, and the percentage of patients experiencing new brain lesions.

Multi-Model Data Fusion to Improve an Early Warning System for Hypo-/Hyperglycemic Events

Correct predictions of future blood glucose levels in individuals with Type 1 Diabetes (T1D) can be used to provide early warning of upcoming hypo-/hyperglycemic events and thus to improve the patient's safety. To increase prediction accuracy and efficiency, various approaches have been proposed which combine multiple predictors to produce superior results compared to single predictors. Three methods for model fusion are presented and comparatively assessed. Data from 23 T1D subjects under sensor-augmented pump (SAP) therapy were used in two adaptive data-driven models (an autoregressive model with output correction - cARX, and a recurrent neural network - RNN). Data fusion techniques based on i) Dempster-Shafer Evidential Theory (DST), ii) Genetic Algorithms (GA), and iii) Genetic Programming (GP) were used to merge the complimentary performances of the prediction models. The fused output is used in a warning algorithm to issue alarms of upcoming hypo-/hyperglycemic events. The fusion schemes showed improved performance with lower root mean square errors, lower time lags, and higher correlation. In the warning algorithm, median daily false alarms (DFA) of 0.25%, and 100% correct alarms (CA) were obtained for both event types. The detection times (DT) before occurrence of events were 13.0 and 12.1 min respectively for hypo-/hyperglycemic events. Compared to the cARX and RNN models, and a linear fusion of the two, the proposed fusion schemes represents a significant improvement.

An Economic Derivation on Trade Coefficients under the Framework of Multi-regional I-O Analysis

The gravity model, entropy model, potential type model and others like these have been adopted to formulate interregional trade coefficients under the framework of Multi-Regional I-O (MRIO) analysis. Since most of these models are based upon analogies in physics or on statistical principles, they do not provide a theoretical explanation from the view of a firm's or individual's rational and deterministic decision making. In this paper, according to the deterministic choice theory, not only is an alternative formulation of the trade coefficients presented, but also a discussion of an appropriate definition for purchasing prices indices. Since this formulation is consistent with the MRIO system, it can be employed as a useful model-building tool in multi-regional models such as the spatial CGE model.

Input-Output Based Economic Impact Evaluation System for Small City Development: A Case Study on Saemangeum's Flux City Design

The paper aims to develop a quasi-dynamic interregional input-output model for evaluating the macro-economic impacts of small city development. The features of the model are summarized as follows: (1) the consumption expenditure of households is regarded as an endogenous variable, (2) the technological change is determined by the change of industrial Location Quotient caused by firm's investment activities. (3) a strong feedback function between the city design and the economic analysis is provided. For checking the performance of the model, Saemangeum's Flux City Design Plan is used as the simulation target in our paper.

Some geometrical methods for constructing contradiction measures on Atanassov's intuitionistic fuzzy sets

Trillas et al. (1999, Soft computing, 3 (4), 197–199) and Trillas and Cubillo (1999, On non-contradictory input/output couples in Zadeh's CRI proceeding, 28–32) introduced the study of contradiction in the framework of fuzzy logic because of the significance of avoiding contradictory outputs in inference processes. Later, the study of contradiction in the framework of Atanassov's intuitionistic fuzzy sets (A-IFSs) was initiated by Cubillo and Castiñeira (2004, Contradiction in intuitionistic fuzzy sets proceeding, 2180–2186). The axiomatic definition of contradiction measure was stated in Castiñeira and Cubillo (2009, International journal of intelligent systems, 24, 863–888). Likewise, the concept of continuity of these measures was formalized through several axioms. To be precise, they defined continuity when the sets ‘are increasing’, denominated continuity from below, and continuity when the sets ‘are decreasing’, or continuity from above. The aim of this paper is to provide some geometrical construction methods for obtaining contradiction measures in the framework of A-IFSs and to study what continuity properties these measures satisfy. Furthermore, we show the geometrical interpretations motivating the measures.

Application of the Extended Kalman filter to fuzzy modeling: Algorithms and practical implementation

Modeling phase is fundamental both in the analysis process of a dynamic system and the design of a control system. If this phase is in-line is even more critical and the only information of the system comes from input/output data. Some adaptation algorithms for fuzzy system based on extended Kalman filter are presented in this paper, which allows obtaining accurate models without renounce the computational efficiency that characterizes the Kalman filter, and allows its implementation in-line with the process

A Visual AGV-Urban Car using Fuzzy Control

The goal of the work described in this paper is to develop a visual line guided system for being used on-board an Autonomous Guided Vehicle (AGV) commercial car, controlling the steering and using just the visual information of a line painted below the car. In order to implement the control of the vehicle, a Fuzzy Logic controller has been implemented, that has to be robust against curvature changes and velocity changes. The only input information for the controller is the visual distance from the image center captured by a camera pointing downwards to the guiding line on the road, at a commercial frequency of 30Hz. The good performance of the controller has successfully been demonstrated in a real environment at urban velocities. The presented results demonstrate the capability of the Fuzzy controller to follow a circuit in urban environments without previous information about the path or any other information from additional sensors

Automatic Inference of Determinacy and Mutual Exclusion for Logic Programs Using Mode and Type Analyses

We propose an analysis for detecting procedures and goals that are deterministic (i.e., that produce at most one solution at most once),or predicates whose clause tests are mutually exclusive (which implies that at most one of their clauses will succeed) even if they are not deterministic. The analysis takes advantage of the pruning operator in order to improve the detection of mutual exclusion and determinacy. It also supports arithmetic equations and disequations, as well as equations and disequations on terms,for which we give a complete satisfiability testing algorithm, w.r.t. available type information. Information about determinacy can be used for program debugging and optimization, resource consumption and granularity control, abstraction carrying code, etc. We have implemented the analysis and integrated it in the CiaoPP system, which also infers automatically the mode and type information that our analysis takes as input. Experiments performed on this implementation show that the analysis is fairly accurate and efficient.

Adaptive Multi-Camera System for Real Time Object Detection

In this paper we present an adaptive multi-camera system for real time object detection able to efficiently adjust the computational requirements of video processing blocks to the available processing power and the activity of the scene. The system is based on a two level adaptation strategy that works at local and at global level. Object detection is based on a Gaussian mixtures model background subtraction algorithm. Results show that the system can efficiently adapt the algorithm parameters without a significant loss in the detection accuracy.

A Stress-Detection System Based on Physiological Signals and Fuzzy Logic

A stress-detection system is proposed based on physiological signals. Concretely, galvanic skin response (GSR) and heart rate (HR) are proposed to provide information on the state of mind of an individual, due to their nonintrusiveness and noninvasiveness. Furthermore, specific psychological experiments were designed to induce properly stress on individuals in order to acquire a database for training, validating, and testing the proposed system. Such system is based on fuzzy logic, and it described the behavior of an individual under stressing stimuli in terms of HR and GSR. The stress-detection accuracy obtained is 99.5% by acquiring HR and GSR during a period of 10 s, and what is more, rates over 90% of success are achieved by decreasing that acquisition period to 3-5 s. Finally, this paper comes up with a proposal that an accurate stress detection only requires two physiological signals, namely, HR and GSR, and the fact that the proposed stress-detection system is suitable for real-time applications.

Multi-microphone recordings (EigenMike32) inside a WFS system (Iosono) through Ambisonics techniques using Matlab

El audio multicanal ha avanzado a pasos agigantados en los últimos años, y no solo en las técnicas de reproducción, sino que en las de capitación también. Por eso en este proyecto se encuentran ambas cosas: un array microfónico, EigenMike32 de MH Acoustics, y un sistema de reproducción con tecnología Wave Field Synthesis, instalado Iosono en la Jade Höchscule Oldenburg. Para enlazar estos dos puntos de la cadena de audio se proponen dos tipos distintos de codificación: la reproducción de la toma horizontal del EigenMike32; y el 3er orden de Ambisonics (High Order Ambisonics, HOA), una técnica de codificación basada en Armónicos Esféricos mediante la cual se simula el campo acústico en vez de simular las distintas fuentes. Ambas se desarrollaron en el entorno Matlab y apoyadas por la colección de scripts de Isophonics llamada Spatial Audio Matlab Toolbox. Para probar éstas se llevaron a cabo una serie de test en los que se las comparó con las grabaciones realizadas a la vez con un Dummy Head, a la que se supone el método más aproximado a nuestro modo de escucha. Estas pruebas incluían otras grabaciones hechas con un Doble MS de Schoeps que se explican en el proyecto “Sally”. La forma de realizar éstas fue, una batería de 4 audios repetida 4 veces para cada una de las situaciones garbadas (una conversación, una clase, una calle y un comedor universitario). Los resultados fueron inesperados, ya que la codificación del tercer orden de HOA quedo por debajo de la valoración Buena, posiblemente debido a la introducción de material hecho para un array tridimensional dentro de uno de 2 dimensiones. Por el otro lado, la codificación que consistía en extraer los micrófonos del plano horizontal se mantuvo en el nivel de Buena en todas las situaciones. Se concluye que HOA debe seguir siendo probado con mayores conocimientos sobre Armónicos Esféricos; mientras que el otro codificador, mucho más sencillo, puede ser usado para situaciones sin mucha complejidad en cuanto a espacialidad. In the last years the multichannel audio has increased in leaps and bounds and not only in the playback techniques, but also in the recording ones. That is the reason of both things being in this project: a microphone array, EigenMike32 from MH Acoustics; and a playback system with Wave Field Synthesis technology, installed by Iosono in Jade Höchscule Oldenburg. To link these two points of the audio chain, 2 different kinds of codification are proposed: the reproduction of the EigenMike32´s horizontal take, and the Ambisonics´ third order (High Order Ambisonics, HOA), a codification technique based in Spherical Harmonics through which the acoustic field is simulated instead of the different sound sources. Both have been developed inside Matlab´s environment and supported by the Isophonics´ scripts collection called Spatial Audio Matlab Toolbox. To test these, a serial of tests were made in which they were compared with recordings made at the time by a Dummy Head, which is supposed to be the closest method to our hearing way. These tests included other recording and codifications made by a Double MS (DMS) from Schoeps which are explained in the project named “3D audio rendering through Ambisonics techniques: from multi-microphone recordings (DMS Schoeps) to a WFS system, through Matlab”. The way to perform the tests was, a collection made of 4 audios repeated 4 times for each recorded situation (a chat, a class, a street and college canteen or Mensa). The results were unexpected, because the HOA´s third order stood under the Well valuation, possibly caused by introducing material made for a tridimensional array inside one made only by 2 dimensions. On the other hand, the codification that consisted of extracting the horizontal plane microphones kept the Well valuation in all the situations. It is concluded that HOA should keep being tested with larger knowledge about Spherical Harmonics; while the other coder, quite simpler, can be used for situations without a lot of complexity with regards to spatiality.