Chirurgie de réduction de volume pulmonaire: Suivi des 26 premiers patients à Lausanne

Ce travail concerne les 26 premiers patients opérés à Lausanne de juillet 1995 à avril 1998 d?une gie de réduction de volume pulmonaire pour un emphysème sévère. Il présente leurs actéristiques préopératoires générales, leur évaluation radiologique et cardiologique, ainsi que mesures fonctionnelles pulmonaires. Il examine ensuite la technique opératoire, la période ériopératoire, ainsi que les résultats fonctionnels postopératoires des patients. De plus il présente les entretiens ayant eu lieu avec chaque patient pour connaître son évaluation de l?opération et de ges résultats. Ces informations sont ensuite comparées avec les résultats présents dans la littérature. Le profil préopératoire, la technique opératoire, la période péripopératoire, et les résultats fonctionnels postopératoires sont comparés. Un groupe de patients qui n?a pas répondu au point de vue fonctionnel A la chirurgie est ensuite examiné afin de tenter de définir des critères préopératoires de bonne ou mauvaise réponse, et ceux-ci sont mis en relation avec les données de la littérature. On compare ensuite le groupe de mauvais répondeurs fonctionnels avec le groupe des patients ne s?estimant pas améliorés par l?opération. En faisant une étude statistiques des valeurs fonctionnelles pré et postopératoire, on observe une amélioration significative du VEMS, du volume résiduel, de la PaC02, de la distance parcounie au test de marche de six minutes et de la dyspnée engendrée par le test sur une échelle de Borg. L?amélioration de la Pa02 postopératoire et de la saturation en oxygène pendant le test de marche n?était pas significative statistiquement. On peut voir que ce collectif de patients lausannois est comparable aux autres séries au niveau du profil préopératoire et de la gravité de l?atteinte fonctionnelle, au niveau de la technique opératoire, de la mortalité et morbidité, et des résultats fonctionnels postopératoires. On observe comme différence un volume résiduel moyen préopératoire plus élevé et davantage amélioré en postopératoire que dans la littérature. Cette étude ne met pas en évidence - et c?est également le cas dans la littérature - de critères clairs préopératoires prédictifs d?une bonne réponse à la chirurgie. De même elle n?a pas mis en évidence de concordance entre l?amélioration de la symptomatologie des patients et les résultats fonctionnels postopératoires. 11 serait donc intéressant de poursuivre ce travail par une évaluation prospective plus systématique des patients opérés et de pouvoir la comparer avec les résultats des patients récusés ou refusant la chirurgie de réduction de volume pulmonaire, afin de pouvoir mieux en évaluer les bénéfices à long terme.

The use of branched ketenedimers in solving the deposit problems related to the internal sizing of uncoated fine paper

Alkyl ketene dimers (AKD) are effective and highly hydrophobic sizing agents for the internal sizing of alkaline papers, but in some cases they may form deposits on paper machines and copiers. In addition, alkenyl succinic anhydrides (ASA)- based sizing agents are highly reactive, producing on-machine sizing, but under uncontrolled wet end conditions the hydrolysis of ASA may cause problems. This thesis aims at developing an improved ketene dimer based sizing agent that would have a lower deposit formation tendency on paper machines and copiers than a traditional type of AKD. The aim is also to improve the ink jet printability of a AKD sized paper. The sizing characteristics ofketene dimers have been compared to those of ASA. A lower tendency of ketene dimer deposit formation was shown in paper machine trials and in printability tests when branched fatty acids were used in the manufacture of a ketene dimer basedsizing agent. Fitting the melting and solidification temperature of a ketene dimer size to the process temperature of a paper machine or a copier contributes to machine cleanliness. A lower hydrophobicity of the paper sized with branched ketene dimer compared to the paper sized with traditional AKD was discovered. However, the ink jet print quality could be improved by the use of a branched ketene dimer. The branched ketene dimer helps in balancing the paper hydrophobicity for both black and color printing. The use of a high amount of protective colloidin the emulsification was considered to be useful for the sizing performance ofthe liquid type of sizing agents. Similar findings were indicated for both the branched ketene dimer and ASA.

Gas-liquid mass transfer in bubbly flow: Estimation of mass transfer, bubble size and reactor performance in various applications

Gas-liquid mass transfer is an important issue in the design and operation of many chemical unit operations. Despite its importance, the evaluation of gas-liquid mass transfer is not straightforward due to the complex nature of the phenomena involved. In this thesis gas-liquid mass transfer was evaluated in three different gas-liquid reactors in a traditional way by measuring the volumetric mass transfer coefficient (kLa). The studied reactors were a bubble column with a T-junction two-phase nozzle for gas dispersion, an industrial scale bubble column reactor for the oxidation of tetrahydroanthrahydroquinone and a concurrent downflow structured bed.The main drawback of this approach is that the obtained correlations give only the average volumetric mass transfer coefficient, which is dependent on average conditions. Moreover, the obtained correlations are valid only for the studied geometry and for the chemical system used in the measurements. In principle, a more fundamental approach is to estimate the interfacial area available for mass transfer from bubble size distributions obtained by solution of population balance equations. This approach has been used in this thesis by developing a population balance model for a bubble column together with phenomenological models for bubble breakage and coalescence. The parameters of the bubble breakage rate and coalescence rate models were estimated by comparing the measured and calculated bubble sizes. The coalescence models always have at least one experimental parameter. This is because the bubble coalescence depends on liquid composition in a way which is difficult to evaluate using known physical properties. The coalescence properties of some model solutions were evaluated by measuring the time that a bubble rests at the free liquid-gas interface before coalescing (the so-calledpersistence time or rest time). The measured persistence times range from 10 msup to 15 s depending on the solution. The coalescence was never found to be instantaneous. The bubble oscillates up and down at the interface at least a coupleof times before coalescence takes place. The measured persistence times were compared to coalescence times obtained by parameter fitting using measured bubble size distributions in a bubble column and a bubble column population balance model. For short persistence times, the persistence and coalescence times are in good agreement. For longer persistence times, however, the persistence times are at least an order of magnitude longer than the corresponding coalescence times from parameter fitting. This discrepancy may be attributed to the uncertainties concerning the estimation of energy dissipation rates, collision rates and mechanisms and contact times of the bubbles.

Direct torque control of permanent magnet synchronous machines - analysis and implementation

Thedirect torque control (DTC) has become an accepted vector control method besidethe current vector control. The DTC was first applied to asynchronous machines,and has later been applied also to synchronous machines. This thesis analyses the application of the DTC to permanent magnet synchronous machines (PMSM). In order to take the full advantage of the DTC, the PMSM has to be properly dimensioned. Therefore the effect of the motor parameters is analysed taking the control principle into account. Based on the analysis, a parameter selection procedure is presented. The analysis and the selection procedure utilize nonlinear optimization methods. The key element of a direct torque controlled drive is the estimation of the stator flux linkage. Different estimation methods - a combination of current and voltage models and improved integration methods - are analysed. The effect of an incorrect measured rotor angle in the current model is analysed andan error detection and compensation method is presented. The dynamic performance of an earlier presented sensorless flux estimation method is made better by improving the dynamic performance of the low-pass filter used and by adapting the correction of the flux linkage to torque changes. A method for the estimation ofthe initial angle of the rotor is presented. The method is based on measuring the inductance of the machine in several directions and fitting the measurements into a model. The model is nonlinear with respect to the rotor angle and therefore a nonlinear least squares optimization method is needed in the procedure. A commonly used current vector control scheme is the minimum current control. In the DTC the stator flux linkage reference is usually kept constant. Achieving the minimum current requires the control of the reference. An on-line method to perform the minimization of the current by controlling the stator flux linkage reference is presented. Also, the control of the reference above the base speed is considered. A new estimation flux linkage is introduced for the estimation of the parameters of the machine model. In order to utilize the flux linkage estimates in off-line parameter estimation, the integration methods are improved. An adaptive correction is used in the same way as in the estimation of the controller stator flux linkage. The presented parameter estimation methods are then used in aself-commissioning scheme. The proposed methods are tested with a laboratory drive, which consists of a commercial inverter hardware with a modified software and several prototype PMSMs.

Measuring gait using a ground laser range sensor

This paper describes a mesurement system designed to register the displacement of the legs using a two-dimensional laser range sensor with a scanning plane parallel to the ground and extract gait parameters. In the proposed methodology, the position of the legs is estimated by fitting two circles with the laser points that define their contour and the gait parameters are extracted applying a step-line model to the estimated displacement of the legs to reduce uncertainty in the determination of the stand and swing phase of the gait. Results obtained in a range up to 8 m shows that the systematic error in the location of one static leg is lower than 10 mm with and standard deviation lower than 8 mm; this deviation increases to 11 mm in the case of a moving leg. The proposed measurement system has been applied to estimate the gait parameters of six volunteers in a preliminary walking experiment.

Concentración de los ingresos más elevados en España

Con la distribución decílica de los ingresos disponibles por familia en España durante los años 1964, 1967, 1970, 1974, 1981 Y 1987; se mide el índice de concentración de las rentas superiores, previo ajuste a la curva de Kakwani y truncamiento en puntos notables Me, Q3, m, 2m y M1, dando lectura a los resultados. Se complementa el trabajo con la razón entre los ingresos medios de aquellos grupos y los de toda la población, cuestión que facilita el análisis de la evolución de la desigualdad en España desde los años 60 hasta la actualidad y se aporta información para un tratamiento completo de la concentración.

Definition of linear color models in the RGB vector color space to detect red peaches in orchard images taken under natural illumination

This work proposes the detection of red peaches in orchard images based on the definition of different linear color models in the RGB vector color space. The classification and segmentation of the pixels of the image is then performed by comparing the color distance from each pixel to the different previously defined linear color models. The methodology proposed has been tested with images obtained in a real orchard under natural light. The peach variety in the orchard was the paraguayo (Prunus persica var. platycarpa) peach with red skin. The segmentation results showed that the area of the red peaches in the images was detected with an average error of 11.6%; 19.7% in the case of bright illumination; 8.2% in the case of low illumination; 8.6% for occlusion up to 33%; 12.2% in the case of occlusion between 34 and 66%; and 23% for occlusion above 66%. Finally, a methodology was proposed to estimate the diameter of the fruits based on an ellipsoidal fitting. A first diameter was obtained by using all the contour pixels and a second diameter was obtained by rejecting some pixels of the contour. This approach enables a rough estimate of the fruit occlusion percentage range by comparing the two diameter estimates.

Un país amb 7 territoris

El nou Estatut d’autonomia de Catalunya (2006) preveu la creació de vegueries, enteses en la doble funció d’ens local en substitució de les diputacions i com a àmbit d’actuació perifèrica de la Generalitat. Resta per aclarir l’encaix de la vegueria amb la província estatal. Hores d’ara la planificació del territori i bona part de l’administració perifèrica de la Generalitat s’organitza en 7 àmbits, en tant que l’Estat manté inalterada la seva organització en 4 províncies. S’estudien els precedents històrics de les vegueries contemporànies i en particular el debat i gestació de 9 regions en temps de la Generalitat republicana (1931-1939). Es posa de relleu la important aportació intel·lectual d’Enric Lluch en la reforma i simplificació del mapa de vegueries (de 9 a 7). Es planteja el feixuc trànsit efectuat des de la idea de “província única” al plantejament d’un increment en el nombre de províncies-vegueries.

Self-navigated isotropic three-dimensional cardiac T2 mapping.

PURPOSE: To implement and characterize an isotropic three-dimensional cardiac T2 mapping technique. METHODS: A self-navigated three-dimensional radial segmented balanced steady-state free precession pulse sequence with an isotropic 1.7-mm spatial resolution was implemented at 3T with a variable T2 preparation module. Bloch equation and Monte Carlo simulations were performed to determine the influence of the heart rate, B1 inhomogeneity and noise on the T2 fitting accuracy. In a phantom study, the accuracy of the pulse sequence was studied through comparison with a gold-standard spin-echo T2 mapping method. The robustness and homogeneity of the technique were ascertained in a study of 10 healthy adult human volunteers, while first results obtained in patients are reported. RESULTS: The numerical simulations demonstrated that the heart rate and B1 inhomogeneity cause only minor deviations in the T2 fitting, whereas the phantom study showed good agreement of the technique with the gold standard. The volunteer study demonstrated an average myocardial T2 of 40.5 ± 3.3 ms and a <15% T2 gradient in the base-apex and anterior-inferior direction. In three patients, elevated T2 values were measured in regions with expected edema. CONCLUSION: This respiratory self-navigated isotropic three-dimensional technique allows for accurate and robust in vitro and in vivo T2 quantification. Magn Reson Med 73:1549-1554, 2015. © 2014 Wiley Periodicals, Inc.

A Be-type star with a black-hole companion

Stellar-mass black holes have all been discovered through X-ray emission, which arises from the accretion of gas from their binary companions (this gas is either stripped from low-mass stars or supplied as winds from massive ones). Binary evolution models also predict the existence of black holes accreting from the equatorial envelope of rapidly spinning Be-type stars (stars of the Be type are hot blue irregular variables showing characteristic spectral emission lines of hydrogen). Of the ~80 Be X-ray binaries known in the Galaxy, however, only pulsating neutron stars have been found as companions. A black hole was formally allowed as a solution for the companion to the Be star MWC 656 (also known as HD 215227), although that was based on a single radial velocity curve of the Be star, a mistaken spectral classification and rough estimates of the inclination angle. Here we report observations of an accretion disk line mirroring the orbit of the Be star. This, together with an improved radial velocity curve of the Be star through fitting sharp Fe II profiles from the equatorial disk, and a refined Be classification (to that of a B1.5-B2 III star), reveals a black hole of 3.8 to 6.9 solar masses orbiting MWC 656, the candidate counterpart of the gamma-ray source AGL J2241+4454. The black hole is X-ray quiescent and fed by a radiatively inefficient accretion flow giving a luminosity less than 1.6 x 10-7 times the Eddington luminosity. This implies that Be binaries with black-hole companions are difficult to detect by conventional X-ray surveys.

Increased risk of cardiovascular disease (CVD) with age in HIV-positive men : a comparison of the D:A:D CVD risk equation and general population CVD risk equations

OBJECTIVES: The aim of the study was to statistically model the relative increased risk of cardiovascular disease (CVD) per year older in Data collection on Adverse events of anti-HIV Drugs (D:A:D) and to compare this with the relative increased risk of CVD per year older in general population risk equations. METHODS: We analysed three endpoints: myocardial infarction (MI), coronary heart disease (CHD: MI or invasive coronary procedure) and CVD (CHD or stroke). We fitted a number of parametric age effects, adjusting for known risk factors and antiretroviral therapy (ART) use. The best-fitting age effect was determined using the Akaike information criterion. We compared the ageing effect from D:A:D with that from the general population risk equations: the Framingham Heart Study, CUORE and ASSIGN risk scores. RESULTS: A total of 24 323 men were included in analyses. Crude MI, CHD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40-45 years to 6.53, 11.91 and 15.89 in those aged 60-65 years, respectively. The best-fitting models included inverse age for MI and age + age(2) for CHD and CVD. In D:A:D there was a slowly accelerating increased risk of CHD and CVD per year older, which appeared to be only modest yet was consistently raised compared with the risk in the general population. The relative risk of MI with age was not different between D:A:D and the general population. CONCLUSIONS: We found only limited evidence of accelerating increased risk of CVD with age in D:A:D compared with the general population. The absolute risk of CVD associated with HIV infection remains uncertain.

Toimitusketjun kehittäminen prosessiteollisuudessa

Diplomityön tavoitteena oli erään prosessiteollisuuden yrityksen toimitusketjun kehittäminen pääasiakkaan toimitusten osalta. Ongelmana olivat epäoptimaalinen tuotannon lajinvaihto ja toimitusketjun jakelutoimintojen tehottomuus asiakkaan tilausmäärien huonon ennustettavuuden vuoksi. Työssä keskityttiin tuotannon lajinvaihto- ja jakelutoimintoihin sekä niiden kustannusten määrittämiseen toimintolaskennan avulla. Päätavoitteena oli mallintaa Excel-pohjainen työkalu, joka soveltuu tuotannon lajinvaihdon, kuljetusten ja jakeluvarastoinnin karkeasuunnitteluun tarpeiden ja kapasiteetin yhteensovittamiseksi sekä em. kustannusten määrittämiseksi. Työkalua voidaan käyttää myös analysointityökaluna simuloimalla kustannuksia eri toimintavaihtoehdoilla ja tarkastelemalla kustannusten suhdetta toisiinsa. Työkalun avulla laskettiin tuotantotiheyden, kuljetuseräkoon ja tuotantoerien lukumäärän kustannusvaikutukset. Edellytyksenä työkalun käytölle suunnittelussa ja analysoinnissa ovat viikkokohtaiset kysyntäennusteet, joiden saamiseksi ehdotetaan yhteistyön kehittämistä asiakkaan kanssa. Työkalua voidaan jatkossa käyttää myös apuna erään tietojärjestelmän syöttötietojen määrittelyssä.