Acute ischemic cerebrovascular events on antiplatelet therapy: what is the optimal prevention strategy?

Even though patients who develop ischemic stroke despite taking antiplatelet drugs represent a considerable proportion of stroke hospital admissions, there is a paucity of data from investigational studies regarding the most suitable therapeutic intervention. There have been no clinical trials to test whether increasing the dose or switching antiplatelet agents reduces the risk for subsequent events. Certain issues have to be considered in patients managed for a first or recurrent stroke while receiving antiplatelet agents. Therapeutic failure may be due to either poor adherence to treatment, associated co-morbid conditions and diminished antiplatelet effects (resistance to treatment). A diagnostic work up is warranted to identify the etiology and underlying mechanism of stroke, thereby guiding further management. Risk factors (including hypertension, dyslipidemia and diabetes) should be treated according to current guidelines. Aspirin or aspirin plus clopidogrel may be used in the acute and early phase of ischemic stroke, whereas in the long-term, antiplatelet treatment should be continued with aspirin, aspirin/extended release dipyridamole or clopidogrel monotherapy taking into account tolerance, safety, adherence and cost issues. Secondary measures to educate patients about stroke, the importance of adherence to medication, behavioral modification relating to tobacco use, physical activity, alcohol consumption and diet to control excess weight should also be implemented.

The Design and Implementation of Loudspeaker Control Network Protocols

The networking and digitalization of audio equipment has created a need for control protocols. These protocols offer new services to customers and ensure that the equipment operates correctly. The control protocols used in the computer networks are not directly applicable since embedded systems have resource and cost limitations. In this master's thesis the design and implementation of new loudspeaker control network protocols are presented. The protocol stack was required to be reliable, have short response times, configure the network automatically and support the dynamic addition and removal of loudspeakers. The implemented protocol stack was also required to be as efficient and lightweight as possible because the network nodes are fairly simple and lack processing power. The protocol stack was thoroughly tested, validated and verified. The protocols were formally described using LOTOS (Language of Temporal Ordering Specifications) and verified using reachability analysis. A prototype of the loudspeaker network was built and used for testing the operation and the performance of the control protocols. The implemented control protocol stack met the design specifications and proved to be highly reliable and efficient.

Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

INTRODUCTION: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. METHODS: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. DISCUSSION: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.

Design and Control of Permanent Magnet Synchronous Machine for Hybrid Electric Vehicle

This master’s thesis mainly focuses on the design requirements of an Electric drive for Hybrid car application and its control strategy to achieve a wide speed range. It also emphasises how the control and performance requirements are transformed into its design variables. A parallel hybrid topology is considered where an IC engine and an electric drive share a common crank shaft. A permanent magnet synchronous machine (PMSM) is used as an electric drive machine. Performance requirements are converted into Machine design variables using the vector model of PMSM. Main dimensions of the machine are arrived using analytical approach and Finite Element Analysis (FEA) is used to verify the design and performance. Vector control algorithm was used to control the machine. The control algorithm was tested in a low power PMSM using an embedded controller. A prototype of 10 kW PMSM was built according to the design values. The prototype was tested in the laboratory using a high power converter. Tests were carried out to verify different operating modes. The results were in agreement with the calculations.

Virtual technology and haptic interface solutions for design and control of mobile working machines

Commercially available haptic interfaces are usable for many purposes. However, as generic devices they are not the most suitable for the control of heavy duty mobile working machines like mining machines, container handling equipment and excavators. Alternative mechanical constructions for a haptic controller are presented and analysed. A virtual reality environment (VRE) was built to test the proposed haptic controller mechanisms. Verification of an electric motor emulating a hydraulic pump in the electro-hydraulic system of a mobile working machine is carried out. A real-time simulator using multi-body-dynamics based software with hardware-in-loop (HIL) setup was used for the tests. Recommendations for further development of a haptic controller and emulator electric motor are given.

Optimal design of 3R manipulators by using classical techniques and simulated annealin

In this paper, the optimum design of 3R manipulators is formulated and solved by using an algebraic formulation of workspace boundary. A manipulator design can be approached as a problem of optimization, in which the objective functions are the size of the manipulator and workspace volume; and the constrains can be given as a prescribed workspace volume. The numerical solution of the optimization problem is investigated by using two different numerical techniques, namely, sequential quadratic programming and simulated annealing. Numerical examples illustrate a design procedure and show the efficiency of the proposed algorithms.

Weed control in corn and weed sample size for growth evaluations

The objectives of this study were to evaluate baby corn yield, green corn yield, and grain yield in corn cultivar BM 3061, with weed control achieved via a combination of hoeing and intercropping with gliricidia, and determine how sample size influences weed growth evaluation accuracy. A randomized block design with ten replicates was used. The cultivar was submitted to the following treatments: A = hoeings at 20 and 40 days after corn sowing (DACS), B = hoeing at 20 DACS + gliricidia sowing after hoeing, C = gliricidia sowing together with corn sowing + hoeing at 40 DACS, D = gliricidia sowing together with corn sowing, and E = no hoeing. Gliricidia was sown at a density of 30 viable seeds m-2. After harvesting the mature ears, the area of each plot was divided into eight sampling units measuring 1.2 m² each to evaluate weed growth (above-ground dry biomass). Treatment A provided the highest baby corn, green corn, and grain yields. Treatment B did not differ from treatment A with respect to the yield values for the three products, and was equivalent to treatment C for green corn yield, but was superior to C with regard to baby corn weight and grain yield. Treatments D and E provided similar yields and were inferior to the other treatments. Therefore, treatment B is a promising one. The relation between coefficient of experimental variation (CV) and sample size (S) to evaluate growth of the above-ground part of the weeds was given by the equation CV = 37.57 S-0.15, i.e., CV decreased as S increased. The optimal sample size indicated by this equation was 4.3 m².

Design and Drive-Cycle Based Analysis of Direct-Driven Permanent Magnet Synchronous Machine for a Small Urban Use Electric Vehicle

A direct-driven permanent magnet synchronous machine for a small urban use electric vehicle is presented. The measured performance of the machine at the test bench as well as the performance over the modified New European Drive Cycle will be given. The effect of optimal current components, maximizing the efficiency and taking into account the iron loss, is compared with the simple id=0 – control. The machine currents and losses during the drive cycle are calculated and compared with each other.

Design of automatic control system for the precipitation of bromelain from the extract of pineapple wastes

In this work, bromelain was recovered from ground pineapple stem and rind by means of precipitation with alcohol at low temperature. Bromelain is the name of a group of powerful protein-digesting, or proteolytic, enzymes that are particularly useful for reducing muscle and tissue inflammation and as a digestive aid. Temperature control is crucial to avoid irreversible protein denaturation and consequently to improve the quality of the enzyme recovered. The process was carried out alternatively in two fed-batch pilot tanks: a glass tank and a stainless steel tank. Aliquots containing 100 mL of pineapple aqueous extract were fed into the tank. Inside the jacketed tank, the protein was exposed to unsteady operating conditions during the addition of the precipitating agent (ethanol 99.5%) because the dilution ratio "aqueous extract to ethanol" and heat transfer area changed. The coolant flow rate was manipulated through a variable speed pump. Fine tuned conventional and adaptive PID controllers were on-line implemented using a fieldbus digital control system. The processing performance efficiency was enhanced and so was the quality (enzyme activity) of the product.

Genomic architecture of sickle cell disease clinical variation in children from West Africa : a case-control study design

Contexte : L’anémie falciforme ou drépanocytose est un problème de santé important, particulièrement pour les patients d’origine africaine. La variation phénotypique de l’anémie falciforme est problématique pour le suivi et le traitement des patients. L’architecture génomique responsable de cette variabilité est peu connue. Principe : Mieux saisir la contribution génétique de la variation clinique de cette maladie facilitera l’identification des patients à risque de développer des phénotypes sévères, ainsi que l’adaptation des soins. Objectifs : L’objectif général de cette thèse est de combler les lacunes relatives aux connaissances sur l’épidémiologie génomique de l’anémie falciforme à l’aide d’une cohorte issue au Bénin. Les objectifs spécifiques sont les suivants : 1) caractériser les profils d’expressions génomiques associés à la sévérité de l’anémie falciforme ; 2) identifier des biomarqueurs de la sévérité de l’anémie falciforme ; 3) identifier la régulation génétique des variations transcriptionelles ; 4) identifier des interactions statistiques entre le génotype et le niveau de sévérité associé à l’expression ; 5) identifier des cibles de médicaments pour améliorer l’état des patients atteints d’anémie falciforme. Méthode : Une étude cas-témoins de 250 patients et 61 frères et soeurs non-atteints a été menée au Centre de Prise en charge Médical Intégré du Nourrisson et de la Femme Enceinte atteints de Drépanocytose, au Bénin entre février et décembre 2010. Résultats : Notre analyse a montré que des profils d’expressions sont associés avec la sévérité de l’anémie falciforme. Ces profils sont enrichis de génes des voies biologiques qui contribuent à la progression de la maladie : l’activation plaquettaire, les lymphocytes B, le stress, l’inflammation et la prolifération cellulaire. Des biomarqueurs transcriptionnels ont permis de distinguer les patients ayant des niveaux de sévérité clinique différents. La régulation génétique de la variation de l’expression des gènes a été démontrée et des interactions ont été identifiées. Sur la base de ces résultats génétiques, des cibles de médicaments sont proposées. Conclusion: Ce travail de thèse permet de mieux comprendre l’impact de la génomique sur la sévérité de l’anémie falciforme et ouvre des perspectives de développement de traitements ciblés pour améliorer les soins offerts aux patients.

Optimal Design of a Surface Mounted Permanent-Magnet BLDC Motor for Spacecraft Applications

This paper presents the optimal design of a surface mounted permanent-magnet (PM) Brushless direct-current (BLDC) motor meant for spacecraft applications. The spacecraft applications requires the choice of a motor with high torque density, minimum cogging torque, better positional stability and high torque to inertia ratio. Performance of two types of machine configurations viz Slotted PMBLDC and Slotless PMBLDC with Halbach array are compared with the help of analytical and finite element (FE) methods. It is found that unlike a Slotted PMBLDC motor, the Slotless type with Halbach array develops zero cogging torque without reduction in the developed torque. Moreover, the machine being coreless provides high torque to inertia ratio and zero magnetic stiction

Design and Control of a Closed-Loop Brushless Torque Actuator

This report explores the design and control issues associated with a brushless actuator capable of achieving extremely high torque accuracy. Models of several different motor - sensor configurations were studied to determine dynamic characteristics. A reaction torque sensor fixed to the motor stator was implemented to decouple the transmission dynamics from the sensor. This resulted in a compact actuator with higher bandwidth and precision than could be obtained with an inline or joint sensor. Testing demonstrated that closed-loop torque accuracy was within 0.1%, and the mechanical bandwidth approached 300 Hz.

Design and Control of an Anthropomorphic Robotic Finger with Multi-point Tactile Sensation

The goal of this research is to develop the prototype of a tactile sensing platform for anthropomorphic manipulation research. We investigate this problem through the fabrication and simple control of a planar 2-DOF robotic finger inspired by anatomic consistency, self-containment, and adaptability. The robot is equipped with a tactile sensor array based on optical transducer technology whereby localized changes in light intensity within an illuminated foam substrate correspond to the distribution and magnitude of forces applied to the sensor surface plane. The integration of tactile perception is a key component in realizing robotic systems which organically interact with the world. Such natural behavior is characterized by compliant performance that can initiate internal, and respond to external, force application in a dynamic environment. However, most of the current manipulators that support some form of haptic feedback either solely derive proprioceptive sensation or only limit tactile sensors to the mechanical fingertips. These constraints are due to the technological challenges involved in high resolution, multi-point tactile perception. In this work, however, we take the opposite approach, emphasizing the role of full-finger tactile feedback in the refinement of manual capabilities. To this end, we propose and implement a control framework for sensorimotor coordination analogous to infant-level grasping and fixturing reflexes. This thesis details the mechanisms used to achieve these sensory, actuation, and control objectives, along with the design philosophies and biological influences behind them. The results of behavioral experiments with a simple tactilely-modulated control scheme are also described. The hope is to integrate the modular finger into an %engineered analog of the human hand with a complete haptic system.