Glycemic Control: Risk Factors, Quality of Life, Workforce Participation, and Mortality Among US Adults with Type 2 Diabetes

Despite research showing the benefits of glycemic control, it remains suboptimal among adults with diabetes in the United States. Possible reasons include unaddressed risk factors as well as lack of awareness of its immediate and long term consequences. The objectives of this study were to, using cross-sectional data, 1) ascertain the association between suboptimal (Hemoglobin A1c (HbA1c) ≥7%), borderline (HbA1c 7-8.9%), and poor (HbA1c ≥9%) glycemic control and potentially new risk factors (e.g. work characteristics), and 2) assess whether aspects of poor health and well-being such as poor health related quality of life (HRQOL), unemployment, and missed-work are associated with glycemic control; and 3) using prospective data, assess the relationship between mortality risk and glycemic control in US adults with type 2 diabetes. Data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys were used. HbA1c values were used to create dichotomous glycemic control indicators. Binary logistic regression models were used to assess relationships between risk factors, employment status and glycemic control. Multinomial logistic regression analyses were conducted to assess relationships between glycemic control and HRQOL variables. Zero-inflated Poisson regression models were used to assess relationships between missed work days and glycemic control. Cox-proportional hazard models were used to assess effects of glycemic control on mortality risk. Using STATA software, analyses were weighted to account for complex survey design and non-response. Multivariable models adjusted for socio-demographics, body mass index, among other variables. Results revealed that being a farm worker and working over 40 hours/week were risk factors for suboptimal glycemic control. Having greater days of poor mental was associated with suboptimal, borderline, and poor glycemic control. Having greater days of inactivity was associated with poor glycemic control while having greater days of poor physical health was associated with borderline glycemic control. There were no statistically significant relationships between glycemic control, self-reported general health, employment, and missed work. Finally, having an HbA1c value less than 6.5% was protective against mortality. The findings suggest that work-related factors are important in a person’s ability to reach optimal diabetes management levels. Poor glycemic control appears to have significant detrimental effects on HRQOL.

Design and implementation of a relative localization system for ground and aerial robotic teams

The main focus of this thesis is to address the relative localization problem of a heterogenous team which comprises of both ground and micro aerial vehicle robots. This team configuration allows to combine the advantages of increased accessibility and better perspective provided by aerial robots with the higher computational and sensory resources provided by the ground agents, to realize a cooperative multi robotic system suitable for hostile autonomous missions. However, in such a scenario, the strict constraints in flight time, sensor pay load, and computational capability of micro aerial vehicles limits the practical applicability of popular map-based localization schemes for GPS denied navigation. Therefore, the resource limited aerial platforms of this team demand simpler localization means for autonomous navigation. Relative localization is the process of estimating the formation of a robot team using the acquired inter-robot relative measurements. This allows the team members to know their relative formation even without a global localization reference, such as GPS or a map. Thus a typical robot team would benefit from a relative localization service since it would allow the team to implement formation control, collision avoidance, and supervisory control tasks, independent of a global localization service. More importantly, a heterogenous team such as ground robots and computationally constrained aerial vehicles would benefit from a relative localization service since it provides the crucial localization information required for autonomous operation of the weaker agents. This enables less capable robots to assume supportive roles and contribute to the more powerful robots executing the mission. Hence this study proposes a relative localization-based approach for ground and micro aerial vehicle cooperation, and develops inter-robot measurement, filtering, and distributed computing modules, necessary to realize the system. The research study results in three significant contributions. First, the work designs and validates a novel inter-robot relative measurement hardware solution which has accuracy, range, and scalability characteristics, necessary for relative localization. Second, the research work performs an analysis and design of a novel nonlinear filtering method, which allows the implementation of relative localization modules and attitude reference filters on low cost devices with optimal tuning parameters. Third, this work designs and validates a novel distributed relative localization approach, which harnesses the distributed computing capability of the team to minimize communication requirements, achieve consistent estimation, and enable efficient data correspondence within the network. The work validates the complete relative localization-based system through multiple indoor experiments and numerical simulations. The relative localization based navigation concept with its sensing, filtering, and distributed computing methods introduced in this thesis complements system limitations of a ground and micro aerial vehicle team, and also targets hostile environmental conditions. Thus the work constitutes an essential step towards realizing autonomous navigation of heterogenous teams in real world applications.

Suppression of patterning effects in digital communications by an adaptive constrained coding

We quantify the error statistics and patterning effects in a 5x 40 Gbit/s WDM RZ-DBPSK SMF/DCF fibre link using hybrid Raman/EDFA amplification. We propose an adaptive constrained coding for the suppression of errors due to patterning effects. It is established, that this coding technique can greatly reduce the bit error rate (BER) value even for large BER (BER > 101). The proposed approach can be used in the combination with the forward error correction schemes (FEC) to correct the errors even when real channel BER is outside the FEC workspace.

Investigating the Tradespace between Increased Automation and Optimal Manning on Aircraft Carrier Decks

With increasing prevalence and capabilities of autonomous systems as part of complex heterogeneous manned-unmanned environments (HMUEs), an important consideration is the impact of the introduction of automation on the optimal assignment of human personnel. The US Navy has implemented optimal staffing techniques before in the 1990's and 2000's with a "minimal staffing" approach. The results were poor, leading to the degradation of Naval preparedness. Clearly, another approach to determining optimal staffing is necessary. To this end, the goal of this research is to develop human performance models for use in determining optimal manning of HMUEs. The human performance models are developed using an agent-based simulation of the aircraft carrier flight deck, a representative safety-critical HMUE. The Personnel Multi-Agent Safety and Control Simulation (PMASCS) simulates and analyzes the effects of introducing generalized maintenance crew skill sets and accelerated failure repair times on the overall performance and safety of the carrier flight deck. A behavioral model of four operator types (ordnance officers, chocks and chains, fueling officers, plane captains, and maintenance operators) is presented here along with an aircraft failure model. The main focus of this work is on the maintenance operators and aircraft failure modeling, since they have a direct impact on total launch time, a primary metric for carrier deck performance. With PMASCS I explore the effects of two variables on total launch time of 22 aircraft: 1) skill level of maintenance operators and 2) aircraft failure repair times while on the catapult (referred to as Phase 4 repair times). It is found that neither introducing a generic skill set to maintenance crews nor introducing a technology to accelerate Phase 4 aircraft repair times improves the average total launch time of 22 aircraft. An optimal manning level of 3 maintenance crews is found under all conditions, the point at which any additional maintenance crews does not reduce the total launch time. An additional discussion is included about how these results change if the operations are relieved of the bottleneck of installing the holdback bar at launch time.

A new latching control technology for improving wave energy conversion

Extracting wave energy from seas has been proven to be very difficult although various technologies have been developed since 1970s. Among the proposed technologies, only few of them have been actually progressed to the advanced stages such as sea trials or pre-commercial sea trial and engineering. One critical question may be how we can design an efficient wave energy converter or how the efficiency of a wave energy converter can be improved using optimal and control technologies, because higher energy conversion efficiency for a wave energy converter is always pursued and it mainly decides the cost of the wave energy production. In this first part of the investigation, some conventional optimal and control technologies for improving wave energy conversion are examined in a form of more physical meanings, rather than the purely complex mathematical expressions, in which it is hoped to clarify some confusions in the development and the terminologies of the technologies and to help to understand the physics behind the optimal and control technologies. As a result of the understanding of the physics and the principles of the optima, a new latching technology is proposed, in which the latching duration is simply calculated from the wave period, rather than based on the future information/prediction, hence the technology could remove one of the technical barriers in implementing this control technology. From the examples given in the context, this new latching control technology can achieve a phase optimum in regular waves, and hence significantly improve wave energy conversion. Further development on this latching control technologies can be found in the second part of the investigation.

Energy efficiency optimization in hardware-constrained large-scale MIMO systems

Large-scale multiple-input multiple-output (MIMO) communication systems can bring substantial improvement in spectral efficiency and/or energy efficiency, due to the excessive degrees-of-freedom and huge array gain. However, large-scale MIMO is expected to deploy lower-cost radio frequency (RF) components, which are particularly prone to hardware impairments. Unfortunately, compensation schemes are not able to remove the impact of hardware impairments completely, such that a certain amount of residual impairments always exists. In this paper, we investigate the impact of residual transmit RF impairments (RTRI) on the spectral and energy efficiency of training-based point-to-point large-scale MIMO systems, and seek to determine the optimal training length and number of antennas which maximize the energy efficiency. We derive deterministic equivalents of the signal-to-noise-and-interference ratio (SINR) with zero-forcing (ZF) receivers, as well as the corresponding spectral and energy efficiency, which are shown to be accurate even for small number of antennas. Through an iterative sequential optimization, we find that the optimal training length of systems with RTRI can be smaller compared to ideal hardware systems in the moderate SNR regime, while larger in the high SNR regime. Moreover, it is observed that RTRI can significantly decrease the optimal number of transmit and receive antennas.

Integrated Optimal Power Flow for Distribution Networks in Local and Urban Scales

This paper develops an integrated optimal power flow (OPF) tool for distribution networks in two spatial scales. In the local scale, the distribution network, the natural gas network, and the heat system are coordinated as a microgrid. In the urban scale, the impact of natural gas network is considered as constraints for the distribution network operation. The proposed approach incorporates unbalance three-phase electrical systems, natural gas systems, and combined cooling, heating, and power systems. The interactions among the above three energy systems are described by energy hub model combined with components capacity constraints. In order to efficiently accommodate the nonlinear constraint optimization problem, particle swarm optimization algorithm is employed to set the control variables in the OPF problem. Numerical studies indicate that by using the OPF method, the distribution network can be economically operated. Also, the tie-line power can be effectively managed.

Restoring function after neuromuscular trauma: novel paradigms for enhancing volitional control of neural activity in untethered environments and vHAB, a gamified therapy platform

Thesis (Ph.D.)--University of Washington, 2016-08

Estimating the effect of the 2008 financial crisis on GNI in Greece and Iceland: A synthetic control approach

The purpose of this thesis is to conduct a comparative study in order to estimate the impact of the financial crisis to the GNI of Greece and Iceland. By applying synthetic control matching (a relatively new methodology) the study intends to compare the two countries, thus deducting conclusions about good or bad measures adopted. The results indicate that in both cases the adopted measures were not the optimal ones, since the synthetic counterfactual appear to perform better than the actual Greece and Iceland. Moreover, it is shown that Iceland reacted better to the shock it was exposed. However, different characteristics of the two countries impede the application of Icelandic actions in the Greek case.

An iterative analytical design framework for the optimal designing of an off-grid renewable energy based hybrid smart micro-grid

Creative ways of utilising renewable energy sources in electricity generation especially in remote areas and particularly in countries depending on imported energy, while increasing energy security and reducing cost of such isolated off-grid systems, is becoming an urgently needed necessity for the effective strategic planning of Energy Systems. The aim of this research project was to design and implement a new decision support framework for the optimal design of hybrid micro grids considering different types of different technologies, where the design objective is to minimize the total cost of the hybrid micro grid while at the same time satisfying the required electric demand. Results of a comprehensive literature review, of existing analytical, decision support tools and literature on HPS, has identified the gaps and the necessary conceptual parts of an analytical decision support framework. As a result this research proposes and reports an Iterative Analytical Design Framework (IADF) and its implementation for the optimal design of an Off-grid renewable energy based hybrid smart micro-grid (OGREH-SμG) with intra and inter-grid (μG2μG & μG2G) synchronization capabilities and a novel storage technique. The modelling design and simulations were based on simulations conducted using HOMER Energy and MatLab/SIMULINK, Energy Planning and Design software platforms. The design, experimental proof of concept, verification and simulation of a new storage concept incorporating Hydrogen Peroxide (H2O2) fuel cell is also reported. The implementation of the smart components consisting Raspberry Pi that is devised and programmed for the semi-smart energy management framework (a novel control strategy, including synchronization capabilities) of the OGREH-SμG are also detailed and reported. The hybrid μG was designed and implemented as a case study for the Bayir/Jordan area. This research has provided an alternative decision support tool to solve Renewable Energy Integration for the optimal number, type and size of components to configure the hybrid μG. In addition this research has formulated and reported a linear cost function to mathematically verify computer based simulations and fine tune the solutions in the iterative framework and concluded that such solutions converge to a correct optimal approximation when considering the properties of the problem. As a result of this investigation it has been demonstrated that, the implemented and reported OGREH-SμG design incorporates wind and sun powered generation complemented with batteries, two fuel cell units and a diesel generator is a unique approach to Utilizing indigenous renewable energy with a capability of being able to synchronize with other μ-grids is the most effective and optimal way of electrifying developing countries with fewer resources in a sustainable way, with minimum impact on the environment while also achieving reductions in GHG. The dissertation concludes with suggested extensions to this work in the future.

Potential of Trichoderma harzianum for control of banana leaf fungal pathogens when applied with a food source and an organic adjuvant

Trichoderma isolates were obtained from diseased leaves and fruit collected from plantations in the main banana production area in Northern Queensland. Phylogenetic analyses identified the Trichoderma isolates as T. harzianum and T. virens. The Trichoderma spp. were found to be antagonistic against the banana leaf pathogens Mycosphaerella musicola, Cordana musae, and Deight-oniella torulosa in vitro. Several products used by the banana industry to increase production, including molasses, Fishoil and Seasol, were tested as food source for the Trichoderma isolates. The optimal food substrate was found to be molasses at a concentration of 5 %, which when used in combination with a di-1-p-menthene spreader-sticker enhanced the survivability of Trichoderma populations under natural conditions. This formulation suppressed D. torulosa development under glasshouse conditions. Furthermore, high sensitivity was observed towards the protectant fungicide Mancozeb but Biopest oil (R), a paraffinic oil, only marginally suppressed the growth of Trichoderma isolates in vitro. Thus, this protocol represents a potential to manage banana leaf pathogens as a part of an integrated disease approach.

NIR-spectroscopy for bioprocess monitoring & control

The Ingold port adaption of a free beam NIR spectrometer is tailored for optimal bioprocess monitoring and control. The device shows an excellent signal to noise ratio dedicated to a large free aperture and therefore a large sample volume. This can be seen particularly in the batch trajectories which show a high reproducibility. The robust and compact design withstands rough process environments as well as SIP/CIP cycles. Robust free beam NIR process analyzers are indispensable tools within the PAT/QbD framework for realtime process monitoring and control. They enable multiparametric, non-invasive measurements of analyte concentrations and process trajectories. Free beam NIR spectrometers are an ideal tool to define golden batches and process borders in the sense of QbD. Moreover, sophisticated data analysis both quantitative and MSPC yields directly to a far better process understanding. Information can be provided online in easy to interpret graphs which allow the operator to make fast and knowledge-based decisions. This finally leads to higher stability in process operation, better performance and less failed batches.

Online Supplement to ‘Myopic Allocation Policy with Asymptotically Optimal Sampling Rate’

This document is the Online Supplement to ‘Myopic Allocation Policy with Asymptotically Optimal Sampling Rate,’ to be published in the IEEE Transactions of Automatic Control in 2017.

Spatiotemporal neuromodulation therapies engaging muscle synergies improve motor control after spinal cord injury.

Electrical neuromodulation of lumbar segments improves motor control after spinal cord injury in animal models and humans. However, the physiological principles underlying the effect of this intervention remain poorly understood, which has limited the therapeutic approach to continuous stimulation applied to restricted spinal cord locations. Here we developed stimulation protocols that reproduce the natural dynamics of motoneuron activation during locomotion. For this, we computed the spatiotemporal activation pattern of muscle synergies during locomotion in healthy rats. Computer simulations identified optimal electrode locations to target each synergy through the recruitment of proprioceptive feedback circuits. This framework steered the design of spatially selective spinal implants and real-time control software that modulate extensor and flexor synergies with precise temporal resolution. Spatiotemporal neuromodulation therapies improved gait quality, weight-bearing capacity, endurance and skilled locomotion in several rodent models of spinal cord injury. These new concepts are directly translatable to strategies to improve motor control in humans.

Optimal impulsive collision avoidance in low earth orbit

This paper presents a high-accuracy fully analytical formulation to compute the miss distance and collision probability of two approaching objects following an impulsive collision avoidance maneuver. The formulation hinges on a linear relation between the applied impulse and the objects? relative motion in the b-plane, which allows one to formulate the maneuver optimization problem as an eigenvalue problem coupled to a simple nonlinear algebraic equation. The optimization criterion consists of minimizing the maneuver cost in terms of delta-V magnitude to either maximize collision miss distance or to minimize Gaussian collision probability. The algorithm, whose accuracy is verified in representative mission scenarios, can be employed for collision avoidance maneuver planning with reduced computational cost when compared with fully numerical algorithms.