Utilite du Remler pour eviter de surtraiter la population dite hypertendue. [Usefulness of the Remler device in avoiding overtreatment of the so-called hypertensive population]

To assess the reliability of the Remler system, a semi-automatic pressure recording device, several blood pressures were measured simultaneously by the conventional auscultatory method and by the Remler in 12 normotensive volunteers. In all situations tested both the Remler and auscultatory blood pressures were very close, thus demonstrating the reliability of this new technique. Ambulatory blood pressure recordings were then obtained with the Remler in 245 untreated patients referred for hypertension by their private physicians. Surprisingly, in close to 60% of them the average of all blood pressures recorded during usual activities was within the normal range. Since cardiovascular complications seem to correlate better with ambulatory than with office blood pressure levels, the Remler system appears particularly useful in recognizing those patients who, although hypertensive in the physician's office, remain normotensive during the day and therefore may not require antihypertensive treatment.

Real-time tree-foliage surface estimation using a ground laser scanner

The optimization of most pesticide and fertilizer applications is based on overall grove conditions. In this work we measurements. Recently, Wei [9, 10] used a terrestrial propose a measurement system based on a ground laser scanner to LIDAR to measure tree height, width and volume developing estimate the volume of the trees and then extrapolate their foliage a set of experiments to evaluate the repeatability and surface in real-time. Tests with pear trees demonstrated that the accuracy of the measurements, obtaining a coefficient of relation between the volume and the foliage can be interpreted as variation of 5.4% and a relative error of 4.4% in the linear with a coefficient of correlation (R) of 0.81 and the foliar estimation of the volume but without real-time capabilities. surface can be estimated with an average error less than 5 %.

Development of a shelling method to recover whole kernels of the Cutia nut (Couepia edulis)

The kernel of the cutia nut (castanha-de-cutia, Couepia edulis (Prance) Prance) of the western Amazon, which is consumed by the local population, has traditionally been extracted from the nut with a machete, a dangerous procedure that only produces kernels cut in half. A shelling off machine prototype, which produces whole kernels without serious risks to its operator, is described and tested. The machine makes a circular cut in the central part of the fruit shell, perpendicular to its main axis. Three ways of conditioning the fruits before cutting were compared: (1) control; (2) oven drying immediately prior to cutting; (3) oven drying, followed by a 24-hour interval before cutting. The time needed to extract and separate the kernel from the endocarp and testa was measured. Treatment 3 produced the highest output: 63 kernels per hour, the highest percentage of whole kernels (90%), and the best kernel taste. Kernel extraction with treatment 3 required 50% less time than treatment 1, while treatment 2 needed 38% less time than treatment 1. The proportion of kernels attached to the testa was 93%, 47%, and 8% for treatments 1, 2, and 3, respectively, and was the main reason for extraction time differences.

A prospective observational study comparing a non-operator dependent automatic PWV analyser to pulse pressure, in assessing arterial stiffness in hemodialysis.

BACKGROUND: Chronic kidney disease (CKD) accelerates vascular stiffening related to age. Arterial stiffness may be evaluated measuring the carotid-femoral pulse wave velocity (PWV) or more simply, as recommended by KDOQI, monitoring pulse pressure (PP). Both correlate to survival and incidence of cardiovascular disease. PWV can also be estimated on the brachial artery using a Mobil-O-Graph; a non-operator dependent automatic device. The aim was to analyse whether, in a dialysis population, PWV obtained by Mobil-O-Graph (MogPWV) is more sensitive for vascular aging than PP. METHODS: A cohort of 143 patients from 4 dialysis units has been followed measuring MogPWV and PP every 3 to 6 months and compared to a control group with the same risk factors but an eGFR > 30 ml/min. RESULTS: MogPWV contrarily to PP did discriminate the dialysis population from the control group. The mean difference translated in age between the two populations was 8.4 years. The increase in MogPWV, as a function of age, was more rapid in the dialysis group. 13.3% of the dialysis patients but only 3.0% of the control group were outliers for MogPWV. The mortality rate (16 out of 143) was similar in outliers and inliers (7.4 and 8.0%/year). Stratifying patients according to MogPWV, a significant difference in survival was seen. A high parathormone (PTH) and to be dialysed for a hypertensive nephropathy were associated to a higher baseline MogPWV. CONCLUSIONS: Assessing PWV on the brachial artery using a Mobil-O-Graph is a valid and simple alternative, which, in the dialysis population, is more sensitive for vascular aging than PP. As demonstrated in previous studies PWV correlates to mortality. Among specific CKD risk factors only PTH is associated with a higher baseline PWV. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02327962.

Energiataseen hallinta ja optimointi metsäteollisuusintegraatissa

Diplomityö on tehty UPM-Kymmene Oyj, Kaukaan tehtailla Lappeenrannassa. Integroidussa metsäteollisuudessa energiantuotanto koostuu yleensä sähkön- ja lämmöntuotannosta. Kaukaan tehtailla prosessien lämmöntarve saadaan katettua kokonaisuudessaan omalla tuotannolla, kun taas kulutetusta sähköstä ainoastaan puolet on tuotettu itse. Loput sähköntarpeesta joudutaan ostamaan ulkopuolelta. Tutkimuksen pääpaino on ollut selvittää, miten kustannukset ovat riippuvaisia energiantuotannosta erilaisissa käyttöolosuhteissa. Työn tuloksena on luotu tietokonepohjainen laskentamalli, jonka avulla Kaukaan tehtaiden energiantuotantoa voidaan ohjata taloudellisesti optimaalisimmalla tavalla kulloinkin vallitsevassa käyttötilanteessa. Lisäksi tutkimuksessa on analysoitu tehdasintegraatin lämmönkulutuksen seurannan mahdollisuuksia lämmönsiirtoverkon nykyisten mittausten perusteella. Työssä on kerrottu yleisesti metsäteollisuuden energiankulutuksesta Suomessa. Lisäksi on esitetty arvioita energiankulutuksen kehityksestä tulevaisuudessa sekä keinoja energiatehokkuuden parantamiseksi. Kaukaan tehtailla lämmönkulutuksen seurantaan käytettävät mittausmenetelmät ja -laitteet on esitelty virtausmittausten osalta sekä arvioitu nykyisten mittausten luotettavuutta ja riittävyyttä kokonaisvaltaisen lämpötaseen hallintaan. Kaukaan tehtaiden energiantuotantojärjestelmästä on luotu termodynaaminen malli, johon energiantuotannosta aiheutuneiden kustannusten laskenta perustuu. Energiantuotannon optimoinnilla pyritään määrittelemään tietyn tarkasteluhetken käyttötilanteessa taloudellisesti optimaalisin kattiloiden ajojärjestys. Tarkastelu on rajattu lämmöntuotannon lisäämisen osalta maakaasun käytön lisäämiseen ja höyryturbiinien ohitukseen. Sähkön ja maakaasun hinnan sekä ympäristön lämpötilan vaihtelujen vaikutusta optimaaliseen ajojärjestykseen on havainnollistettu esimerkkien avulla.

Single breath-hold 3D measurement of left atrial volume using compressed sensing cardiovascular magnetic resonance and a non-model-based reconstruction approach.

BACKGROUND: Left atrial (LA) dilatation is associated with a large variety of cardiac diseases. Current cardiovascular magnetic resonance (CMR) strategies to measure LA volumes are based on multi-breath-hold multi-slice acquisitions, which are time-consuming and susceptible to misregistration. AIM: To develop a time-efficient single breath-hold 3D CMR acquisition and reconstruction method to precisely measure LA volumes and function. METHODS: A highly accelerated compressed-sensing multi-slice cine sequence (CS-cineCMR) was combined with a non-model-based 3D reconstruction method to measure LA volumes with high temporal and spatial resolution during a single breath-hold. This approach was validated in LA phantoms of different shapes and applied in 3 patients. In addition, the influence of slice orientations on accuracy was evaluated in the LA phantoms for the new approach in comparison with a conventional model-based biplane area-length reconstruction. As a reference in patients, a self-navigated high-resolution whole-heart 3D dataset (3D-HR-CMR) was acquired during mid-diastole to yield accurate LA volumes. RESULTS: Phantom studies. LA volumes were accurately measured by CS-cineCMR with a mean difference of -4.73 ± 1.75 ml (-8.67 ± 3.54%, r2 = 0.94). For the new method the calculated volumes were not significantly different when different orientations of the CS-cineCMR slices were applied to cover the LA phantoms. Long-axis "aligned" vs "not aligned" with the phantom long-axis yielded similar differences vs the reference volume (-4.87 ± 1.73 ml vs. -4.45 ± 1.97 ml, p = 0.67) and short-axis "perpendicular" vs. "not-perpendicular" with the LA long-axis (-4.72 ± 1.66 ml vs. -4.75 ± 2.13 ml; p = 0.98). The conventional bi-plane area-length method was susceptible for slice orientations (p = 0.0085 for the interaction of "slice orientation" and "reconstruction technique", 2-way ANOVA for repeated measures). To use the 3D-HR-CMR as the reference for LA volumes in patients, it was validated in the LA phantoms (mean difference: -1.37 ± 1.35 ml, -2.38 ± 2.44%, r2 = 0.97). Patient study: The CS-cineCMR LA volumes of the mid-diastolic frame matched closely with the reference LA volume (measured by 3D-HR-CMR) with a difference of -2.66 ± 6.5 ml (3.0% underestimation; true LA volumes: 63 ml, 62 ml, and 395 ml). Finally, a high intra- and inter-observer agreement for maximal and minimal LA volume measurement is also shown. CONCLUSIONS: The proposed method combines a highly accelerated single-breathhold compressed-sensing multi-slice CMR technique with a non-model-based 3D reconstruction to accurately and reproducibly measure LA volumes and function.

Lisäainetehtaan tuotantoprosessin kehittäminen

Tämän diplomityön tarkoituksena oli Finnsementti osakeyhtiöön kuuluvan betonin lisäaineita valmistavan tehtaan tuotantoprosessin kehittäminen. Työssä laadittiin myynnin kasvuennusteen perusteella suunnitelma, jonka mukaan määriteltiin betonin lisäaineille ja raaka-aineille sopivat varastosäiliöt. Suunnitelman perusteella määriteltiin kiinteät putkilinjat sekä kirkkaille että tummille nesteille, jolloin materiaalihäviöt saatiin pienemmiksi ja putkilinjojen pesun tarve väheni. Lisäksi työssä otettiin huomioon tuotantoprosessin automatisointi. Suunnitellusta projektista laadittiin alustava kustannusarvio, toteutusaikataulu sekä sijoituspiirustus, putkisto-instrumentointikaavio ja 3D-piirrokset. Projektin kustannusarvioksi saatiin noin 290 tuhatta markkaa ja projektin pituudeksi noin 11 viikkoa.

Bilateral deep brain stimulation: the placement of the second electrode is not necessarily less accurate than that of the first one.

BACKGROUND: Deep brain stimulation (DBS) is recognized as an effective treatment for movement disorders. We recently changed our technique, limiting the number of brain penetrations to three per side. OBJECTIVES: The first aim was to evaluate the electrode precision on both sides of surgery since we implemented this surgical technique. The second aim was to analyse whether or not the electrode placement was improved with microrecording and macrostimulation. METHODS: We retrospectively reviewed operation protocols and MRIs of 30 patients who underwent bilateral DBS. For microrecording and macrostimulation, we used three parallel channels of the 'Ben Gun' centred on the MRI-planned target. Pre- and post-operative MRIs were merged. The distance between the planned target and the centre of the implanted electrode artefact was measured. RESULTS: There was no significant difference in targeting precision on both sides of surgery. There was more intra-operative adjustment of the second electrode positioning based on microrecording and macrostimulation, which allowed to significantly approach the MRI-planned target on the medial-lateral axis. CONCLUSION: There was more electrode adjustment needed on the second side, possibly in relation with brain shift. We thus suggest performing a single central track with electrophysiological and clinical assessment, with multidirectional exploration on demand for suboptimal clinical responses.

Reconstruction of Fresnel Holograms using partial wave front information

n this work we analyze the behavior of complex information in Fresnel domain taking into account the limited capability to display complex transmittance values of current liquid crystal devices, when used as holographic displays. In order to do this analysis we compute the reconstruction of Fresnel holograms at several distances using the different parts of the complex distribution (real and imaginary parts, amplitude and phase) as well as using the full complex information adjusted with a method that combines two configurations of the devices in an adding architecture. The RMS error between the amplitude of these reconstructions and the original amplitude is used to evaluate the quality of the information displayed. The results of the error analysis show different behavior for the reconstructions using the different parts of the complex distribution and using the combined method of two devices. Better reconstructions are obtained when using two devices whose configurations densely cover the complex plane when they are added. Simulated and experimental results are also presented.

TMP- laitoksen mallinnus ja simulointi

Diplomityössä tehtiin Balas- simulointimalli Stora Enso Publication Papers Oy Ltd Varkauden tehtaiden kuumahierrelaitoksesta, johon sovitettiin tehtaan lämpö-, kuitu- ja kiertovesivirtaukset sekä kiertovesissä olevien liuenneiden ja kolloidisten aineiden virtaukset. Kirjallisuusosassa perehdyttiin simulaattorimallin luontiin ja käyttötarkoituksiin. Siinä käsitellään Balas- simulaattorin ominaisuuksia ja laiteparametrointia. Tarkastellaan kuumahierreprosessin eri vaiheita, olosuhteita ja laitteiden toimintaa. Perehdytään prosessin energian kulutukseen ja talteenottoon sekä kiertovesien liuenneiden ja kolloidisten aineiden mittaussuureisiin ja vaikutuksiin prosessissa. Simulaattorimallin tekemiseen kuului tehtaan virtauskaavion ja simulaattorimallin tekeminen, mittauskoesuunnittelu, tehdasmittaukset, simulaattorin parametrointi, mittaus- ja simulaattoritulosten yhteensovittaminen sekä mallin kelpoistaminen. Tehtaan virtauskaavion piirtämisessä käytettiin apuna tehtaan prosessi- ja instrumentointikaavioita, joiden pohjalta mittauskoesuunnitelma ja simulaattorimalli tehtiin. Koesuunnitelman mittaussuureiksi valittiin virtaukset, sakeudet, lämpötilat sekä kiertovesien kiintoaineen-, kokonaisorgaanisen hiilen- ja liuenneen orgaanisen aineen pitoisuuksien määritykset. Mittauksilla saatiin tietoja prosessivirtausten taseista, joita käytettiin simulaattorimallin keskeisempien laiteparametriarvojen määrityksessä. Exceliä hyödynnettiin mittaus- ja simulaattoritulosten taulukoinnissa, laiteparametrien laskemisessa sekä arvojen syötössä ja vastaanotossa Excelin ja simulaattorin välillä. Sitä käytettiin myös graafisessa mittaus- ja simulaattoritulosten yhteensovittamisessa, jolla pystyttiin havainnollisesti näkemään eri syöttöparametrien muutoksien vaikutukset simulaattorin laskemissa virtaustuloksissa. Mallin antamien arvojen ja todellisten prosessimittausarvojen yhteensovittamisen ja mallista varmistumisen tuloksista voidaan todeta mallin korreloivan todellista prosessia melko hyvin.

Digitalización del sistema de control de nivel en calentadores y tanques de drenaje de una Central Nuclear

Contexto Una central nuclear, al igual que cualquier otro tipo de central generadora de energía eléctrica, mediante turbinas de vapor, está basada en un proceso termodinámico. El rendimiento de las mismas es función del salto entálpico del vapor, para mejorarlo las centrales están constituidas por un ciclo compound formado por turbina de alta presión y turbinas de baja presión, y un ciclo regenerativo consistente en calentar el agua de alimentación antes de su introducción a los generadores de vapor. Un ciclo regenerativo está basado en etapas de calentadores o cambiadores de calor para aprovechar al máximo la energía térmica del vapor, este proyecto está basado en la mejora y optimización del proceso de control de estos para contribuir a mejorar el rendimiento de la central. Objetivo Implementar un sistema de control que nos permita modernizar los clásicos sistemas basados en controles locales y comunicaciones analógicas. Mejorar el rendimiento del ciclo regenerativo de la central, aprovechando las mejoras tecnológicas que ofrece el mercado, tanto en el hardware como en el software de los sistemas de instrumentación y control. Optimizar el rendimiento de los lazos de control de cada uno de los elementos del ciclo regenerativo mediante estrategias de control. Procedimiento Desarrollo de un sistema de control actualizado considerando, como premisa principal, la fiabilidad del sistema, el análisis de fallos y la jerarquización del riesgo. Análisis y cálculo de los lazos de control considerando las premisas establecidas. Configuración de los lazos mediante estrategias de control que nos permitan optimizar y minimizar los efectos del fallo. Para ello se han utilizado parámetros y datos extraídos de la Central Nuclear de Ascó. Conclusiones Se ha modernizado y optimizado el sistema de control mejorando el rendimiento del ciclo regenerativo. Se ha conseguido un sistema más fiable, reduciendo el riesgo del fallo y disminuyendo los efectos de los mismos. El coste de un proyecto de estas características es inferior al de un sistema convencional y ofrece más posibilidades. Es un sistema abierto que permite utilizar e interconectar equipos de diferentes fabricantes, lo que favorece tanto el mantenimiento como las posibles ampliaciones futuras del sistema.

Wavefront reconstruction by adding modulation capabilities of two liquid crystal devices

We analyze the behavior of complex information in the Fresnel domain, taking into account the limited capability to display complex values of liquid crystal devices when they are used as holographic displays. To do this analysis we study the reconstruction of Fresnel holograms at several distances using the different parts of the complex distribution. We also use the information adjusted with a method that combines two configurations of the devices in an adding architecture. The results of the error analysis show different behavior for the reconstructions when using the different methods. Simulated and experimental results are presented.

Fluoroscopic-Guided Radial Endobronchial Ultrasound Without Guide Sheath For Peripheral Pulmonary Lesions: A Safe And Efficient Combination.

BACKGROUND: Several guidelines recommend computed tomography scans for populations with high-risk for lung cancer. The number of individuals evaluated for peripheral pulmonary lesions (PPL) will probably increase, and with it non-surgical biopsies. Associating a guidance method with a target confirmation technique has been shown to achieve the highest diagnostic yield, but the utility of bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy as guidance without a guide sheath has not been reported. METHODS: We conducted a retrospective analysis of bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy procedures for the investigation of PPL performed by experienced bronchoscopists with no specific previous training in this particular technique. Operator learning curves and radiological predictors were assessed for all consecutive patients examined during the first year of application of the technique. RESULTS: Fifty-one PPL were investigated. Diagnostic yield and visualization yield were 72.5 and 82.3% respectively. The diagnostic yield was 64.0% for PPL ≤20mm, and 80.8% for PPL>20mm. No false-positive results were recorded. The learning curve of all diagnostic tools showed a DY of 72.7% for the first sub-group of patients, 81.8% for the second, 72.7% for the third, and 81.8% for the last. CONCLUSION: Bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy as guidance is safe and simple to perform, even without specific prior training, and diagnostic yield is high for PPL>and ≤20mm. Based on these findings, this method could be introduced as a first-line procedure for the investigation of PPL, particularly in centers with limited resources.

An outcome and cost analysis of anal fistula plug insertion vs endorectal advancement flap for complex anal fistulae.

AIM: The study aimed to compare the rate of success and cost of anal fistula plug (AFP) insertion and endorectal advancement flap (ERAF) for anal fistula. METHOD: Patients receiving an AFP or ERAF for a complex single fistula tract, defined as involving more than a third of the longitudinal length of of the anal sphincter, were registered in a prospective database. A regression analysis was performed of factors predicting recurrence and contributing to cost. RESULTS: Seventy-one patients (AFP 31, ERAF 40) were analysed. Twelve (39%) recurrences occurred in the AFP and 17 (43%) in the ERAF group (P = 1.00). The median length of stay was 1.23 and 2.0 days (P < 0.001), respectively, and the mean cost of treatment was euro5439 ± euro2629 and euro7957 ± euro5905 (P = 0.021), respectively. On multivariable analysis, postoperative complications, underlying inflammatory bowel disease and fistula recurring after previous treatment were independent predictors of de novo recurrence. It also showed that length of hospital stay ≤ 1 day to be the most significant independent contributor to lower cost (P = 0.023). CONCLUSION: Anal fistula plug and ERAF were equally effective in treating fistula-in-ano, but AFP has a mean cost saving of euro2518 per procedure compared with ERAF. The higher cost for ERAF is due to a longer median length of stay.

A digital holography technique for generating beams with arbitrary polarization and shape

A method for generating beams with arbitrary polarization and shape is proposed. Our design requires the use of a Mach-Zehnder set-up combined with translucent liquid crystal displays in each arm of the interferometer; in this way, independent manipulation of each transverse beam components is possible. The target of this communication is to develop a numerical procedure for calculating the holograms required for dynamically encode any amplitude value and polarization state in each point of the wavefront. Several examples demonstrating the capabilities of the method are provided.