Comparison of Quantitative Imaging Devices and Subjective Optic Nerve Head Assessment by General Ophthalmologists to Differentiate Normal From Glaucomatous Eyes

Purpose: To compare the ability of Subjective assessment of optic nerve head (ONH) and retinal nerve fiber layer (RNFL) by general ophthalmologists and by a glaucoma expert with objective measurements by optical coherence tomography (Stratus OCT, Carl Zeiss Meditec Inc), confocal scanning laser ophthalmoscope (HRT III; Heidelberg Engineering, Heidelberg. Germany), and scanning laser polarimetry (GDx enhanced corneal compensation; Carl Zeiss Meditec Inc, Dublin, CA) in discriminating glaucomatous and normal eyes. Methods: Sixty-one glaucomatous and 57 normal eyes or 118 subjects Were included in the study. Three independent general ophthalmologists and I glaucoma expert evaluated ONH stereo-photographs. Receiver operating characteristic curves were constructed for each imaging technique and sensitivity at fixed specificity was estimated. Comparisons or areas under these curves (aROCs) and agreement (k) were determined between stereophoto grading and best parameter from each technique. Results: Best parameter from each technique showed larger aROC (Stratus OCT RNFL 0.92; Stratus OCT ONH vertical integrated area = 0.86; Stratus OCT macular thickness = 0.82; GDx enhanced corneal compensation = 0.91, HRT3 global cup-to-disc ratio = 0.83; HRT3 glaucoma probability score numeric area score 0.83) compared with stereophotograph grading by general ophthalmologists (0.80) in separating glaucomatous and normal eyes. Glaucoma expert stereophoto grading provided equal or larger aROC (0.92) than best parameter of each computerized imaging device. Stereophoto evaluated by a glaucoma expert showed better agreement with best parameter of each quantitative imaging technique in classifying eyes either as glaucomatous or normal compared with stereophoto grading by general ophthalmologists, The combination Of Subjective assessment of the optic disc by general ophthalmologists with RNFL objective parameters improved identification of glaucoma patients in a larger proportion than the combination of these objective parameters with Subjective assessment of the optic disc by a glaucoma expert (29.5% vs. 19.7%, respectively). Conclusions: Diagnostic ability of all imaging techniques showed better performance than subjective assessment of the ONH by general ophthalmologists, but not by It glaucoma expert, Objective RNFL measurements may provide improvement in glaucoma detection when combined with subjective assessment of the optic disc by general ophthalmologists or by a glaucoma expert.

Placental Volumes Measured by 3-Dimensional Ultrasonography in Normal Pregnancies From 12 to 40 Weeks` Gestation

Objective. The purpose of this study was to construct nomograms of placental volumes according to gestational age and estimated fetal weight. Methods. From March to November 2007, placental volumes were prospectively measured by ultrasonography in 295 normal pregnancies from 12 to 40 weeks` gestation and correlated with gestational age and estimated fetal weight. Inclusion criteria were healthy women, singleton pregnancies with normal fetal morphologic characteristics on ultrasonography, and confirmed gestational age by first-trimester ultrasonography. Results. The mean placental volume ranged from 83 cm(3) at 12 weeks to 427.7 cm(3) at 40 weeks. Linear regression yielded the following formula for the expected placental volumes (ePV) according to gestational age (GA): ePV` (cm(3)) = -64.68 + 12.31 x GA (r = 0.572; P < .001). Placental volumes also varied according to estimated fetal weight (EFW), and the following mathematical equation was also obtained by linear regression: ePV = 94.19 + 0.09 x EFW (r = 0.505; P < 0.001). Conclusions. Nomograms of placental volumes according to gestational age and estimated fetal weight were constructed, generating reference values.

The frequency of human papillomavirus findings in normal oral mucosa of healthy people by PCR

The human papillomavirus (HPV) is a DNA virus, which belongs to papillomaviridae family, being of low and high risk, which infect the skin and mucous membranes and can induce benign and malign tumor formation. In the oral mucosa they have been associated with oral papilloma, focal epithelial hyperplasia, leucoplakia and oral neoplasia. Aim: to study the frequency of HPV finding in oral mucosa of normal people. Materials and methods: Prospective study, cross-sectional cohort. One hundred volunteers, young adults, healthy, aged between 20 and 31 years, university students with no history, no complains, without oral or oropharyngeal lesions. They were submitted to a questionnaire with questions regarding HPV infection epidemiology. The samples were harvested by brushing and analyzed by PCR. Results: The results were negative for HPV in all samples. Conclusion: It seems we had high social and economical class individuals, with nutrition rich in carotenoyds and vitamin C, low smoking and alcohol consumption and heterosexual habits with predominant monogamy and regular use of condoms.

Dual mode cooling house in the warm humid tropics

Passive techniques as an alternative to artificial cooling can bring important energy, environmental, financial, operational and qualitative benefits. However, regions such as the wet tropics can reach high levels of thermal stress in which passive means alone are unable to provide appropriate thermal comfort standards for some parts of the year. Despite a great accumulation of empirical information on the passive performance of houses for either free-running or conditioned modes, very little work has been done on the thermal performance of buildings that can operate with a mixed-running strategy in warm-humid climates. Buildings with such design features are able to balance the needs for comfort, privacy, and energy efficiency during different periods of the year. As free-running and conditioned modes are believed by many to be 'opposite' approaches, and have been presented as separate strategies, this paper demonstrates that not all parameters are directly opposite and a possible dual-mode integrated operation can be used for warm-humid locations for maximum comfort and minimum energy requirements. For this purpose, simulation runs using ESP-R (University of Strathclyde, ESRU, UK) were based on the climate data of Darwin (Australia) and on the ventilation styles of the house: free running and conditioned. Design features applicable to both, i.e. for a dual mode operation could be identified and the differences between conditioned and free running were demonstrated and proved not to be totally conflicting and therefore suitable for a dual mode operation. Different daily usage profiles (five use patterns were defined), and zoning of sleeping and living areas are presented. The dual mode use patterns compared to the base case house, for all the user possibilities, had improved performances of 17-52%, when compared to the free-running mode and 66-98% when compared to the conditioned mode. Simulation runs using other warm-humid climates (Miami, USA; Sao Luis, Brazil; Kuala Lumpur, Malaysia) were also conducted and compared to the results found for Darwin. (C) 2002 Elsevier Science Ltd. All rights reserved.

Usefulness of B-type natriuretic peptide in hypertensive patients with exertional dyspnea and normal left ventricular ejection fraction and correlation with new echocardiographic indexes of systolic and diastolic function

B-type natriuretic peptide (BNP) levels increase in systolic heart failure (HF). However, the value of BNP in hypertensive patients with suspected diastolic HF (symptoms suggestive of HF but normal ejection fraction) and its relation to myocardial function in these patients is unclear. We prospectively studied 72 ambulatory hypertensive subjects (40 women, mean age 58 +/- 8 years) with exertional dyspnea and ejection fraction greater than or equal to50%. Diastolic function was evaluated with transmitral and pulmonary venous Doppler, mitral annular velocities (pulsed-wave tissue Doppler), and flow propagation velocity (color M-mode). Systolic function was assessed with strain and strain rate derived from color tissue Doppler imaging. BNP was related to myocardial function and the presence or absence of global diastolic dysfunction. By conventional Doppler criteria, 34 patients had normal left ventricular diastolic function and 38 had isolated diastolic dysfunction. BNP values were higher in patients with diastolic dysfunction (46 +/- 48 vs 20 +/- 20 pg/ml, p = 0.004) and were related independently to blood pressure, systolic strain rate, left atrial function (p < 0.01 for all), and age (p = 0.015). Patients with diastolic dysfunction and pseudonormal filling had higher BNP levels compared with impaired relaxation (89 +/- 47 vs 35 +/- 42 pg/ml, p = 0.001). However, 79% of patients with diastolic dysfunction had BNP levels within the normal range. We conclude that in ambulatory hypertensive patients with symptoms suggestive of mild HF and normal ejection fraction, BNP is related to atrial and ventricular systolic parameters, blood pressure, and age. Although elevated in the presence of diastolic dysfunction, the BNP level mostly is in the normal range and, therefore, has limited diagnostic value in stable patients with suspected diastolic HF. (C) 2003 by Excerpta Medica, Inc.

Partitioned scheduling of multimode systems on multiprocessor platforms: when to do the mode transition?

Systems composed of distinct operational modes are a common necessity for embedded applications with strict timing requirements. With the emergence of multi-core platforms protocols to handle these systems are required in order to provide this basic functionality.In this work a description on the problems of creating an effective mode-transition protocol are presented and it is proven that in some cases previous single-core protocols can not be extended to handle the mode-transition in multi-core.

Global-EDF scheduling of multimode real- time systems considering mode independent tasks

Embedded real-time systems often have to support the embedding system in very different and changing application scenarios. An aircraft taxiing, taking off and in cruise flight is one example. The different application scenarios are reflected in the software structure with a changing task set and thus different operational modes. At the same time there is a strong push for integrating previously isolated functionalities in single-chip multicore processors. On such multicores the behavior of the system during a mode change, when the systems transitions from one mode to another, is complex but crucial to get right. In the past we have investigated mode change in multiprocessor systems where a mode change requires a complete change of task set. Now, we present the first analysis which considers mode changes in multicore systems, which use global EDF to schedule a set of mode independent (MI) and mode specific (MS) tasks. In such systems, only the set of MS tasks has to be replaced during mode changes, without jeopardizing the schedulability of the MI tasks. Of prime concern is that the mode change is safe and efficient: i.e. the mode change needs to be performed in a predefined time window and no deadlines may be missed as a function of the mode change.

Uniprocessor EDF scheduling with mode change

Consider the problem of scheduling sporadically-arriving tasks with implicit deadlines using Earliest-Deadline-First (EDF) on a single processor. The system may undergo changes in its operational modes and therefore the characteristics of the task set may change at run-time. We consider a well-established previously published mode-change protocol and we show that if every mode utilizes at most 50% of the processing capacity then all deadlines are met. We also show that there exists a task set that misses a deadline although the utilization exceeds 50% by just an arbitrarily small amount. Finally, we present, for a relevant special case, an exact schedulability test for EDF with mode change.

OnBoard reconfigurable battery charger for electric vehicles with traction-to-auxiliary mode

This paper proposes a single-phase reconfigurable battery charger for Electric Vehicle (EV) that operates in three different modes: Grid-to-Vehicle (G2V) mode, in which the traction batteries are charged from the power grid; Vehicle-to-Grid (V2G) mode, in which the traction batteries deliver part of the stored energy back to the power grid; and in Traction-to-Auxiliary (T2A) mode, in which the auxiliary battery is charged from the traction batteries. When connected to the power grid, the battery charger works with sinusoidal current in the AC side, for both G2V and V2G modes, and also regulates the reactive power. When the EV is disconnected from the power grid, the control algorithms are modified and the full-bridge AC-DC bidirectional converter works as a full-bridge isolated DC-DC converter that is used to charge the auxiliary battery of the EV, avoiding the use of an additional charger to accomplish this task. To assess the behavior of the proposed reconfigurable battery charger under different operation scenarios, a 3.6 kW laboratory prototype has been developed and experimental results are presented.

Differential activation of the default mode network in jet lagged individuals

Long-term exposure to transmeridian flights has been shown to impact cognitive functioning. Nevertheless, the immediate effects of jet lag in the activation of specific brain networks have not been investigated. We analyzed the impact of short-term jet lag on the activation of the default mode network (DMN). A group of individuals who were on a transmeridian flight and a control group went through a functional magnetic resonance imaging acquisition. Statistical analysis was performed to test for differences in the DMN activation between groups. Participants from the jet lag group presented decreased activation in the anterior nodes of the DMN, specifically in bilateral medial prefrontal and anterior cingulate cortex. No areas of increased activation were observed for the jet lag group. These results may be suggestive of a negative impact of jet lag on important cognitive functions such as introspection, emotional regulation and decision making in a few days after individuals arrive at their destination.

Normal values of echocardiographic measurements. A population-based study

OBJECTIVE: To describe echocardiographic measurements and left ventricular mass in a population sample of healthy adults inhabitants of the urban region of Porto Alegre. METHODS: An analytical, observational, population-based, cross-sectional study was done. Through a multi-stage probability sample, 114 individuals were selected to be submitted to a M-mode and two-dimensional echocardiogram with color Doppler. The analyses were restricted to healthy participants. Echocardiographic measurements were described by mean, standard deviation, 95 percentile and 95% confidence limits. RESULTS: A total of 100 healthy participants, with several characteristics similar to those from the original population, had a complete and reliable echocardiographic examination. The measurements of aorta, left atrium, interventricular septum, left ventricle in systole and diastole, left posterior wall and left ventricular mass, adjusted or not for body surface area or height, were significantly higher in males. The right ventricle size was similar among the genders. Several echocardiographic measurements were within standard normal limits. Interventricular septum, left posterior wall and left ventricular mass, adjusted or not for anthropometric measurements, and aortic dimensions had lower mean and range than the reference limits. CONCLUSION: The means and estimates of distribution for the measurements of interventricular septum, left posterior wall and left ventricular mass found in this survey were lower than those indicated by the international literature and accepted as normal limits.

Correction of through-plane deformation artifacts in stimulated echo acquisition mode cardiac imaging.

Attempts to use a stimulated echo acquisition mode (STEAM) in cardiac imaging are impeded by imaging artifacts that result in signal attenuation and nulling of the cardiac tissue. In this work, we present a method to reduce this artifact by acquiring two sets of stimulated echo images with two different demodulations. The resulting two images are combined to recover the signal loss and weighted to compensate for possible deformation-dependent intensity variation. Numerical simulations were used to validate the theory. Also, the proposed correction method was applied to in vivo imaging of normal volunteers (n = 6) and animal models with induced infarction (n = 3). The results show the ability of the method to recover the lost myocardial signal and generate artifact-free black-blood cardiac images.

Lateral instability in normal viscous fingers

We study a low-amplitude, long-wavelength lateral instability of the Saffman-Taylor finger by means of a phase-field model. We observe such an instability in two situations in which small dynamic perturbations are overimposed to a constant pressure drop. We first study the case in which the perturbation consists of a single oscillatory mode and then a case in which the perturbation consists of temporal noise. In both cases the instability undergoes a process of selection.

Smith Predictor Sliding Mode Closed-loop Glucose Controller in Type 1 Diabetes

Type 1 diabetic patients depend on external insulin delivery to keep their blood glucose within near-normal ranges. In this work, two robust closed-loop controllers for blood glucose regulation are developed to prevent the life-threatening hypoglycemia, as well as to avoid extended hyperglycemia. The proposed controllers are designed by using the sliding mode control technique in a Smith predictor structure. To improve meal disturbance rejection, a simple feedforward controller is added to inject meal-time insulin bolus. Simulations scenarios were used to test the controllers, and showed the controllers ability to maintain the glucose levels within the safe limits in the presence of errors in measurements, modeling and meal estimation

Sliding Mode Control for Switched Mode Power Supplies

Control applications of switched mode power supplies have been widely investigated. The main objective ofresearch and development (R&D) in this field is always to find the most suitable control method to be implemented in various DC/DC converter topologies. Inother words, the goal is to select a control method capable of improving the efficiency of the converter, reducing the effect of disturbances (line and load variation), lessening the effect of EMI (electro magnetic interference), and beingless effected by component variation. The main objective of this research work is to study different control methods implemented in switched mode power supplies namely (PID control, hysteresis control, adaptive control, current programmed control, variable structure control (VSC), and sliding mode control (SMC). The advantages and drawbacks of each control method are given. Two control methods, the PID and the SMC are selected and their effects on DC/DC (Buck, Boost, and Buck-Boost) converters are examined. Matlab/SimulinkTM is used to implement PID control method in DC/DC Buck converter and SMC in DC/DC (Buck, and Buck Boost) converters. For the prototype, operational amplifiers (op-amps) are used to implement PID control in DC/DC Buck converter. For SMC op-amps are implemented in DC/DC Buck converter and dSPACETM is used to control the DC/DC Buck-Boost converter. The SMC can be applied to the DC/DC (Buck, Boost, and Buck-Boost) converters. A comparison of the effects of the PID control and the SMC on the DC/DC Buck converter response in steady state, under line variations, load variations, and different component variations is performed. Also the Conducted RF-Emissions between the PID and SMC DC/DC Buck Converter are compared. The thesis shows that, in comparison with the PID control, the SMC provides better steady-state response, better dynamic response, less EMI, inherent order reduction, robustness against system uncertainty disturbances, and an implicit stability proof. Giving a better steady-state and dynamic response, the SMC is implemented in a DC/DC resonant converter. The half-wave zero current switching (HWZCS) DC/DC Buck converter is selected as a converter topology. A general guideline to select the tank component values, needed for the designing of a HWZCS DC/DC Buck, is obtained. The implementation of the SMC to a HWZCS DC/DC Buck converter is analysed. The converter response is investigated in the steady-state region and in the dynamic region.