Ultrasound-assisted versus conventional catheter-directed thrombolysis for acute iliofemoral deep vein thrombosis

BACKGROUND For patients with acute iliofemoral deep vein thrombosis, it remains unclear whether the addition of intravascular high-frequency, low-power ultrasound energy facilitates the resolution of thrombosis during catheter-directed thrombolysis. METHODS AND RESULTS In a controlled clinical trial, 48 patients (mean age 50±21 years, 52% women) with acute iliofemoral deep vein thrombosis were randomized to receive ultrasound-assisted catheter-directed thrombolysis (N=24) or conventional catheter-directed thrombolysis (N=24). Thrombolysis regimen (20 mg r-tPA over 15 hours) was identical in all patients. The primary efficacy end point was the percentage of thrombus load reduction from baseline to 15 hours according to the length-adjusted thrombus score, obtained from standardized venograms and evaluated by a core laboratory blinded to group assignment. The percentage of thrombus load reduction was 55%±27% in the ultrasound-assisted catheter-directed thrombolysis group and 54%±27% in the conventional catheter-directed thrombolysis group (P=0.91). Adjunctive angioplasty and stenting was performed in 19 (80%) patients and in 20 (83%) patients, respectively (P>0.99). Treatment-related complications occurred in 3 (12%) and 2 (8%) patients, respectively (P>0.99). At 3-month follow-up, primary venous patency was 100% in the ultrasound-assisted catheter-directed thrombolysis group and 96% in the conventional catheter-directed thrombolysis group (P=0.33), and there was no difference in the severity of the post-thrombotic syndrome (mean Villalta score: 3.0±3.9 [range 0-15] versus 1.9±1.9 [range 0-7]; P=0.21), respectively. CONCLUSIONS In this randomized controlled clinical trial of patients with acute iliofemoral deep vein thrombosis treated with a fixed-dose catheter thrombolysis regimen, the addition of intravascular ultrasound did not facilitate thrombus resolution. CLINICAL TRIAL REGISTRATION URL http://www.clinicaltrials.gov. Unique identifier: NCT01482273.

Prioritizing – the task strategy of the powerful?

Previous research has shown that power increases focus on the main goal when distractor information is present. As a result, high-power people have been described as goal-focused. In real life, one typically wants to pursue multiple goals at the same time. There is a lack of research on how power affects how people deal with situations in which multiple important goals are present. To address this question, 158 participants were primed with high or low power or assigned to a control condition, and were asked to perform a dual-goal task with three difficulty levels. We hypothesized and found that high-power primed people prioritize when confronted with a multiple-goal situation. More specifically, when task demands were relatively low, power had no effect; participants generally pursued multiple goals in parallel. However, when task demands were high, the participants in the high-power condition focused on a single goal whereas participants in the low-power condition continued using a dual-task strategy. This study extends existing power theories and research in the domain of goal pursuit.

Electronic tuning effects via π-linkers in tetrathiafulvalene-based dyes

Four new tetrathiafulvalene (TTF)-based dyes featured with a donor–bridge–acceptor (D–π–A) structure were synthesized and characterized. All of them undergo two reversible oxidations to form stable radical cation and dication species. The electronic interactions between the TTF donor and the cyanoacrylic acid acceptor through the different π-linkers have been demonstrated by the presence of a photo-induced intramolecular charge-transfer (ICT) absorption band in the visible region. A red shift of the ICT state can be finely tuned by the degree of aromaticity and extended conjugation of π-bridges. To some extent, the oxidation potentials of these dyes are affected by the nature of π-bridges. They have been applied in organic dye-sensitized solar cells, showing relatively low power conversion efficiencies of up to 0.87% due to substantial charge recombination losses.

A Baseline Wander Tracking System for Artifact Rejection in Long-Term Electrocardiography

Long-term electrocardiogram (ECG) signals might suffer from relevant baseline disturbances during physical activity. Motion artifacts in particular are more pronounced with dry surface or esophageal electrodes which are dedicated to prolonged ECG recording. In this paper we present a method called baseline wander tracking (BWT) that tracks and rejects strong baseline disturbances and avoids concurrent saturation of the analog front-end. The proposed algorithm shifts the baseline level of the ECG signal to the middle of the dynamic input range. Due to the fast offset shifts, that produce much steeper signal portions than the normal ECG waves, the true ECG signal can be reconstructed offline and filtered using computationally intensive algorithms. Based on Monte Carlo simulations we observed reconstruction errors mainly caused by the non-linearity inaccuracies of the DAC. However, the signal to error ratio of the BWT is higher compared to an analog front-end featuring a dynamic input ranges above 15 mV if a synthetic ECG signal was used. The BWT is additionally able to suppress (electrode) offset potentials without introducing long transients. Due to its structural simplicity, memory efficiency and the DC coupling capability, the BWT is dedicated to high integration required in long-term and low-power ECG recording systems.

Widespread Signals of Convergent Adaptation to High Altitude in Asia and America

Living at high altitude is one of the most difficult challenges that humans had to cope with during their evolution. Whereas several genomic studies have revealed some of the genetic bases of adaptations in Tibetan, Andean, and Ethiopian populations, relatively little evidence of convergent evolution to altitude in different continents has accumulated. This lack of evidence can be due to truly different evolutionary responses, but it can also be due to the low power of former studies that have mainly focused on populations from a single geographical region or performed separate analyses on multiple pairs of populations to avoid problems linked to shared histories between some populations. We introduce here a hierarchical Bayesian method to detect local adaptation that can deal with complex demographic histories. Our method can identify selection occurring at different scales, as well as convergent adaptation in different regions. We apply our approach to the analysis of a large SNP data set from low- and high-altitude human populations from America and Asia. The simultaneous analysis of these two geographic areas allows us to identify several candidate genome regions for altitudinal selection, and we show that convergent evolution among continents has been quite common. In addition to identifying several genes and biological processes involved in high-altitude adaptation, we identify two specific biological pathways that could have evolved in both continents to counter toxic effects induced by hypoxia.

The Nurturing of Seagliders By the National Oceanographic Partnership Program

The National Oceanographic Partnership Program provided critical support to the development of Seaglider long-range autonomous underwater vehicles. This support enabled: (1) development and integration of chemical and biological sensors, (2) transition to low-power, bi-directional satellite communication, and (3) software upgrades to enhance capability and reliability. Sponsored improvements led to setting the mission endurance and range records for autonomous underwater vehicles, wide use by the oceanographic community and licensing for commercialization.

A full pedigree based method for the statistical assessment of genetic anticipation

Genetic anticipation is defined as a decrease in age of onset or increase in severity as the disorder is transmitted through subsequent generations. Anticipation has been noted in the literature for over a century. Recently, anticipation in several diseases including Huntington's Disease, Myotonic Dystrophy and Fragile X Syndrome were shown to be caused by expansion of triplet repeats. Anticipation effects have also been observed in numerous mental disorders (e.g. Schizophrenia, Bipolar Disorder), cancers (Li-Fraumeni Syndrome, Leukemia) and other complex diseases. ^ Several statistical methods have been applied to determine whether anticipation is a true phenomenon in a particular disorder, including standard statistical tests and newly developed affected parent/affected child pair methods. These methods have been shown to be inappropriate for assessing anticipation for a variety of reasons, including familial correlation and low power. Therefore, we have developed family-based likelihood modeling approaches to model the underlying transmission of the disease gene and penetrance function and hence detect anticipation. These methods can be applied in extended families, thus improving the power to detect anticipation compared with existing methods based only upon parents and children. The first method we have proposed is based on the regressive logistic hazard model. This approach models anticipation by a generational covariate. The second method allows alleles to mutate as they are transmitted from parents to offspring and is appropriate for modeling the known triplet repeat diseases in which the disease alleles can become more deleterious as they are transmitted across generations. ^ To evaluate the new methods, we performed extensive simulation studies for data simulated under different conditions to evaluate the effectiveness of the algorithms to detect genetic anticipation. Results from analysis by the first method yielded empirical power greater than 87% based on the 5% type I error critical value identified in each simulation depending on the method of data generation and current age criteria. Analysis by the second method was not possible due to the current formulation of the software. The application of this method to Huntington's Disease and Li-Fraumeni Syndrome data sets revealed evidence for a generation effect in both cases. ^

Evaluation of the Hosmer -Lemeshow global goodness -of-fit statistic for mixed variable logistic regression models

The performance of the Hosmer-Lemeshow global goodness-of-fit statistic for logistic regression models was explored in a wide variety of conditions not previously fully investigated. Computer simulations, each consisting of 500 regression models, were run to assess the statistic in 23 different situations. The items which varied among the situations included the number of observations used in each regression, the number of covariates, the degree of dependence among the covariates, the combinations of continuous and discrete variables, and the generation of the values of the dependent variable for model fit or lack of fit.^ The study found that the $\rm\ C$g* statistic was adequate in tests of significance for most situations. However, when testing data which deviate from a logistic model, the statistic has low power to detect such deviation. Although grouping of the estimated probabilities into quantiles from 8 to 30 was studied, the deciles of risk approach was generally sufficient. Subdividing the estimated probabilities into more than 10 quantiles when there are many covariates in the model is not necessary, despite theoretical reasons which suggest otherwise. Because it does not follow a X$\sp2$ distribution, the statistic is not recommended for use in models containing only categorical variables with a limited number of covariate patterns.^ The statistic performed adequately when there were at least 10 observations per quantile. Large numbers of observations per quantile did not lead to incorrect conclusions that the model did not fit the data when it actually did. However, the statistic failed to detect lack of fit when it existed and should be supplemented with further tests for the influence of individual observations. Careful examination of the parameter estimates is also essential since the statistic did not perform as desired when there was moderate to severe collinearity among covariates.^ Two methods studied for handling tied values of the estimated probabilities made only a slight difference in conclusions about model fit. Neither method split observations with identical probabilities into different quantiles. Approaches which create equal size groups by separating ties should be avoided. ^

Cost and energy efficient reconfigurable embedded platform using Spartan-6 FPGAs

Modern FPGAs with run-time reconfiguration allow the implementation of complex systems offering both the flexibility of software-based solutions combined with the performance of hardware. This combination of characteristics, together with the development of new specific methodologies, make feasible to reach new points of the system design space, and make embedded systems built on these platforms acquire more and more importance. However, the practical exploitation of this technique in fields that traditionally have relied on resource restricted embedded systems, is mainly limited by strict power consumption requirements, the cost and the high dependence of DPR techniques with the specific features of the device technology underneath. In this work, we tackle the previously reported problems, designing a reconfigurable platform based on the low-cost and low-power consuming Spartan-6 FPGA family. The full process to develop the platform will be detailed in the paper from scratch. In addition, the implementation of the reconfiguration mechanism, including two profiles, is reported. The first profile is a low-area and low-speed reconfiguration engine based mainly on software functions running on the embedded processor, while the other one is a hardware version of the same engine, implemented in the FPGA logic. This reconfiguration hardware block has been originally designed to the Virtex-5 family, and its porting process will be also described in this work, facing the interoperability problem among different families.

Terapia por láser de baja potencia: consideraciones óptico-físicas y biológicas determinantes en su aplicación clínica.

Objetivos : Analizar la distribución de energía en un tejido cuando se emplea terapia por láser de baja potencia y estudiar las especificaciones mínimas de equipos de terapia láser para estimar la dosis. Material y métodos: Se ha empleado el método de Monte Carlo para obtener la distribución de energía absorbida por la piel para dos tipos de láser y la teoría de la difusión para estimar la longitud de penetración y el recorrido libre medio. Se ha estudiado la variación de esa distribución en función de la raza (caucásico, asiático, afroamericano) y para dos localizaciones anatómicas distintas. Se ha analizado la información facilitada por diversos fabricantes de equipos comerciales para determinar si es necesario adaptar la dosimetría recomendada. Resultados: La radiación láser infrarroja (810nm) se absorbe mayoritariamente en un espesor de piel de 1,9±0,2mm para caucásicos, entre 1,73±0,08mm (volar del antebrazo) y 1,80±0,11mm (palma) para asiáticos y entre 1,25±0,09mm (volar del antebrazo) y 1,65±0,2mm (palma) para afroamericanos. El recorrido libre medio de la luz siempre es menor que 0,69±0,09mm. Para los equipos comerciales analizados la única característica geométrica del haz láser que se menciona es la superficie que oscila entre 0,08 y 1cm2, pero no se especifica cómo es la distribución de energía, la divergencia del haz, forma de la sección transversal, etc. Conclusiones:Dependiendo del equipo de terapia por láser de baja potencia utilizado, el tipo de paciente y la zona a tratar, el clínico debe adaptar las dosis recomendadas. Abstract: Objectives: To analyze the distribution of energy deposited in a tissue when this is irradiated with a low power laser and to study the minimum characteristics that manufacturers of low power laser therapy equipments should include to estimate the dosage. Material and methods: Monte Carlo simulation was performed to determine the absorption location of the laser energy. The diffusion theory was used to estimate penetration depth and mean free path. Variation of this distribution was studied based on three different skin types (Caucasians, Asians and Afroamericans) and for two different anatomic locations: palm and volar forearm. Information given by several manufactures of low power laser therapy equipments has been analyzed. Results: Infrared (810 nm) laser radiation is mainly absorbed in a skin layer of thickness 1.9±0.2mm for Caucasians, from 1.73±0.08mm (volar forearm) to 1.80±0.11mm (palm) for Asians, and from 1.25±0.09mm (volar forearm) to 1.65±0.2mm (palm) for Afroamericans. The light mean free path is lower than 0.69±0.09mm for all cases. The laser beam characteristics (beam shape, energy distribution on a transversal section, divergence, incidence angle,etc.) are not usually specified by the manufacturers. Only beam size (ranging from 0.08 to 1cm2) is given in some cases. Discussion and conclusions: Depending on the low power laser therapy equipment, on the patient and on the anatomic area to be treated, the staff should adapt the recommended dosage for each individual case.

VLC oriented energy efficient driver techniques

LEDs are substituting fluorescent and incandescent bulbs as illumination sources due to their low power consumption and long lifetime. Visible Light Communications (VLC) makes use of the LEDs short switching times to transmit information. Although LEDs switching speed is around Mbps range, higher speeds (hundred of Mbps) can be reached by using high bandwidth-efficiency modulation techniques. However, the use of these techniques requires a more complex driver which elevates drastically its power consumption. In this work an energy efficiency analysis of the different VLC modulation techniques and drivers is presented. Besides, the design of new schemes of VLC drivers is described.

Estudio de redes WSN y su aplicación a la ingeniería civil

Las redes inalámbricas están experimentando un gran crecimiento en el campo de la instrumentación electrónica. En concreto las redes de sensores inalámbricas (WSN de Wireless Sensor Network) suponen la opción más ventajosa para su empleo en la instrumentación electrónica ya que sus principales características se acoplan perfectamente a las necesidades. Las WSN permiten la utilización de un número relativamente alto de nodos, están orientadas a sistemas de bajo consumo y funcionamiento con baterías y poseen un ancho de banda adecuado para las necesidades de la instrumentación electrónica. En este proyecto fin de carrera se ha realizado un estudio de las tecnologías inalámbricas disponibles, se han comparado y se ha elegido la tecnología ZigBeeTM por considerarse la más adecuada y la que más se ajusta a las necesidades descritas. En el desarrollo de mi vida profesional se han conectado dos campos teóricamente distantes como son la instrumentación electrónica y la ingeniería civil. En este proyecto se hace una descripción de la instrumentación que se utiliza para controlar estructuras como presas, túneles y puentes y se proponen casos prácticos en los que las redes WSN aportan valor añadido a instrumentación actual y a los sistemas de comunicaciones utilizados. Se definen tanto los sistemas de comunicaciones utilizados actualmente como una serie de sensores utilizados para medir los principales parámetros a controlar en una obra civil. Por último se ha desarrollado una aplicación de prueba de una red ZigBeeTM basada en equipos comerciales del fabricante Digi. consiste en una aplicación desarrollada en entorno web que maneja de forma remota, a través de Internet, las entradas y salidas digitales y analógicas de los nodos que forman la red. Se forma una red ZigBeeTM con un coordinador, un router y un dispositivo final. El Coordinador está integrado en un Gateway que permite acceder a la red ZigBeeTM a través de internet y conocer el estado de los nodos que forman la red. Con los comandos adecuados se puede leer el estado de las entradas y salidas analógicas y digitales y cambiar el estado de una salida digital. ABSTRACT. Wireless networks are experiencing tremendous growth in the field of electronic instrumentation. In particular wireless sensor networks represent the most advantageous for use in electronic instrumentation since its main characteristics fit perfectly to the needs. The WSN allow the use of a relatively large number of nodes, are aimed at low-power systems and battery operation and have an adequate bandwidth for the needs of electronic instrumentation. In this project has made a study of available wireless technologies have been compared and chosen ZigBeeTM technology was considered the most appropriate to the needs described. In the course of my professional life have connected two fields are theoretically distant as electronic instrumentation and civil engineering. In this project, there is a description of the instrumentation used to control structures such as dams, tunnels and bridges and proposes practical cases in which WSN networks add value to current instrumentation and communications systems used. There are defined as communications systems now being used as a set of sensors used to measure the main parameters to be controlled in a civil structure. Finally, I have developed a test application based ZigBeeTM networking equipment maker Digi trading. It consists of a Web-based application developed to manage remotely, via the Internet, the digital and analog inputs and outputs nodes forming the network. ZigBeeTM It forms a network with a coordinator, router and end device. The Coordinator is built into a gateway that allows access to the ZigBeeTM network through internet and know the status of the nodes forming the network. With the appropriate command can read the status of the digital inputs and outputs and change the state of a digital output.

Contribución al estudio de sistemas de hipertermia óptica y su aplicación en muestras biológicas

Las nanopartículas de metales nobles (especialmente las de oro) tienen un gran potencial asociado al desarrollo de sistemas de terapia contra el cáncer debido principalmente a sus propiedades ópticas, ya que cuando son irradiadas con un haz de luz sintonizado en longitud de onda con su máximo de Resonancia de Plasmón Superficial, absorben de manera muy eficiente dicha luz y la disipan rápidamente al medio en forma de calor localizado. Esta característica por tanto, puede ser aprovechada para conseguir elevar la temperatura de células tumorales hasta sobrepasar umbrales a partir de los cuales se produciría la muerte celular. Partiendo de estos principios, esta tesis se centra en el desarrollo y la caracterización de una serie de prototipos de hipertermia óptica basados en la irradiación de nanopartículas de oro con un haz de luz adecuado, así como en la aplicación in vitro de la terapia sobre células cancerígenas. Además, el trabajo se orienta a identificar y comprender los procesos mecánicos y térmicos asociados a este tipo de hipertermia, y a desarrollar modelos que los describan, estudiando y planteando nuevas formas de irradiación, para, en última instancia, poder optimizar los procesos descritos y hacerlos más efectivos. Los resultados obtenidos indican que, el uso de nanopartículas de oro, y más concretamente de nanorods de oro, para llevar a cabo terapias de hipertermia óptica, permite desarrollar terapias muy efectivas para inducir muerte en células cancerígenas, especialmente en tumores superficiales, o como complemento quirúrgico en tumores internos. Sin embargo, los efectos de la toxicidad de las nanopartículas de oro, aún deben ser detalladamente estudiados, ya que este tipo de terapias sólo será viable si se consigue una completa biocompatibilidad. Por otro lado, el estudio exhaustivo de los procesos térmicos que tienen lugar durante la irradiación de las nanopartículas ha dado lugar a una serie de modelos que permiten determinar la efectividad fototérmica de las nanopartículas y además, visualizar la evolución de la temperatura tanto a escala nanométrica como a escala macrométrica, en función de los parámetros ópticos y térmicos del sistema. El planteamiento de nuevas formas de irradiación y el desarrollo de dispositivos orientados a estudiar los fenómenos mecánicos que tienen lugar durante la irradiación pulsada de baja frecuencia y baja potencia de nanopartículas de oro, ha dado lugar a la detección de ondas de presión asociadas a procesos de expansión termoelástica, abriendo la puerta al desarrollo de terapias de hipertermia que combinen la muerte celular producida por calentamiento con la muerte derivada de los fenómenos mecánicos descritos.VII Noble metal nanoparticles (especially gold ones), have a huge potential in the development of therapy systems against cancer mainly due to their optical properties, so that, when these particles are irradiated with a light that is syntonized in wavelength with their maximum of Surface Plasmon Resonance, they effectively absorb and dissipate the light to the surrounding medium as localized heat. We can take advantage of this characteristic for rising the temperature of cancer cells above the threshold at which cellular death would occur. From these principles, this thesis is oriented to the development and characterization of a series of optical hyperthermia prototypes based on the irradiation of gold nanoparticles using the suitable light, and on the in vitro application of this therapy over cancer cells, to understand the mechanical and thermal processes associated with this kind of hyperthermia, developing descriptive models, and to study and to approach new ways of irradiation in order to, ultimately, optimize the described processes and make them more effective. The obtained results show that, the use of gold nanoparticles, and more specifically, of gold nanorods, to carry out optical hyperthermia therapies, allows the development of very effective therapies in order to induce death in VIII cancer cells, especially in superficial tumors, or like surgical complement in more internal tumors. However, the toxicity effects of the gold nanoparticles still need to be studied more detail, because this kind of therapies will be feasible only if a complete biocompatibility is achieved. On the other hand, the exhaustive study of the thermal processes that take place during the irradiation of the nanoparticles resulted in a series of models that allow the determination of the photothermal efficiency of the nanoparticles and also the visualization of the temperature evolution, both at nanoscale and at macroscale, as a function of the optical and thermal parameters of the system. The proposal of new ways of irradiation and the development of devices oriented to study the mechanical effects that take place during the low frequency and low power pulsing irradiation of gold nanoparticles has led to the detection of pressure waves associated to thermoelastic expansion processes, opening the door to the development of hyperthermia therapies that combine the cellular death due to the heating with the death derived from the described mechanical phenomena.

Bare Tethers for Electrodynamic Spacecraft Propulsion

Electrodynamic tether thrusters can use the power provided by solar panels to drive a current in the tether and then the Lorentz force to push against the Earth's magnetic field, thereby achieving propulsion without the expenditure of onboard energy sources or propellant. Practical tether propulsion depends critically on being able to extract multiamp electron currents from the ionosphere with relatively short tethers (10 km or less) and reasonably low power. We describe a new anodic design that uses an uninsulated portion of the metallic tether itself to collect electrons. Because of the efficient collection of this type of anode, electrodynamic thrusters for reboost of the International Space Station and for an upper stage capable of orbit raising, lowering, and inclination changes appear to be feasible. Specifically, a 10-km-long bare tether, utilizing 10 kW of the space station power could save most of the propellant required for the station reboost over its 10-year lifetime. The propulsive small expendable deployer system experiment is planned to test the bare-tether design in space in the year 2000 by deploying a 5-km bare aluminum tether from a Delta II upper stage to achieve up to 0.5-N drag thrust, thus deorbiting the stage.

Wireless Sensor Network Solution for Sustainable Food Production

Environmental monitoring has become a key aspect in food production over the last few years. Due to their low cost, low power consumption and flexibility, Wireless Sensor Networks (WSNs) have turned up as a very convenient tool to be used in these environments where no intrusion is a must. In this work, a WSN application in a food factory is presented. The paper gives an overview of the system set up, covering from the initial study of the parameters and sensors, to the hardware-software design and development needed for the final tests in the factory facilities.