Automated versus non-automated weaning for reducing the duration of mechanical ventilation in critically ill adults & children (Review)

Background Automated closed loop systems may improve adaptation of mechanical support for a patient's ventilatory needs and facilitate systematic and early recognition of their ability to breathe spontaneously and the potential for discontinuation of ventilation. This review was originally published in 2013 with an update published in 2014. Objectives The primary objective for this review was to compare the total duration of weaning from mechanical ventilation, defined as the time from study randomization to successful extubation (as defined by study authors), for critically ill ventilated patients managed with an automated weaning system versus no automated weaning system (usual care). Secondary objectives for this review were to determine differences in the duration of ventilation, intensive care unit (ICU) and hospital lengths of stay (LOS), mortality, and adverse events related to early or delayed extubation with the use of automated weaning systems compared to weaning in the absence of an automated weaning system. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8); MEDLINE (OvidSP) (1948 to September 2013); EMBASE (OvidSP) (1980 to September 2013); CINAHL (EBSCOhost) (1982 to September 2013); and the Latin American and Caribbean Health Sciences Literature (LILACS). Relevant published reviews were sought using the Database of Abstracts of Reviews of Effects (DARE) and the Health Technology Assessment Database (HTA Database). We also searched the Web of Science Proceedings; conference proceedings; trial registration websites; and reference lists of relevant articles. The original search was run in August 2011, with database auto-alerts up to August 2012. Selection criteria We included randomized controlled trials comparing automated closed loop ventilator applications to non-automated weaning strategies including non-protocolized usual care and protocolized weaning in patients over four weeks of age receiving invasive mechanical ventilation in an ICU. Data collection and analysis Two authors independently extracted study data and assessed risk of bias. We combined data in forest plots using random-effects modelling. Subgroup and sensitivity analyses were conducted according to a priori criteria. Main results We included 21 trials (19 adult, two paediatric) totaling 1676 participants (1628 adults, 48 children) in this updated review. Pooled data from 16 eligible trials reporting weaning duration indicated that automated closed loop systems reduced the geometric mean duration of weaning by 30% (95% confidence interval (CI) 13% to 45%), however heterogeneity was substantial (I2 = 87%, P < 0.00001). Reduced weaning duration was found with mixed or medical ICU populations (42%, 95% CI 10% to 63%) and Smartcare/PS™ (28%, 95% CI 7% to 49%) but not in surgical populations or using other systems. Automated closed loop systems reduced the duration of ventilation (10%, 95% CI 3% to 16%) and ICU LOS (8%, 95% CI 0% to 15%). There was no strong evidence of an effect on mortality rates, hospital LOS, reintubation rates, self-extubation and use of non-invasive ventilation following extubation. Prolonged mechanical ventilation > 21 days and tracheostomy were reduced in favour of automated systems (relative risk (RR) 0.51, 95% CI 0.27 to 0.95 and RR 0.67, 95% CI 0.50 to 0.90 respectively). Overall the quality of the evidence was high with the majority of trials rated as low risk. Authors' conclusions Automated closed loop systems may result in reduced duration of weaning, ventilation and ICU stay. Reductions are more likely to occur in mixed or medical ICU populations. Due to the lack of, or limited, evidence on automated systems other than Smartcare/PS™ and Adaptive Support Ventilation no conclusions can be drawn regarding their influence on these outcomes. Due to substantial heterogeneity in trials there is a need for an adequately powered, high quality, multi-centre randomized controlled trial in adults that excludes 'simple to wean' patients. There is a pressing need for further technological development and research in the paediatric population.

State detection of bond wires in IGBT modules using eddy current pulsed thermography

Insulated gate bipolar transistor (IGBT) modules are important safety critical components in electrical power systems. Bond wire lift-off, a plastic deformation between wire bond and adjacent layers of a device caused by repeated power/thermal cycles, is the most common failure mechanism in IGBT modules. For the early detection and characterization of such failures, it is important to constantly detect or monitor the health state of IGBT modules, and the state of bond wires in particular. This paper introduces eddy current pulsed thermography (ECPT), a nondestructive evaluation technique, for the state detection and characterization of bond wire lift-off in IGBT modules. After the introduction of the experimental ECPT system, numerical simulation work is reported. The presented simulations are based on the 3-D electromagnetic-thermal coupling finite-element method and analyze transient temperature distribution within the bond wires. This paper illustrates the thermal patterns of bond wires using inductive heating with different wire statuses (lifted-off or well bonded) under two excitation conditions: nonuniform and uniform magnetic field excitations. Experimental results show that uniform excitation of healthy bonding wires, using a Helmholtz coil, provides the same eddy currents on each, while different eddy currents are seen on faulty wires. Both experimental and numerical results show that ECPT can be used for the detection and characterization of bond wires in power semiconductors through the analysis of the transient heating patterns of the wires. The main impact of this paper is that it is the first time electromagnetic induction thermography, so-called ECPT, has been employed on power/electronic devices. Because of its capability of contactless inspection of multiple wires in a single pass, and as such it opens a wide field of investigation in power/electronic devices for failure detection, performance characterization, and health monitoring. 

In situ diagnostics and prognostics of solder fatigue in IGBT modules for electric vehicle drives

This paper proposes an in situ diagnostic and prognostic (D&P) technology to monitor the health condition of insulated gate bipolar transistors (IGBTs) used in EVs with a focus on the IGBTs' solder layer fatigue. IGBTs' thermal impedance and the junction temperature can be used as health indicators for through-life condition monitoring (CM) where the terminal characteristics are measured and the devices' internal temperature-sensitive parameters are employed as temperature sensors to estimate the junction temperature. An auxiliary power supply unit, which can be converted from the battery's 12-V dc supply, provides power to the in situ test circuits and CM data can be stored in the on-board data-logger for further offline analysis. The proposed method is experimentally validated on the developed test circuitry and also compared with finite-element thermoelectrical simulation. The test results from thermal cycling are also compared with acoustic microscope and thermal images. The developed circuitry is proved to be effective to detect solder fatigue while each IGBT in the converter can be examined sequentially during red-light stopping or services. The D&P circuitry can utilize existing on-board hardware and be embedded in the IGBT's gate drive unit.

Thermography-based virtual MPPT scheme for improving PV energy efficiency under partial shading conditions

This paper proposes a new thermography-based maximum power point tracking (MPPT) scheme to address photovoltaic (PV) partial shading faults. Solar power generation utilizes a large number of PV cells connected in series and in parallel in an array, and that are physically distributed across a large field. When a PV module is faulted or partial shading occurs, the PV system sees a nonuniform distribution of generated electrical power and thermal profile, and the generation of multiple maximum power points (MPPs). If left untreated, this reduces the overall power generation and severe faults may propagate, resulting in damage to the system. In this paper, a thermal camera is employed for fault detection and a new MPPT scheme is developed to alter the operating point to match an optimized MPP. Extensive data mining is conducted on the images from the thermal camera in order to locate global MPPs. Based on this, a virtual MPPT is set out to find the global MPP. This can reduce MPPT time and be used to calculate the MPP reference voltage. Finally, the proposed methodology is experimentally implemented and validated by tests on a 600-W PV array. 

Viscosity Control for Extrusion Processes Using Recycled Polymers

The aim of this paper is to develop a new extruder control system for recycled materials which has ability to automatically maintain constant a polymer melt viscosity of mixed recycled polymers during extrusion, regardless of variations in the Melt Flow Index (MFI) of recycled mixed grade high density polyethylene (HDPE) feedstock. A closed-loop controller is developed to automatically regulate screw speed and barrel temperature profile to achieve constant viscosity and enable consistent processing of variable grade recycled HDPE materials. The experimental results of real time viscosity measurement and control using a 38mm single screw extruder with different recycled HDPEs with widely different MFIs are reported in this work

On Infinite Time Performance of Nonlinear Model Predictive Controllers

This paper addresses the problem of infinite time performance of model predictive controllers applied to constrained nonlinear systems. The total performance is compared with a finite horizon optimal cost to reveal performance limits of closed-loop model predictive control systems. Based on the Principle of Optimality, an upper and a lower bound of the ratio between the total performance and the finite horizon optimal cost are obtained explicitly expressed by the optimization horizon. The results also illustrate, from viewpoint of performance, how model predictive controllers approaches to infinite optimal controllers as the optimization horizon increases.

Control energy consumption and system performance in vector control of voltage source converters

Power electronics plays an important role in the control and conversion of modern electric power systems. In particular, to integrate various renewable energies using DC transmissions and to provide more flexible power control in AC systems, significant efforts have been made in the modulation and control of power electronics devices. Pulse width modulation (PWM) is a well developed technology in the conversion between AC and DC power sources, especially for the purpose of harmonics reduction and energy optimization. As a fundamental decoupled control method, vector control with PI controllers has been widely used in power systems. However, significant power loss occurs during the operation of these devices, and the loss is often dissipated in the form of heat, leading to significant maintenance effort. Though much work has been done to improve the power electronics design, little has focused so far on the investigation of the controller design to reduce the controller energy consumption (leading to power loss in power electronics) while maintaining acceptable system performance. This paper aims to bridge the gap and investigates their correlations. It is shown a more thoughtful controller design can achieve better balance between energy consumption in power electronics control and system performance, which potentially leads to significant energy saving for integration of renewable power sources.

Central-Tapped Node Linked Modular Fault-Tolerance Topology for SRM Applications

Electric vehicles (EVs) and hybrid electric vehicles (HEVs) can reduce greenhouse gas emissions while switched reluctance motor (SRM) is one of the promising motor for such applications. This paper presents a novel SRM fault-diagnosis and fault-tolerance operation solution. Based on the traditional asymmetric half-bridge topology for the SRM driving, the central tapped winding of the SRM in modular half-bridge configuration are introduced to provide fault-diagnosis and fault-tolerance functions, which are set idle in normal conditions. The fault diagnosis can be achieved by detecting the characteristic of the excitation and demagnetization currents. An SRM fault-tolerance operation strategy is also realized by the proposed topology, which compensates for the missing phase torque under the open-circuit fault, and reduces the unbalanced phase current under the short-circuit fault due to the uncontrolled faulty phase. Furthermore, the current sensor placement strategy is also discussed to give two placement methods for low cost or modular structure. Simulation results in MATLAB/Simulink and experiments on a 750-W SRM validate the effectiveness of the proposed strategy, which may have significant implications and improve the reliability of EVs/HEVs.

Mercaptans extraction from jet-fuel streams using ionic liquids

Desulfurization is one of the most important processes in the refining industry. Due to a growing concern about the risks to human health and environment, associated with the emissions of sulfur compounds, legislation has become more stringent, requiring a drastic reduction in the sulfur content of fuel to levels close to zero (< 10 ppm S). However, conventional desulfurization processes are inefficient and have high operating costs. This scenario stimulates the improvement of existing processes and the development of new and more efficient technologies. Aiming at overcoming these shortcomings, this work investigates an alternative desulfurization process using ionic liquids for the removal of mercaptans from "jet fuel" streams. The screening and selection of the most suitable ionic liquid were performed based on experimental and COSMO-RS predicted liquid-liquid equilibrium data. A model feed of 1-hexanethiol and n-dodecane was selected to represent a jet-fuel stream. High selectivities were determined, as a result of the low mutual solubility between the ionic liquid and the hydrocarbon matrix, proving the potential use of the ionic liquid, which prevents the loss of fuel for the solvent. The distribution ratios of mercaptans towards the ionic liquids were not as favorable, making the traditional liquid-liquid extraction processes not suitable for the removal of aliphatic S-compounds due to the high volume of extractant required. This work explores alternative methods and proposes the use of ionic liquids in a separation process assisted by membranes. In the process proposed the ionic liquid is used as extracting solvent of the sulfur species, in a hollow fiber membrane contactor, without co-extracting the other jet-fuel compound. In a second contactor, the ionic liquid is regenerated applying a sweep gas stripping, which allows for its reuse in a closed loop between the two membrane contactors. This integrated extraction/regeneration process of desulfurization produced a jet-fuel model with sulfur content lower than 2 ppm of S, as envisaged by legislation for the use of ultra-low sulfur jet-fuel. This result confirms the high potential for development of ultra-deep desulfurization application.

Reduced-Reference Image Quality Assessment Based on Edge Preservation

Assessing the subjective quality of processed images through an objective quality metric is a key issue in multimedia processing and transmission. In some scenarios, it is also important to evaluate the quality of the received images with minimal reference to the transmitted ones. For instance, for closed-loop optimisation of image and video transmission, the quality measure can be evaluated at the receiver and provided as feedback information to the system controller. The original images - prior to compression and transmission - are not usually available at the receiver side, and it is important to rely at the receiver side on an objective quality metric that does not need reference or needs minimal reference to the original images. The observation that the human eye is very sensitive to edge and contour information of an image underpins the proposal of our reduced reference (RR) quality metric, which compares edge information between the distorted and the original image. Results highlight that the metric correlates well with subjective observations, also in comparison with commonly used full-reference metrics and with a state-of-the-art reduced reference metric. © 2012 ICST Institute for Computer Science, Social Informatics and Telecommunications Engineering.

Multidimensional scaling analysis of fractional systems

This paper investigates the use of multidimensional scaling in the evaluation of fractional system. Several algorithms are analysed based on the time response of the closed loop system under the action of a reference step input signal. Two alternative performance indices, based on the time and frequency domains, are tested. The numerical experiments demonstrate the feasibility of the proposed visualization method.

A multi-objective approach for the motion planning of redundant manipulators

Kinematic redundancy occurs when a manipulator possesses more degrees of freedom than those required to execute a given task. Several kinematic techniques for redundant manipulators control the gripper through the pseudo-inverse of the Jacobian, but lead to a kind of chaotic inner motion with unpredictable arm configurations. Such algorithms are not easy to adapt to optimization schemes and, moreover, often there are multiple optimization objectives that can conflict between them. Unlike single optimization, where one attempts to find the best solution, in multi-objective optimization there is no single solution that is optimum with respect to all indices. Therefore, trajectory planning of redundant robots remains an important area of research and more efficient optimization algorithms are needed. This paper presents a new technique to solve the inverse kinematics of redundant manipulators, using a multi-objective genetic algorithm. This scheme combines the closed-loop pseudo-inverse method with a multi-objective genetic algorithm to control the joint positions. Simulations for manipulators with three or four rotational joints, considering the optimization of two objectives in a workspace without and with obstacles are developed. The results reveal that it is possible to choose several solutions from the Pareto optimal front according to the importance of each individual objective.

Evolutionary trajectory optimization for redundant robots

The trajectory planning of redundant robots is an important area of research and efficient optimization algorithms have been investigated in the last years. This paper presents a new technique that combines the closed-loop pseudoinverse method with genetic algorithms. In this case the trajectory planning is formulated as an optimization problem with constraints.

An evolutionary approach for the motion planning of redundant and hyper-redundant manipulators

The trajectory planning of redundant robots is an important area of research and efficient optimization algorithms are needed. The pseudoinverse control is not repeatable, causing drift in joint space which is undesirable for physical control. This paper presents a new technique that combines the closed-loop pseudoinverse method with genetic algorithms, leading to an optimization criterion for repeatable control of redundant manipulators, and avoiding the joint angle drift problem. Computer simulations performed based on redundant and hyper-redundant planar manipulators show that, when the end-effector traces a closed path in the workspace, the robot returns to its initial configuration. The solution is repeatable for a workspace with and without obstacles in the sense that, after executing several cycles, the initial and final states of the manipulator are very close.

Trajectory planning of redundant manipulators using genetic algorithms

The trajectory planning of redundant robots is an important area of research and efficient optimization algorithms are needed. This paper presents a new technique that combines the closed-loop pseudoinverse method with genetic algorithms. The results are compared with a genetic algorithm that adopts the direct kinematics. In both cases the trajectory planning is formulated as an optimization problem with constraints.