Impact de la pression artérielle et influence de l’insuffisance cardiaque systolique sur le contrôle de la fibrillation auriculaire et la survie

La pression artérielle est un déterminant potentiellement majeur de l’évolution de pathologies telles que la FA et l’insuffisance cardiaque. Pourtant, il demeure plusieurs incertitudes quant à la prise en charge optimale de la pression artérielle chez ces patients. Le rôle potentiel de la pression artérielle sur l’efficacité du maintien en rythme sinusal est inconnu. De plus, en présence d’insuffisance cardiaque, non seulement une pression artérielle élevée, mais aussi une pression artérielle basse pourrait augmenter la mortalité. Les travaux présentés ont pour but d’évaluer l’impact de la pression artérielle sur l’efficacité du contrôle du rythme et la mortalité ainsi que d’évaluer le rôle potentiel de l’insuffisance cardiaque sur cette interaction. Une étude post-hoc utilisant une banque de données combinant les études AFFIRM et AF-CHF a été réalisée. Les patients ont d’abord été classés selon leur FEVG (>40%, ≤40%), puis nous avons évalué l’impact de la PAS (<120 mmHg, 120-140 mmHg, >140 mmHg) sur les issues. Premièrement, chez les 2715 patients randomisés au contrôle du rythme, nous avons évalué la survie sans récidive de FA. Deuxièmement, chez tous les 5436 patients inclus dans les 2 études sources, nous avons évalué la mortalité et la morbidité. Chez les patients avec FEVG >40%, aucune des issues n’a été affectée par la PAS dans des analyses de régression multivariées de Cox. Par contraste, chez les patients avec FEVG ≤40%, le taux de récidive de FA était plus élevé avec une PAS >140 mmHg et une PAS <120 mmHg, par rapport à une PAS de 120-140 mmHg [HR, 1.47; IC 95% (1.12-1.93)] et [HR 1.15; IC 95% (0.92-1.43)], respectivement. La mortalité s’est également avérée augmentée chez ces patients avec une PAS >140 mmHg et une PAS <120 mmHg [HR 1.75; IC 95% (1.41-2.17)] et [HR 1.40; IC 95% (1.04-1.90)], respectivement. En conclusion, le maintien en rythme sinusal et la survie sont influencés par la PAS chez les patients avec FA et FEVG diminuée, mais non chez les patients avec FEVG normale. Une courbe en forme de U a été identifiée, où les pression plus basses (<120 mmHg) et plus hautes (>140 mmHg) sont associées à un moins bon pronostic.

Monoacylglycerol, alpha/beta-hydrolase domain-6, and the regulation of insulin secretion and energy metabolism

Le cycle glycérolipides/acides gras libres (GL/FFA) est une voie métabolique clé qui relie le métabolisme du glucose et des acides gras et il est composé de deux processus métaboliques appelés lipogenèse et lipolyse. Le cycle GL/FFA, en particulier la lipolyse des triglycérides, génère diverses molécules de signalisation pour réguler la sécrétion d'insuline dans les cellules bêta pancréatiques et la thermogenèse non-frissonnante dans les adipocytes. Actuellement, les lipides provenant spécifiquement de la lipolyse impliqués dans ce processus sont mal connus. L’hydrolyse des triglycérides dans les cellules β est réalisée par les actions successives de la triglycéride lipase adipocytaire pour produire le diacylglycérol, ensuite par la lipase hormono-sensible pour produire le monoacylglycérol (MAG) et enfin par la MAG lipase (MAGL) qui relâche du glycerol et des acides gras. Dans les cellules bêta, la MAGL classique est très peu exprimée et cette étude a démontré que l’hydrolyse de MAG dans les cellules β est principalement réalisée par l'α/β-Hydrolase Domain-6 (ABHD6) nouvellement identifiée. L’inhibition d’ABHD6 par son inhibiteur spécifique WWL70, conduit à une accumulation des 1-MAG à longues chaines saturées à l'intérieur des cellules, accompagnée d’une augmentation de la sécrétion d'insuline stimulée par le glucose (GSIS). Baisser les niveaux de MAG en surexprimant ABHD6 dans la lignée cellulaire bêta INS832/13 réduit la GSIS, tandis qu’une augmentation des niveaux de MAG par le « knockdown » d’ABHD6 améliore la GSIS. L'exposition aiguë des monoacylglycérols exogènes stimule la sécrétion d'insuline de manière dose-dépendante et restaure la GSIS supprimée par un inhibiteur de lipases appelé orlistat. En outre, les souris avec une inactivation du gène ABHD6 dans tous les tissus (ABHD6-KO) et celles avec une inactivation du gène ABHD6 spécifiquement dans la cellule β présentent une GSIS stimulée, et leurs îlots montrent une augmentation de la production de monoacylglycérol et de la sécrétion d'insuline en réponse au glucose. L’inhibition d’ABHD6 chez les souris diabétiques (modèle induit par de faibles doses de streptozotocine) restaure la GSIS et améliore la tolérance au glucose. De plus, les résultats montrent que les MAGs non seulement améliorent la GSIS, mais potentialisent également la sécrétion d’insuline induite par les acides gras libres ainsi que la sécrétion d’insuline induite par divers agents et hormones, sans altération de l'oxydation et l'utilisation du glucose ainsi que l'oxydation des acides gras. Nous avons démontré que le MAG se lie à la protéine d’amorçage des vésicules appelée Munc13-1 et l’active, induisant ainsi l’exocytose de l'insuline. Sur la base de ces observations, nous proposons que le 1-MAG à chaines saturées agit comme facteur de couplage métabolique pour réguler la sécrétion d'insuline et que ABHD6 est un modulateur négatif de la sécrétion d'insuline. En plus de son rôle dans les cellules bêta, ABHD6 est également fortement exprimé dans les adipocytes et son niveau est augmenté avec l'obésité. Les souris dépourvues globalement d’ABHD6 et nourris avec une diète riche en gras (HFD) montrent une faible diminution de la prise alimentaire, une diminution du gain de poids corporel et de la glycémie à jeun et une amélioration de la tolérance au glucose et de la sensibilité à l'insuline et ont une activité locomotrice accrue. En outre, les souris ABHD6-KO affichent une augmentation de la dépense énergétique et de la thermogenèse induite par le froid. En conformité avec ceci, ces souris présentent des niveaux élevés d’UCP1 dans les adipocytes blancs et bruns, indiquant le brunissement des adipocytes blancs. Le phénotype de brunissement est reproduit dans les souris soit en les traitant de manière chronique avec WWL70 (inhibiteur d’ABHD6) ou des oligonucléotides anti-sense ciblant l’ABHD6. Les tissus adipeux blanc et brun isolés de souris ABHD6-KO montrent des niveaux très élevés de 1-MAG, mais pas de 2-MAG. L'augmentation des niveaux de MAG soit par administration exogène in vitro de 1-MAG ou par inhibition ou délétion génétique d’ABHD6 provoque le brunissement des adipocytes blancs. Une autre évidence indique que les 1-MAGs sont capables de transactiver PPARα et PPARγ et que l'effet de brunissement induit par WWL70 ou le MAG exogène est aboli par les antagonistes de PPARα et PPARγ. L’administration in vivo de l’antagoniste de PPARα GW6471 à des souris ABHD6-KO inverse partiellement les effets causés par l’inactivation du gène ABHD6 sur le gain de poids corporel, et abolit l’augmentation de la thermogenèse, le brunissement du tissu adipeux blanc et l'oxydation des acides gras dans le tissu adipeux brun. L’ensemble de ces observations indique que ABHD6 régule non seulement l’homéostasie de l'insuline et du glucose, mais aussi l'homéostasie énergétique et la fonction des tissus adipeux. Ainsi, 1-MAG agit non seulement comme un facteur de couplage métabolique pour réguler la sécrétion d'insuline en activant Munc13-1 dans les cellules bêta, mais régule aussi le brunissement des adipocytes blancs et améliore la fonction de la graisse brune par l'activation de PPARα et PPARγ. Ces résultats indiquent que ABHD6 est une cible prometteuse pour le développement de thérapies contre l'obésité, le diabète de type 2 et le syndrome métabolique.

Studies on function projective synchronization in chaotic and hyperchaotic systems

FPS is a more general form of synchronization. Hyperchaotic systems possessing more than one positive Lypaunov exponent exhibit highly complex behaviour and are more suitable for some applications like secure communications. In this thesis we report studies of FPS and MFPS of a few chaotic and hyperchaotic systems. When all the parameters of the system are known we show that active nonlinear control method can be efectively used to obtain FPS. Adaptive nonlinear control and OPCL control method are employed for obtaining FPS and MFPS when some or all parameters of the system are uncertain. A secure communication scheme based on MFPS is also proposed in theory. All our theoretical calculations are verified by numerical simulations.

Real Estate Development In India And The Behavior of Investors to Invest In The Real Estate Market: An Empirical Investigation

This study examines the behavioral factors that influence the Indian Investors to invest in the Real Estate Market. Among the various factors that affect the tendency of investors to invest in the real market, certain factors are greatly influenced the investors at greatest extend while others at least level. From this study it is revealed that motivation from the real estate developers and brokers (mean value- 3.46) is most influencing factor and happening of uncertain events (mean value- 1.75) is the least factor that influences the investors’ investment behavior. In this study, the behavioral factor like over confidence and the hypotheses regarding education, religion were analyzed and found that religious factor influences the Indian investors to invest in the real estate

Operational Flexibility: A Model for Effective Project Management

The aim of this study is to investigate the role of operational flexibility for effective project management in the construction industry. The specific objectives are to: a) Identify the determinants of operational flexibility potential in construction project management b) Investigate the contribution of each of the determinants to operational flexibility potential in the construction industry c) Investigate on the moderating factors of operational flexibility potential in a construction project environment d) Investigate whether moderated operational flexibility potential mediates the path between predictors and effective construction project management e) Develop and test a conceptual model of achieving operational flexibility for effective project management The purpose of this study is to findout ways to utilize flexibility inorder to manage uncertain project environment and ultimately achieve effective project management. In what configuration these operational flexibility determinants are demanded by construction project environment in order to achieve project success. This research was conducted in three phases, namely: (i) exploratory phase (ii) questionnaire development phase; and (iii) data collection and analysis phase. The study needs firm level analysis and therefore real estate developers who are members of CREDAI, Kerala Chapter were considered. This study provides a framework on the functioning of operational flexibility, offering guidance to researchers and practitioners for discovering means to gain operational flexibility in construction firms. The findings provide an empirical understanding on kinds of resources and capabilities a construction firm must accumulate to respond flexibly to the changing project environment offering practitioners insights into practices that build firms operational flexibility potential. Firms are dealing with complex, continuous changing and uncertain environments due trends of globalization, technical changes and innovations and changes in the customers’ needs and expectations. To cope with the increasingly uncertain and quickly changing environment firms strive for flexibility. To achieve the level of flexibility that adds value to the customers, firms should look to flexibility from a day to day operational perspective. Each dimension of operational flexibility is derived from competences and capabilities. In this thesis only the influence on customer satisfaction and learning exploitation of flexibility dimensions which directly add value in the customers eyes are studied to answer the followingresearch questions: “What is the impact of operational flexibility on customer satisfaction?.” What are the predictors of operational flexibility in construction industry? .These questions can only be answered after answering the questions like “Why do firms need operational flexibility?” and “how can firms achieve operational flexibility?” in the context of the construction industry. The need for construction firms to be flexible, via the effective utilization of organizational resources and capabilities for improved responsiveness, is important because of the increasing rate of changes in the business environment within which they operate. Achieving operational flexibility is also important because it has a significant correlation with a project effectiveness and hence a firm’s turnover. It is essential for academics and practitioners to recognize that the attainment of operational flexibility involves different types namely: (i) Modification (ii) new product development and (iii) demand management requires different configurations of predictors (i.e., resources, capabilities and strategies). Construction firms should consider these relationships and implement appropriate management practices for developing and configuring the right kind of resources, capabilities and strategies towards achieving different operational flexibility types.

DNA methylation in Dictyostelium discoideum

DNA methyltransferases of type Dnmt2 are a highly conserved protein family with enigmatic function. The aim of this work was to characterize DnmA, the Dnmt2 methyltransferase in Dictyostelium discoideum, and further to investigate its implication in DNA methylation and transcriptional gene silencing. The genome of the social amoeba Dictyostelium encodes DnmA as the sole DNA methyltransferase. The enzyme bears all ten characteristic DNA methyltransferase motifs in its catalytic domain. The DnmA mRNA was found by RT-PCR to be expressed during vegetative growth and down regulated during development. Investigations using fluorescence microscopy showed that both DnmA-myc and DnmA-GFP fusions predominantly localised to the nucleus. The function of DnmA remained initially unclear, but later experiment revealed that the enzyme is an active DNA methyltransferase responsible for all DNA (cytosine) methylation in Dictyostelium. Neither in gel retardation assays, nor by the yeast two hybrid system, clues on the functionality of DnmA could be obtained. However, immunological detection of the methylation mark with an α - 5mC antibody gave initial evidence that the DNA of Dictyostelium was methylated. Furthermore, addition of 5-aza-cytidine as demethylating agent to the Dictyostelium medium and subsequent in vitro incubation of the DNA isolated from these cells with recombinant DnmA showed that the enzyme binds slightly better to this target DNA. In order to investigate further the function of the protein, a gene knock-out for dnmA was generated. The gene was successfully disrupted by homologous recombination, the knock-out strain, however, did not show any obvious phenotype under normal laboratory conditions. To identify specific target sequences for DNA methylation, a microarray analysis was carried out. Setting a threshold of at least 1.5 fold for differences in the strength of gene expression, several such genes in the knock-out strain were chosen for further investigation. Among the up-regulated genes were the ESTs representing the gag and the RT genes respectively of the retrotransposon skipper. In addition Northern blot analysis confirmed the up-regulation of skipper in the DnmA knock-out strain. Bisufite treatment and sequencing of specific DNA stretches from skipper revealed that DnmA is responsible for methylation of mostly asymmetric cytosines. Together with skipper, DIRS-1 retrotransposon was found later also to be methylated but was not present on the microarray. Furthermore, skipper transcription was also up-regulated in strains that had genes disrupted encoding components of the RNA interference pathway. In contrast, DIRS 1 expression was not affected by a loss of DnmA but was strongly increased in the strain that had the RNA directed RNA polymerase gene rrpC disrupted. Strains generated by propagating the usual wild type Ax2 and the DnmA knock-out cells over 16 rounds in development were analyzed for transposon activity. Northern blot analysis revealed activation for skipper expression, but not for DIRS-1. A large number of siRNAs were found to be correspondent to the DIRS-1 sequence, suggesting concerted regulation of DIRS-1 expression by RNAi and DNA methylation. In contrast, no siRNAs corresponding to the standard skipper element were found. The data show that DNA methylation plays a crucial role in epigenetic gene regulation in Dictyostelium and that different, partially overlapping mechanisms control transposon silencing for skipper and DIRS-1. To elucidate the mechanism of targeting the protein to particular genes in the Dictyostelium genome, some more genes which were up-regulated in the DnmA knock-out strain were analyzed by bisulfite sequencing. The chosen genes are involved in the multidrug response in other species, but their function in Dictyostelium is uncertain. Bisulfite data showed that two of these genes were methylated at asymmetrical C-residues in the wild type, but not in DnmA knock-out cells. This suggested that DNA methylation in Dictyostelium is involved not only in transposon regulation but also in transcriptional silencing of specific genes.

Information Exchange and Fusion in Dynamic and Heterogeneous Distributed Environments

Context awareness, dynamic reconfiguration at runtime and heterogeneity are key characteristics of future distributed systems, particularly in ubiquitous and mobile computing scenarios. The main contributions of this dissertation are theoretical as well as architectural concepts facilitating information exchange and fusion in heterogeneous and dynamic distributed environments. Our main focus is on bridging the heterogeneity issues and, at the same time, considering uncertain, imprecise and unreliable sensor information in information fusion and reasoning approaches. A domain ontology is used to establish a common vocabulary for the exchanged information. We thereby explicitly support different representations for the same kind of information and provide Inter-Representation Operations that convert between them. Special account is taken of the conversion of associated meta-data that express uncertainty and impreciseness. The Unscented Transformation, for example, is applied to propagate Gaussian normal distributions across highly non-linear Inter-Representation Operations. Uncertain sensor information is fused using the Dempster-Shafer Theory of Evidence as it allows explicit modelling of partial and complete ignorance. We also show how to incorporate the Dempster-Shafer Theory of Evidence into probabilistic reasoning schemes such as Hidden Markov Models in order to be able to consider the uncertainty of sensor information when deriving high-level information from low-level data. For all these concepts we provide architectural support as a guideline for developers of innovative information exchange and fusion infrastructures that are particularly targeted at heterogeneous dynamic environments. Two case studies serve as proof of concept. The first case study focuses on heterogeneous autonomous robots that have to spontaneously form a cooperative team in order to achieve a common goal. The second case study is concerned with an approach for user activity recognition which serves as baseline for a context-aware adaptive application. Both case studies demonstrate the viability and strengths of the proposed solution and emphasize that the Dempster-Shafer Theory of Evidence should be preferred to pure probability theory in applications involving non-linear Inter-Representation Operations.

Parameter identification of structural dynamic models by inverse statistical analysis

Auf dem Gebiet der Strukturdynamik sind computergestützte Modellvalidierungstechniken inzwischen weit verbreitet. Dabei werden experimentelle Modaldaten, um ein numerisches Modell für weitere Analysen zu korrigieren. Gleichwohl repräsentiert das validierte Modell nur das dynamische Verhalten der getesteten Struktur. In der Realität gibt es wiederum viele Faktoren, die zwangsläufig zu variierenden Ergebnissen von Modaltests führen werden: Sich verändernde Umgebungsbedingungen während eines Tests, leicht unterschiedliche Testaufbauten, ein Test an einer nominell gleichen aber anderen Struktur (z.B. aus der Serienfertigung), etc. Damit eine stochastische Simulation durchgeführt werden kann, muss eine Reihe von Annahmen für die verwendeten Zufallsvariablengetroffen werden. Folglich bedarf es einer inversen Methode, die es ermöglicht ein stochastisches Modell aus experimentellen Modaldaten zu identifizieren. Die Arbeit beschreibt die Entwicklung eines parameter-basierten Ansatzes, um stochastische Simulationsmodelle auf dem Gebiet der Strukturdynamik zu identifizieren. Die entwickelte Methode beruht auf Sensitivitäten erster Ordnung, mit denen Parametermittelwerte und Kovarianzen des numerischen Modells aus stochastischen experimentellen Modaldaten bestimmt werden können.

Modeling Robot Dynamic Performance for Endpoint Force Control

This research aims to understand the fundamental dynamic behavior of servo-controlled machinery in response to various types of sensory feedback. As an example of such a system, we study robot force control, a scheme which promises to greatly expand the capabilities of industrial robots by allowing manipulators to interact with uncertain and dynamic tasks. Dynamic models are developed which allow the effects of actuator dynamics, structural flexibility, and workpiece interaction to be explored in the frequency and time domains. The models are used first to explain the causes of robot force control instability, and then to find methods of improving this performance.

On Probabilistic Strategies for Robot Tasks

Robots must act purposefully and successfully in an uncertain world. Sensory information is inaccurate or noisy, actions may have a range of effects, and the robot's environment is only partially and imprecisely modeled. This thesis introduces active randomization by a robot, both in selecting actions to execute and in focusing on sensory information to interpret, as a basic tool for overcoming uncertainty. An example of randomization is given by the strategy of shaking a bin containing a part in order to orient the part in a desired stable state with some high probability. Another example consists of first using reliable sensory information to bring two parts close together, then relying on short random motions to actually mate the two parts, once the part motions lie below the available sensing resolution. Further examples include tapping parts that are tightly wedged, twirling gears before trying to mesh them, and vibrating parts to facilitate a mating operation.

Modeling, Estimation, and Control of Robot-Soil Interactions

This thesis presents the development of hardware, theory, and experimental methods to enable a robotic manipulator arm to interact with soils and estimate soil properties from interaction forces. Unlike the majority of robotic systems interacting with soil, our objective is parameter estimation, not excavation. To this end, we design our manipulator with a flat plate for easy modeling of interactions. By using a flat plate, we take advantage of the wealth of research on the similar problem of earth pressure on retaining walls. There are a number of existing earth pressure models. These models typically provide estimates of force which are in uncertain relation to the true force. A recent technique, known as numerical limit analysis, provides upper and lower bounds on the true force. Predictions from the numerical limit analysis technique are shown to be in good agreement with other accepted models. Experimental methods for plate insertion, soil-tool interface friction estimation, and control of applied forces on the soil are presented. In addition, a novel graphical technique for inverting the soil models is developed, which is an improvement over standard nonlinear optimization. This graphical technique utilizes the uncertainties associated with each set of force measurements to obtain all possible parameters which could have produced the measured forces. The system is tested on three cohesionless soils, two in a loose state and one in a loose and dense state. The results are compared with friction angles obtained from direct shear tests. The results highlight a number of key points. Common assumptions are made in soil modeling. Most notably, the Mohr-Coulomb failure law and perfectly plastic behavior. In the direct shear tests, a marked dependence of friction angle on the normal stress at low stresses is found. This has ramifications for any study of friction done at low stresses. In addition, gradual failures are often observed for vertical tools and tools inclined away from the direction of motion. After accounting for the change in friction angle at low stresses, the results show good agreement with the direct shear values.

Maximum Entropy Discrimination

We present a general framework for discriminative estimation based on the maximum entropy principle and its extensions. All calculations involve distributions over structures and/or parameters rather than specific settings and reduce to relative entropy projections. This holds even when the data is not separable within the chosen parametric class, in the context of anomaly detection rather than classification, or when the labels in the training set are uncertain or incomplete. Support vector machines are naturally subsumed under this class and we provide several extensions. We are also able to estimate exactly and efficiently discriminative distributions over tree structures of class-conditional models within this framework. Preliminary experimental results are indicative of the potential in these techniques.

Safe Distributed Coordination of Heterogeneous Robots through Dynamic Simple Temporal Networks

Research on autonomous intelligent systems has focused on how robots can robustly carry out missions in uncertain and harsh environments with very little or no human intervention. Robotic execution languages such as RAPs, ESL, and TDL improve robustness by managing functionally redundant procedures for achieving goals. The model-based programming approach extends this by guaranteeing correctness of execution through pre-planning of non-deterministic timed threads of activities. Executing model-based programs effectively on distributed autonomous platforms requires distributing this pre-planning process. This thesis presents a distributed planner for modelbased programs whose planning and execution is distributed among agents with widely varying levels of processor power and memory resources. We make two key contributions. First, we reformulate a model-based program, which describes cooperative activities, into a hierarchical dynamic simple temporal network. This enables efficient distributed coordination of robots and supports deployment on heterogeneous robots. Second, we introduce a distributed temporal planner, called DTP, which solves hierarchical dynamic simple temporal networks with the assistance of the distributed Bellman-Ford shortest path algorithm. The implementation of DTP has been demonstrated successfully on a wide range of randomly generated examples and on a pursuer-evader challenge problem in simulation.

Interaction and Intelligent Behavior

We introduce basic behaviors as primitives for control and learning in situated, embodied agents interacting in complex domains. We propose methods for selecting, formally specifying, algorithmically implementing, empirically evaluating, and combining behaviors from a basic set. We also introduce a general methodology for automatically constructing higher--level behaviors by learning to select from this set. Based on a formulation of reinforcement learning using conditions, behaviors, and shaped reinforcement, out approach makes behavior selection learnable in noisy, uncertain environments with stochastic dynamics. All described ideas are validated with groups of up to 20 mobile robots performing safe--wandering, following, aggregation, dispersion, homing, flocking, foraging, and learning to forage.

Robust fault detection using consistency techniques for uncertainty handling

Often practical performance of analytical redundancy for fault detection and diagnosis is decreased by uncertainties prevailing not only in the system model, but also in the measurements. In this paper, the problem of fault detection is stated as a constraint satisfaction problem over continuous domains with a big number of variables and constraints. This problem can be solved using modal interval analysis and consistency techniques. Consistency techniques are then shown to be particularly efficient to check the consistency of the analytical redundancy relations (ARRs), dealing with uncertain measurements and parameters. Through the work presented in this paper, it can be observed that consistency techniques can be used to increase the performance of a robust fault detection tool, which is based on interval arithmetic. The proposed method is illustrated using a nonlinear dynamic model of a hydraulic system