Adaptive state-dependent impulsive observer design for nonlinear deterministic and stochastic dynamics with time-delays.

The present research has introduced a novel adaptive state-dependent impulsive observer (ASDIO) used to control diverse nonlinear systems with time-varying delay. This designed ASDIO is in conformity with the approach of extended pseudo-linearization for the purpose of parametrizing a nonlinear system with time-delay to a pseudo-linear time-delay structure having state-dependent coefficients. This technique makes the ASDIO applicable to nonlinear systems with distributed, multiple, and time-varying delays. The time-varying and delay-independent Lyapunov functional approach, coupled with the comparison method for impulsive systems, was used to confirm the stability of ASDIO. This new theorem affirmed the state and parameter estimation error to approach zero asymptotically through distinct and less-conservative adequate conditions with respect to practical linear matrix inequalities. Furthermore, the maximum impulse time was specified via the presented stability theorem. The ASDIO has also been offered for a special set of stochastic nonlinear systems with time-delay. An investigation of the asymptotic stability for the intended ASDIO was performed via a new theorem employing the comparison principle for stochastic impulsive systems. Accordingly, this observer was simulated on an epidemic system with time-delay nonlinear features to affirm its performance.

In vitro localisation of intracranial haematoma using electrical impedance tomography semi-array.

Electrical Impedance Tomography is a non-invasive and portable method that has good potential as an alternative to the conventional modalities for early detection of intracranial haematomas in high risk patients. Early diagnosis can reduce treatment delays and most significantly can impact patient outcomes. Two eight-electrode layouts, a standard ring full array (FA) and a semi-array (SA), were investigated for their ability to detect, localise and quantify simulated intracranial haematomas in vitro on ovine models for the purpose of early diagnosis. SA layout speeds up electrode application and avoids the need to move and lift the patient's head. Haematomas were simulated using gel samples with the same conductivity as blood. Both layouts, FA and SA, could detect the presence of haematomas at any location within the skull. The mean of the relative radial position error with respect to the brain radius was 7% for FA and 6% for SA, for haematomas close to the electrodes, and 11% for SA for haematomas far from the electrodes at the back of the head. Size estimation was not as good; the worst size estimation error for FA being around 30% while the best for SA was 50% for simulated haematomas close to the electrodes.

Protein/creatinine ratio on random urine samples for prediction of proteinuria in preeclampsia.

OBJECTIVE: To evaluate Protein/Creatinine ratio on random urine samples for prediction of proteinuria in preeclampsia. MATERIALS AND METHODS: This study was performed on 150 pregnant women who were hospitalized as preeclampsia in Ghaem Hospital during 2006. At first, a 24-hours urine sample was collected for each patient to determine protein/creatinine ratio. Then, 24-hours urine collection was analyzed for the evaluation of proteinuria. Statistical analysis was performed with SPSS software. RESULTS: A total of 150 patients entered the study. There was a significant relation between the 24-hours urine protein and protein/creatinine ratio (r = 0.659, P < 0.001). CONCLUSION: Since the measurement of protein/creatinine ratio is more accurate, reliable, and cost-effective, it can be replaced by the method of measurement the 24-hours urine protein.

Transthoracic cardioversion of atrial fibrillation: comparison of rectilinear biphasic versus damped sine wave monophasic shocks.

BACKGROUND: Clinical studies have shown that biphasic shocks are more effective than monophasic shocks for ventricular defibrillation. The purpose of this study was to compare the efficacy of a rectilinear biphasic waveform with a standard damped sine wave monophasic waveform for the transthoracic cardioversion of atrial fibrillation. METHODS AND RESULTS: In this prospective, randomized, multicenter trial, patients undergoing transthoracic cardioversion of atrial fibrillation were randomized to receive either damped sine wave monophasic or rectilinear biphasic shocks. Patients randomized to the monophasic protocol (n=77) received sequential shocks of 100, 200, 300, and 360 J. Patients randomized to the biphasic protocol (n=88) received sequential shocks of 70, 120, 150, and 170 J. First-shock efficacy with the 70-J biphasic waveform (60 of 88 patients, 68%) was significantly greater than that with the 100-J monophasic waveform (16 of 77 patients, 21%, P<0.0001), and it was achieved with 50% less delivered current (11+/-1 versus 22+/-4 A, P<0.0001). Similarly, the cumulative efficacy with the biphasic waveform (83 of 88 patients, 94%) was significantly greater than that with the monophasic waveform (61 of 77 patients, 79%; P=0.005). The following 3 variables were independently associated with successful cardioversion: use of a biphasic waveform (relative risk, 4.2; 95% confidence intervals, 1.3 to 13.9; P=0.02), transthoracic impedance (relative risk, 0.64 per 10-Omega increase in impedance; 95% confidence intervals, 0.46 to 0.90; P=0.005), and duration of atrial fibrillation (relative risk, 0.97 per 30 days of atrial fibrillation; 95% confidence intervals, 0.96 to 0.99; P=0.02). CONCLUSIONS: For transthoracic cardioversion of atrial fibrillation, rectilinear biphasic shocks have greater efficacy (and require less energy) than damped sine wave monophasic shocks.

Comparison of a novel rectilinear biphasic waveform with a damped sine wave monophasic waveform for transthoracic ventricular defibrillation. ZOLL Investigators.

OBJECTIVES: We compared the efficacy of a novel rectilinear biphasic waveform, consisting of a constant current first phase, with a damped sine wave monophasic waveform during transthoracic defibrillation. BACKGROUND: Multiple studies have shown that for endocardial defibrillation, biphasic waveforms have a greater efficacy than monophasic waveforms. More recently, a 130-J truncated exponential biphasic waveform was shown to have equivalent efficacy to a 200-J damped sine wave monophasic waveform for transthoracic ventricular defibrillation. However, the optimal type of biphasic waveform is unknown. METHODS: In this prospective, randomized, multicenter trial, 184 patients who underwent ventricular defibrillation were randomized to receive a 200-J damped sine wave monophasic or 120-J rectilinear biphasic shock. RESULTS: First-shock efficacy of the biphasic waveform was significantly greater than that of the monophasic waveform (99% vs. 93%, p = 0.05) and was achieved with nearly 60% less delivered current (14 +/- 1 vs. 33 +/- 7 A, p < 0.0001). Although the efficacy of the biphasic and monophasic waveforms was comparable in patients with an impedance < 70 ohms (100% [biphasic] vs. 95% [monophasic], p = NS), the biphasic waveform was significantly more effective in patients with an impedance > or = 70 ohms (99% [biphasic] vs. 86% [monophasic], p = 0.02). CONCLUSIONS: This study demonstrates a superior efficacy of rectilinear biphasic shocks as compared with monophasic shocks for transthoracic ventricular defibrillation, particularly in patients with a high transthoracic impedance. More important, biphasic shocks defibrillated with nearly 60% less current. The combination of increased efficacy and decreased current requirements suggests that biphasic shocks as compared with monophasic shocks are advantageous for transthoracic ventricular defibrillation.