State of Charge Estimation Model Based on Genetic Algorithms and Multivariate Linear Regression with Applications in Electric Vehicles.

Nowadays, the use of renewable, green/eco-friendly technologies is attracting the attention of researchers, with a view to overcoming recent challenges that must be faced to guarantee the availability of Electric Vehicles (EVs). Therefore, this work proposes a methodology based on Genetic Algorithms (GA) and multivariate regression for estimating and modeling the State of Charge (SOC) in Electric Vehicles. Indeed, the proposal considers the continuous monitoring of six load-related variables that have an influence on the SOC (State of Charge), specifically, the vehicle acceleration, vehicle speed, battery bank temperature, motor RPM, motor current, and motor temperature. Thus, these measurements are evaluated in a structure comprised of a Genetic Algorithm and a multivariate regression model in order to find those relevant signals that better model the State of Charge, as well as the Root Mean Square Error (RMSE). The proposed approach is validated under a real set of data acquired from a self-assembly Electric Vehicle, and the obtained results show a maximum accuracy of approximately 95.5%; thus, this proposed method can be applied as a reliable diagnostic tool in the automotive industry.

Clinical manifestations of Rickettsia rickettsii in a familial outbreak in Panama.

We report an isolated outbreak of Rickettsia rickettsii in the Ngäbe-Buglé indigenous region, located 750 m (tropical wet) above sea level, in a jungle and mountainous area of Western Panama. Seven members of a family were infected simultaneously, resulting in four deaths. Family outbreaks have been previously described and are responsible for 4-8% of the cases described [1-4]. The simultaneous onset of symptoms in the affected population group is extremely unusual [1,5], but it should not dissuade the clinician from considering the possibility of Rickettsia rickettsii infection.

Accuracy of Consecutive Fecal Calprotectin Measurements to Predict Relapse in Inflammatory Bowel Disease Patients Under Maintenance With Anti-TNF Therapy: A Prospective Longitudinal Cohort Study.

BACKGROUND AND GOAL: Predicting relapse in inflammatory bowel disease (IBD) patients could allow early changes in therapy. We aimed at evaluating the accuracy of consecutive fecal calprotectin (FC) measurements to predict flares in IBD patients under maintenance treatment with anti-tumor necrosis factor (TNF) drugs. STUDY: A prospective longitudinal cohort study with 16-month follow-up period was designed. IBD patients in clinical remission for at least 6 months under anti-TNF therapy were included. FC was quantified at 4-month intervals for 1 year, and patients were clinically evaluated for relapse at 2-month intervals. Diagnostic accuracy of FC for predicting relapse was evaluated by receiver-operating characteristic curve analysis. RESULTS: In total, 95 of 106 included patients finalized the study and were analyzed (median age 44 y, 50.5% female, 75% with Crohn's disease). A total of 30 patients (31.6%) had a relapse over follow-up. FC concentration was significantly higher in patients who relapsed (477 µg/g) than in patients who maintained in remission (65 µg/g) (P<0.005). The optimal cutoff to predict remission was 130 µg/g (negative predictive value of 100%), and 300 µg/g to predict relapse (positive predictive value of 78.3%). CONCLUSIONS: FC is a good predictor of clinical relapse and a particularly good predictor of remission over the following 4 months in patients with IBD on maintenance therapy with anti-TNF drugs. FC levels <130 µg/g is consistently associated with maintained disease remission, whereas concentrations >300 µg/g allow predicting relapse with a high probability at any time over the following 4 months.

A Novel Physical Sensing Principle for Liquid Characterization Using Paper-Based Hygro-Mechanical Systems (PB-HMS).

In recent years paper-based microfluidic systems have emerged as versatile tools for developing sensors in different areas. In this work; we report a novel physical sensing principle for the characterization of liquids using a paper-based hygro-mechanical system (PB-HMS). The PB-HMS is formed by the interaction of liquid droplets and paper-based mini-structures such as cantilever beams. The proposed principle takes advantage of the hygroscopic properties of paper to produce hygro-mechanical motion. The dynamic response of the PB-HMS reveals information about the tested liquid that can be applied to characterize certain properties of liquids. A suggested method to characterize liquids by means of the proposed principle is introduced. The experimental results show the feasibility of such a method. It is expected that the proposed principle may be applied to sense properties of liquids in different applications where both disposability and portability are of extreme importance.

Usefulness of a rapid faecal calprotectin test to predict relapse in Crohn's disease patients on maintenance treatment with adalimumab.

BACKGROUND AND AIM: Predicting relapse in Crohn's disease (CD) patients by measuring non-invasive biomarkers could allow for early changes of treatment. Data are scarce regarding the utility of monitoring calprotectin to predict relapse. The aim of the study was to evaluate the predictive value of a rapid test of faecal calprotectin (FC) to predict for flares in CD patients on maintenance treatment with adalimumab (ADA). METHODS: A prospective, observational cohort study was designed. Inclusion criteria were CD patients in clinical remission on a standard dose of ADA therapy. Fresh FC was measured using a rapid test. RESULTS: Thirty patients were included (median age 38 years, 56.7% female). After the 4 months follow-up, 70.0% patients remained in clinical remission and 30.0% had a relapse. FC concentration at inclusion was significantly higher in those patients who relapsed during the follow-up (625 µg/g) compared to those who stayed in remission (45 µg/g). The optimal cut-off for FC to predict relapse was 204 µg/g. The area under the receiver-operating characteristic curve was 0.968. Sensitivity, specificity, positive, and negative predictive value of FC to predict relapse were 100%, 85.7%, 74.1%, and 100%, respectively. CONCLUSION: In CD patients on ADA maintenance therapy, FC levels measured with a rapid test allow relapse over the following months to be predicted with high accuracy. Low FC levels exclude relapse within at least 4 months after testing, whereas high levels are associated with relapse in three out of every four patients.

Fecal Calprotectin as Predictor of Relapse in Patients With Inflammatory Bowel Disease Under Maintenance Infliximab Therapy.

BACKGROUND AND GOALS: Predicting relapse in Inflammatory Bowel Disease (IBD) could allow for early changes of treatment. Close monitoring of fecal calprotectin (FC) could be useful to predict relapse in IBD. Aim of the study was to evaluate the predictive value of a rapid FC test to predict flares in patients with IBD under maintenance therapy with Infliximab. STUDY: A prospective observational cohort study was designed. IBD patients in clinical remission under maintenance Infliximab therapy were included. FC was measured using a rapid test on a stool sample obtained within 24 hours before Infliximab infusion. Clinical examination was performed 2 months after that infusion. RESULTS: Fifty-three patients were included (52.8% female). Thirty-three patients (62.3%) had Crohn's disease and 20 (37.7%) had ulcerative colitis. All patients were in remission at inclusion. After 2 months, 41 patients (77.4%) remained in clinical remission and 12 (22.6%) presented a relapse. FC (mean±SD) in relapsing and not-relapsing disease was 332±168 and 110±163 µg/g, respectively (P<0.005). A FC concentration>160 µg/g had a sensitivity of 91.7%, and specificity of 82.9% to predict relapse. CONCLUSIONS: In IBD patients under Infliximab maintenance therapy, high FC levels allow predicting relapse within the following 2 months. Long-term remission is associated with low calprotectin levels. Further studies are required to confirm these results.

Psychological factors are associated with changes in the health-related quality of life in inflammatory bowel disease.

BACKGROUND: The effect of different sociodemographic and clinical variables on the health-related quality of life (HRQOL) of patients with inflammatory bowel disease (IBD) is currently known, but the influence of psychological factors has not been sufficiently explored. The objective of this study was to identify psychological predictors of HRQOL in patients with IBD. METHODS: A cross-sectional prospective study was undertaken including 875 consecutive IBD patients. Independent variables were measured using a sociodemographic and clinical questionnaire, the Hospital Anxiety and Depression Scale (HADS) questionnaire, the Perceived Stress Scale (PSS) questionnaire, and the COPE questionnaire. Dependent variables were measured using the Short Form 36 Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ-36). Logistic regression was performed to identify factors associated with HRQOL. RESULTS: The participation rate was 91.3%. Patients with IBD had a poorer HRQOL than the general population except on the Physical Function, Social Function, and Emotional Function Scale. Moreover, high levels of anxiety, depression, and stress were found to be associated with low levels in all quality of life measurements. No significant relationship was found between HRQOL and coping strategies. CONCLUSIONS: In patients with IBD, stress, anxiety and depression are important determinants of HRQOL and should therefore be considered in the management of this patient population.

How do psychological variables influence coping strategies in inflammatory bowel disease?

BACKGROUND: Adjusting to chronic disease is a complex process and one that, in the case of inflammatory bowel disease (IBD), has received very little attention. The objectives of this study were to identify coping strategies used by patients with IBD and to explore how these strategies are related to psychological characteristics. METHODS: A transversal study was designed in which 875 patients with IBD were prospectively enrolled. Independent variables were evaluated using a sociodemographic questionnaire and a clinical questionnaire-the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS); dependent variables were evaluated using the COPE Inventory (Coping Orientation to Problems Experienced), a multidimensional scale for evaluating general coping styles. Multiple linear regression was used to identify the variables associated with the type of coping used. RESULTS: The participation rate was 91.3%. The most common coping strategy was emotion-focused coping (X=2.64; 95% CI=2.61-2.69), with no differences in relation to type of disease. The highest scores for anxiety were associated with emotion-focused coping (ß=0.164, p=0.001) whereas, for depression, the highest scores were associated with escape-avoidance (ß=0.108, p=0.044). No correlation was found between stress levels and type of coping. CONCLUSIONS: Patients with IBD have a tendency to focus on emotions in their coping process, and this process appears to be related not only to sociodemographic characteristics or features of the disease itself but also to psychological factors-anxiety and depression, primarily.

Optimization of Q-factor of AFM cantilevers using genetic algorithms.

Micro cantilever beams have been intensively used in sensing applications including to scanning profiles and surfaces where there resolution and imaging speed are critical. Force resolution is related to the Q-factor. When the micro-cantilever operates in air with small separation gaps, the Q-factor is even more reduced due to the squeeze-film damping effect. Thus, the optimization of the configuration of an AFM micro-cantilever is presented in this work with the objective of improving its Q-factor. To accomplish this task, we propose the inclusion of holes as breathing chimneys in the initial design to reduce the squeeze-film damping effect. The evaluation of the Q-factor was carried out using finite element model, which is implemented to work together with the squeeze-film damping model. The methodology applied in the optimization process was genetic algorithms, which considers as constraints the maximum allowable stress, fundamental frequency and spring constant with respect to the initial design. The results show that the optimum design, which includes holes with an optimal location, increases the Q-factor almost five times compared to the initial design.

Influence of alexithymia on health-related quality of life in inflammatory bowel disease: are there any related factors?

OBJECTIVE: Alexithymia is a personality trait characterized by difficulty to perceive and express emotions. Previous studies have indicated a high prevalence of alexithymia in patients with inflammatory bowel disease (IBD) but results have been inconsistent. The aim of the present study was to investigate the prevalence of alexithymia in a large IBD cohort and to establish the impact of alexithymia on health-related quality of life (HRQOL) in these patients. MATERIAL AND METHODS: A cross-sectional prospective study was undertaken including 534 consecutive IBD patients. Independent variables were measured using one socio-demographic and clinical questionnaire, the hospital anxiety and depression scale (HADS) and the Toronto alexithymia scale (TAS-26). Dependent variables were measured using the short form 36 health survey (SF-36) and the inflammatory bowel disease questionnaire (IBDQ-36). Multiple linear regression and logistic regression were performed to identify factors associated with HRQOL. RESULTS: Participation rate was 91.3%. The overall prevalence of alexithymia was 30.2% (95% CI: 26.0-35.0), with no difference between Crohn's disease and ulcerative colitis. The most affected scales in quality of life were general health (mean = 48.35, 95% CI: 46.43-50.27), vitality (mean = 55.81, 95% CI: 53.59-58.04) and systemic symptoms (mean = 5.19, 95% CI: 5.08-5.29). Alexithymia was significantly associated with an impaired quality of life (OR = 3.34, 95% CI: 1.98-5.65). "Difficulty identifying feelings" and "externally oriented thinking" were the alexithymia factors related to the impaired HRQOL. CONCLUSIONS: Alexithymia is highly prevalent in IBD and represents a significant determinant of HRQOL. Alexithymia and its components need to be taken into consideration in the management of IBD patients.

FPGA-based fused smart-sensor for tool-wear area quantitative estimation in CNC machine inserts.

Manufacturing processes are of great relevance nowadays, when there is a constant claim for better productivity with high quality at low cost. The contribution of this work is the development of a fused smart-sensor, based on FPGA to improve the online quantitative estimation of flank-wear area in CNC machine inserts from the information provided by two primary sensors: the monitoring current output of a servoamplifier, and a 3-axis accelerometer. Results from experimentation show that the fusion of both parameters makes it possible to obtain three times better accuracy when compared with the accuracy obtained from current and vibration signals, individually used.

A field programmable gate array-based reconfigurable smart-sensor network for wireless monitoring of new generation computer numerically controlled machines.

Computer numerically controlled (CNC) machines have evolved to adapt to increasing technological and industrial requirements. To cover these needs, new generation machines have to perform monitoring strategies by incorporating multiple sensors. Since in most of applications the online Processing of the variables is essential, the use of smart sensors is necessary. The contribution of this work is the development of a wireless network platform of reconfigurable smart sensors for CNC machine applications complying with the measurement requirements of new generation CNC machines. Four different smart sensors are put under test in the network and their corresponding signal processing techniques are implemented in a Field Programmable Gate Array (FPGA)-based sensor node.

Tratamiento del dedo en resorte con laserpuntura / Treatment of the spring finger with laserpuncture

Se realizó un estudio prospectivo clínico-terapéutico a 76 pacientes, los cuales fueron tratados con laserpuntura, y con el diagnóstico de dedo en resorte, remitidos de la Consulta Externa del Hospital Militar Central ôDr. Carlos J. Finlayö. Sesenta y tres pacientes correspondieron al sexo femenino, el grupo de edades más afectado fue entre 40 y 60 años, y en el 75 por ciento del total, se obtuvieron resultados satisfactorios. Se exponen los criterios de diagnóstico, los fundamentos para determinar el realizar un proceder quirúrgico o conservador, la acción terapéutica de la acupuntura y de la irradiación con rayos láser y se hace énfasis en nuestra hipótesis de trabajo respecto a la acción sumatoria de ambos procederes, al estimular puntos específicos de acupuntura con rayos láser de baja potencia

Tratamiento del dedo en resorte con laserpuntura / Treatment of the spring finger with laserpuncture

Se realizó un estudio prospectivo clínico-terapéutico a 76 pacientes, los cuales fueron tratados con laserpuntura, y con el diagnóstico de dedo en resorte, remitidos de la Consulta Externa del Hospital Militar Central “Dr. Carlos J. Finlay”. Sesenta y tres pacientes correspondieron al sexo femenino, el grupo de edades más afectado fue entre 40 y 60 años, y en el 75 por ciento del total, se obtuvieron resultados satisfactorios. Se exponen los criterios de diagnóstico, los fundamentos para determinar el realizar un proceder quirúrgico o conservador, la acción terapéutica de la acupuntura y de la irradiación con rayos láser y se hace énfasis en nuestra hipótesis de trabajo respecto a la acción sumatoria de ambos procederes, al estimular puntos específicos de acupuntura con rayos láser de baja potencia(AU)

Metástasis endobronquiales y laríngeas. Una forma poco habitual de diseminación del hipernefroma / Endobronchial and laryngeal laryngeal metastasis: Uncommon forms of dissemination of hyperphroma

OBJETIVO: Mostrar algunas formas poco habituales de diseminación del hipernefroma. MATERIAL Y MÉTODOS: Describimos el caso clínico de un paciente con antecedentes de hipernefroma y diseminación metastásica en lugares atípicos, como vallécula laríngea y bronquio. Realizamos una búsqueda bibliográfica que nos confirma la rareza del caso, nos permita comparar hallazgos y establecer coincidencias con nuestro paciente. RESULTADOS: Exponemos unas formas de metastatización atípica, señalando los datos diagnósticos, radiológicos y clínicos que las definen, mostrando, también, las vías de diseminación tumoral que consideramos necesario conocer para comprender el proceso en su totalidad. CONCLUSIONES: Es importante el conocimiento de estas metástasis atípicas, ya que pueden aparecer sincrónicamente con el tumor o preceder a la detección del mismo; la sospecha es la principal arma para su diagnóstico correcto, con la evidente repercusión tanto en el tratamiento como en el pronóstico. La radiología tiene indiscutible valor en estos casos, siendo imprescindible la confirmación histológica para alcanzar un correcto diagnóstico (AU)

Papel de la galactografía en el manejo de pacientes con secreción por el pezón: comparación con citología

Se realizó galactografía y citología en 30 pacientes con secreción espontánea por el pezón. La secreción hemática fue la mas frecuente (43,3 por ciento). Los cambios fibroquísticos fueron la causa mas común de telorrea diagnosticada por los dos métodos (60 por ciento por galactografía y 56,7 por ciento por citología), los cuales coinciden para el diagnóstico de papiloma en el 50 por ciento de los casos y en el 70,6 por ciento para el diagnóstico de patología benigna no tumoral. La galactografía sigue siendo el método de elección para la evaluación de las pacientes con secreción hemática, reservandose la citología como un exámen complementario

Ultrasonido de la colelitiasis sintomática: prevalencia en nuestro medio

Se realiza una revisión retrospectiva de 2.812 pacientes con síntomas abdominales, encontrando una prevalencia global de 29,3 por ciento de colelitiasis, con una relación de 6,6 mujeres por 1 hombre. Se resalta el elevado número de pacientes menores de 30 años con colelitiasis (tasa porcentual de 21,78 por ciento) a la vez que se encontró una alta prevalencia en hombres (19,2 por ciento). Una submuestra de 827 pacientes sirvió para el análisis de los tipos de colelitiasis, con 68,8 por ciento para el grado 1, 29 por ciento el grado 2 y 1,2 por ciento del grado 3. Se comparan los resultados con los resportes de otras series de la literatura y se discute el valor del ultrasonido en relación al tratamiento no quirúrgico de la colelitiasis

El caso de infecciosas: micosis sistematicas severas y su tratamiento con derivados imidazolicos / The infectious case: severe systemic mycoses and its treatment using imidazolic derivates

Se describen tres casos severos de paracoccidiodomicosis e histoplasmosis en pacientes jovenes (7 a 21 anos) quienes recibieron como tratamiento unico compuestos imidazolicos (ketoconazol 200 mg. itraconazol 100 mg/dia); estos fueron administrados por via oral por periodos variables (14-24 meses). Los pacientes empezaron a mejorar desde los tres primeros meses de terapia, aumentando dicha mejoria con el transcurso del tiempo. Durante la terapia no se detectaron alteraciones en las pruebas hepaticas o hematologicas, como tampoco efectos secundarios significativos. Los controles post-tratamiento han sido llevados a cabo por mas de dos anos sin que se hayan encontrado signos de reactivacion de la micosis. Los resultados clinicos, serologicos y radiologicos obtenidos en los pacientes bajo estudio, permiten aceptar que estos compuestos imidazolicos son una alternativa valiosa para el manejo de casos graves de histoplasmosis y de paracocciodiodomicosis.

Algunas consideraciones sobre la acupuntura

En nuestra medio la Acupuntura, ha pasado por etapas de alza y bajas, dado por diversos motivos, entre los cuales citaremos en primerr lugar una no adecuada información científica, una propaganda no controlada, creencia por parte del paciente de que se encuentra frente a "la maravilla del siglo" que todo lo cura. En este artículo, tratamos de dar a conocer aspectos de la acupuntura que motiven a los científicos cubanos al estudio, a la experimentación, pero a la vez mostramois las dificultades actuales para la aceptación de esta técnica de tratamiento(AU)

El nivel de efecto y mecanismo de la anestesia por acupuntura

Sin duda alguna uno de los aspectos más interesantes que nos brinda la acupuntura, es su utilización como método de anestesia. En este trabajo se realiza un recuento de las diversas teorías que tratan de explicar el nivel de efecto y el mecanismo de acción de este método. Las investigaciones de los mecanismos de la acupuntura como método de anestesia continúan hoy día. No obstante existen dos teorías, que son las que tiene mayores adeptos:1) La teoría de la puerta ( Gate control theory ) de Casey Wall y Walclzach.2) La teoría de la Beta endorfina de mayer y pomeranz(AU)