Real-time nonlinear parameter estimation and tracking control of unmanned aerial vehicles in closed-loop

The real-time unknown parameter estimation and adaptive tracking control problems are investigated in this paper for a six degrees of freedom (6-DOF) of under-actuated quadrotor unmanned aerial vehicle (UAV). A virtual proportional derivative (PD) controller is designed to maintain the translational dynamics. Two adaptive schemes are developed to handle the attitude dynamics of the UAV with several unknown parameters. In the beginning, a classical adaptive scheme (CAS) using the certainty equivalence principle is proposed and designed. The idea is to design a controller for an ideal situation by assuming the unknown parameters were known. Then the unknown parameters are replaced by their estimation. A theoretical analysis is provided to ensure the trajectory tracking of the adaptive controller. However, an inherent drawback of this scheme is that there is no guarantee for the estimated parameters to converge to the actual values. To address this issue, a new adaptive scheme (NAS) is developed as the next step by adding a continuously differentiable function to the control structure. The proposed technique guarantees handling of the parametric uncertainties with an appropriate design manifold. A rigorous analytical proof, numerical simulation analyses, and experimental validation are presented to show the effectiveness of the proposed control design.

Evaluation of medication adherence of glaucoma patients during the COVID-19 pandemic

PURPOSE

To evaluate changes in the medication adherence of glaucoma patients during the COVID-19 pandemic and the factors influencing medication adherence.

MATERIALS AND METHODS

This cross-sectional study included a total of 197 glaucoma patients who were followed for at least six months in the Glaucoma Unit of the Ophthalmology Department of Inonu University, Faculty of Medicine. Patients were given a 28-item questionnaire, including the eight-item Morisky Medication Adherence Questionnaire, to evaluate medication adherence. Demographic and clinical data were recorded. P<0.05 was considered statistically significant.

RESULTS

Interruption of glaucoma clinic visits during the pandemic was reported by 82 (41.6%) patients. Nonadherence was reported by 56 patients (28.4%) (95% confidence interval: 22.1-34.7). For these patients, the most common reasons for nonadherence were forgetfulness (50%), the inability to receive a prescription for the drug (10.7%) and being busy (10.7%). Factors influencing nonadherence were determined to be younger age, female gender, interruption of glaucoma clinic visits and high-income levels (P˂0.05).

CONCLUSION

Interruption of glaucoma clinic visits during the COVID-19 pandemic and the resulting inability to have medications prescribed resulted in patient nonadherence with medication use.

Prophylactic Cerclage Cabling Decreases the Intraoperative Periprosthetic Fracture Rate during Cement-Less Total Hip Arthroplasty in Patients with Severe Developmental Hip Dysplasia

PURPOSE OF THE STUDY Cementless stems in highly dysplastic hips are considered to increase the risk of femoral fracture and associated morbidity. Several authors speculated to use prophylactic cabling in this patient group to prevent intraoperative fractures. This study aims to reveal objective results regarding the perioperative complications in a large and consecutive patient group with respect to use of prophylactic cabling. MATERIAL AND METHODS A retrospective comparative study was planned. A total of 122 consecutive patients with dysplastic hips of Crowe type 3 or 4, operated on with total hip arthroplasty (THA) and shortening osteotomy using a rectangular femoral stem were included. Patients were stratified according to use of a diaphyseal prophylactic cerclage cable. Perioperative complications were recorded. Clinical outcome was measured in terms of Harris Hip Score and Visual Analog Scale (VAS) for pain. All results were compared between the groups. RESULTS The mean follow-up time was 27 months. Two (2%) versus five (14%) patients had a fracture at the diaphyseal level in cabled versus non-cabled groups. Difference between groups was statistically significant (p=0.01). Relative risk of fracture in case of a non-cabling was 5.8 (p=0.03). Eleven (9%) patients had a non-displaced fracture at the metaphyseal level. No significant differences were detected with respect to preoperative clinical outcome scores or change in these scores between groups. CONCLUSIONS Femoral diaphyseal fracture rates are low when cementless, rectangular stems are used in dysplastic high riding hips. Prophylactic cerclage cabling further decreases the fracture risk and eases treatment in case of a fracture without causing additional complications and therefore is recommended. Key words: intraoperative fracture, periprosthetic fracture, total hip arthroplasty, cerclage cabling, developmental hip dysplasia, transverse shortening osteotomy.

Animal models to improve our understanding and treatment of suicidal behavior

Worldwide, suicide is a leading cause of death. Although a sizable proportion of deaths by suicide may be preventable, it is well documented that despite major governmental and international investments in research, education and clinical practice suicide rates have not diminished and are even increasing among several at-risk populations. Although nonhuman animals do not engage in suicidal behavior amenable to translational studies, we argue that animal model systems are necessary to investigate candidate endophenotypes of suicidal behavior and the neurobiology underlying these endophenotypes. Animal models are similarly a critical resource to help delineate treatment targets and pharmacological means to improve our ability to manage the risk of suicide. In particular, certain pathophysiological pathways to suicidal behavior, including stress and hypothalamic-pituitary-adrenal axis dysfunction, neurotransmitter system abnormalities, endocrine and neuroimmune changes, aggression, impulsivity and decision-making deficits, as well as the role of critical interactions between genetic and epigenetic factors, development and environmental risk factors can be modeled in laboratory animals. We broadly describe human biological findings, as well as protective effects of medications such as lithium, clozapine, and ketamine associated with modifying risk of engaging in suicidal behavior that are readily translatable to animal models. Endophenotypes of suicidal behavior, studied in animal models, are further useful for moving observed associations with harmful environmental factors (for example, childhood adversity, mechanical trauma aeroallergens, pathogens, inflammation triggers) from association to causation, and developing preventative strategies. Further study in animals will contribute to a more informed, comprehensive, accelerated and ultimately impactful suicide research portfolio.

Describing and classifying urban sound environments with a relevant set of physical indicators

Categorization is a powerful method for describing urban sound environments. However, it has only been applied, until now, to discrete noise data collection, whereas sound environments vary continuously both in space and time. Therefore, a procedure is developed in this paper for describing the variations of urban sound environments. The procedure consists of mobile measurements, followed by a statistical clustering analysis that selects relevant noise indicators and classifies sound environments. Analysis are based on a 3 days + 1 night survey where geo-referenced noise measurements were collected over 19 1-h soundwalk periods in a district of Marseille, France. The clustering analysis showed that a limited subset of indicators is sufficient to discriminate sound environments. The three indicators that emerged from the clustering, namely, the Leq, A, the standard deviation σL eq, A, and the sound gravity spectrum SGC[50 Hz-10 kHz], are consistent with previous studies on sound environment classification. Moreover, the procedure proposed enables the description of the sound environment, which is classified into homogenous sound environment classes by means of the selected indicators. Thus, the procedure can be adapted to any urban environment, and can, for instance, favorably enhance perceptive studies by delimiting precisely the spatial extent of each typical sound environment.

The relationship of insulin resistance and metabolic syndrome with known breast cancer prognostic factors in postmenopausal breast cancer patients

PURPOSE

The aim of this study was to investigate the effect of metabolic syndrome and insulin resistance at the time of diagnosis on the known prognostic factors of breast cancer in postmenopausal breast cancer patients.

METHODS

The study included 71 patients with a recent diagnosis of postmenopausal breast cancer, admitted at the Medical Oncology outpatient clinic of the Izmir Ataturk Training and Research Hospital between June 2010 and June 2011. We determined whether the patients had metabolic syndrome and insulin resistance at diagnosis, and recorded known prognostic factors, such as tumor size, axillary lymph node involvement, presence of distant metastasis, tumor grade, estrogen receptor (ER), progesterone receptor (PR), and CerbB-2 status.

RESULTS

Among 71 patients, 25 (35%) had metabolic syndrome at the time of diagnosis, and 33 (46%) had insulin resistance with Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR)>2.7. No statistically significant difference was found in the prognostic values of breast cancer, i.e. tumor size, axillary lymph node involvement, distant metastasis, tumor grade, ER, PR, and CerbB-2 status between the patients with and without metabolic syndrome. There was no statistically significant difference in the prognostic factors of breast cancer at the time of diagnosis between 33 patients with insulin resistance and 38 patients without insulin resistance.

CONCLUSION

Several previous studies showed a negative relationship between metabolic syndrome and insulin resistance and prognostic factors of breast cancer in postmenopausal breast cancer patients. However, our study failed to show such a relationship. The relationship between metabolic syndrome and insulin resistance and postmenopausal breast cancer was not well demonstrated due to the small number of patients, unknown duration of the metabolic syndrome and insulin resistance, and shorter follow-up period. Further studies are required to demonstrate the effect of metabolic syndrome and insulin resistance on the prognosis of breast cancer, including larger number of patients and longer follow-up periods.

The association of hematologic parameters on the prognosis of patients with metastatic renal cell carcinoma

PURPOSE

Metastatic renal cell carcinoma (mRCC) bears a poor prognosis. We investigated the prognostic significance of some hematologic parameters of patients with mRCC.

METHODS

We retrospectively reviewed the records of 53 patients with mRCC . The mean follow up time was 34 months (range 5-142).We assessed the prognostic value of hematologic parameters (leukocytes ,neutrophils, lymphocytes, platelets, neutrophil to lymphocyte ratio/NLR, platelet to lymphocyte ratio/PLR), and other clinical parameters with univariate and multivariate analysis.

RESULTS

Memorial Sloan-Kettering Cancer Center (MSKCC) risk group , lung metastases, sunitinib treatment, lymphocyte count, NLR, and anemia significantly correlated with median overall survival (OS) on univariate analysis. The median OS in patients with a NLR < 3.4 was 32.2 months , significantly higher than the 13.9 months in patients with a ratio ≥ 3.4 (p = 0.006). Multivariate analysis revealed that MSKCC risk group and the NLR were independent predictors of OS.

CONCLUSION

Hematologic parameters may be associated with OS in mRCC. However, further studies are needed to establish their routine use.

Micro-metastases into the uterine leiomyoma from invasive ductal breast cancer under adjuvant tamoxifen therapy: case report

Metastasis of breast cancer to the uterus is extremely rare. However, breast cancer is the leading tumor metastasizing from extragenital organs to the uterus. The most common signs of uterine metastasis are bleeding and mass effect. Tamoxifen use is known to increase risk of endometrial cancer. Immunohistochemical staining with GCDFP can be useful in differentiating primary uterine tumors from breast cancer metastasis. Metastasis to the uterus has been reported to worsen the prognosis. Although hysterectomy has been effective on survival, treatment modality to be used in the presence of other systemic metastases is not clear. Locoregional treatments can be used in oligometastatic cases. In addition, removal of solitary organ metastasis together with bone metastasis provides improvement in survival.

Noise measurements as proxies for traffic parameters in monitoring networks

The present research describes how microphones could be used as proxies for traffic parameter measurements for the estimation of airborne pollutant emissions. We consider two distinct measurement campaigns of 7 and 12 days, at two different locations along the urban ring road in Antwerp, Belgium, where sound pressure levels and traffic parameters were measured simultaneously. Noise indicators are calculated and used to construct models to estimate traffic parameters. It is found that relying on different statistical levels and selecting specific sound frequencies permits an accurate estimation of traffic intensities and mean vehicle speeds, both for light and heavy vehicles. Estimations of R(2) values ranging between 0.81 and 0.92 are obtained, depending on the location and traffic parameters. Furthermore, the usefulness of these estimated traffic parameters in a monitoring strategy is assessed. Carbon monoxide, hydrocarbon and nitrogen oxide emissions are calculated with the airborne pollutant emission model Artemis. The Artemis outputs fed with directly measured and estimated traffic parameters (based on noise measurements) are very similar. Finally, a method is proposed to enable using a model calibrated at one location at another location without the need for new calibration, making it straightforward to include new measurement locations in a monitoring network.

The toxicity and efficacy of Nordic-FLOX regimen as adjuvant treatment of stage III colon cancer

PURPOSE

To evaluate the toxicity and efficacy of oxaliplatin combined with the Nordic regimen of bolus 5-fluorouracil (5-FU) and leucovorin (LV) (Nordic-FLOX) as adjuvant treatment in stage III colon cancer patients.

METHODS

Fifty-three patients with resected stage III colon cancer were treated with adjuvant bolus Nordic-FLOX regimen (oxaliplatin 85 mg/m(2) on day 1, bolus 5-FU 500 mg/ m(2) and bolus LV 60 mg/m(2) days 1 and 2) every 2 weeks for 12 cycles.

RESULTS

The probability of disease-free survival (DFS) at a median follow-up time of 29 months was 72%. Relapse was seen in 13 (24.5%) patients. The probability of 3-year overall survival (OS) at 36 months was 85%. Grade IV neutropenia was noticed in 15.1% of the patients, grade III-IV neurotoxicity was not encountered, while grade II neurotoxicity was 17%. Gastrointestinal toxicity (mild diarrhea) was seen in 11.3% of the patients.

CONCLUSION

Adjuvant treatment of stage III colon cancer with the Nordic-FLOX regimen can be an alternative regimen to infusional and other bolus regimens due to its easy administration, lower toxicity, and similar efficacy.

Towards Traffic Situation Noise Emission Models

This article proposes a methodology to account for vehicle kinematics in a fast and efficient way when using single vehicle noise emission models such as the Harmonoise/Imagine, Nord2000 or NMPB. A model is built, which mimics the traffic situation emission models developed in the field of airborne pollutants research. The model aggregates the sound power emitted over driving cycles which are statistically representative of real-world driving conditions. Four different driving conditions are included in the cycles, ranging from free-flowing to stop-and-go traffic conditions. The sound power levels estimated with this new approach are significantly different from the ones estimated with the mean speed approach recommended by the noise mapping guidelines, especially when traffic is congested, suggesting that the method could prove relevant for improving noise map accuracy, in particular in urban context.

Antidepressant-like responses to lithium in genetically diverse mouse strains

A mood stabilizing and antidepressant response to lithium is only found in a subgroup of patients with bipolar disorder and depression. Identifying strains of mice that manifest differential behavioral responses to lithium may assist in the identification of genomic and other biologic factors that play a role in lithium responsiveness. Mouse strains were tested in the forced swim test (FST), tail suspension test (TST) and open-field test after acute and chronic systemic and intracerebroventricular (ICV) lithium treatments. Serum and brain lithium levels were measured. Three (129S6/SvEvTac, C3H/HeNHsd and C57BL/6J) of the eight inbred strains tested, and one (CD-1) of the three outbred strains, showed an antidepressant-like response in the FST following acute systemic administration of lithium. The three responsive inbred strains, as well as the DBA/2J strain, displayed antidepressant-like responses to lithium in the FST after chronic administration of lithium. However, in the TST, acute lithium resulted in an antidepressant-like effect only in C3H/HeNHsd mice. Only C57BL/6J and DBA/2J showed an antidepressant-like response to lithium in the TST after chronic administration. ICV lithium administration resulted in a similar response profile in BALB/cJ (non-responsive) and C57BL/6J (responsive) strains. Serum and brain lithium concentrations showed that behavioral results were not because of differential pharmacokinetics of lithium in individual strains, suggesting that genetic factors likely regulate these behavioral responses to lithium. Our results indicate that antidepressant-like responses to lithium in tests of antidepressant efficacy varies among genetically diverse mouse strains. These results will assist in identifying genomic factors associated with lithium responsiveness and the mechanisms of lithium action.

The role of insulin therapy and glucose normalisation in patients with acute coronary syndrome

Patients with acute myocardial infarction (AMI) and diabetes mellitus, as well as patients admitted with elevated blood glucose without known diabetes, have impaired outcome. Therefore intensive glucose-lowering therapy with insulin (IGL) has been proposed in diabetic or hyperglycaemic patients and has been shown to improve survival and reduce incidence of adverse events. The current manuscript provides an overview of randomised controlled trials investigating the effect of IGL. Furthermore, systematic glucose-insulin-potassium infusion (GIK) has been studied to improve outcome after AMI. In spite of positive findings in some early studies, GIK did not show any beneficial effects in recent clinical trials and thus this concept has been abandoned. While IGL targeted to achieve normoglycaemia improves outcome in patients with AMI, achievement of glucose regulation is difficult and carries the risk of hypoglycaemia. More research is needed to determine the optimal glucose target levels in AMI and to investigate whether computerised glucose protocols and continuous glucose sensors can improve safety and efficacy of IGL.

Correlation analysis of noise and ultrafine particle counts in a street canyon

Ultrafine particles (UFP, diameter<100 nm) are very likely to negatively affect human health, as underlined by some epidemiological studies. Unfortunately, further investigation and monitoring are hindered by the high cost involved in measuring these UFP. Therefore we investigated the possibility to correlate UFP counts with data coming from low-cost sensors, most notably noise sensors. Analyses are based on an experiment where UFP counts, noise levels, traffic counts, nitrogen oxide (NO, NO(2) and their combination NO(x)) concentrations, and meteorological data were collected simultaneously in a street canyon with a traffic intensity of 3200 vehicles/day, over a 3-week period during summer. Previous reports that NO(x) concentrations could be used as a proxy to UFP monitoring were verified in our setup. Traffic intensity or noise level data were found to correlate with UFP to a lesser degree than NO(x) did. This can be explained by the important influence of meteorological conditions (mainly wind and humidity), influencing UFP dynamics. Although correlations remain moderate, sound levels are more correlated to UFP in the 20-30 nm range. The particles in this size range have indeed rather short atmospheric residence times, and are thus more closely short-term traffic-related. Finally, the UFP estimates were significantly improved by grouping data with similar relative humidity and wind conditions. By doing this, we were able to devise noise indicators that correlate moderately with total particle counts, reaching a Spearman correlation of R=0.62. Prediction with noise indicators is even comparable to the more-expensive-to-measure NO(x) for the smallest UFP, showing the potential of using microphones to estimate UFP counts.

Ultrastructural alterations in human decidua in miscarriages compared to normal pregnancy decidua

BACKGROUND

Pregnant endometrial stroma, an immunologically privileged site in the female reproductive system, is enriched by decidual and natural killer (NK) cells. Since the cellular microenvironment in early pregnancy from the decidual tissues of normal and miscarriage cases has gained importance, with special emphasis on cell-to-cell contacts, we aimed to document the plastic structure of the cellular milieu in normal and miscarriage decidua.

METHODS

Endometrial biopsies were obtained from women after legal curettage or women who had been treated by curettage after miscarriage. Samples were analysed in a light microscope (LM), a scanning electron microscope (SEM) and a transmission electron microscope (TEM).

RESULTS

Decidual cells possess several polyploidic protrusions on cell membranes. NK cells were distributed among decidual cells. Decidual cells were found to develop gap junctions in the interfaces between each other. Their cytoplasms were also found to possess well-developed protein synthesising organelles. Decidual cells obtained from miscarriages showed a moderate degree of degeneration and, in between, a decreased number of junctional complexes. Mononuclear cell infiltration was found to be significantly low.

CONCLUSION

We conclude that decidual cells during early pregnancy build a series of miniature cell-cell contacts to assemble a proper endometrial milieu. In contrast, in miscarriage samples, those intercellular communications seem lacking, associated with an increased number of NK cells, a phenomenon which obviously alters proper implantation and leads to the induction of embryonic disgenesis and miscarriage.

Attenuation of microtubule associated protein-2 degradation after mild head injury by mexiletine and calpain-2 inhibitor

The objective of the study was to address the early effects of mild, closed, head injuries on neuronal stability and the prevention of microtubule-associated protein-2 (MAP-2) degradation by mexiletine and calpain-2 inhibitor. Twenty-four rats were divided into four groups: control group (1); trauma group without treatment (2); mexiletine-pretreated and subjected to trauma group (3); trauma subjected and then calpain-2 inhibitor received group (4). All animals were subjected to mild, closed, head trauma. Frontal lobes were removed and processed for staining and immunofluorescent labelling of MAP-2 cytoskeletal proteins, which were evaluated by confocal microscopy in serial optical sections showing the three dimensional cytoarchitecture of affected areas. MAP-2 decoration in almost all neurons obtained from traumatized brain regions drastically diminished, while minute filamentous and granular profiles in axons and/or dendrites were retained together implying a massive degradation/depolymerization of microtubules. In contrast, in mexiletine-pretreated animals, MAP-2 positivity in axonal and perikaryonal profiles was fairly retained, which clearly depicts the protective role of mexiletine after trauma. Compared with mexiletine-pretreated group, calpain-2 inhibitor treated group displayed a less well-preserved MAP-2 expression. Mexiletine can prevent cytoskeletal structure and protein degradation after mild head trauma. Calpain-2 inhibitor prevents protein degradation, but cytoskeletal organization is better preserved with mexiletine.

Permeability of latex gloves after exposure to 6 chemical agents

OBJECTIVES

To assess the effects of exposure to 6 chemical agents on the permeability of latex gloves by dye permeability test and to qualitatively evaluate the microscopic changes in the ultrastructure of the gloves.

METHOD AND MATERIALS

The middle fingers of 35 medium-sized, nonsterile latex gloves were used. The chemical agents tested were eugenol, 5% NaOCl, 17% EDTA, 0.2% chlorhexidine gluconate, Cresophene (Septodent), and Chlorispray (Anios). Following treatment for 15 minutes with each chemical agent, glove fingers were filled with 10 mL of 0.02% erythrosine dye solution. Then the outer glove surface was washed with 10 mL of distilled water at intervals of 15, 30, 45, and 60 minutes. A spectrophotometer was used at 530-nm wavelength to determine the percentage of absorption from each collected washing solution. The results were compared with the values obtained from untreated gloves. Additionally, small pieces of the glove samples were examined by SEM to determine whether any ultrastructural changes occurred upon exposure to the chemicals.

RESULTS

The permeability of gloves was increased by exposure to Chlorispray and Cresophene, but 5% NaOCl, 17% EDTA, and 0.2% chlorhexidine gluconate had no effect. Major surface changes were noticed in NaOCl, EDTA, Cresophene, and Chlorispray groups, while eugenol and chlorhexidine gluconate had minimal or no effect.

CONCLUSION

Damaging effects of chemical agents on latex gloves for penetration and infection control should be considered by the dental practitioner.

Unchanged asymmetric dimethylarginine levels in non-diabetic, premenopausal obese women who have common risk factors for cardiovascular disease

This study was performed to test whether plasma asymmetric dimethylarginine (ADMA) concentrations are related to obesity and obesity complications including decrement in insulin sensitivity and adiponectin levels, dyslipidemia and low-grade inflammation. Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) concentrations were analyzed by HPLC in 17 overweight (BMI > or = 25 kg/m2) and 40 obese (BMI > or = 30 kg/m2) premenopausal women. Age-matched healthy women were studied as controls. Obesity did not give rise to a significant change in circulating ADMA levels but reduced in SDMA levels. As compared with control subjects (0.441 +/- 0.102 microM), ADMA values in overweight and obese subjects were found to be as 0.412 +/- 0.102 and 0.436 +/- 0.093, respectively. No Pearson's association of ADMA with relevant risk variables for cardiovascular disease, including blood pressure, insulin sensitivity, inflammatory markers, lipid and adiponectin levels. However, in linear regression analysis, BMI, diastolic blood pressure, glucose, insulin, and IL-8 emerged as significant predictors of ADMA. In spite of obese women have elevated hs-CRP, triglyceride levels and decreased insulin sensitivity, adiponectin and HDL-cholesterol levels, all of which is closely linked risk factors for cardiovascular disease, circulating ADMA levels remained unchanged in obese individuals as compared with controls.