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Introduction Burnout syndrome refers to the physical and psychological fatigue suffered by workers as a result of their professional activity. It has three main characteristics: emotional exhaustion, depersonalization and lack of personal fulfillment. Purpose To determine the prevalence of burnout syndrome among Andalusian ophthalmologists, both consultants and residents, analyzing its relationship with several sociodemographic variables. Material and methods Descriptive cross-sectional study. All the sociodemographic variables were included in a Google® form together with the standardized questionnaire Maslach Burnout Inventory-Human Services Survey (MBI-HSS). This form was sent to the Andalusian ophthalmological community by different electronic means (Andalusian Society of Ophthalmology, instant messaging mobile apps, etc.). Results 142 ophthalmologists answered the form, with a similar distribution by sex and a mean age of 43,77 years, with 67,1% of them meeting criteria of burnout syndrome. Its prevalence was higher among young ophthalmologists, with fewer years of clinical practice, divorced / separated, those with fewer children, belonging to centers in the province of Huelva, workers in rural / regional areas, those with exclusive public activity, consultants with temporary contracts and four-year residents. Regarding subspecialties, its prevalence was higher among those who focused on cornea-ocular surface-refractive surgery. Conclusions This study quantify for the first time in Andalusia the prevalence of burnout syndrome among ophthalmologists. The fact that two thirds of the analyzed sample meet criteria proves the need to implement improvements in the clinical and professional conditions of our group.

OBJECTIVE There is a paucity of data regarding financial trends for procedural reimbursements in otolaryngology. The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for the 20 most commonly billed otolaryngology procedures from 2000 to 2019. STUDY DESIGN Analysis of physician reimbursement. METHODS The American Academy of Otolaryngology-Head and Neck Surgery database was queried to determine the 20 most performed otolaryngology procedures. Next, the Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services was utilized to assess each of the top 20 most utilized Current Procedural Terminology (CPT) codes in otolaryngology, and reimbursement data was extracted. All monetary data was adjusted for inflation to 2019 U.S. dollars using changes to consumer price index. Average annual and total percentage change in reimbursement were calculated based on adjusted values for all included procedures. RESULTS After adjusting for inflation, the average reimbursement for the total 20 procedures decreased by 37.63% from 2000 to 2019. The greatest single mean decrease was seen in CPT code 61782 for stereotaxis procedures on the skull, meninges, and brain (-59.96%), whereas the smallest mean decrease was in CPT code 30520 for septoplasty (-1.50%). From 2000 to 2019, the adjusted reimbursement rate for the combined procedures decreased by an average of 2.33% each year. CONCLUSION Medicare reimbursement for included procedures has decreased from 2000 to 2019. Increased awareness and consideration of these trends will be important for policy makers, hospitals, and surgeons in order to assure continued access to meaningful otolaryngology care in the United States. LEVEL OF EVIDENCE 4 Laryngoscope, 131:496-501, 2021.

There are several methods to assess the function of the autonomic nervous system. Among them, heart rate recovery (HRR) is an accepted, easy, low-cost technique. Different pathological conditions have been related to the development of autonomic dysfunction. Our study aimed to evaluate the relationship between HRR and HRR-derived parameters in ambulatory patients with asthma or type 2 diabetes followed at the National Institutes of Health in Mexico City. A total of 78 participants, 50 women and, 28 men were enrolled; anthropometric, respiratory evaluations, and fasting blood samples were taken before participants performed a 6-min walking test (6MWT). Abnormal HRR was defined as a drop of ≤8 and ≤11 beats/min at 1 or 2 min and correlated negatively with basal oxygen saturation at 1 min. Heart rate at 1 min, correlated negatively with final oxygen saturation (p < 0.01). Statistically significant negative correlations were also observed between red cell count and white blood cell count and HOMA-IR with a p < 0.01. Since discrete hematological but significant changes correlated with HRR and HRR-derived parameters, we consider that these measures are helpful in clinical settings to identify subclinical autonomic dysfunction that permits us to prevent or anticipate chronic and fatal clinical outcomes.

The following brief report summarized the results of a study where Ultra-widefield images analysis demonstrated superior capability and reliability than indirect ophthalmoscopy, during the clinical assessment of patients with type 1 Boston Keratoprosthesis.

Resumen Introduccion y objetivo La enfermedad por virus Zika constituye un reto para la salud publica por su rapida expansion y sus potenciales complicaciones fetales. En Espana la enfermedad por virus Zika es importada, aunque la presencia de Aedes albopictus no descarta su transmision autoctona. La enfermedad por virus Zika y los casos congenitos se vigilan desde 2016. El objetivo es conocer su epidemiologia y el resultado de la gestacion en las embarazadas. Material y metodos Estudio descriptivo de casos notificados a la Red Nacional de Vigilancia Epidemiologica (RENAVE) entre el 30/11/2015 y el 31/12/2017. La definicion de caso y la encuesta se recogen en los protocolos de la RENAVE. Las variables fueron: fecha, comunidad autonoma (CC. AA.), clasificacion, modo y lugar de infeccion, variables sociodemograficas, clinicas, microbiologicas, embarazo y su evolucion. Se realizo un analisis descriptivo de los casos y su distribucion segun el resto de variables. Resultados Diecisiete CC. AA. notificaron 512 casos, de los cuales 507 fueron no congenitos: 327 (64,5%) eran mujeres (52,5% en edad fertil); 403 casos (79,5%) correspondieron a 2016 y 193 (38,1%) residian en CC. AA. colonizadas por A. albopictus entre mayo y octubre. El 96,1% de casos importados se infectaron en America y el 51,7% en visitas familiares. Se detectaron 3 casos de infeccion congenita en 77 embarazadas. Conclusiones La evolucion de notificaciones mostro paralelismo con la de la epidemia en America. El grupo mas numeroso de viajeros fue el de mujeres jovenes que fueron a Latinoamerica en visitas familiares. El seguimiento de las embarazadas permitio identificar complicaciones fetales.

Pulmonary hypertension is a rare condition that impairs patients’ quality of life and life expectancy. The development of noninvasive instruments may help elucidate the prognosis of this cardiorespiratory disease. We aimed to evaluate the utility of routinely performed noninvasive test results as prognostic markers in patients with pulmonary hypertension. We enrolled 198 patients with mean pulmonary artery pressure &gt, 25 mmHg measured at cardiac catheterisation or echocardiographic pulmonary artery systolic pressure &gt, 40 mmHg and tricuspid regurgitation Vmax &gt, 2.9 m/s, and clinical information regarding management and follow-up studies from the date of diagnosis. Multivariate analysis revealed that female sex [HR: 0.21, (95% CI: 0.07–0.64), p = 0.006], the presence of collagenopathies [HR: 8.63, (95% CI: 2.38–31.32), p = 0.001], an increased red blood cell distribution width [HR: 1.25, (95% CI: 1.04–1.49), p = 0.017] and an increased electrocardiographic P axis (P°)/T axis (T°) ratio [HR: 0.93, (95% CI: 0.88–0.98), p = 0.009] were severity-associated factors, while older age [HR: 1.57, (95% CI: 1.04–1.28), p = 0.006], an increased QRS axis (QRS°)/T° ratio [HR: 1.21, (95% CI: 1.09–1.34), p &lt, 0.001], forced expiratory volume in 1 s [HR: 0.94, (95% CI: 0.91–0.98), p = 0.01] and haematocrit [HR: 0.93, (95% CI: 0.87–0.99), p = 0.04] were mortality-associated factors. Our results support the importance of red blood cell distribution width, electrocardiographic ratios and collagenopathies for assessing pulmonary hypertension prognosis.

In recent years, society has been growing and aging at accelerated rates. Consequently, it has been of great interest to develop rehabilitation and gait assistance solutions by medical and engineering professionals. Moreover, worldwide statistics report high incidence indicators of neurological and physical impairments, being a public health concern in several countries. In this sense, there are four types of assistive technologies that can be found in the field of rehabilitation engineering, focusing on human mobility: (1) wearable robots, (2) mobile robots, (3) social robots, and (4) combined platforms. Depending on the requirements of each user, these robotic devices aim to compensate, retrain, or provide the affected locomotion capabilities of the individual. This chapter defines these devices and describes their implementation in the context of gait assistance and rehabilitation. Similarly, it provides some evidence of applications in clinical scenarios.

Summary Very low enthalpy geothermal energy is one of the least known NCRES in Colombia, but it has been widely used around the world in particular for space conditioning (heating and/or cooling) for domestic and industrial purposes, due to its great adaptability since all it needs is a GHP to directly exchange heat with subsoil and/or groundwater. This investigation evaluates the possibility of implementing a SWSHP system to cool at 3°C a preservation room for exportation flowers in La Virginia S.A.S located in La Ceja, at 41 km to the southeast of Medellin (Antioquia, Colombia). The temperature of two reservoirs belonging to the flower farm was monitored to analyze their potential as heat sinks for a SWSHP. The traditional and geothermal refrigeration systems were compared using empirical formulas based on the theoretical performance proposed by Carnot. It was found that the water temperature had a very little variation with respect to the ambient air temperature. The feasibility of using a surface water body as a heat sink of a SWSHP was evaluated. The coupling with other geothermal arrangements such as vertical and/or horizontal Ground Source Heat Pumps (GSHP) and even combining aerothermal is suggested.

Smart Walkers are robotic devices commonly used to improve physical stability and sensory support for people with lower limb weakness or cognitive impairments. Even though such devices offer continuous monitoring during physical rehabilitation, providing a tool to empower therapists might reduce their efforts and increase patient’s safety during gait therapies. The implementation of remote-operation strategies enable therapy managers to remote control and assess the smart walker and user information. In this context, this paper presents a new strategy to control and perceive a walker-assisted gait therapy, by means of a haptic joystick with three operational modes. A set of path following tasks were implemented to validate the operational modes. The kinematic estimation error was calculated, and it was found a decrease in the error, when feedback modes were used. Likewise, results from an usability and acceptance questionnaire show better participant’s understating of visual feedback mode, and higher effort perception under haptic feedback mode. This interaction strategy represents a potential joystick application as a safety and control interface in walker-assisted gait.

PLATO, PLAnetary Transits and Oscillation of stars, is an ESA mission mainly devoted to survey the Galaxy searching for and characterizing Earth-like exoplanets, and their host stars. This will be achieved using continuous and extremely accurate photometry for both exoplanetary transits and asteroseismology analysis. Current design plans to mount 26 cameras in the same instrument bench in order to cover a large field of view with the highest possible photon statistics. Each PLATO camera consists of the telescope (TOU, Telescope Optical Unit), the focal plane assembly (FPA), and the detector and camera read out electronics (FEE). Four CCDs (Charge Coupled Devices) will be included in each FPA, which implies a really delicate assembly and integration verification (AIV) process due to the stringent scientific requirements breakdown into hard engineering ones (among others, CCDs co-alignment in terms of tip and tilt and roll with respect to the optical axis). In the following lines, the FPA current opto-mechanical design is briefly presented and an integration process conceptual proposal is reported on, discussing the error budgets associated to the main requirements to be verified during FPAs AIV, and the main results obtained during the prototype first AIV round.

Resumen Introduccion El estomago es el segmento del tracto gastrointestinal donde tienen inicio las principales funciones de secrecion y digestion del tubo digestivo. Fisiopatologia Sin embargo, la funcion gastrica mas critica e importante en la fisiologia digestiva esta dada por su actividad motora, que permite el almacenaje, el inicio del proceso de trituracion, digestion y vaciamiento/progresion del alimento al resto de tracto digestivo. Alteraciones en este complejo proceso de coordinacion pueden conducir a modificaciones en el vaciamiento gastrico. Gastroparesia Aunque existen patologias en las que tiene lugar una aceleracion del vaciamiento gastrico, la disfuncion motora por retardo es la que predomina y, por este motivo, es la que ocupa gran parte de esta revision.

Purpose To describe characteristics of choroidal osteomas (CO), using ocular ultrasound, fluorescein angiography, ultra-widefield retinal imaging, ultra-widefield autofluorescence, optical coherence tomography, enhanced-depth-imaging OCT, and OCT angiography (OCT-A). Methods Retrospective, observational case series study. Clinical records from patients with diagnosis of CO who underwent complete imaging evaluation were analyzed. Results Sixteen eyes from 11 patients were included. Mean patient age was 33.4 years (range 20–61), 72.7% were female, 100% were Hispanic, and 54.5% had unilateral CO. Median visual acuity was 20/150 (range 20/20–2000). CO was completely calcified in 25%, partially decalcified in 50%, and decalcified in 25%. Other features included choroidal neovascularization (18.75%), focal choroidal excavation (12.5%), choroidal depression associated to decalcification (18.75%), thinning of outer retina and photoreceptor layers over decalcified tumor (75%). Decreased fluorescence on FAF was observed in decalcified regions while relatively preserved fluorescence was observed in calcified regions. Conclusions Nowadays, diagnostic tests provide important information about each stage of choroidal osteoma. Progressive decalcification of the tumor might have a common pathogenic role for development of FCE or choroidal depression. OCT-A/FA proved to be valuable tools for detection of CNV in patients with CO.

Smartfuel is a research project from a European Commission Framework Programme. The project aims to move away from a centralized control architecture for aircraft fuel management. The controlling functionality (originally located in a central computer) in a Distributed Aircraft Fuel Management System (DAFMS) is partially deployed in networked Smart Fuel Components (SFCs). SFCs are mechatronic fuel components that can make their decisions by themselves based on the DAFMS states and the sequence of actions of the DAFMS operation. Smartfuel considers three DAFMS operation modes: pressure refueling, engine supply, and fuel transfer. This paper discusses the investigation work done toward developing the above DAFMS. The discussion includes computer models, laboratory prototypes, and an aircraft rig as well as a real-scale helicopter used to evaluate the DAFMS approach. Potential use of the approach proposed for spacecraft and concluding remarks are also discussed.

The menace of floating spills is frequently solved using a team of ships towing a boom. This operation involves specific control and coordination aspects. Some automatic advice, on board the ships, could be helpful for the pilots. Moreover, it could be convenient to have the alternative of using unmanned boats, especially if the spill represents a danger for humans. This paper studies the control and coordination needs for automatically towing a boom, and proposes the use of unmanned boats with autonomous control. The research is supported by simulations and experiments with scaled boats towing a boom. Promising results have been obtained.

This paper studies of the performance of Ant Colony Extended to the Travelling Salesman Problem.The algorithm includes two kinds of ants: patrollers (exploration search) and foragers (exploitation search).The algorithm includes a population dynamics allows the algorithm to self-organise.The algorithm is able to solve the Travelling Salesman Problem successfully compared with other classical ant algorithms. Ant Colony Extended (ACE) is a novel algorithm belonging to the general Ant Colony Optimisation (ACO) framework. Two specific features of ACE are: the division of tasks between two kinds of ants, namely patrollers and foragers, and the implementation of a regulation policy to control the number of each kind of ant during the searching process. In addition, ACE does not employ the construction graph usually employed by classical ACO algorithms. Instead, the search is performed using a state space exploration approach. This paper studies the performance of ACE in the context of the Travelling Salesman Problem (TSP), a classical combinatorial optimisation problem. The results are compared with the results of two well known ACO algorithms: ACS and MMAS. ACE shows better performance than ACS and MMAS in almost every TSP tested instance.

In this paper we present the NECSAVE system which allows the control of heterogeneous unmanned vehicles under challenging environments by a single human operator by providing it with the desired highlevel objectives. The described software stack takes care of decomposing the high-level objectives into assignable tasks and (re)distributing the workload among team members according to their announced capabilities and eventual failures. NECSAVE is robust to system failures by supporting decentralized planning and adapting allocation in face of platform losses. The system was validated in multiple field trials where NECSAVE was used for the coordination of heterogeneous vehicles under challenged communication environments, namely the sea using radio (at surface) and acoustic communications (underwater).

impact of architectural choices and increase confidence through early verification/validation of the model assumptions. This design methodology is well suitable for a European project (SmartFuel) that proposes a distributed control strategy for aircraft fuel systems. During the first SmartFuel phase, the verification and validation of the aforementioned avionics system was successfully carried out through prototype-based simulations. The future second project phase develops models and tools to analyze, synthesize, and preverify/prevalidate the avionics system architecture at early development stages. This paper addresses the latter project phase by focusing on the prediction of system quality characteristics and the automatic code generation for the system components. It presentsasoftwaredevelopmentframeworktodealwiththeavionicssystemspecificationsbymeansofarchitectural representationsthatfacilitatetheearlyevaluationofthesystem.Theproposedmodelingmethodologyisevaluatedin simulations and prototypes, and it is compared with the results obtained from the first project phase. The experimental outcomes from two case studies (helicopter and airplane fuel systems) are also presented.

Classification is a fundamental activity in many scientific disciplines, and in a large variety of professional applications. In many circumstances, classification is not an easy task. Analysis tools are needed in order to detect distinctive characteristics, and to compare according with suitable measures. The aim of this chapter is to introduce a repertory of important data analysis and classification methods. Some aspects of the chapter have evident connections with pattern recognition techniques, and with data mining. The first sections introduce component analysis (both PCA and ICA), including an interesting example: blind source separation. Next sections focus on clustering and discrimination, introducing linear discriminant analysis (LDA), support vector machines (SVM), K-means, K-nn, and the use of kernels. This is continued with a view of probabilistic contexts, including Bayesian methodology. In this part, the chapter presents the expectation-maximization (EM) algorithm. Bayesian regression, Kriging, Gaussian processes, neurons, etc. The final section on experiments considers face detection, and K-means for picture color reduction.

This chapter is devoted to the analysis of 2D signals and/or images, with emphasis on the use of wavelet variants. Many important applications are interested on such methods. In particular, the detection of edges, borders, contours, etc., is suitable for several purposes, like for instance spatially selective filtering (for example, in medical studies that want to have a clearer view of vessels against a noisy image background). By using wavelets, simple methods can be devised for image denoising and compression. The first sections of the chapter focus on how to obtain wavelet decompositions of images. It is noticed that the decomposition would be better if it was adapted to characteristics of the image, to take into account–for instance-certain predominant directions or curves. The central sections of the chapter introduce wavelet versions, like ridgelets, curvelets, contourlets, bandelets, etc. that try to capture these characteristics. The final sections contains experiments about image denoising, and pointers to the literature on applications.

Most satellites use an on-board attitude estimation system, based on available sensors. In the case of low-cost satellites, which are of increasing interest, it is usual to use magnetometers and Sun sensors. A Kalman filter is commonly recommended for the estimation, to simultaneously exploit the information from sensors and from a mathematical model of the satellite motion. It would be also convenient to adhere to a quaternion representation. This article focuses on some problems linked to this context. The state of the system should be represented in observable form. Singularities due to alignment of measured vectors cause estimation problems. Accommodation of the Kalman filter originates convergence difficulties. The article includes a new proposal that solves these problems, not needing changes in the Kalman filter algorithm. In addition, the article includes assessment of different errors, initialization values for the Kalman filter; and considers the influence of the magnetic dipole moment perturbation, showing how to handle it as part of the Kalman filter framework.

The SmarFuel project aims to develop a new generation of AFMS (Aircraft Fuel Management System). It proposes a Distributed Avionics Control Architecture (DACA) based on networked Smart Fuel Components (SFCs). This decentralized solution (opposite to conventionally-centralized approaches) reduces avionics wiring whilst the AFMS is fault tolerant. The DACA is realized by distributing the control system through microcontrollers embedded in SFCs and across a fieldbus. Thus, SFCs are able to implement advanced functions such as auto-calibration. The AFMS operation modes considered are three: pressure refueling, engine supply, and fuel transfer. The operation sequence of AFMS events is not fixed which makes the SFC decision-making process critical. The above DACA for AFMS was already realized and evaluated successfully in laboratory prototypes. This paper presents experimental results from verification and validation tests of the DACA realization carried out in a real-scaled helicopter rig. These ground experiments are based on the above fuel system operations. This paper also presents a verification tool for the SFC state machines. Conclusions and future research directions are also discussed.

A main problem in autonomous vehicles in general, and in unmanned aerial vehicles (UAVs) in particular, is the determination of the attitude angles. A novel method to estimate these angles using off-the-shelf components is presented. This paper introduces an attitude heading reference system (AHRS) based on the unscented Kalman filter (UKF) using the three-axis attitude determination (TRIAD) algorithm as the observation model. The performance of the method is assessed through simulations and compared to an AHRS based on the extended Kalman filter (EKF). The paper presents field experiment results using a real fixed-wing UAV. The results show good real-time performance with low computational cost in a microcontroller.

PURPOSE To determine the short-term safety of intravitreal bevacizumab by multifocal electroretinography testing. METHODS Thirty-one eyes with choroidal neovascularization, proliferative diabetic retinopathy, and retinal vein occlusion received intravitreal bevacizumab (2.5 mg/0.1 mL). All patients underwent best-corrected visual acuity measurement, retinal fluorescein angiography, optical coherence tomography, and multifocal electroretinography at baseline and 1 month after the treatment. RESULTS Subjects undergoing multifocal electroretinography testing had no statistically significant changes in electrophysiologic responses 1 month after the intravitreal injection of bevacizumab. CONCLUSION Multifocal electrophysiologic testing did not demonstrate any short-term cone photoreceptor toxicity after intravitreal bevacizumab.

The paper introduces a method for local navigation of mobile robots based on the discrimination of multiple artificial fields, which correspond to targets, obstacles, robots and, if this is the case, robot collectives. Instead of just adding up all potentials, the robot discerns the pertinent potentials at its location and applies a set of motion decisions at each moment. Satisfactory results are obtained. This is the first paper of a more extensive work dealing with individual robots, unorganized groups of robot and robot formations. Here, the method is introduced, with examples for a single robot and for several independent robots.

In the preceding paper, a method for mobile robot navigation control based on discrimination of multiple artificial fields was introduced. In this second paper, the method is extended to robot formations. Experimental demonstrations are presented taking examples of four types of formations. The experiments cover formation initialization, maneuvering, obstacle avoidance and formation switching.

BACKGROUND: Literature about long implants used together with a minimally invasive spine surgery (MISS) technique is scarce. Our objective is to contribute our surgical experience in this field and to specifically focus on several technical details. PATIENTS AND METHODS: A digitally-dissected canal along the paravertebral muscles was created linking the stab wounds on each side in relation with the pedicles to be cannulated. Screws were inserted following the percutaneous technique. Long rods were modelled, threaded through the extender sleeves along the paravertebral canal and pushed into the screw heads with the reduction forceps. When fusion was needed, the facet complex was decorticated with a drill. To insert a cross-link, a canal between the 2 rods was digitally created and the spinous process was drilled. RESULTS: 8 patients underwent surgery (age range: 25–77 years). Indications were postosteomyelitis kyphosis in 3 patients, bone tumor in 3, and spine fracture in 2. No blood transfusions were necessary during or after surgery. A cross-link was inserted in 2 patients. Posterolateral bone fusion was attempted in 4, but radiologically identifiable in none. In one patient a cantilever manoeuvre was done to correct kyphosis. Mean duration of surgery was 4 h. There were no clinical complications related to the operation or the hardware (mean follow-up of 7.14 months, range: 1–15 months). CONCLUSION: The application of MISS techniques can be broadened to long spinal constructs to assess fractures, tumors or deformity, especially in elderly or debilitated patients. Nevertheless, posterolateral fusion is still a challenge through these limited exposures.

An iterative procedure for the frequency domain evaluation of control effects in nonlinear loops is introduced. The article focuses on ship seakeeping control, to attenuate ship motions. There is no model of the ship, only CFD tabulated data. The proposed procedure could be used for design or empirical tuning of a controller. The actuators have angle and rate limits. In the case of a ship, the actuators are submerged moving wings: flaps, fins and T-foil. The control evaluation procedure uses a describing function approach. The paper considers amplitude and rate saturation in series. The results are validated with experiments using a scaled ship in a towing tank facility. Copyright © 2010 John Wiley & Sons, Ltd.

Ship motion prediction is useful for several purposes, related to navigation or to special operations. For instance the short-term predictions, perhaps a few seconds ahead, is important to help helicopter pilots when landing on ships. This paper reviews technologies for wave height measurement in order to predict ship motion. Two main philosophies are distinguished: one looks to distant incoming waves to get more prediction time, the other points downwards near the bow. Radar is a key technology, and in particular X-band radar: new relevant developments are taking place in this direction.

The paper describes the first steps of the development of an autonomous surface ship for sea demining. The objective is to substitute humans in a dangerous humanitarian task. The research has three main phases. The first one is to develop at laboratory scale the infrastructure for the final system. The second is devoted to medium scale tests in open air scenarios. The third phase is real scale operation. This paper refers to the first phase, in which a ‘universal control unit’ is being developed for autonomous navigation control. Software modules are also under development for on-board control with self-localization, and for area scanning trajectory generation and then tracking. The vehicle uses a towed fish. Both the towing cable and the fish generate electric and magnetic fields, to cause mine detonation by field influence. This study is made both with simulations and with scale experiments.

In this paper, a new distributed electronic on-board system for seakeeping studies is introduced. The system is based on a controller area network bus (CANbus) and includes motion sensors, actuators for submerged moving wings, an embedded personal computer (PC), a miniaturized inertial unit, and a digital radio link. This paper describes the system architecture and the main system operations along seakeeping experimental studies with a scaled ship. The on-board system can be applied to scaled or real ships.

The incidence of Clostridium difficile infection in North America and Europe has increased in the last years, generating concern among health professionals. A new strain of C. difficile has been identified in recent nosocomial outbreaks and community-acquired infections. This new strain, characterized as toxigenic type III, PCR ribotype 027 (C. difficile 027), presents higher pathogenicity because of increased exotoxin production, and a characteristic antibiotic resistance profile. Since 2003, several European countries have notified cases of C. difficile 027-associated disease, a fact that demonstrates its rapid dissemination. In this article, we review the latest nosocomial outbreaks associated with this new strain, which illustrate the need for a standardized surveillance system for early detection and implementation of control measures aimed at reducing the spread of this microorganism.

This paper presents some results achieved from a preliminary study on the use of a new method, based on Celular Automata and an extension of the Ant Colony Optimization, to plan feasible optimal or suboptimal trajectories for an autonomous ship manoeuvring.

Purpose To assess the short-term complications of a single dose of intravitreal bevacizumab in patients with proliferative diabetic retinopathy (PDR). Methods Retrospective review of 343 patients with PDR who were treated with intravitreal injection of bevacizumab (2.5 mg/0.1 mL). Results Five patients (1.45%) presented tractional retinal detachment 1 to 6 weeks (mean 3 weeks) after intravitreal injection. All cases underwent pars plana vitrectomy, removal of all epiretinal fibrovascular membranes, further endolaser panretinal photocoagulation, and silicone tamponade. Conclusion Tractional retinal detachment may occur in a short time post intravitreal injection of bevacizumab in patients with proliferative diabetic retinopathy with extensive areas of ischemia and fibrovascular proliferations, and may require prompt vitreoretinal surgery.

A new distributed control system for fuel management and other avionics applications is introduced. The system consists of a network of smart components such as sensors, valves, and pumps which are connected via a controlled area network bus (CANbus). Thus, no central fuel management computer is required, wiring is simplified, and the weight decreases. The heart of each smart component is a CAN-enabled microcontroller. All smart components share a copy of the same code inside its microcontroller, for easier certification. A distribution methodology has been developed based on a set of automata and on the employment of CANbus (as the communication protocol) for global state broadcasting.

This paper describes the development of a graphic computer tool that facilitates the generation of control software for a new distributed fuel management system for aircraft. The system has been the result of a three-year European Community Research Project. The goal was to move from a centralized control architecture to a fully distributed one, where each component of the system makes a decision by itself and the control of the whole system is a shared task. The interchange of information between components is performed via fieldbuses. The graphic computer tool developed is able to perform an automatic code generation starting from a graphic description of the system provided by the user. Thus, different aircraft fuel system configurations can be considered. According to the specific aircraft under study, they can include more or less tanks and components in the system. For each case, the control code of the distributed system can be quickly modified. It can, then, be integrated in each component device to operate in the system. This paper describes the main ideas of the new distributed avionic system and the graphical tool. Some experimental results in a laboratory plant simulator are also shown.

Longitudinal, heave and pitch, motion of ships in response to encountered waves can be smoothed using moving submerged wings, like transom flaps or a T-foil under the bow. Recently a 3 DOF detailed model of the surge, pitch and heave motions of a fast ferry has been developed, in terms of a structure of twelve transfer functions. On the basis of this model the most effective control for motion attenuation using a T-foil has been determined in the frequency domain, both for unlimited or saturated action. The results have been obtained by point to point exploration and depict amplitude and phase profiles of the controller. This result is useful to orientate linear control design. A first preliminary linear controller is presented.

Aircrafts usually have several fuel tanks, and there are fuel transfers among these tanks along a flight. These transfers are controlled with valves, and may follow several alternative paths, since structural fuel system redundancies are provided for evident reasons. An on board program for the management and reconfiguration of the fuel system must be developed and tested. The article introduces an aircraft fuel management system simulation, which provides a platform for the study of the fuel system logic and sequencing that the on board program must implement for normal flights and for malfunction cases. The simulation environment can be easily modified and extended, for instance to consider the use of new components. A specific example is considered: an aircraft with six tanks in the wings and a tail tank. The article presents a two-layer model, the use of the model for simulation experiments, and some illustrative examples.

A commonly used technique for oil spill response is to use two or more ships towing a boom. Our research proposes fully automated operations based on unmanned ships and a computer-based planning system. The system will carry on a complete autonomous operation, requiring only the position of the oil-spill and to push a start button. The paper describes the steps of the research already accomplished, which involves computer modeling and experimental studies. The experiments started with scaled ships and now are based on real scale zodiacs. Boom towing is a peculiar task, which require specific control strategies‥

Marine environments offer suggestive scenarios for Automatic control and Cooperation strategies to be applied. The present paper focus on a particular one: Two ships towing together an off-shore oil retaining boom. Basic dynamical equations are presented for the combined displacement of both ships plus the boom. Computer simulation of basic manoeuvres works out the basic control implications of the problem and suggests cooperation among the ships as a more reliable technique to fulfil ships goals and minimize boom strain.

To present a unique case of a 33-year-old woman using paroxetine who presented with acute unilateral visual loss due to chronic angle-closure glaucoma.Case report.A 33-year-old women who had been under paroxetine treatment for the past four months presented at the emergency room due to a sudden loss of visual acuity (VA) in the left eye (LE). Narrow anterior chamber was detected. Intraocular pressure (IOP) was 29 mmHg right eye (RE) and 42 mm Hg LE. A fundus exam revealed a cup-to-disc ratio of 0.9-1 for the LE and of 0.1-0.2 for the RE. Paroxetine treatment was suspended, and after 48 h IOP was 10 mm Hg in both eyes (BE). ND-YAG laser iridotomy was performed in BE. In the subsequent visit, IOP was 25 mm Hg in the RE and 41 mm Hg in the LE; on her own initiative the patient had resumed paroxetine treatment. After requesting the patient again to stop taking the anti-depressant, IOP was 10 mm Hg in BE in the next exam 48 h later.As far as we are aware, there are no other reports of chronic angle-closure glaucoma related to the use of paroxetine. We thus consider that, before initiating treatment with this drug, patients should be informed of its potential ocular risks and they should be subjected to an ophthalmologic examination before its use is authorized.

In the present stage of our research on the use of moving submerged appendages for motions smoothing of a fast ferry, a 6 DOF motions mathematical model of the ship for control studies is under development. This model is needed from the very beginning of the next experimental research, because we are going to use an autonomous scaled physical model of the ship, and we need to design a basic course control. The actuators for motion smoothing of the fast ferry are two transom flaps, two lateral fins and a T-foil. These actuators must be considered by the 6DOF model. In a previous paper we discussed a first principles approach to build the mathematical control-oriented model, using data from a CFD program. On the basis of these principles, now we present new developments of the 6DOF model. In particular, we study the ship dynamic behaviour for heading angles of 180°, 150° and 90°. Some hints are obtained to predict how the model will change for other heading angles.

This paper describes a new experimental system that has been recently developed for a research on vertical motion alleviation of fast ferries. The case of a fast ferry with a pair of transom flaps, lateral fins and a T-foil is considered. All these actuators should be moved in the most effective way, and an appropriate control strategy must be obtained and tested. A scaled physical model of the fast ferry has been built, with moving actuators and a distributed monitoring and control system. The research considers 6DOF motion attenuation, for any ship's heading. For this scenario, an autonomous physical model, not to be towed, is required. The physical model includes two scaled waterjets, with the jet orientation under control. The ship has no rudder. Heading and motion alleviation control includes many sensors and actuators. As a good practical control solution, a distributed architecture based on the CANbus has been devised. There is a set of microcontrollers and an embedded PC as coordinator. The microcontrollers for the actuators simulate the time behaviour of hydraulic cylinders. The microcontrollers for sensors include signal conditioning functions. There is a digital radio communication with an off-shore monitoring system. The off-shore system can display the present and the recorded experiments with animated 3D graphics. The complete experimental platform can be used as an Internet laboratory. The system can be easily tailored for use in real ships.

Along our research on increasing the passengers comfort in fast ferries by using moving actuators, frequency domain models to predict seasickness caused by ship motions in different seas states, have been established. Seasickness can be alleviated by a correct control of the moving actuators, in this case flaps, fins and T-foil. The capability of seasickness prediction based on models are useful for actuator and control design focusing on minimizing seasickness. In particular, there is a frequency band where the actuation should intervene; while there are other ship motion frequencies with much less impact on seasickness, so actuators work is not needed and can be saved. The paper is devoted to actuator and control design based on seasickness models. This study considers in particular the effect of actuator area and position on seasickness alleviation. The control design turns out to be nonlinear, due to saturations. A particular actuator and control design example is studied in detail.