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This paper provides an overview of current techniques to allow the industrial systems to automatically adapt to change while maintaining predictable and stable system behaviour. This is performed along the dimensions of simple, dynamic and intelligent reconfiguration and focuses on the physical device and software component levels of the shop floor and in particular, on automatic reconfiguration of programmable logic controller systems. Through an analysis of recent work by the authors and others in this area, the paper identifies the basic requirements for intelligent reconfiguration and the outstanding issues in this area.

Thrombelastography (TEG) is a bedside method used to determine coagulation parameters such as clot formation, stabilization and lysis. This report describes a case of cardiopulmonary arrest due to fulminant pulmonary embolism in a 42-year-old postpartum patient. We discuss the dynamics of coagulation parameters during CPR and thrombolysis complicated by bleeding, as assessed by TEG.

We calculated photoemission spectra within the one-step model for the (001) surface of the (AlAs) 2 (GaAs) 2 superlattice structure. The purpose is to discriminate between spectral features which are caused by the surface, and those which are characteristic properties of the superlattice. Direct transitions indicate the opening of band gaps at the Brillouin zone edge, which are characteristic for the modified periodicity of the superlattice. Furthermore, the layer resolved photocurrent shows that one can also identify excitations from AlAs which are hidden below the first two GaAs layers and from As atoms at the boundary between the different semiconductors. Furthermore, emissions from surface states and resonances are also recognized.

High-temperature melt-textured material prepared in a batch process with reproducible material parameters and properties can be used successfully to construct electromotors with an increased energy and force density. A production process with high efficiency and moderate costs is the basis for the technical application of bulk melt-textured yttrium-barium-copper-oxide. The increased production rate also demands adequate characterization techniques that have to provide the material parameters needed for the specific application. The most suitable characterization technique has to be chosen for routine characterization. In this article, measurements were performed to simulate magnetic processes in electromotors. Functional models running in liquid nitrogen were constructed.

Vascular dementia (VD) is the second most common cause of dementia in the elderly after Alzheimer’s disease (AD). Prevalence estimates from community surveys indicate that, on average, 5% of persons over 65 and 15 to 20% of people over 80 suffer from “severe dementia”. Clinico-pathological studies have shown that AD accounts for 50 to 60% of the cases and VD for about 10 to 20%; 20% of the patients have both disorders. The incidence rate of VD ranges from 7 per 1,000 person-years in normal volunteers to 16 per 1,000 person-years in subjects with risk factors for strokes, particularly high blood pressure. The only effective therapeutic approach to VD is the prevention of strokes, mainly through the treatment of hypertension; however, none of the therapeutic trials has included VD prevention as one of its treatment goals. Syst-Eur Study is a European placebo controlled trial which aims to determine whether morbidity and mortality are changed when elderly patients (60 years and over) with isolated systolic hypertension are treated. In this trial, the incidence of VD will be carefully recorded during the five year follow-up of the expected 3,000 patients. The present side project to the Syst-Eur trial will specifically address the following questions: does antihypertensive treatment reduce the incidence of VD?, and how do the cognitive functions of elderly patients change when treated with active or placebo treatment? The protocol is based on the administration of the MMS (Folstein) once a year to all patients. If the MMS score is 23 or less, a set of criteria will be used to establish the diagnosis of vascular dementia. p]A pilot study has demonstrated the feasibility of the trial. The main study is in progress.

Leukotriene B4 (LTB4) plays an important role in acute and chronic inflammatory and hypersensitive reactions. We studied the time course of LTB4 biosynthesis in whole blood in 18 patients with end-stage renal failure maintained on regular hemodialysis with two different membranes, cuprophane and polyacrylonitrile (AN 69). The basal levels of LTB4 from dialysis patients did not differ significantly from a normal control group. Compared to predialytic values, the cuprophane membrane caused a maximal release of LTB4 by a factor of about 4.5 (p less than 0.01) within the first 10 to 20 minutes. Thereafter the level fell and returned to baseline range at the end of the hemodialysis session. With the use of the AN 69 membrane no significant increase of LTB4 could be demonstrated. The changes in LTB4 concentration showed a close temporal correlation to the alterations in white blood cell count. We conclude that (1) LTB4 is a biologically important mediator of neutrophil activation during hemodialysis, and (2) LTB4 may be a sensitive marker of biocompatibility in vivo.

The Syst-Eur Trial is a concerted action of the European Community's Medical and Health Research Programme. The trial is carried out in consultation with the World Health Organization, the International Society of Hypertension, the European Society of Hypertension and the World Hypertension League. This article describes the objectives and the protocol of Syst-Eur, a multicentre trial designed by the European Working Party on High Blood Pressure in the Elderly (EWPHE), to test the hypothesis that antihypertensive treatment of elderly patients with isolated systolic hypertension results in a significant change in stroke morbidity and mortality. Secondary endpoints include cardiovascular events, such as myocardial infarction and congestive heart failure. To be eligible patients must be at least 60 years old and have a systolic blood pressure averaging 160-219 mmHg with a diastolic pressure less than 95 mmHg. Patients must give their informed consent and be free of major cardiovascular and non-cardiovascular diseases at entry. The patients are randomized to active treatment or placebo. Active treatment consists of nitrendipine (10-40 mg/day), combined with enalapril (5-20 mg/day) and hydrochlorothiazide (12.5-25 mg/day), as necessary. The patients of the control group receive matching placebos. The drugs (or matching placebos) are stepwise titrated and combined in order to reduce systolic blood pressure by 20 mmHg at least to a level below 150 mmHg. Morbidity and mortality are monitored to enable an intention-to-treat and per-protocol comparison of the outcome in the 2 treatment groups. A one-year pilot trial (1989) showed that the protocol is practicable. The Ethics Committee therefore decided to start the definite study (1990), in which randomized patients will be followed for 5 years. Recruitment of new centres and of the required 3,000 patients will last 3 years (until 1993).

OSNR penalties demonstrate excellent filtering and power divergence performance for low cost tunable filter access ROADMs, with resulting performance reported at 10 Gb/s (36 nodes) and 40 Gb/s (8 nodes).

Carriers are generating business cases for deploying ROADM networks based on the elimination of wavelength blocking in FOADM networks. We quantify the real cost of stranding bandwidth in FOADM networks and determine optimum network size depending on the traffic patterns.

The objective of this paper is an automatic fault detection scheme for applications in the automotive industry. In order to increase data reliability and for the purpose of monitoring and control of test equipment, a fault detection system based on multivariate data analysis is being developed. The detection scheme has to process up to several hundreds of different measurements at a time and check them for consistency. The main problem lies in the fact that besides the available data, no further information is provided. The chosen approach models the distribution function of available fault-free data using ellipsoidal basis function networks. An important requirement for the fault detection scheme is that it should be able to automatically adapt itself to new data. The present paper is focused on this feature. It is demonstrated how a gradient optimization with algebraic constraints can be applied to adapt a pre-existing network to new data points. Numerical examples with actual data show that the proposed method produces good results.

High power lasers and amplifiers for communication networks based on cladding pump fiber operate at unprecedented power levels. The high power and unique structure of cladding pump fiber present new challenges to the optical reliability of lasers and amplifiers based on these novel fibers. In this paper we present results on the reliability of cladding pump fiber under high power both in the multimode pump waveguide and in the rare earth doped core.

The mortality of critically ill patients with acute renal failure has been halved through intervention by haemodialysis. However, several reports suggest that the course of the disorder may be prolonged by this procedure. Our prospective randomised study was done to see whether the generation of inflammatory mediators by bio-compatible membranes has an adverse effect on the outcome of acute renal failure. 52 patients, similar in age, severity of acute renal failure, general disease status (APACHE II), and management of acute renal failure or its related conditions, were divided into two groups. Haemodialysis was done with cuprophane or polyacrylonitrile membranes. Cuprophane membranes induced intense activation of the complement system (as judged by measurement of C3a) and lipooxygenase pathway (leukotriene B4) resulting in alterations of neutrophil kinetics and function. The cuprophane group had a lower survival rate (38 vs 65%), a higher proportion of patients dying from sepsis (71 vs 40%), required more haemodialysis sessions (12 vs 9), and demonstrated delayed resolution and recovery from acute renal failure than the polyacrylonitrile group. The difference in mortality regarding lethal sepsis as cause of death was statistically significant. Our observations indicate that the outcome of critically ill patients with acute renal failure may be influenced by bio-incompatibility reactions to the dialysis membrane. These results have direct implications for such patients on haemodialysis.

We present IVORY a newly developed, platform-independent framework for physics based visualization. IVORY is especially designed for information visualization applications and multidimensional graph layout. It is fully implemented in Java 1.1 and its architecture features client server setup, which allows us to run the visualization even on thin clients. In addition, VRML 2.0 exports can be viewed by any VRML plugged-in WWW browser. Individual visual metaphors are invoked into IVORY via an advanced plug-in mechanism, where plug-ins can be implemented by any experienced user. The configuration of IVORY is accomplished using a script language, called IVML. Some interactive visualization examples, such as the integration of a haptic interface illustrate the performance and versatility of our system. Our current implementation supports NT 4.0.

Gasified biomass has become an attractive fuel source for the production of electricity for various processes due to its potential to reduce the net CO2 emission. The overall aim is to combine biomass as a fuel source with high temperature catalytic combustion in order to lower emissions of nitrogen oxides, carbon monoxide and hydrocarbons. This paper presents the design of a pressurized test facility for testing various catalytic materials under varying operating conditions and arrangements in the combustor. Instrumentation of the rig is described. Catalyst development and preparations are being described as well as the first results from the pilot-scale test facility. Different catalyst configurations and compositions have been tested. It was shown that a Pd / LaAl11O18 catalyst is able to ignite the synthetic gasified biomass and that high conversion rates of H2 can be achieved with this type of catalyst. By applying a layer of barium stabilized alumina, thermal protection of the catalyst is achieved, hence limiting the maximum catalyst temperature.

The relationship between serum total cholesterol, measured at randomization, and mortality was investigated in 822 patients, who were followed for an average of 3.1 years in a double-blind trial, conducted by the European Working Party on High Blood Pressure in the Elderly. Serum cholesterol, measured at randomization, was 0.54 mmol/l higher in women than in men, and declined with increasing age in both men (0.028 mmol/l per year) and women (0.036 mmol/l per year). During follow-up on randomized treatment, cholesterol fell by a similar amount with placebo (0.11 mmol/l per year) and with active treatment (0.14 mmol/l per year). Active treatment consisted of hydrochlorothiazide (25-50 mg/day) plus triamterene (50-100 mg/day) with the addition of alpha-methyldopa (0.5-2.0 g/day) in one-third of the patients. Serum total cholesterol, measured at randomization, was independently and inversely correlated with total (P = 0.03), non-cardiovascular (P = 0.03) and cancer (P = 0.04) mortality during follow-up on double-blind treatment. Total and non-cardiovascular mortality were also negatively correlated with haemoglobin and body weight at randomization.

It is worth recalling, not only as a mere curiosity, that as recently as the student years of today’s senior physicians, small doses of phenobarbitone were the best available treatment for hypertension. Phlebotomy and leeches were considered the last recourse in intractable cases, at least in some parts of Central Europe, when combinations of hypnotics, garlic extracts, and mistletoe failed to reduce blood pressure, and the patient, bleeding severely from the nose, was irreparably heading towards uremic death.

Synthesis of leukotriene B4 (LTB4) upon stimulation of peripheral blood samples with the calcium ionophore A 23187 was studied in patients with primary hyperparathyroidism who underwent parathyroidectomy. Preoperatively, an increased LTB4 concentration of 1.76 +/- 0.19 ng/ml plasma was found, vs. 0.95 +/- 0.28 ng/ml in healthy individuals. On the fourth day after operation, the LTB4 concentration was almost normalized, reaching 1.25 +/- 0.23 ng/ml plasma. At the same time, mean serum calcium levels were reduced from 6.1 +/- 0.6 meq/liter before operation to 4.53 +/- 0.28 meq/liter after operation. In a control group, euthyroid patients with thyroid adenomas who underwent adenomectomy had normal LTB4 levels before operation (0.84 +/- 0.11 ng/ml) and did not show significant changes in LTB4-synthesizing capacity. The results indicate that synthesis of LTB4 in vivo may depend in part on factors related to serum calcium concentration or calcium metabolism.

1. A number of major therapeutic trials in mild hypertension were conducted from 1972 to 1980. With one exception, there was little or no coordination between the trials, although they were dealing with the same problem. 2. A Joint WHO/ISH Mild Hypertension Liaison Committee was set up after most of the trials had started. The objective of the Committee, to promote information exchange and comparisons among the trials, was attained. Certain similarities and disparities between the trials were also identified. 3. Some of the disparities proved useful because they made it possible to analyse the problem from different points of view. Others did not introduce any new elements but, on the contrary, hampered inter-trial comparability. 4. Early standardization of methodological details in such trials is essential, particularly if several studies are to investigate the same problem. This would be possible only if prior agreement were reached concerning research policy, especially in rapidly developing fields of hypertension research.

The long-term sequelae of vasectomy were studied in a retrospective cohort study of 4596 vasectomized and 4340 nonvasectomized farmers from eight rural communes in Sichuan, People's Republic of China. The mean duration since the operation was 14.5 years with a range of 10 to 25 years. At the time of evaluation the vasectomized men were generally healthier than the non-vasectomized for a wide range of health indicators including clinical signs of cardiovascular disease, resting ECG changes, positive ECG changes following a maximal stress test, or fundus abnormalities. The lack of association between vasectomy and cardiovascular disease noted in Europe and the USA is supported by the present study conducted in a population with a low prevalence of cardiovascular disease and risk factors.A study was conducted in Sichuan, China to further determine if any correlation exists between vasectomy and the risk of heart disease. In a retrospective analysis of 4596 men who had received vasectomies and 4340 who had not been vasectomized, it was found that the cardiovascular status of men who had had a vasectomy was actually better that those who had not. The mean duration since the operation was 14.5 years with a range of 10-25 years. The results confirmed past conclusions that vasectomy is not linked with coronary disease. Testing for other endpoints and areas such as stomach ulcer and hypertension indicated that men who had received a vasectomy were in general in better health. Resting ECG changes and positive ECG changes following a stress test further confirmed the results. Mortality associated with vasectomy was also examined with no negative connection found. Vasectomy has been extensively studied and has been proven repeatedly to be a safe procedure that is not linked to adverse effects.

The latter was due to a reduction in cardiac mortality (−38%, p=0.036) and a nonsignificant decrease in cerebrovascular mortality (−32%, p=0.16). In the double-blind part of the trial, the total mortality rate was not significantly reduced (−26%, p=0.077). However, cardiovascular mortality was reduced in the actively treated group (−38%, p=0.023), owing to a reduction in cardiac deaths (−47%, p=0.048) and a non-significant decrease in cerebrovascular mortality (−43%, p=0.15). Deaths from myocardial infarction were reduced (−60%, p=0.043), and study-terminating morbid cardiovascular events were significantly reduced by active treatment (−60%, p=0.0064). Non-terminating cerebrovascular events were reduced (−52%, p=0.026), but the non-terminating cardiac events were not (+ 3%, p=0.98). In the patients randomised to active treatment there were 29 fewer cardiovascular events and 14 fewer cardiovascular deaths per 1000 patient years during the double-blind part of the trial.

The epidemiologic associations of smoking with atherosclerosis, especially that of the peripheral and coronary arteries are well known and often quoted. Less frequently are references made to morphological population studies, such as the WHO Cooperative Study of Atherosclerosis of the Aorta and Coronary Arteries in Five Towns (1), although it has clearly demonstrated the grave anatomical consequences of smoking.

In a masterly review of major developments and trends in health care in the twentieth century Milton Roemer quotes 16 points, including health manpower growth, specialization, organization for team work, population control, geriatrics and rehabilitation, health care planning, medical humanization, internationalism in health and health as a human right1. To this World Perspective on Health Care in the Twentieth Century one more important point should be added: the development of the concept of community control of disease. According to this concept, disease control rests on a defined community as a socio-biological entity. All its strata and components are taken into account and the community itself is being used to control and combat its own disease or diseases. There is an important difference between this participatory concept of community disease control and the earlier, classical public health approaches to disease prevention such as the draining of swamps as part of malaria prevention, or the provision of safe community water supply, or vaccination. In the classical situation, the community is rather the scene on which a medical or public health action is taking place. On the contrary, the community disease control programme of our days is like a happening in which all those present are required to participate.

Results of the European Working Party on High Blood Pressure in the Elderly (EWPHE) trial have been analysed in relation to age, sex, blood pressure, and previous cardiovascular disease. Cardiovascular mortality and the cardiovascular study-terminating events were significantly and independently related to treatment, age, cardiovascular complications at randomisation, and systolic but not diastolic blood pressure. The benefits of treatment observed in the trial seemed to be independent of entry blood pressure and the presence or absence of cardiovascular complications at entry. There was some evidence that treatment effect decreases with advancing age. Little or no benefit from treatment could be demonstrated in patients over the age of 80 years, the great majority of whom were women.

160 adolescents des deux sexes ont ete interroges sur leur alimentation. Le cholesterol et les triglycerides (valeurs totales et fraction des lipoproteines) ont ete mesures a jeun. Les correlations qui font egalement intervenir l'indice ponderal et l'activite physique sont etablies par l'analyse multifactorielle de la variance (Tableau I).

The efficiency of drug therapy diminishes strongly for low values of blood pressure. From the point of vue of prevention the attributable risk in the population can not be significantly reduced by drug treatment, when one takes into account the distribution of blood pressure values.

Im Rahmen einer Studie zur Erfassung von Risikofaktoren die moglicherweise zu kardiovaskularen Erkrankungen im spateren Lebensalter fuhren, wurde eine Gruppe von 14-jahrigen Schweizer Schulern und Schulerinnen untersucht. Diese Untersuchung erfolgte im Schuljahr 1977/1978 im Rahmen des schularztlichen Dienstes. Die statistische Verteilung folgender Faktoren wird prasentiert: systolische und diastolische Blutdruckwerte, das Gesamtcholesterol, die Triglyceride, sowie die Lipoproteinfrak tion “HDL” des Cholesterols. Dans le cadre d'une etude sur les facteurs precurseurs des maladies cardiovasculaires, un echantillon de la population scolarisee âgee de 14 ans, d'origine suisse, a ete examine au cours de l'annee scolaire 1977–1978. Les distributions observees des facteurs suivants sont presentees: tension arterielle (systolique et diastolique) cholesterol, HDL-cholesterol et triglycerides.