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Background and Objective: The purpose of this study was to evaluate the accuracy and the time to find a lesion, taken in different platforms, color fundus photographs and infrared scanning laser ophthalmoscope images, using the traditional side-by-side (SBS) colocalization technique to an artificial intelligence (AI)-assisted technique. Patients and Methods: Fifty-three pathological lesions were studied in 11 eyes. Images were aligned using SBS and AI overlaid methods. The location of each color fundus lesion on the corresponding infrared scanning laser ophthalmoscope image was analyzed twice, one time for each method, on different days, for two specialists, in random order. The outcomes for each method were measured and recorded by an independent observer. Results: The colocalization AI method was superior to the conventional in accuracy and time ( P < .001), with a mean time to colocalize 37% faster. The error rate using AI was 0% compared with 18% in SBS measurements. Conclusions: AI permitted a more accurate and faster colocalization of pathologic lesions than the conventional method. [ Ophthalmic Surg Lasers Imaging Retina 2023;54:108–113.]

Multi-modal retinal image registration plays an important role in the ophthalmological diagnosis process. The conventional methods lack robustness in aligning multi-modal images of various imaging qualities. Deep-learning methods have not been widely developed for this task, especially for the coarse-to-fine registration pipeline. To handle this task, we propose a two-step method based on deep convolutional networks, including a coarse alignment step and a fine alignment step. In the coarse alignment step, a global registration matrix is estimated by three sequentially connected networks for vessel segmentation, feature detection and description, and outlier rejection, respectively. In the fine alignment step, a deformable registration network is set up to find pixel-wise correspondence between a target image and a coarsely aligned image from the previous step to further improve the alignment accuracy. Particularly, an unsupervised learning framework is proposed to handle the difficulties of inconsistent modalities and lack of labeled training data for the fine alignment step. The proposed framework first changes multi-modal images into a same modality through modality transformers, and then adopts photometric consistency loss and smoothness loss to train the deformable registration network. The experimental results show that the proposed method achieves state-of-the-art results in Dice metrics and is more robust in challenging cases.

We previously identified a homozygous G178R mutation in human ASRGL1 (hASRGL1) through whole-exome analysis responsible for early onset retinal degeneration (RD) in patients with cone–rod dystrophy. The mutant G178R ASRGL1 expressed in Cos-7 cells showed altered localization, while the mutant ASRGL1 in E. coli lacked the autocatalytic activity needed to generate the active protein. To evaluate the effect of impaired ASRGL1 function on the retina in vivo, we generated a mouse model with c.578_579insAGAAA (NM_001083926.2) mutation (Asrgl1mut/mut) through the CRISPR/Cas9 methodology. The expression of ASGRL1 and its asparaginase activity were undetectable in the retina of Asrgl1mut/mut mice. The ophthalmic evaluation of Asrgl1mut/mut mice showed a significant and progressive decrease in scotopic electroretinographic (ERG) response observed at an early age of 3 months followed by a decrease in photopic response around 5 months compared with age-matched wildtype mice. Immunostaining and RT-PCR analyses with rod and cone cell markers revealed a loss of cone outer segments and a significant decrease in the expression of Rhodopsin, Opn1sw, and Opn1mw at 3 months in Asrgl1mut/mut mice compared with age-matched wildtype mice. Importantly, the retinal phenotype of Asrgl1mut/mut mice is consistent with the phenotype observed in patients harboring the G178R mutation in ASRGL1 confirming a critical role of ASRGL1 in the retina and the contribution of ASRGL1 mutations in retinal degeneration.

This paper presents the implementation of a GMVC-based WAPSS to damp the interarea modes of power systems. The choise for the GMVC to tackle this problem lies on the fact that it can be used to compensate the time delay due to the latency of the transmission system in a more natural way than other controllers. The paper shows that it is possible to improve system’s closed-loop stability since its behavior is the same as if the time delay is not regarded. Simulation results with Kundur’s System prove that a latency of 1 second at a conventional WAPSS might lead system’s power to oscillate for 50 seconds for a short-circuit at the transmission line, whereas the oscillation decreases to only 5 seconds if the GMVC-based WAPSS is implemented.

One of the main reasons that prevent the use of model-based predictive control (MPC) in power electronics and motor drive is the MPC design. The processes related to these fields have fast dynamics, and most of the MPC design guides involve the control of slow dynamic processes, which allow high sampling times and, consequently, a large time for the control action calculation. Moreover, practically only the linear model-based predictive controller can have small computational cost, which causes difficulty for MPC application in nonlinear processes as electrical motors. Therefore, this paper presents a MPC design theory for first-order control models, as the brushless direct current (BLDC) motor drive, assuming direct speed control (without current inner loop). Thus, the MPC cost function tune is obtained according to prediction model parameters, the study of optimization gain curves and, optionally, an extended closed-loop root locus analysis. To deal with the motor nonlinearities, both multi-model approach and six-step modulation are employed. This paper also discusses current peak transients, salient pole BLDC motor modeling, integral action included in the MPC control action and solutions for Hall effect sensor nonlinear speed measurement. Simulation and experimental results confirm the proposed design theory as well as the other discussed issues.

This paper provides alternative FCS-MPC algorithms for cascade-free motor speed control and compares with conventional FCS-MPC. The proposed algorithms uses the concept of virtual vectors combined with a modulation to reduce the ripple caused by conventional FCS-MPC. The difference in the proposed algorithms is related with the search of the virtual vectors in order to reduce computational cost, memory use or processing. Simulation results are provide showing the benefits of the proposed algorithms.

In this paper, permanent magnet synchronous motor flux control is performed, involving the active flux concept. This flux control is associated with a scalar drive (V/f), being a native sensorless technique, without a special approach. Moreover, the applied strategy has low computational cost and can operate at very reduced speeds, tracking references and rejecting disturbances. The focused application is direct-drive washing machines. Experimental results are presented, including a very low-speed test. The main contribution of this paper is related to the control design.

This paper presents a comparative study between two model-based predictive control (MPC) methods applied in a three-phase power inverter in terms of design and performance: finite control set (FCS-MPC) and convex control set (CCS-MPC). Moreover, different FCS-MPC strategies are tested. In order to analyze their advantages and disadvantages, it is shown a brief explanation about the inverter modeling and the control algorithms implementation. Note that the same parameters are used in the controllers numerical analyses, including unitary prediction horizon and an analytical solution for FCS-MPC. Furthermore, a different cost function for FCS-MPC is proposed in order to remove steady state error.

Purpose: We determined the characteristics of Chinese men undergoing initial prostate biopsy and evaluated the relationship between prostate specific antigen levels and prostate cancer/high grade prostate cancer detection in a large Chinese multicenter cohort.Materials and Methods: This retrospective study included 13,904 urology outpatients who had undergone biopsy for the indications of prostate specific antigen greater than 4.0 ng/ml or prostate specific antigen less than 4.0 ng/ml but with abnormal digital rectal examination results. The prostate specific antigen measurements were performed in accordance with the standard procedures at the respective institutions. The type of assay used was documented and recalibrated to the WHO standard.Results: The incidence of prostate cancer and high grade prostate cancer was lower in the Chinese cohort than the Western cohorts at any given prostate specific antigen level. Around 25% of patients with a prostate specific antigen of 4.0 to 10.0 ng/ml were found to h...

This paper presents a method to evaluate the computational cost of a function in embedded systems. This method, which uses the Least Squares method, is useful to see the sample time choice feasibility, in control applications. In this work, the developed method is used to evaluate the computational cost of the model-based predictive control to speed control of a shunt direct current motor. The method was tested using two embedded devices allowing to find the correct sample time for each device evaluated.

Esse artigo propoe o estudo do controle preditivo baseado em modelo de conjunto de acoes de controle finito applicado a um processo nao baseado em eventos. Uma fundamentacao teorica e fornecida, apresentando os pros e contras da tecnica de controle. Algumas melhorias a estrategia convencional sao propostas, como variacao dinâmica do conjunto. Resultados de simulacao sao apresentados para corroborar a teoria desenvolvida.

Hintergrund Die praoperative Anamie hat in den Industrienationen eine Pravalenz von ungefahr 30 %, ist einer der starksten Pradiktoren fur die perioperative Gabe von Erythrozytenkonzentraten (EK) und zugleich ein eigenstandiger und unabhangiger Risikofaktor fur das Auftreten postoperativer Komplikationen. Im Bereich der Hamotherapie ist weltweit eine breite Variabilitat der Indikationsstellung zum Einsatz von EK auffallend. Vor diesem Hintergrund wird seit 2011 von der Weltgesundheitsorganisation die Implementierung eines Patient-blood-Managements (PBM) gefordert.

This paper presents a discussion about cost function design procedure for finite control set model predictive control (FCS-MPC) applied to electrical permanent magnet synchronous motor (PMSM) drive. In such analysis, different cost function choices were evaluated, with different type of costs and weighting, in order to achieve the main control objective: minimum torque error, accomplishing the maximum torque per ampere condition. Moreover, this study is completed with discussion on the choice of weighted variables for each objective and its influence in some figures of merit, such as current THD and torque ripple.

This work presents a permanent magnet synchronous motor optimal field oriented control through linear quadratic regulator for speed control in maximum torque per ampere operation. An analytic approach for Q and R matrices is evaluated and linearization methods associated to a proposed incremental decoupling component are studied verifying the most efficient control approach according to a given cost function. Numerical simulation and experimental results are presented and it is shown that the proposed control provides a more efficient linear quadratic regulator permanent magnet synchronous control, supporting the use of the presented controller.

Urolithiasis is a widespread disease. Diagnostic imaging plays an important role in the evaluation and management of patients with suspected urolithiasis. Furthermore, modern imaging methods may provide information on stone location, size, fragility and composition aiding the urologist to determine the appropriate treatment modality.Based on the current literature and guidelines, this review reports on the various new and established diagnostic imaging modalities.Ultrasound should always be the initial imaging modality. Following ultrasound, noncontrast CT-principally using a low-dose protocol-is the imaging modality of choice in the evaluation of patients with acute flank pain and suspected urolithiasis. New imaging modalities like dual energy CT, Uro Dyna CT and digital tomosynthesis are currently under investigation but not yet part of daily clinical practice. Magnetic resonance imaging can be used to detect obstruction caused by urinary stones but is not a first-line imaging modality.

OBJECTIVES: To compare the predictive performance and potential clinical usefulness of risk calculators of the European Randomized Study of Screening for Prostate Cancer (ERSPC RC) with and without information on prostate volume. METHODS: We studied 6 cohorts (5 European and 1 US) with a total of 15,300 men, all biopsied and with pre-biopsy TRUS measurements of prostate volume. Volume was categorized into 3 categories (25, 40, and 60 cc), to reflect use of digital rectal examination (DRE) for volume assessment. Risks of prostate cancer were calculated according to a ERSPC DRE-based RC (including PSA, DRE, prior biopsy, and prostate volume) and a PSA + DRE model (including PSA, DRE, and prior biopsy). Missing data on prostate volume were completed by single imputation. Risk predictions were evaluated with respect to calibration (graphically), discrimination (AUC curve), and clinical usefulness (net benefit, graphically assessed in decision curves). RESULTS: The AUCs of the ERSPC DRE-based RC ranged from 0.61 to 0.77 and were substantially larger than the AUCs of a model based on only PSA + DRE (ranging from 0.56 to 0.72) in each of the 6 cohorts. The ERSPC DRE-based RC provided net benefit over performing a prostate biopsy on the basis of PSA and DRE outcome in five of the six cohorts. CONCLUSIONS: Identifying men at increased risk for having a biopsy detectable prostate cancer should consider multiple factors, including an estimate of prostate volume.

— This paper presents a 1 kHz SVM-FOC (Space Vector Modulation with Field Oriented Control) drive system for a Permanent Magnet Synchronous Motor, using different control strategies. Such strategies are internal model and frequency response designed PI (Proportional and Integral) controllers and a multivariable MPC (Model Predictive Control) controller using a state-space prediction model. This MPC method becomes interesting for improving the closed-loop speed frequency response, since it results in a cascade-free controller. The performance of each controller was evaluated in a qualitative manner through simulations and quantitatively by load torque and speed reference AC sweeps, generating dynamic stiffness curves and Bode diagrams for the utilized techniques. Results show that the MPC approach is useful for enabling fast dynamic responses with the reduced switching frequency, which reduces the drive system cost and improves its efficiency.

When offering watchful waiting or active monitoring protocols to prostate cancer (PCa) patients, differentiation between Gleason scores (GS) 6 and 7 at biopsy is important. However, upgrading after prostatectomy is common. We investigated the impact of different PSA levels on misclassification in the PSA range of 2-3.9 and 4-10 ng ml(-1). A total of 448 patients with GS 6 PCa on prostate biopsy were evaluated by comparing biopsy and prostatectomy GS. Possible over diagnosis was defined as GS7, pathological stage pT2a and negative surgical margins, and possible under diagnosis was defined as pT3a or greater, or positive surgical margins; the percentage of over- or under diagnosis was determined for correctly and upgraded tumors after prostatectomy. A match between biopsy and prostatectomy GS was found in 210 patients (46.9%). Patients in the PSA range of 2.0-3.9 and 4.0-10.0 ng ml(-1) were upgraded in 32.6 and 44.0%, respectively. Over diagnosis was more common than under diagnosis (23.2% vs 15.6%). When upgraded there was a significant increase in under diagnosis. As almost 40% of GS 6 tumors on biopsy are GS 7 or higher after surgery with a significant rise in under diagnosis there is a risk of misclassification and subsequent delayed or even insufficient treatment, when relying on favorable biopsy GS.

We sought to evaluate the efficacy of transdermal dihydrotestosterone treatment based on the results of hypospadias repair in children with primary hypospadias.A total of 75 randomized consecutive children who were a mean of 33.4 +/- 3.7 months old and had primary hypospadias were included in the study between September 2004 and April 2006. While 37 children were treated with 2.5% transdermal gel daily, applied directly onto the penile shaft and glans for 3 months (group 1), 38 children did not receive any treatment preoperatively (group 2). All children underwent hypospadias repair using tubularized incised plate urethroplasty. Postoperative complications were analyzed using the Mann-Whitney U test with respect to fistulas, urethral strictures, diverticula, meatal stenosis, glanular dehiscence and scar formation according to the results at 1-year followup.Mean ages of the children in groups 1 and 2 were similar (30.8 +/- 5.4 months and 35.1 +/- 5.1 months, respectively). The urethral meatus was coronal in 70%, penile in 24% and penoscrotal in 5% of the patients in group 1, while it was coronal in 84% and penile in 16% of the patients in group 2. Postoperative complications included urethrocutaneous fistula in 4 patients (11%) in group 2, compared to 1 patient (3%) in group 1 (p0.05). While 3 patients (8%) in group 2 had glanular dehiscence, no patient in the dihydrotestosterone group had this complication (p0.05). There were 2 patients with meatal stenosis in group 2 (5%), and no patient with meatal stenosis in group 1 (p0.05). In addition, there were 16 patients (42%) with moderate to severe postoperative scar formation in group 2, compared to only 2 patients (5%) in the dihydrotestosterone group (p0.05). Finally, there was a significant difference between the overall reoperation rates of group 2 (9 patients, 24%) and group 1 (1 patient, 3%, p0.05). None of our patients had signs or symptoms of urethral stricture or urethral diverticulum.Pretreatment with dihydrotestosterone transdermal gel was effective in decreasing the complications and improving the cosmetic results after hypospadias repair.

In the last years preclinical studies have paved the way for the use of adult muscle derived stem cells for reconstruction of the lower urinary tract. Between September 2002 and October 2004, 42 women and 21 men suffering from urinary stress incontinence (age 36-84 years) were recruited and subsequently treated with transurethral ultrasonography-guided injections of autologous myoblasts and fibroblasts obtained from skeletal muscle biopsies. The fibroblasts were injected into the urethral submucosa, while the myoblasts were implanted into the rhabdosphincter. In parallel, 7 men and 21 women (age 39-83 years) also diagnosed with urinary stress incontinence were treated with standard transurethral endoscopic injections of collagen. Patients were randomly assigned to both groups. After a follow-up of 12 months incontinence was cured in 39 women and 11 men after injection of autologous myoblasts and fibroblasts. Mean quality of life score (51.38 preoperatively, 104.06 postoperatively), thickness of urethra and rhabdosphincter (2.103 mm preoperatively, 3.303 mm postoperatively) as well as contractility of the rhabdosphincter (0.56 mm preoperatively, 1.462 mm postoperatively) were improved postoperatively. Only in two patients treated with injections of collagen incontinence was cured. The present clinical results demonstrate that, in contrast to injections of collagen, urinary incontinence can be treated effectively with ultrasonography-guided injections of autologous myo- and fibroblasts.

OBJECTIVE To describe the influence of blood sampling/sampling tubes on mass spectrometric and clustering results, and on clinical blood variables, in blood samples collected from healthy volunteers and patients with prostate cancer. PATIENTS, SUBJECTS AND METHODS Two venous blood samples were taken from 12 healthy volunteers and 12 patients with localized prostate cancer. Two blood samples were taken from each participant using two different venepuncture systems (group A and group B). The Kolmogorov–Smirnov test was used to identify the peaks distinguishing the different groups. In a 10-fold cross-validation study, decision trees for identifying discriminatory peaks that separate the benign from the malignant were constructed. RESULTS The decision tree separated samples measured by matrix-assisted laser desorption/ionization mass spectrometry (MALDI MS) from healthy volunteers from those of patients with prostate cancer, with a sensitivity of 93.6% and a specificity of 91.6%. Of special interest is that one peak at 6941 m/z was produced during blood sample preparation and had a very powerful influence on the results of the classification. CONCLUSION The results clearly showed that blood-sampling systems have a great influence on the recorded MALDI MS traces, and thus can markedly influence and confound the results of the MS analysis, whereas clinical variables might remain unchanged. MS profiling is a promising method of marker discovery, but as it could be shown well-designed studies are critical to allow proper interpretation for the identification of key variables as well as for the clinical use.

1 Ein aus Zostera marina isolierter Stamm von Labyrinthula coenocystis entwickelte sich unter verschiedenen Kulturbedingungen stets in der typischen Form netzartiger Zellverbande. Bei relativ trockener Agaroberflache erfolgte die Entwicklung bevorzugt innerhalb des Agars. Nach Zugabe von Olsaure bzw. loslicher Starke zum Medium oder bei Verwendung von Leinol anstelle einer Futtermikroben-Suspension entstanden an Verzweigungsstellen der Schleimbahnen auf der Agaroberflache kolonieartige Zellaggregationen. 2 Die Zellen sind spindelformig und 10–15 μ lang. In alteren Kulturen oder bei Eintritt ungunstiger Bedingungen stellen sie ihre Bewegung ein und haben dann wie die „Kolonie” Zellen abgerundete Spindelpole. 3 Elektronenmikroskopisch unterscheiden sich die Labyrinthula-Zellen. von anderen Protisten-Zellen durch ein sparliches endoplasmatisches Reticulum, geringe Zahl der Tubuli pro Mitochondrium, besonders aber durch zahlreiche Lipidtropfen. Eine Differenzierung von Ekto- und Endoplasma erfolgt nicht. Desgleichen fehlen protoplasmatische Fibrillen innerhalb des Cytoplasmas. Hinsichtlich ihrer Feinstruktur unterscheiden sich die Labyrinthula-Zellen junger Verbande und der „Kolonien” nur unwesentlich. 4 Unter allen gepruften Kulturbedingungen sind die Zellen von der Schleimbahn umgeben, so das sie sich stets innerhalb derselben vorwarts bewegen mussen. Auch nach Einstellung der Fortbewegung sowie in den „Kolonien” liegen die Zellen einzeln innerhalb der Schleimbahn. 5 Die Begrenzung zur Schleimbahn bildet eine dunne Zellmembran. Besondere Organelle, die der Fortbewegung dienen konnten, liesen sich nicht nachweisen. In allen Altersstadien besitzt die Zellmembran jedoch als „bothrosomes” bezeichnete Einstulpungen, deren Struktur und Funktion diskutiert werden. 6 Trotz zahlreicher Versuche gelang es nicht, die Bildung spezieller Dauer-. Entwicklungs- oder Propagationsstadien zu induzieren. Es bleibt jedoch offen, ob solche Stadien uberhaupt fehlen oder infolge der mehrjahrigen Kultur nicht mehr ausgebildet werden.

Preoperative anemia has a prevalence of approximately 30% and is one of the strongest predictors of perioperative red blood cell (RBC) transfusion. It is rarely treated although it is an independent risk factor for the occurrence of postoperative complications. Additionally, the high variability in the worldwide usage of RBC transfusions is alarming. Due to these serious deficits in patient care, in 2011 the World Health Organization recommended the implementation of a patient blood management (PBM).This article provides information about PBM as a multidimensional and interdisciplinary approach.A selective literature search was carried out in the Medline and Cochrane library databases including consideration of national and international guidelines.A PBM promotes the medically and ethically appropriate use of all available resources, techniques and materials in favor of an optimized perioperative patient care. Patients' own resources should be specifically protected, strengthened and used and include (i) diagnosis and therapy of preoperative anemia, (ii) minimizing perioperative blood loss, (iii) blood-conserving surgical techniques, (iv) restriction of diagnostic blood sampling, (v) utilization of individual anemia tolerance, (vi) optimal coagulation and hemotherapy concepts and (vii) guideline-based, rational indications for the use of RBC transfusions.A PBM should be advocated as an incentive to evaluate and critically optimize local conditions. An individual, interdisciplinarily structured bundle of different PBM measures has great potential to optimize the quality of patient care and to make it safer.

This work presents a comparative analysis of a successively evaluated state space model-based predictive control approach used to drive a five-phase permanent magnet synchronous motor. It is presented a five-phase motor modelling and control theoretical basis main concept, including the prediction model preparation, as well unconstrained and constrained formulations. Both formulations are used and compared to drive the motor, in the simulation results. The results satisfactorily demonstrate the advantages of the model-based predictive control to drive this motor, specially due to the constraints treatment.

This work proposes a study about using the successively evaluated state space model-based predictive control to drive a permanent magnet synchronous motor. The objective of this paper is to show as the control constraints and the anticipative reference characteristics influence in the drive. Still, it is done a brief analysis about the improvement of the drive efficiency with the proposed control scheme. The obtained results present the validity of the proposed approach.