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Estudo clínico prospectivo das modificações da borda alveolar inferior após projeção ortodôntica em tomografia computadorizada de feixe cônico / Prospective clinical study of the lower alveolar ridge modifications after orthodontic projection with cone beam computerized tomographyFlavio Cesar de Carvalho 27 February 2013 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A projeção de incisivos e expansão dos arcos dentários são uma alternativa valiosa à extração dentária, especialmente quando se considera a estética facial em pacientes adultos. O efeito da projeção ortodôntica dos incisivos inferiores sobre o periodonto é controverso devido às avaliações em exames bidimensionais e os aspectos multi-fatoriais que envolvem as recessões gengivais. O objetivo deste estudo foi comparar as modificações na altura da borda alveolar dos dentes ântero-inferiores de pacientes, que foram submetidos à projeção ortodôntica, com pacientes tratados sem projeção; e correlacionar estas modificações com o grau de inclinação dentária, com as alterações da distância bicanina e com o biotipo gengival. Pacientes adultos com mais de 3 mm de falta de espaço no arco inferior e curva de Spee moderada ou acentuada compuseram o grupo experimental (n=15). O grupo controle (n=7) consistiu de pacientes com bons arcos inferiores, que não necessitavam de grandes movimentos dentários. Estes pacientes foram submetidos a alinhamento e nivelamento dentário até o fio de aço .020". Tomografias computadorizadas de feixe cônico (TCFC) foram obtidas antes do tratamento e ao final da fase de alinhamento e nivelamento. As alturas das bordas alveolares (BA) de incisivos e caninos inferiores foram medidas nas TCFC em reconstruções 3D e comparadas entre os grupos e entre os tempos pelos testes-t de Student não pareado e pareado, respectivamente. As BA foram correlacionadas com o grau de inclinação dentária (IMPA), com a distância intercaninos (DIC) e com o biotipo gengival (BG) pelo teste de correlação de Pearson. Os resultados demonstraram que os caninos inferiores do grupo experimental apresentaram perda óssea significativa (p<0,005), quando comparados com o grupo controle, em média 2,5 mm. As BA dos dentes 43, 33 e 32 ao final do alinhamento e nivelamento eram significativamente maiores do que ao início do tratamento no grupo experimental (p<0,001). Não foram encontradas diferenças significativas entre as medidas iniciais e finais das BA de todos os dentes do grupo controle. Apesar destes resultados, não foram encontradas correlações entre a remodelação da BA e o IMPA, a DIC e o BG. Pode-se concluir que o aumento no comprimento do arco inferior com arcos ortodônticos contínuos aumenta a inclinação dos incisivos inferiores e a DIC. O aumento da DIC parece exercer maior efeito sobre a BA dos caninos inferiores do que a inclinação de incisivos sobre a BA dos incisivos inferiores. No entanto, as modificações da BA não estão associadas ao grau de inclinação dos incisivos, a quantidade de expansão do arco inferior e ao biotipo gengival. / Incisor proclination and dental arch expansion are a valuable choice of treatment instead of extraction, especially when considering facial aesthetics in adult patients. The effect of orthodontic projection of the lower incisors on the periodontium is controversial because of evaluation in two-dimensional exams and the multi factorial aspects of gingival recessions. The aim of this study was to compare alveolar height modifications in the lower arch of patients that were treated with orthodontic proclination, with patients treated without proclination, and correlate these modifications with the degree of dental projection, with the changes in the lower intercanine width and with gingival biotype. Adult patients with lower arch discrepancy of more than 3 mm and moderate or pronounced curve of Spee composed the experimental group (n=15). The control group (n=7) consisted of patients with good lower arches, that did not need large dental movements. These patients had their dental arches aligned and leveled up to a .020 wire. Cone beam computed tomography (CBCT) was taken before treatment and after leveling and alignment. The height of the alveolar border (AB) of the lower incisors and canines were measured on CBCT with 3D reconstruction, and compared between groups, and between times, by paired and independent Students t-test, respectively. The AB were correlated with the degree of dental inclination (IMPA), intercanine width (ICW) and gingival biotype (GB) by the Pearson correlation test. Results showed that the lower canines of the experimental group presented significant bone loss (p<0,005) when compared with the control group, with a mean of 2.5 mm. The AB of teeth 43, 33 and 32 at the end of alignment were significantly greater than at beginning of treatment for the experimental group (p<0,001). No significant differences were found between initial and final AB measurements for all control group teeth. Despite these results, no correlation was found between remodeling of AB and IMPA, ICW and GB. It can be concluded that the increase of lower arch length with continuous orthodontic archwires increases lower incisor inclination and ICW. The increase of the ICW seems to exert more effect over the AB of lower canines, than the incisor inclination over the AB of the incisors. However, AB modifications are not associated with the degree of incisors inclination, neither the amount of lower arch expansion, nor to the gingival biotype.
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Desenvolvimento de uma fonte de potência CA para geração de formas de onda de até 2kHz / Development of an ac power source for generation of waveforms up to 2kHzTambara, Rodrigo Varella 30 July 2010 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / This work presents the development of an alternating current power source with a single-phase full bridge voltage inverter, based on electronic switches. The source is designed to drive electromechanical and electric plants. The prototype is designed with 1kVA nominal
power and is able to generate sinusoidal waveforms up to 2kHz. The inverter operates at the switching frequency of 50kHz. A robust model reference adaptive controller is designed and implemented to adjust the output voltage of the source. Additionally, the elements of the source and the system for measuring the electrical parameters are presented. A digital signal controller is used to control and generate signals with pulse width modulation. The
discretization of the control system is performed using the delta operator. Finally, experimental results and analysis of the closed loop system are presented. Based on these results, the experimental performance of the designed source and the proposed control system
are examined. / Este trabalho apresenta o desenvolvimento de uma fonte de potência de corrente alternada com um inversor de tensão em ponte completa monofásico, composto por interruptores eletrônicos. Esta fonte é concebida para o acionamento de plantas elétricas e eletromecânicas. O protótipo projetado tem uma potência nominal de 1kVA e é capaz de gerar
formas de onda senoidais de até 2kHz. O inversor opera em uma frequência de comutação de 50kHz. Um controlador adaptativo robusto por modelo de referência é projetado e
implementado para ajuste da tensão de saída da fonte. Adicionalmente, são apresentados os elementos da fonte e o sistema de medição das variáveis elétricas. Um processador digital de sinais é utilizado para controle e geração de sinais com modulação por largura de pulso. A discretização do sistema de controle é realizada por meio do operador delta. Por fim, são apresentados resultados experimentais e análise do sistema em malha fechada. A partir destes resultados, averiguou-se o desempenho experimental da fonte projetada e do sistema de controle proposto.
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Modulation naturelle généralisée des convertisseurs matriciels pour la variation de vitesse / Generalized carrier based modulation of the matrix converters for adjustable speed drivesGruson, François 13 December 2010 (has links)
La variation de vitesse des machines électriques est une application très porteuse de l’électronique de puissance. La solution de conversion la plus répandue consiste à connecter en cascade deux convertisseurs statiques et d’effectuer une double conversion (AC/DC/AC). Une autre solution, faiblement répandue dans l’industrie, effectue une conversion directe AC/AC. Ce mémoire effectue une synthèse sur les solutions de conversion directe ainsi que sur les stratégies de modulation des convertisseurs matriciels et matriciels « double étage » dans le but de piloter des machines électriques triphasées à partir d’un réseau alternatif triphasé. Cette synthèse a permis de développer une modulation scalaire généralisée, associée à un modulateur par porteuse, équivalente à la modulation vectorielle et applicable aux différents convertisseurs matriciels. Les modulations, à nombre de commutation réduit par période de découpage, ont été approfondies. Cette généralisation a permis de mettre en évidence une solution réduisant les pertes et améliorant le comportement électromagnétique du dispositif comparativement aux modulations traditionnellement utilisées. La présentation des contraintes réelles (commande rapprochée des interrupteurs, Les protections ainsi que le filtrage) est abordée et a été utilisée pour développer une maquette laboratoire. Les stratégies de modulation ont été implantées expérimentalement et valident l’étude théorique. Enfin, un fonctionnement direct à la fréquence réseau, sans modulation donc à faibles pertes, est proposé. Un fonctionnement particulier est introduit, permettant d’effectuer le transitoire du mode modulé classique au fonctionnement direct non modulé / In the power electronics field, the adjustable speed drives is a growing application for electric motors control. The most common conversion solution is to connect in series two static converters and perform a double conversion (AC/DC/AC). Another solution, hardly proposed by industry, uses a direct AC/AC conversion. This thesis aims to make a direct conversion solutions and matrix converters and ‘‘two stage’’ matrix converters modulation strategies synthesis for the purpose to control three-phase electric motor with a three phase input network. This synthesis has developed a generalized scalar modulation, combined with a carrier wave modulator, equivalent to the space vector modulation and applied to matrix converters and the ‘‘two stage’’ matrix converters. Some attention has been done to reduced the switching number during the modulation period. The generalization allows to propose a modified modulation which reduces the losses and improves the electromagnetic performance compared to the traditional modulations used for these kind of converters. The practical constraint (switches control, protection system and filtering) are discussed and has been used to develop a laboratory prototype. The modulations strategies have been implemented experimentally and validate the theoretical study. Finally, a direct function mode with an equal frequency between the input and output network is proposed, without modulation and therefore low losses. In the last part, a particular operation mode is then introduced, permitting the transient operation between the modulated conventional mode to the direct mode without modulation
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Distribuição longitudinal de adultos de Odonata em riachos no Cerrado: uma hipótese ecofisiológica / Longitudinal distribution of adult Odonata in Cerrado streams: an ecophysiologic hypothesisBatista, Joana Darc 06 July 2006 (has links)
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Previous issue date: 2006-07-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The longitudinal distribution of adult Odonata was examined in streams of different channel width in the Pindaíba River Basin, in the municipalities of Barra do Garças and Nova Xavantina. The general purpose was to evaluate the existence of environmental gradients that affect the longitudinal distribution of Odonata, and to establish testable predictions to this predator group regarding the River Continuum Concept. Two hypotheses were tested: (1) increasing channel width longitudinally along the basin causes an increase of light input, and, assuming restraints and distinct abilities, there would be a decrease of Zygoptera and increase of Anisoptera species richness. (2) Dragonflies are affected by the gradient generated through river continuum mechanisms, increasing species richness in medium-sized streams. I sampled 19 sites in rivers and streams from 1st to 6th orders, and in each site I sample once in the dry and once in the rainy seasons. Quantitative survey was conducted through scan method in fixed areas, counting visually on Odonata adults along 100 meters of the waterbody, divided into 20 stretches of 5 meters each. Channel width and depth measures were taken at the beginning, middle, and end of each 20-meter region. A total of 549 individuals were collected, distributed in one family, 13 genera and 17 species of Anisoptera, and six families, 15 genera and 30 species of Zygoptera. The abundance and proportion of Zygoptera species decrease while Anisoptera increase with channel width and mean depth of rivers and streams. The channel width was considered the best predictor of Odonata species distribution. The distribution of Odonata, species richness, did not corroborate the hypotheses of higher species richness in the middle courses of streams. The results obtained in this study confirm the thermoregulation hypothesis as a determining factor in the distribution of Odonata species in the system. / A distribuição longitudinal de Odonata adultos foi avaliada em riachos de diferentes larguras na Bacia do Rio Pindaíba nos municípios de Barra do Garças e Nova Xavantina-MT. O objetivo geral foi avaliar a existência de gradientes ambientais influenciando a distribuição longitudinal de Odonata, estabelecendo predições testáveis para o grupo predador sobre o Conceito de Continuum fluvial. Foram testadas duas hipóteses: (1) o aumento da largura do canal longitudinalmente na bacia causa um aumento da entrada de luz e, assumindo restrições e habilidades distintas, haveria uma diminuição da riqueza de espécies de Zygoptera e aumento da riqueza de Anisoptera. (2) as libélulas respondem ao gradiente gerado pelo mecanismo do continuum fluvial, aumentando de riqueza nos riachos de tamanho intermediário. Foram amostrados 19 trechos em oito rios e riachos de 1a a 6a ordem, sendo que em cada um dos trechos foram efetuadas duas coletas, uma na estação seca e outra na estação chuvosa. A amostragem quantitativa foi feita pelo método de varredura com áreas fixas que consistiu na contagem visual do número de adultos em 100 metros do corpo d água, divididos em 20 segmentos de cinco metros. As medidas de largura e profundidade do canal foram tomadas no início, meio e final de cada segmento de 20 metros. Um total de 549 indivíduos foi coletado, pertencentes a uma família, 13 gêneros e 17 espécies de Anisoptera, e seis famílias, 15 gêneros e 30 espécies de Zygoptera. A abundância e a proporção de espécies de Zygoptera diminuem enquanto as de Anisoptera aumentam em relação à largura e a profundidade média dos rios e riachos. A largura foi considerada o melhor preditor da distribuição de espécies de Odonata. A distribuição de Odonata, considerando agregadamente Zygoptera e Anisoptera, não corrobora a hipótese de maior riqueza nos trechos médios dos riachos. Os resultados desse estudo suportaram a hipótese de termorregulação como fator determinante da distribuição das espécies de Odonata no sistema.
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Estudo de técnica utilizando a modulação PWM baseada em portadora aplicada ao inversores monofásicos assimétricos com diodos de grampeamentoOliveira, Francisco Hércules de 25 May 2017 (has links)
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Previous issue date: 2017-05-25 / This work presents a technique using carrier-based pulse width modulation (PWM) applied to single-phase asymmetrical multilevel inverters with diodes clamped, aiming to increase the amount of output voltage levels to improve signal quality, reducing the total harmonic distortion rate (THD). The technique was used in inverters of three, four and five levels per arm, providing an output signal with seven, thirteen and nineteen levels respectively, presenting two, six and ten levels higher than the equivalent symmetrical multilevel inverters. The technique was described with a set of equations and procedures that can be generalized for inverters of any number of levels. To verify the operation, simulations were performed using the PSIM program and an experimental assembly of an asymmetrical multilevel inverter of three levels was performed, using a field programmable gate array device (FPGA) in the implementation of the PWM modulator. Finally, the simulation and experimental results that prove the effectiveness of the modulation strategy employed in this work are presented and compared / Este trabalho apresenta uma técnica utilizando a modulação por largura de pulso (PWM) baseada em portadora, aplicada aos inversores multiníveis monofásicos assimétricos com diodos de grampeamento, com o objetivo de elevar a quantidade de níveis na tensão de saída, para melhorar a qualidade do sinal, reduzindo a taxa de distorção harmônica total (THD). A técnica foi empregada em inversores de três, quatro e cinco níveis por braço, fornecendo um sinal de saída com sete, treze e dezenove níveis respectivamente, apresentando dois, seis e dez níveis a mais que os inversores multiníveis simétricos equivalentes. A técnica foi descrita com um conjunto de equações e procedimentos que pode ser generalizada para inversores de qualquer número de níveis. Para comprovar o funcionamento, foram realizadas simulações utilizando o programa PSIM e efetuada montagem experimental de uma inversor multinível assimétrico de três níveis, utilizando na implementação do modulador PWM um dispositivo em matriz de porta programável em campo (FPGA). Por fim, são apresentados e comparados os resultados de simulações e experimentais que comprovam a eficácia da estratégia de modulação empregada neste trabalho
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Experimental Studies on Acoustic Noise Emitted by Induction Motor Drives Operated with Different Pulse-Width Modulation SchemesBinoj Kumar, A C January 2015 (has links) (PDF)
Voltage source inverter (VSI) fed induction motors are increasingly used in industrial and transportation applications as variable speed drives. However, VSIs generate non-sinusoidal voltages and hence result in harmonic distortion in motor current, motor heating, torque pulsations and increased acoustic noise. Most of these undesirable effects can be reduced by increasing the switching frequency of the inverter. This is not necessarily true for acoustic noise. Acoustic noise does not decrease monotonically with increase in switching frequency since the noise emitted depends
on the proximity of harmonic frequencies to the motor resonant frequencies. Also there are practical limitations on the inverter switching frequency on account of device rating and losses. The switching frequency of many inverters often falls in the range 2 kHz - 6 kHz where the human ear is highly sensitive. Hence, the acoustic noise emission from the motor drive is of utmost important.
Further, the acoustic noise emitted by the motor drive is known to depend on the waveform quality of the voltage applied. Hence, the acoustic performance varies with the pulse width modulation (PWM) technique used to modulate the inverter, even at the same modulation index. Therefore a
comprehensive study on the acoustic noise aspects of induction motor drive is required.
The acoustic noise study of the motor drive poses multifaceted challenges. A simple motor
model is sufficient for calculation of total harmonic distortion (THD). A more detailed model is required for torque pulsation studies. But the motor acoustic noise is affected by many other factors such as stator winding distribution, space harmonics, geometry of stator and rotor slots, motor irregularities, structural issues controlling the resonant frequency and environmental factors.
Hence an accurate model for acoustic noise would have to be very detailed and would span different domains such as electromagnetic fields, structural engineering, vibration and acoustics. Motor designers employ such detailed models along with details of the materials used and geometry to predict the acoustic noise that would be emitted by a motor and also to design a low-noise motor.
However such detailed motor model for acoustic noise purposes and the necessary material and constructional details of the motor are usually not available to the user. Also, certain factors influencing the acoustic noise change due to wear and tear during the operational life of the motor.
Hence this thesis takes up an experimental approach to study the acoustic noise performance of an inverter-fed induction motor at any stage of its operating life.
A 10 kVA insulated gate bipolar transistor (IGBT) based inverter is built to feed the induction motor; a 6 kW and 2.3 kW induction motors are used as experimental motors. A low-cost acoustic noise measurement system is also developed as per relevant standards for measurement and spectral analysis of the acoustic noise emitted. For each PWM scheme, the current and acoustic noise measurements are carried out extensively at different carrier frequencies over a range of fundamental frequencies.
The main cause of acoustic noise of electromagnetic origin is the stator core vibration, which is caused by the interaction of air-gap fluxes produced by fundamental current and harmonic currents.
In this thesis, an experimental procedure is suggested for the acoustic noise characterization of an induction motor inclusive of determination of resonant frequencies. Further, based on current and
acoustic noise measurements, a vibration model is proposed for the stator structure. This model is used to predict the acoustic noise pertaining to time harmonic currents with reasonable accuracy.
Literature on motor acoustic noise mainly focuses on sinusoidal PWM (SPWM), conventional space vector PWM (CSVPWM) and random PWM (RPWM). In this thesis, acoustic noise pertaining to two bus-clamping PWM (BCPWM) schemes and an advanced bus-clamping PWM (ABCPWM) scheme is investigated. BCPWM schemes are mainly used to reduce the switching loss of the inverter by clamping any of the three phases to DC rail for 120◦ duration of the fundamental cycle. Experimental results show that these BCPWM schemes reduce the amplitude of the tonal
component of noise at the carrier frequency, compared to CSVPWM. Experimental results with
ABCPWM show that the overall acoustic noise produced by the motor drive is reduced at low and medium speeds if the switching frequency is above 3 kHz. Certain spread in the frequency spectrum of noise is also seen with both BCPWM and ABCPWM.
To spread the acoustic noise spectrum further, many variable-frequency PWM schemes have been suggested by researchers. But these schemes, by and large, increase the current total harmonic distortion (THD) compared to CSVPWM. Thus, a novel variable-frequency PWM (VFPWM) method is proposed, which offers reduced current THD in addition to uniformly spread noise spectrum. Experimental results also show spread in the acoustic noise spectrum and reduction in the dominant noise components with the proposed VFPWM. Also, the current THD is reduced at high speeds of the motor drive with the proposed method.
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Estudo clínico prospectivo das modificações da borda alveolar inferior após projeção ortodôntica em tomografia computadorizada de feixe cônico / Prospective clinical study of the lower alveolar ridge modifications after orthodontic projection with cone beam computerized tomographyFlavio Cesar de Carvalho 27 February 2013 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A projeção de incisivos e expansão dos arcos dentários são uma alternativa valiosa à extração dentária, especialmente quando se considera a estética facial em pacientes adultos. O efeito da projeção ortodôntica dos incisivos inferiores sobre o periodonto é controverso devido às avaliações em exames bidimensionais e os aspectos multi-fatoriais que envolvem as recessões gengivais. O objetivo deste estudo foi comparar as modificações na altura da borda alveolar dos dentes ântero-inferiores de pacientes, que foram submetidos à projeção ortodôntica, com pacientes tratados sem projeção; e correlacionar estas modificações com o grau de inclinação dentária, com as alterações da distância bicanina e com o biotipo gengival. Pacientes adultos com mais de 3 mm de falta de espaço no arco inferior e curva de Spee moderada ou acentuada compuseram o grupo experimental (n=15). O grupo controle (n=7) consistiu de pacientes com bons arcos inferiores, que não necessitavam de grandes movimentos dentários. Estes pacientes foram submetidos a alinhamento e nivelamento dentário até o fio de aço .020". Tomografias computadorizadas de feixe cônico (TCFC) foram obtidas antes do tratamento e ao final da fase de alinhamento e nivelamento. As alturas das bordas alveolares (BA) de incisivos e caninos inferiores foram medidas nas TCFC em reconstruções 3D e comparadas entre os grupos e entre os tempos pelos testes-t de Student não pareado e pareado, respectivamente. As BA foram correlacionadas com o grau de inclinação dentária (IMPA), com a distância intercaninos (DIC) e com o biotipo gengival (BG) pelo teste de correlação de Pearson. Os resultados demonstraram que os caninos inferiores do grupo experimental apresentaram perda óssea significativa (p<0,005), quando comparados com o grupo controle, em média 2,5 mm. As BA dos dentes 43, 33 e 32 ao final do alinhamento e nivelamento eram significativamente maiores do que ao início do tratamento no grupo experimental (p<0,001). Não foram encontradas diferenças significativas entre as medidas iniciais e finais das BA de todos os dentes do grupo controle. Apesar destes resultados, não foram encontradas correlações entre a remodelação da BA e o IMPA, a DIC e o BG. Pode-se concluir que o aumento no comprimento do arco inferior com arcos ortodônticos contínuos aumenta a inclinação dos incisivos inferiores e a DIC. O aumento da DIC parece exercer maior efeito sobre a BA dos caninos inferiores do que a inclinação de incisivos sobre a BA dos incisivos inferiores. No entanto, as modificações da BA não estão associadas ao grau de inclinação dos incisivos, a quantidade de expansão do arco inferior e ao biotipo gengival. / Incisor proclination and dental arch expansion are a valuable choice of treatment instead of extraction, especially when considering facial aesthetics in adult patients. The effect of orthodontic projection of the lower incisors on the periodontium is controversial because of evaluation in two-dimensional exams and the multi factorial aspects of gingival recessions. The aim of this study was to compare alveolar height modifications in the lower arch of patients that were treated with orthodontic proclination, with patients treated without proclination, and correlate these modifications with the degree of dental projection, with the changes in the lower intercanine width and with gingival biotype. Adult patients with lower arch discrepancy of more than 3 mm and moderate or pronounced curve of Spee composed the experimental group (n=15). The control group (n=7) consisted of patients with good lower arches, that did not need large dental movements. These patients had their dental arches aligned and leveled up to a .020 wire. Cone beam computed tomography (CBCT) was taken before treatment and after leveling and alignment. The height of the alveolar border (AB) of the lower incisors and canines were measured on CBCT with 3D reconstruction, and compared between groups, and between times, by paired and independent Students t-test, respectively. The AB were correlated with the degree of dental inclination (IMPA), intercanine width (ICW) and gingival biotype (GB) by the Pearson correlation test. Results showed that the lower canines of the experimental group presented significant bone loss (p<0,005) when compared with the control group, with a mean of 2.5 mm. The AB of teeth 43, 33 and 32 at the end of alignment were significantly greater than at beginning of treatment for the experimental group (p<0,001). No significant differences were found between initial and final AB measurements for all control group teeth. Despite these results, no correlation was found between remodeling of AB and IMPA, ICW and GB. It can be concluded that the increase of lower arch length with continuous orthodontic archwires increases lower incisor inclination and ICW. The increase of the ICW seems to exert more effect over the AB of lower canines, than the incisor inclination over the AB of the incisors. However, AB modifications are not associated with the degree of incisors inclination, neither the amount of lower arch expansion, nor to the gingival biotype.
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AVALIAÇÃO DO POTENCIAL PROGNÓSTICO DA ANEMIA E DO RDW NA ESTRATIFICAÇÃO DE RISCO EM PACIENTES COM SÍNDROME CORONARIANA AGUDA / ASSESSMENT OF PROGNOSTIC POTENTIAL OF ANEMIA AND RDW IN RISK STRATIFICATION OF PATIENTS WITH ACUTE CORONARY SYNDROMESangoi, Manuela Borges 03 April 2013 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / Ischemic heart diseases stands out among the diseases that affect the cardiovascular system due to its high prevalence and its impact on mortality in the general population. Ischemic heart disease is the leading worldwide cause of mortality. Fenomenum that also happens in the Americas and Brazil. The term acute coronary syndrome (ACS) is used to describe a heterogeneous spectrum of clinical conditions associated with acute myocardial ischemia, including unstable angina and acute myocardial infarction (AMI). The plurality in its clinical presentation represents a diagnostic challenge for clinicians. Moreover, appropriate risk stratification is mandadatory in all patients with ACS. Some clinical tools such as physical examination, electrocardiographic observations and risk scores are extremely usefull to identify patients at high risk of unfavorable clinical outcomes. Scores of risk stratification, among those the Global Registry of Acute Coronary Events (GRACE), are widely used in the prognostic evaluation of patients with ACS.Some plasma biomarkers have also been used to improove risk stratification. The GRACE score is a fundamental part of the assessment of patients with ACS and may even prevent or minimize adverse consequences in these individuals. Nevertheless, the search for new potential prognostic parameters that could add information to these establised scores has been the subject of intense research. In this context, stands out the use of routine hematological tests , since the complete blood count is readily available for clinical use and has a good cost-benefit relationship. Recent studies have investigated the potential role of some of red cell indices, especially anemia and red cell distribution width (RDW), in the prognostic evaluation of patients with several cardiovascular conditions. The presence of anemia and elevated RDW in patients with ACS have been independently associated with increased risk of adverse events such as heart failure, recurrent ischemic events, and death. We have hipotezazed that the addition of the hemalological indices to the GRACE score would improve its ability to stratify patients.The main objective of this study was to investigate whether inclusion of anemia or RDW, assessed at admission, in the GRACE score model to predic in-hospital mortality, could improve the discrimination and calibration of these model, as well as risk stratification in patients with ACS. For this, a cohort study, including 109 patients with AMI was carried out. Cox regression models including the variables of the GRACE score and RDW or anemia were constructed. Measures of calibration and discrimination, and reclassification of patients were also calculated for the new models. The new models, either with the inclusion of anemia, or the addition of RDW showed adequate calibration and discrimination. Furthermore, the addition of these
parameters to the original model allowed adequate reclassification of patients in different categories of risk. The red cell indices, anemia and RDW showed potential prognostic for use in risk assessment of patients with ACS, allowing the improvement of risk stratification performed through the GRACE score. / A cardiopatia isquêmica destaca-se entre as doenças que acometem o sistema cardiovascular, devido à sua alta prevalência e a seu impacto sobre a mortalidade na população em geral. As doenças isquêmicas do coração são a principal causa de mortalidade mundial, nas Américas e no Brasil. O termo SCA é usado para descrever um espectro heterogêneo de condições clínicas associadas com isquemia aguda do miocárdio, incluindo angina instável e infarto agudo do miocárdio (IAM). A diversidade na apresentação clínica de pacientes com esta patologia representa um desafio para os clínicos em termos de diagnóstico e de estratificação de risco apropriada. Algumas ferramentas clínicas como exame físico, observações eletrocardiográficas e escores de risco, são de extrema relevância na identificação de pacientes com alto risco de desfechos clínicos desfavoráveis. Além disso, alguns biomarcadores plasmáticos também vêm sendo utilizados com este propósito e a busca por novos parâmetros com potencial prognóstico tem sido alvo de intensas pesquisas. Neste contexto, destaca-se a utilização dos testes hematológicos de rotina na estratificação de risco, uma vez que o hemograma é um exame amplamente disponível para uso clínico e possui uma boa relação custo benefício. Estudos recentes tem investigado o potencial papel de alguns dos índices hematimétricos, especialmente anemia e amplitude de distribuição dos eritrócitos (RDW), na avaliação prognóstica de pacientes apresentando diversas condições cardiovasculares. A presença de anemia, bem como valores elevados de RDW em pacientes com SCA tem sido independentemente associados com maior risco de eventos adversos como mortalidade, desenvolvimento de insuficiência cardíaca e ocorrência de eventos isquêmicos recorrentes. Os escores de estratificação de risco, principalmente o Global Registry of Acute Coronary Events (GRACE), são amplamente utilizados na avaliação prognóstica de pacientes com SCA. No entanto, os modelos disponíveis atualmente não incluem os índices hematimétricos na determinação do risco do paciente. Considerando que a estratificação de risco é parte fundamental da avaliação de pacientes com SCA, podendo evitar ou mesmo minimizar consequências adversas nestes indivíduos, o principal objetivo deste estudo foi investigar se a inclusão de anemia ou RDW, avaliados na admissão hospitalar, ao escore GRACE para a predição de mortalidade durante o período de internação hospitalar, podem melhorar a calibração e discriminação do modelo, bem como a estratificação de risco em pacientes com SCA. Para isso, um estudo de coorte, incluindo 109 pacientes com IAM, foi realizado. Modelos de regressão de Cox incluindo as variáveis do escore GRACE e o RDW ou a anemia foram construídos. Medidas de calibração e discriminação também foram calculadas, bem como o percentual de reclassificação dos pacientes para os novos modelos propostos. Os novos modelos, tanto com a inclusão de anemia, quanto com a adição de RDW, apresentaram adequada calibração e discriminação. Além disso, a adição destes parâmetros ao modelo original permitiu uma adequada reclassificação dos pacientes em diferentes categorias de risco. Os índices hematimétricos, anemia e RDW, demonstraram potencial prognóstico para utilização na avaliação de risco de pacientes com SCA, permitindo o aprimoramento da estratificação de risco realizada através do escore GRACE.
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Theoretical Approaches to the Study of Fluctuation Phenomena in Various Polymeric SystemsSharma, Rati January 2013 (has links) (PDF)
The goal of this thesis has been to throw light on a selection of open problems in chemical and biological physics using the general principles of statistical mechanics. These problems are all broadly concerned with the role of fluctuations in the dynamics of macromolecular systems. More specifically, they are concerned with identifying the microscopic roots of a number of interesting and unusual effects, including fractional viscoelasticity, anomalous chain cyclization dynamics in crowded environments, subdifffusion in hair bundles, symmetries in the work distributions of stretched polymers, heterogeneities in the geometries of reptation channels in polymer melts, and non-Gaussianity in the distributions of the end products of gene expression. I have shown here that all these effects are expressions of essentially the same underlying process of stochasticity, which can be described in terms of the dynamics of a point particle or a continuous curve that evolves in simple potentials under the action of white or colored Gaussian noise [8]. I have also shown that this minimal model of time-dependent behavior in condensed phases is amenable to analysis, often exactly, by path integral methods [13-15], which are naturally suited to the treatment of random processes in many-body physics. The results of such analyses are theoretical expressions for various experimentally measured quantities, comparisons with which form the basis for developing physical intuition about the phenomena under study.
The general success of this approach to the study of stochasticity in biophysics and molecular biology holds out hopes of its application to other unsolved problems in these fields. These include electrical transport in DNA [143], quantum coherence in photosynthesis [144], power generation in molecular motors [145], cell signaling and chemotaxis [146], space dependent diffusion [147], and self-organization of active matter [148], to name a few. Most of these problems are characterized by non-linearities of one kind or another, so they add a new layer of complexity to the problems considered in this thesis. Although path integral and related field theoretic methods are equipped to handle such complexities, the attendant calculations are expected to be non-trivial, and the challenge to theory will be to devise effective approximation schemes for these methods, or to develop new and more sophisticated methods altogether.
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Contribuição ao controle de máquinas de vibração eletrodinâmicas / Contribution to the control of electrodynamic vibration machinesFlora, Leandro Della 20 March 2009 (has links)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work presents contributions to the sinusoidal acceleration control of electrodynamic shakers applied in vibration testing. Considering the importance of sine tests to identify critical frequencies of operation and to determine mechanical weakness in the specified performance of specimens, vibration controllers are designed to reproduce the amplitude and the frequency of the reference acceleration specifically at the interface between
the shaker and the structure under test. Two distinct approaches are considered to solve the control problem: time domain control, where the acceleration instantaneous
value is adjusted to track the sinusoidal reference, and frequency domain control, in which only the amplitude or the root mean square value of the acceleration is compensated to follow the reference magnitude. The solutions developed based on these two different
approaches are implemented in a digital control platform and experimentally evaluated. The development of vibration controllers is complemented by contributions to the
study of the shaker dynamic model, as well as to the instrumentation applied to measure and feedback the acceleration and to the voltage control of switching-mode power amplifiers designed to drive the shaker. Regarding the vibration machine dynamic model, a method is proposed to experimentally identify the mechanical parameters of a two degrees of freedom system that represents the suspension resonance and the finite armature stiffness of the electrodynamic shaker. A procedure is developed to design and implement charge mode preamplifiers and signal conditioning circuits for piezoelectric accelerometers.
A robust model reference adaptive algorithm is applied to control the output voltage of an industrial switching-mode power amplifier. The experimental analysis of the adaptive
controller considers not only the improvements on the power amplifier performance, but also the of impact over the behavior of a commercial digital vibration control system. / Este trabalho apresenta contribuições ao controle de aceleração senoidal de vibradores eletrodinâmicos utilizados em ensaios de vibração. Considerando a importância de testes
com aceleração senoidal para identificar freqüências críticas de operação e determinar a resistência de materiais e estruturas, são desenvolvidos controladores para a máquina de
vibração com o propósito de garantir que a amplitude e a freqüência da aceleração imposta à estrutura sob teste correspondam aos valores de referência. Na solução do problema, admitem-se duas abordagens distintas: controle no domínio do tempo, onde o valor instantâneo da aceleração é ajustado para seguir a referência senoidal, e controle no domínio da freqüência, no qual apenas a amplitude ou o valor eficaz da aceleração é regulado conforme a magnitude de referência. As técnicas propostas com base nestas abordagens são implementadas numa plataforma de controle digital e avaliadas experimentalmente. O desenvolvimento dos controladores de vibrações é complementado por contribuições
ao estudo do modelo dinâmico do vibrador, à instrumentação aplicada para realimentar a aceleração e ao controle da tensão de amplificadores de potência que utilizam inversores
com modulação por largura de pulso para acionar a máquina. Com relação ao modelo do vibrador, é descrito um método que permite determinar experimentalmente os parâmetros mecânicos de um modelo com dois graus de liberdade, o qual representa o comportamento da máquina devido à suspensão e à rigidez finita da armadura. Um procedimento de projeto e realização prática de pré-amplificadores de carga e de um circuito de condicionamento para acelerômetros piezoelétricos é apresentado. Um algoritmo adaptativo robusto por modelo de referência é avaliado no controle da tensão de saída de um
amplificador industrial projetado para excitar o enrolamento da armadura do vibrador. A análise experimental do impacto do controlador adaptativo é realizada considerando não
apenas a melhoria no desempenho do amplificador, mas também em termos dos reflexos na performance de uma plataforma comercial de controle de ensaios de vibrações.
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