Spelling suggestions: "subject:"none"" "subject:"note""
301 |
Sequential Equivalence Checking of Circuits with Different State Encodings by Pruning Simulation-based Multi-Node InvariantsYuan, Zeying 05 October 2015 (has links)
Verification is an important step for Integrated Circuit (IC) design. In fact, literature has reported that up to 70% of the design effort is spent on checking if the design is functionally correct. One of the core verification tasks is Equivalence Checking (EC), which attempts to check if two structurally different designs are functionally equivalent for all reachable states. Powerful equivalence checking can also provide opportunities for more aggressive logic optimizations, meeting different goals such as smaller area, better performance, etc. The success of Combinational Equivalence Checking (CEC) has laid a foundation to industry-level combinational logic synthesis and optimization. However, Sequential Equivalence Checking (SEC) still faces much challenge, especially for those complex circuits that have different state encodings and few internal signal equivalences.
In this thesis, we propose a novel simulation-based multi-node inductive invariant generation and pruning technique to check the equivalence of sequential circuits that have different state encodings and very few equivalent signals between them. By first grouping flip-flops into smaller subsets to make it scalable for large designs, we then propose a constrained logic synthesis technique to prune potential multi-node invariants without inadvertently losing important constraints. Our pruning technique guarantees the same conclusion for different instances (proving SEC or not) compared to previous approaches in which merging of such potential invariants might lose important relations if the merged relation does not turn out to be a true invariant. Experimental results show that the smaller invariant set can be very effective for sequential equivalence checking of such hard SEC instances. Our approach is up to 20x-- faster compared to previous mining-based methods for larger circuits. / Master of Science
|
302 |
A CMA-FRESH Whitening Filter for Blind Interference RejectionJauhar, Ahmad Shujauddin 16 October 2018 (has links)
The advent of spectrum sharing has increased the need for robust interference rejection methods. The Citizens Broadband Radio Service (CBRS) band is soon to be occupied by LTE waveforms and License Assisted Access (LAA) will have LTE signals coexisting with other signals in the 5 GHz band. In anticipation of this need, we present a method for interference rejection of cyclostationary signals, which can also help avoid interference through better detection of low power co-channel signals. The method proposed in this thesis consists of a frequency-shift (FRESH) filter which acts as a whitening filter, canceling the interference by exploiting its cyclostationarity. It learns the cyclostationary characteristics of the interferer blindly, through a property restoration algorithm which aims to drive the spectrum to white noise. The property restoration algorithm, inspired by the constant modulus algorithm (CMA), is applied to each frequency bin to determine the optimal coefficients for the proposed CMA FRESH whitening filter (CFW). The performance of the CFW in interference rejection is compared to a time-invariant version, and proposed use cases are analyzed. The use cases consist of the rejection of a high powered, wider bandwidth interferer which is masking the signal-of-interest (SOI). The interferer is rejected blindly, with no knowledge of its characteristics. We analyzed signal detection performance in the case that the SOI is another user with much lower power, for multiple types of SOIs ranging from BPSK to OFDM. We also deal with the case that the SOI is to be received and demodulated; we recover it and compare resulting bit error rates to state of the art FRESH filters. The results show significantly better signal detection and recovery. / Master of Science / Wireless communication is complicated by the fact that multiple radios may be attempting to transmit at the same frequency, time and location concurrently. This scenario may be a due to malicious intent by certain radios (jamming), or mere confusion due to a lack of knowledge that another radio is transmitting in the same channel. The latter scenario is more common due to congested wireless spectrum, as the number of devices increases exponentially. In either case, interference results. We present a novel interference rejection method in this work, one that is blind to the properties of the interferer and adapts to cancel it. It follows the philosophy of property restoration as extolled by the constant modulus algorithm (CMA) and is a frequency shift (FRESH) filter, hence the name. The process of restoring the wireless spectrum to white noise is what makes it a whitening filter, and is also how it adapts to cancel interference. Such a filter has myriad possible uses, and we examine the use case of rejecting interference to detect or recover the signal-of-interest (SOI) that we are attempting to receive. We present performance results in both cases and compare with conventional time-invariant filters and state of the art FRESH filters.
|
303 |
Common-mode EMI characterization and mitigation in networked power electronics-enabled power systemsAmin, Ashik 10 May 2024 (has links) (PDF)
Rapidly-increasing medium-voltage power electronics applications in emerging industry systems, including electrical ships, more electric aircraft, and microgrids, have emphasized the critical need for highly energy-efficient, reliable, and fast switching devices. As a result, Wide-Bandgap (WBG) devices have gained considerable interest over conventional silicon-based switches in recent years. For example, emerging WBG devices have unlocked new dimensions for modern motor drive systems with increased efficiency, switching frequency, and superior power density. Commercially-developed WBG devices such as Silicon Carbide (SiC) and Gallium Nitride (GaN) offer promising opportunities to meet those pressing requirements. However, the fast switching operation of WBG devices may cause substantially increased EMI emissions in medium-voltage applications, which can decrease the overall system’s performance or merits of power converters. This will be particularly an issue in a system where electric ground is unavailable, such as an electric ship, as a large Electro-Magnetic Interference current will be circulating within the system. The EMI in the WBG switch module will be emitted up to 500 MHz. This is the near radio-frequency (RF) band whose impact had not been clearly understood or properly analyzed in the power electronics field until recently. With new and critical challenges in recent years, to reliably adopt WBG devices in emerging power systems, there has been significant effort to improve electromagnetic compatibility (EMC) with new EMI mitigation techniques that comply with existing standards, including International Special Committee on Radio Interference (CISPR), Federal Communications Commission (FCC), Department of Defense (DOD), International Electro-Technical Commission (IEC), etc. This research investigates the common-mode EMI in networked power electronics-enabled power systems. Common-mode EMI phase information is a vital degree of freedom in EMI study that has not been considered in the state of the art. The EMI phase information reduces EMI without implementing any active or passive filter circuit. An effective and less complex method is introduced to reduce EMI in power electronics network. The work includes developing hybrid filter with passive and virtual filter. Including virtual filter reduces the passive common mode choke weight and volume significantly. Finally, a simplified switching node capacitance characterization technique for packaged WBG SiC has been introduced.
|
304 |
Average Consensus over Networks with Imperfect CommunicationKotsurenko, Kateryna January 2024 (has links)
Average consensus is a fundamental concept in distributed computing, where distributed agents exchange messages in order to obtain the average of their ini- tial values without relying on a centralized computing unit. However, achiev- ing average consensus in the presence of communication imperfections, such as quantization and random link or node failures, becomes more challenging. This thesis evaluates various average consensus algorithms regarding their ability to mitigate quantization effects and explores node dropout for reducing communi- cation cost per iteration. It also identifies the conditions required for achieving average consensus in both scenarios. The first part of this thesis deals with average consensus with quantized up- dates, comparing algorithms such as quantized gossip, average preserving quan- tized gossip, and CHOCO-GOSSIP. CHOCO-GOSSIP stands out as the most ef- fective algorithm, which shows the importance of pre-compensating the quanti- zation error before transmitting the node values. Among other algorithms, aver- age preserving quantized gossip shows slightly better performance. Additionally, graphs with higher connectivity tend to perform better. The second part of this thesis focuses on energy-efficient average consensus with random node dropout. It compares the optimized node dropout proba- bilities with heuristic designs such as the degree-based method and Metropolis- Hastings method. The degree-based method is shown to give good convergence performance despite its simplicity. Furthermore, in irregular graphs, the perfor- mance difference between optimized probabilities and heuristic designs tends to be more pronounced.
|
305 |
Regulation of sinoatrial node and pacemaking mechanisms in health and diseaseEl Khoury, Nabil 12 1900 (has links)
Le noeud sinusal (NS) est le centre de l‟automatisme cardiaque. Grâce à son activité électrique spontanée, il dicte la fréquence cardiaque (FC) en réponse aux demandes physiologiques. A ce jour, le NS demeure un sujet de recherche important puisque les mécanismes moléculaires responsables de sa régulation sont encore méconnus. Par exemple, les processus menant à la bradycardie sinusale et à la maladie du sinus (MS) chez les personnes âgées sont mécompris et présentement l‟implantation d‟un stimulateur cardiaque demeure le seul traitement disponible. Ainsi, l‟objectif de cette thèse était de déterminer les changements moléculaires et cellulaires se produisant au niveau du NS en réponse à divers stimuli physiologiques et pathologiques afin d'établir leurs rôles potentiels dans la régulation de la FC et le développement de la MS. Dans les deux premiers chapitres, la grossesse est présentée comme modèle physiologique. En effet, la réponse adaptative aux demandes croissantes de la mère et du foetus engendre des changements physiologiques considérables au niveau du myocarde, dont une augmentation de la FC essentielle pour la perfusion adéquate des organes. Toutefois, cette augmentation peut aussi favoriser le développement d‟arythmies. Dans le troisième chapitre, l‟inflammation, un facteur présent lors du vieillissement et dans plusieurs pathologies où la MS se manifeste, a fait l‟objet d‟une étude dans le but de déterminer son rôle dans le développement de la MS. Les résultats obtenus dans cette thèse démontrent que la grossesse induit une hausse de la FC chez la souris gestante similaire à celle retrouvée chez la femme enceinte. Cette accélération était due à un remodelage électrique du NS. Plus spécifiquement, la fréquence des potentiels d‟action ainsi que la densité et l‟expression des courants pacemaker (If) et calcique de type L (ICaL) étaient augmentées. De plus, une accélération des transitoires calciques spontanés et de la vitesse de relâche calcique du réticulum sarcoplasmique a été observée. La régulation de l‟automaticité par un stimulus pathologique, l‟interleukine-1β, est abordée par la suite. L‟interleukine-1β, une cytokine ayant un rôle majeur comme médiateur inflammatoire, se retrouve en concentrations élevées dans plusieurs maladies associées avec la ii MS. Nos résultats démontrent que l‟interleukine-1β engendre une diminution de l‟automaticité associée à une réduction de If et ICaL dans les cardiomyocytes humains de type nodal dérivés de cellules souches induites pluripotentes (hiPSC-CM). En parallèle, le phénotype électrophysiologique et moléculaire des hiPSC-CM a été caractérisé démontrant leur homologie avec les cellules du NS humain adulte, les validant comme modèle in vitro de cellules nodales humaines. En conclusion, les études présentées dans cette thèse démontrent que le NS est plus qu‟un simple tissu régulé par l‟innervation autonome. En effet, son automaticité est dynamique et peut être influencée par des facteurs physiologiques ou pathologiques. Nos résultats contribuent ainsi à une meilleure compréhension des mécanismes sous-jacents à l‟automaticité. Ces avancées sont importantes non seulement pour la santé des femmes, mais aussi pour les individus souffrant de la MS. À terme, nous espérons que ces résultats contribueront au développement de stratégies thérapeutiques pour traiter des complications liées aux troubles d‟automaticité cardiaque. / The sinoatrial node (SAN) is the dominant cardiac pacemaker. With its spontaneous automaticity, it dictates rhythm and controls heart rate in response to varying physiological demands. Despite its modest size, the SAN is a very heterogeneous and complex structure that remains the topic of research efforts due, in part, to uncertainties in the mechanisms that regulate pacemaking in various conditions. For instance, the processes that lead to severe sinus bradycardia and SAN dysfunction (SND) in the elderly are unknown and to date, the implantation of electronic pacemaker remains the only SND treatment. Accordingly, the overall objective of this thesis was to explore and highlight the molecular and cellular changes that occur within the SAN in both physiological and pathological states, while determining how they contribute to regulation of heart rate and potentially SND. In the first two chapters, we present pregnancy as a physiological model considering it is a period during which substantial adaptive changes to the myocardium and increases in heart rate occur. Paradoxically, the rapid rate, which is essential for adequate organ perfusion of both mother and foetus, may also increase vulnerability to certain arrhythmias. In the third chapter, inflammation, a central process in pathology and common factor to several diseases and even ageing, was evaluated as potential underlying circumstance contributing to the development of sinus bradycardia and SND. Combinations of in vivo, ex vivo, biochemical, molecular and cellular approaches were used in order to generate an integrated understanding of the models we examined. Our data shows that in pregnant mice, an increase in heart rate similar to that of pregnant women occurs and was due to an electrical remodelling of the SAN. Specifically, an increase in action potential frequency of isolated individual SAN cells was observed. This was attributed to increased expression and density of pacemaker (If) and L-type Ca2+ currents (ICaL) along with a rapid spontaneous Ca2+ transient rate and faster intracellular sarcoplasmic reticulum Ca2+ release. We then demonstrate that the pro-inflammatory cytokine interleukin-1β which is a major inflammatory mediator that is upregulated in several diseases associated with SND, iv dramatically slows automaticity by reducing If and ICaL density in nodal-like cardiomyocytes derived from human-induced pluripotent stem cells (hiPSC-CM). Importantly, in that study, hiPSC-CMs were also physiologically and molecularly characterized revealing their high resemblance to adult human SAN and a potential use as a novel in vitro model to study pacemaking in humans. In conclusion, the results of this thesis demonstrate that the SAN is not a simple, neurally controlled tissue, but a rather dynamic pacemaker that undergoes extensive intrinsic remodelling during states of health and disease. The results contribute to understanding physiological mechanisms of pacemaking and how they are altered by disease and may be relevant for both women‟s health and the individuals affected by SND. Ultimately, we hope these findings will be helpful in the development of therapeutic strategies to treat pacemaking-related complications.
|
306 |
Using Node-Red to Connect Patient, Staff and Medical EquipmentOlsson, Joel, Asante, Junior January 2016 (has links)
The emergency departments in Region Östergötland use pen and paper to a large extent when recording emergency care procedures and measurements. During treatment the patient should be the main focus. Because of this, recording of measurements done could be delayed or in worst case forgotten during stressful situations. The proposal of this project is the development of a prototype that tries to make the administrative work a passive procedure rather than an active one. The system developed uses a Raspberry Pi, along with Node-Red, which connects predefined patient data and medical records, with the clinical staff tending the patient. All these connections are initiated by mainly using RFID technology. The conclusion made with the developed system is that it should unload the staff with the recording of data and that it helps make a data logging a more passive work than today’s used methods. Along with a process that is easier to operate, the time spent on administrative work could be reduced with the proposed system.
|
307 |
La gouvernance nodale de la sécurité localeQuéro, Yann-Cédric 08 1900 (has links)
No description available.
|
308 |
Impacto da solução de Carnoy no número de linfonodos resgatados em peças cirúrgicas de câncer gástrico: estudo prospectivo randomizado / Impact of Carnoy\'s solution in lymph node retrieval following D2 gastrectomy for gastric cancer: prospective randomized trialDias, Andre Roncon 25 August 2014 (has links)
Introdução: O adenocarcinoma gástrico é uma doença de elevada incidência e alta mortalidade. A gastrectomia com linfadenectomia é tratamento potencialmente curativo, promovendo controle loco-regional da doença e fornecendo material para análise histopatológica. Para o adequado estadiamento dos pacientes é recomendado que pelo menos 16 linfonodos sejam examinados pela patologia, entretanto, espera-se maior sobrevida quando >= 30 linfonodos são avaliados, mesmo em pacientes com tumores precoces. A justificativa para este achado é o sub-estadiamento de pacientes com poucos linfonodos examinados. Linfonodos pequenos são particularmente difíceis de serem encontrados, mas podem conter metástases e impactar negativamente na sobrevida. Visando facilitar sua identificação, soluções clareadoras de gordura foram propostas, entretanto não há evidência clara de seu benefício clínico. Objetivos: Comparar as soluções de Carnoy e de formalina neutra tamponada em relação ao número absoluto de linfonodos encontrados na peça cirúrgica de pacientes submetidos a gastrectomia. Averiguar se linfonodos retirados cirurgicamente são perdidos com a fixação em formalina e, caso isso ocorra, se este fato é relevante para o estadiamento. Observar se o protocolo de pesquisa influenciou o número de linfonodos encontrados. Métodos: Cinquenta produtos de gastrectomia subtotal com linfadenectomia D2 por adenocarcinoma gástrico foram randomizados para fixação em Carnoy ou formalina com posterior dissecção da peça em busca de linfonodos. Após a dissecção do grupo Formalina, a gordura residual a ser desprezada foi imersa em Carnoy e reavaliada posteriormente. Os dados de 25 gastrectomias D2 operadas previamente ao estudo também foram avaliados. Resultados: A média de linfonodos encontrados nos grupos Carnoy e Formalina foi de 50,4 e 34,8; respectivamente (p < 0,001). Na gordura residual foram encontrados linfonodos em todos os casos (média 16,9 linfonodos), elevando a média do grupo Formalina para 51,7 (valor similar ao do grupo Carnoy, p=0,809). Com exceção de 1 linfonodo de 7mm, todos os demais encontrados na gordura residual mediram <= 3mm. Treze linfonodos metastáticos passaram despercebidos com a fixação em formalina e a revisão da gordura residual determinou a mudança de estadiamento de 2 (8%) pacientes. Os linfonodos encontrados no Carnoy possuíam tamanho significativamente menor quando comparados aos do grupo Formalina (p=0,01). A média de linfonodos encontrados no grupo retrospectivo foi similar ao do grupo Formalina prospectivo (p=0,802). Conclusões: Quando comparada à formalina, a solução de Carnoy permite encontrar número maior de linfonodos no espécime cirúrgico de gastrectomias com linfadenectomia. Linfonodos milimétricos foram perdidos após a fixação em formalina, estes foram identificados com o Carnoy e são clinicamente relevantes, pois podem conter metástases modificando assim, o estádio clínico e prognóstico do paciente. A implementação de protocolo de pesquisa não influenciou o número de linfonodos encontrados neste estudo / Background: Gastric adenocarcinoma is a frequent disease with high mortality ratio. Gastrectomy with lymphadenectomy is potentially curative, allows local control of the disease and provides material for TNM classification. While pathology examination of at least 16 lymph nodes is recommended following surgery, longer survival rates are expected when >=30 lymph nodes are examined, even for early gastric cancer. The understaging of patients with less examined lymph nodes justifies this findings. Small lymph nodes are particularly difficult to identify and fat clearing solutions have been proposed to improve this, but there is no evidence of their clinical benefit. Objectives: Compare Carnoy\'s solution (CS) and formalin in terms of the total number of examined lymph nodes following gastrectomy. Verify if surgically retrieved lymph nodes are lost with the formalin fixation and if this fact is clinically significant. Observe if a research protocol influences the number of examined lymph nodes. Methods: Fifty specimens of gastrectomy with D2 lymphadenectomy were randomized for fixation in CS or formalin with posterior dissection in search for lymph nodes. In the Formalin group, the residual fat to be discarded was immersed in CS and dissected again. Data from 25 D2 gastrectomies performed previously the present study were retrospectively analyzed. Results: The medium number of examined lymph nodes was 50.4 and 34.8 for CS and formalin, respectively (p < 0.001). Lost lymph nodes were found in all cases in the Residual Fat group (medium 16.9), this increased the Formalin group average to 51.7 (which is similar to the CS group, p=0.809). With one exception (7mm), all other examined lymph nodes in the Residual Fat group measured <= 3mm. Thirteen lymph nodes from this group were metastatic, this determined the upstaging of 2 (8%) patients. Lymph nodes from the CS group were smaller than those found in the formalin group (p=0.01). The medium number of retrieved lymph nodes in the retrospective group was similar to the formalin group (p=0.802). Conclusions: When compared to formalin, Carnoy\'s solution increases lymph node detection following gastrectomy with lymphadenectomy. CS identifies small lymph nodes lost with formalin fixation and that are clinically significant, since they may contain metastasis, modifying the TNM classification. No influence of the research protocol over the number of examined lymph nodes was observed in the present study.
|
309 |
Desempenho da ultrassonografia e da punção aspirativa por agulha fina axilar em pacientes com carcinomas invasivos da mama: correlação com aspectos do linfonodo e características tumorais / Performance of ultrasound and axillary FNA in patients with invasive breast carcinomas: correlation with lymph node and tumor characteristicsTeixeira, Patricia Akissue de Camargo 08 August 2017 (has links)
INTRODUÇÃO: O status linfonodal da axila ainda permanece como importante fator prognóstico em pacientes com câncer de mama invasivo. Muitos estudos já relataram a importância da ultrassonografia axilar e da punção aspirativa por agulha fina (PAAF) na avaliação pré-operatória das pacientes com câncer de mama. Nossos objetivos foram avaliar as características ultrassonográficas dos linfonodos axilares relacionadas à metástase linfonodal e o papel da PAAF na avaliação pré-operatória de pacientes com câncer de mama. Nosso objetivo secundário foi avaliar se, dependendo das características dos tumores, linfonodos sem alterações na ultrassonografia poderiam ter comprometimento metastático. MÉTODOS: Este estudo foi realizado no Instituto de Radiologia e no Instituto do Câncer do HCFMUSP. Foram incluídas 182 pacientes com câncer de mama invasivo recém-diagnosticado, sendo que, destas, apenas 145 realizaram cirurgia - 74 prosseguiram direto para cirurgia e 71 realizaram tratamento neoadjuvante e após cirurgia. Foi realizada avaliação ultrassonográfica da axila ipsilateral ao tumor e punção aspirativa por agulha fina de um linfonodo selecionado pelo radiologista. Os dados ultrassonográficos dos linfonodos e os achados citológicos da PAAF foram correlacionados com os resultados anatomopatológicos da biópsia do linfonodo sentinela ou do esvaziamento axilar. RESULTADOS: Nas 74 pacientes (75 axilas) que não realizaram tratamento neoadjuvante, as características ultrassonográficas do linfonodo associadas à metástase na análise univariada foram espessamento cortical difuso e a obliteração parcial ou completa do hilo gorduroso. A sensibilidade, especificidade, acurácia, valor preditivo positivo (VPP) e valor preditivo negativo (VPN) da ultrassonografia foram, respectivamente, 72,7%, 57,1%, 64,0%, 57,1% e 72,7% (p=0,009), e da PAAF: 36,4%, 97,6%, 70,7%, 92,3% e 66,1% (p < 0,001). Incluindo apenas linfonodos alterados na ultrassonografia, obtivemos, respectivamente, sensibilidade, especificidade, acurácia, VPP e VPN de 50%, 94%, 69%, 92% 59% (p=0,001). Nenhuma PAAF de linfonodo classificado como normal na ultrassonografia teve resultado positivo. Obtivemos, nas análises das curvas ROC, um valor de corte da espessura da cortical de 2,65 mm (p < 0,001) e do tamanho do tumor pré-cirúrgico de 2,45 cm (p=0,042). Na análise multivariada, as seguintes características foram associadas à metástase linfonodal: espessura da cortical (p = 0,005), tamanho do tumor pré-cirúrgico (p = 0,030), status pré-menopausa (p = 0,017), tipo histológico não especial (p = 0,034) e localização do tumor no quadrante superolateral (p = 0,011). Construiu-se um modelo de predição de risco de metástase axilar usando estas características. Nas 71 pacientes que realizaram tratamento adjuvante, a única característica do linfonodo associada à metástase linfonodal foi a forma redonda ou irregular. Os demais resultados deste grupo não podem ser generalizados, pois não é possível separar o efeito do tratamento nesta população. CONCLUSÕES: Linfonodos axilares com espessamento cortical difuso e com obliteração parcial ou completa do hilo gorduroso estão associados à malignidade. A PAAF apresentou-se mais útil nos linfonodos alterados, com sensibilidade de 50%. Pacientes com PAAF positivas devem ser encaminhadas para esvaziamento axilar ou quimioterapia neoadjuvante. Não há benefício da realização da PAAF em linfonodos sem alterações na ultrassonografia / BACKGROUND: The lymph node status of the axilla remains an important prognostic factor in patients with invasive breast cancer. Many studies have already reported the importance of axillary ultrasonography and fine needle aspiration (FNA) in the preoperative evaluation of patients with breast cancer. Our objectives were to evaluate the ultrasound characteristics of axillary lymph nodes related to lymph node metastasis and the role of FNA in the preoperative evaluation of patients with breast cancer. Our secondary objective was to assess whether, depending on the tumor characteristics, lymph nodes that showed no change on ultrasonography could have metastatic involvement. METHODS: This study was conducted at the Institute of Radiology and the Institute of Cancer of HCFMUSP. A total of 182 patients with newly diagnosed invasive breast cancer were included, of whom only 145 had undergone surgery - 74 went straight to surgery and 71 underwent neoadjuvant treatment and after surgery. Ultrasound evaluation of the axilla ipsilateral to the tumor and fine needle aspiration of a lymph node selected by the radiologist were performed. The ultrasound data of the lymph nodes and the cytological findings of FNA were correlated with pathology results from sentinel lymph node biopsy or surgical dissection. RESULTS: In the 74 patients (75 axillae) who did not undergo neoadjuvant treatment, the ultrasound characteristics of the lymph nodes associated with metastasis in the univariate analysis were diffuse cortical thickening and partial or complete fatty hilum obliteration. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of ultrasound were respectively 72.7%, 57.1%, 64.0%, 57.1% and 72.7% (p = 0.009) and of the FNA 36.4%, 97.6%, 70.7%, 92.3% and 66.1% (p <0.001). Including only atypical lymph nodes on ultrasonography, we obtained respectively sensitivity, specificity, accuracy, PPV and NPV of 50%, 94%, 69% 92% and 59% (p = 0.001). No FNA of lymph node classified as normal on ultrasonography had a positive result. With ROC curves analysis we obtained a cut-off value of cortical thickness of 2.65 mm (p <0.001) and pre-surgical tumor size of 2.45 cm (p = 0.042). In the multivariate analysis, the following characteristics were associated with lymph node metastasis: cortical thickness (p = 0.005), preoperative tumor size (p = 0.030), premenopausal status (p = 0.017), non-special histological type and tumor location in the upper outer quadrant (p = 0.011). A predictive model of axillary metastasis risk was constructed using these characteristics. In the 71 patients who underwent adjuvant treatment the only feature of the lymph node associated with lymph node metastasis was the round or irregular shape. The other results of this group cannot be generalized since it is not possible to separate the treatment effect in this population. CONCLUSIONS: Axillary lymph nodes with diffuse cortical thickening and with partial or complete fatty hilum obliteration are associated with malignancy. FNA was more useful in atypical lymph nodes, with a sensitivity of 50%. Patients with positive FNA should be referred for axillary surgical dissection or neoadjuvant chemotherapy. There is no benefit of performing FNA in lymph nodes without changes in ultrasound
|
310 |
Pendlarnod : en knutpunkt för ett hållbart samhälle / Commuter node : a junction for a sustainable societyTrulsson, Patricia, Wahlgren, Amanda January 2019 (has links)
Examensarbetet är bland annat ett förslag med hållbara riktlinjer för hur planering av en pendlarnod kan gå till samt identifikation av generella servicefunktioner som bör finnas hos en pendlarnod. Arbetet grundas i den ökande användningen av bilen gentemot val av hållbara färdmedel i form av gång-, cykel- och kollektivtrafik. En viktig aspekt i planeringen av pendlarnoder är stadskärnornas attraktivitet samt sammankopplingen mellan landsbygd och tätort. Om bilens framkomlighet begränsas kan hållbart resande gynnas och på så sätt sammankoppla Sveriges vägnät med bättre förbindelser. Förslaget är till för att underlätta för framtida stads- och trafikplanering i Sveriges tätorter. Studien grundas på vad andra städer har gjort för att öka det hållbara resandet. Resultaten visar att genom att placera pendlarnoder i utkanten av Växjö minskas bilanvändningen i centrum och främjar istället människans hälsa och välbefinnande. Pendlarnoderna är även en förutsättning för att alla människor ska ha möjlighet att kunna ta sig till fritidsaktiviteter, arbete och studier oavsett vart de bor. Samtidigt frigörs stora ytor i centrum som kan utformas till gröna områden som uppmuntrar till en mer levande stad och fysisk aktivitet för människorna som bor i den. En pendlarnods attraktion ökar i takt med vad den kan erbjuda. Genom att erbjuda ett utbud av funktioner, tjänster och upplevelser under samma tak kan attraktionen av det hållbara resandet öka i Sveriges tätorter. / This work including a proposal with sustainable guidelines on how to plan a commuter node, as well as identification of general service functions that should be available. The work is based on the increasing use of cars against choice of sustainable transport in the form of pedestrian, bicycle and public transport. An important part of the planning of the commuter hubs is the attractiveness of the city center as well as the interconnection between countryside and urban areas. If the cars accessibility is limited, sustainable travel can benefit and thus better link Sweden’s road network with better connections. This proposal will make urban and traffic planning easier. The study is based on what other cities have done in the past to encourage sustainable travel, use of proven analytical methods and interviews with expert and potential users. The result shows that by placing commuter nodes on the edge of Växjö, car use is reduced in the center and instead promotes human health and well-being. The commuter nodes are also a prerequisite for all people to have the opportunity to access leisure activities, work and studies wherever they live. At the same time, large areas in the center are released, which can be designed into green areas that encourage a more vibrant city and physical activity for people living in it. A commuter node's attraction increases as it can offer. Being able to offer a range of functions, services and experiences is a connection between public transport and land value.
|
Page generated in 0.0395 seconds