Fuzzy controller to compensate comunication loads in real-time

[EN] A Fuzzy Resource Manager (RM) to compensate communication loads in real-time systems is presented. The design is based on a new model of a Constant Bandwidth Server (CBS), which is responsible for assigning time slots to tasks with the highest priority when idle time is available. Assuming that each application can be executed at dierent service levels, without being below a minimum limit, a fuzzy approach is introduced that allows to adjust the time resources assigned to each task and to compensate non-linearities in time resources requests. The RM increases or decreases the virtual platform for each application and assigns a maximum process time budget for it, which is gradually used and refilled when depleted, without aecting the other applications. The scheme self-adjusts to sudden changes in applications process time requirements.[ES] Se presenta un administrador de recursos (RM) difuso para compensar las cargas de comunicación en sistemas en tiempo real. El diseño del RM se basa en un nuevo modelo de Servidor de Ancho de Banda Constante (CBS) que se encarga, a través de una plataforma virtual, de asignar tiempo de proceso a las tareas de mayor prioridad cuando existe capacidad disponible. Si se asume que cada aplicación puede ser ejecutada con diferentes niveles de servicio sin que este esté por debajo de un límite mínimo, se propone una aproximación difusa que permite actualizar de manera gradual los tiempos de proceso asignados a cada tarea. Esta aproximación permite compensar el comportamiento no lineal en las solicitudes de tiempo de proceso. El RM aumenta o disminuye la plataforma virtual para cada aplicación y le asigna un presupuesto máximo de tiempo de proceso, mismo que la aplicación usa gradualmente y que se reasigna al agotarse, sin por ello afectar el desempeño del resto de las aplicaciones. El esquema se auto-ajusta cuando ocurren a cambios repentinos en los requerimientos de tiempo de proceso de las aplicaciones.Este trabajo ha sido realizado parcialmente gracias al apoyo del CONACYT BECA 597175, PAPIIT IT100320 y PAPIIT IN104516.Aparicio-Santos, J.; Hermosillo-Gómez, J.; Benítez-Pérez, H.; Álvarez-Icaza, L. (2021). Controlador difuso para compensar cargas de comunicación en sistemas en tiempo real. Revista Iberoamericana de Automática e Informática industrial. 18(3):288-299. https://doi.org/10.4995/riai.2021.14544OJS288299183Abeni, L., Buttazzo, G., Dec 1998. Integrating multimedia applications in hard real-time systems. In: Proceedings 19th IEEE Real-Time Systems Symposium (Cat. No.98CB36279). pp. 4-13. https://doi.org/10.1109/REAL.1998.739726Aparicio, Santos, J. A., 2017. Diseño de un controlador difuso para compensar cargas de comunicación en tiempo real. Master's thesis, Universidad Nacional Autónoma de México, México.Bini, E., Buttazzo, G., Eker, J., Schorr, S., Guerra, R., Fohler, G., Arzen, K. E., Romero, V., Scordino, C., May 2011. Resource management on multicore systems: The actors approach. IEEE Micro 31 (3), 72-81. https://doi.org/10.1109/MM.2011.1Boutalis, Y., Theodoridis, D., Kottas, T., Christodoulou, M. A., 2014. System Identification and Adaptive Control: Theory and Applications of the Neurofuzzy and Fuzzy Cognitive Network Models. Springer.Buttazzo, G. C., 2011. Hard Real-Time Computing Systems: Predictable Scheduling Algorithms and Applications, 3rd Edition. Springer Publishing Company, Incorporated. Byeong Gi, L., Daeyoung, P., Hanbyul, S., 2009. Wireless Communications Resource Managemen. John Wiley and Sons.Byeong Gi, L., Daeyoung, P., Hanbyul, S., 2009. Wireless Communications Resource Managemen. John Wiley and Sons.Chasparis, G., Maggio, M., Arzen, K. E., Bini, E., June 2013. Distributed management of cpu resources for time-sensitive applications. In: 2013 American Control Conference. pp. 5305-5312. https://doi.org/10.1109/ACC.2013.6580666Chasparis, G. C., Maggio, M., Bini, E., Arzen, K.-E., 2016. Desing and implementation of distributed resource management for time-sensitive applications. Automatica 64, 44 - 53. https://doi.org/10.1016/j.automatica.2015.09.015Clark, R. K., 1990. Scheduling dependent real-time activities. Ph.D. thesis, USA, aAI9107552.Ganz, A., Ganz, Z., Wongthavarawat, K., 2003. Multimedia Wireless Networks: Technologies, Standards and QoS. Pearson Education.Horn, W., 1974. Some simple scheduling algorithms. Naval Research Logistics Quarterly 21 (1), 177-185. https://doi.org/10.1002/nav.3800210113IEEE Standard Glossary of Software Engineering Terminology. https://doi.org/10.1109/IEEESTD.1990.101064Litoiu, M., Tadei, R., 2001. Fuzzy scheduling with application to real-time systems. Fuzzy Sets and Systems 121 (3), 523 - 535. https://doi.org/10.1016/S0165-0114(99)00176-1Mahmoud, M., of Engineering, I., Technology, 2013. Distributed Control and Filtering for Industrial Systems. Control, Robotics and Sensors. Institution of Engineering and Technology. URL: https://books.google.com.mx/books?id=qWhWx2hRLYcC https://doi.org/10.1049/PBCE088EMok, A. K., Feng, X., May 2001. Resource partition for real-time systems. In: Proceedings Seventh IEEE Real-Time Technology and Applications Symposium. pp. 75-84. https://doi.org/10.1109/RTTAS.2001.929867Nesbit, K. J., Moreto, M., Cazorla, F. J., Ramirez, A., Valero, M., Smith, J. E., May 2008. Multicore resource management. IEEE Micro 28 (3), 6-16. https://doi.org/10.1109/MM.2008.43Quanser, 2012. USER MANUAL 3 DOF Gyroscope Experiment Set Up and Configuration. Quanser inc.Robert H. Cannon, J., 2003. Dynamics Of Physical Systems. Dover Publications, INC.Stankovic, J. A., 1988. Misconceptions about real-time computing: a serious problem for next-generation systems. Computer 21 (10), 10-19. https://doi.org/10.1109/2.7053Subrata, R., Zomaya, A. Y., Landfeldt, B., Oct 2008. A cooperative game framework for qos guided job allocation schemes in grids. IEEE Transactions on Computers 57 (10), 1413-1422. https://doi.org/10.1109/TC.2008.79Tanaka, K., Ikeda, T., Wang, H. O., May 1998. Fuzzy regulators and fuzzy observers: relaxed stability conditions and lmi-based designs. IEEE Transactions on Fuzzy Systems 6 (2), 250-265. https://doi.org/10.1109/91.66902

Apixaban versus warfarin in patients with atrial fibrillation

BACKGROUND: Vitamin K antagonists are highly effective in preventing stroke in patients with atrial fibrillation but have several limitations. Apixaban is a novel oral direct factor Xa inhibitor that has been shown to reduce the risk of stroke in a similar population in comparison with aspirin. METHODS: In this randomized, double-blind trial, we compared apixaban (at a dose of 5 mg twice daily) with warfarin (target international normalized ratio, 2.0 to 3.0) in 18,201 patients with atrial fibrillation and at least one additional risk factor for stroke. The primary outcome was ischemic or hemorrhagic stroke or systemic embolism. The trial was designed to test for noninferiority, with key secondary objectives of testing for superiority with respect to the primary outcome and to the rates of major bleeding and death from any cause. RESULTS: The median duration of follow-up was 1.8 years. The rate of the primary outcome was 1.27% per year in the apixaban group, as compared with 1.60% per year in the warfarin group (hazard ratio with apixaban, 0.79; 95% confidence interval [CI], 0.66 to 0.95; P<0.001 for noninferiority; P = 0.01 for superiority). The rate of major bleeding was 2.13% per year in the apixaban group, as compared with 3.09% per year in the warfarin group (hazard ratio, 0.69; 95% CI, 0.60 to 0.80; P<0.001), and the rates of death from any cause were 3.52% and 3.94%, respectively (hazard ratio, 0.89; 95% CI, 0.80 to 0.99; P = 0.047). The rate of hemorrhagic stroke was 0.24% per year in the apixaban group, as compared with 0.47% per year in the warfarin group (hazard ratio, 0.51; 95% CI, 0.35 to 0.75; P<0.001), and the rate of ischemic or uncertain type of stroke was 0.97% per year in the apixaban group and 1.05% per year in the warfarin group (hazard ratio, 0.92; 95% CI, 0.74 to 1.13; P = 0.42). CONCLUSIONS: In patients with atrial fibrillation, apixaban was superior to warfarin in preventing stroke or systemic embolism, caused less bleeding, and resulted in lower mortality. Copyright © 2011 Massachusetts Medical Society. All rights reserved

Gender differences and management of stroke risk of nonvalvular atrial fibrillation in an upper middle-income country: Insights from the CARMEN-AF registry

Background: Atrial Fibrillation (AF) is associated with an increased risk of stroke and systemic embolism. Several studies have suggested that female AF patients could have a greater risk for stroke. There is scarce information about clinical characteristics and use of antithrombotic therapies in Latin American patients with nonvalvular AF. Objective: To describe the gender differences in clinical characteristics, thromboembolic risk, and antithrombotic therapy of patients with nonvalvular AF recruited in Mexico, an upper middle-income country, into the prospective national CARMEN-AF Registry. Methods: A total of 1423 consecutive patients, with at least one thromboembolic risk factor were enrolled in CARMEN-AF Registry during a three-year period (2014–2017). They were categorized according to Gender. Results: Overall, 48.6% were women, mean age 70 ± 12 years. Diabetes, smoking, alcoholism, non-ischemic cardiomyopathy, coronary artery disease, and obstructive sleep apnea were higher in men. Most women were found with paroxysmal AF (40.6%), and most men with permanent AF (44.0%). No gender differences were found in the use of vitamin K antagonists (VKA) (30.5% in women vs. 28.0% in men). No gender differences were found in the use of direct oral anticoagulants (DOAC) (33.8% women vs 35.4% men). Conclusions: CARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC. Keywords: Atrial fibrillation, Gender, Thromboembolic risk, Antithrombotic therapy, Stroke, Mexic

Apixaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: A subgroup analysis of the ARISTOTLE trial

Background: In the ARISTOTLE trial, the rate of stroke or systemic embolism was reduced by apixaban compared with warfarin in patients with atrial fibrillation (AF). Patients with AF and previous stroke or transient ischaemic attack (TIA) have a high risk of stroke. We therefore aimed to assess the efficacy and safety of apixaban compared with warfarin in prespecified subgroups of patients with and without previous stroke or TIA. Methods: Between Dec 19, 2006, and April 2, 2010, patients were enrolled in the ARISTOTLE trial at 1034 clinical sites in 39 countries. 18 201 patients with AF or atrial flutter were randomly assigned to receive apixaban 5 mg twice daily or warfarin (target international normalised ratio 2·0-3·0). The median duration of follow-up was 1·8 years (IQR 1·4-2·3). The primary efficacy outcome was stroke or systemic embolism, analysed by intention to treat. The primary safety outcome was major bleeding in the on-treatment population. All participants, investigators, and sponsors were masked to treatment assignments. In this subgroup analysis, we estimated event rates and used Cox models to compare outcomes in patients with and without previous stroke or TIA. The ARISTOTLE trial is registered with ClinicalTrials.gov, number NTC00412984. Findings: Of the trial population, 3436 (19%) had a previous stroke or TIA. In the subgroup of patients with previous stroke or TIA, the rate of stroke or systemic embolism was 2·46 per 100 patient-years of follow-up in the apixaban group and 3·24 in the warfarin group (hazard ratio [HR] 0·76, 95% CI 0·56 to 1·03); in the subgroup of patients without previous stroke or TIA, the rate of stroke or systemic embolism was 1·01 per 100 patient-years of follow-up with apixaban and 1·23 with warfarin (HR 0·82, 95% CI 0·65 to 1·03; p for interaction=0·71). The absolute reduction in the rate of stroke and systemic embolism with apixaban versus warfarin was 0·77 per 100 patient-years of follow-up (95% CI -0·08 to 1·63) in patients with and 0·22 (-0·03 to 0·47) in those without previous stroke or TIA. The difference in major bleeding with apixaban compared with warfarin was 1·07 per 100 patient-years (95% CI 0·09-2·04) in patients with and 0·93 (0·54-1·32) in those without previous stroke or TIA. Interpretation: The effects of apixaban versus warfarin were consistent in patients with AF with and without previous stroke or TIA. Owing to the higher risk of these outcomes in patients with previous stroke or TIA, the absolute benefits of apixaban might be greater in this population. Funding: Bristol-Myers Squibb and Pfizer. © 2012 Elsevier Ltd

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation: The GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores &gt;2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores &gt;2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score &gt;2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores &gt;2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores &gt;2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007. © 2020 Hellenic Society of Cardiolog

Patterns of oral anticoagulant use and outcomes in Asian patients with atrial fibrillation: a post-hoc analysis from the GLORIA-AF Registry

Background: Previous studies suggested potential ethnic differences in the management and outcomes of atrial fibrillation (AF). We aim to analyse oral anticoagulant (OAC) prescription, discontinuation, and risk of adverse outcomes in Asian patients with AF, using data from a global prospective cohort study. Methods: From the GLORIA-AF Registry Phase II-III (November 2011-December 2014 for Phase II, and January 2014-December 2016 for Phase III), we analysed patients according to their self-reported ethnicity (Asian vs. non-Asian), as well as according to Asian subgroups (Chinese, Japanese, Korean and other Asian). Logistic regression was used to analyse OAC prescription, while the risk of OAC discontinuation and adverse outcomes were analysed through Cox-regression model. Our primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACE). The original studies were registered with ClinicalTrials.gov, NCT01468701, NCT01671007, and NCT01937377. Findings: 34,421 patients were included (70.0&nbsp;±&nbsp;10.5 years, 45.1% females, 6900 (20.0%) Asian: 3829 (55.5%) Chinese, 814 (11.8%) Japanese, 1964 (28.5%) Korean and 293 (4.2%) other Asian). Most of the Asian patients were recruited in Asia (n&nbsp;=&nbsp;6701, 97.1%), while non-Asian patients were mainly recruited in Europe (n&nbsp;=&nbsp;15,449, 56.1%) and North America (n&nbsp;=&nbsp;8378, 30.4%). Compared to non-Asian individuals, prescription of OAC and non-vitamin K antagonist oral anticoagulant (NOAC) was lower in Asian patients (Odds Ratio [OR] and 95% Confidence Intervals (CI): 0.23 [0.22-0.25] and 0.66 [0.61-0.71], respectively), but higher in the Japanese subgroup. Asian ethnicity was also associated with higher risk of OAC discontinuation (Hazard Ratio [HR] and [95% CI]: 1.79 [1.67-1.92]), and lower risk of the primary composite outcome (HR [95% CI]: 0.86 [0.76-0.96]). Among the exploratory secondary outcomes, Asian ethnicity was associated with higher risks of thromboembolism and intracranial haemorrhage, and lower risk of major bleeding. Interpretation: Our results showed that Asian patients with AF showed suboptimal thromboembolic risk management and a specific risk profile of adverse outcomes; these differences may also reflect differences in country-specific factors. Ensuring integrated and appropriate treatment of these patients is crucial to improve their prognosis. Funding: The GLORIA-AF Registry was funded by Boehringer Ingelheim GmbH