Resilient Parameter-Invariant Control With Application to Vehicle Cruise Control

This work addresses the general problem of resilient control of unknown stochastic linear time-invariant (LTI) systems in the presence of sensor attacks. Motivated by a vehicle cruise control application, this work considers a first order system with multiple measurements, of which a bounded subset may be corrupted. A frequency-domain-designed resilient parameter-invariant controller is introduced that simultaneously minimizes the effect of corrupted sensors, while maintaining a desired closed-loop performance, invariant to unknown model parameters. Simulated results illustrate that the resilient parameter-invariant controller is capable of stabilizing unknown state disturbances and can perform state trajectory tracking

Current lifestyles in the context of future climate targets: analysis of long-term scenarios and consumer segments for residential and transport

The carbon emissions of individuals strongly depend on their lifestyle, both between and within regions. Therefore, lifestyle changes could have a significant potential for climate change mitigation. This potential is not fully explored in long-term scenarios, as the representation of behaviour change and consumer heterogeneity in these scenarios is limited. We explore the impact and feasibility of lifestyle and behaviour changes in achieving climate targets by analysing current per-capita emissions of transport and residential sectors for different regions and consumer segments within one of the regions, namely Japan. We compare these static snapshots to changes in per-capita emissions from consumption and technology changes in long-term mitigation scenarios. The analysis shows less need for reliance on technological solutions if consumption patterns become more sustainable. Furthermore, a large share of Japanese consumers is characterised by consumption patterns consistent with those in scenarios that achieve ambitious climate targets, especially regarding transport. The varied lifestyles highlight the importance of representing consumer heterogeneity in models and further analyses

Antithrombotic therapy in patients undergoing TAVI: an overview of Dutch hospitals

To assess current antithrombotic treatment strategies in the Netherlands in patients undergoing transcatheter aortic valve implantation (TAVI). For every Dutch hospital performing TAVI (n = 14) an interventional cardiologist experienced in performing TAVI was interviewed concerning heparin, aspirin, thienopyridine and oral anticoagulation treatment in patients undergoing TAVI. The response rate was 100 %. In every centre, a protocol for antithrombotic treatment after TAVI was available. Aspirin was prescribed in all centres, concomitant clopidogrel was prescribed 13 of the 14 centres. Duration of concomitant clopidogrel was 3 months in over two-thirds of cases. In 2 centres, duration of concomitant clopidogrel was based upon type of prosthesis: 6 months versus 3 months for supra-annular and intra-annular prostheses, respectively. Leaning on a small basis of evidence and recommendations, the antithrombotic policy for patients undergoing TAVI is highly variable in the Netherlands. As a standardised regimen might further reduce haemorrhagic complications, large randomised clinical trials may help to establish the most appropriate approac

Bivalirudin started during emergency transport for primary PCI.

BACKGROUND: Bivalirudin, as compared with heparin and glycoprotein IIb/IIIa inhibitors, has been shown to reduce rates of bleeding and death in patients undergoing primary percutaneous coronary intervention (PCI). Whether these benefits persist in contemporary practice characterized by prehospital initiation of treatment, optional use of glycoprotein IIb/IIIa inhibitors and novel P2Y12 inhibitors, and radial-artery PCI access use is unknown. METHODS: We randomly assigned 2218 patients with ST-segment elevation myocardial infarction (STEMI) who were being transported for primary PCI to receive either bivalirudin or unfractionated or low-molecular-weight heparin with optional glycoprotein IIb/IIIa inhibitors (control group). The primary outcome at 30 days was a composite of death or major bleeding not associated with coronary-artery bypass grafting (CABG), and the principal secondary outcome was a composite of death, reinfarction, or non-CABG major bleeding. RESULTS: Bivalirudin, as compared with the control intervention, reduced the risk of the primary outcome (5.1% vs. 8.5%; relative risk, 0.60; 95% confidence interval [CI], 0.43 to 0.82; P=0.001) and the principal secondary outcome (6.6% vs. 9.2%; relative risk, 0.72; 95% CI, 0.54 to 0.96; P=0.02). Bivalirudin also reduced the risk of major bleeding (2.6% vs. 6.0%; relative risk, 0.43; 95% CI, 0.28 to 0.66; P<0.001). The risk of acute stent thrombosis was higher with bivalirudin (1.1% vs. 0.2%; relative risk, 6.11; 95% CI, 1.37 to 27.24; P=0.007). There was no significant difference in rates of death (2.9% vs. 3.1%) or reinfarction (1.7% vs. 0.9%). Results were consistent across subgroups of patients. CONCLUSIONS: Bivalirudin, started during transport for primary PCI, improved 30-day clinical outcomes with a reduction in major bleeding but with an increase in acute stent thrombosis. (Funded by the Medicines Company; EUROMAX ClinicalTrials.gov number, NCT01087723.)

Decomposition analysis of per capita emissions : a tool for assessing consumption changes and technology changes within scenarios

Recent studies show that behaviour changes can provide an essential contribution to achieving the Paris climate targets. Existing climate change mitigation scenarios primarily focus on technological change and underrepresent the possible contribution of behaviour change. This paper presents and applies a methodology to decompose the factors contributing to changes in per capita emissions in scenarios. With this approach, we determine the relative contribution to total emissions from changes in activity, the way activities are carried out, the intensity of activities, as well as fuel choice. The decomposition tool breaks down per capita emissions loosely following the Kaya Identity, allowing a comparison between the contributions of technology and consumption changes among regions and between various scenarios. We illustrate the use of the tool by applying it to three previously-published scenarios; a baseline scenario, a scenario with a selection of behaviour changes, and a 2 degrees C scenario with the same selection of behaviour changes. Within these scenarios, we explore the contribution of technology and consumption changes to total emission changes in the transport and residential sector, for a selection of both developed and developing regions. In doing so, the tool helps identify where specifically (i.e. via consumption or technology factors) different measures play a role in mitigating emissions and expose opportunities for improved representation of behaviour changes in integrated assessment models. This research shows the value of the decomposition tool and how the approach could be flexibly replicated for different global models based on available variables and aims. The application of the tool to previously-published scenarios shows substantial differences in consumption and technology changes from CO2 price and behaviour changes, in transport and residential per capita emissions and between developing and developed regions. Furthermore, the tool's application can highlight opportunities for future scenario development of a more nuanced and heterogeneous representation of behaviour and lifestyle changes in global models.Peer reviewe

Loss of Endothelial Glycocalyx During Normothermic Machine Perfusion of Porcine Kidneys Irrespective of Pressure and Hematocrit

BACKGROUND: Normothermic machine perfusion (NMP) is a promising modality for marginal donor kidneys. However, little is known about the effects of NMP on causing endothelial glycocalyx (eGC) injury. This study aims to evaluate the effects of NMP on eGC injury in marginal donor kidneys and whether this is affected by perfusion pressures and hematocrits.METHODS: Porcine slaughterhouse kidneys (n = 6/group) underwent 35 min of warm ischemia. Thereafter, the kidneys were preserved with oxygenated hypothermic machine perfusion for 3 h. Subsequently, 4 h of NMP was applied using pressure-controlled perfusion with an autologous blood-based solution containing either 12%, 24%, or 36% hematocrit. Pressures of 55, 75, and 95 mm Hg were applied in the 24% group. Perfusate, urine, and biopsy samples were collected to determine both injury and functional parameters.RESULTS: During NMP, hyaluronan levels in the perfusate increased significantly ( P &lt; 0.0001). In addition, the positivity of glyco-stained glycocalyx decreased significantly over time, both in the glomeruli ( P = 0.024) and peritubular capillaries ( P = 0.003). The number of endothelial cells did not change during NMP ( P = 0.157), whereas glomerular endothelial expression of vascular endothelial growth factor receptor-2 decreased significantly ( P &lt; 0.001). Microthrombi formation was significantly increased after NMP. The use of different pressures and hematocrits did not affect functional parameters during perfusion. CONCLUSIONS: NMP is accompanied with eGC and vascular endothelial growth factor receptor-2 loss, without significant loss of endothelial cells. eGC loss was not affected by the different pressures and hematocrits used. It remains unclear whether endothelial injury during NMP has harmful consequences for the transplanted kidney.</p

Antithrombotic therapy in patients undergoing TAVI: An overview of Dutch hospitals

Purpose To assess current antithrombotic treatment strategies in the Netherlands in patients undergoing transcatheter aortic valve implantation (TAVI). Methods For every Dutch hospital performing TAVI (n =14) an interventional cardiologist experienced in performing TAVI was interviewed concerning heparin, aspirin, thienopyridine and oral anticoagulation treatment in patients undergoing TAVI. Results The response rate was 100 %. In every centre, a protocol for antithrombotic treatment after TAVI was available. Aspirin was prescribed in all centres, concomitant clopidogrel was prescribed 13 of the 14 centres. Duration of concomitant clopidogrel was 3 months in over twothirds of cases. In 2 centres, duration of concomitant clopidogrel was based upon type of prosthesis: 6 months versus 3 months for supra-annular and intra-annular prostheses, respectively. Conclusions Leaning on a small basis of evidence and recommendations, the antithrombotic policy for patients undergoing TAVI is highly variable in the Netherlands. As a standardised regimen might further reduce haemorrhagic complications, large randomised clinical trials may help to establish the most appropriate approach

Multidrug-Resistant Tuberculosis, People’s Republic of China, 2007–2009

Early detection, effective treatment, and infection control measures are needed to reduce transmission