Project of on-board control system with air-task efficiency estimation subsystem based on fuzzy logic for unmanned combat aerial vehicle rockets

In this article, a project of on-board control system with fuzzy efficiency of air-task estimation subsystem for UCAV rockets is presented. Moreover, some features allowing the use of fuzzy logic subsystems in unmanned aviation will be described as well. Complexity of the project and some mathematical calculations required relevant assumptions which are also reported. Finally, prognosis about operation of the system and conclusions are provided. This article is an integral part of authors’ scientific research

Leczenie trombolityczne udaru mózgu poza europejską rejestracją dla alteplazy w Polsce

Background and purpose The European licence for alteplase excludes from thrombolysis large groups of acute stroke patients. The Polish licence was revised in 2010, but until then many patients could receive the treatment only off-label. Our aim was to evaluate the safety and effectiveness of intravenous alteplase in Polish patients not fully adhering to the original European drug licence compared to patients treated strictly on-label. Material and methods We analysed all patient data contributed to the Safe Implementation of Thrombolysis in Stroke registry from Polish centres between October 2003 and July 2009. Results Off-label thrombolysis was administered in 224/946 (23.7%) patients. The most frequent deviations were: use of intravenous antihypertensives (8.2%), age > 80 years (5.4%), time-to-treatment > 3 hours (4.5%), oral anticoagulation (4.2%), previous stroke with concomitant diabetes (2.1%), and previous stroke ≤ 3 months (1.5%). We found no differences in the ratio of symptomatic intracranial haemorrhage (sICH) according to SITS, ECASS and NINDS definitions. Adjusted odds for 3-month mortality were similar (OR 0.86, 95% CI: 0.51-2.41), excluding patients with previous stroke ≤ 3 months (OR 3.48, 95% CI: 0.96-12.7). Adjusted odds for death or dependency were slightly increased (OR 1.40, 95% CI: 0.92-2.13), especially in patients aged > 80 years (OR 2.80, 95% CI: 1.11-7.05), and with previous stroke ≤ 3 months (OR 4.07, 95% CI: 0.97-17.1). Conclusions Polish stroke patients receiving off-label thrombolysis tended to achieve a less favourable outcome, but they were not at increased risk of sICH or death. Considering the current Polish license for alteplase, it may be reasonable to additionally stratify the risk in patients aged > 80 years or with previous stroke ≤ 3 months.Wstęp i cel pracy Dostępność leczenia trombolitycznego w udarze niedokrwiennym mózgu jest ograniczona przez liczne przeciwwskazania zapisane w europejskiej rejestracji alteplazy. Polska charakterystyka produktu została uaktualniona w 2010 r., co znacząco rozszerzyło możliwości oficjalnego stosowania trombolizy. Celem badania była ocena bezpieczeñstwa i skuteczności alteplazy podawanej dożylnie w udarze mózgu poza oficjalnymi wskazaniami lub przeciwwskazaniami w porównaniu z leczeniem w pełnej zgodności z europejską rejestracją. Materiał i metody Analizie poddano wszystkie przypadki leczenia trombolitycznego w Polsce zgłoszone do rejestru Safe Implementation of Thrombolysis in Stroke od października 2003 r. do lipca 2009 r. Wyniki Leczenie trombolityczne poza wskazaniami lub przeciwwskazaniami rejestracyjnymi przeprowadzono u 224/946 (23,7%) chorych. Najczęstszymi odstępstwami były: stosowanie dożylnych leków przeciwnadciśnieniowych (8,2%), wiek powyżej 80 lat (5,4%), czas od zachorowania do leczenia > 3 godz. (4,5%), stosowanie doustnych antykoagulantów (4,2%), przebyty udar ze współistniejącą cukrzycą (2,1%), przebyty udar ≤ 3 miesięcy (1,5%). U pacjentów leczonych poza wskazaniami lub przeciwwskazaniami nie wykazano zwiększonej częstości występowania objawowego krwawienia wewnątrzczaszkowego (sICH) wg definicji SITS, ECASS i NINDS. Ryzyko zgonu w ciągu 3 miesięcy było porównywalne (OR 0,86; 95% CI: 0,51-2,41), z wyłączeniem podgrupy z przebytym udarem ≤ 3 miesięcy (OR 3,48; 95% CI: 0,96-12,7). Ryzyko zgonu lub niesprawności było nieznacznie zwiększone (OR 1,40; 95% CI: 0,92-2,13), zwłaszcza u chorych powyżej 80. roku życia (OR 2,80; 95% CI: 1,117,05) i po przebytym udarze mózgu ≤ 3 miesięcy (OR 4,07; 95% CI: 0,97-17,1). Wnioski Polscy pacjenci otrzymujący leczenie trombolityczne w udarze mózgu poza wskazaniami lub przeciwwskazaniami zapisanymi w europejskiej charakterystyce alteplazy uzyskują mniej korzystny efekt leczenia. Natomiast ryzyko sICH i zgonu jest porównywalne. W kontekście aktualnie obowiązujących zapisów rejestracyjnych zasadne wydaje się zindywidualizowane kwalifikowanie do leczenia chorych powyżej 80. roku życia lub z wywiadem udaru ≤ 3 miesięcy

The Place of 3D Printing in the Manufacturing and Operational Process Based on the Industry 4.0 Structure

The article presents the place of 3D printing in the manufacturing and operational process. It analyzes selected incremental technologies in the product life cycle. It describes selected processes for testing the properties of materials used in 3D printing, including accelerated aging tests and simulation of operating conditions. Areas of application of 3D printing were defined, starting from design and prototype development through manufacturing of technological tools and finally finished products. Design criteria of additivelymanufactured elements in relation to the exploitation process are discussed. A methodology for the development of 3D-CAD models of manufactured elements, software processing of data and data storage format for manufacturing products and spare parts is presented. The assumptions of repair procedures based on the production of spare parts by means of 3D printing in relation to data circulation compatible with the idea of Industry 4.0 structure have been adopted

Millimeter-Wave Transmitter with LTCC Antenna and Silicon Lens

Millimeter-wave (mm-wave) transmitters are often fabricated using advanced technology and require a sophisticated manufacturing facility. Access to such technologies is often very limited and difficult to gain particularly at the initial stage of research. Therefore, to increase the accessibility of mm-wave transmitters, this study proposes a design that can be assembled in a standard microwave laboratory from commercially available or externally ordered components. The transmitter demonstrated in this paper operates above 100 GHz and is based on a low-temperature co-fired ceramic board in which the antenna array, microstrip lines, and power-supply lines are fabricated in a single process. Different technologies are used to assemble the module, e.g., wire-bonding, soldering, and wax adhesion. Advantages and disadvantages of the proposed design are given based on experimental evaluation of the prototype. Although the performance of the developed transmitter is not as good as that of the similar modules available in the recent literature, the results confirm the feasibility of a mm-wave transmitter that is assembled without employing advanced technologies and superior machinery

Is there a bad time for intravenous thrombolysis? The experience of Polish stroke centers

Background and purpose The outcome in acute stroke strongly depends on patient-related issues, as well as on the availability of human and diagnostic resources. Our aim was to evaluate safety and effectiveness of intravenous alteplase for stroke according to the time of admission to the hospital. Materials and methods We analyzed the data of all acute stroke patients treated with alteplase between October 2003 and December 2010, contributed to the Safe Implementation of Thrombolysis for Stroke registry from 27 Polish stroke centers. According to the time of admission we distinguished between: (1) non-working days (Friday 14:30–Monday 08:00 plus national holidays); (2) out-of-office hours (non-working days plus 14:30–08:00 during working days); and (3) night hours (time from 23:00 to 06:00). Patients admitted during regular working hours (Monday 08:00–Friday 14:30, excluding national holidays) were used as the reference. Results Of 1330 patients, 448 (32.5%) were admitted on non-working days, 868 (65.3%) at out-of-office hours, and 105 (7.9%) during night hours. In multivariate logistic regression, none of the evaluated periods showed association with symptomatic intracranial hemorrhage, 7-day mortality, and neurological improvement ≥4 points in the National Institutes of Health Stroke Scale score at day 7. Patients admitted during night hours had lower odds (OR 0.53, 95% CI: 0.29–0.95, p=0.032) for achieving favorable outcome (modified Rankin Scale score 0–2). Conclusions There is no bad time for thrombolysis. Stroke centers should feel confident about the treatment outside regular working hours, irrespective of equipment and staff availability. However, it may be reasonable to pay additional attention during nighttime

Sex-related differences among ischaemic stroke patients treated with intravenous thrombolysis in Poland

Aim of study. We investigated sex differences i n i schaemic s troke p atients t reated w ith i ntravenous a lteplase. Clinical rationale for study. We suggest that it is necessary to improve care for women with atrial fibrillation. Our data suggests that closer evaluation of treatment for ischaemic stroke in men and women is needed, preferably in the form of a prospective study. Materials and methods. This was a multicentre analysis of 1,830 ischaemic stroke patients treated with alteplase from 2004 to 2012. Data was prospectively collected in the Safe Implementation of Treatments in Stroke (SITS) registry. The main outcome measures were symptomatic intracerebral haemorrhage (sICH) within 36 hours of treatment, three months of functional independence, and mortality. Results. Women were significantly older (mean age 71.3 vs 66.2 years; p < 0.01), more often suffered from hypertension (78.3% vs 70.1%; p < 0.01) and cardio-embolic strokes (34.7% vs 27.1%; p < 0.01), and presented heavier baseline deficits. There were no differences in sICH, but after three months fewer women were functionally independent (46.5% vs 53.3%; p < 0.01) and women had higher mortality (26.0% vs 19.7%; p < 0.01). Conclusions. Of the ischaemic stroke patients treated with intravenous thrombolysis, women had worse long-term outcomes than men. This discrepancy may be explained by the older age and higher proportion of cardio-embolic strokes with more severe baseline deficits. However, multiple logistic analysis did not show that sex itself had an impact on the greater mortality in women after a stroke, or on the poorer prognosis

Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland

Introduction. The Registry of Stroke Care Quality (RES-Q) is used in Poland for quality monitoring by numerous hospitals participating in the Angels Initiative. Our aim was to assess the degree of improvement in highly stroke-oriented centres that report cases to the RES-Q each year. Material and methods. This retrospective analysis included Polish stroke units that from January 2017 to December 2020 contributed to the RES-Q at least 25 patients annually. Results. Seventeen out of 180 Polish stroke units reported patients each year (2017, n = 1,691; 2018, n = 2,986; 2019, n = 3,750; 2020, n = 3,975). The percentage of ischaemic stroke patients treated with alteplase remained stable (26%, 29%, 30% and 28%, respectively). The door-to-needle time progressively decreased, from a median 49 minutes to 32 minutes. The percentage of patients treated ≤ 60 minutes and ≤ 45 minutes significantly increased (from 68% to 86% and from 43% to 70%, respectively), with no change observed between 2019 and 2020. Despite a general improvement in dysphagia screening (81%, 91%, 98% and 99%), screening performed within the first 24h from admission became less frequent (78%, 76%, 69% and 65%). In-hospital mortality significantly increased (11%, 11%, 13% and 15%), while the proportion of patients discharged home remained stable. Conclusions. Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic

Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience

Introduction. The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited.Materials and methods. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health.Results. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used.Conclusions and clinical implications. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs