A Fuzzy-Kalman filtering strategy for state estimation

This thesis considers the combination of Fuzzy logic and Kalman Filtering that have traditionally been considered to be radically different. The former is considered heuristic and the latter statistical. In this thesis a philosophical justification for their combination is presented. Kalman Filtering is revised to enable the incorporation of fuzzy logic in its formulation. This formulation is subsequently referred to as the Revised-Kalman Filter. Heuristic membership functions are then used in the Revised-Kalman Filter to substitute for the system and measurement covariance matrices to form a fuzzy rendition of the Kalman Filter. The Fuzzy Kalman Filter formulation is further revised according to a concept referred to as the “Parallel Distributed Compensation” to allow for further heuristic adjustment of the corrective gain. This formulation is referred to as the Parallel Distributed Compensated-Fuzzy Kalman Filter. Simulated implementations of the above filters reveal that a tuned Kalman Filter provides the best performance. However, if conditions change, the Kalman filter’s performance degrades and a better performance is obtained from the two versions of the Fuzzy Kalman Filters

Two-timed Strategy for Self-identification

Self-identification is studied to identify a being itself including versatile identities of a being. A being is considered to be combination of spatio and temporal identities. Self-identification does not need an outer observer but requires no time flows. Therefore, a concept of a dream is introduced to realize self-identification in time flows. Dream is defined by two-timed flows, which are depicted by opposite moving directions in time flows. The Aristotelian paradigm asserts that the future decides the past which includes candidate beings with probability and allows an instant temporal observation. Thus, the Aristotelian paradigm is adopted to allow a temporal observer who can travel backward in time flows. Accordingly, two-timed flows are brought into the Aristotelian paradigm to let opposite moving directions in time flows and self-identification is realizable in time flows

Two-timed: self-identification strategy

The essay offers an original view on the issues of identity and self-identification. Self-identification is being studied in the process of its implementation in different time flows. Two directions of thought (to the past and the future) which are defined according to Hameroff»s hypothesis as the bi-directional time flows, constitute the concept of a dream. Using this concept, the author explains how self-identification is realized in two time flows. The strategy of self-identification is explained using a stochastic algorithm which balances the present and the future states at the same stage. The Kalman filter is used as the stochastic algorithm

Two-timed Strategy for Self-identification

Self-identification strategy is presented so that a being identify itself wherein a subject is not an outer observer. A being is able to observe as a subject and be observed as an object. Thus, self-identification could be realized because a being acts to observe and be observed. A being is supposed to consist of spatio and temporal identities. They are considered to provide a basis of respective a spatio object to be observed and a temporal subject to observe. Two thought experiments are presented for self-identification. In the first place, self-identification is explained by using the Out-of-Boddy experiences in no time flows. Secondly, a dream in a dream is provided to reveal a self-identification strategy in time flows. For this, dream is described by bi-directional movements in time flows. A teleological philosophy from the Aristotelian paradigm insists that the future decides the past which is thought to be the source of potentiality. Accordingly, the Aristotelian paradigm is modified to include the concept of a dream between the future and the past so that the reason why versatile a priori being such as Schrödinger's cat is created is explained and how they are distinguished among ontological potentiality by a teleological causation

Lactate normalization within 6 hours of bundle therapy and 24 hours of delayed achievement were associated with 28-day mortality in septic shock patients

This study evaluated the prognostic ability of lactate normalization achieved within 6 and 24 h from septic shock recognition. Data from a septic shock registry from October 2015 to February 2017 were reviewed. The study included 2,102 eligible septic shock patients to analyze the prognostic ability of lactate normalization, defined as a follow-up lactate level <2 mmol/L within six hours of bundle therapy and within 24 hours of delayed normalization. The primary outcome was 28-day mortality. The overall 28-day mortality rate was 21.4%. The rates of lactate normalization within 6 and 24 h were significantly higher in the survivor groups than in the non-survivor group (42.4% vs. 23.4% and 60.2% vs. 31.2%; P<0.001, respectively). Multivariate logistic regression analysis showed that both 6-and 24-h lactate normalization were independent predictors (odds ratio [ OR] 0.58, 95% confidence interval [ CI] 0.45-0.75, p<0.001 and OR 0.42, 95% CI 0.33-0.54, p<0.001, respectively). When we could not achieve the lactate normalization, the sensitivity, specificity, positive, and negative predictive value to predict mortality were 76.6%, 42.4%, 26.5% and 87.0% respectively for 6-h normalization, and 68.8%, 60.2%, 32.0% and 87.7% respectively for 24-h normalization. Besides 6-h lactate normalization, 24-h delayed lactate normalization was associated with decreasing mortality in septic shock patients. Lactate normalization may have a role in early risk stratification and as a therapeutic target.Y

Clinical Factors Associated with Obstructive Coronary Artery Disease in Patients with Out-of-Hospital Cardiac Arrest: Data from the Korean Cardiac Arrest Research Consortium (KoCARC) Registry

Background: Although coronary artery disease (CAD) is a major cause of out-of-hospital cardiac arrest (OHCA), there has been no convinced data on the necessity of routine invasive coronary angiography (ICA) in OHCA. We investigated clinical factors associated with obstructive CAD in OHCA. Methods: Data from 516 OHCA patients (mean age 58 years, 83% men) who underwent ICA after resuscitation was obtained from a nation-wide OHCA registry. Obstructive CAD was defined as the lesions with diameter stenosis >= 50% on ICA. Independent clinical predictors for obstructive CAD were evaluated using multiple logistic regression analysis, and their prediction performance was compared using area under the receiver operating characteristic curve with 10,000 repeated random permutations. Results: Among study patients, 254 (49%) had obstructive CAD. Those with obstructive CAD were older (61 vs. 55 years, P < 0.001) and had higher prevalence of hypertension (54% vs. 36%, P < 0.001), diabetes mellitus (29% vs. 21%, P = 0.032), positive cardiac enzyme (84% vs. 74%, P = 0.010) and initial shockable rhythm (70% vs. 61%, P = 0.033). In multiple logistic regression analysis, old age (>= 60 years) (odds ratio [On 2.01; 95% confidence interval [CI], 1.36-3.00; P = 0.001), hypertension (OR, 1.74; 95% CI, 1.18-2.57; P = 0.005), positive cardiac enzyme (OR, 1.72; 95% CI, 1.09-2.70; P = 0.019), and initial shockable rhythm (OR, 1.71; 95% CI, 1.16-2.54; P = 0.007) were associated with obstructive CAD. Prediction ability for obstructive CAD increased proportionally when these 4 factors were sequentially combined (P < 0.001). Conclusion: In patients with OHCA, those with old age, hypertension, positive cardiac enzyme and initial shockable rhythm were associated with obstructive CAD. Early ICA should be considered in these patients.Y