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Background: Cardiac stress tests for diagnosis of coronary artery disease (CAD) are incompletely sensitive and specific.Objective: We examined the frequency of significant CAD in patients presenting to the emergency department (ED) with chest pain who have had a recent negative or inconclusive (

Background: The prevalence of cancer patients with concomitant cardiovascular (CV) disease is on the rise due to improved cancer prognoses. The aim of this study is to evaluate the long‐term outcomes of cancer patients referred to a cardiology department (CD) via primary care using e‐consultation. Methods: We analysed data from cancer patients with prior referrals to a CD between 2010 and 2021 (n = 6889) and compared two care models: traditional in‐person consultations and e‐consultations. In e‐consultation model, cardiologists reviewed electronic health records (e‐consultation) to determine whether the demand could be addressed remotely or necessitated an in‐person consultation. We used an interrupted time series regression model to assess outcomes during the two periods: (1) time to cardiology consultation, (2) rates of all‐cause and CV related hospital admissions and (3) rates of all‐cause and CV‐related mortality within the first year after the initial consultation or e‐consultation at the CD. Results: Introduction of e‐consultation for cancer patients referred to cardiology care led to a 51.8% reduction (95%CI: 51.7%–51.9%) in waiting times. Furthermore, we observed decreased 1‐year incidence rates, with incidence rate ratios (iRRs) [IC95%] of.75 [.73–.77] for CV‐related hospitalizations,.43 [.42–.44] for all‐cause hospitalizations, and.87 [.86–.88] for all‐cause mortality. Conclusions: Compared to traditional in‐person consultations, an outpatient care program incorporating e‐consultation for cancer patients significantly reduced waiting times for cardiology care and demonstrated safety, associated with lower rates of hospital admissions. [ABSTRACT FROM AUTHOR]

This paper presents a study of a robust control strategy based on the Attractive Ellipsoid Method (AEM) to achieve trajectory tracking for a Permanent Magnet Synchronous Generator (PMSG). For the PMSG system, trajectory tracking control is necessary such that the maximum power point tracking can be carried out, which depends on controlling time-varying references (the generator angular speed), mainly when the generator motion is originated from a variable and intermittent energy source such as the wind. The proposed controller is based on the selection of the best gain matrix by numerically employing the AEM with the bilinear matrix inequality technique application. The controller guarantees that the trajectory tracking error reaches an ellipsoid of small enough size, which is determined in an optimized way, such that the practical stability for the tracking error is ensured. The effectiveness of the proposed controller is verified via simulations for a PMSG coupled with a three-phase rectifier, where the variables to be controlled reach the desired time-varying references, additionally a comparison is made against a classical Proportional Integral (PI) control scheme and a state feedback LQR controller. [ABSTRACT FROM AUTHOR]

Aims: To assess the longer‐term results (hospital admissions and mortality) in women versus men referred to a cardiology department from primary care using an e‐consultation in our outpatient care programme. Methods: We selected 61,306 patients (30,312 women and 30,994 men) who visited the cardiology service at least once between 2010 and 2021: 69.1% (19,997 women and 20,462 men) were attended in e‐consultation (from 2013 to 2021) and 30.9% (8920 women and 9136 men) in in‐person consultations (from 2010 to 2012) without gender differences in the proportion of patients attended in each period. Using an interrupted time series regression model, we analysed the impact of incorporating e‐consultation into the healthcare model and evaluated the elapsed time to cardiology care, heart failure (HF), cardiovascular (CV), and all‐cause hospital admissions and mortality during the one‐year after cardiology consultation. Results: The introduction of e‐consultation substantially decreased waiting times to cardiology care; during the in‐person consultation period, the mean delay for cardiology care was 57.9 (24.8) days in men and 55.8 (22.8) days in women. During the e‐consultation period, the waiting time to cardiology care was markedly reduced to 9.41 (4.02) days in men and 9.46 (4.18) in women. After e‐consultation implantation, there was a significant reduction in the 1‐year rate of hospital admissions and mortality, both in women and men iRR [IC 95%]: 0.95 [0.93–0.96] for HF, 0.90 [0.89–0.91] for CV and 0.70 [0.69–0.71] for all‐cause hospitalization; and 0.93 [0.92–0.95] for HF, 0.86 [0.86–0.87] for CV and 0.88 [0.87–0.89] for all‐cause mortality in women; and 0.91 [0.89–0.92] for HF, 0.90 [0.89–0.91] for CV and 0.72 [0.71–0.73] for all‐cause hospitalization; and 0.96 [0.93–0.97] for HF, 0.87 [95% CI: 0.86–0.87] for CV and 0.87 [0.86–0.87] for all‐cause mortality, in men. Conclusion: Compared with the in‐person consultation period, an outpatient care programme that includes an e‐consultation significantly reduced waiting time to cardiology care and was safe, with a lower rate of hospital admissions and mortality in the first year, without significative gender differences. [ABSTRACT FROM AUTHOR]

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This paper proposes the study of a robust control scheme for an Unmanned Surface Vehicle (USV) in a urban waterway using Visual Odometry (VO) for position estimation of the vehicle instead of traditional sensors. For different applications, a USV is required to operate in autonomous navigation mode and under various disturbances inherent to its environment as currents and waves. To achieve efficient operation, a robust control scheme is required to cope with such disturbances. The autonomous navigation is achieved by using VO to estimate the vehicle's position for denied Global Positioning Systems (GPS) environments. A robust control scheme based on Sliding Modes (SM) control theory is designed and its convergence is guaranteed by means of Lyapunov analysis. The tracking capabilities under disturbance conditions using VO for position estimation are verified in simulation using the virtual world tool from Matlab and Simulink. [ABSTRACT FROM AUTHOR]

Background: An early diagnosis and early initiation of oral anticoagulants (OAC) are main determinants for outcomes in patients with atrial fibrillation (AF). Inter‐clinician electronic consultations (e‐consultations) program for the general practitioner referrals to cardiologist may improve health care access by reducing the elapsed time for cardiology care. Objective: To evaluate the effect of a reduced elapsed time to care after a inter‐clinician e‐consultations program implementation (2013–2019) in comparison with previous in‐person consultation (2010–2012) in the outpatient health care management in a Cardiology Department. Methodology: We included 10,488 patients with AF from 1 January 2010, to 31 December 2019. Until 2012, all patients attended an in‐person consultation (2010–2012). In 2013, we instituted an e‐consult program (2013–2019) for all primary care referrals to cardiologists that preceded patient's in‐person consultation when considered. The shared electronic patient dossier (EPD) was available between GP and cardiologist, and any change in therapy advice from cardiologist was directly implemented in this EPD. Results: During the e‐consultation period (2013–2019) were referred 6627 patients by GPs to cardiology versus 3861 during the in‐person consultation (2010–2012). The e‐consultation implementation was associated with a reduction in the elapsed time to anticoagulation prescription (177.6 ± 8.9 vs. 22.5 ± 8.1 days, p <.001), and an increase of OAC use (61% [95% IC: 19.6%–102.4%], p <.001). The e‐consult program implementation was associated with a reduction in the 1‐year CV mortality (.48 [95% CI:.30–.75]) and all‐cause mortality (.42 [95% CI:.29–.62]). The OAC reduces the stroke mortality (.15 [95% CI:.06–.39]) and CV mortality (.43 [95% CI:.29–.62]) and all‐cause mortality (.23 [95% CI:.17–.31]). Conclusion: A shared EPD‐based inter‐clinician e‐consultation program significantly reduced the elapsed time for cardiology consultation and initiation of OAC. The implementation of this program was associated with a lower risk of stroke and cardiovascular/all‐cause mortality. [ABSTRACT FROM AUTHOR]

Aims: e‐consults are asynchronous, clinician‐to‐clinician exchanges that answer focused, non‐urgent, patient‐specific questions using the electronic medical record. We instituted an e‐consultation programme (2013–2019) for all general practitioners (GPs) referrals to cardiologists that preceded patients' in‐person consultations when considered. In our study, we aimed to analyse the clinical characteristics, 1 year prognosis and the prognostic determinants of patients with a previous diagnosis of HF referred for an e‐consult, categorized by their previous HF‐related hospitalization status (recent hospitalization, <1 year before; remote hospitalization, >1 year before or never been hospitalized because of HF), and to analyse the impact of reducing the time elapsed between e‐consultation and response by the cardiologist in terms of prognosis. Methods and results: Epidemiological and clinical data were obtained from 4851 HF patients referred by GPs to the cardiology department for an e‐consultation 2013 and 2020. The delay of time to e‐consults were solved was 8.6 + 8.6 days with 84.3% solved in <14 days. For the 1 year prognosis evaluation after the e‐consult were assessed the cardiovascular hospitalizations, HF‐related hospitalizations, HF‐related mortality, cardiovascular mortality, and all‐cause mortality. Compared with the group without a previous hospitalization, patients with recent and remote HF hospitalization were at higher risk of a new HF‐related hospitalization (OR: 19.41 [95% CI: 12.95–29.11]; OR: 8.44 [95% CI: 5.14–13.87], respectively), HF‐related mortality (OR: 2.47 [95% CI: 1.43–4.27]; OR: 1.25 [95% CI: 0.51–3.06], respectively), as well as cardiovascular hospitalizations and mortality and all‐cause mortality. Reduction in the time elapsed because e‐consultation was solved was associated with lower risk of HF‐related mortality (OR: 0.94 [95% CI: 0.89–0.99]), cardiovascular mortality (OR: 0.96 [95% CI: 0.93–0.98]), and all‐cause mortality (OR: 0.98 [95% CI: 0.97–1.00]). Conclusions: A clinician‐to‐clinician e‐consultation programme between GPs and cardiologists in patients with HF allows to solve the demand of care in around 25% e‐consults without an in‐person consultation; the patients with a previous history of HF‐related hospitalization showed a worse 1 year outcome. A reduction in the time elapsed because e‐consultation was solved was associated with a mortality reduction. [ABSTRACT FROM AUTHOR]

A study of DVB-T (Digital Video Broadcasting-Terrestrial) signal variability for indoor reception environments is stated in this paper. A commercial signal was measured and analyzed in order to obtain C/N threshold values that account time and space fluctuations. In this way, results increase the accuracy of the values provided by the ETSI (European Telecommunications Standards Institute) standard and other studies that assume static propagation channels. On the other hand, the fading influence due to people walking near the reception antenna has been proved as critical for correct reception. Characterization of this effect has been made in terms of its depth and duration. The results obtained results improve DVB-T network planning and could be also relevant for other technologies sharing similar frequencies and bandwidths. Index Terms--BER before Reed Solomon, C/N thresholds, channel propagation, DVB-T indoor portable reception, [ESR.sub.5], space variability, time variability.

The Lee method, which was recommended by the International Telecommunications Union (ITU) and the European Conference of Postal and Telecommunications Administrations (CEPT) to obtain the local mean values of the received signal along a route, was developed for a Rayleigh distribution in the ultrahigh-frequency (UHF) band. This paper describes the generalization of this method to any propagation channel and frequency band and describes the methodology to obtain the parameters involved. The Generalized Lee Method is based on field data samples, which allows estimating the mean values without the requirement of a priori knowing the distribution function that better fits the propagation channel. The accuracy in obtaining the averaging interval is also improved. The Generalized Lee Method is solved for ground-wave propagation at the medium-wave (MW) band, taking data from field trials of a Digital Radio Mondiale (DRM) transmission. The results show that the values considerably differ from those obtained for a Rayleigh channel and prove that the method allows the adequate differentiation of long-term and short-term signals. The Generalized Lee Method completes the results obtained by Lee and Parsons and makes better characterization of the spatial variability possible. Index Terms--Channel estimation, coverage prediction techniques, propagation models, signal variability.

Cardiovascular disease (CVD) is the leading cause of death in the world. In 2019, 550 million people were suffering from CVD and 18 million of them died as a result. Most of them had associated risk factors such as high fasting glucose, which caused 134 million deaths, and obesity, which accounted for 5.02 million deaths. Diabesity, a combination of type 2 diabetes and obesity, contributes to cardiac, metabolic, inflammation and neurohumoral changes that determine cardiac dysfunction (diabesity-related cardiomyopathy). Epicardial adipose tissue (EAT) is distributed around the myocardium, promoting myocardial inflammation and fibrosis, and is associated with an increased risk of heart failure, particularly with preserved systolic function, atrial fibrillation and coronary atherosclerosis. In fact, several hypoglycaemic drugs have demonstrated a volume reduction of EAT and effects on its metabolic and inflammation profile. However, it is necessary to improve knowledge of the diabesity pathophysiologic mechanisms involved in the development and progression of cardiovascular diseases for comprehensive patient management including drugs to optimize glucometabolic control. This review presents the mechanisms of diabesity associated with cardiovascular disease and their therapeutic implications. [ABSTRACT FROM AUTHOR]

This article reviews the basis and the main aspects of the recent evolution of Broadband Power Line Communications (BB-PLC or, more commonly, BPL) technologies. The article starts describing the organizations and alliances involved in the development and evolution of BPL systems, as well as the standardization institutions working on PLC technologies. Then, a short description of the technical foundation of the recent proposed technologies and a comparison of the main specifications are presented; the regulatory activities related to the limits of emissions and immunity are also addressed. Finally, some representative applications of BPL and some selected use cases enabled by these technologies are summarized, together with the main challenges to be faced. [ABSTRACT FROM AUTHOR]

Photovoltaic (PV) systems are among the most used alternatives for electrical power generation from renewable sources. To ensure that PV systems make the most of the available solar energy, maximum power point tracking (MPPT) schemes must be implemented, which usually require voltage and current sensors to track the PV power. This paper presents the design of a robust observer using the Attractive Ellipsoid Method to achieve a precise estimation of PV current under parametric uncertainty and output perturbations. The application of such an observer enables the PV generation system to operate in a current sensorless mode, which reduces the overall cost of the system and enhances its reliability. The convergence of the observer is guaranteed by solving an optimization problem which generates the optimal gains using Linear Matrix Inequalities (LMI). To prove the effectiveness of the proposed sensorless scheme, simulations are performed in Matlab under test profiles based on the EN50530 standard and parameter uncertainty conditions, obtaining an accurate estimation which is used for MPPT operation. [ABSTRACT FROM AUTHOR]

This paper presents the results obtained from the first extensive field trials of Medium Wave DRM (Digital Radio Mondiale) simulcast, which were carried out in Mexico D.F.. The transmitted signal was composed of a 10 kHz bandwidth AM part at 1060 kHz and an adjacent 10 kHz bandwidth DRM part at 1070 kHz broadcasting the same audio contents and with a theoretically calculated back-off ratio of 16 dB at transmission. The results in this paper will be accompanied by a thorough description of the transmission network set up and also with the measurement system and measurement techniques. The data processing techniques are also included to give a meaningful interpretation of the final results. The conclusions of this work have focused on threshold values for AM and DRM correct reception, simulcast time variability, mutual analogue--digital SNR degradation and reception impairment analysis. The overall result of this work is a high reliability of the AM and DRM services in the difficult Medium Wave reception environments of Mexico D.F. Index Terms--AM, DRM, field trials, medium wave, simuleast and static reception.

This paper presents an up to date study on external noise levels in the medium wave band based on field trials carried out in Spain and Mexico during years 2004 and 2005 respectively. External noise levels predicted by the ITU-R P.372 recommendation are based on measurements carried out more than 30 years ago and no updated results for the medium wave band have been published in this time. An increment on these noise levels have been measured, which leads to a significant impact on the minimum usable field strength requirements for the broadcasting systems used in this frequency band, such as the new Digital Radio Mondiale (DRM) and In-Band/On-Channel (IBOC) systems. Index Terms--Field trials, medium wave band, noise, noise measurement.

Millington's field strength prediction method is analyzed under different simulation conditions on the basis of the results of a medium waveband (MW or medium wave band extends from 530 to 1600 kHz) digital radio mondiale (DRM) measurement campaign. Millington technique applies the reciprocity condition by simply averaging the forward and reverse field strength values. This simplified approach could be a source of field strength prediction error in the MW planning tools. Critical path features for the fulfillment of the reciprocity condition are identified and their influence on predicted values is stated. Reciprocity effect on the predictions error is evaluated by means of the difference between digital medium wave field strength measured values of certain critical selected paths, and the corresponding Millington's method predicted ones. It has been found that the prediction error can be as high as 15 dB when comparing Millington's method results and measurements but the simple reciprocity approach made by Millington procedure is not the most remarkable source of error. Index Terms--Digital radio mondiale (DRM), field strength prediction, ground wave, medium wave, Millington's method.

Traditional imaging with one-photon confocal microscopy and organic fluorophores poses several challenges for the visualization of vascular tissue, including autofluorescence, fluorophore crosstalk, and photobleaching. We studied human coronary arteries (HCAs) and mouse aortas with a modified immunohistochemical (IHC) 'en face' method using quantum dot (Qdot) bioconjugates and two-photon excitation laser scanning microscopy (TPELSM). We demonstrated the feasibility of multilabeling intimal structures by exciting multicolored Qdots with only one laser wavelength (750 nm). Detailed cell structures, such as the granular appearance of von Willebrand factor (VWF) and the subcellular distribution of endothelial nitric oxide synthase, were visualized using green dots (525 nm), even when the emission maximum of these Qdots overlapped that of tissue autofluorescence (510-520 nm). In addition, sensitive fluorescence quantification of vascular cell adhesion molecule 1 expression at areas of varying hemodynamics (intercostal branches vs. nonbranching areas) was performed in normal C57B1/6 mice. Finally, we took advantage of the photostability of Qdots and the inherent three-dimensional (3D) resolution of TPELSM to obtain large z-stack series without photobleaching. This innovative en face method allowed simple multicolor profiling, highly sensitive fluorescence quantitation, and 3D visualization of the vascular endothelium with excellent spatial resolution. This is a promising technique to define the spatial and temporal interactions of endothelial inflammatory markers and quantify the effects of different interventions on the endothelium. semiconductor nanocrystals; multiphoton microscopy; atherosclerosis; shear stress; vascular cell adhesion molecule 1

An electrostatic potential-based methodology is presented to study the nature of Lewis acid sites on molybdenum and ruthenium sulfides. The results obtained suggest that the presence of Lewis acid sites on the MoS2 particles can be the more energetically favorable sites on the S edges with 50% sulfur coverage.