Fuzzy Control of Pressure in a Water Supply Network Based on Neural Network System Modeling and IoT Measurements.

As hydroenergetic losses are inherent to water supply systems, they are a frequent issue which water utilities deal with every day. The control of network pressure is essential to reducing these losses, providing a quality supply to consumers, saving electricity and preserving piping from excess pressure. However, to obtain these benefits, it is necessary to overcome some difficulties such as sensing the pressure of geographically distant consumer units and developing a control logic that is capable of making use of the data from these sensors and, at the same time, a good solution in terms of cost benefit. Therefore, this work has the purpose of developing a pressure monitoring and control system for water supply networks, using the ESP8266 microcontroller to collect data from pressure sensors for the integrated ScadaLTS supervisory system via the REST API. The modeling of the plant was developed using artificial neural networks together with fuzzy pressure control, both designed using the Python language. The proposed method was tested by considering a pumping station and two reference units located in the city of João Pessoa, Brazil, in which there was an excess of pressure in the supply network and low performance from the old controls, during the night period from 12:00 a.m. to 6:00 a.m. The field results estimated 2.9% energy saving in relation to the previous form of control and a guarantee that the pressure in the network was at a healthy level.

Risk Factors and Protective Factors against Ventilator-Associated Pneumonia-A Single-Center Mixed Prospective and Retrospective Cohort Study.

Introduction: Understanding the factors associated with the development of ventilator-associated pneumonia (VAP) in critically ill patients in the intensive care unit (ICU) will allow for better prevention and control of VAP. The aim of the study was to evaluate the incidence of VAP, as well as to determine risk factors and protective factors against VAP. Design: Mixed prospective and retrospective cohort study. Methods: The cohort involved 371 critically ill patients who received standard interventions to prevent VAP. Additionally, patients in the prospective cohort were provided with continuous automatic pressure control in tapered cuffs of endotracheal or tracheostomy tubes and continuous automatic subglottic secretion suction. Logistic regression was used to assess factors affecting VAP. Results: 52 (14%) patients developed VAP, and the incidence density of VAP per 1000 ventilator days was 9.7. The median days to onset of VAP was 7 [4; 13]. Early and late onset VAP was 6.2% and 7.8%, respectively. According to multivariable logistic regression analysis, tracheotomy (OR = 1.6; CI 95%: 1.1 to 2.31), multidrug-resistant bacteria isolated in the culture of lower respiratory secretions (OR = 2.73; Cl 95%: 1.83 to 4.07) and ICU length of stay >5 days (OR = 3.32; Cl 95%: 1.53 to 7.19) were positively correlated with VAP, while continuous control of cuff pressure and subglottic secretion suction used together were negatively correlated with VAP (OR = 0.61; Cl 95%: 0.43 to 0.87). Conclusions: Tracheotomy, multidrug-resistant bacteria, and ICU length of stay >5 days were independent risk factors of VAP, whereas continuous control of cuff pressure and subglottic secretion suction used together were protective factors against VAP.

Automatic Continuous Control of Cuff Pressure and Subglottic Secretion Suction Used Together to Prevent Pneumonia in Ventilated Patients-A Retrospective and Prospective Cohort Study.

The ventilator bundle consists of multiple methods to reduce ventilator-associated pneumonia (VAP) rates in Intensive Care Units (ICU). The aim of the study was to evaluate how the continuous automatic pressure control in tapered cuffs of endotracheal/tracheostomy tubes applied along with continuous automatic subglottic secretion suction affect the incidence of VAP. In the prospective cohort (n = 198), the standard VAP bundle was modified by continuous automatic pressure control in taper-shaped cuff of endotracheal/tracheostomy tubes and subglottic secretion suction. VAP incidence, time to VAP onset, invasive mechanical ventilation days/free days, length of ICU stay, ICU mortality, and multidrug-resistant bacteria were assessed and compared to the retrospective cohort (n = 173) with the standard bundle (intermittent cuff pressure of standard cuff, lack of subglottic secretion suction). A smaller incidence of VAP (9.6% vs. 19.1%) and early onset VAP (1.5% vs. 8.1%) was found in the prospective compared to the retrospective cohort (p < 0.01). Patients in the prospective cohort were less likely to develop VAP (RR = 0.50; 95% CI: 0.29 to 0.85) and early-onset VAP (RR = 0.19; 95% CI: 0.05 to 0.64) and had longer time to onset VAP (median 9 vs. 5 days; p = 0.03). There was no significant difference (p > 0.05) between both cohorts in terms of invasive mechanical ventilation days/free days, length of ICU stay, ICU mortality and multidrug-resistant bacteria. Modification of the bundle for prevention of VAP can reduce early-onset VAP and total incidence of VAP and delay the time of VAP occurrence.

Effect of thermal and non-thermal techniques for microbial safety in food powder: Recent advances.

Food powders are appreciated worldwide, as it enables food to be preserved for an extended period without significant loss of quality, even under the ambient storage condition. However, it is evidenced that the development of resistant microbial spore and viable microbial cells is a matter of concern even in low moisture foods like food powders. For microbial inactivation, the strategy generally applied is the implication of conventional preservation methods, such as heat treatment which is greatly accompanied by degradation of nutritional organoleptic properties. To overcome the shortcomings of conventional thermal processing, a set of advanced or emerging technologies are being developed which can inactivate the microbial spores and viable microbial cells capable of surviving with maximum retention in the nutritional or organoleptic profile. The examples include infrared heating, microwave heating, radiofrequency heating, instant control pressure drop technology, high-pressure processing, pulsed electric field, pulsed light, ozone processing, and cold plasma. In this review, the potential of different advanced thermal and non-thermal technologies towards the inactivation of spores and viable cells of microorganisms in food powders has been highlighted precisely along with their mechanism of action. The summary of the literature encompassing the use of different processing techniques will help the readers to understand the underlying mechanism of microbial inactivation associated with each processing techniques applied to powders. Eventually, this information will help them to select the suitable technique (individual or in combination with another counterpart) to inactivate spores and viable cells in a specific food powder.

Analysis of the efficacy of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure in the treament of intrarenal and proximal ureteral stones.Methods From November 2014 to December 2016,a total of 372 patients,including 200 males and 172 females,with upper urinary tract calculi were studied.The average age of patients was 48.1 years old.The average size of stone was 5-35mm,mean 15.7mm.There were 272 cases of renal calculi,80 cases of ureteral calculi and 20 cases of renal calculi combined with ureteral calculi.There were 252 cases of single calculi and 127 cases of multiple calculi.There were 237 cases of urinary tract infection and 14 cases of bacteremia.All patients were treated by suctioning fiexible uretemscopy with automatic control of renal pelvic pressure by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath with a pressuresensitive tip.Statistical analysis was performed regarding renal pelvic pressure,operative time,stone-free rates,and complications.Results Three hundred and thirty of 372 patients only accepted one surgery to remove the stone.There were 12 cases of upper ureteral calculi were converted to ureteroscope lithotripsy.Seventeen cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis.Seven cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks.No stone was found in 6 cases,and the soft endoscope of ureter was examined.In all patients,the renal pelvic pressure of the pelvis was controlled within 20 mmHg.The average operative time was 15-180 min(mean 58.9 min).The stone-free rates was 95.55％ (322/337),the incidence of postoperative fever was 2.97％ (10/337),the sepsis rate was 1.19％ (4/337),the incidence of urinary sepsis was 0.89％ (3/337),the incidence of lumbago caused by extravasation was 0.59％ (2/337),and no peripheral viscera injury or death case.There was no statistically significant difference between preoperative and postoperative white and red blood cells (P ＞ 0.05).Conclusions This new type of suctioning flexible ureteroscopy with intelligent pressure-control has the advantages of perfusion attraction,pressure feedback,intelligent control and visualization of intracavity pressure.It could be a new type of operation with high safety,low complication and high stone free rate.