Neurostimulation for fecal incontinence after correction of repair of imperforate anus

We are reporting the case of a 32-year-old female who had suffered from fecal incontinence(FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.

Emerging Noninvasive Neurostimulation Technologies: CN-NINM and SYMPATOCORECTION

Two emerging noninvasive neurostimulation technologies, based on electrocutaneius stimulation of the tongue (CN-NINM) and the neck (SYMPATOCORRECTION) are presented. Currently, two portable devices were developed and introduced in clinical practice: PoNSTM (portable neurostimulator) and SYMPATOCOR. Both technologies are complement each other and demonstrate perspectives in various applications for purpose of neurorehabilitation and neurological symptoms management in such difficult rehabilitation areas, as traumatic brain injury, stroke, Parkinson’s disease, multiple sclerosis and many other neurological disorders.

A chaotic hierarchical encryption/watermark embedding scheme for multi-medical images based on row-column confusion and closed-loop bi-directional diffusion

Security during remote transmission has been an important concern for researchers in recent years.In this paper,a hierarchical encryption multi-image encryption scheme for people with different security levels is designed,and a multiimage encryption(MIE)algorithm with row and column confusion and closed-loop bi-directional diffusion is adopted in the paper.While ensuring secure communication of medical image information,people with different security levels have different levels of decryption keys,and differentiated visual effects can be obtained by using the strong sensitivity of chaotic keys.The highest security level can obtain decrypted images without watermarks,and at the same time,patient information and copyright attribution can be verified by obtaining watermark images.The experimental results show that the scheme is sufficiently secure as an MIE scheme with visualized differences and the encryption and decryption efficiency is significantly improved compared to other works.

Evaluation of hybrid closed-loop insulin delivery system in type 1 diabetes in real-world clinical practice:One-year observational study

BACKGROUND In 2016,the Food and Drug Administration approved the first hybrid closed-loop(HCL)insulin delivery system for adults with type 1 diabetes(T1D).There is limited information on the impact of using HCL systems on patient-reported outcomes(PROs)in patients with T1D in real-world clinical practice.In this independent study,we evaluated glycemic parameters and PROs over one year of continuous use of Medtronic’s 670G HCL in real-world clinical practice.AIM To assess the effects of hybrid closed loop system on glycemic control and quality of life in adults with T1D.METHODS We evaluated 71 patients with T1D(mean age:45.5±12.1 years;59%females;body weight:83.8±18.7 kg,body mass index:28.7±5.6 kg/m2,A1C:7.6%±0.8%)who were treated with HCL at Joslin Clinic from 2017 to 2019.We measured A1C and percent of glucose time-in-range(%TIR)at baseline and 12 months.We measured percent time in auto mode(%TiAM)for the last two weeks preceding the final visit and assessed PROs through several validated quality-of-life surveys related to general health and diabetes management.RESULTS At 12 mo,A1C decreased by 0.3%±0.1%(P=0.001)and%TIR increased by 8.1%±2.5%(P=0.002).The average%TiAM was only 64.3%±32.8%and was not associated with A1C,%TIR or PROs.PROs,provided at baseline and at the end of the study,showed that the physical functioning submodule of 36Item Short-Form Health Survey increased significantly by 22.9%(P<0.001).Hypoglycemia fear survey/worry scale decreased significantly by 24.9%(P<0.000);Problem Areas In Diabetes reduced significantly by-17.2%(P=0.002).The emotional burden submodules of dietary diversity score reduced significantly by-44.7%(P=0.001).Furthermore,analysis of Clarke questionnaire showed no increase in awareness of hypoglycemic episodes.WHO-5 showed no improvements in subject’s wellbeing among participants after starting the 670G HCL system.Finally,analysis of Pittsburgh Sleep Quality Index showed no difference in sleep quality,sleep latency,or duration of sleep from baseline to 12 mo.CONCLUSION The use of HCL in real-world clinical practice for one year was associated with significant improvements in A1C,%TIR,physical functioning,hypoglycemia fear,emotional distress,and emotional burden related to diabetes management.However,these changes were not associated with time in auto mode.

Diabetic peripheral neuropathy and neuromodulation techniques:a systematic review of progress and prospects

Neuromodulation for diabetic peripheral neuropathy represents a significant area of interest in the management of chronic pain associated with this condition.Diabetic peripheral neuropathy,a common complication of diabetes,is characterized by nerve damage due to high blood sugar levels that lead to symptoms,such as pain,tingling,and numbness,primarily in the hands and feet.The aim of this systematic review was to evaluate the efficacy of neuromodulatory techniques as potential therapeutic interventions for patients with diabetic peripheral neuropathy,while also examining recent developments in this domain.The investigation encompassed an array of neuromodulation methods,including frequency rhythmic electrical modulated systems,dorsal root ganglion stimulation,and spinal cord stimulation.This systematic review suggests that neuromodulatory techniques may be useful in the treatment of diabetic peripheral neuropathy.Understanding the advantages of these treatments will enable physicians and other healthcare providers to offer additional options for patients with symptoms refractory to standard pharmacologic treatments.Through these efforts,we may improve quality of life and increase functional capacity in patients suffering from complications related to diabetic neuropathy.

Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

A novel closed-loop vacuum silicon microgyroscope

A novel closed-loop control strategy of a silicon microgyroscope （SMG） is proposed. The SMG is sealed in metal can package in drive and sense modes and works under the air pressure of 10 Pa. Its quality factor reaches greater than l0 000. Self-oscillating and closed-loop methods based on electrostatic force feedback are adopted in both measure and control circuits. Both single side driving and sensing methods are used to simplify the drive circuit. These dual channel decomposition and reconstruction closed loops are applied in sense modes. The testing results demonstrate that useful signals and guadrature signals do not interact with each other because of the decoupling of their phases. Under the condition of a scale factor of 9. 6 mV/（（°） .s）, in a full measurement range of±300 （°）/s, the zero bias stability reaches 28 （°）/h with a nonlinear coefficient of 400 × 10^-6 and a simulated bandwidth of more than 100 Hz. The overall performance is improved by two orders of magnitude in comparison to that at atmospheric pressure.

Closed-Loop MIMO系统线性预编码技术

本文讨论了Closed-Loop MIMO系统在有限反馈资源下如何进行反馈的方法,即两种发射端线性预编码的思路,特别是其中的反馈码本设计问题。由于需要接收端向发射端反馈信道信息,而上行反馈资源又非常有限,所以发射端线性预编码技术成为解决把MIMO技术应用于新一代蜂窝系统或无线局域网的关键问题之一,具有无限广阔的发展前景。

Dynamics and adaptive control of a dual-arm space robot with closed-loop constraints and uncertain inertial parameters

A dynamics-based adaptive control approach is proposed for a planar dual-arm space robot in the presence of closed-loop constraints and uncertain inertial parameters of the payload. The controller is capable of controlling the po- sition and attitude of both the satellite base and the payload grasped by the manipulator end effectors. The equations of motion in reduced-order form for the constrained system are derived by incorporating the constraint equations in terms of accelerations into Kane＇s equations of the unconstrained system. Model analysis shows that the resulting equations perfectly meet the requirement of adaptive controller design. Consequently, by using an indirect approach, an adaptive control scheme is proposed to accomplish position/attitude trajectory tracking control with the uncertain parameters be- ing estimated on-line. The actuator redundancy due to the closed-loop constraints is utilized to minimize a weighted norm of the joint torques. Global asymptotic stability is proven by using Lyapunov＇s method, and simulation results are also presented to demonstrate the effectiveness of the proposed approach.

Remanufacturing closed-loop supply chain network design based on genetic particle swarm optimization algorithm

As the huge computation and easily trapped local optimum in remanufacturing closed-loop supply chain network (RCSCN) design considered, a genetic particle swarm optimization algorithm was proposed. The total cost of closed-loop supply chain was selected as fitness function, and a unique and tidy coding mode was adopted in the proposed algorithm. Then, some mutation and crossover operators were introduced to achieve discrete optimization of RCSCN structure. The simulation results show that the proposed algorithm can gain global optimal solution with good convergent performance and rapidity. The computing speed is only 22.16 s, which is shorter than those of the other optimization algorithms.

Closed-loop cobalt recycling from spent lithium-ion batteries based on a deep eutectic solvent (DES) with easy solvent recovery

Efficient recycling technology for the rapid growth of spent lithium-ion batteries(LIBs)is essential to tackle the resources and environmental crisis.Hydrometallurgical approach has attracted extensive research due to its potential to reduce the consumption of energy and threat to the environment.However,the simultaneous realization of green,efficient and closed-loop recycling is still challenging.Herein,we report a closed-loop and highly efficient approach to recycle lithium cobalt oxide from spent LIBs based on a choline chloride:oxalic acid(ChCl:OA)type deep eutectic solvent(DES).An ultrafast leaching process is observed at 180°C for 10 s with no observable residues.The energy barrier during leaching is calculated to be 113.9 kJ/mol.Noteworthy,the solubility of cobalt ions can be reversibly tuned by simply adding/evaporating deionized water,thus avoiding the addition of precipitant and enabling the easy recovery of the leaching solvent for realizing a closed-loop recycling process.The simultaneous realization of high efficiency,green and closed-loop process is expected to push the DES into practical application for recycling the electrodes of LIBs.

An Implanted Closed-loop Chip System for Heart Rate Control:System Design and Effects in Conscious Rats

Objective： To evaluate the efficiency of an implanted chip system for the control of heart rate （HR）. Methods： The HR was recorded in six conscious Sprague-Dawley （SD） rats. An implanted chip system was designed to regulate the HR by stimulating the right cervical vagus nerve according to the feedback of real time HR. Each rat was subjected to 30-min regulation and 30-min recovery. The change of HR during the regulation period was compared with the control. The ECG was recorded during the experiment for 24 h. Results： The ECG signals were successfully recorded during the experiment. The HR was significantly decreased during the period of regulation compared with control （-79.3 ± 34.5, P 〈 0.01, n = 6） and then recovered to normal after regulation. Conclusion： The described implanted chip system can regulate the HR to a designated set point.

Noise behaviors of a closed-loop micro-electromechanical system capacitive accelerometer

The noise of closed loop micro-electromechanical systems(MEMS) capacitive accelerometer is treated as one of the significant performance specifications.Traditional optimization of noise performance often focuses on designing large capacitive sensitivity accelerometer and applying closed loop structure to shape total noise,but different noise sources in closed loop and their behaviors at low frequencies are seldom carefully studied,especially their behaviors with different electronic parameters.In this work,a thorough noise analysis is established focusing on the four noise sources transfer functions near 0 Hz with simplified electronic parameters in closed loop,and it is found that the total electronic noise equivalent acceleration varies differently at different frequency points,such that the noise spectrum shape at low frequencies can be altered from 1/f noise-like shape to flat spectrum shape.The bias instability changes as a consequence.With appropriate parameters settings,the 670 Hz resonant frequency accelerometer can reach resolution of 2.6 μg/(Hz)1/2 at 2 Hz and 6 μg bias instability,and 1300 Hz accelerometer can achieve 5μg/(Hz)1/2 at 2 Hz and 31 μg bias instability.Both accelerometers have flat spectrum profile from 2 Hz to 15 Hz.

A review of closed-loop reservoir management

The closed-loop reservoir management technique enables a dynamic and real-time optimal production schedule under the existing reservoir conditions to be achieved by adjusting the injection and production strategies. This is one of the most effective ways to exploit limited oil reserves more economically and efficiently. There are two steps in closed-loop reservoir management： automatic history matching and reservoir production opti- mization. Both of the steps are large-scale complicated optimization problems. This paper gives a general review of the two basic techniques in closed-loop reservoir man- agement; summarizes the applications of gradient-based algorithms, gradient-free algorithms, and artificial intelligence algorithms; analyzes the characteristics and application conditions of these optimization methods; and finally discusses the emphases and directions of future research on both automatic history matching and reservoir production optimization.

Application of Single Neuron Adaptive PID Regulators with Auto-tuning Gain in Industrial Parameter(Pressure)Closed-loop Process Control Systems

A type of single neuron adaptive PID regulator with auto-tuning gain is proposed and applied to the work control of fans, waterpumps and air-pressers etc. in Handan Iron & Steel Compel China. The robusthess of induStrial parameter closed-loop process controlsystems is improved, and the work quality of the systems bettered.

An Extended Closed-loop Subspace Identification Method for Error-in-variables Systems

A closed-loop subspace identification method is proposed for industrial systems subject to noisy input-output observations, known as the error-in-variables (EIV) problem. Using the orthogonal projection approach to eliminate the noise influence, consistent estimation is guaranteed for the deterministic part of such a system. A strict proof is given for analyzing the rank condition for such orthogonal projection, in order to use the principal component analysis (PCA) based singular value decomposition (SVD) to derive the extended observability matrix and lower triangular Toeliptz matrix of the plant state-space model. In the result, the plant state matrices can be retrieved in a transparent manner from the above matrices. An illustrative example is shown to demonstrate the effectiveness and merits of the proposed subspace identification method.

Efficient and accurate worm grinding of spur face gears according to an advanced geometrical analysis and a closed-loop manufacturing process

Worm grinding has been applied to manufacture gears to pursue high accuracy and fine surface finish.When the worm used to grind face gears is manufactured with multi-axis computer numerical control(CNC)machining,the machining accuracy is usually improved by increasing the number of tool paths with more time cost.Differently,this work proposes a generated method to improve the efficiency by dressing the worm surface with only one path,and a closed-loop manufacturing process is applied to ensure the machining accuracy.According to an advanced geometric analysis,the worm surface is practically approximated as a swept surface generated by a planar curve.Meanwhile,this curve is applied as the profile of a dressing wheel,which is used to dress the worm surface.The practical machining is carried out in a CNC machine tool,which was originally used to grind helical gears.Finally,a closed-loop manufacturing process including machining,measurement,and modification is proposed to compensate the machining errors.The proposed method is validated with simulations and practical experiments.

Opportunities and challenges for developing closed-loop bioelectronic medicines

The peripheral nervous system plays a major role in the maintenance of our physiology. Several peripheral nerves intimately regulate the state of the brain, spinal cord, and visceral systems. A new class of therapeutics, called bioelectronic medicines, are being developed to precisely regulate physiology and treat dysfunction using peripheral nerve stimulation. In this review, we first discuss new work using closed-loop bioelectronic medicine to treat upper limb paralysis. In contrast to open-loop bioelectronic medicines, closed-loop approaches trigger ‘on demand' peripheral nerve stimulation due to a change in function(e.g., during an upper limb movement or a change in cardiopulmonary state). We also outline our perspective on timing rules for closedloop bioelectronic stimulation, interface features for non-invasively stimulating peripheral nerves, and machine learning algorithms to recognize disease events for closed-loop stimulation control. Although there will be several challenges for this emerging field, we look forward to future bioelectronic medicines that can autonomously sense changes in the body, to provide closed-loop peripheral nerve stimulation and treat disease.

A closed-loop particle swarm optimizer for multivariable process controller design

Design of general multivariable process controllers is an attractive and practical alternative to optimizing design by evolutionary algorithms (EAs) since it can be formulated as an optimization problem. A closed-loop particle swarm optimization (CLPSO) algorithm is proposed by mapping PSO elements into the closed-loop system based on control theories. At each time step, a proportional integral (PI) controller is used to calculate an updated inertia weight for each particle in swarms from its last fitness. With this modification, limitations caused by a uniform inertia weight for the whole population are avoided, and the particles have enough diversity. After the effectiveness, efficiency and robustness are tested by benchmark functions, CLPSO is applied to design a multivariable proportional-integral-derivative (PID) controller for a solvent dehydration tower in a chemical plant and has improved its performances.

Reliability Analysis on Repairable System with Dual Input Closed-Loop Feedback Link Considering Shutdown Correlation Based on Goal Oriented Methodology

Goal oriented( GO) methodology is a kind of success oriented system reliability analysis method and has been used widely.The repairable system with dual input closed-loop feedback link( DICLFL) considering shutdown correlation didn't make reliability analysis accurately based on existing GO methodology. So, a reliability analysis method used to deal with DICLFL considering shutdown correlation is provided based on GO methodology.Firstly, a new operator, which is used to describe DICLFL considering shutdown correlation,whose number is 1,is created and named as Type 9C operator. And then,the formulas of type 9C operator are derived based on Markov process theory. Finally,the new method presented in this paper is adopted to conduct the reliability analysis of an electro-hydraulic servo speed control system. The analysis result is compared with those of Monte Carlo simulation and fault tree analysis( FTA). The comparison results show that this new reliability analysis method based on GO methodology is feasible and meaningful for reliability analysis of repairable systems with DICLFL considering shutdown correlation.Meantime,it will be useful for more other applications.