Prosthetic valve endocarditis: superiority of surgical valve replacement versus medical therapy only

The objective of our study was to assess the long-term outcome of patients with prosthetic valve endocarditis. We used a multicenter, prospective, observational study design. Six university teaching hospitals with high volume cardiothoracic surgery participated. Seventy-four patients with prosthetic valve endocarditis as defined by explicit, objective criteria were selected for participation. All patients were followed up prospectively for 1 year. Thirty-one percent and 69% had development of endocarditis within 60 days of valve insertion ("early") and after 60 days ("late"), respectively. The most common causes were Staphylococcus epidermidis (40%), Staphylococcus aureus (20%), streptococcal species (18%), and aerobic gram-negative bacilli (11%). Physical signs of endocarditis (new or changing murmur, stigmata, emboli) were seen in 58%. At 6 months and 12 months, mortality was 46% and 47%, respectively. Surgical replacement of the infected valve led to significantly lower mortality (23%) as compared with medical therapy alone (56%), as assessed by both univariate and multivariate analyses (p < 0.05). Improved outcome was seen for the surgical group even when controlling for severity of illness at time of diagnosis. From these findings we conclude that accurate assessment of outcome in prosthetic valve endocarditis requires long-term follow-up of at least 6 months following diagnosis. Surgical therapy warrants greater scrutiny; evaluation in controlled clinical trials is appropriate.     

The effect of surfaces on the tunneling density of states of an anisotropically paired superconductor

We present calculations of the tunneling density of states in an anisotropically paired superconductor for two different sample geometries: a semi-infinite system with a single specular wall, and a slab of finite thickness and infinite lateral extent. In both cases we are interested in the effects of surface pair breaking on the tunneling spectrum. We take the stable bulk phase to be of d_x ²–y² symmetry. Our calculations are performed within two different band structure environments: an isotropic cylindrical Fermi surface with a bulk order parameter of the form k _x ² –k _y ² , and a nontrivial tight-binding Fermi surface with the order parameter structure coming from an antiferromagnetic spin-fluctuation model. In each case we find additional structures in the energy spectrum coming from the surface layer. These structures are sensitive to the orientation of the surface with respect to the crystal lattice, and have their origins in the detailed form of the momentum and spatial dependence of the order parameter. By means of tunneling spectroscopy, one can obtain information on both the anisotropy of the energy gap, ¦(p)¦, as well as on the phase of the order parameter, (p) = ¦(p)¦ e^i(p).     

Understanding unforeseen production downtimes in manufacturing processes using log data-driven causal reasoning

Journal of Intelligent Manufacturing - In discrete manufacturing, the knowledge about causal relationships makes it possible to avoid unforeseen production downtimes by identifying their root...     

Localized Synthesis of Iron Oxide Nanowires and Fabrication of High Performance Nanosensors Based on a Single Fe2O3 Nanowire

A composed morphology of iron oxide microstructures covered with very thin nanowires (NWs) with diameter of 15–50 nm has been presented. By oxidizing metallic Fe microparticles at 255 °C for 12 and 24 h, dense iron oxide NW networks bridging prepatterned Au/Cr pads are obtained. X‐ray photoelectron spectroscopy studies reveal formation of α‐Fe₂O₃ and Fe₃O₄ on the surface and it is confirmed by detailed high‐resolution transmission electron microscopy and selected area electron diffraction (SAED) investigations that NWs are single phase α‐Fe₂O₃ and some domains of single phase Fe₃O₄. Localized synthesis of such nano‐ and microparticles directly on sensor platform/structure at 255 °C for 24 h and reoxidation at 650 °C for 0.2–2 h, yield in highly performance and reliable detection of acetone vapor with fast response and recovery times. First nanosensors on a single α‐Fe₂O₃ nanowire are fabricated and studied showing excellent performances and an increase in acetone response by decrease of their diameter was developed. The facile technological approach enables this nanomaterial as candidate for a range of applications in the field of nanoelectronics such as nanosensors and biomedicine devices, especially for breath analysis in the treatment of diabetes patients.     

An Overview of Control Charts for High‐quality Processes

Major difficulties in the study of high‐quality processes with traditional process monitoring techniques are a high false alarm rate and a negative lower control limit. The purpose of time‐between‐events control charts is to overcome existing problems in the high‐quality process monitoring setup. Time‐between‐events charts detect an out‐of‐control situation without great loss of sensitivity as compared with existing charts. High‐quality control charts gained much attention over the last decade because of the technological revolution. This article is dedicated to providing an overview of recent research and presenting it in a unifying framework. To summarize results and draw a precise conclusion from the statistical point of view, cross‐tabulations are also given in this article. Copyright © 2016 John Wiley & Sons, Ltd.     

Specification and refinement of networks of asynchronously communicating agents using the assumption/commitment paradigm

This paper presents an assumption/commitment specification technique and a refinement calculus for networks of agents communicating asynchronously via unbounded FIFO channels in the tradition of Kahn.

We define two types of assumption/commitment specifications, namely simple and general specifications.

It is shown that semantically, any deterministic agent can be uniquely characterized by a simple specification, and any nondeterministic agent can be uniquely characterized by a general specification.

We define two sets of refinement rules, one for simple specifications and one for general specifications. The rules are Hoare-logic inspired. In particular the feedback rules employ invariants in the style of a traditional while-rule.

Both sets of rules have been proved to be sound and also (semantic) relative complete.

Conversion rules allow the two logics to be combined. This means that general specifications and the rules for general specifications have to be introduced only at the point in a system development where they are really needed.

     

Distance visualization for interactive 3D implant planning

An instant and quantitative assessment of spatial distances between two objects plays an important role in interactive applications such as virtual model assembly, medical operation planning, or computational steering. While some research has been done on the development of distance-based measures between two objects, only very few attempts have been reported to visualize such measures in interactive scenarios. In this paper we present two different approaches for this purpose, and we investigate the effectiveness of these approaches for intuitive 3D implant positioning in a medical operation planning system. The first approach uses cylindrical glyphs to depict distances, which smoothly adapt their shape and color to changing distances when the objects are moved. This approach computes distances directly on the polygonal object representations by means of ray/triangle mesh intersection. The second approach introduces a set of slices as additional geometric structures, and uses color coding on surfaces to indicate distances. This approach obtains distances from a precomputed distance field of each object. The major findings of the performed user study indicate that a visualization that can facilitate an instant and quantitative analysis of distances between two objects in interactive 3D scenarios is demanding, yet can be achieved by including additional monocular cues into the visualization.     

Non-standard bone simulation: interactive numerical analysis by computational steering

Numerous numerical methods have been developed in an effort to accurately predict stresses in bones. The largest group are variants of the h-version of the finite element method (h-FEM), where low order Ansatz functions are used. By contrast, we3 investigate a combination of high order FEM and a fictitious domain approach, the finite cell method (FCM). While the FCM has been verified and validated in previous publications, this article proposes methods on how the FCM can be made computationally efficient to the extent that it can be used for patient specific, interactive bone simulations. This approach is called computational steering and allows to change input parameters like the position of an implant, material or loads and leads to an almost instantaneous change in the output (stress lines, deformations). This direct feedback gives the user an immediate impression of the impact of his actions to an extent which, otherwise, is hard to obtain by the use of classical non interactive computations. Specifically, we investigate an application to pre-surgical planning of a total hip replacement where it is desirable to select an optimal implant for a specific patient. Herein, optimal is meant in the sense that the expected post-operative stress distribution in the bone closely resembles that before the operation.     

Temporal kernel CCA and its application in multimodal neuronal data analysis

Data recorded from multiple sources sometimes exhibit non-instantaneous couplings. For simple data sets, cross-correlograms may reveal the coupling dynamics. But when dealing with high-dimensional multivariate data there is no such measure as the cross-correlogram. We propose a simple algorithm based on Kernel Canonical Correlation Analysis (kCCA) that computes a multivariate temporal filter which links one data modality to another one. The filters can be used to compute a multivariate extension of the cross-correlogram, the canonical correlogram, between data sources that have different dimensionalities and temporal resolutions. The canonical correlogram reflects the coupling dynamics between the two sources. The temporal filter reveals which features in the data give rise to these couplings and when they do so. We present results from simulations and neuroscientific experiments showing that tkCCA yields easily interpretable temporal filters and correlograms. In the experiments, we simultaneously performed electrode recordings and functional magnetic resonance imaging (fMRI) in primary visual cortex of the non-human primate. While electrode recordings reflect brain activity directly, fMRI provides only an indirect view of neural activity via the Blood Oxygen Level Dependent (BOLD) response. Thus it is crucial for our understanding and the interpretation of fMRI signals in general to relate them to direct measures of neural activity acquired with electrodes. The results computed by tkCCA confirm recent models of the hemodynamic response to neural activity and allow for a more detailed analysis of neurovascular coupling dynamics.     

Evaluating the relationship between chemical exposure and cryptorchidism

One method for the evaluation of complex environmental and health datasets is the discrete mathematical method Hasse diagram technique based on partial orders. The introduced software program package is named PyHasse. In this paper we evaluate a possible human association between maternal exposure to organochlorine compounds used as pesticides and cryptorchidism among male children in Finland and Denmark. We identified differences in comparable and incomparable objects and quantified these differences by the software tool Similarity Analysis in the program PyHasse. Furthermore we interpreted the corresponding Hasse diagrams concerning chosen “striking objects”. We found the position of the chemicals AHCH (alpha-Hexachlorohexane), CHCE (cis-Heptachloroepoxide), DIEL (Dieldrin), and MIRE (Mirex) has some influence on the differentiation of the Hasse diagrams and hence of each two datasets analyzed. The largest disparities can be observed when we compare the Finnish and Danish datasets concerning cryptorchidism. The disparities are demonstrated in the corresponding Hasse diagrams.