Prediction of indications for valve replacement among asymptomatic or minimally symptomatic patients with chronic aortic regurgitation and normal left ventricular performance

BACKGROUND: Optimal criteria for valve replacement are unclear in asymptomatic/minimally symptomatic patients with aortic regurgitation (AR) and normal left ventricular (LV) performance at rest. Moreover, previous studies have not assessed the prognostic capacity of load-adjusted LV performance ("contractility") variables, which may be fundamentally related to clinical state. Therefore, 18 years ago, we set out to test prospectively the hypothesis that objective noninvasive measures of LV size and performance and, specifically, of load-adjusted variables, assessed at rest and during exercise (ex), could predict the development of currently accepted indications for operation for AR. METHODS AND RESULTS: Clinical variables and measures of LV size, performance, and end-systolic wall stress (ESS) were assessed annually in 104 patients by radionuclide cineangiography at rest and maximal ex and by echocardiography at rest; ESS was derived during ex. During an average 7.3-year follow-up among patients who had not been operated on, 39 of 104 patients either died suddenly (n = 4) or developed operable symptoms only (n = 22) or subnormal LV performance with or without symptoms (n = 13) (progression rate=6.2%/y). By multivariate Cox model analysis, change (delta) in LV ejection fraction (EF) from rest to ex, normalized for deltaESS from rest to ex (deltaLVEF-deltaESS index), was the strongest predictor of progression to any end point or to sudden cardiac death alone. Unadjusted deltaLVEF was almost as efficient. Symptom status modified prediction on the basis of the deltaLVEF-deltaESS index. The population tercile at highest risk by deltaLVEF-deltaESS progressed to end points at a rate of 13.3%/y, and the lowest-risk tercile progressed at 1.8%/y. CONCLUSIONS: Currently accepted symptom and LV performance indications for valve replacement, as well as sudden cardiac death, can be predicted in asymptomatic/minimally symptomatic patients with AR by load-adjusted deltaLVEF-deltaESS index, which includes data obtained during exercise.     

Plasma-derived proteins in airway defence, disease and repair of epithelial injury

One significant characteristic of the airway mucosa in vivo, that cannot easily be mimicked in vitro, is its microcirculation, which generates a highly dynamic, biologically active milieu of plasma-derived molecules that may pass to the airway lumen in vivo. New data on the mechanisms of airway mucosal exudation indicate that the protein systems of circulating plasma may contribute significantly to the biology and immunology of the lamina propria, its surface epithelium and the luminal surface, not only in injured airways, but also in airways that are activated but display no sign of oedema, epithelial disruption, or increased absorption capacity. We suggest that present knowledge of the mechanisms of plasma exudation, together with rapidly emerging information (not detailed herein) on receptors, target cells and cellular responses to the plasma-derived molecules, must be considered in any realistic model that investigates "immuno-inflammatory" mechanisms of the airway mucosa.     

Isotype-specific antibody responses to foot-and-mouth disease virus in sera and secretions of "carrier' and "non-carrier' cattle

Isotype-specific antibody responses to foot-and-mouth disease virus (FMDV) were measured in the sera and upper respiratory tract secretions of vaccinated and susceptible cattle challenged with FMDV by direct contact or by intranasal inoculation. A comparison was made between cattle that eliminated FMDV and those that developed and maintained a persistent infection. Serological and mucosal antibody responses were detected in all animals after challenge. IgA and IgM were detected before the development of IgG1 and IgG2 responses. IgM was not detected in vaccinated cattle. Challenge with FMDV elicited a prolonged biphasic secretory antibody response in FMDV "carrier' animals only. The response was detected as FMDV-specific IgA in both mucosal secretions and serum samples, which gained statistical significance (P < 0.05) by 5 weeks after challenge. This observation could represent the basis of a test to differentiate vaccinated and/or recovered convalescent cattle from FMDV "carriers'.     

Post-processing and visualization techniques in 2D boundary element analysis

Most post-processors for boundary element (BE) analysis use an auxiliary domain mesh to display domain results, working against the profitable modelling process of a pure boundary discretization. This paper introduces a novel visualization technique which preserves the basic properties of the boundary element methods. The proposed algorithm does not require any domain discretization and is based on the direct and automatic identification of isolines. Another critical aspect of the visualization of domain results in BE analysis is the effort required to evaluate results in interior points. In order to tackle this issue, the present article also provides a comparison between the performance of two different BE formulations (conventional and hybrid). In addition, this paper presents an overview of the most common post-processing and visualization techniques in BE analysis, such as the classical algorithms of scan line and the interpolation over a domain discretization. The results presented herein show that the proposed algorithm offers a very high performance compared with other visualization procedures.     

Tree pattern mining with tree automata constraints

Most work on pattern mining focuses on simple data structures such as itemsets and sequences of itemsets. However, a lot of recent applications dealing with complex data like chemical compounds, protein structures, XML and Web log databases and social networks, require much more sophisticated data structures such as trees and graphs. In these contexts, interesting patterns involve not only frequent object values (labels) appearing in the graphs (or trees) but also frequent specific topologies found in these structures. Recently, several techniques for tree and graph mining have been proposed in the literature. In this paper, we focus on constraint-based tree pattern mining. We propose to use tree automata as a mechanism to specify user constraints over tree patterns. We present the algorithm CoBMiner which allows user constraints specified by a tree automata to be incorporated in the mining process. An extensive set of experiments executed over synthetic and real data (XML documents and Web usage logs) allows us to conclude that incorporating constraints during the mining process is far more effective than filtering the interesting patterns after the mining process.     

A methodology for the generation of planar models for multibody chain drives

To overcome the difficulty on building manually complex models of chain drives, this work proposes a comprehensive methodology to build multibody models of any general chain drive automatically from a minimal set of data. The proposed procedure also evaluates the initial positions and velocities of all components of the drive that are consistent with the kinematic joints or with the contact pairs used in the model. In this methodology, all links and sprockets are represented by rigid bodies connected to each other either by ideal or by clearance revolute joints. The clearance revolute joint contact is further extended to handle the contact between the chain rollers and the sprocket teeth exact profiles. A suitable cylindrical continuous contact law is applied to describe the interaction on all contact pairs. One of the complexities of the computational study of roller chain drives is the large number of bodies in the system and the dynamics of the successive engagement and disengagement of the rollers with the sprockets. Each time a roller engages or disengages with a sprocket tooth, the number of rigid bodies in contact changes. The search for the contact pairs is recognized as one of the most time consuming task in contact analysis. This work proposes a procedure to specify the contact pairs and their update during the dynamic analysis optimizing the computational efficiency of the contact search. The methodologies adopted result in a general computer program that is applied and demonstrated in a generic chain drive that can be used in industrial machines, vehicle engines or any other type of mechanical system.     

An haptic-based immersive environment for shape analysis and modelling

Currently, the design of aesthetic products is a process that requires a set of activities where digital models and physical mockups play a key role. Typically, these are modified (and built) several times before reaching the desired design, increasing the development time and, consequently, the final product cost. In this paper, we present an innovative design environment for computer-aided design (CAD) surface analysis. Our system relies on a direct visuo-haptic display system, which enables users to visualize models using a stereoscopic view, and allows the evaluation of sectional curves using touch. Profile curves are rendered using an haptic device that deforms a plastic strip, thanks to a set of actuators, to reproduce the curvature of the shape co-located with the virtual model. By touching the strip, users are able to evaluate shape characteristics, such as curvature or discontinuities (rendered using sound), and to assess the surface quality. We believe that future computer-aided systems (CAS)/CAD systems based on our approach will contribute in improving the design process at industrial level. Moreover, these will allow companies to reduce the product development time by reducing the number of physical mockups necessary for the product design evaluation and by increasing the quality of the final product, allowing a wider exploration and comparative evaluation of alternatives in the given time.     

Plumes of discolored water of volcanic origin and possible implications for algal communities. The case of the Home Reef eruption of 2006 (Tonga, Southwest Pacific Ocean)

The Home Reef volcano (Tonga, Southwest Pacific Ocean) erupted in August 2006. Initially a submarine eruption it quickly evolved into a subaerial event upon the formation of an ephemeral island.Remote sensing data from different sensors including MODIS, ASTER, EO-1 ALI and Landsat-7 ETM+ were used to analyze the event, focusing on the plumes of discolored water, ocean chlorophyll-a concentration (OCC) and sea surface temperature.An early classification system for the plumes was devised based on spectral properties and point of origin. Plumes originated at the volcano were named Type-I and those associated to the pumice rafts Type-II.Anomalies in ocean chlorophyll-a concentration, measured using MODIS data, were analyzed and a large bloom, presumably dominated by Trichodesmium sp. was identified. The bloom, which contributed to OCC values 17 times higher than the background, was spatially and temporally coincident with a Type-I plume of discolored water. The OCC increase appears to have been caused by a combined effect of both ocean fertilizations by the subsurface volcanic plume and rising sea surface temperatures.The Home Reef event offers a good candidate for a case of ocean enrichment by a submarine volcano and highlights the need for continuous monitoring of the eruptions even after the end of the explosive, more spectacular stages.     

3D porosity prediction from seismic inversion and neural networks

In this work, we address the problem of transforming seismic reflection data into an intrinsic rock property model. Specifically, we present an application of a methodology that allows interpreters to obtain effective porosity 3D maps from post-stack 3D seismic amplitude data, using measured density and sonic well log data as constraints. In this methodology, a 3D acoustic impedance model is calculated from seismic reflection amplitudes by applying an L₁-norm sparse-spike inversion algorithm in the time domain, followed by a recursive inversion performed in the frequency domain. A 3D low-frequency impedance model is estimated by kriging interpolation of impedance values calculated from well log data. This low-frequency model is added to the inversion result which otherwise provides only a relative numerical scale. To convert acoustic impedance into a single reservoir property, a feed-forward Neural Network (NN) is trained, validated and tested using gamma-ray and acoustic impedance values observed at the well log positions as input and effective porosity values as target. The trained NN is then applied for the whole reservoir volume in order to obtain a 3D effective porosity model. While the particular conclusions drawn from the results obtained in this work cannot be generalized, such results suggest that this workflow can be applied successfully as an aid in reservoir characterization, especially when there is a strong non-linear relationship between effective porosity and acoustic impedance.     

Transient temperature responses of hydronic radiant floor heating system by different pipe embedding depth and water supply condition

"Ondol" is a Korean unique heating system. It is a specific radiant floor heating system using combustion heat of briquette or timber in Korea. Such traditional "Ondol" is changed to radiant heating system with pipe-coil embedded in the floor or slab. This study has contributed to the understandings of the transient behaviours of Ondol-heated floor panels and enclosure exposed to this type of heating system. The result is that the water supply temperature had a large effect on the rate of increase in floor surface and room air temperature. But, in spite of a higher water supply temperature, the heat flow rate was not increased considerably. The shallow pipe embedding depths, of course, result in a low heat flow rate.