Aortic root replacement: twenty years of experience

BACKGROUND: Aortic root replacement is a complex surgical procedure which has undergone major technical modifications with time. In order to assess the early and long-term outcome after aortic root replacement with this procedure, our entire experience of a two decade period was reviewed. METHODS: Between January 1979 and March 1997, 156 aortic root replacement operations were performed. One hundred and twenty five patients (80%) were male and 31 female; their mean age was 50 +/- 16 years. Diagnosis was annuloaortic ectasia in 79 patients, aortic dissection in 51 (acute 22, chronic 29), isolated aortic valve pathology in 24 and aneurysm of sinus of Valsalva in 5. Thirty nine patients had aortic root replacement using the standard "Bentall" technique, 73 using the "modified Bentall" technique, 15 using the Cabrol technique. Biologic substitutes of the aortic root were used in 29 patients (19 autografts, 4 homografts, 6 xenografts). Mean follow-up time was 41 +/- 40 months (range 1 month-18 years). RESULTS: There were 12 (7.6%) hospital deaths. Hospital mortality in elective cases was 5% (7/134) and 22% (5/22) in emergent (p = 0.01). A trend toward reduced early mortality was demonstrated in recent years. Mortality was 5% for the "modified Bentall" group, 3% for the "Biologic root" group, 10% for the "Bentall" group and 20% for the "Cabrol" group. Hospital mortality was significant higher in "Cabrol" group than in "modified Bentall" group (p = 0.04). The overall long-term survival rate was 78 +/- 4% at 5 years, 71 +/- 6% at 10 years and 51 +/- 13% at 15 years. No significant difference in survival rate nor freedom from complications was observed among patient groups. Need for reoperation and valve-related adverse events become prevalent after 10 years of follow-up. CONCLUSION: The decrease in early mortality and the satisfying late results demonstrate that aortic root replacement is a low risk surgical procedure and an effective and durable treatment. The availability of biologic substitutes for the aortic root has allowed the extension of this operation to all patient age group, with results comparable to these obtained with composite grafts.     

Service Discovery and Negotiation With COWS

To provide formal foundations to current (web) services technologies, we put forward using COWS, a process calculus for specifying, combining and analysing services, as a uniform formalism for modelling all the relevant phases of the life cycle of service-oriented applications, such as publication, discovery, negotiation, deployment and execution. In this paper, we show that constraints and operations on them can be smoothly incorporated in COWS, and propose a disciplined way to model multisets of constraints and to manipulate them through appropriate interaction protocols. Therefore, we demonstrate that also QoS requirement specifications and SLA achievements, and the phases of dynamic service discovery and negotiation can be comfortably modelled in COWS. We illustrate our approach through a scenario for a service-based web hosting provider.     

Distributed data mining on grids: services, tools, and applications

Data mining algorithms are widely used today for the analysis of large corporate and scientific datasets stored in databases and data archives. Industry, science, and commerce fields often need to analyze very large datasets maintained over geographically distributed sites by using the computational power of distributed and parallel systems. The grid can play a significant role in providing an effective computational support for distributed knowledge discovery applications. For the development of data mining applications on grids we designed a system called Knowledge Grid. This paper describes the Knowledge Grid framework and presents the toolset provided by the Knowledge Grid for implementing distributed knowledge discovery. The paper discusses how to design and implement data mining applications by using the Knowledge Grid tools starting from searching grid resources, composing software and data components, and executing the resulting data mining process on a grid. Some performance results are also discussed.     

The Tutelary Architecture of Immigration Detention Prisons and the Spectacle of ‘Necessary Suffering’

In this essay, I address Debord's concept of the spectalist society in the context of the transmutation of the trauma of the refugees incarcerated in Australia's immigration prisons into telegenic spectacle. I argue that the razor wire fences of these prisons generate a double movement of both enclosure and exposure. The potential for exposure is what enables refugee trauma to be telegenically transmitted as spectacle. The architecture of Australia's immigration prisons, I conclude, functions as a type of tutelary architecture that dispenses object lessons on deterrence whilst simultaneously generating the production of refugee trauma-as-spectacle.     

Expression of the alpha 5 beta 1 fibronectin receptor on T lymphocytes of patients with HIV-1 infection

AIMS: To evaluate the expression of the alpha 5 beta 1 integrin fibronectin receptor (FNR), which mediates several processes, including phagocytosis, cell motility and the immune response, on T lymphocytes of patients with HIV-1 infection. METHODS: T lymphocytes were incubated with monoclonal antibody directed against FNR and then with monoclonal antibodies, conjugated with phycoerythrin, directed against CD3, CD4 and CD8 positive cells. Expression of FNR on CD3, CD4 and CD8 positive cells was analysed using flow cytometry. RESULTS: Normal expression of FNR was observed on CD3 positive cells from asymptomatic HIV positive patients and those with AIDS. Increased expression of FNR was observed on CD8 positive cells from asymptomatic HIV positive patients and on CD4 positive cells from patients with AIDS. Increased FNR expression was observed on CD4 positive cells from patients with AIDS, particularly those with opportunistic infections caused by Pneumocystis carinii, Mycobacterium sp, Toxoplasma gondii, and Cryptococcus neoformans. CONCLUSION: Increased expression of FNR on CD8 and CD4 positive cells in asymptomatic HIV positive patients and those with AIDS, respectively, may be an epiphenomenon correlated with lymphocyte activation by HIV-1 or opportunistic infection, Further study is required to determine whether upregulation of FNR expression has a direct role in the pathogenesis of AIDS.     

Parental socialization of child and adolescent physical activity: A meta-analysis.

Meta-analysis was used to integrate research on the relations between parental socialization behavior and child and adolescent physical activity (PA) levels. Four major databases were examined: PubMED, ERIC, Web of Science, and PsychLit (1960 -2005). Thirty studies met the following inclusion criteria: (a) child age (2-18 years) and (b) statistical information permitting calculation of an effect size between parent socialization behavior and child PA. Mean age of participants across studies ranged from 2.54 to 15.5 years. The unweighted mean and median effect sizes (as indexed by r) were .17 and .13, respectively, indicating that a moderate positive relation exists between parental support and modeling behavior and child and adolescent PA levels. The moderating effect of type of parental socialization behavior, population characteristics, and methodological factors were investigated. Theoretical and methodological implications concern the inclusion of mediated models of parental influence and the use of longitudinal investigations in determining causal direction. From an applied viewpoint, these results are useful for the design of future, more effective childhood obesity prevention programs by suggesting child-age-appropriate parental influences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guardians for Ambient-Based Monitoring

In the Mobile Ambients of Cardelli and Gordon an ambient is a unit for mobility, which may contain processes (data) and sub-ambients. Since the seminal work of Cardelli and Gordon, several ambient-based calculi have been proposed (Seal, Box-π, Safe Ambients, Secure Safe Ambients, Boxed Ambients), mainly for supporting security. At the operational level these (box- and) ambient-based calculi differ only in the capabilities of processes. We propose a way of extending ambient-based calculi, which embodies two principles: an ambient is a unit for monitoring and coordination, the name of an ambient determines its (monitoring and coordination) policy. More specifically, to each ambient we attach a guardian, which monitors the activity of sub-components (i.e. processes and sub-ambients) and the interaction with the external environment. In our proposal, guardians and processes play a dual role: guardians are centralized entities monitoring and inhibiting actions, while processes are decentralized entities performing actions. We exemplify the use of guardians for enforcing security properties.     

Design Procedure for Settling Time Minimization in Three-Stage Nested-Miller Amplifiers

Low-power, low-voltage, and high-performance requirements are badly needed for operational amplifiers (op-amps) in modern applications. In this brief, a design method for minimizing the settling time in three-stage nested-Miller schemes is presented. As an application example, a CMOS 0.35-mum voltage follower with 115-dB dc gain and fastest step response to 1% accuracy level, is designed. Circuital simulations demonstrate that the proposed procedure allows the amplifier settling-time/power-consumption ratio to be significantly improved with respect to conventionally designed op-amps.     

The HIV/AIDS epidemics among drug injectors: a study of contact structure through a mathematical model

Numerical results of a model with variable infectivity for the dynamics of HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) have been compared with the data of AIDS cases among intravenous drug users in Italy, especially in the Latium region. We examined several hypotheses about the dynamics of the epidemics; for each we obtained, mainly through a least-square approach but also minimizing a different quantity, a best-fit estimate of the parameters. In the simplest model, the population is assumed to be homogeneous, and we estimate contact rate and year of start of the epidemics, obtaining a good fit up to 1989, less so after. A substantial increase in fit is obtained in assuming either a decrease of the contact rate over time or a heterogeneous population with a smaller active group. We have also compared models with different infectivity curves during the incubation period: the assumption of constant infectivity is untenable, whereas the often suggested hypothesis of a peak in infectivity shortly after infection seems to be in agreement with data.