Aortic valve replacement and concomitant procedures with the Perceval valve: results of European trials.

BACKGROUND The Perceval (Sorin Group, Milan, Italy) is a self-anchoring sutureless aortic valve prosthesis. We report the short- to midterm results of combined aortic valve replacement (AVR) with concomitant procedures in elderly patients undergoing operation as part of 3 consecutive prospective multicenter European studies. METHODS From April 2007 to February 2013, 243 patients (mean age, 79.7 ± 5.1 years; female patients, 61%; median EuroSCORE, 9%) underwent AVR with concomitant procedures. The concomitant procedures were coronary artery bypass grafting (CABG) (182 cases), septal myectomy (21 cases), CABG + other procedures (18 cases), and 22 other procedures. Primary and secondary end points included implant feasibility and safety (for mortality and morbidity) and efficacy (New York Heart Association [NYHA] class improvement and hemodynamic results) of the prosthesis at the different follow-up periods. Data were expressed as mean ± standard deviation. Kaplan-Meier analysis was performed for survival analysis. RESULTS Mean aortic cross-clamp and extracorporeal circulation (ECC) times were 50.7 ± 22.8 minutes and 78.9 ± 32.3 minutes, respectively. Thirty-day mortality was 2.1%. Mean postoperative gradient and effective orifice area were 10.1 ± 4.7 mm Hg and 1.5 ± 0.4 cm(2) and 8.9 ± 5.6 mm Hg and 1.6 ± 0.4 cm(2), respectively, at 1 year. There were early explantations, 4 of which resulted from paravalvular leaks. One additional valve explantation resulted from aortic root bleeding, probably caused by excessively extensive decalcification. In the late period, there was 1 mild paravalvular leak and no intravalvular insufficiency. No migration, dislodgement, or degeneration of the valve occurred during follow-up. Median follow-up was 444 days. CONCLUSIONS These trials confirm the safety and efficacy of the Perceval sutureless aortic valve, especially in elderly patients requiring AVR + concomitant procedures. In this patient group, sutureless valves may be advantageous compared to transcatheter valve implantations as concomitant procedures other than percutaneous coronary artery angioplasty are not always possible in the latter.

fMRI-Compatible Electromagnetic Haptic Interface

A new haptic interface device is suggested, which can be used for functional magnetic resonance imaging (fMRI) studies. The basic component of this 1 DOF haptic device are two coils that produce a Lorentz force induced by the large static magnetic field of the MR scanner. A MR-compatible optical angular encoder and a optical force sensor enable the implementation of different control architectures for haptic interactions. The challenge was to provide a large torque, and not to affect image quality by the currents applied in the device. The haptic device was tested in a 3T MR scanner. With a current of up to 1A and a distance of 1m to the focal point of the MR-scanner it was possible to generate torques of up to 4 Nm. Within these boundaries image quality was not affected.

Flow and wakes in complex terrain and offshore. Model development and verification in UPWIND

The paper presents research conducted in the Flow workpackage of the EU funded UPWIND project which focuses on improving models for flow within and downwind of large wind farms in complex terrain and offshore. The main activity is modelling the behaviour of wind turbine wakes in order to improve power output predictions.

Sensitivity analysis on turbulence models for the ABL in complex terrain

Análisis de sensibilidad de modelos de turbulencia para un modelo CFD de viento aplicados a un emplazamiento en terreno complejo. Validación con datos de viento y turbulencia registrados a 3 alturas en 3 torres de medida.

Simulating Metabolic Processes Using an Architecture Based on Networks of Bio-inspired Processors.

In this work, we propose the Networks of Evolutionary Processors (NEP) [2] as a computational model to solve problems related with biological phenomena. In our first approximation, we simulate biological processes related with cellular signaling and their implications in the metabolism, by using an architecture based on NEP (NEP architecture) and their specializations: Networks of Polarized Evolutionary Processors (NPEP) [1] and NEP Transducers (NEPT) [3]. In particular, we use this architecture to simulate the interplay between cellular processes related with the metabolism as the Krebs cycle and the malate-aspartate shuttle pathway (MAS) both being altered by signaling by calcium.

Sensitisation to Act 2d in patientsallergic to Alternaria alternanta: an epiphenomenom without clinical significance?

In the last few years, the introduction of microarrays in the diagnosis of type I allergy is allowing the clinicians to have a much more accurate picture of their allergenic profile. However, the simultaneous measurement of specific IgE to multiple molecules can show unexpected sensitisations, without knowing their clinical relevance. For instance, we have been observing a high prevalence (74%) of sensitisation to Act d 2 (the thaumatin of kiwifruit) in patients sensitised to Alt a 1 (major allergen of Alternaria alternata) with a confirmed allergy to this mould. The aim of the present study was to clarify if there was any clinical relevance in this finding.

Enriched mannose glycosylation contributes to Act d 2 allergenicity.

Allergens are responsible for the Th2 response in patients as part of complex mixtures of proteins, fatty acids and other molecules. Plant allergens have hitherto been included in several protein families that share no common biochemical features. Their physical, biochemical and immunological characteristics have been widely studied, but no definite conclusion has been reached about what makes a protein an allergen. N-glycosylation is characteristic of plant allergen sources but is not present in mammals.

Modulatory impact of cinnamaldehyde on immune cells is partly due to induction of apoptosis.

Cinnamaldehyde (CA) has been reported to have antiinflammatory, anti-bacterial, anti-fungal, chemoprotective and anti-carcinogenic activity. Here, we further investigated the immune-modulating capacity of CA.

Finite Element Model of the Innovation Diffusion: An Application to Photovoltaic Systems

This paper presents a Finite Element Model, which has been used for forecasting the diffusion of innovations in time and space. Unlike conventional models used in diffusion literature, the model considers the spatial heterogeneity. The implementation steps of the model are explained by applying it to the case of diffusion of photovoltaic systems in a local region in southern Germany. The applied model is based on a parabolic partial differential equation that describes the diffusion ratio of photovoltaic systems in a given region over time. The results of the application show that the Finite Element Model constitutes a powerful tool to better understand the diffusion of an innovation as a simultaneous space-time process. For future research, model limitations and possible extensions are also discussed.

What role does climate change play in agricultural market uncertainty? An integrated assessment taking into account market-driven adjustments

Recent studies point to climate change being one of the long-term drivers of agricultural market uncertainty. To advance in the understanding of the influence of climate change on future agricultural market developments, we compare a reference scenario for 2030 with alternative simulation scenarios that differ regarding: (1) emission scenarios; (2) climate projections; and (3) the consideration of carbon fertilization effects. For each simulation scenario, the CAPRI model provides global and EU-wide impacts of climate change on agricultural markets. Results show that climate change would considerably affect agrifood markets up to 2030. Nevertheless, market-driven adaptation strategies (production intensification, trade adjustments) would soften the impact of yield shocks on supply and demand. As a result, regional changes in production would be lower than foreseen by other studies focused on supply effects.

Beyond a logic of effectiveness: Horizontal coordination, democratic legitimacy and accountability

Horizontal coordination, where actors join together to accomplish a common task, has been applauded for its output legitimacy. However, such processes often face challenges due to opposition from local actors who raise concerns about democratic legitimacy and accountability. Moving beyond a logic of effectiveness, we aim to show how and why other forms of legitimacy such as input and throughput dimensions also affect horizontal coordination, in addition to output criteria. Beyond the assumed positive relationship between coordination and effectiveness, we additionally expect horizontal coordination to be (a) impeded by local actors' fear of losing democratic legitimacy; and (b) fostered by accountability in terms of the steering capacity of the state. A comparative case study analysis of water supply structures at the regional level in Switzerland shows, in contrast to our expectation, that effectiveness has mixed impacts on horizontal coordination. Rather than being solely a positive factor for horizontal coordination, certain output criteria such as financial redistribution are found to be a key hindrance. We also find that democratic legitimacy may, indeed, impede horizontal coordination whereas increased accountability positively affects such coordination.

Principj elementari di musica : adottati dall'I.R. Conservatorio di Milano per le ripetizioni giornaliere degli alunni /

Mode of access: Internet.

Santa Maria delle Grazie /

Includes bibliographical references (p. 268-271).

Annuario della Istituzione agraria ...

Mode of access: Internet.