The Hybrid Approach for Palliation of Hypoplastic Left Heart Syndrome: Intermediate Results of a Single-Center Experience

INTRODUCTION: Hypoplastic left heart syndrome (HLHS) is a major cause of cardiac death during the first week of life. The hybrid approach is a reliable, reproducible treatment option for patients with HLHS. Herein we report our results using this approach, focusing on its efficacy, safety and late outcome. METHODS: We reviewed prospectively collected data on patients treated for HLHS using a hybrid approach between July 2007 and September 2014. RESULTS: Nine patients had a stage 1 hybrid procedure, with seven undergoing a comprehensive stage 2 procedure. One patient completed the Fontan procedure. Five patients underwent balloon atrial septostomy after the hybrid procedure; in three patients, a stent was placed across the atrial septum. There were three deaths: two early after the hybrid procedure and one early after stage two palliation. Overall survival was 66%. CONCLUSIONS: In our single-center series, the hybrid approach for HLHS yields intermediate results comparable to those of the Norwood strategy. The existence of dedicated teams for the diagnosis and management of these patients, preferably in high-volume centers, is of major importance in this condition.

Liver Depurative Techniques: A Single Liver Transplantation Center Experience

In a liver transplant (LT) center, treatments with Prometheus were evaluated. The main outcome considered was 1 and 6 months survival. Methods. During the study period, 74 patients underwent treatment with Prometheus; 64 were enrolled,with a mean age of 51 13 years; 47men underwent 212 treatments (mean, 3.02 per patient). The parameters evaluated were age, sex, laboratorial (liver enzymes, ammonia) and clinical (model for end-stage liver disease and Child-Turcotte-Pugh score) data. Results. Death was verified in 23 patients (35.9%) during the hospitalization period, 20 patients (31.3%) were submitted to liver transplantation, and 21 were discharged. LT was performed in 4 patients with acute liver failure (ALF, 23.7%), in 7 patients with acute on chronic liver failure (AoCLF, 43.7%), and in 6 patients with liver disease after LT (30%). Seven patients who underwent LT died (35%). In the multivariate analysis, older age (P ¼ .015), higher international normalized ratio (INR) (P ¼ .019), and acute liver failure (P ¼ .039) were independently associated with an adverse 1-month clinical outcome. On the other hand, older age (P ¼ .011) and acute kidney injury (P ¼ .031) at presentation were both related to worse 6-month outcome. For patients with ALF and AoCLF we did not observe the same differences. Conclusions. In this cohort, older age was the most important parameter defining 1- and 6-month survival, although higher INR and presence of ALF were important for 1-month survival and AKI for 6-month survival. No difference was observed between patients who underwent LT or did not have LT.

Infections After Liver Transplantation: A Retrospective, Single-Center Study

Objective. To access the incidence of infectious problems after liver transplantation (LT). Design. A retrospective, single-center study. Materials and Methods. Patients undergoing LT from January 2008 to December 2011 were considered. Exclusion criterion was death occurring in the first 48 hours after LT. We determined the site of infection and the bacterial isolates and collected and compared recipient’s variables, graft variables, surgical data, post-LT clinical data. Results. Of the 492 patients who underwent LT and the 463 considered for this study, 190 (Group 1, 41%) developed at least 1 infection, with 298 infections detected. Of these, 189 microorganisms were isolated, 81 (51%) gram-positive bacteria (most frequently Staphylococcus spp). Biliary infections were more frequent (mean time of 160.4 167.7 days after LT); from 3 months after LT, gram-negative bacteria were observed (57%). Patients with infections after LT presented lower aminotransferase levels, but higher requirements in blood transfusions, intraoperative vasopressors, hemodialysis, and hospital stay. Operative and cold ischemia times were similar. Conclusion. We found a 41% incidence of all infections in a 2-year follow-up after LT. Gram-positive bacteria were more frequent isolated; however, negative bacteria were commonly isolated later. Clinical data after LT were more relevant for the development of infections. Donors’ variables should be considered in future analyses.

Validation of Two US Risk Scores for Percutaneous Coronary Intervention in a Single-Center Portuguese Population of Patients with Acute Coronary Syndrome

INTRODUCTION: New scores have been developed and validated in the US for in-hospital mortality risk stratification in patients undergoing coronary angioplasty: the National Cardiovascular Data Registry (NCDR) risk score and the Mayo Clinic Risk Score (MCRS). We sought to validate these scores in a European population with acute coronary syndrome (ACS) and to compare their predictive accuracy with that of the GRACE risk score. METHODS: In a single-center ACS registry of patients undergoing coronary angioplasty, we used the area under the receiver operating characteristic curve (AUC), a graphical representation of observed vs. expected mortality, and net reclassification improvement (NRI)/integrated discrimination improvement (IDI) analysis to compare the scores. RESULTS: A total of 2148 consecutive patients were included, mean age 63 years (SD 13), 74% male and 71% with ST-segment elevation ACS. In-hospital mortality was 4.5%. The GRACE score showed the best AUC (0.94, 95% CI 0.91-0.96) compared with NCDR (0.87, 95% CI 0.83-0.91, p=0.0003) and MCRS (0.85, 95% CI 0.81-0.90, p=0.0003). In model calibration analysis, GRACE showed the best predictive power. With GRACE, patients were more often correctly classified than with MCRS (NRI 78.7, 95% CI 59.6-97.7; IDI 0.136, 95% CI 0.073-0.199) or NCDR (NRI 79.2, 95% CI 60.2-98.2; IDI 0.148, 95% CI 0.087-0.209). CONCLUSION: The NCDR and Mayo Clinic risk scores are useful for risk stratification of in-hospital mortality in a European population of patients with ACS undergoing coronary angioplasty. However, the GRACE score is still to be preferred.

Applying Data mining using Statistical Techniques for Career Selection

For years, choosing the right career by monitoring the trends and scope for different career paths have been a requirement for all youngsters all over the world. In this paper we provide a scientific, data mining based method for job absorption rate prediction and predicting the waiting time needed for 100% placement, for different engineering courses in India. This will help the students in India in a great deal in deciding the right discipline for them for a bright future. Information about passed out students are obtained from the NTMIS ( National technical manpower information system ) NODAL center in Kochi, India residing in Cochin University of science and technology

Photoperiod-dependent plasticity of circadian pacemaker center in the brain of the Madeira cockroach Rhyparobia maderae

To various degrees, insects in nature adapt to and live with two fundamental environmental rhythms around them: (1) the daily rhythm of light and dark, and (2) the yearly seasonal rhythm of the changing photoperiod (length of light per day). It is hypothesized that two biological clocks evolved in organisms on earth which allow them to harmonize successfully with the two environmental rhythms: (1) the circadian clock, which orchestrates circadian rhythms in physiology and behavior, and (2) the photoperiodic clock, which allows for physiological adaptations to changes in photoperiod during the course of the year (insect photoperiodism). The circadian rhythm is endogenous and continues in constant conditions, while photoperiodism requires specific light inputs of a minimal duration. Output pathways from both clocks control neurosecretory cells which regulate growth and reproduction. This dissertation focuses on the question whether different photoperiods change the network and physiology of the circadian clock of an originally equatorial cockroach species. It is assumed that photoperiod-dependent plasticity of the cockroach circadian clock allows for adaptations in physiology and behavior without the need for a separate photoperiodic clock circuit. The Madeira cockroach Rhyparobia maderae is a well established circadian clock model system. Lesion and transplantation studies identified the accessory medulla (aMe), a small neuropil with about 250 neurons, as the cockroach circadian pacemaker. Among them, the pigment-dispersing factor immunoreactive (PDF-ir) neurons anterior to the aMe (aPDFMes) play a key role as inputs to and outputs of the circadian clock system. The aim of my doctoral thesis was to examine whether and how different photoperiods modify the circadian clock system. With immunocytochemical studies, three-dimensional (3D) reconstruction, standardization and Ca2+-imaging technique, my studies revealed that raising cockroaches in different photoperiods changed the neuronal network of the circadian clock (Wei and Stengl, 2011). In addition, different photoperiods affected the physiology of single, isolated circadian pacemaker neurons. This thesis provides new evidence for the involvement of the circadian clock in insect photoperiodism. The data suggest that the circadian pacemaker system of the Madeira cockroach has the plasticity and potential to allow for physiological adaptations to different photoperiods. Therefore, it may express also properties of a photoperiodic clock.

Big Data or Right Data?

Abstract Big data nowadays is a fashionable topic, independently of what people mean when they use this term. But being big is just a matter of volume, although there is no clear agreement in the size threshold. On the other hand, it is easy to capture large amounts of data using a brute force approach. So the real goal should not be big data but to ask ourselves, for a given problem, what is the right data and how much of it is needed. For some problems this would imply big data, but for the majority of the problems much less data will and is needed. In this talk we explore the trade-offs involved and the main problems that come with big data using the Web as case study: scalability, redundancy, bias, noise, spam, and privacy. Speaker Biography Ricardo Baeza-Yates Ricardo Baeza-Yates is VP of Research for Yahoo Labs leading teams in United States, Europe and Latin America since 2006 and based in Sunnyvale, California, since August 2014. During this time he has lead the labs in Barcelona and Santiago de Chile. Between 2008 and 2012 he also oversaw the Haifa lab. He is also part time Professor at the Dept. of Information and Communication Technologies of the Universitat Pompeu Fabra, in Barcelona, Spain. During 2005 he was an ICREA research professor at the same university. Until 2004 he was Professor and before founder and Director of the Center for Web Research at the Dept. of Computing Science of the University of Chile (in leave of absence until today). He obtained a Ph.D. in CS from the University of Waterloo, Canada, in 1989. Before he obtained two masters (M.Sc. CS & M.Eng. EE) and the electronics engineer degree from the University of Chile in Santiago. He is co-author of the best-seller Modern Information Retrieval textbook, published in 1999 by Addison-Wesley with a second enlarged edition in 2011, that won the ASIST 2012 Book of the Year award. He is also co-author of the 2nd edition of the Handbook of Algorithms and Data Structures, Addison-Wesley, 1991; and co-editor of Information Retrieval: Algorithms and Data Structures, Prentice-Hall, 1992, among more than 500 other publications. From 2002 to 2004 he was elected to the board of governors of the IEEE Computer Society and in 2012 he was elected for the ACM Council. He has received the Organization of American States award for young researchers in exact sciences (1993), the Graham Medal for innovation in computing given by the University of Waterloo to distinguished ex-alumni (2007), the CLEI Latin American distinction for contributions to CS in the region (2009), and the National Award of the Chilean Association of Engineers (2010), among other distinctions. In 2003 he was the first computer scientist to be elected to the Chilean Academy of Sciences and since 2010 is a founding member of the Chilean Academy of Engineering. In 2009 he was named ACM Fellow and in 2011 IEEE Fellow.

Gestión de la cadena de suministros desde la dinámica de sistemas. Aproximación al mejoramiento de la toma de decisiones

El objetivo de este trabajo es hacer un estudio sobre la cadena de suministros en organizaciones empresariales desde la Dinámica de Sistemas y como esta puede aportar al desempeño y el control de las cadenas de suministros. Se buscará Abordar el cocimiento sobre tres perspectivas de Supply Chain y su relación con la dinámica de sistemas. También se buscará identificar los tipos de integración en las actividades de la gestión en la cadena de suministros y sus horizontes de planeación. Por último, se pretende analizar las aplicaciones de Supply Chain Management que se han basado en el uso de la metodología de dinámica de sistemas. Para esto, la investigación empezará por definir la problemática alrededor de unir estas dos áreas y definirá el marco teórico que fundan estas dos disciplinas. Luego se abordará la metodología usada por la Dinámica de Sistemas y los diferentes aspectos de la cadena de suministros. Se Ahondará en el acercamiento de las dos disciplinas y como convergen ayudando la SD a la SCM (Supply Chain Management). En este punto también se describirán los trabajos en los diferentes enfoques que se han hecho a partir de uso de la dinámica de sistemas. Por último, presentaremos las correspondientes conclusiones y comentarios acerca de este campo de investigación y su pertinencia en el campo de la Supply Chain. Esta investigación abarca dos grandes corrientes de pensamiento, una sistémica, a través de la metodología de dinámica de sistemas y la otra, lógico analítica la cual es usada en Supply Chain. Se realizó una revisión de la literatura sobre las aplicaciones de dinámica de sistemas (SD) en el área de Supply Chain, sus puntos en común y se documentaron importantes empleos de esta metodología que se han hecho en la gestión de la cadena de suministros.

Correlación de las condiciones de iluminación, ángulo visual, agudeza visual y contraste con y síntomas visuales en trabajadores de un call center en Bogotá, Colombia

Objetivo: Establecer la correlación entre condiciones de iluminación, ángulo visual, discriminación de contrastes y agudeza visual en la aparición de síntomas visuales en operarios de computador. Materiales y métodos: Estudio de corte transversal y correlación en muestra de 136 trabajadores administrativos de un “call center” perteneciente a una entidad de salud en la ciudad de Bogotá, utilizando un cuestionario con el que se evaluaron las variables sociodemográficas y ocupacionales; aplicando la escala de síntomas visión – computador (CVSS17), realizando evaluación médica y midiendo iluminación y distancia operario pantalla de computador y con los datos recolectados se realizó un análisis estadístico bivariado y se estableció la correlación entre las condiciones de iluminación, ángulo visual, discriminación de contrataste y agudeza visual; frente a la aparición de síntomas visuales asociados con el uso del computador. El análisis se llevó a cabo con medidas de tendencia central y dispersión y con el coeficiente de correlación paramétrico de Pearson o no-paramétrico de Spearman, previamente se evaluó la normalidad con la prueba de Shapiro-Wilk. Las pruebas estadísticas se evaluarán a un nivel de significancia del 5% (p<0.05). Resultados: El promedio de edad de los participantes en el estudio fue de 36,3 años con un rango entre los 22 y 57 años y en donde el género predominante fue el femenino con el 79,4%. Se encontraron síntomas visuales asociados al uso de pantalla de computador del 59,6%, siendo los más frecuentes la epifora (70,6%), fotofobia (67,6%) y ardor ocular (54,4%). Se reportó una correlación inversa significativa entre niveles de iluminación y manifestación de fotofobia (p=0.02; r= 0,262). Por otra parte no se encontró correlación significativa entre los síntomas referidos con ángulo de visión y agudeza visual y discriminación de contrastes. Conclusión: Las condiciones laborales de iluminación del grupo de estudio están relacionadas con la manifestación de fotofobia, Se encontró asociación entre síntomas visuales y variables sociodemográficas, específicamente con el género, fotofobia a pantalla, fatiga visual y fotofobia

La ??tica en el Aprendizaje-Servicio (ApS) : un Meta-An??lisis a partir de Education Resources Information Center (ERIC)

Resumen basado en el de la publicaci??n

The GlobMODEL demonstrator: assimilation of new satellite products in an operational meteorological center

As part of its Data User Element programme, the European Space Agency funded the GlobMODEL project which aimed at investigating the scientific, technical, and organizational issues associated with the use and exploitation of remotely-sensed observations, particularly from new sounders. A pilot study was performed as a "demonstrator" of the GlobMODEL idea, based on the use of new data, with a strong European heritage, not yet assimilated operationally. Two parallel assimilation experiments were performed, using either total column ozone or ozone profiles retrieved at the Royal Netherlands Meteorological Institute (KNMI) from the Ozone Monitoring Instrument (OMI). In both cases, the impact of assimilating OMI data in addition to the total ozone columns from the SCanning Imaging Absorption spectroMeter for Atmospheric CartograpHY (SCIAMACHY) on the European Centre for Medium Range Weather Forecasts (ECMWF) ozone analyses was assessed by means of independent measurements. We found that the impact of OMI total columns is mainly limited to the region between 20 and 80 hPa, and is particularly important at high latitudes in the Southern hemisphere where the stratospheric ozone transport and chemical depletion are generally difficult to model with accuracy. Furthermore, the assimilation experiments carried out in this work suggest that OMI DOAS (Differential Optical Absorption Spectroscopy) total ozone columns are on average larger than SCIAMACHY total columns by up to 3 DU, while OMI total columns derived from OMI ozone profiles are on average about 8 DU larger than SCIAMACHY total columns. At the same time, the demonstrator brought to light a number of issues related to the assimilation of atmospheric composition profiles, such as the shortcomings arising when the vertical resolution of the instrument is not properly accounted for in the assimilation. The GlobMODEL demonstrator accelerated scientific and operational utilization of new observations and its results - prompted ECMWF to start the operational assimilation of OMI total column ozone data.

Thermal expansion of deuterated hopeite, Zn-3(PO4)(2)center dot 4D(2)O

The lattice parameters extracted from Lebail analysis of neutron powder diffraction data collected between 2 and 300 K have been used to calculate the temperature evolution of the thermal expansion tensor for hopeite, Zn-3(PO4)(2)center dot 2H(2)O, Pnma,Z=4with a= 10.6065(4) angstrom, b = 18.2977(4) angstrom, c= 5.0257(2) A at 275 K. The a lattice parameter shows a negative thermal expansion, the b lattice parameter appears to saturate at 275 K while the c lattice parameter has a more typical positive thermal expansion. At 275 K, the magnitudes of the thermal expansion coefficients are alpha(a) = -1. 1(4) x 10(-5) K-1, alpha(b) = 2.4(9) x 10(-6) K-1 and alpha(c) = 3.6(2) x 10(-1) K-1. Under the conditions of these experiments, hopeite begins to dehydrate to the dihydrate between 300 and 325 K, and between 480 and 500 K the monohydrate is formed. The thermal expansion of the dihydrate has been calculated between 335 and 480 and at 480 K the magnitudes of the thermal expansion coefficients are alpha(a) = 1(2) x 10(-5) K-1, alpha(b) = 4(l) x 10(-6) K-1, alpha(c) = 4(2) x 10(-5) K-1, alpha(beta) = 1 (1) x 10(-1) K-1, and alpha(v) = 2(2) x 10(-1) K-1. The thermal expansion of hopeite is described in terms of its crystal structure and possible dehydration mechanisms for the alpha and beta modifications of hopeite are discussed.

Crops and cultures in the Pacific: new data and new techniques for the investigation of old questions

Fifty years ago Carl Sauer suggested, controversially and on the basis of theory rather than evidence, that Southeast Asia was the source area for agriculture throughout the Old World, including the Pacific. Since then, the archaeobotanical record (macroscopic and microscopic) from the Pacific islands has increased, leading to suggestions, also still controversial, that Melanesia was a center of origin of agriculture independent of South-east Asia, based on tree fruits and nuts and vegetatively propagated starchy staples. Such crops generally lack morphological markers of domestication, so exploitation, cultivation and domestication cannot easily be distinguished in the archaeological record. Molecular studies involving techniques such as chromosome painting, DNA fingerprinting and DNA sequencing, can potentially complement the archaeological record by suggesting where species which were spread through the Pacific by man originated and by what routes they attained their present distributions. A combination of archaeobotanical and molecular studies should therefore eventually enable the rival claims of Melanesia versus South-east Asia as independent centers of invention of agriculture to be assessed.

Population subdivision and molecular sequence variation: Theory and analysis of Drosophila ananassae data

Population subdivision complicates analysis of molecular variation. Even if neutrality is assumed, three evolutionary forces need to be considered: migration, mutation, and drift. Simplification can be achieved by assuming that the process of migration among and drift within subpopulations is occurring fast compared to Mutation and drift in the entire population. This allows a two-step approach in the analysis: (i) analysis of population subdivision and (ii) analysis of molecular variation in the migrant pool. We model population subdivision using an infinite island model, where we allow the migration/drift parameter Theta to vary among populations. Thus, central and peripheral populations can be differentiated. For inference of Theta, we use a coalescence approach, implemented via a Markov chain Monte Carlo (MCMC) integration method that allows estimation of allele frequencies in the migrant pool. The second step of this approach (analysis of molecular variation in the migrant pool) uses the estimated allele frequencies in the migrant pool for the study of molecular variation. We apply this method to a Drosophila ananassae sequence data set. We find little indication of isolation by distance, but large differences in the migration parameter among populations. The population as a whole seems to be expanding. A population from Bogor (Java, Indonesia) shows the highest variation and seems closest to the species center.

Synthesis, structure and properties of a mononuclear and an end-on double azido-bridged copper(II) complex incorporating an N,N,N,O-coordinating tripodal ligand

The blue coloured complex [Cu(HL)(H2O)(ClO4)]ClO.H2O.MeOH (1.H2O.MeOH) has been synthesised in excellent yields by reacting Cu(ClO4)(2).6H(2)O with N,N-bis(2-methylpyridyl)(3,5-dimethyl-2-hydroxybenzyl)amine (HL) in methanol. The same reaction, when carried out in the presence of sodium azide, afforded a dark-blue complex of formula [Cu-2(HL)(2)(mu-1,1-N-3)(2)](ClO4)(2) (2). The crystal and molecular structures of the complexes have been solved. Variable-temperature magnetic susceptibility data in the range of 2-300 K for 2 reveal the existence of an antiferromagnetic interaction through an end-on azido linker. Temperature-dependent susceptibility studies for 2 were fitted using the Bleaney-Bowers expression, which led to the parameters J = -3.2 cm(-1), g = 2.12 and R = 2.14 x 10(-4). (C) Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004.