Tecniche per il controllo dinamico del consumo di potenza per piattaforme system-on-chip

Providing support for multimedia applications on low-power mobile devices remains a significant research challenge. This is primarily due to two reasons: • Portable mobile devices have modest sizes and weights, and therefore inadequate resources, low CPU processing power, reduced display capabilities, limited memory and battery lifetimes as compared to desktop and laptop systems. • On the other hand, multimedia applications tend to have distinctive QoS and processing requirementswhichmake themextremely resource-demanding. This innate conflict introduces key research challenges in the design of multimedia applications and device-level power optimization. Energy efficiency in this kind of platforms can be achieved only via a synergistic hardware and software approach. In fact, while System-on-Chips are more and more programmable thus providing functional flexibility, hardwareonly power reduction techniques cannot maintain consumption under acceptable bounds. It is well understood both in research and industry that system configuration andmanagement cannot be controlled efficiently only relying on low-level firmware and hardware drivers. In fact, at this level there is lack of information about user application activity and consequently about the impact of power management decision on QoS. Even though operating system support and integration is a requirement for effective performance and energy management, more effective and QoSsensitive power management is possible if power awareness and hardware configuration control strategies are tightly integratedwith domain-specificmiddleware services. The main objective of this PhD research has been the exploration and the integration of amiddleware-centric energymanagement with applications and operating-system. We choose to focus on the CPU-memory and the video subsystems, since they are the most power-hungry components of an embedded system. A second main objective has been the definition and implementation of software facilities (like toolkits, API, and run-time engines) in order to improve programmability and performance efficiency of such platforms. Enhancing energy efficiency and programmability ofmodernMulti-Processor System-on-Chips (MPSoCs) Consumer applications are characterized by tight time-to-market constraints and extreme cost sensitivity. The software that runs on modern embedded systems must be high performance, real time, and even more important low power. Although much progress has been made on these problems, much remains to be done. Multi-processor System-on-Chip (MPSoC) are increasingly popular platforms for high performance embedded applications. This leads to interesting challenges in software development since efficient software development is a major issue for MPSoc designers. An important step in deploying applications on multiprocessors is to allocate and schedule concurrent tasks to the processing and communication resources of the platform. The problem of allocating and scheduling precedenceconstrained tasks on processors in a distributed real-time system is NP-hard. There is a clear need for deployment technology that addresses thesemulti processing issues. This problem can be tackled by means of specific middleware which takes care of allocating and scheduling tasks on the different processing elements and which tries also to optimize the power consumption of the entire multiprocessor platform. This dissertation is an attempt to develop insight into efficient, flexible and optimalmethods for allocating and scheduling concurrent applications tomultiprocessor architectures. It is a well-known problem in literature: this kind of optimization problems are very complex even in much simplified variants, therefore most authors propose simplified models and heuristic approaches to solve it in reasonable time. Model simplification is often achieved by abstracting away platform implementation ”details”. As a result, optimization problems become more tractable, even reaching polynomial time complexity. Unfortunately, this approach creates an abstraction gap between the optimization model and the real HW-SW platform. The main issue with heuristic or, more in general, with incomplete search is that they introduce an optimality gap of unknown size. They provide very limited or no information on the distance between the best computed solution and the optimal one. The goal of this work is to address both abstraction and optimality gaps, formulating accurate models which accounts for a number of ”non-idealities” in real-life hardware platforms, developing novel mapping algorithms that deterministically find optimal solutions, and implementing software infrastructures required by developers to deploy applications for the targetMPSoC platforms. Energy Efficient LCDBacklightAutoregulation on Real-LifeMultimediaAp- plication Processor Despite the ever increasing advances in Liquid Crystal Display’s (LCD) technology, their power consumption is still one of the major limitations to the battery life of mobile appliances such as smart phones, portable media players, gaming and navigation devices. There is a clear trend towards the increase of LCD size to exploit the multimedia capabilities of portable devices that can receive and render high definition video and pictures. Multimedia applications running on these devices require LCD screen sizes of 2.2 to 3.5 inches andmore to display video sequences and pictures with the required quality. LCD power consumption is dependent on the backlight and pixel matrix driving circuits and is typically proportional to the panel area. As a result, the contribution is also likely to be considerable in future mobile appliances. To address this issue, companies are proposing low power technologies suitable for mobile applications supporting low power states and image control techniques. On the research side, several power saving schemes and algorithms can be found in literature. Some of them exploit software-only techniques to change the image content to reduce the power associated with the crystal polarization, some others are aimed at decreasing the backlight level while compensating the luminance reduction by compensating the user perceived quality degradation using pixel-by-pixel image processing algorithms. The major limitation of these techniques is that they rely on the CPU to perform pixel-based manipulations and their impact on CPU utilization and power consumption has not been assessed. This PhDdissertation shows an alternative approach that exploits in a smart and efficient way the hardware image processing unit almost integrated in every current multimedia application processors to implement a hardware assisted image compensation that allows dynamic scaling of the backlight with a negligible impact on QoS. The proposed approach overcomes CPU-intensive techniques by saving system power without requiring either a dedicated display technology or hardware modification. Thesis Overview The remainder of the thesis is organized as follows. The first part is focused on enhancing energy efficiency and programmability of modern Multi-Processor System-on-Chips (MPSoCs). Chapter 2 gives an overview about architectural trends in embedded systems, illustrating the principal features of new technologies and the key challenges still open. Chapter 3 presents a QoS-driven methodology for optimal allocation and frequency selection for MPSoCs. The methodology is based on functional simulation and full system power estimation. Chapter 4 targets allocation and scheduling of pipelined stream-oriented applications on top of distributed memory architectures with messaging support. We tackled the complexity of the problem by means of decomposition and no-good generation, and prove the increased computational efficiency of this approach with respect to traditional ones. Chapter 5 presents a cooperative framework to solve the allocation, scheduling and voltage/frequency selection problem to optimality for energyefficient MPSoCs, while in Chapter 6 applications with conditional task graph are taken into account. Finally Chapter 7 proposes a complete framework, called Cellflow, to help programmers in efficient software implementation on a real architecture, the Cell Broadband Engine processor. The second part is focused on energy efficient software techniques for LCD displays. Chapter 8 gives an overview about portable device display technologies, illustrating the principal features of LCD video systems and the key challenges still open. Chapter 9 shows several energy efficient software techniques present in literature, while Chapter 10 illustrates in details our method for saving significant power in an LCD panel. Finally, conclusions are drawn, reporting the main research contributions that have been discussed throughout this dissertation.

Sulfur isotope analysis of aerosol particles by NanoSIMS

A new method to measure the sulfur isotopic composition of individual aerosol particles by NanoSIMS has been developed and tested on several standards such as barite (BaSO4), anhydrite (CaSO4), gypsum (CaSO4·2H2O), mascagnite ((NH4)2SO4), epsomite (MgSO4·7H2O), magnesium sulfate (MgSO4·xH2O), thenardite (Na2SO4), boetite (K2SO4) and cysteine (an amino acid). This ion microprobe technique employs a Cs+ primary ion beam and measures negative secondary ions permitting the analysis of sulfur isotope ratios in individual aerosol particles down to 500 nm in size (0.001-0.5 ng of sample material). The grain-to-grain reproducibility of measurements is typically 5‰ (1σ) for micron-sized grains, <5‰ for submicron-sized grains, and <2‰ for polished thin sections and ultra microtome sections which were studied for comparison. The role of chemical omposition (matrix effect) and sample preparation techniques on the instrumental mass fractionation (IMF) of the 34S/32S ratio in the NanoSIMS has been investigated. The IMF varies by ~15‰ between the standards studied here. A good correlation between IMF and ionic radius of the cations in sulfates was observed. This permits to infer IMF corrections even for sulfates for which no isotope standards are available. The new technique allows to identify different types of primary and secondary sulfates based on their chemical composition and to measure their isotopic signature separately. It was applied to marine aerosol samples collected in Mace Head and urban aerosol samples collected in Mainz. It was shown that primary sulfate particles such as sulfate in NaCl or gypsum particles precipitated from ocean water retain the original isotopic signature of their source. The isotopic composition of secondary sulfate depends on the isotopic composition of precursor SO2 and the oxidation pathway. The 34S/32S fractionation with respect to the precursor SO2 is -9‰ for homogeneous oxidation and +16.5‰ for heterogeneous oxidation. This large difference between the isotopic fractionation of both pathways allows identifying the oxidation pathway from which the SO42- in a secondary sulfate particle is derived, by means of its sulfur isotope ratio, provided that the isotopic signature of the precursor SO2 is known. The isotopic composition of the precursor SO2 of secondary sulfates was calculated based on the isotopic composition of particles with known oxidation pathway such as fine mode ammonium sulfate.

Funktionelle Blockcopolymere für photovoltaische Anwendungen

Zusammenfassung der Dissertation von Pablo A. Walter Thema der Arbeit: Funktionelle Blockcopolymere für photovoltaische Anwendungen Im Zentrum dieser Dissertation stand die Erarbeitung eines Konzepts zum Bau neuartiger Solarzellen auf der Basis von Blockcopolymeren aus Elektronendonatorund Akzeptorblöcken. Dabei soll die Nanophasenseparation in Blockcopolymeren zur Kontrolle und Beeinflussung der Morphologie der Akzeptor- und Donatorkomponenten benutzt werden. Die Blockcopolymere müssen damit alle Materialeigenschaften vereinen, die für den Betrieb einer Solarzelle notwendig sind. Um diesem Ziel gerecht zu werden, war es notwendig, sowohl Monomere als auch neuartige monofunktionale Farbstoffe herzustellen. Es wurden gezielt funktionale Homopolymere und Diblockcopolymeren hergestellt. Es gelang ferner, sowohl die Homopolymere als auch die Blockcopolymere mittels Farbstoffen zu funktionalisieren. Im Zuge der Charakterisierung war es möglich, im Bereich der Polymeranalyse die Glastemperaturen, die Molekulargewichte und die Polydispersitäten zu bestimmen. Des Weiteren galt es, im Rahmen der polymeranalogen Umsetzungen, Möglichkeiten zur gezielten Bestimmung der angebundenen Farbstoffmenge zu entwickeln. Bezüglich der Materialeigenschaften wurden, die HOMOs und die LUMOs der funktionalen Block- und Homopolymere bestimmt. Mittels TEM war es auch erstmals möglich, die Phasenseparation der beiden Blöcke deutlich zu machen. Somit ist es gelungen, neue funktionale Blockcopolymere herzustellen und diese bei dem Bau von neuen polymerbasierten Solarzellen einzusetzen. Es konnte gezeigt werden, dass das Konzept prinzipiell funktioniert.

La tutela del disoccupato nel mercato del lavoro. Dal sostegno del reddito ai servizi per l'occupazione

La tesi affronta il tema degli istituti e degli strumenti di tutela della condizione di disoccupazione. In mancanza d’una nozione giuridica generale di disoccupazione, l’obiettivo è quello di ricercare gli elementi comuni ai differenti istituti in grado di definire l’ambito della protezione garantita alla persona priva d’impiego. Lo studio fornisce, dapprima, una complessiva ricognizione storico-critica degli strumenti per il sostegno del reddito nelle ipotesi di mancanza di lavoro. L’esame dei modelli d’intervento legislativo evidenzia finalità, caratteristiche e criticità dei singoli istituti, sia di quelli più consolidati, che degli interventi più recenti. La seconda parte della tesi si propone d’integrare la ricognizione delle forme di tutela economica con l’analisi delle politiche attive nel mercato del lavoro e degli interventi a sostegno all’occupabilità. L’intento è di verificare le modalità attraverso le quali l’ordinamento tenta di collegare tutela del reddito e promozione dell’occupazione. La ricerca affronta anche la questione dei limiti alla libertà di circolazione nell’Unione Europea dei cittadini non lavoratori, nonché il condizionamento determinato dalle misure che riducono o scoraggiano l’esportabilità delle prestazioni previdenziali negli altri Paesi europei. La parte finale si propone d’individuare gli elementi che caratterizzano il complesso degli istituti analizzati, al fine di verificare a quale evento giuridico l’ordinamento offra protezione. Lo studio identifica due elementi rilevanti: la condizione di “mancanza di lavoro”, che accomuna l’intervento per la disoccupazione e quello a favore dei rapporti di lavoro sospesi, nonché l’attualità dello stato di disoccupazione, parametro generale per gli interventi protettivi. L’analisi svolta sottolinea, però, che i meccanismi di c.d. condizionalità per l’accesso alle prestazioni economiche e ai servizi per l’impiego non consentono un’adeguata promozione della qualità del lavoro e della professionalità del lavoratore. La tesi individua un possibile terreno di sviluppo della protezione della condizione del disoccupato nell’integrazione tra strumenti di sostegno all’impiego e interventi a base universalistica.

Das deutsche Kriegsgefangenenwesen 1939 - 1945

Zusammenfassung: Die vorliegende Untersuchung zum deutschen Kriegsgefangenenwesen (KGW) im Zweiten Weltkrieg schließt eine wichtige Lücke innerhalb der geschichtswissenschaftlichen Forschungen zum Themenkreis der Kriegsgefangenschaft in deutschem Gewahrsam. Bisherige Studien (bis einschließlich 1997) behandeln vor allem sozial- und kulturgeschichtliche Aspekte der Kriegsgefangenen (Kgf.), der Lagergesellschaft und dem Alltag von Soldaten in Kriegsgefangenschaft. Der Verfasser indes legt mit seiner Magisterarbeit erstmals eine Organisations- und Strukturgeschichte des deutschen Kriegsgefangenenwesens von 1939 bis 1945 vor, welche fundamentale Grundlagen der deutschen militärischen Lagerorganisation und Verwaltung dokumentiert. So wird die Entwicklung von den Vorkriegsplanungen bis zum Kriegsende anhand der zentralen Dienststellen herausgearbeitet und im Kontext des Genfer Kriegsgefangenenabkommens von 1929 und völkerrechtlicher Implikationen gewichtet. Hiermit untrennbar verbundene Einflußnahmen nichtmilitärischer Stellen in die Entscheidungsgewalt der Streitkräfte im Heimatkriegsgebiet und in den Wehrmachtbefehlshaberbereichen werden nicht zuletzt auch anhand mehrerer Organigramme veranschaulicht. Zudem dokumentiert und analysiert die Untersuchung die im Kriegsverlauf stetig verschärften Maßnahmen zur Fluchtprävention und der konzertierten Fahndung nach geflohenen Kriegsgefangenen: Die Machterosion des Oberkommandos der Wehrmacht (OKW) zugunsten des Reichsführers-SS, des Reichssicherheitshauptamts und nicht zuletzt der Parteikanzlei der NSDAP wird so augenfällig. Trotz eminenter Schriftgutverluste kann der Verfasser vor allem anhand einer nahezu vollständig erhaltenen Schlüsselquelle die Stellenbesetzung und Organisationsstruktur der mit Kriegsgefangenenfragen befassten Stellen im OKW rekonstruieren. Die Auswertung dieser Sammelmitteilungen / Befehlssammlung für das Kriegsgefangenenwesen sowie an anderer Stelle überlieferter Organisationsbefehle ermöglicht wichtige Änderungen am derzeitigen Forschungsstand. Darüber hinaus beschäftigt sich die vorliegende Untersuchung mit dem Arbeitseinsatz Kriegsgefangener in der deutschen Wirtschaft als in der zweiten Kriegshälfte zentralem Element der Kriegsgefangenschaft. Außerdem wird beleuchtet, welche politischen, (rassen)ideologischen oder reziprok konnotierten Faktoren den Stellenwert gefangener Soldaten unterschiedlicher Nationalität innerhalb der Gefangenenhierarchie im deutschen Kriegsgefangenenwesen bestimmten. Inhalt: 1. Einführung; 2. Die Entwicklung des Kriegsvölkerrechts und das Genfer Kriegsgefangenenabkommen von 1929; 3. Einleitende Bemerkungen zum deutschen Kriegsgefangenenwesen: Quellenlage, Grundlagen; 4. Organisationsstruktur und Aufgaben des KGW: Zuständigkeiten für Kgf. in OKW und OKH, Abt. Wehrmachtverluste und Kriegsgefangene, der General z.b.V. für das KGW 1939 bis Ende 1941, Allgemeine und Organisationsabteilung seit Januar 1942, Generalinspekteur und Inspekteur des KGW von Juli 1943 bis Oktober 1944, das Kriegsgefangenenwesen unter Himmler seit Oktober 1944; 5. Die Kriegsgefangenenlager: Lagertypen, Anzahl und Verwendung, die Gesamtzahl Kgf. und Belegstärken ausgewählter Lager; 6. Richtlinien für KGL: Die Sammelmitteilungen / Befehlssammlung für das KGW, Lagerorganisation und Behandlung Kriegsgefangener; 7. Die Post der Kriegsgefangenen: Tätigkeit von Auslandsbriefprüfstelle, Abwehr III Referat Kgf. und Abwehrstellen der Wehrkreise, Vorgaben für Postüberwachung und Stimmungsberichte der Asten, Befehle zur Kgf-Post und Kooperation mit Hilfsorganisationen und Schutzmächten; 8. Fluchtprävention: Bestimmungen und Maßnahmen zur Fluchtvereitelung, der Fluchterlass vom 22.09.1942, der Sonderfahndungsplan der Sicherheitspolizei und des SD vom 28.09.1942, Erlass zur Kriegsfahndung vom 5.12.1942, der Fluchterlaß vom 02.07.1943, der Erlaß zur Mitarbeit NSDAP bei Groß- und Kriegsfahndungen vom 10.07.1943, Schulung zur Fluchtprävention auf Wehrkreisebene 1944, Preisausschreiben "Wie verhindere ich Fluchten?" vom 09.04.1945, Anwerbung von V-Leuten durch die Abwehr; 9. Arbeitseinsatz Kriegsgefangener in der deutschen Wirtschaft und beteiligte Stellen; 10. Der Status Kriegsgefangener unterschiedlicher Nationalitäten im Vergleich; 11. Schluss

America's Shifting Color Line? Reexamining Determinants of Latino Racial Self-Identification

Objectives. Latinos are the nation's largest minority group and will double in size by 2050. Their size coupled with the fact that Latinos do not constitute a separate race raises questions about Latinos' incorporation into the U. S. racial hierarchy. This article explores patterns of Latino racial identity formation, examining the determinants of racial identity. Methods. Using the 2006 Latino National Survey, I estimate multinomial logit and ordered probit models of identification choices. Results. Latino racial identity is strongly associated with several factors, including socioeconomic status, measures of perceived discrimination and commonality, and measures of acculturation/assimilation. Most Latinos have a broader, more complex understanding of race. Furthermore, some Latinos do believe that they occupy a unique position in the racial hierarchy. Conclusions. The results suggest that the color line W. E. DuBois argued has long divided our nation may eventually shift.

Social Networks Analysis

This morning Dr. Risser will introduce you to the basic ideas of social network analysis. You will learn some history behind the study of social networks. Dr. Risser will introduce you to mathematical measures of social networks including centrality measures and measures of spread and cohesion. You will also learn how to use a computer program to analyze social network data

Family Preservation Research: Where We've Been, Where We Should Be Going

Although the literature has provided many critiques of research done on family preservation programs, these critiques have usually been limited to the studies ' assumptions, approach, or methodology. Because of the nature of these critiques, suggestions for future research in this field of practice have been scattered throughout the literature and have not benefitted from a wider historical perspective. This paper examines the historical evolution of family preservation studies in child welfare and suggests future directions for research in the field. Among the suggestions the authors posit are (1) research questions should be framed by what we know about improvements in the lives of families and children served by family preservation programs; (2) future explorations should include areas that have received relatively little attention in current research, including the impact of organizational conditions on service fidelity and worker performance; (3) newer treatment models, particularly those that provide both intensive services during a crisis period and less intensive services for maintenance, should be tested; (4) data collection points in longitudinal studies should be guided by theory, and measures should change over time to reflect the theoretically expected changes in families; (5) complex measures of placement prevention and other measures that capture changes in family functioning, child well-being, and child safety, should be utilized to obtain a full picture of program effects; and (6) multiple informants should be used to provide data about program effectiveness. In addition, the authors will argue that the field should carefully consider the amount of change that should be expected from the service models delivered.

Family Preservation Services to At-Risk Families: A Macro Case Study

Although the literature has provided many critiques of research done on family preservation programs, these critiques have usually been limited to the studies ' assumptions, approach, or methodology. Because of the nature of these critiques, suggestions for future research in this field of practice have been scattered throughout the literature and have not benefited from a wider historical perspective. This paper examines the historical evolution of family preservation studies in child welfare and suggests future directions for research in the field. Among the suggestions the authors posit are (1) research questions should be framed by what we know about improvements in the lives of families and children served by family preservation programs; (2) future explorations should include areas that have received relatively little attention in current research, including the impact of organizational conditions on service fidelity and worker performance; (3) newer treatment models, particularly those that provide both intensive services during a crisis period and less intensive services for maintenance, should be tested; (4) data collection points in longitudinal studies should be guided by theory, and measures should change over time to reflect the theoretically expected changes in families; (5) complex measures of placement prevention and other measures that capture changes in family functioning, child well-being, and child safety, should be utilized to obtain a full picture of program effects; and (6) multiple informants should be used to provide data about program effectiveness. In addition, the authors will argue that the field should carefully consider the amount of change that should be expected from the service models delivered.

Sex differences in acute coronary syndrome symptom presentation in young patients

IMPORTANCE Little is known about whether sex differences in acute coronary syndrome (ACS) presentation exist in young patients and what factors determine absence of chest pain in ACS presentation. OBJECTIVES To evaluate sex differences in ACS presentation and to estimate associations between sex, sociodemographic, gender identity, psychosocial and clinical factors, markers of coronary disease severity, and absence of chest pain in young patients with ACS. DESIGN, SETTING, PARTICIPANTS We conducted a prospective cohort study of 1015 patients (30% women) 55 years or younger, hospitalized for ACS and enrolled in the GENESIS PRAXY (Gender and Sex Determinants of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary Syndrome) study (January 2009-September 2012). MAIN OUTCOMES AND MEASURES The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey was administered during hospitalization. RESULTS The median age for both sexes was 49 years. Women were more likely to have non-ST-segment elevation myocardial infarction (37.5 vs 30.7; P = .03) and present without chest pain compared with men (19.0% vs 13.7%; P = .03). Patients without chest pain reported fewer symptoms overall and no discernable pattern of non-chest pain symptoms was found. In the multivariate model, being a woman (odds ratio [OR], 1.95 [95% CI, 1.23-3.11]; P = .005) and tachycardia (OR, 2.07 [95% CI, 1.20-3.56]; P = .009) were independently associated with ACS presentation without chest pain. Patients without chest pain did not differ significantly from those with chest pain in terms of ACS type, troponin level elevation, or coronary stenosis. CONCLUSIONS AND RELEVANCE Chest pain was the most common ACS symptom in both sexes. Although women were more likely to present without chest pain than men, absence of chest pain was not associated with markers of coronary disease severity. Strategies that explicitly incorporate assessment of common non-chest pain symptoms need to be evaluated.

Insulin-associated changes in carnitine palmitoyltransferase activity are mediated through the insulin-like growth factor I pathway in the cultured neonatal rat cardiac myocyte

The mitochondrial carnitine palmitoyltransferase (CPT) system is composed of two proteins, CPT-I and CPT-II, involved in the transport of fatty acids into the mitochondrial matrix to undergo $\beta$-oxidation. CPT-I is located outside the inner membrane and CPT-II is located on the inner aspect of the inner membrane. The CPT proteins are distinct with different molecular weights and activities. The malonyl-CoA sensitivity of CPT-I has been proposed as a regulatory step in $\beta$-oxidation. Using the neonatal rat cardiac myocyte, assays were designed to discriminate between these activities in situ using digitonin and Triton X-100. With this methodology, we are able to determine the involvement of the IGF-I pathway in the insulin-mediated increase in CPT activities. Concentrations of digitonin up to 25 $\mu$M fail to release citrate synthase from the mitochondrial matrix or alter the malonyl-CoA sensitivity of CPT-I. If the mitochondrial matrix was exposed, malonyl-CoA insensitive CPT-II would reduce malonyl-CoA sensitivity. In contrast to digitonin, Triton X-100 (0.15%) releases citrate synthase from the matrix and exposes CPT-II. CPT-II activity is confirmed by the absence of malonyl-CoA sensitivity. To examine the effects of various agents on the expression and/or activity of CPT, it is necessary to use serum-free medium to eliminate mitogenic effects of serum proteins. Comparison of different media to optimize CPT activity and cell viability resulted in the decision to use Dulbecco's Modified Eagle medium supplemented with transferrin. In three established models of cardiac hypertrophy using the neonatal rat cardiac myocyte there is a significant increase in CPT-I and CPT-II activity in the treated cells. Analogous to the situation seen in the hypertrophy model, insulin also significantly increases the activity of the mitochondrial proteins CPT-I, CPT-II and cytochrome oxidase with a coinciding increase the expression of CPT-II and cytochrome oxidase mRNA. The removal of serum increases the I$\sb{50}$ (concentration of inhibitor that halves enzyme activity) of CPT-I for malonyl-CoA by four-fold. Incubation with insulin returns I$\sb{50}$ values to serum levels. Incubation with insulin significantly increases malonyl-CoA and ATP levels in the cells with a resulting reduction in palmitate oxidation. Once malonyl-CoA inhibition of CPT-I is removed by permeabilizing the cells, insulin significantly increases the oxidation of palmitoyl-CoA in a manner which parallels the increase in CPT-I activity. Interestingly, CPT-II activity increases significantly only at the tissue culture concentration (1.7 $\mu$M) of insulin suggesting that the IGF-I pathway may be involved. Supporting a role for the IGF-I pathway in the insulin-induced increase in CPT activity is the significant increase in the synthesis of both cellular and mitochondrial proteins as well as increased synthesis of CPT-II. Consistent with an IGF-mediated pathway for the effect of insulin, IGF-I (10 ng/ml) significantly increases the activities of both CPT-I and -II. An IGF-I analogue which inhibits the autophosphorylation of the IGF-I receptor blunts the insulin-mediated increase in CPT-I and -II activity by greater than 70% and virtually eliminates the IGF-I response by greater than 90%. This is the first study to demonstrate the involvement of the IGF-I pathway in the regulation of mitochondrial protein expression, e.g. CPT. ^

Non-coronary atherosclerosis

During the last decades, the clinical and research interest in atherosclerosis has been mostly focused on coronary arteries. After the publications of the European Society Guidelines and AHA/ACC Guidelines on Peripheral artery diseases, and of the Registry REduction in Atherothrombosis for Continued Health Registry, there has been an increased interest in atherosclerosis of the lower extremity arteries and its presence in multifocal disease. However, awareness in the general population and the medical community of non-coronary artery diseases, and of its major prognostic implications remain relatively low. The aim of this general review stemming out of an ESC Working Group on Peripheral Circulation meeting in 2011 is to enhance awareness of this complex disease highlighting the importance of the involvement of atherosclerosis at different levels with respect to clinical presentation, diagnosis, and co-existence of the disease in the distinct arterial territories. We also emphasize the need of an interdisciplinary approach to face the broad and complex spectrum of multifocal disease, and try to propose a series of tentative recommendations and measures to be implemented in non-coronary atherosclerosis.

Transcatheter aortic valve implantation in failed bioprosthetic surgical valves.

IMPORTANCE Owing to a considerable shift toward bioprosthesis implantation rather than mechanical valves, it is expected that patients will increasingly present with degenerated bioprostheses in the next few years. Transcatheter aortic valve-in-valve implantation is a less invasive approach for patients with structural valve deterioration; however, a comprehensive evaluation of survival after the procedure has not yet been performed. OBJECTIVE To determine the survival of patients after transcatheter valve-in-valve implantation inside failed surgical bioprosthetic valves. DESIGN, SETTING, AND PARTICIPANTS Correlates for survival were evaluated using a multinational valve-in-valve registry that included 459 patients with degenerated bioprosthetic valves undergoing valve-in-valve implantation between 2007 and May 2013 in 55 centers (mean age, 77.6 [SD, 9.8] years; 56% men; median Society of Thoracic Surgeons mortality prediction score, 9.8% [interquartile range, 7.7%-16%]). Surgical valves were classified as small (≤21 mm; 29.7%), intermediate (>21 and <25 mm; 39.3%), and large (≥25 mm; 31%). Implanted devices included both balloon- and self-expandable valves. MAIN OUTCOMES AND MEASURES Survival, stroke, and New York Heart Association functional class. RESULTS Modes of bioprosthesis failure were stenosis (n = 181 [39.4%]), regurgitation (n = 139 [30.3%]), and combined (n = 139 [30.3%]). The stenosis group had a higher percentage of small valves (37% vs 20.9% and 26.6% in the regurgitation and combined groups, respectively; P = .005). Within 1 month following valve-in-valve implantation, 35 (7.6%) patients died, 8 (1.7%) had major stroke, and 313 (92.6%) of surviving patients had good functional status (New York Heart Association class I/II). The overall 1-year Kaplan-Meier survival rate was 83.2% (95% CI, 80.8%-84.7%; 62 death events; 228 survivors). Patients in the stenosis group had worse 1-year survival (76.6%; 95% CI, 68.9%-83.1%; 34 deaths; 86 survivors) in comparison with the regurgitation group (91.2%; 95% CI, 85.7%-96.7%; 10 deaths; 76 survivors) and the combined group (83.9%; 95% CI, 76.8%-91%; 18 deaths; 66 survivors) (P = .01). Similarly, patients with small valves had worse 1-year survival (74.8% [95% CI, 66.2%-83.4%]; 27 deaths; 57 survivors) vs with intermediate-sized valves (81.8%; 95% CI, 75.3%-88.3%; 26 deaths; 92 survivors) and with large valves (93.3%; 95% CI, 85.7%-96.7%; 7 deaths; 73 survivors) (P = .001). Factors associated with mortality within 1 year included having small surgical bioprosthesis (≤21 mm; hazard ratio, 2.04; 95% CI, 1.14-3.67; P = .02) and baseline stenosis (vs regurgitation; hazard ratio, 3.07; 95% CI, 1.33-7.08; P = .008). CONCLUSIONS AND RELEVANCE In this registry of patients who underwent transcatheter valve-in-valve implantation for degenerated bioprosthetic aortic valves, overall 1-year survival was 83.2%. Survival was lower among patients with small bioprostheses and those with predominant surgical valve stenosis.

Evaluating perspectives for PRRS virus elimination from pig dense areas with a risk factor based herd index

Porcine reproductive and respiratory syndrome virus (PRRSV) is wide-spread in pig populations globally. In many regions of Europe with intensive pig production and high herd densities, the virus is endemic and can cause disease and production losses. This fuels discussion about the feasibility and sustainability of virus elimination from larger geographic regions. The implementation of a program aiming at virus elimination for areas with high pig density is unprecedented and its potential success is unknown. The objective of this work was to approach pig population data with a simple method that could support assessing the feasibility of a sustainable regional PRRSV elimination. Based on known risk factors such as pig herd structure and neighborhood conditions, an index characterizing individual herds' potential for endemic virus circulation and reinfection was designed. This index was subsequently used to compare data of all pig herds in two regions with different pig- and herd-densities in Lower Saxony (North-West Germany) where PRRSV is endemic. Distribution of the indexed herds was displayed using GIS. Clusters of high herd index densities forming potential risk hot spots were identified which could represent key target areas for surveillance and biosecurity measures under a control program aimed at virus elimination. In an additional step, for the study region with the higher pig density (2463 pigs/km(2) farmland), the potential distribution of PRRSV-free and non-free herds during the implementation of a national control program aiming at national virus elimination was modeled. Complex herd and trade network structures suggest that PRRSV elimination in regions with intensive pig farming like that of middle Europe would have to involve legal regulation and be accompanied by important trade and animal movement restrictions. The proposed methodology of risk index mapping could be adapted to areas varying in size, herd structure and density. Interpreted in the regional context, this could help to classify the density of risk and to accordingly target resources and measures for elimination.

Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial

IMPORTANCE High-dose immunosuppressive therapy and autologous hematopoietic stem cell transplantation (HSCT) have shown efficacy in systemic sclerosis in phase 1 and small phase 2 trials. OBJECTIVE To compare efficacy and safety of HSCT vs 12 successive monthly intravenous pulses of cyclophosphamide. DESIGN, SETTING, AND PARTICIPANTS The Autologous Stem Cell Transplantation International Scleroderma (ASTIS) trial, a phase 3, multicenter, randomized (1:1), open-label, parallel-group, clinical trial conducted in 10 countries at 29 centers with access to a European Group for Blood and Marrow Transplantation-registered transplant facility. From March 2001 to October 2009, 156 patients with early diffuse cutaneous systemic sclerosis were recruited and followed up until October 31, 2013. INTERVENTIONS HSCT vs intravenous pulse cyclophosphamide. MAIN OUTCOMES AND MEASURES The primary end point was event-free survival, defined as time from randomization until the occurrence of death or persistent major organ failure. RESULTS A total of 156 patients were randomly assigned to receive HSCT (n = 79) or cyclophosphamide (n = 77). During a median follow-up of 5.8 years, 53 events occurred: 22 in the HSCT group (19 deaths and 3 irreversible organ failures) and 31 in the control group (23 deaths and 8 irreversible organ failures). During the first year, there were more events in the HSCT group (13 events [16.5%], including 8 treatment-related deaths) than in the control group (8 events [10.4%], with no treatment-related deaths). At 2 years, 14 events (17.7%) had occurred cumulatively in the HSCT group vs 14 events (18.2%) in the control group; at 4 years, 15 events (19%) had occurred cumulatively in the HSCT group vs 20 events (26%) in the control group. Time-varying hazard ratios (modeled with treatment × time interaction) for event-free survival were 0.35 (95% CI, 0.16-0.74) at 2 years and 0.34 (95% CI, 0.16-0.74) at 4 years. CONCLUSIONS AND RELEVANCE Among patients with early diffuse cutaneous systemic sclerosis, HSCT was associated with increased treatment-related mortality in the first year after treatment. However, HCST conferred a significant long-term event-free survival benefit. TRIAL REGISTRATION isrctn.org Identifier: ISRCTN54371254.