Valve surgery in active infective endocarditis: a simple score to predict in-hospital prognosis

Aims Surgery for infective endocarditis (IE) is associated with high mortality. Our objectives were to describe the experience with surgical treatment for IE in Spain, and to identify predictors of in-hospital mortality. Methods Prospective cohort of 1000 consecutive patients with IE. Data were collected in 26 Spanish hospitals. Results Surgery was performed in 437 patients (43.7%). Patients treated with surgery were younger and predominantly male. They presented fewer comorbid conditions and more often had negative blood cultures and heart failure. In-hospital mortality after surgery was lower than in the medical therapy group (24.3 vs 30.7%, p = 0.02). In patients treated with surgery, endocarditis involved a native valve in 267 patients (61.1%), a prosthetic valve in 122 (27.9%), and a pacemaker lead with no clear further valve involvement in 48 (11.0%). The most common aetiologies were Staphylococcus (186, 42.6%), Streptococcus (97, 22.2%), and Enterococcus (49, 11.2%). The main indications for surgery were heart failure and severe valve regurgitation. A risk score for in-hospital mortality was developed using 7 prognostic variables with a similar predictive value (OR between 1.7 and 2.3): PALSUSE: prosthetic valve, age ≥ 70, large intracardiac destruction, Staphylococcus spp, urgent surgery, sex [female], EuroSCORE ≥ 10. In-hospital mortality ranged from 0% in patients with a PALSUSE score of 0 to 45.4% in patients with PALSUSE score > 3. Conclusions The prognosis of IE surgery is highly variable. The PALSUSE score could help to identify patients with higher in-hospital mortality.

Biblioteka Uniwersytecka w Poznaniu w Web 2.0 - rozwój przyjaznej komunikacji cyfrowej i wynikające z niej korzyści

Poster pokazuje metody komunikacji z czytelnikiem stosowane w Bibliotece Uniwersyteckiej w Poznaniu w technologii mediów cyfrowych. Cyfrowe narzędzia komunikacji stały się bardzo pomocne, niemal niezbędne w pozyskiwaniu nowych czytelników, podtrzymywaniu i rozwijaniu współpracy w społeczności w sieci Web.2.0, zarówno tej globalnej, jak i lokalnej akademickiej. Strona WWW jako statyczna komunikacyjnie jest wspierana przez fora dyskusyjne, chaty, wideokonferencje, warsztaty informacyjne, które są prowadzone w czasie rzeczywistym. Twórczą siłę relacji społecznych z biblioteką rozwinęły interaktywne serwisy społecznościowe (Facebook) oraz komunikatory internetowe integrowane na platformie Ask a Librarian. Biblioteka stała się Biblioteką 2.0 ukierunkowaną na komunikację z czytelnikiem. Aktywne uczestnictwo i udział czytelników przy tworzeniu zasobów naukowych wdrożyliśmy w projekcie instytucjonalnego repozytorium - Adam Mickiewicz Repository (AMUR). Biblioteka zmienia się dla czytelników i z czytelnikami. Wykorzystywane platformy i serwisy społecznościowe dostarczają unikatowych danych o nowych potrzebach informacyjnych i oczekiwaniach docelowego Patrona 2.0, co skutkuje doskonaleniu usług istniejących i tworzeniu nowych. Biblioteka monitoruje usługi i potrzeby czytelników przez prowadzone badania społeczne. Technologie cyfrowe stosowane w komunikacji sprawiają, iż biblioteka staje się bliższa, bardziej dostępna, aby stać się w rezultacie partnerem dla stałych i nowych czytelników. Biblioteka Uniwersytecka w Poznaniu bierze udział w programach europejskich w zakresie katalogowania i digitalizacji zasobu biblioteki cyfrowej WBC, w zakresie wdrożenia nowych technologii i rozwiązań podnoszących jakość usług bibliotecznych, działalności kulturotwórczej (Poznańska Dyskusyjna Akademia Kominksu, deBiUty) i edukacji informacyjnej. Biblioteka Uniwersytecka w Poznaniu jest członkiem organizacji międzynarodowych: LIBER (Liga Europejskich Bibliotek Naukowych), IAML (Stowarzyszenie Bibliotek Muzycznych, Archiwów i Ośrodków Dokumentacji), CERL - Europejskie Konsorcjum Bibliotek Naukowych.

Qual a eficácia clínica do sistema CEREC com os seus diferentes materiais para reabilitação em prótese fixa e sobre implantes?

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Estudo da prevalência das alterações biológicas e mecânicas associadas à reabilitação com prótese parcial removível nas clínicas pedagógicas de Medicina Dentária da FCS-UFP

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Enxertos de dente particulado

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Genome-wide association with bone mass and geometry in the Framingham Heart Study

BACKGROUND:Osteoporosis is characterized by low bone mass and compromised bone structure, heritable traits that contribute to fracture risk. There have been no genome-wide association and linkage studies for these traits using high-density genotyping platforms.METHODS:We used the Affymetrix 100K SNP GeneChip marker set in the Framingham Heart Study (FHS) to examine genetic associations with ten primary quantitative traits: bone mineral density (BMD), calcaneal ultrasound, and geometric indices of the hip. To test associations with multivariable-adjusted residual trait values, we used additive generalized estimating equation (GEE) and family-based association tests (FBAT) models within each sex as well as sexes combined. We evaluated 70,987 autosomal SNPs with genotypic call rates [greater than or equal to]80%, HWE p [greater than or equal to] 0.001, and MAF [greater than or equal to]10% in up to 1141 phenotyped individuals (495 men and 646 women, mean age 62.5 yrs). Variance component linkage analysis was performed using 11,200 markers.RESULTS:Heritability estimates for all bone phenotypes were 30-66%. LOD scores [greater than or equal to]3.0 were found on chromosomes 15 (1.5 LOD confidence interval: 51,336,679-58,934,236 bp) and 22 (35,890,398-48,603,847 bp) for femoral shaft section modulus. The ten primary phenotypes had 12 associations with 100K SNPs in GEE models at p < 0.000001 and 2 associations in FBAT models at p < 0.000001. The 25 most significant p-values for GEE and FBAT were all less than 3.5 x 10-6 and 2.5 x 10-5, respectively. Of the 40 top SNPs with the greatest numbers of significantly associated BMD traits (including femoral neck, trochanter, and lumbar spine), one half to two-thirds were in or near genes that have not previously been studied for osteoporosis. Notably, pleiotropic associations between BMD and bone geometric traits were uncommon. Evidence for association (FBAT or GEE p < 0.05) was observed for several SNPs in candidate genes for osteoporosis, such as rs1801133 in MTHFR; rs1884052 and rs3778099 in ESR1; rs4988300 in LRP5; rs2189480 in VDR; rs2075555 in COLIA1; rs10519297 and rs2008691 in CYP19, as well as SNPs in PPARG (rs10510418 and rs2938392) and ANKH (rs2454873 and rs379016). All GEE, FBAT and linkage results are provided as an open-access results resource at http://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?id=phs000007.CONCLUSION:The FHS 100K SNP project offers an unbiased genome-wide strategy to identify new candidate loci and to replicate previously suggested candidate genes for osteoporosis.

The Sensor Network Workbench: Towards Functional Specification, Verification and Deployment of Constrained Distributed Systems

As the commoditization of sensing, actuation and communication hardware increases, so does the potential for dynamically tasked sense and respond networked systems (i.e., Sensor Networks or SNs) to replace existing disjoint and inflexible special-purpose deployments (closed-circuit security video, anti-theft sensors, etc.). While various solutions have emerged to many individual SN-centric challenges (e.g., power management, communication protocols, role assignment), perhaps the largest remaining obstacle to widespread SN deployment is that those who wish to deploy, utilize, and maintain a programmable Sensor Network lack the programming and systems expertise to do so. The contributions of this thesis centers on the design, development and deployment of the SN Workbench (snBench). snBench embodies an accessible, modular programming platform coupled with a flexible and extensible run-time system that, together, support the entire life-cycle of distributed sensory services. As it is impossible to find a one-size-fits-all programming interface, this work advocates the use of tiered layers of abstraction that enable a variety of high-level, domain specific languages to be compiled to a common (thin-waist) tasking language; this common tasking language is statically verified and can be subsequently re-translated, if needed, for execution on a wide variety of hardware platforms. snBench provides: (1) a common sensory tasking language (Instruction Set Architecture) powerful enough to express complex SN services, yet simple enough to be executed by highly constrained resources with soft, real-time constraints, (2) a prototype high-level language (and corresponding compiler) to illustrate the utility of the common tasking language and the tiered programming approach in this domain, (3) an execution environment and a run-time support infrastructure that abstract a collection of heterogeneous resources into a single virtual Sensor Network, tasked via this common tasking language, and (4) novel formal methods (i.e., static analysis techniques) that verify safety properties and infer implicit resource constraints to facilitate resource allocation for new services. This thesis presents these components in detail, as well as two specific case-studies: the use of snBench to integrate physical and wireless network security, and the use of snBench as the foundation for semester-long student projects in a graduate-level Software Engineering course.

Service Provisioning in Mobile Networks Through Distributed Coordinated Resource Management

The pervasiveness of personal computing platforms offers an unprecedented opportunity to deploy large-scale services that are distributed over wide physical spaces. Two major challenges face the deployment of such services: the often resource-limited nature of these platforms, and the necessity of preserving the autonomy of the owner of these devices. These challenges preclude using centralized control and preclude considering services that are subject to performance guarantees. To that end, this thesis advances a number of new distributed resource management techniques that are shown to be effective in such settings, focusing on two application domains: distributed Field Monitoring Applications (FMAs), and Message Delivery Applications (MDAs). In the context of FMA, this thesis presents two techniques that are well-suited to the fairly limited storage and power resources of autonomously mobile sensor nodes. The first technique relies on amorphous placement of sensory data through the use of novel storage management and sample diffusion techniques. The second approach relies on an information-theoretic framework to optimize local resource management decisions. Both approaches are proactive in that they aim to provide nodes with a view of the monitored field that reflects the characteristics of queries over that field, enabling them to handle more queries locally, and thus reduce communication overheads. Then, this thesis recognizes node mobility as a resource to be leveraged, and in that respect proposes novel mobility coordination techniques for FMAs and MDAs. Assuming that node mobility is governed by a spatio-temporal schedule featuring some slack, this thesis presents novel algorithms of various computational complexities to orchestrate the use of this slack to improve the performance of supported applications. The findings in this thesis, which are supported by analysis and extensive simulations, highlight the importance of two general design principles for distributed systems. First, a-priori knowledge (e.g., about the target phenomena of FMAs and/or the workload of either FMAs or DMAs) could be used effectively for local resource management. Second, judicious leverage and coordination of node mobility could lead to significant performance gains for distributed applications deployed over resource-impoverished infrastructures.

The s-mote: a versatile heterogeneous multi-radio platform for wireless sensor networks applications

This paper presents a novel architecture and its implementation for a versatile, miniaturised mote which can communicate concurrently using a variety of combinations of ISM bands, has increased processing capability, and interoperability with mainstream GSM technology. All these features are integrated in a small form factor platform. The platform can have many configurations which could satisfy a variety of applications’ constraints. To the best of our knowledge, it is the first integrated platform of this type reported in the literature. The proposed platform opens the way for enhanced levels of Quality of Service (QoS), with respect to reliability, availability and latency, in addition to facilitating interoperability and power reduction compared to existing platforms. The small form factor also allows potential of integration with other mobile platforms including smart phones.

Hardware design of cryptographic accelerators

With the rapid growth of the Internet and digital communications, the volume of sensitive electronic transactions being transferred and stored over and on insecure media has increased dramatically in recent years. The growing demand for cryptographic systems to secure this data, across a multitude of platforms, ranging from large servers to small mobile devices and smart cards, has necessitated research into low cost, flexible and secure solutions. As constraints on architectures such as area, speed and power become key factors in choosing a cryptosystem, methods for speeding up the development and evaluation process are necessary. This thesis investigates flexible hardware architectures for the main components of a cryptographic system. Dedicated hardware accelerators can provide significant performance improvements when compared to implementations on general purpose processors. Each of the designs proposed are analysed in terms of speed, area, power, energy and efficiency. Field Programmable Gate Arrays (FPGAs) are chosen as the development platform due to their fast development time and reconfigurable nature. Firstly, a reconfigurable architecture for performing elliptic curve point scalar multiplication on an FPGA is presented. Elliptic curve cryptography is one such method to secure data, offering similar security levels to traditional systems, such as RSA, but with smaller key sizes, translating into lower memory and bandwidth requirements. The architecture is implemented using different underlying algorithms and coordinates for dedicated Double-and-Add algorithms, twisted Edwards algorithms and SPA secure algorithms, and its power consumption and energy on an FPGA measured. Hardware implementation results for these new algorithms are compared against their software counterparts and the best choices for minimum area-time and area-energy circuits are then identified and examined for larger key and field sizes. Secondly, implementation methods for another component of a cryptographic system, namely hash functions, developed in the recently concluded SHA-3 hash competition are presented. Various designs from the three rounds of the NIST run competition are implemented on FPGA along with an interface to allow fair comparison of the different hash functions when operating in a standardised and constrained environment. Different methods of implementation for the designs and their subsequent performance is examined in terms of throughput, area and energy costs using various constraint metrics. Comparing many different implementation methods and algorithms is nontrivial. Another aim of this thesis is the development of generic interfaces used both to reduce implementation and test time and also to enable fair baseline comparisons of different algorithms when operating in a standardised and constrained environment. Finally, a hardware-software co-design cryptographic architecture is presented. This architecture is capable of supporting multiple types of cryptographic algorithms and is described through an application for performing public key cryptography, namely the Elliptic Curve Digital Signature Algorithm (ECDSA). This architecture makes use of the elliptic curve architecture and the hash functions described previously. These components, along with a random number generator, provide hardware acceleration for a Microblaze based cryptographic system. The trade-off in terms of performance for flexibility is discussed using dedicated software, and hardware-software co-design implementations of the elliptic curve point scalar multiplication block. Results are then presented in terms of the overall cryptographic system.

Hybrid integration and packaging of grating-coupled silicon photonics

This thesis covers both the packaging of silicon photonic devices with fiber inputs and outputs as well as the integration of laser light sources with these same devices. The principal challenge in both of these pursuits is coupling light into the submicrometer waveguides that are the hallmark of silicon-on-insulator (SOI) systems. Previous work on grating couplers is leveraged to design new approaches to bridge the gap between the highly-integrated domain of silicon, the Interconnected world of fiber and the active region of III-V materials. First, a novel process for the planar packaging of grating couplers with fibers is explored in detail. This technology allows the creation of easy-to-use test platforms for laser integration and also stands on its own merits as an enabling technology for next-generation silicon photonics systems. The alignment tolerances of this process are shown to be well-suited to a passive alignment process and for wafer-scale assembly. Furthermore, this technology has already been used to package demonstrators for research partners and is included in the offerings of the ePIXfab silicon photonics foundry and as a design kit for PhoeniX Software’s MaskEngineer product. After this, a process for hybridly integrating a discrete edge-emitting laser with a silicon photonic circuit using near-vertical coupling is developed and characterized. The details of the various steps of the design process are given, including mechanical, thermal, optical and electrical steps. The interrelation of these design domains is also discussed. The construction process for a demonstrator is outlined, and measurements are presented of a series of single-wavelength Fabry-Pérot lasers along with a two-section laser tunable in the telecommunications C-band. The suitability and potential of this technology for mass manufacture is demonstrated, with further opportunities for improvement detailed and discussed in the conclusion.

Design, fabrication and characterisation of components for microfluidic enzymatic biofuel cells

The concept of a biofuel cell takes inspiration from the natural capability of biological systems to catalyse the conversion of organic matter with a subsequent release of electrical energy. Enzymatic biofuel cells are intended to mimic the processes occurring in nature in a more controlled and efficient manner. Traditional fuel cells rely on the use of toxic catalysts and are often not easily miniaturizable making them unsuitable as implantable power sources. Biofuel cells however use highly selective protein catalysts and renewable fuels. As energy consumption becomes a global issue, they emerge as important tools for energy generation. The microfluidic platforms developed are intended to maximize the amount of electrical energy extracted from renewable fuels which are naturally abundant in the environment and in biological fluids. Combining microfabrication processes, chemical modification and biological surface patterning these devices are promising candidates for micro-power sources for future life science and electronic applications. This thesis considered four main aspects of a biofuel cell research. Firstly, concept of a miniature compartmentalized enzymatic biofuel cell utilizing simple fuels and operating in static conditions is verified and proves the feasibility of enzyme catalysis in energy conversion processes. Secondly, electrode and microfluidic channel study was performed through theoretical investigations of the flow and catalytic reactions which also improved understanding of the enzyme kinetics in the cell. Next, microfluidic devices were fabricated from cost-effective and disposable polymer materials, using the state-of-the-art micro-processing technologies. Integration of the individual components is difficult and multiple techniques to overcome these problems have been investigated. Electrochemical characterization of gold electrodes modified with Nanoporous Gold Structures is also performed. Finally, two strategies for enzyme patterning and encapsulation are discussed. Several protein catalysts have been effectively immobilized on the surface of commercial and microfabricated electrodes by electrochemically assisted deposition in sol-gel and poly-(o-phenylenediamine) polymer matrices and characterised with confirmed catalytic activity.

Networking protocols for long life wireless sensor networks

My original contribution to knowledge is the creation of a WSN system that further improves the functionality of existing technology, whilst achieving improved power consumption and reliability. This thesis concerns the development of industrially applicable wireless sensor networks that are low-power, reliable and latency aware. This work aims to improve upon the state of the art in networking protocols for low-rate multi-hop wireless sensor networks. Presented is an application-driven co-design approach to the development of such a system. Starting with the physical layer, hardware was designed to meet industry specified requirements. The end system required further investigation of communications protocols that could achieve the derived application-level system performance specifications. A CSMA/TDMA hybrid MAC protocol was developed, leveraging numerous techniques from the literature and novel optimisations. It extends the current art with respect to power consumption for radio duty-cycled applications, and reliability, in dense wireless sensor networks, whilst respecting latency bounds. Specifically, it provides 100% packet delivery for 11 concurrent senders transmitting towards a single radio duty cycled sink-node. This is representative of an order of magnitude improvement over the comparable art, considering MAC-only mechanisms. A novel latency-aware routing protocol was developed to exploit the developed hardware and MAC protocol. It is based on a new weighted objective function with multiple fail safe mechanisms to ensure extremely high reliability and robustness. The system was empirically evaluated on two hardware platforms. These are the application-specific custom 868 MHz node and the de facto community-standard TelosB. Extensive empirical comparative performance analyses were conducted against the relevant art to demonstrate the advances made. The resultant system is capable of exceeding 10-year battery life, and exhibits reliability performance in excess of 99.9%.

Subterfuge-safe trust management for delegation of permissions in open environments

Open environments involve distributed entities interacting with each other in an open manner. Many distributed entities are unknown to each other but need to collaborate and share resources in a secure fashion. Usually resource owners alone decide who is trusted to access their resources. Since resource owners in open environments do not have a complete picture of all trusted entities, trust management frameworks are used to ensure that only authorized entities will access requested resources. Every trust management system has limitations, and the limitations can be exploited by malicious entities. One vulnerability is due to the lack of globally unique interpretation for permission specifications. This limitation means that a malicious entity which receives a permission in one domain may misuse the permission in another domain via some deceptive but apparently authorized route; this malicious behaviour is called subterfuge. This thesis develops a secure approach, Subterfuge Safe Trust Management (SSTM), that prevents subterfuge by malicious entities. SSTM employs the Subterfuge Safe Authorization Language (SSAL) which uses the idea of a local permission with a globally unique interpretation (localPermission) to resolve the misinterpretation of permissions. We model and implement SSAL with an ontology-based approach, SSALO, which provides a generic representation for knowledge related to the SSAL-based security policy. SSALO enables integration of heterogeneous security policies which is useful for secure cooperation among principals in open environments where each principal may have a different security policy with different implementation. The other advantage of an ontology-based approach is the Open World Assumption, whereby reasoning over an existing security policy is easily extended to include further security policies that might be discovered in an open distributed environment. We add two extra SSAL rules to support dynamic coalition formation and secure cooperation among coalitions. Secure federation of cloud computing platforms and secure federation of XMPP servers are presented as case studies of SSTM. The results show that SSTM provides robust accountability for the use of permissions in federation. It is also shown that SSAL is a suitable policy language to express the subterfuge-safe policy statements due to its well-defined semantics, ease of use, and integrability.

New phosphorescence based probes and techniques for the analysis of cellular oxygen and respiration

Real time monitoring of oxygenation and respiration is on the cutting edge of bioanalysis, including studies of cell metabolism, bioenergetics, mitochondrial function and drug toxicity. This thesis presents the development and evaluation of new luminescent probes and techniques for intracellular O2 sensing and imaging. A new oxygen consumption rate (OCR) platform based on the commercial microfluidic perfusion channel μ-slides compatible with extra- and intracellular O2 sensitive probes, different cell lines and measurement conditions was developed. The design of semi-closed channels allowed cell treatments, multiplexing with other assays and two-fold higher sensitivity to compare with microtiter plate. We compared three common OCR platforms: hermetically sealed quartz cuvettes for absolute OCRs, partially sealed with mineral oil 96-WPs for relative OCRs, and open 96-WPs for local cell oxygenation. Both 96-WP platforms were calibrated against absolute OCR platform with MEF cell line, phosphorescent O2 probe MitoXpress-Intra and time-resolved fluorescence reader. Found correlations allow tracing of cell respiration over time in a high throughput format with the possibility of cell stimulation and of changing measurement conditions. A new multimodal intracellular O2 probe, based on the phosphorescent reporter dye PtTFPP, fluorescent FRET donor and two-photon antennae PFO and cationic nanoparticles RL-100 was described. This probe, called MM2, possesses high brightness, photo- and chemical stability, low toxicity, efficient cell staining and high-resolution intracellular O2 imaging with 2D and 3D cell cultures in intensity, ratiometric and lifetime-based modalities with luminescence readers and FLIM microscopes. Extended range of O2 sensitive probes was designed and studied in order to optimize their spectral characteristics and intracellular targeting, using different NPs materials, delivery vectors, ratiometric pairs and IR dyes. The presented improvements provide useful tool for high sensitive monitoring and imaging of intracellular O2 in different measurement formats with wide range of physiological applications.