Short- and long-term outcome of patients aged 65 and over after cardiac surgery

To analyze the short and long-term outcome of patients aged 65 years and over, after cardiac surgery. Over a 12-year period we analyzed 1750 patients with a mean age of 70.09 3.94 years. They were classified into three age groups: between 65 and 69 (n = 709), between 70 and 74 (n = 695) and 75 years and above (n = 346). Follow-up information was obtained by telephone conversation after a 6-month and 3-year period of discharge from the hospital. Included in the follow-up were 1235 patients and an interview was conducted with 501 (40.6%) patients or their next of kin. Even though the in-hospital morbidity was highest in the oldest age group, there were no significant differences between groups (p = 0.051). There was no significant difference between groups in the length of hospital stay. The greatest in-hospital mortality was noted in the oldest age group (p = 0.046) compared to patients in the age groups between 65 and 69 and between 70 and 74 years old (p = 0.023 and p = 0.036). In the follow-up study, there was a significantly smaller telephone feedback response in the oldest age group compared to the youngest group (p = 0.003). There were no differences between the groups with respect to mortality and cardiac death after the 6-month and 3-year periods of discharge from hospital. Our data showed that despite a poor short – and long-term outcome in patients aged 75 and over, all patients had an acceptable operative risk

Ultrasound-guided transversus abdominis plane block in combination with ilioinguinal-iliohypogastric block in a high risk cardiac patient for inguinal hernia repair: a case report

Background and Purpose: A high risk cardiac patient, ASA IV, was planned for inguinal hernia repair. Since general anaesthesia presented a high risk, anaesthesia was conducted with a transversus abdominis plane (TAP) in combination with ilioinguinal-iliohypogastric (ILIH) block. Material and Methods: A 70-year old male patient with severe CAD and previous LAD PTCA, AVR, in situ PPM and severe MR and TR 3+, was planned for elective inguinal hernia repair. The preoperative ECHO showed IVS dyskinesis with apicoseptal hypokinesis, global EF 42% and grade III diastolic dysfunction. The patient also suffered from hypertension, diabetes mellitus and had severe stenosis of both femoral arteries. Preoperative preparation included IBP monitoring while the TAP block was carried out under ultrasound guidance using an 8 Hertz linear probe. The ilioinguinal and iliohypogastric nerves were identified with ultrasound and peripheral nerve stimulator. Local anaesthetic [0.5% levobupivacaine (Chirocaine®, Abbott Laboratories) ] was applied in two locations: in the upper right fascia of the transversus abdominis muscle (15 ml) and around the right ilioinguinal and iliohypogastric nerves (10 ml), totalling a volume of 25 ml. Skin infiltration was performed with 5 ml 2% lidocaine [Lidocaine ®, Belupo] and 5 ml of normal saline. Results: Sensory block onset was at 28 minutes after administration and lasted for approximately 18 hours. There were no haemodynamic disturbances and the perioperative course was uneventful. Conclusion: During the first 18 postoperative hours, the patient was comfortable and satisfied with the anaesthetic procedure

Surface displacements in the September 2005 Afar rifting event from satellite image matching: Asymmetric uplift and faulting

Combining sub‐pixel analysis of SPOT4 images with InSAR measurements, we generate 3D surface displacements for the September 2005 rifting event on the Dabbahu Segment in the Afar valley. The axis of rifting in the event is shifted to the east of the geomorphic rift. The horizontal displacements reveal 6 m of extension, and vertical displacements show asymmetric uplift of the flanks of the dike. Simple forward modelling indicates this asymmetry is due to the dike dipping 80° to the west towards the geomorphic rift. The boundary between eastward and westward displacements aligns with the transition between uplift and subsidence on the east in the north part of the segment, but on the west in the south. Normal faulting is not required on both sides of the instantaneous rift. East‐dipping normal faulting on the west side of the instantaneous rift aligns with a west‐dipping normal fault in the topography

Sistema constructivo ER 66

Manual de armado y catálogo de elementos del sistema constructivo para escuelas rurales ER 66.Material digitalizado en SEDICI gracias al Centro Interdisciplinario de Estudios Complejos, el colectivo ArqCom LP y el colectivo Agite.Centro Interdisciplinario de Estudios Complejos (CIEC

Sistema constructivo ER 66

Manual de armado y catálogo de elementos del sistema constructivo para escuelas rurales ER 66.Material digitalizado en SEDICI gracias al Centro Interdisciplinario de Estudios Complejos, el colectivo ArqCom LP y el colectivo Agite.Centro Interdisciplinario de Estudios Complejos (CIEC

Sistema constructivo ER 66

Manual de armado y catálogo de elementos del sistema constructivo para escuelas rurales ER 66.Material digitalizado en SEDICI gracias al Centro Interdisciplinario de Estudios Complejos, el colectivo ArqCom LP y el colectivo Agite.Centro Interdisciplinario de Estudios Complejos (CIEC

Methods for scale and orientation invariant analysis of lower dimensional structures in 3d images

This thesis is motivated by two groups of scientific disciplines: engineering sciences and mathematics. On the one hand, engineering sciences such as civil engineering want to design sustainable and cost-effective materials with desirable mechanical properties. The material behaviour depends on physical properties and production parameters. Therefore, physical properties are measured experimentally from real samples. In our case, computed tomography (CT) is used to non-destructively gain insight into the materials’ microstructure. This results in large 3d images which yield information on geometric microstructure characteristics. On the other hand, mathematical sciences are interested in designing methods with suitable and guaranteed properties. For example, a natural assumption of human vision is to analyse images regardless of object position, orientation, or scale. This assumption is formalized through the concepts of equivariance and invariance. In Part I, we deal with oriented structures in materials such as concrete or fiber-reinforced composites. In image processing, knowledge of the local structure orientation can be used for various tasks, e.g. structure enhancement. The idea of using banks of directed filters parameterized in the orientation space is effective in 2d. However, this class of methods is prohibitive in 3d due to the high computational burden of filtering when using a fine discretization of the unit sphere. Hence, we introduce a method for 3d pixel-wise orientation estimation and directional filtering inspired by the idea of adaptive refinement in discretized settings. Furthermore, an operator for distinction between isotropic and anisotropic structures is defined based on our method. Finally, usefulness of the method is shown on 3d CT images in three different tasks on a fiber-reinforced polymer, concrete with cracks, and partially closed foams. Additionally, our method is extended to construct line granulometry and characterize fiber length and orientation distributions in fiber-reinforced polymers produced by either 3d printing or by injection moulding. In Part II, we investigate how to introduce scale invariance for neural networks by using the Riesz transform. In classical convolutional neural networks, scale invariance is typically achieved by data augmentation. However, when presented with a scale far outside the range covered by the training set, the network may fail to generalize. Here, we introduce the Riesz network, a novel scale invariant neural network. Instead of standard 2d or 3d convolutions for combining spatial information, the Riesz network is based on the Riesz transform, a scale equivariant operator. As a consequence, this network naturally generalizes to unseen or even arbitrary scales in a single forward pass. As an application example, we consider segmenting cracks in CT images of concrete. In this context, 'scale' refers to the crack thickness which may vary strongly even within the same sample. To prove its scale invariance, the Riesz network is trained on one fixed crack width. We then validate its performance in segmenting simulated and real CT images featuring a wide range of crack widths. As an alternative to deep learning models, the Riesz transform is utilized to construct a scale equivariant scattering network, which does not require a lengthy training procedure and works with very few training examples. Mathematical foundations behind this representation are laid out and analyzed. We show that this representation with 4 times less features than the original scattering networks from Mallat performs comparably well on texture classification and gives superior performance when dealing with scales outside the training set distribution

Co-seismic vertical displacements from a single post-seismic lidar DEM: example from the 2010 El Mayor-Cucapah earthquake

A method is outlined by means of which it is possible to estimate high-resolution vertical displacements due to an earthquake even in the case where high-resolution topography is lacking before the earthquake. This result can be achieved by combining a highly accurate, post-event digital elevation model (DEM), for example lidar, with archived satellite imagery. The method is illustrated by calculating vertical displacements for the 2010 El Mayor-Cucapah earthquake. For this earthquake, there are both pre- and post-event lidar DEMs from which vertical displacements may also be estimated after correcting for the lateral advection of topography due to horizontal displacements. A comparison between the two means of deriving vertical displacements shows generally good agreement, with the displacements obtained using satellite imagery performing better in high relief areas. As a result of this property, we are able to trace the vertical offsets due to the El Mayor-Cucapah earthquake as the rupture jumped from the Pescadores fault to the Borrego fault in propagating through the high relief of the Sierra Cucapah