A Scalable Location Service for Distributed Objects

We describe a service for locating distributed objects using location-independent object identifiers. An object in our model is physically distributed, with multiple copies simultaneously active on different machines. Processes must bind to an object in order to invoke its methods. Part of the binding protocol is concerned with contacting the object, which offers one or more contact points. An object can change its contact points in the course of time, thus exhibiting migration behavior. Finding an object’s contact points is the essence of our location service.

A Model for Worldwide Tracking of Distributed Objects

We describe a service for locating distributed objects identified by location-independent object identifiers. An object in our model is physically distributed, with multiple active copies on different machines. Processes must bind to an object in order to invoke its methods. Part of the binding protocol is concerned with contacting the object, which offers one or more contact points. A contact point is associated with an active part of the distributed object, and describes exactly how and where initial communication should take place. An object can change its contact points in the course of time, thus exhibiting migration behavior. Finding an object's contact points is the essence of our location service. Our model is based on a worldwide distributed search tree, capable of handling trillions of distributed objects. The tree adapts dynamically to individual migration patterns. By exploiting an object 's relative stability with respect to a region, combined with the use of pointer caches, an object can be contacted through a search path of only length two. We present the architecture of our location service, including its update and lookup mechanism, and discuss its scalability.

A Location Service for Worldwide Distributed Objects

This position paper introduces the Globe object model for wide-area distributed systems and its location service. The location service provides transparency of location, migration, distribution, and replication of distributed objects. We present the architecture of the service and briefly discuss scalability.

Impact of atrial fibrillation on outcome in Takotsubo syndrome: data from the international Takotsubo registry

Background Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS. Methods and Results Patients with TTS were enrolled from the International Takotsubo Registry, which is a multinational network with 26 participating centers in Europe and the United States. Patients were dichotomized according to the presence or absence of AF at the time of admission. Of 1584 patients with TTS, 112 (7.1%) had AF. The mean age was higher (P<0.001), and there were fewer women (P=0.046) in the AF than in the non-AF group. Left ventricular ejection fraction was significantly lower (P=0.001), and cardiogenic shock was more often observed (P<0.001) in the AF group. Both in-hospital (P<0.001) and long-term mortality (P<0.001) were higher in the AF group. Multivariable Cox regression analysis revealed that AF was independently associated with higher long-term mortality (hazard ratio, 2.31; 95% CI, 1.50-3.55; P<0.001). Among patients with AF on admission, 42% had no known history of AF before the acute TTS event, and such patients had comparable in-hospital and long-term outcomes compared with those with a history of AF. Conclusions In patients presenting with TTS, AF on admission is significantly associated with increased in-hospital and long-term mortality rates. Whether antiarrhythmics and/or cardioversion are beneficial in TTS with AF should thus be tested in a future trial. Registration URL: ; Unique identifier: NCT01947621.Cardiolog

Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry

Aims Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes.Methods and results Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes.Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33-3.38; P = 0.002).Conclusions The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.Cardiolog

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

Background Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes.Methods TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients.Results A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 +/- 11.4 years vs. 68.0 +/- 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p< 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p< 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients.Conclusion Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers.Cardiolog

Supporting Class Evolution by Typing Inheritance

. While there are suitable type-systems for aggregation that allow the exchange of objects and classes, the configuration of systems, and dynamic binding, there are no type-systems for inheritance relationships. Thus, maintenance of class libraries becomes difficult or even impossible because changes in a class library can cause changes in the inheriting classes of an application program. Modeling inheritance with explicit and parametrical bindings introduces a typed interface for inheritance which allows type-safe changes in class libraries. 1 Introduction An exchange of base classes is necessary for maintenance in class libraries, e.g. for bug-fixing. In this case application programmers should not be forced to change their programs when a library class is changed. Recompiling or rebinding of the application should be sufficient. This is only possible if there is a typed interface between base and subclasses. An improved base class in a library must be type-conforming to the inheri..