71 research outputs found
Estimation of the seismic hazard parameters for various sites in Greece using a probabilistic approach
International audienceThe probabilistic approach that was recently introduced by Kijko and Graham (1998,1999) was applied for the estimation of seismic hazard for various sites in Greece in terms of peak ground acceleration (PGA) and peak ground velocity (PGV). These sites represent geographically cities of Greece among which are the capital of Greece and some others with high, intermediate and low seismicity. The approach allows the use of earthquake catalogues with incomplete reported historical and complete instrumental data, the consideration of different magnitude thresholds, and the incorporation of magnitude uncertainties. One of the advantages of the method is that it does not require any determination of seismic zones. The estimated values of PGA for return periods of 476 years were grouped in 4 categories, the same ones used in the seismic hazard map for the New Seismic Code of Greece. Comparison results were quite interesting and very encouraging concerning the reliability of this probabilistic approach
Stress echocardiography in elderly patients with coronary artery disease Applicability, safety and prognostic value of dobutamine and adenosine echocardiography in elderly patients
AbstractObjectives. Our aim was to determine the applicability, safety and prognostic value of adenosine and dobutamine stress echocardiography in patients ≥70 years old.Background. These tests are sometimes mandatory because of difficulties and inaccuracies in interpreting traditional electrocardiographic stress tests. Furthermore, if these tests could be used to avoid coronary arteriography and cardiac catheterization, they would become essential in the care of the elderly, whose numbers are increasing.Methods. We performed coronary arteriography and dobutamine and adenosine stress echocardiographic tests in 120 patients (72 men) ≥70 years old who entered the hospital because of chest pain and had known or suspected coronary artery disease. The stress tests were performed on separate days, within 2 weeks of coronary arteriography. Both the arteriograms and the echocardiograms were analyzed by two experts who had no knowledge of the patients' other data or the other interpreter's report. Tests were judged to have positive or negative results, and the patients were followed up for the development of cardiac events. Univariate and multivariate analyses and other statistical modalities were applied for comparisons.Results. Documented coronary artery disease was found in 89 patients. During the 14 ± 7 months of follow-up, cardiac events developed in 50 patients, including 3 (7.9%) of 38 patients with negative dobutamine and 12 (20.7%) of 58 patients with negative adenosine test results. Demonstration of any abnormality on stress echocardiography was an independent factor for cardiac events, both for dobutamine (relative risk 7.3) and for adenosine (relative risk 3.0). Both cessation of dobutamine or adenosine tests and diagnosis of disease in two or more coronary vessels were also independent predictors. ST segment depression ≥1 mm was related to future events only with the dobutamine test.Conclusions. These echocardiographic stress tests proved safe and well tolerated. They successfully stratified this cohort of elderly patients with coronary artery disease to low or high risk subgroups for subsequent cardiac events
Spatio-temporal Models of Lymphangiogenesis in Wound Healing
Several studies suggest that one possible cause of impaired wound healing is
failed or insufficient lymphangiogenesis, that is the formation of new
lymphatic capillaries. Although many mathematical models have been developed to
describe the formation of blood capillaries (angiogenesis), very few have been
proposed for the regeneration of the lymphatic network. Lymphangiogenesis is a
markedly different process from angiogenesis, occurring at different times and
in response to different chemical stimuli. Two main hypotheses have been
proposed: 1) lymphatic capillaries sprout from existing interrupted ones at the
edge of the wound in analogy to the blood angiogenesis case; 2) lymphatic
endothelial cells first pool in the wound region following the lymph flow and
then, once sufficiently populated, start to form a network. Here we present two
PDE models describing lymphangiogenesis according to these two different
hypotheses. Further, we include the effect of advection due to interstitial
flow and lymph flow coming from open capillaries. The variables represent
different cell densities and growth factor concentrations, and where possible
the parameters are estimated from biological data. The models are then solved
numerically and the results are compared with the available biological
literature.Comment: 29 pages, 9 Figures, 6 Tables (39 figure files in total
Superconducting spintronics
The interaction between superconducting and spin-polarized orders has recently emerged as a major research field following a series
of fundamental breakthroughs in charge transport in superconductor-ferromagnet heterodevices which promise new device
functionality. Traditional studies which combine spintronics and superconductivity have mainly focused on the injection of
spin-polarized quasiparticles into superconducting materials. However, a complete synergy between superconducting and magnetic
orders turns out to be possible through the creation of spin-triplet Cooper pairs which are generated at carefully engineered
superconductor interfaces with ferromagnetic materials. Currently, there is intense activity focused on identifying materials
combinations which merge superconductivity and spintronics in order to enhance device functionality and performance. The results
look promising: it has been shown, for example, that superconducting order can greatly enhance central effects in spintronics such as
spin injection and magnetoresistance. Here, we review the experimental and theoretical advances in this field and provide an outlook
for upcoming challenges related to the new concept of superconducting spintronics.J.L. was supported by the Research Council of Norway, Grants No. 205591 and 216700.
J.W.A.R. was supported by the UK Royal Society and the Leverhulme Trust through an
International Network Grant (IN-2013-033).This is the accepted manuscript. The final version is available at http://www.nature.com/nphys/journal/v11/n4/full/nphys3242.html
The Hellenic emergency laparotomy study (HELAS): a prospective multicentre study on the outcomes of emergency laparotomy in Greece
Background
Emergency laparotomy (EL) is accompanied by high post-operative morbidity and mortality which varies significantly between countries and populations. The aim of this study is to report outcomes of emergency laparotomy in Greece and to compare them with the results of the National Emergency Laparotomy Audit (NELA).
Methods
This is a multicentre prospective cohort study undertaken between 01.2019 and 05.2020 including consecutive patients subjected to EL in 11 Greek hospitals. EL was defined according to NELA criteria. Demographics, clinical variables, and post-operative outcomes were prospectively registered in an online database. Multivariable logistic regression analysis was used to identify independent predictors of post-operative mortality.
Results
There were 633 patients, 53.9% males, ASA class III/IV 43.6%, older than 65 years 58.6%. The most common operations were small bowel resection (20.5%), peptic ulcer repair (12.0%), adhesiolysis (11.8%) and Hartmann’s procedure (11.5%). 30-day post-operative mortality reached 16.3% and serious complications occurred in 10.9%. Factors associated with post-operative mortality were increasing age and ASA class, dependent functional status, ascites, severe sepsis, septic shock, and diabetes. HELAS cohort showed similarities with NELA patients in terms of demographics and preoperative risk. Post-operative utilisation of ICU was significantly lower in the Greek cohort (25.8% vs 56.8%) whereas 30-day post-operative mortality was significantly higher (16.3% vs 8.7%).
Conclusion
In this study, Greek patients experienced markedly worse mortality after emergency laparotomy compared with their British counterparts. This can be at least partly explained by underutilisation of critical care by surgical patients who are at high risk for death
Development and internal validation of a clinical prediction model for serious complications after emergency laparotomy
Purpose
Emergency laparotomy (EL) is a common operation with high risk for postoperative complications, thereby requiring accurate risk stratification to manage vulnerable patients optimally. We developed and internally validated a predictive model of serious complications after EL.
Methods
Data for eleven carefully selected candidate predictors of 30-day postoperative complications (Clavien-Dindo grade >  = 3) were extracted from the HELAS cohort of EL patients in 11 centres in Greece and Cyprus. Logistic regression with Least Absolute Shrinkage and Selection Operator (LASSO) was applied for model development. Discrimination and calibration measures were estimated and clinical utility was explored with decision curve analysis (DCA). Reproducibility and heterogeneity were examined with Bootstrap-based internal validation and Internal–External Cross-Validation. The American College of Surgeons National Surgical Quality Improvement Program’s (ACS-NSQIP) model was applied to the same cohort to establish a benchmark for the new model.
Results
From data on 633 eligible patients (175 complication events), the SErious complications After Laparotomy (SEAL) model was developed with 6 predictors (preoperative albumin, blood urea nitrogen, American Society of Anaesthesiology score, sepsis or septic shock, dependent functional status, and ascites). SEAL had good discriminative ability (optimism-corrected c-statistic: 0.80, 95% confidence interval [CI] 0.79–0.81), calibration (optimism-corrected calibration slope: 1.01, 95% CI 0.99–1.03) and overall fit (scaled Brier score: 25.1%, 95% CI 24.1–26.1%). SEAL compared favourably with ACS-NSQIP in all metrics, including DCA across multiple risk thresholds.
Conclusion
SEAL is a simple and promising model for individualized risk predictions of serious complications after EL. Future external validations should appraise SEAL’s transportability across diverse settings
Enhanced magnetic properties in antiferromagnetic-core/ferrimagnetic-shell nanoparticles
Bi-magnetic core/shell nanoparticles are gaining increasing interest due to their foreseen applications. Inverse antiferromagnetic(AFM)/ferrimagnetic(FiM) core/shell nanoparticles are particularly appealing since they may overcome some of the limitations of conventional FiM/AFM systems. However, virtually no simulations exist on this type of morphology. Here we present systematic Metropolis Monte Carlo simulations of the exchange bias properties of such nanoparticles. The coercivity, H C, and loop shift, H ex, present a non-monotonic dependence with the core diameter and the shell thickness, in excellent agreement with the available experimental data. Additionally, we demonstrate novel unconventional behavior in FiM/AFM particles. Namely, while H C and H ex decrease upon increasing FiM thickness for small AFM cores (as expected), they show the opposite trend for large cores. This presents a counterintuitive FiM size dependence for large AFM cores that is attributed to the competition between core and shell contributions, which expands over a wider range of core diameters leading to non-vanishing H ex even for very large cores. Moreover, the results also hint different possible ways to enhance the experimental performance of inverse core/shell nanoparticles for diverse applications
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