479 research outputs found

    A Mechanized Semantic Framework for Real-Time Systems

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    International audienceConcurrent systems consist of many components which may execute in parallel and are complex to design, to analyze, to verify, and to implement. The complexity increases if the systems have real-time constraints, which are very useful in avionic, spatial and other kind of embedded applications. In this paper we present a logical framework for defining and validating real-time formalisms as well as reasoning methods over them. For this purpose, we have implemented in the Coq proof assistant well known semantic domains for real-time systems based on labelled transitions systems and timed runs. We experiment our framework by considering the real-time CSP-based language fiacre, which has been defined as a pivot formalism for modeling languages (aadl, sdl, ...) used in the TOPCASED project. Thus, we define an extension to the formal semantic models mentioned above that facilitates the modeling of fine-grained time constraints of fiacre. Finally, we implement this extension in our framework and provide a proof method environment to deal with real-time system in order to achieve their formal certification

    An Automatic Technique for Checking the Simulation of Timed Systems

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    International audienceIn this paper, we suggest an automatic technique for checking the timed weak simulation between timed transition systems. The technique is an observation-based method in which two timed transition systems are composed with a timed observer. A Ό-calculus property that captures the timed weak simulation is then verified on the result of the composition. An interesting feature of the suggested technique is that it only relies on an untimed Ό-calculus model-checker without any specific algorithm needed to analyze the result of the composition. We also show that our simulation relation supports interesting results concerning the trace inclusion and the preservation of linear properties. Finally, the technique is validated using the FIACRE/TINA toolset

    Towards a verified transformation from AADL to the formal component-based language FIACRE

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    International audienceDuring the last decade, aadl  is an emerging architecture description languages addressing the modeling of embedded systems. Several research projects have shown that aadl  concepts are well suited to the design of embedded systems. Moreover, aadl  has a precise execution model which has proved to be one key feature for effective early analysis. In this paper, we are concerned with the foundational aspects of the verification support for aadl. More precisely, we propose a verification toolchain for aadl  models through its transformation to the Fiacre language which is the pivot verification language of the TOPCASED project: high level models can be transformed to Fiacre  models and then model-checked. Then, we investigate how to prove the correctness of the transformation from AADL into Fiacre and present related elementary ingredients: the semantics of aadl  and Fiacre  subsets expressed in a common framework, namely timed transition systems. We also briefly discuss experimental validation of the work

    El aceite de oliva en nutriciĂłn clĂ­nica

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    The different beneficial effects of olive oil have a rational and scientific basis due to advances in the knowledge of lipid metabolism. The evidence that for a similar plasma cholesterol concentration, the rate of cardiovascular deaths is lower in the Mediterranean countries than in other ones, suggests that the beneficial effects of olive oil may not be only related to the known quantitative changes in plasma lipoproteins, but also to other, as yet unknown or little known, anti-atherogenic factors. The peculiarities of olive oil in terms of certain biochemical, biological and nutritional characteristics, open up a field of application in normal clinical practice. The benefits of olive oil in clinical nutrition correlate with its action on lipid metabolism and the cardiovascular system. Even a moderate increase in the ingestion of monounsaturated fats and a reduction in the ingestion of carbohydrates could be more advantageous in those patients with diabetes and hypertriglyceridemia and/or in those where loss of weight is not a priority. Different studies have also demonstrated the benefits of olive oil in different inflammatory and autoimmune diseases, such as rheumatoid arthritis. The chemical composition of extra virgin olive oil contributes to daily requirements of essential fatty acids and active antioxidant nutrients in vitamin E deficiency. This particular and well-balanced situation [oleic acid (18:1 n -9) and minor components in an ideal ratio] undoubtedly has a significant relevance in human clinical nutrition.Los avances en el conocimiento del metabolismo lipídico estån permitiendo establecer las bases científicas de los efectos saludables del aceite de oliva. En los países del årea Mediterrånea, la mortalidad cardiovascular es menor que en otros, aunque la concentración de colesterol en sangre es similar. Es muy probable que la capacidad cardio-protectora del aceite de oliva se relacione con otros factores de riesgo, algunos de los cuales son poco o completamente desconocidos. Las propiedades bioquímicas, biológicas y nutricionales del aceite de oliva son peculiares y permiten su aplicación en la nutrición clínica. Los beneficios del aceite de oliva se correlacionan con su acción sobre el metabolismo lipídico y el sistema cardiovascular. Un aumento moderado en la ingesta de grasa monoinsaturada (aceite de oliva), a expensas de los carbohidratos, es la recomendación en pacientes con diabetes e hipertrigliceridemia. En nutrición clínica, el aceite de oliva también tiene efectos beneficiosos en enfermedades relacionadas con respuestas inflamatorias y autoinmunes, como la artritis reumatoide. La composición química del aceite de oliva virgen extra contribuye a las necesidades diarias de åcidos grasos esenciales y de antioxidantes, especialmente en situaciones patológicas de deficiencia en vitamina E. Sin duda, el aceite de oliva (virgen extra) tiene måxima relevancia, por su contenido de åcido oleico (18:1 n -9) y compuestos minoritarios, en la nutrición clínica

    Expert Statements on the Standard of Care in Critically Ill Adult Patients With Atypical Hemolytic Uremic Syndrome.

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    A typical hemolytic uremic syndrome (aHUS) presents similarly to thrombotic thrombocytopenic purpura (TTP) and other causes or conditions with thrombotic microangiopathy (TMA), such as disseminated intravascular coagulation or sepsis. Similarity in clinical presentation may hinder diagnosis and optimal treatment selection in the urgent setting in the ICU. However, there is currently no consensus on the diagnosis or treatment of aHUS for ICU specialists. This review aims to summarize available data on the diagnosis and treatment strategies of aHUS in the ICU to enhance the understanding of aHUS diagnosis and outcomes in patients managed in the ICU. To this end, a review of the recent literature (January 2009-March 2016) was performed to select the most relevant articles for ICU physicians. Based on the paucity of adult aHUS cases overall and within the ICU, no specific recommendations could be formally graded for the critical care setting. However, we recognize a core set of skills required by intensivists for diagnosing and managing patients with aHUS: recognizing thrombotic microangiopathies, differentiating aHUS from related conditions, recognizing involvement of other organ systems, understanding the pathophysiology of aHUS, knowing the diagnostic workup and relevant outcomes in critically ill patients with aHUS, and knowing the standard of care for patients with aHUS based on available data and guidelines. In conclusion, managing critically ill patients with aHUS requires basic skills that, in the absence of sufficient data from patients treated within the ICU, can be gleaned from an increasingly relevant literature outside the ICU. More data on critically ill patients with aHUS are needed to validate these conclusions within the ICU setting

    A formal framework to prove the correctness of model driven engineering composition operators

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    International audienceCurrent trends in system engineering combine modeling, composition and verification technologies in order to harness their ever growing complexity. Each composition operator dedicated to a different modeling concern should be proven to be property preserving at assembly time. These proofs are usually burdensome with repetitive aspects. Our work targets the factorisation of these aspects relying on primitive generic composition operators used to express more sophisticated language specific ones. These operators are defined for languages expressed with OMG MOF metamodeling technologies. The proof are done with the Coq proof assistant relying on the Coq4MDE framework defined previously. These basic operators, Union and Substitution, are illustrated using the MOF Package Merge as composition operator and the preservation of model conformance as verified property

    Multidrug resistant Acinetobacter baumannii: a descriptive study in a city hospital

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    <p>Abstract</p> <p>Background</p> <p>Multidrug resistant <it>Acinetobacter baumannii</it>, (MRAB) is an important cause of hospital acquired infection. The purpose of this study is to determine the risk factors for MRAB in a city hospital patient population.</p> <p>Methods</p> <p>This study is a retrospective review of a city hospital epidemiology data base and includes 247 isolates of Acinetobacter baumannii (AB) from 164 patients. Multidrug resistant <it>Acinetobacter baumannii </it>was defined as resistance to more than three classes of antibiotics. Using the non-MRAB isolates as the control group, the risk factors for the acquisition of MRAB were determined.</p> <p>Results</p> <p>Of the 247 AB isolates 72% (177) were multidrug resistant. Fifty-eight percent (143/247) of isolates were highly resistant (resistant to imipenem, amikacin, and ampicillin-sulbactam). Of the 37 patients who died with Acinetobacter colonization/infection, 32 (86%) patients had the organism recovered from the respiratory tract. The factors which were found to be significantly associated (p ≀ 0.05) with multidrug resistance include the recovery of AB from multiple sites, mechanical ventilation, previous antibiotic exposure, and the presence of neurologic impairment. Multidrug resistant Acinetobacter was associated with significant mortality when compared with sensitive strains (p ≀ 0.01). When surgical patients (N = 75) were considered separately, mechanical ventilation and multiple isolates remained the factors significantly associated with the development of multidrug resistant Acinetobacter. Among surgical patients 46/75 (61%) grew a multidrug resistant strain of AB and 37/75 (40%) were resistant to all commonly used antibiotics including aminoglycosides, cephalosporins, carbepenems, extended spectrum penicillins, and quinolones. Thirty-five percent of the surgical patients had AB cultured from multiple sites and 57% of the Acinetobacter isolates were associated with a co-infecting organism, usually a Staphylococcus or Pseudomonas. As in medical patients, the isolation of Acinetobacter from multiple sites and the need for mechanical ventilation were significantly associated with the development of MRAB.</p> <p>Conclusions</p> <p>The factors significantly associated with MRAB in both the general patient population and surgical patients were mechanical ventilation and the recovery of Acinetobacter from multiple anatomic sites. Previous antibiotic use and neurologic impairment were significant factors in medical patients. Colonization or infection with MRAB is associated with increased mortality.</p

    A motivational interview program for cardiac rehabilitation after acute myocardial infarction: study protocol of a randomized controlled trial in primary healthcare

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    Cardiac rehabilitation after acute myocardial infarction permits recovery of the heart function and enables secondary prevention programs in which changes in lifestyle habits are crucial. Cardiac rehabilitation often takes place in hospitals without coordination with primary healthcare and is not focused on individual patient preferences and goals, which is the core of the motivational interview. The objective of this study was to evaluate the efficacy of a cardiac rehabilitation program with a motivational interview in patients discharged from hospital after acute myocardial infarction.A randomized, non-pharmacological clinical trial in six primary healthcare centers in Barcelona (Spain) will assess whether a tailored cardiac rehabilitation program consisting of four motivational interviews and visits with family physicians, primary healthcare nurses and a cardiologist, coordinated with the reference hospital, results in better cardiac rehabilitation than standard care. A minimum sample of 284 participants requiring cardiac rehabilitation after acute myocardial infarction will be randomized to a cardiac rehabilitation group with a motivational interview program or to standard primary healthcare. The main outcome will be physical function measured by the six-minute walk test, and the secondary outcome will be the effectiveness of secondary prevention: a composite outcome comprising control of blood pressure, cholesterol, diabetes mellitus, smoking and body weight. Results will be evaluated at 1,3 and 6 months.This is the first clinical trial to study the impact of a new primary healthcare cardiac rehabilitation program with motivational interviews for patients discharged from hospital after myocardial infarction. Changes in lifestyles and habits after myocardial infarction are a core element of secondary prevention and require patient-centered care strategies such as motivational interviews. Therefore, this study could clarify the impact of this approach on health indicators, such as functional capacity.ClinicalTriasl.gov NCT05285969 registered on March 18, 2022.© 2022. The Author(s)
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