Correctness of Generalisation and Customisation of Concurrent Model Synchronisation Based on Triple Graph Grammars

Triple graph grammars (TGGs) have been successfully applied to specify and analyse bidirectional model transformations. Recently, a formal approach to concurrent model synchronisation has been presented, where a source and a target modification have to be synchronised simultaneously. In this approach, conflicts between the given and propagated source or target model modifications are taken into account. A semi-automatic conflict resolution strategy is proposed, where a formal resolution strategy can be combined with a user-specific strategy. Up to now, our approach requires deterministic propagation operations. In this paper, we want to relax this condition and also consider non-deterministic (conflicting) operations which might require backtracking. For optimisation, we propose to eliminate conflicts between the operational rules of a TGG using the concept of filter NACs. Nevertheless, concurrent synchronisation is non-deterministic from a user perspective: The user may choose between forward synchronisation and backward synchronisation. Moreover, the conflict resolution strategy may result in several solutions from which the user has to select the most adequate one. Hence, we discuss different kinds of customisation of the synchronisation process and explain the impacts of the different strategies

Acetylation Suppresses the Proapoptotic Activity of GD3 Ganglioside

GD3 synthase is rapidly activated in different cell types after specific apoptotic stimuli. De novo synthesized GD3 accumulates and contributes to the apoptotic program by relocating to mitochondrial membranes and inducing the release of apoptogenic factors. We found that sialic acid acetylation suppresses the proapoptotic activity of GD3. In fact, unlike GD3, 9-O-acetyl-GD3 is completely ineffective in inducing cytochrome c release and caspase-9 activation on isolated mitochondria and fails to induce the collapse of mitochondrial transmembrane potential and cellular apoptosis. Moreover, cells which are resistant to the overexpression of the GD3 synthase, actively convert de novo synthesized GD3 to 9-O-acetyl-GD3. The coexpression of GD3 synthase with a viral 9-O-acetyl esterase, which prevents 9-O-acetyl-GD3 accumulation, reconstitutes GD3 responsiveness and apoptosis. Finally, the expression of the 9-O-acetyl esterase is sufficient to induce apoptosis of glioblastomas which express high levels of 9-O-acetyl-GD3. Thus, sialic acid acetylation critically controls the proapoptotic activity of GD3

Immediate Outcome Indicators in Perioperative Care: A Controlled Intervention Study on Quality Improvement in Hospitals in Tanzania.

Outcome assessment is the standard for evaluating the quality of health services worldwide. In this study, outcome has been divided into immediate and final outcome. Aim was to compare an intervention hospital with a Continuous Quality Improvement approach to a control group using benchmark assessments of immediate outcome indicators in surgical care. Results were compared to final outcome indicators. Surgical care quality in six hospitals in Tanzania was assessed from 2006-2011, using the Hospital Performance Assessment Tool. Independent observers assessed structural, process and outcome quality using checklists based on evidence-based guidelines. The number of surgical key procedures over the benchmark of 80% was compared between the intervention hospital and the control group. Results were compared to Case Fatality Rates. In the intervention hospital, in 2006, two of nine key procedures reached the benchmark, one in 2009, and four in 2011. In the control group, one of nine key procedures reached the benchmark in 2006, one in 2009, and none in 2011. Case Fatality Rate for all in-patients in the intervention hospital was 5.5% (n = 12,530) in 2006, 3.5% (n = 21,114) in 2009 and 4.6% (n = 18,840) in 2011. In the control group it was 3.1% (n = 17,827) in 2006, 4.2% (n = 13,632) in 2009 and 3.8% (n = 17,059) in 2011. Results demonstrated that quality assurance improved performance levels in both groups. After the introduction of Continuous Quality Improvement, performance levels improved further in the intervention hospital while quality in the district hospital did not. Immediate outcome indicators appeared to be a better steering tool for quality improvement compared to final outcome indicators. Immediate outcome indicators revealed a need for improvement in pre- and postoperative care. Quality assurance programs based on immediate outcome indicators can be effective if embedded in Continuous Quality Improvement. Nevertheless, final outcome indicators cannot be neglected

Organic matter fluxes and biogeochemical processes in the OMZ off Peru, Cruise No. M138, 01 June - 03 July 2017, Callao (Peru) - Bahia Las Minas (Panama)

The oxygen minimum zone (OMZ) in the eastern tropical South Pacific Ocean is tightly connected to the coastal upwelling system off Peru. The high biological productivity off Peru is therefore, driven by the complex interplay between the amount of nutrients recycled by remineralisation processes in the OMZ and the upwelling which brings these nutrients to the surface layer. However, surprisingly little is known about organic matter cycling and its effects on biogeochemical processes in the OMZ off Peru. To this end we conducted a first comprehensive study on the role of organic matter for the biogeochemical processes and the maintenance of the OMZ off Peru. M138 combined measurements of marine biogeochemistry, microbiology, physical oceanography and air chemistry with foci on (i) the efficiency of the biological pump, (ii) the nitrogen cycle processes in the OMZ, (iii) the ventilation of the OMZ as well as (iv) the air/sea gas exchange across the ocean/atmosphere interface and (v) aerosol deposition. The METEOR cruise M138 was performed as part of the third phase of the SFB754 'Climate-Biogeochemistry Interactions in the Tropical Ocean' (www.sfb754.de)

Towards the Propagation of Model Updates along different Views in Multi-View Models

Models are the keystones in model-driven systems development. They describe systems at different layers of abstraction and with a focus to different domains. For each domain, dedicated domain specific visual modelling languages are used for model definitions with the idea to separate concerns to different domain experts. This enables precise problem and requirement definitions and should decrease efforts in developing and validating systems. We focus on multi-view models that are in relationship with source models by triple graph grammars. A multi-view model provides different views of the source model at different layers of abstraction but within the same DSL which is typically different from the DSL of the source model. In practice, elements in different views may overlap. We present an informal methodology for consistently propagating updates from one view to the other views and also to the source domain. We motivate our approach by multi-view models in a hospital scenario

Obesity in critically ill patients is associated with increased need of mechanical ventilation but not with mortality

Summary: Worldwide incidence of obesity is increasing and impaired outcome in postoperative patients has been described. Antibiotic prescribing is complicated by different pharmacology in this population. This study evaluates mortality and morbidity of obese postoperative patients and explores possible relation to antibiotic therapy. Therefore, data obtained in a prospective study in 2009–2010 were analysed. Postoperative patients on 5 ICUs were included with >48 h of ICU treatment and documented body-mass-index (BMI). Altogether 451 non-obese patients (BMI  0.999), but 65.4% of obese patients required mechanical ventilation compared with only 53.2% of non-obese patients (p = 0.016). These findings were validated in multivariate regression analyses (adjusted OR for ICU-mortality for obese patients 0.53, 95%-CI 0.188–1.321, p = 0.197; adjusted OR for mechanical ventilation 1.841, 95%-CI 1.113–3.076, p = 0.018). Results were confirmed by propensity score matching. Therapeutic drug monitoring for vancomycin (TDM) showed that underdosing and overdosing occurred more often in obese patients and sufficient TDM levels were less often achieved. In conclusion, obesity is associated with increased morbidity but ICU mortality is equal compared with a non-obese population. Pharmacological differences might explain observed differences in antibiotic therapy and in obese patients TDM might be especially of importance. Keywords: Obesity, Adiposity, Antibiotics, Mortality, Therapeutic drug monitorin

Triple Graph Grammars in the Large for Translating Satellite Procedures - Extended Version

Software translation is a challenging task. Several requirements are important - including automation of the execution, maintainability of the translation patterns, and, most importantly, reliability concerning the correctness of the translation. Triple graph grammars (TGGs) have shown to be an intuitive, wellde ned technique for model translation. In this paper, we leverage TGGs for industry scale software translations. The approach is implemented using the Eclipse-based graph transformation tool Henshin and has been successfully applied in a large industrial project with the satellite operator SES on the translation of satellite control procedures. We evaluate the approach regarding requirements from the project and performance on a complete set of procedures of one satellite