Management of Anticoagulation Around Cardiac Implantable Electronic Device Surgery

The number of patients requiring cardiovascular implantable electronic device (CIED, e.g., pacemaker and defibrillator) surgery is increasing rapidly and at least a quarter of them are using chronic oral anticoagulation (OAC). Recently, the traditional approach of withholding anticoagulation and using heparin bridging has been challenged by studies showing safety of performing CIED surgery under anticoagulation with vitamin K antagonists. Bridging with heparin is associated with incremental healthcare costs, prolonged hospital admission, and also with an augmented relative risk of pocket hematoma. The risk of embolic events seems to be low and similar with the use of two strategies (heparin bridging and continuous warfarin). Experience with novel oral anticoagulants is limited. Few studies suggest that withholding 48–72 hours before surgery and performing the procedure under anticoagulation are safe alternatives. However, larger randomized clinical trials are needed before definitive conclusions. In this chapter, we review the management of anticoagulation around cardiac implantable electronic device surgery under new conditions

Nested-multiplex PCR detection of Orthopoxvirus and Parapoxvirus directly from exanthematic clinical samples

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Allergies and Diabetes as Risk Factors for Dengue Hemorrhagic Fever: Results of a Case Control Study

Dengue is an arboviral disease that affects large areas of countries in tropical and subtropical regions of the world. Around 500,000 cases and 22,000 deaths of dengue hemorrhagic fever (DHF)/Dengue Shock Syndrome (DSS), the most severe presentations of this disease, occur annually. It is unclear why some cases of dengue fever (0.5% to 4%) progress to DHF/DSS. There is weak evidence that some diseases could have a role in this process, such as diabetes, hypertension, and allergies. In epidemics most dengue fever cases are sent home as there are too many to be kept in observation, but if it were possible to identify those with a higher risk of progression to DHF, they could be kept for observation, for early detection of signs, symptoms and alterations in laboratory tests suggestive of DHF, to enable timely and effective clinical management and early intervention. We study this issue and we believe that the evidence produced in this study, when confirmed in other studies, suggests that screening criteria might be used to identify adult patients at a greater risk of developing DHF with a recommendation that they remain under observation and monitoring in a hospital

GeantV: Results from the prototype of concurrent vector particle transport simulation in HEP

Full detector simulation was among the largest CPU consumer in all CERN experiment software stacks for the first two runs of the Large Hadron Collider (LHC). In the early 2010's, the projections were that simulation demands would scale linearly with luminosity increase, compensated only partially by an increase of computing resources. The extension of fast simulation approaches to more use cases, covering a larger fraction of the simulation budget, is only part of the solution due to intrinsic precision limitations. The remainder corresponds to speeding-up the simulation software by several factors, which is out of reach using simple optimizations on the current code base. In this context, the GeantV R&D project was launched, aiming to redesign the legacy particle transport codes in order to make them benefit from fine-grained parallelism features such as vectorization, but also from increased code and data locality. This paper presents extensively the results and achievements of this R&D, as well as the conclusions and lessons learnt from the beta prototype.Comment: 34 pages, 26 figures, 24 table

Land–atmosphere interactions in sub-polar and alpine climates in the CORDEX Flagship Pilot Study Land Use and Climate Across Scales (LUCAS) models – Part 2: The role of changing vegetation

Land cover in sub-polar and alpine regions of northern and eastern Europe have already begun changing due to natural and anthropogenic changes such as afforestation. This will impact the regional climate and hydrology upon which societies in these regions are highly reliant. This study aims to identify the impacts of afforestation/reforestation (hereafter afforestation) on snow and the snow-albedo effect and highlight potential improvements for future model development. The study uses an ensemble of nine regional climate models for two different idealised experiments covering a 30-year period; one experiment replaces most land cover in Europe with forest, while the other experiment replaces all forested areas with grass. The ensemble consists of nine regional climate models composed of different combinations of five regional atmospheric models and six land surface models. Results show that afforestation reduces the snow-albedo sensitivity index and enhances snowmelt. While the direction of change is robustly modelled, there is still uncertainty in the magnitude of change. The greatest differences between models emerge in the snowmelt season. One regional climate model uses different land surface models which shows consistent changes between the three simulations during the accumulation period but differs in the snowmelt season. Together these results point to the need for further model development in representing both grass–snow and forest–snow interactions during the snowmelt season. Pathways to accomplishing this include (1) a more sophisticated representation of forest structure, (2) kilometre-scale simulations, and (3) more observational studies on vegetation–snow interactions in northern Europe

Land–atmosphere interactions in sub-polar and alpine climates in the CORDEX flagship pilot study Land Use and Climate Across Scales (LUCAS) models – Part 1: Evaluation of the snow-albedo effect

Seasonal snow cover plays a major role in the climate system of the Northern Hemisphere via its effect on land surface albedo and fluxes. In climate models the parameterization of interactions between snow and atmosphere remains a source of uncertainty and biases in the representation of local and global climate. Here, we evaluate the ability of an ensemble of regional climate models (RCMs) coupled with different land surface models to simulate snow–atmosphere interactions over Europe in winter and spring. We use a previously defined index, the snow-albedo sensitivity index (SASI), to quantify the radiative forcing associated with snow cover anomalies. By comparing RCM-derived SASI values with SASI calculated from reanalyses and satellite retrievals, we show that an accurate simulation of snow cover is essential for correctly reproducing the observed forcing over middle and high latitudes in Europe. The choice of parameterizations, and primarily the choice of the land surface model, strongly influences the representation of SASI as it affects the ability of climate models to simulate snow cover accurately. The degree of agreement between the datasets differs between the accumulation and ablation periods, with the latter one presenting the greatest challenge for the RCMs. Given the dominant role of land surface processes in the simulation of snow cover during the ablation period, the results suggest that, during this time period, the choice of the land surface model is more critical for the representation of SASI than the atmospheric model

Petri Net Plans A framework for collaboration and coordination in multi-robot systems

Programming the behavior of multi-robot systems is a challenging task which has a key role in developing effective systems in many application domains. In this paper, we present Petri Net Plans (PNPs), a language based on Petri Nets (PNs), which allows for intuitive and effective robot and multi-robot behavior design. PNPs are very expressive and support a rich set of features that are critical to develop robotic applications, including sensing, interrupts and concurrency. As a central feature, PNPs allow for a formal analysis of plans based on standard PN tools. Moreover, PNPs are suitable for modeling multi-robot systems and the developed behaviors can be executed in a distributed setting, while preserving the properties of the modeled system. PNPs have been deployed in several robotic platforms in different application domains. In this paper, we report three case studies, which address complex single robot plans, coordination and collaboration

Measurement of the cross-section and charge asymmetry of WW bosons produced in proton-proton collisions at s=8\sqrt{s}=8 TeV with the ATLAS detector

This paper presents measurements of the $W^+ \rightarrow \mu^+\nu$ and $W^- \rightarrow \mu^-\nu$ cross-sections and the associated charge asymmetry as a function of the absolute pseudorapidity of the decay muon. The data were collected in proton--proton collisions at a centre-of-mass energy of 8 TeV with the ATLAS experiment at the LHC and correspond to a total integrated luminosity of 20.2~\mbox{fb^{-1}}. The precision of the cross-section measurements varies between 0.8% to 1.5% as a function of the pseudorapidity, excluding the 1.9% uncertainty on the integrated luminosity. The charge asymmetry is measured with an uncertainty between 0.002 and 0.003. The results are compared with predictions based on next-to-next-to-leading-order calculations with various parton distribution functions and have the sensitivity to discriminate between them.Comment: 38 pages in total, author list starting page 22, 5 figures, 4 tables, submitted to EPJC. All figures including auxiliary figures are available at https://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-13