CafeOBJ: Logical Foundations and Methodologies

CafeOBJ is an executable industrial strength multi-logic algebraic specification language which is a modern successor of OBJ and incorporates several new algebraic specification paradigms. In this paper we survey its logical foundations and present some of its methodologies

Guz neuroendokrynny odbytnicy jako rzadka przyczyna wgłobienia odcinka odbytniczo-esiczego u dorosłych: opis przypadku i przegląd piśmiennictwa

Wgłobienie jelita jest często rozpoznawane u dzieci i młodzieży, natomiast u dorosłych występuje rzadko i nie daje charakterystycznych objawów. Niezależnie od lokalizacji u większości dorosłych wgłobienie jest następstwem obecności guza o różnej budowie histologicznej, wywodzącego się z błony wewnętrznej jelita. W niniejszej pracy przedstawiono przypadek wgłobienia odbytniczo-esiczego u dorosłego na podłożu guza neuroendokrynnego. Opisany przypadek jest wyjątkowy z następujących powodów: (1) guzy neuroendokrynne rzadko lokalizują się w esiczo-odbytniczym odcinku jelita, (2) obraz kliniczny wgłobienia odbytniczo-esiczego sprawia trudności diagnostyczne

Neuroendocrine rectal tumour as a rare aetiology of adult recto-sigmoidal intussusception: case presentation and literature review

Intestinal intussusception is a frequent paediatric pathology, but adult cases are rare and do not have a specific presentation. In most cases adult intestinal intussusception, regardless of its localisation, is caused by an endoluminal tumour, which can be of multiple pathological types. We report a sigmoido-rectal intussusception in an adult in whom an adenoneuroendocrine tumour was identified as the lead point. This case is unique for the following reasons: (1) neuroendocrine tumours rarely involve the sigmoido-rectal segment of the gut, (2) clinical presentation with a recto-sigmoidal intussusception presented a diagnostic challenge

Bisimilarity and refinement for hybrid(ised) logics

The complexity of modern software systems entails the need for reconfiguration mechanisms governing the dynamic evolution of their execution configurations in response to both external stimulus or internal performance measures. Formally, such systems may be represented by transition systems whose nodes correspond to the different configurations they may assume. Therefore, each node is endowed with, for example, an algebra, or a first-order structure, to precisely characterise the semantics of the services provided in the corresponding configuration. Hybrid logics, which add to the modal description of transition structures the ability to refer to specific states, offer a generic framework to approach the specification and design of this sort of systems. Therefore, the quest for suitable notions of equivalence and refinement between models of hybrid logic specifications becomes fundamental to any design discipline adopting this perspective. This paper contributes to this effort from a distinctive point of view: instead of focussing on a specific hybrid logic, the paper introduces notions of bisimilarity and refinement for hybridised logics, i.e. standard specification logics (e.g. propositional, equational, fuzzy, etc) to which modal and hybrid features were added in a systematic way.FC

Adoptive immunotherapy against allogeneic kidney grafts in dogs with stable hematopoietic trichimerism.

Dogs given nonmyeloablative conditioning and marrow grafts from 2 dog leukocyte antigen (DLA)-identical littermate donors developed stable trichimerism and stably accepted a subsequent kidney graft from one of the marrow donors without the need for immunosuppression. In this study, we used trichimeras to evaluate strategies for adoptive immunotherapy to solid tumors, using the kidney as a tumor surrogate. Three DLA-identical trichimeric recipients were established by simultaneously infusing marrow from 2 DLA-identical donor dogs into a DLA-identical recipient conditioned with 2 Gy of total body irradiation (TBI) and given a short course of postgraft immunosuppression. After stable hematopoietic engraftment was confirmed, a kidney was transplanted from 1 of the 2 marrow donors into each respective trichimeric recipient. Peripheral blood lymphocytes from each kidney donor were then used to sensitize the alternate marrow donor. The trichimeric recipients were given donor lymphocyte infusions (DLIs) from the sensitized dogs and monitored for chimerism, graft-versus-host disease (GVHD), and kidney rejection. After DLI, we observed both prompt rejection of the transplanted marrow and donor kidney and disappearance of corresponding hematopoietic chimerism. Presumably due to shared minor histocompatibility antigens, host chimerism also disappeared, and GVHD in skin, gut, and liver developed. The native kidneys, although exhibiting lymphocytic infiltration, remained functionally normal. This study demonstrates that under certain experimental conditions, the kidney--an organ ordinarily not involved in graft-versus-host reactions--can be targeted by sensitized donor lymphocytes

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Foundations of Behavioural Specification in Rewriting Logic

We extend behavioural specification based on hidden sorts to rewriting logic by constructing a hybrid between the two underlying logics. This is achieved by defining a concept of behavioural satisfaction for rewriting logic. Our approach is semantic in that it is based on a general construction on models, called behaviour image, which uses final models in an essential way. However we provide syntactic characterisations for the for the behavioural satisfaction relation, thus opening the door for shifting recent advanced proof techniques for behavioural satisfaction to rewriting logic. We also show that the rewriting logic behavioural satisfaction obeys the socalled &quot;satisfaction condition&quot; of the theory of institutions, thus providing support for OBJ style modularisation for this new paradigm. 1 Introduction This research aims at integrating two different semantic approaches on objects and concurrency by internalising behavioural specification [12] to [conditional] rewriting logic (abb..