Graph transformation systems for modeling three dimensional finite element method : part II

In this paper we introduce formal definitions for several graph transformation systems modeling three dimensional h-adaptive Finite Element Method (3D h-FEM) algorithms with tetrahedral finite elements. We introduce a composite graph representation of the computational mesh and graph transformation rules expressing the mesh operations. In particular, there are graph transformation rules expressing the generation of the initial mesh consisting with tetrahedral finite elements, graph transformation rules expressing the construction of an elimination tree for interfacing with multi-frontal direct solver algorithm, graph transformation rules selecting sub-graph representing finite elements for further refinements, graph transformation rules responsible for execution of mesh refinements. We also discuss several benefits of using graph transformation system instead of classical FEM approach, including the benefits from the viewpoint of multi-frontal direct solvers

Graph transformation systems for modeling three dimensional finite element method : part I

In this paper we present several graph transformation systems modeling three dimensional h-adaptive Finite Element Method (3D h-FEM) algorithms with tetrahedral finite elements. In our approach a computational mesh is represented by a composite graph and mesh operations are expressed by the graph transformation rules. Each graph transformation system is responsible for different kind of operations. In particular, there is a graph transformation system expressing generation of an initial mesh, generating element matrices and elimination trees for interfacing with direct solver algorithm, a graph transformation system deciding which elements have to be further refined, as well as a graph transformation system responsible for execution of mesh refinements. These graph transformation systems are tested using a graph transformation tool (called GRAGRA), which provides a graphical environment for defining graphs, graph transformation rules and graph transformation systems. In this paper we illustrate the concepts by using an exemplary derivation for a three dimensional projection problem, based on a set of graph transformation rules

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications