Current AATS guidelines on surgical treatment of infective endocarditis

© Annals of Cardiothoracic Surgery. The 2016 American Association for Thoracic Surgery (AATS) guidelines for surgical treatment of infective endocarditis (IE) are question based and address questions of specific relevance to cardiac surgeons. Clinical scenarios in IE are often complex, requiring prompt diagnosis, early institution of antibiotics, and decision-making related to complications, including risk of embolism and timing of surgery when indicated. The importance of an early, multispecialty team approach to patients with IE is emphasized. Management issues are divided into groups of questions related to indications for and timing of surgery, pre-surgical work-up, preoperative antibiotic treatment, surgical risk assessment, intraoperative management, surgical management, surveillance, and follow up. Standard indications for surgery are severe heart failure, severe valve dysfunction, prosthetic valve infection, invasion beyond the valve leaflets, recurrent systemic embolization, large mobile vegetations, or persistent sepsis despite adequate antibiotic therapy for more than 5-7 days. The guidelines emphasize that once an indication for surgery is established, the operation should be performed as soon as possible. Timing of surgery in patients with strokes and neurologic deficits require close collaboration with neurological services. In surgery infected and necrotic tissue and foreign material is radically debrided and removed. Valve repair is performed whenever possible, particularly for the mitral and tricuspid valves. When simple valve replacement is required, choice of valve-mechanical or tissue prosthesis-should be based on normal criteria for valve replacement. For patients with invasive disease and destruction, reconstruction should depend on the involved valve, severity of destruction, and available options for cardiac reconstruction. For the aortic valve, use of allograft is still favored

A Positive-Weight Next-to-Leading-Order Monte Carlo for Z Pair Hadroproduction

We present a first application of a previously published method for the computation of QCD processes that is accurate at next-to-leading order, and that can be interfaced consistently to standard shower Monte Carlo programs. We have considered Z pair production in hadron-hadron collisions, a process whose complexity is sufficient to test the general applicability of the method. We have interfaced our result to the HERWIG and PYTHIA shower Monte Carlo programs. Previous work on next-to-leading order corrections in a shower Monte Carlo (the MC@NLO program) may involve the generation of events with negative weights, that are avoided with the present method. We have compared our results with those obtained with MC@NLO, and found remarkable consistency. Our method can also be used as a standalone, alternative implementation of QCD corrections, with the advantage of positivity, improved convergence, and next-to-leading logarithmic accuracy in the region of small transverse momentum of the radiated parton.Comment: 33 pages, 10 figure

Levels Of The 4p4 Configuration Of Ge-like Kr V

The spectrum of four-times-ionized krypton, Kr v, has been observed in the vuv region using a θ-pinch as a light source. The 4s4p3-4p4 transition array has been observed in this ion. This transition has not previously been observed in the Ge i isoelectronic sequence. Thirteen lines were classified that belong to this transition array. All levels of the 4p4 configuration were determined. The identifications are supported by relativistic Hartree-Fock calculations. © 1993 The American Physical Society.4853595359

Early introduction of fish decreases the risk of eczema in infants

BACKGROUND: Atopic eczema in infants has increased in western societies. Environmental factors and the introduction of food may affect the risk of eczema. AIMS: To investigate the prevalence of eczema among infants in western Sweden, describe patterns of food introduction and assess risk factors for eczema at 1 year of age. METHODS: Data were obtained from a prospective, longitudinal cohort study of infants born in western Sweden in 2003; 8176 families were randomly selected and, 6 months after the infant\u27s birth, were invited to participate and received questionnaires. A second questionnaire was sent out when the infants were 12 months old. Both questionnaires were completed and medical birth register data were obtained for 4921 infants (60.2% of the selected population). RESULTS: At 1 year of age, 20.9% of the infants had previous or current eczema. Median age at onset was 4 months. In multivariable analysis, familial occurrence of eczema, especially in siblings (OR 1.87; 95% confidence interval (CI) 1.50 to 2.33) or the mother (OR 1.54; 95% CI 1.30 to 1.84), remained an independent risk factor. Introducing fish before 9 months of age (OR 0.76; 95% CI 0.62 to 0.94) and having a bird in the home (OR 0.35; 95% CI 0.17 to 0.75) were beneficial. CONCLUSIONS: One in five infants suffer from eczema during the first year of life. Familial eczema increased the risk, while early fish introduction and bird keeping decreased it. Breast feeding and time of milk and egg introduction did not affect the risk

Uncertainty quantification for kinetic models in socio-economic and life sciences

Kinetic equations play a major rule in modeling large systems of interacting particles. Recently the legacy of classical kinetic theory found novel applications in socio-economic and life sciences, where processes characterized by large groups of agents exhibit spontaneous emergence of social structures. Well-known examples are the formation of clusters in opinion dynamics, the appearance of inequalities in wealth distributions, flocking and milling behaviors in swarming models, synchronization phenomena in biological systems and lane formation in pedestrian traffic. The construction of kinetic models describing the above processes, however, has to face the difficulty of the lack of fundamental principles since physical forces are replaced by empirical social forces. These empirical forces are typically constructed with the aim to reproduce qualitatively the observed system behaviors, like the emergence of social structures, and are at best known in terms of statistical information of the modeling parameters. For this reason the presence of random inputs characterizing the parameters uncertainty should be considered as an essential feature in the modeling process. In this survey we introduce several examples of such kinetic models, that are mathematically described by nonlinear Vlasov and Fokker--Planck equations, and present different numerical approaches for uncertainty quantification which preserve the main features of the kinetic solution.Comment: To appear in "Uncertainty Quantification for Hyperbolic and Kinetic Equations

Integral representation of the linear Boltzmann operator for granular gas dynamics with applications

We investigate the properties of the collision operator associated to the linear Boltzmann equation for dissipative hard-spheres arising in granular gas dynamics. We establish that, as in the case of non-dissipative interactions, the gain collision operator is an integral operator whose kernel is made explicit. One deduces from this result a complete picture of the spectrum of the collision operator in an Hilbert space setting, generalizing results from T. Carleman to granular gases. In the same way, we obtain from this integral representation of the gain operator that the semigroup in L^1(\R \times \R,\d \x \otimes \d\v) associated to the linear Boltzmann equation for dissipative hard spheres is honest generalizing known results from the first author.Comment: 19 pages, to appear in Journal of Statistical Physic

Minimum-Cost Reachability for Priced Timed Automata

This paper introduces the model of linearly priced timed automata as an extension of timed automata, with prices on both transitions and locations. For this model we consider the minimum-cost reachability problem: i.e. given a linearly priced timed automaton and a targetstate, determine the minimum cost of executions from the initial state to the target state. This problem generalizes the minimum-time reachability problem for ordinary timed automata. We prove decidability of this problem by offering an algorithmic solution, which is based on a combination of branch-and-bound techniques and a new notion of priced regions. The latter allows symbolic representation and manipulation of reachable states together with the cost of reaching them.Keywords: Timed Automata, Verification, Data Structures, Algorithms,Optimization