Ex vivo perfusion, arteriography, and autotransplantation procedures for kidney salvage

Three kidneys with arterial lesions that would have been difficult or impossible to repair by standard vascular reconstruction were removed, perfused by the Belzer technique, and returned to host after partial or complete autotransplantation. The fact that kidneys can be studied, dissected, repaired, and constantly salvaged with this technique should have important implications in several aspects of urologic operations

Tracking Middleboxes in the Mobile World with TraceboxAndroid

peer reviewedMiddleboxes are largely deployed over cellular networks. It is known that they might disrupt network performance, expose users to security issues, and harm protocols deployability. Further, hardly any network measurements tools for smartphones are able to infer middlebox behaviors, specially if one cannot control both ends of a path. In this paper, we present TraceboxAndroid a proof-of-concept measurement application for Android mobile devices implementing the tracebox algorithm. It aims at diagnosing middlebox-impaired paths by detecting and locating rewriting middleboxes. We analyze a dataset sample to highlight the range of opportunities offered by TraceboxAndroid. We show that TraceboxAndroid can be useful for mobile users as well as for the research community

Use of approximations of Hamilton-Jacobi-Bellman inequality for solving periodic optimization problems

We show that necessary and sufficient conditions of optimality in periodic optimization problems can be stated in terms of a solution of the corresponding HJB inequality, the latter being equivalent to a max-min type variational problem considered on the space of continuously differentiable functions. We approximate the latter with a maximin problem on a finite dimensional subspace of the space of continuously differentiable functions and show that a solution of this problem (existing under natural controllability conditions) can be used for construction of near optimal controls. We illustrate the construction with a numerical example.Comment: 29 pages, 2 figure

A proposal for selective resuscitation of adult cardiac arrest patients in a pandemic

Allocation of limited resources in pandemics begs for ethical guidance. The issue of ventilator allocation in pandemics has been reviewed by many medical ethicists, but as localities activate crisis standards of care, and health care workers are infected from patient exposure, the decision to pursue cardiopulmonary resuscitation (CPR) must also be examined to better balance the increased risks to healthcare personnel with the very low resuscitation rates of patients infected with coronavirus disease 2019 (COVID‐19). A crisis standard of care that is equitable, transparent, and mindful of both human and physical resources will lessen the impact on society in this era of COVID‐19. This paper builds on previous work of ventilator allocation in pandemic crises to propose a literature‐based, justice‐informed ethical framework for selecting treatment options for CPR. The pandemic affects regions differently over time, so these suggested guidelines may require adaptation to local practice variations.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156457/3/emp212096_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156457/2/emp212096.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156457/1/emp212096-sup-0001-Appendix.pd

Providing Self-Aware Systems with Reflexivity

We propose a new type of self-aware systems inspired by ideas from higher-order theories of consciousness. First, we discussed the crucial distinction between introspection and reflexion. Then, we focus on computational reflexion as a mechanism by which a computer program can inspect its own code at every stage of the computation. Finally, we provide a formal definition and a proof-of-concept implementation of computational reflexion, viewed as an enriched form of program interpretation and a way to dynamically "augment" a computational process.Comment: 12 pages plus bibliography, appendices with code description, code of the proof-of-concept implementation, and examples of executio

How Low Can We Go? The Implications of Delayed Ratcheting and Negative Emissions Technologies on Achieving Well Below 2 °C

Pledges embodied in the nationally determined contributions (NDCs) represent an interim step from a global “no policy” path towards an optimal long-term global mitigation path. However, the goals of the Paris Agreement highlight that current pledges are insufficient. It is, therefore, necessary to ratchet-up parties’ future mitigation pledges in the near-term. The ambitious goals of remaining well below 2 °C and pursuing reductions towards 1.5 °C mean that any delay in ratcheting-up commitments could be extremely costly or may even make the targets unachievable. In this chapter, we consider the impacts of delaying ratcheting until 2030 on global emissions trajectories towards 2 °C and 1.5 °C, and the role of offsets via negative emissions technologies (NETs). The analysis suggests that delaying action makes pursuing the 1.5 °C goal especially difficult without extremely high levels of negative emissions technologies (NETs), such as carbon capture and storage combined with bioenergy (BECCS). Depending on the availability of biomass, other NETs beyond BECCS will be required. Policymakers must also realise that the outlook for fossil fuels are closely linked to the prospects for NETs. If NETs cannot be scaled, the levels of fossil fuels suggested in this analysis are not compatible with the Paris Agreement goals i.e. there are risks of lock-in to a high fossil future. Decision makers must, therefore, comprehend fully the risks of different strategies

The relationship between quality of life (EORTC QLQ-C30) and survival in patients with gastro-oesopohageal cancer

It remains unclear whether any aspect of quality of life has a role in predicting survival in an unselected cohort of patients with gastro-oesophageal cancer. Therefore the aim of the present study was to examine the relationship between quality of life (EORTC QLQ-C30), clinico-pathological characteristics and survival in patients with gastro-oesophageal cancer. Patients presenting with gastric or oesophageal cancer, staged using the UICC tumour node metastasis (TNM) classification and who received either potentially curative surgery or palliative treatment between November 1997 and December 2002 (n=152) participated in a quality of life study, using the EORTC QLQ-C30 core questionnaire. On univariate analysis, age (P < 0.01), tumour length (P < 0.0001), TNM stage (P<0.0001), weight loss (P<0.0001), dysphagia score (P<0.001), performance status (P<0.1) and treatment (P<0.0001) were significantly associated with cancer-specific survival. EORTC QLQ-C30, physical functioning (P<0.0001), role functioning (P<0.001), cognitive functioning (P<0.01), social functioning (P<0.0001), global quality of life (P<0.0001), fatigue (P<0.0001), nausea/vomiting (P<0.01), pain (P<0.001), dyspnoea (P<0.0001), appetite loss (P<0.0001) and constipation (P<0.05) were also significantly associated with cancer-specific survival. On multivariate survival analysis, tumour stage (P<0.0001), treatment (P<0.001) and appetite loss (P<0.0001) were significant independent predictors of cancer-specific survival. The present study highlights the importance of quality of life (EORTC QLQ-C30) measures, in particular appetite loss, as a prognostic factor in these patients

The connection between superconducting phase correlations and spin excitations in YBa2_2Cu3_3O6.6_{6.6}: A magnetic field study

One of the most striking universal properties of the high-transition-temperature (high-$T_c$) superconductors is that they are all derived from the hole-doping of their insulating antiferromagnetic (AF) parent compounds. From the outset, the intimate relationship between magnetism and superconductivity in these copper-oxides has intrigued researchers. Evidence for this link comes from neutron scattering experiments that show the unambiguous presence of short-range AF correlations (excitations) in cuprate superconductors. Even so, the role of such excitations in the pairing mechanism and superconductivity is still a subject of controversy. For YBa$_2$Cu$_3$O$_{6+x}$, where $x$ controls the hole-doping level, the most prominent feature in the magnetic excitations spectra is the ``resonance''. Here we show that for underdoped YBa$_2$Cu$_3$O$_{6.6}$, where $x$ and $T_c$ are below the optimal values, modest magnetic fields suppress the resonance significantly, much more so for fields approximately perpendicular rather than parallel to the CuO$_2$ planes. Our results indicate that the resonance measures pairing and phase coherence, suggesting that magnetism plays an important role in the superconductivity of cuprates. The persistence of a field effect above $T_c$ favors mechanisms with preformed pairs in the normal state of underdoped cuprates.Comment: 12 pages, 4 figures, Nature (in press

Prediction of the Caspian Sea level using ECMWF seasonal forecasts and reanalysis

This article is made available through the Brunel Open Access Publishing Fund. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.The hydrological budget of the Caspian Sea (CS) is investigated using the European Centre for Medium-Range Weather Forecasts interim reanalysis (ERAi) and seasonal forecast (FCST) data with the aim of predicting the Caspian Sea Level (CSL) some months ahead. Precipitation and evaporation are used. After precipitation events over the Volga River, the discharge (Volga River discharge (VRD)) follows with delays, which are parameterized. The components of the water budget from ERAi and FCSTs are integrated to obtain time series of the CSL. Observations of the CSL and the VRD are used for comparison and tuning. The quality of ERAi data is sufficiently good to calculate the time variability of the CSL with a satisfactory accuracy. Already the storage of water within the Volga Basin allows forecasts of the CSL a few months ahead, and using the FCSTs of precipitation improves the CSL forecasts. The evaporation in the seasonal forecasts is deficient due to unrealistic sea surface temperatures over the CS. Impacts of different water budget terms on the CSL variability are shown by a variety of validation tools. The importance of precipitation anomalies over the catchment of the Volga River is confirmed, but also impacts from the two southern rivers (Sefidrud and Kura River) and the evaporation over the CS become obvious for some periods. When pushing the FCSTs beyond the limits of the seasonal FCSTs to 1 year, considerable forecast skill can still be found. Validating only FCSTs by the present approach, which show the same trend as one based on a statistical method, significantly enhances the skill scores

Traffic-related pollution and asthma prevalence in children. Quantification of associations with nitrogen dioxide.

Ambient nitrogen dioxide is a widely available measure of traffic-related air pollution and is inconsistently associated with the prevalence of asthma symptoms in children. The use of this relationship to evaluate the health impact of policies affecting traffic management and traffic emissions is limited by the lack of a concentration-response function based on systematic review and meta-analysis of relevant studies. Using systematic methods, we identified papers containing quantitative estimates for nitrogen dioxide and the 12 month period prevalence of asthma symptoms in children in which the exposure contrast was within-community and dominated by traffic pollution. One estimate was selected from each study according to an a priori algorithm. Odds ratios were standardised to 10 μg/m(3) and summary estimates were obtained using random- and fixed-effects estimates. Eighteen studies were identified. Concentrations of nitrogen dioxide were estimated for the home address (12) and/or school (8) using a range of methods; land use regression (6), study monitors (6), dispersion modelling (4) and interpolation (2). Fourteen studies showed positive associations but only two associations were statistically significant at the 5 % level. There was moderate heterogeneity (I(2) = 32.8 %) and the random-effects estimate for the odds ratio was 1.06 (95 % CI 1.00 to 1.11). There was no evidence of small study bias. Individual studies tended to have only weak positive associations between nitrogen dioxide and asthma prevalence but the summary estimate bordered on statistical significance at the 5 % level. Although small, the potential impact on asthma prevalence could be considerable because of the high level of baseline prevalence in many cities. Whether the association is causal or indicates the effects of a correlated pollutant or other confounders, the estimate obtained by the meta-analysis would be appropriate for estimating impacts of traffic pollution on asthma prevalence