Unexpected limited chronic dissection of the ascending aorta

We report a rare case of a limited chronic dissection of the ascending aorta that was accidentally discovered at operation performed for severe aortic stenosis and moderate to severe dilatation of the ascending aorta. Preoperative investigations such as transoesophageal echocardiography and cardiac catheterization missed the diagnosis of dissection. Intraoperative findings included a 3.5 cm eccentric bulge of the ascending aorta and a 5 mm circular shaped intimal tear comunicating with a limited hematoma or small dissection of the media layer. (The rarety of the report is that the chronic dissection is limited to a small area (approximatively 3.5 × 2.5 cm) of the ascending aorta)

Pareto Optimal Matchings in Many-to-Many Markets with Ties

We consider Pareto-optimal matchings (POMs) in a many-to-many market of applicants and courses where applicants have preferences, which may include ties, over individual courses and lexicographic preferences over sets of courses. Since this is the most general setting examined so far in the literature, our work unifies and generalizes several known results. Specifically, we characterize POMs and introduce the \emph{Generalized Serial Dictatorship Mechanism with Ties (GSDT)} that effectively handles ties via properties of network flows. We show that GSDT can generate all POMs using different priority orderings over the applicants, but it satisfies truthfulness only for certain such orderings. This shortcoming is not specific to our mechanism; we show that any mechanism generating all POMs in our setting is prone to strategic manipulation. This is in contrast to the one-to-one case (with or without ties), for which truthful mechanisms generating all POMs do exist

Cardiopulmonary bypass via common carotid artery cannulation in redo sternotomy

There are certain situations in redo cardiac surgery in adults where it may not be possible to use alternate arterial cannulation sites like the common femoral artery and axillary artery. We report a case where we established safe cardiopulmonary bypass with common carotid artery cannulation in an adult patient. The patient underwent aortic valve replacement for severe aortic regurgitation 8 months after repair of type A aortic dissection plus aortic valve resuspension

Surgical treatment of aortobronchial fistula after thoracic endograft failure

Endovascular stent grafting has been recently considered as a less invasive alternative to either medical therapy or open surgical treatment for many patients with descending thoracic aortic disease. Late complications are rarely described in literature. Herein, we described the occurrence of an aorto-bronchial fistula and a retro-A dissection in a 73-year-old man after stent-grafting for a penetrating atherosclerotic ulcer (PAU) of the descending thoracic aorta and the successful surgical technique adopted in order to remove the stent-graft

Endovascular treatment of thoracoabdominal aortic aneurysm: a case report

<p>Abstract</p> <p>Introduction</p> <p>Thoracoabdominal aortic aneurysms usually present in elderly patients with serious renal, pulmonary, cerebral, or cardiac comorbidities that pose a great challenge to the attending surgeon. Endovascular techniques for the treatment of thoracoabdominal aneurysms are not yet widely used due to limitations associated with them, such as spinal and visceral ischemia.</p> <p>Case presentation</p> <p>An 87-year-old Caucasian man with a symptomatic Crawford type I thoracoabdominal aortic aneurysm was treated successfully with a long tube stent graft using endovascular techniques and without any complication in follow-up examinations. The stent was placed distal to the left subclavian artery, and proximal to the celiac axis.</p> <p>Conclusion</p> <p>The use of endovascular stents for long segment thoracoabdominal aortic aneurysms needs to undergo clinical investigation to determine whether this procedure decreases morbidity and mortality rates.</p

Aortic root surgery in septuagenarians: impact of different surgical techniques

<p>Abstract</p> <p>Background</p> <p>To evaluate the impact and safety of different surgical techniques for aortic root replacement (ARR) on early and late morbidity and mortality in septuagenarians undergoing ARR.</p> <p>Methods</p> <p>Ninety-five patients (73.8 ± 3.2 years) were operated and divided into three groups according to the aortic root procedure; MECH-group (n = 51) patients with a mechanical composite graft, BIO-group (n = 22) patients with a customized biological composite graft, and REIMPL-group (n = 22) patients with a valve sparing aortic root reimplantation (David I). In 42.1% (40/95) of these patients the aortic arch was replaced. Follow-up was completed in 95.2% (79/83) of in-hospital survivors.</p> <p>Results</p> <p>Hospital mortality was 12.6% (12/95) in the entire population (MECH. 15.7% (8/51), BIO 19.7% (4/22), REIMPL 0% (0/22); p = 0.004). Two patients died intraoperatively. The most frequent postoperative complications were prolonged mechanical ventilation ((>48 h) in 16.8% (16/93) (MECH. 7% (7/51), BIO 36.4% (8/22), REIMPL 4.5% (1/22); p = 0.013) and rethoracotomy for postoperative bleeding in 12.6% (12/95) (MECH. 12% (6/51), BIO 22.7% (5/22), REIMPL 4.5% (1/22); p = 0.19). Nineteen late deaths (22.9%) (19/83) (MECH 34.8% (15/43), BIO 16.7% (3/18), REIMPL 4.5% (1/22); p = 0.012) occurred during a mean follow-up of 41 ± 42 months (MECH 48 ± 48 months, BIO 25 ± 37 months, REIMPL 40 ± 28 months, p = 0.028). Postoperative NYHA class decreased significantly (p = 0.017) and performance status (p = 0.027) increased for the entire group compared to preoperative values.</p> <p>Conclusion</p> <p>Our data indicate that valve sparing aortic root reimplantation is safe and effective in septuagenarians, and is associated with low early and late morbidity and mortality.</p

Social Cost Guarantees in Smart Route Guidance

We model and study the problem of assigning traffic in an urban road network infrastructure. In our model, each driver submits their intended destination and is assigned a route to follow that minimizes the social cost (i.e., travel distance of all the drivers). We assume drivers are strategic and try to manipulate the system (i.e., misreport their intended destination and/or deviate from the assigned route) if they can reduce their travel distance by doing so. Such strategic behavior is highly undesirable as it can lead to an overall suboptimal traffic assignment and cause congestion. To alleviate this problem, we develop moneyless mechanisms that are resilient to manipulation by the agents and offer provable approximation guarantees on the social cost obtained by the solution. We then empirically test the mechanisms studied in the paper, showing that they can be effectively used in practice in order to compute manipulation resistant traffic allocations

Determinants of medication adherence to antihypertensive medications among a Chinese population using Morisky medication adherence scale

&lt;b&gt;Background and objectives&lt;/b&gt; Poor adherence to medications is one of the major public health challenges. Only one-third of the population reported successful control of blood pressure, mostly caused by poor drug adherence. However, there are relatively few reports studying the adherence levels and their associated factors among Chinese patients. This study aimed to study the adherence profiles and the factors associated with antihypertensive drug adherence among Chinese patients.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; A cross-sectional study was conducted in an outpatient clinic located in the New Territories Region of Hong Kong. Adult patients who were currently taking at least one antihypertensive drug were invited to complete a self-administered questionnaire, consisting of basic socio-demographic profile, self-perceived health status, and self-reported medication adherence. The outcome measure was the Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as MMAS scores greater than 6 points (out of a total score of 8 points).&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; From 1114 patients, 725 (65.1%) had good adherence to antihypertensive agents. Binary logistic regression analysis was conducted. Younger age, shorter duration of antihypertensive agents used, job status being employed, and poor or very poor self-perceived health status were negatively associated with drug adherence.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusion&lt;/b&gt; This study reported a high proportion of poor medication adherence among hypertensive subjects. Patients with factors associated with poor adherence should be more closely monitored to optimize their drug taking behavior

Characterizing Vickrey allocation rule by anonymity

We consider the problem of allocating finitely many units of an indivisible good among a group of agents when each agent receives at most one unit of the good and pays a non-negative price. For example, imagine that a government allocates a fixed number of licenses to private firms, or that it distributes equally divided lands to households. Anonymity in welfare is a condition of impartiality in the sense that it requires allocation rules to treat agents equally in welfare terms from the viewpoint of agents who are ignorant of their own valuations or identities. We show that the Vickrey allocation rule is the unique allocation rule satisfying strategy-proofness, anonymity in welfare, and individual rationality

Formalizing enrichment mechanisms for bibliographic ontologies in the Semantic Web

This paper presents an analysis of current limitations to the reuse of bibliographic data in the Semantic Web and a research proposal towards solutions to overcome them. The limitations identified derive from the insufficient convergence between existing bibliographic ontologies and the principles and techniques of linked open data (LOD); lack of a common conceptual framework for a diversity of standards often used together; reduced use of links to external vocabularies and absence of Semantic Web mechanisms to formalize relationships between vocabularies, as well as limitations of Semantic Web languages for the requirements of bibliographic data interoperability. A proposal is advanced to investigate the hypothesis of creating a reference model and specifying a superontology to overcome the misalignments found, as well as the use of SHACL (Shapes Constraint Language) to solve current limitations of RDF languages.info:eu-repo/semantics/acceptedVersio