Approximate computation of alignments of business processes through relaxation labelling

A fundamental problem in conformance checking is aligning event data with process models. Unfortunately, existing techniques for this task are either complex, or can only be applicable to restricted classes of models. This in practice means that for large inputs, current techniques often fail to produce a result. In this paper we propose a method to approximate alignments for unconstrained process models, which relies on the use of relaxation labelling techniques on top of a partial order representation of the process model. The implementation on the proposed technique achieves a speed-up of several orders of magnitude with respect to the approaches in the literature (either optimal or approximate), often with a reasonable trade-off on the cost of the obtained alignment.Peer ReviewedPostprint (author's final draft

A Primary Prevention Clinical Risk Score Model for Patients With Brugada Syndrome (BRUGADA-RISK)

OBJECTIVES: The goal of this study was to develop a risk score model for patients with Brugada syndrome (BrS). BACKGROUND: Risk stratification in BrS is a significant challenge due to the low event rates and conflicting evidence. METHODS: A multicenter international cohort of patients with BrS and no previous cardiac arrest was used to evaluate the role of 16 proposed clinical or electrocardiogram (ECG) markers in predicting ventricular arrhythmias (VAs)/sudden cardiac death (SCD) during follow-up. Predictive markers were incorporated into a risk score model, and this model was validated by using out-of-sample cross-validation. RESULTS: A total of 1,110 patients with BrS from 16 centers in 8 countries were included (mean age 51.8 ± 13.6 years; 71.8% male). Median follow-up was 5.33 years; 114 patients had VA/SCD (10.3%) with an annual event rate of 1.5%. Of the 16 proposed risk factors, probable arrhythmia-related syncope (hazard ratio [HR]: 3.71; p < 0.001), spontaneous type 1 ECG (HR: 3.80; p < 0.001), early repolarization (HR: 3.42; p < 0.001), and a type 1 Brugada ECG pattern in peripheral leads (HR: 2.33; p < 0.001) were associated with a higher risk of VA/SCD. A risk score model incorporating these factors revealed a sensitivity of 71.2% (95% confidence interval: 61.5% to 84.6%) and a specificity of 80.2% (95% confidence interval: 75.7% to 82.3%) in predicting VA/SCD at 5 years. Calibration plots showed a mean prediction error of 1.2%. The model was effectively validated by using out-of-sample cross-validation according to country. CONCLUSIONS: This multicenter study identified 4 risk factors for VA/SCD in a primary prevention BrS population. A risk score model was generated to quantify risk of VA/SCD in BrS and inform implantable cardioverter-defibrillator prescription

PKIX certificate status in hybrid MANET

Certificate status validation is a hard problem in general but it is particularly complex in Mobile Ad-hoc Networks (MANETs) because we require solutions to manage both the lack of fixed infrastructure inside the MANET and the possible absence of connectivity to trusted authorities when the certification validation has to be performed. In this sense, certificate acquisition is usually assumed as an initialization phase. However, certificate validation is a critical operation since the node needs to check the validity of certificates in real-time, that is, when a particular certificate is going to be used. In such MANET environments, it may happen that the node is placed in a part of the network that is disconnected from the source of status data at the moment the status checking is required. Proposals in the literature suggest the use of caching mechanisms so that the node itself or a neighbour node has some status checking material (typically on-line status responses or lists of revoked certificates). However, to the best of our knowledge the only criterion to evaluate the cached (obsolete) material is the time. In this paper, we analyse how to deploy a certificate status checking PKI service for hybrid MANET and we propose a new criterion based on risk to evaluate cached status data that is much more appropriate and absolute than time because it takes into account the revocation process.Anglai

Recombinant Adenovirus Delivery of Calreticulin-ESAT-6 Produces an Antigen-Specific Immune Response but no Protection Against a Mycobacterium Tuberculosis Challenge

Bacillus CalmetteGuerin (BCG) has failed to efficaciously control the worldwide spread of the disease. New vaccine development targets virulence antigens of Mycobacterium tuberculosis that are deleted in Mycobacterium bovis BCG. Immunization with ESAT-6 and CFP10 provides protection against M. tuberculosis in a murine infection model. Further, previous studies have shown that calreticulin increases the cell-mediated immune responses to antigens. Therefore, to test whether calreticulin enhances the immune response against M. tuberculosis antigens, we fused ESAT-6 to calreticulin and constructed a recombinant replication-deficient adenovirus to express the resulting fusion protein (AdCRTESAT-6). The adjuvant effect of calreticulin was assayed by measuring cytokine responses specific to ESAT-6. Recombinant adenovirus expressing the fusion protein produced higher levels of interferon-gamma and tumour necrosis factor-a in response to ESAT-6. This immune response was not improved by the addition of CFP-10 to the CRT-ESAT-6 fusion protein (AdCRTESAT-6CFP10). Mice immunized with these recombinant adenoviruses did not decrease the mycobacterial burden after low-dose aerosol infection with M. tuberculosis. We conclude that calreticulin can be used as an adjuvant to enhance the immune response against mycobacterial antigens, but it is not enough to protect against tuberculosis

Improving risk assessment for post-surgical low cardiac output syndrome in patients without severely reduced ejection fraction undergoing open aortic valve replacement. The role of global longitudinal strain and right ventricular free wall strain

Low cardiac output syndrome (LCOS) after surgical aortic valve replacement (SAVR) is related to increased mortality and treatment related costs. We aimed to evaluate whether echocardiography-derived left ventricular global longitudinal strain (LV-GLS) relates to the occurrence of postoperative LCOS in patients undergoing SAVR. We prospectively enrolled 75 patients with symptomatic severe aortic stenosis, left ventricular ejection fraction (LVEF) > 40%, NYHA Class <IV, without other significant valve disease. Echocardiographic examination, including LV-GLS assessment was performed before SAVR. In a subgroup of patients right ventricular free wall strain (RVFWS) was also measured. The main outcome was the occurrence of LCOS. Secondary outcome was 30-day mortality. Patients were divided according to LCOS occurrence, which was found in 41% of the population. Baseline clinical characteristics were similar between groups except for LVEF, and LV-GLS. We found LV-GLS to be related to 30-day mortality (OR 1.3, p <0.041, 95% CI 1.02-1.69). After multivariate analysis for variables related to LCOS, only age (p = 0.034), LVEF (p = 0.037) and LV-GLS (p = 0.040) independently predicted LCOS. Mean RVFWS was lower in patients in whom the primary outcome occurred (-12.8 +/- 4.3 vs. -17.1 +/- 3.9, p = 0.0081). In ROC curves analysis a RVFWS of -15% yielded a sensitivity of 81.2% and specificity of 71.4% for the occurrence of LCOS. LV-GLS is a useful parameter for risk stratification in patients with severe aortic stenosis without severely depressed LVEF, and is independently associated with LCOS occurrence. RVFWS wall strain may be useful for risk stratification in patients undergoing AVR

Differences between familial and sporadic dilated cardiomyopathy: ESC EORP Cardiomyopathy & Myocarditis registry

Aims: Dilated cardiomyopathy (DCM) is a complex disease where genetics interplay with extrinsic factors. This study aims to compare the phenotype, management, and outcome of familial DCM (FDCM) and non-familial (sporadic) DCM (SDCM) across Europe. Methods and results: Patients with DCM that were enrolled in the prospective ESC EORP Cardiomyopathy & Myocarditis Registry were included. Baseline characteristics, genetic testing, genetic yield, and outcome were analysed comparing FDCM and SDCM; 1260 adult patients were studied (238 FDCM, 707 SDCM, and 315 not disclosed). Patients with FDCM were younger (P\ua0<\ua00.01), had less severe disease phenotype at presentation (P\ua0<\ua00.02), more favourable baseline cardiovascular risk profiles (P\ua0 64\ua00.007), and less medication use (P\ua0 64\ua00.042). Outcome at 1\ua0year was similar and predicted by NYHA class (HR 0.45; 95% CI [0.25\u20130.81]) and LVEF per % decrease (HR 1.05; 95% CI [1.02\u20131.08]. Throughout Europe, patients with FDCM received more genetic testing (47% vs. 8%, P\ua0<\ua00.01) and had higher genetic yield (55% vs. 22%, P\ua0<\ua00.01). Conclusions: We observed that FDCM and SDCM have significant differences at baseline but similar short-term prognosis. Whether modification of associated cardiovascular risk factors provide opportunities for treatment remains to be investigated. Our results also show a prevalent role of genetics in FDCM and a non-marginal yield in SDCM although genetic testing is largely neglected in SDCM. Limited genetic testing and heterogeneity in panels provides a scaffold for improvement of guideline adherence

Detection of Carbon Monoxide in the Atmosphere of WASP-39b Applying Standard Cross-correlation Techniques to JWST NIRSpec G395H Data

Carbon monoxide was recently reported in the atmosphere of the hot Jupiter WASP-39b using the NIRSpec PRISM transit observation of this planet, collected as part of the JWST Transiting Exoplanet Community Early Release Science Program. This detection, however, could not be confidently confirmed in the initial analysis of the higher-resolution observations with NIRSpec G395H disperser. Here we confirm the detection of CO in the atmosphere of WASP-39b using the NIRSpec G395H data and cross-correlation techniques. We do this by searching for the CO signal in the unbinned transmission spectrum of the planet between 4.6 and 5.0 μm, where the contribution of CO is expected to be higher than that of other anticipated molecules in the planet's atmosphere. Our search results in a detection of CO with a cross-correlation function (CCF) significance of 6.6σ when using a template with only 12C16O lines. The CCF significance of the CO signal increases to 7.5σ when including in the template lines from additional CO isotopologues, with the largest contribution being from 13C16O. Our results highlight how cross-correlation techniques can be a powerful tool for unveiling the chemical composition of exoplanetary atmospheres from medium-resolution transmission spectra, including the detection of isotopologues

GATOS: missing molecular gas in the outflow of NGC 5728 revealed by JWST

\ua9 2024 EDP Sciences. All rights reserved.The ionisation cones of NGC 5728 have a deficit of molecular gas based on millimetre observations of CO (2-1) emission. Although photoionisation from the active nucleus may lead to suppression of this transition, warm molecular gas can still be present. We report the detection of eight mid-infrared rotational H2 lines throughout the central kiloparsec, including the ionisation cones, using integral field spectroscopic observations with JWST/MIRI MRS. The H2 line ratios, characteristic of a power-law temperature distribution, indicate that the gas is warmest where it enters the ionisation cone through disk rotation, suggestive of shock excitation. In the nucleus, where the data can be combined with an additional seven ro-vibrational H2 transitions, we find that moderate velocity (30 km s-1) shocks in dense (105 cm-3) gas, irradiated by an external UV field (G0 = 103), do provide a good match to the full set. The warm molecular gas in the ionisation cone that is traced by the H2 rotational lines has been heated to temperatures &gt; 200 K. Outside of the ionisation cone the molecular gas kinematics are undisturbed. However, within the ionisation cone, the kinematics are substantially perturbed, indicative of a radial flow, but one that is quantitatively different from the ionised lines. We argue that this outflow is in the plane of the disk, implying a short 50 pc acceleration zone up to speeds of about 400 km s-1 followed by an extended deceleration over ~700 pc where it terminates. The deceleration is due to both the radially increasing galaxy mass, and mass-loading as ambient gas in the disk is swept up