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The need to identify the risk factors (RFs) predictive of mortality after pulmonary lobectomy has fuelled several single- or multi-institution studies, without establishing a prediction model of the generally accepted risk. Each single-institution study offers its own RFs, which corroborated with the RFs published in other multicentric studies may allow a better prediction of postoperative mortality for specific categories of patients. The aim of our study was to identify the 30-day mortality RFs in our lobectomy patients and to compare our results with those published in literature. We therefore analysed the influence of 49 perioperative parameters on postoperative mortality of consecutive lobectomy patients. The 192 lobectomy patients enrolled had malignant (81.25%) and infectious conditions (12.5%) and a 2.6% mortality rate. The results of our study support the following perioperative RF associated with a high mortality rate: thrombocytosis, chronic obstructive bronchopulmonary disease (COPD), digestive and hepatic comorbidities, neoadjuvant chemotherapy, tuberculosis, the American Society of Anesthesiologists rating and the characteristics of postoperative drainage. In conclusion, these RFs may serve as the factors to consider when calculating the mortality rate after lobectomy, in preoperative selection as well as in instruments for the assessment of postoperative results.

Background Neopterin and RNA-ase are markers of inflammation with low disclosed role in diagnosis and prognosis of either STEMI or NSTEMI, although inflammation is well documented as a leader pathogenic mechanism in these pathologies. Aim Evaluation of serum admission levels of neopterin and ARN-ase in pts with STEMI and NSTEMI and their prediction value concerning the risk of MACE in 1 year of follow up period. Material and methods The admission serum concentration of neopterin and ARN-ase was determined by ELISA in 94 pts with STEMI and 92 pts with NSTEMI which was compared with normal markers appreciated in 32 healthy persons. Likewise, the rate of MACE in both groups was estimated during 1 year of post-infarction period. Diagnostic worth and MACE prediction power of markers have been established using respectively ROC curve and odds ratio. Results In patients with STEMI the serum level of neopterin was significantly increased compared with normal index by 3,5 times (11,6±3,4 vs 3,3±1,4 nM/L), but RNA-ase was significantly decreased by 43,4% (24,1±3,2 vs 42,6±5,2 nM/ml). In pts with NSTEMI neopterin level was lesser than STEMI, but significantly elevated by 39% (4,6±2,5 vs 3,3±1,4 nM/L) vs normal marker. RNA-ase level didn't significantly differ from normal level. However, adjusted to diabetes mellitus established in 19 pts, RNA-ase significantly diminished (36,4±3,9 vs 42,6±5,2 nM/ml), and its diagnostic value of NSTEMI according to ROC was 69,6% (RNA-ase level indicates inversely inflammation response, such as it breaks down extracellular RNA which has proinflammatory ability). Both markers in pts with NSTEMI and diabetes mellitus demonstrated a diagnostic value of 77,6%. In pts with STEMI highest tertile level of neopterin and lowest tertile level of ARN-ase had 2,8fold (adds ratio=2,8; CI=1,98–4,62; p Conclusions 1. In STEMI both neopterin and RNA-ase could be as diagnostic markers, due to their significant change. In NSTEMI neopterin significantly elevated, but RNA-ase didn't shift from normal. In diabetic pts with NSTEMI, however, their combination demonstrated in ROC estimation a diagnostic value of 77,6%. 2. Prediction value of markers combination regarding MACE risk in pts with NSTEMI is significant and close to each marker in partly prediction of MACE for pts with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Research Institute of Cardiology, Moldova Republic of

Thoracic lymphangiomatosis (proliferation of anastomosing lymphatic vessels, of different sizes, in pulmonary, pleural and mediastinal regions) is an extremely rare disorder occurring mostly in childhood. We present a diffuse pulmonary lymphangiomatosis (DPL) case in a young adult female patient in which repeated surgical biopsies were inconclusive and transthoracic ultrasound-guided (TUS) biopsy led to the diagnosis. Even histologically, DPL is very difficult to differentiate from other lymphatic diseases such as lymphangioma and lymphangiomyomatosis, requiring an experienced pathologist and proper immunohistochemistry staining. This case highlights the importance of TUS-guided biopsies in the armamentarium of imagistic techniques in this very rare case

The thoracic paravertebral block (PVB), a technique of post-thoracotomy analgesia of similar effectiveness as continuous epidural analgesia (CEA) but with a better safety profile, is underutilized in current practice. This study compares the outcome of post-lobectomy patients in relation to the analgesic method used: parenteral analgesia (PA) vs. PVB + PA, and provides justification for the routine use of PVB in all patients where CEA is contraindicated.We randomized 213 consecutive patients undergoing open lobectomy to benefit from two different protocols of postoperative analgesia: PA vs. PVB +PA. We compared the frequency of cardiac hemodynamic, respiratory, pleural or surgical-related complications.After lobectomy, the PVB patients (72/213) were found to have a significantly lower frequency of congestive heart failure (7.1%vs.0.0%)(p=0.049), ischemic cardiomyopathy (10.6%vs.0.0%)(p=0.010), pulmonary atelectasis (35%vs.1.1%)(p0.001), residual pleural space (29.8%vs.15.3%)(p=0.032) and residual intrapleural blood clots (14.9%vs.1.4%)(p=0.005). Other postoperative complications, Intensive Care stay, total hospital stay and mortality rate were less frequent in the PVB group but without reaching statistical significance.The use of SPVB is associated with significant less postoperative complications than PA only. This study suggests that the SPVB might be the ideal choice in post-thoracotomy pain management when CEA cannot be used.Open lobectomy, Post-lobectomy, Thoracic paravertebral block.Il blocco toracico paravertebrale (PVB), pur essendo una tecnica di analgesia post-toracotomia di efficacia simile a quella di analgesia epidurale continua (CEA) ma con un profilo di sicurezza migliore, è sottoutilizzato nella pratica corrente. Questo studio confronta l’esito dei pazienti post-lobectomia in relazione al metodo analgesico utilizzato: analgesia parenterale (PA) vs PVB + PA e fornisce una giustificazione per l’uso di routine del PVB in tutti i pazienti in cui il CEA è controindicato. Lo studio è stato condotto su 213 pazienti consecutivi sottoposti a lobectomia aperta, e randomizzati rispetto a due diversi protocolli di analgesia postoperatoria: PA vs PVB + PA. Abbiamo confrontato la frequenza delle complicanze emodinamiche cardiache, respiratorie, pleuriche o chirurgiche. RISULTATI: Dopo la lobectomia, i pazienti PVB (72/213) hanno mostrato una incidenza significativamente più bassa di insufficienza cardiaca congestizia (7,1% vs.0,0%) (p = 0,049), di cardiomiopatia ischemica (10,6% vs.0,0%) ( p = 0.010), di atelettasia polmonare (35% vs.1.1%) (p0.001), di spazio pleurico residuo (29.8% vs.15.3%) (p = 0.032) e di coaguli ematici intrapleurici residui (14.9% vs.1.4%) (p = 0,005). Altre complicanze postoperatorie, degenza intensiva, degenza ospedaliera totale e mortalità sono state meno frequenti nel gruppo PVB ma senza raggiungere un significato statistico. CONCLUSIONE: L’uso di SPVB è associato a complicanze postoperatorie importanti significativamente inferiori alla sola PA. Questo studio suggerisce che l’SPVB potrebbe essere la scelta ideale nella gestione del dolore post-toracotomia quando non è possibile utilizzare il CEA.

The recent demonstration of ferroelectricity in ultrathin HfO

International audience; Ticks transmit more pathogens-including bacteria, parasites and viruses-than any other arthropod vector. Although the epidemiological status of many tick-borne bacteria is very well characterized, tick-borne viruses are still relatively under-studied. Recently, several novel tick-borne viruses have been isolated from human febrile illnesses following tick bites, indicating the existence of other potential new and unknown tick-borne viruses. We used high-throughput sequencing to analyse the virome of Ixodes ricinus, the main vector of tick-borne pathogens in Europe. The majority of collected viral sequences were assigned to two potentially novel Nairovirus and Phlebovirus viruses, with prevalence rates ranging from 3.95% to 23.88% in adults and estimated to be between 0.14% and 72.16% in nymphs. These viruses could not be isolated from the brains of inoculated immunocompromised mice, perhaps indicating that they are unable to infect vertebrates. Within the I. ricinus virome, we also identified contigs with >90% identity to the known Eyach virus. Initially isolated in the 1980s, this virus was indirectly associated with human disease, but had never been extensively studied. Eyach virus prevalence varied between 0.07% and 5.26% in ticks from the French Ardennes and Alsace regions. Eyach virus was successfully isolated following intracerebral inoculation of immunocompromised mice with Eyach virus-positive tick extracts. This virus was also able to multiply and persist in the blood of immunocompetent mice inoculated by intraperitoneal injection, and caused brain infections in three of nine juveniles, without any obvious deleterious effects.

Alternative use of alfalfa, for various purposes, including the production of biofuels or food supplement for human alimentation, is a study topic still in its early stages of research. Studying and understanding the biology of alfalfa and the factors with a major influence on it are very important activities. The productivity and quality of alfalfa are two indicators that help determine, in addition to economic value, the way in which alfalfa can be used. Evolution of alfalfa yield and quality depends on many factors, such as the growth stage of alfalfa plants at harvesting. It was observed over three years of vegetation the influence of alfalfa plant growth stage at harvest on plant height, leaves/stems ratio, production of leaves, stems and whole plant (DM - dry matter) per hectare and on quality indicators (CP - crude protein, NDF - neutral detergent fiber and ADF - acid detergent fiber). The results showed that, with the advancement of phenological phases, from early bud stage to complete flowering, the total biomass output raised from 2.79 Mg·ha-1 to 4.60 Mg·ha-1, the neutral detergent fiber raised from 48.4-50.6% to 62.0-67.7%, while crude protein content decreased from 21.2-24.0% to 13.3-16.5%. The parameter values were correlated with alfalfa growth stage during the harvesting (significant at the 0.05 and 0.01 probability levels).

International audience; Progressive cavitation pumps are designed to work in aggressive environments thus their wear is inevitable. The specific tribological coupling of these pumps is composed of a helical rotor with a single outward helix and a stator with a double inside helix. These elements are in relative motion and direct contact to each other and also in direct contact with the pumped oil. Therefore the main forms of wear of rotor-stator coupling elements are the abrasive wear and the erosion wear. In this paper is presented the analysis of erosion with Finnie models. The results are useful for estimation of progressive cavity pumps specific abrasive-erosive wear.

Aims: There are few data on the use of endoscopic ultrasound (EUS) for the biopsy of suspected malignant lesions of the lung. The main objective of this study was to evaluate the performance of transesophageal EUS fine needle aspiration (EUSFNA) for the diagnosis of paraesophageal lung tumors and also for the confirmation of metastatic sites of lung cancer during the same procedure.Material and methods: We performed a retrospective study in a tertiary care unit including 19 patientswith paraesophageal lung tumors referred to our department for a lung biopsy. Transesophageal EUS-FNA was performed using a linear echoendoscope and 22G needles.Results: In all 19 patients with suspected lung tumors the confirmation of the malignant disease was achieved. Pathological examination revealed 16 cases of non-small cell lung cancers, 2 small cell lung cancers and one case of lung metastases. Diagnostic yield of lung EUS-FNA was 1, with no post-procedural complications. In 7 cases, we performed also biopsies of suspected metastasis and all biopsies revealed the same histopathological type as the primary tumor.Conclusions: Our study supports the use of this minimally invasive technique for paraesophageally locatedlung tumors and demonstrates that EUS-FNA is safe and has an excellent diagnostic yield.

Migration of the flange lubricant to the top of the high rail may compromise the traction of a rail vehicle and affect its curving behaviour. In order to simulate this possible situation, a lubrication model has been coupled to commercial multi-body dynamics software to describe the tangential formulation of the lubricated high-rail contact. Different friction levels have been adopted for the low rail to study their influence on the curving behaviour and traction. Since the creep force in the wheel–rail contact approaches saturation of the friction, the traction control unit of the rail vehicle under study has also been modelled to account for the reduction of the wheel axle torque in the presence of wheel macro-slip.

We study the orbits, stability and coexistence of orbits in the two-dimensional dynamical system introduced by Kline and Baker to model cardiac rhythmic response to periodic stimulation — as a function of (a) kinetic parameters (two amplitudes, two rate constants) and (b) stimulus period. The original paper focused mostly on the one-dimensional version of this model (one amplitude, one rate constant), whose orbits, stability properties, and bifurcations were analyzed via the theory of skew-tent (hence unimodal) maps; the principal family of orbits were so-called "n-escalators", with n a positive integer. The two-dimensional analog (motivated by experimental results) has led to the current study of continuous, piecewise smooth maps of a polygonal planar region into itself, whose dynamical behavior includes the coexistence of stable orbits. Our principal results show (1) how the amplitude parameters control which escalators can come into existence, (2) escalator bifurcation behavior as the stimulus period is lowered — leading to a "1/n bifurcation law", and (3) the existence of basins of attraction via the coexistence of three orbits (two of them stable, one unstable) at the first (largest stimulus period) bifurcation. We consider the latter result our most important, as it is conjectured to be connected with arrhythmia.

We present a method for deriving a parametric description of a conic section (quadratic curve) in an image from the moments of the image with respect to several specially-constructed kernel functions. In contrast to Hough-transform-type methods, the moment approach requires no large accumulator array. Judicious implementation allows the parameters to be determined using five multiplication operations and six addition operations per pixel. The use of moments renders the calculation robust in the presence of high-frequency noise or texture and resistant to small-scale irregularities in the edge. Our method is generalizable to more complex classes of curves with more parameters as well as to surfaces in higher dimensions.

We present a method of locating edges in JPEG-coded images which operates in frequency space on the DCT coefficients. Applied to the quantized DCT coefficients of a block containing a straight edge, the method yields an equation for the edge in a fraction of the operations needed to dequantize and transform the coefficents to pixel values. As a sample application of this method, we present a technique for alleviating ringing artifacts in JPEG-coded images

We present a general construction of functions whose moments serve to locate and parametrize step edges within an image. Previous use of moments to locate edges was limited to functions supported on a circular region, but our method allows the use of "custom-designed" functions supported on circles, rectangles, or any desired shape, and with graphs whose shape may be chosen with great freedom. We present analyses of the sensitivity of our method to pixelization errors or discrepancy between the image and an idealized edge model. The parametric edge description yielded by our method makes it especially suitable as a component of wedgelet image coding.

In this paper we describe research that has been on-going within our group for the past four years on semantically-smart disk systems . A semantically-smart system goes beyond typical block-based storage systems by extracting higher-level information from the stream of traffic to disk; doing so enables new and interesting pieces of functionality to be implemented within low-level storage systems. We first describe the development of our efforts over the past four years, highlighting the key technologies needed to build semantically-smart systems as well as the main weaknesses of our approach. We then discuss future directions in the design and implementation of smarter storage systems.

We introduce the eidochromatic transform as a tool for improved lossy coding of color images. Many current image-coding formats (such as JPEG 2000) utilize both a color-component transform (relating values of different image components at a single location) and a wavelet or other spatial transform (relating values of a single-image component at proximate, but different image locations). The eidochromatic transform further reduces redundancy by relating image values simultaneously across color components and in the two spatial dimensions. Our approach is to introduce an additional transform step following the color-component and spatial transforms. In tests, this step reduced the overall static entropy of the chrominance components of quantized transformed images by up to 40% or more. Combined with JPEG 2000's modeling and coding method, the eidochromatic transform was found to reduce the size of lossily coded color images by up to 27% overall.

We introduce Shear, a user-level software tool that characterizes RAID storage arrays. Shear employs a set of controlled algorithms combined with statistical techniques to automatically determine the important properties of a RAID system, including the number of disks, chunk size, level of redundancy, and layout scheme. We illustrate the correctness of Shear by running it upon numerous simulated configurations, and then verify its real-world applicability by running Shear on both software-based and hardware-based RAID systems. Finally, we demonstrate the utility of Shear through three case studies. First, we show how Shear can be used in a storage management environment to verify RAID construction and detect failures. Second, we demonstrate how Shear can be used to extract detailed characteristics about the individual disks within an array. Third, we show how an operating system can use Shear to automatically tune its storage subsystems to specific RAID configurations.

International audience; Progressive cavitation pumps are designed to work in aggressive environments thus their wear is inevitable. The specific tribological coupling of these pumps is composed of a helical rotor with a single outward helix and a stator with a double inside helix. These elements are in relative motion and direct contact to each other and also in direct contact with the pumped oil. Therefore the main forms of wear of rotor-stator coupling elements are the abrasive wear and the erosion wear. In this paper is presented the analysis of erosion with Bitter and Hutchings models. The results are useful for estimation of progressive cavity pumps specific abrasive-erosive wear.

Programs running on insecure or malicious hosts have often been cited as ripe targets for security attacks. The enabling technology for these attacks is the ability to easily analyze and control the running program. Dynamic instrumentation provides the necessary technology for this analysis and control. As embodied in the DynInst API library, dynamic instrumentation allows easy construction of tools that can: (1) inspect a running process, obtaining structural information about the program; (2) control the execution of the program, (3) cause new libraries to be dynamically loaded into the process' address space; (4) splice new code sequences into the running program and remove them; and (5) replace individual call instructions or entire functions. With this technology, we have provided two demonstrations of its use: exposing vulnerabilities in a distributed scheduling system (Condor), and bypassing access to a license server by a word processor (Framemaker). The first demonstration shows the danger of remote execution of a job on a system of unknown pedigree, and the second demonstration shows the vulnerabilities of software license protection schemes. While these types of vulnerabilities have long been speculated, we show how, with the right tool (the DynInst API), they can be easily accomplished. Along with this discussion of vulnerabilities, we also discuss strategies for compensating for them.

In this paper we are condidering positive, symmetric, harmonic functions in a Denjoy domain with uniformly perfect boundary that vanish continuously on the boundary of that domain. Given two such functions ν, υ we are proving that the ratio (ν/υ) can be extended to the boundary, and the extension is Holder continuous with exponent depending on the uniformly perfectness cnstants of the bundary.

The research in the period 2010-2011, within the Ezareni Farm from Iasi, were focused on the influence of inoculation, fertilization and harvesting growth stage on the leaf/shoot ratio and dry matter (DM) yield, at alfalfa ( medicago sativa L.) in the second year after sowing at the first harvest. The results indicated that the interaction between inoculation, fertilization and harvesting growth stage determined increases of yield in the range of 23-110%. The control plot where fertilization was not applied, without inoculation, which was harvested at early bud registered the lowest yield, 3.21 t/ha D.M., and the biggest yield (6.72 t/ha) was registered at the plot with inoculation, fertilized with N 75 P 50, harvested at 10% blooming. The leaves/shoots ratio registered differences in the range of +11% to -42%, accordingly to the interaction between the inoculation, fertilization and harvesting growth stage. The highest leaves/shoots ratio, 0.64% was observed at the plot with inoculation, unfertilized, harvested late bloom, and the lowest leaves/shoots ratio (0.33) was observed at the plot without inoculation, fertilized with N 75 P 50 harvested at full bloom.

The method of custom-built moments allows location of step edges in an image in parametric form, as an equation ax + by = c, using a customizable mask of almost any desired shape, or moment functions adapted to calculation in a particular basis. We adapt this method to the problem of locating both thin lines and roof edges in parametric form.

In a service-oriented, utility-computing, Grid-like world, service providers will execute jobs on behalf of their clients on systems rented from resource providers. This poses many challenges to the service provider, such as choosing which jobs to admit, when to run them, whether to execute them on one system or many, and how many resources to rent. To complicate matters, the service provider may experience resource uncertainty an inability to get the resources it needs or expects. The result will be sub-optimal choices of which jobs to accept and when to run them, and the service provider may have to pay penalties to its clients. Using an economics-based approach, we have developed scheduling policies that systematically address these problems. We show that the new policies deliver significantly more profit (or added value) than ones oblivious to such concerns.

We describe an evolutionary path that allows operating systems to be used in a more flexible and appropriate manner by higher-level services. An infokernel exposes key pieces of information about its algorithms and internal state; thus, its default policies become mechanisms, which can be controlled from user-level. We have implemented two prototype infokernels based on the linuxtwofour and netbsdver kernels, called infolinux and infobsd, respectively. The infokernels export key abstractions as well as basic information primitives. Using infolinux, we have implemented four case studies showing that policies within Linux can be manipulated outside of the kernel. Specifically, we show that the default file cache replacement algorithm, file layout policy, disk scheduling algorithm, and TCP congestion control algorithm can each be turned into base mechanisms. For each case study, we have found that infokernel abstractions can be implemented with little code and that the overhead and accuracy of synthesizing policies at user-level is acceptable.

The key to storage manageability is adaptation. In traditional storage systems, adaptation is performed by a human administrator who must assess problems and then manually adjust various knobs and levers to bring the behavior of the system back to an acceptable level. Future storage systems must themselves adapt and, in doing so, reduce the need for manual intervention. In this paper, we describe the Wisconsin Network Disks (WiND) project, wherein we seek to understand and develop the key adaptive techniques required to build a truly manageable network-attached storage system. WiND gracefully and efficiently adapts to changes in the environment, reducing the burden of administration and increasing the flexibility and performance of storage for an eclectic range of clients. In particular, WiND automatically adapts to the addition of new disks to the system, the failure or erratic performance of existing disks and changes in client workload and access patterns.

Pathogenic mechanism of chronic inflammation is associated with increased production of superoxide anion and hydrogen peroxide. In the neutralization process of that anions, superoxid dismutase (SOD), catalase (CAT), and glutation peroxidase (GPx) are key enzymes. Aim of study consists of establishing of some clinic-biological correlations in JRA chronic inflammation in childhood between clinical status and determination of lipoperoxidation products and antioxidative enzymes in the blood.Blood samples were obtained from 20 patients admitted in 2nd Clinic of Pediatrics, 4-6 months after onset of disease, diagnosed with JRA, oligoarticular form (6 cases), poliarticular form (9 cases) and systemic form (5 cases), as compared to 10 control subjects. SOD, CAT, GPx were measured comparing with malonildialdehyde (MDA), seric glutation (GSH) and usual inflammatory tests (ESR, fibrinogen, CRP). Determinations were repeated after 6 weeks of treatment.In all our cases, level of antioxidant enzymes (CAT, GPx) was decreased at time of diagnosis, concomitant with increased MDA, SOD and inflammatory tests. In most of cases, after 6 weeks of correct anti-inflammatory treatment, levels of enzymatic antioxidant markers were still decreased, as compared to usual inflammatory tests that came back to normal. Persistent decreased antioxidant enzymatic activity was found in cases that need immunomodulatory activity (Methotrexat).Determination of antioxidant enzymes level can be considered an evolution marker in JRA. More studies are necessary to find if antioxidant potential of blood can be used as following marker for immunosuppressive therapy.

Alcoholic cardiomyopathy can ensue from heavy consumption of alcohol over a long period of time. The clinical features include dilatation of the left ventricle, poor myocardial contractility with reduced left ventricular ejection volume, raised tissue enzymes. In numerous experimental data has been observed increased generation of oxygen and ethanol free radicals, indicate that free radicals are implied in myocardial and hepatic damage. Ethanol administration also elicits hepatic disturbances in the availability of antioxidant defense. The resulting antioxidative stress leads to enhanced lipid peroxidation and can also affect other important cellular component.

Aim: Evaluation the gender, inflammation and diabetes mellitus impact on coronary remodeling after stenting by assaying of myocardium infarction (MI), coronary spasm (CS) inducing unstable angina and in-stent restenosis (ISR) or in-stent thrombosis (IST). Material and methods: In study 140 patients (101 men and 38 women) with age range of 42-73 years exposed to coronary stenting due to marked coronary stentosis have been taken. After coronary stenting (PCI) the evidences (MI, CS, ISR and IST) linked to negative coronary remodeling (NCRE) have been assayed using coronary angiography and intravascular ultrasound. Non-specific inflammation markers such as hsCRP, IL-6 and TNF-alpha were determined using ELISA initially and after PCI during 1 year: 72 h, 1, 3, 6 and 12 months. Results: The rate of total NCRE evaluated during 1 year was as 27,86% and it has been markedly higher in men: 31,68% vs 18,42%. To underline that MI and IST have not been observed in women. The pre- and post-PCI levels of circulating inflammation markers were higher in patients with NCRE compared to pts without NCRE (reference pattern). The most pre-PCI difference (61%) was characteristic for hsPCR: 6,89±0,21 vs 4,28±0,11 g/l; p