Anesthetic considerations in the child with Gaucher disease

Alpidem, an imidazopyridine that acts at the gamma-aminobutyric acid/benzodiazepine receptor complex, has been reported to be an effective anxiolytic with a more favorable side effect profile than benzodiazepines. The effect of alpidem was investigated in an 8-week, open, clinical trial in 13 patients with panic disorder, with or without agoraphobia. Three patients were responders (much improved or very much improved), five patients were nonresponders, and five patients dropped out after less than 6 weeks of treatment. Significant improvement was seen in the sample as a whole for spontaneous panic attacks, phobic avoidance, and anticipatory anxiety. Most improvement occurred during the first 4 weeks of treatment, and responders had milder panic disorder at baseline. Adverse effects were generally mild. After 8 weeks of treatment, taper of medication over 2 weeks occurred without significant worsening of panic disorder symptoms. The efficacy of alpidem in the treatment of panic disorder remains uncertain and requires assessment in a controlled trial.     

Performance-Analyse und -Optimierung in der Softwareentwicklung

Nicht-funktionale Anforderungen an ein Softwaresystem beschreiben Aspekte, die nicht direkt die Funktionalit?t, wie sie der Benutzer sieht, betreffen.     

Clinical significance of sleep apnea disorders after implantation of a cardioverter-defibrillator in patients with cardiac disease and sustained ventricular tachyarrhythmia

The purpose of our study was to determine the prevalence of sleep related breathing disorders (SRBD) in patients with an implantable cardioverter-defibrillator (ICD) and to evaluate prospectively the possible influence of SRBD on arrhythmia recurrence and circadian arrhythmia variation as well as on cardiac mortality during long-term follow-up. Forty consecutive ICD recipients with cardiac disease and a documented history of spontaneous, life-threatening, ventricular tachyarrhythmias underwent full-night polysomnography and were followed for 2 years. In 16 of 40 patients (40%), SRBD were diagnosed (Apnea/Hypopnea Index (AHI) > 10); in 9 of these 16 patients (56%) central sleep apneas (CSA) occurred (in 8 of these 9 patients in combination with Cheyne-Stokes respiration). Seven of the 16 patients with SRBD (44%) revealed obstructive sleep apneas (OSA). AHI was 32 +/- 15 (12-60) in patients with CSA and 32 +/- 27 (11-86) in patients with OSA. Patients with and without SRBD were comparable concerning left ventricular ejection fraction, NYHA classification, cardiac disease, ICD indication, and concomitant medication. ICD registered ventricular tachyarrhythmias occurred in 10 of 24 patients (42%) without SRBD, in 4 of 9 patients (44%) with CSA, and in 3 of 7 patients (44%) with OSA. The numbers and circadian variation of episodes registered during follow-up in patients without SRBD, with OSA or CSA were comparable (14 +/- 25, median 4 vs 15 +/- 15, median 7 vs 4 +/- 5, median 2.5). The 2-year cardiac mortality was highest in patients with CSA (4/9 (44%) vs. 0/7 patients (0%) with OSA vs 3/24 patients (12.5%) without SRBD. Thus, the prevalence of SRBD in patients with chronic heart failure and a history of malignant ventricular tachyarrhythmias is high (40%) and the occurrence of CSA seems to be predictive for cardiac mortality in these patients. An influence of moderate SRBD on arrhythmia recurrence and circadian variation of spontaneous sustained tachyarrhythmic events could not be demonstrated.     

Dysregulated CD38 Expression on Peripheral Blood Immune Cell Subsets in SLE

Given its uniformly high expression on plasma cells, CD38 has been considered as a therapeutic target in patients with systemic lupus erythematosus (SLE). Herein, we investigate the distribution of CD38 expression by peripheral blood leukocyte lineages to evaluate the potential therapeutic effect of CD38-targeting antibodies on these immune cell subsets and to delineate the use of CD38 as a biomarker in SLE. We analyzed the expression of CD38 on peripheral blood leukocyte subsets by flow and mass cytometry in two different cohorts, comprising a total of 56 SLE patients. The CD38 expression levels were subsequently correlated across immune cell lineages and subsets, and with clinical and serologic disease parameters of SLE. Compared to healthy controls (HC), CD38 expression levels in SLE were significantly increased on circulating plasmacytoid dendritic cells, CD14⁺⁺CD16⁺ monocytes, CD56⁺ CD16^dim natural killer cells, marginal zone-like IgD⁺CD27⁺ B cells, and on CD4⁺ and CD8⁺ memory T cells. Correlation analyses revealed coordinated CD38 expression between individual innate and memory T cell subsets in SLE but not HC. However, CD38 expression levels were heterogeneous across patients, and no correlation was found between CD38 expression on immune cell subsets and the disease activity index SLEDAI-2K or established serologic and immunological markers of disease activity. In conclusion, we identified widespread changes in CD38 expression on SLE immune cells that highly correlated over different leukocyte subsets within individual patients, but was heterogenous within the population of SLE patients, regardless of disease severity or clinical manifestations. As anti-CD38 treatment is being investigated in SLE, our results may have important implications for the personalized targeting of pathogenic leukocytes by anti-CD38 monoclonal antibodies.     

Spectral Ray Differentials

Light refracted by a dispersive interface leads to beautifully colored patterns that can be rendered faithfully with spectral Monte‐Carlo methods. Regrettably, results often suffer from chromatic noise or banding, requiring high sampling rates and large amounts of memory compared to renderers operating in some trichromatic color space. Addressing this issue, we introduce spectral ray differentials, which describe the change of light direction with respect to changes in the spectrum. In analogy with the classic ray and photon differentials, this information can be used for filtering in the spectral domain. Effectiveness of our approach is demonstrated by filtering for offline spectral light and path tracing as well as for an interactive GPU photon mapper based on splatting. Our results show considerably less chromatic noise and spatial aliasing while retaining good visual similarity to reference solutions with negligible overhead in the order of milliseconds.     

Spatio‐temporal geometry fusion for multiple hybrid cameras using moving least squares surfaces

Multi‐view reconstruction aims at computing the geometry of a scene observed by a set of cameras. Accurate 3D reconstruction of dynamic scenes is a key component for a large variety of applications, ranging from special effects to telepresence and medical imaging. In this paper we propose a method based on Moving Least Squares surfaces which robustly and efficiently reconstructs dynamic scenes captured by a calibrated set of hybrid color+depth cameras. Our reconstruction provides spatio‐temporal consistency and seamlessly fuses color and geometric information. We illustrate our approach on a variety of real sequences and demonstrate that it favorably compares to state‐of‐the‐art methods.     

Approximate Symmetry Detection in Partial 3D Meshes

Symmetry is a common characteristic in natural and man‐made objects. Its ubiquitous nature can be exploited to facilitate the analysis and processing of computational representations of real objects. In particular, in computer graphics, the detection of symmetries in 3D geometry has enabled a number of applications in modeling and reconstruction. However, the problem of symmetry detection in incomplete geometry remains a challenging task. In this paper, we propose a vote‐based approach to detect symmetry in 3D shapes, with special interest in models with large missing parts. Our algorithm generates a set of candidate symmetries by matching local maxima of a surface function based on the heat diffusion in local domains, which guarantee robustness to missing data. In order to deal with local perturbations, we propose a multi‐scale surface function that is useful to select a set of distinctive points over which the approximate symmetries are defined. In addition, we introduce a vote‐based scheme that is aware of the partiality, and therefore reduces the number of false positive votes for the candidate symmetries. We show the effectiveness of our method in a varied set of 3D shapes and different levels of partiality. Furthermore, we show the applicability of our algorithm in the repair and completion of challenging reassembled objects in the context of cultural heritage.     

A method for predicting the probability of business network profitability

In the design phase of business collaboration, it is desirable to be able to predict the profitability of the business-to-be. Therefore, techniques to assess qualities such as costs, revenues, risks, and profitability have been previously proposed. However, they do not allow the modeler to properly manage uncertainty with respect to the design of the considered business collaboration. In many real collaboration projects today, uncertainty regarding the business’ present or future characteristics is so significant that ignoring it becomes problematic. In this paper, we propose an approach based on the predictive, probabilistic architecture modeling framework (P²AMF), capable of advanced and probabilistically sound reasoning about profitability risks. The P²AMF-based approach for profitability risk prediction is also based on the e³-value modeling language and on the object constraint language. The paper introduces the prediction and modeling approach, and a supporting software tool. The use of the approach is illustrated by means of a case study originated from the Stockholm Royal Seaport smart city project.     

Model development and validation: Co-combustion of residual char, gases and volatile fuels in the fast fluidized combustion chamber of a dual fluidized bed biomass gasifier

A one-dimensional steady state model has been developed for the combustion reactor of a dual fluidized bed biomass steam gasification system. The combustion reactor is operated as fast fluidized bed (riser) with staged air introduction (bottom, primary and secondary air). The main fuel i.e., residual biomass char (from the gasifier), is introduced together with the circulating bed material at the bottom of the riser. The riser is divided into two zones: bottom zone (modelled according to modified two phase theory) and upper zone (modelled with core-annulus approach). The model consists of sub-model for bed hydrodynamic, conversion and conservation. Biomass char is assumed to be a homogeneous matrix of C, H and O and is modelled as partially volatile fuel. The exit gas composition and the temperature profile predicted by the model are in good agreement with the measured value.     

Influence of motion correction on the visual analysis of cardiac magnetic resonance stress perfusion imaging

Objective

Image post-processing corrects for cardiac and respiratory motion (MoCo) during cardiovascular magnetic resonance (CMR) stress perfusion. The study analyzed its influence on visual image evaluation.

Materials and methods

Sixty-two patients with (suspected) coronary artery disease underwent a standard CMR stress perfusion exam during free-breathing. Image post-processing was performed without (non-MoCo) and with MoCo (image intensity normalization; motion extraction with iterative non-rigid registration; motion warping with the combined displacement field). Images were evaluated regarding the perfusion pattern (perfusion deficit, dark rim artifact, uncertain signal loss, and normal perfusion), the general image quality (non-diagnostic, imperfect, good, and excellent), and the reader’s subjective confidence to assess the images (not confident, confident, very confident).

Results

Fifty-three (non-MoCo) and 52 (MoCo) myocardial segments were rated as ‘perfusion deficit’, 113 vs. 109 as ‘dark rim artifacts’, 9 vs. 7 as ‘uncertain signal loss’, and 817 vs. 824 as ‘normal’. Agreement between non-MoCo and MoCo was high with no diagnostic difference per-patient. The image quality of MoCo was rated more often as ‘good’ or ‘excellent’ (92 vs. 63%), and the diagnostic confidence more often as “very confident” (71 vs. 45%) compared to non-MoCo.

Conclusions

The comparison of perfusion images acquired during free-breathing and post-processed with and without motion correction demonstrated that both methods led to a consistent evaluation of the perfusion pattern, while the image quality and the reader’s subjective confidence to assess the images were rated more favorably for MoCo.