A 'second generation' approach to the provision of Grid middleware is now emerging which is built on service-oriented architecture and web services standards and technologies. However, advanced Grid applications have significant demands that are not addressed by present-day web services platforms. As one prime example, current platforms do not support the rich diversity of communication 'interaction types' that are demanded by advanced applications (e.g. publish-subscribe, media streaming, peer-to-peer interaction). In the paper we describe the Gridkit middleware which augments the basic service-oriented architecture to address this particular deficiency. We particularly focus on the communications infrastructure support required to support multiple interaction types in a unified, principled and extensible manner-which we present in terms of the novel concept of pluggable overlay networks.
The majority of children did well following cessation of antibiotic prophylaxis despite persistent vesicoureteral reflux. Cessation of antibiotic prophylaxis is a reasonable option in a highly select patient population with reflux.
Our results, combined with recommendations from the Centers for Disease Control and Prevention, suggest that all patients older than 65 years undergoing left transperitoneal nephrectomy or those at increased risk for splenic injury should receive preoperative pneumococcal vaccination.
With extended followup the percentage of patients requiring open surgery after endoscopic incision of ureteroceles increased from our original report of 27% to 41% (p = 0.166). Only 18% of cases with an intravesical ureterocele required a subsequent operation compared to 64% with an extravesical ureterocele (p = 0.002). The reduction in size of the obstructed ureter following endoscopic decompression facilitated successful reimplantation. Endoscopic puncture permits definitive treatment in the majority of children by at most a single incision, open operation at the bladder level.
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