Purpose This study was designed to retrospectively analyze outcomes of axillofemoral bypass (AxFB) operations performed in patients with severe comorbidities. Methods All patients (n = 45) who received an AxFB between 1990 and 2005 for aortoiliac occlusive disease (AIOD, n = 35) or infectious aortic disease (IAD, n = 10) were included. Information on patency of the bypass and mortality was retrieved from patient records. A KaplanMeier survival analysis was performed to illustrate survival rates, limb salvage, and primary and secondary patency. Results Included patients had several comorbidities and a high operative risk. In this group, a 30-day mortality rate of 20% was found: 17% for the AIOD group, and 30% for the IAD group. During 5-year follow-up 20 patients died, of which 15 during the first year after operation. Survival rates were at 64 and 41% at 1 and 5 years and limb salvage rates were 84% for both these years. Primary patency rates at 1 and 5 years were 72 and 58%, respectively, and secondary patency rates were 86% at both time points. Conclusions High mortality rates were found in AIOD or IAD patients who received an AxFB. However, for highrisk patients with an already reduced life expectancy, the AxFB remains an alternative with acceptable patency rates.
Abstract. We present a theorem-prover based analysis tool for object-oriented database systems with integrity constraints. Object-oriented database specifications are mapped to higher-order logic (HOL). This allows us to reason about the semantics of database operations using a mechanical theorem prover such as Isabelle or PVS. The tool can be used to verify various semantics requirements of the schema (such as transaction safety, compensation, and commutativity) to support the advanced transaction models used in workflow and cooperative work. We give an example of method safety analysis for the generic structure editing operations of a cooperative authoring system.
In the context of the object-oriented data model, a compiletime approach is given that provides for a significant reduction of the amount of run-time transaction overhead due to integrity constraint checking. The higher-order logic Isabelle theorem prover is used to automatically prove which constraints might, or might not be violated by a given transaction in a manner analogous to the one used by Sheard and Stemple (1989) for the relational data model. A prototype transaction verification tool has been implemented, which automates the semantic mappings and generates proof goals for Isabelle. Test results are discussed to illustrate the effectiveness of our approach.
Pubic symphysiolysis and retroperitoneal arterial vessel rupture after bareback horse riding is a rare traumatic combination. We report a case of a 59-year-old man who experienced severe pubic, abdominal and lower back pain due to a bounce after a asynchronous rhythm of horseback riding without a saddle. The patient was referred to our Emergency Department because of a suspected ruptured abdominal aortic aneurysm. Computer tomography demonstrated diastasis of the pubic symphysis, active bleeding of a branch of the left internal iliac artery and a massive retroperitoneal haematoma. The arterial bleeding was directly coiled in the emergency setting, the stable pubic symphysiolysis was treated conservatively and the haematoma was surgically drained after three days. Bareback horse riding can lead to a pelvic fracture and severe bleeding leading to haemodynamical instability and life threatening situations. Using proper protective equipment including a saddle to prevent equestrian injury should be emphasized
SUMMARYCompensation plays an important role in advanced transaction models, cooperative work and workflow systems. A schema designer is typically required to supply for each transaction T another transaction T −1 to semantically undo the effects of T . Little attention has been paid to the verification of the desirable properties of such operations, however. This paper demonstrates the use of a higher-order logic theorem prover for verifying that compensating transactions return a database to its original state. It is shown how an OODB schema is translated to the language of the theorem prover so that proofs can be performed on the compensating transactions.
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