1,721,123 research outputs found
Safety of Salvaged Blood and Risk of Coagulopathy in Cardiac Surgery
No full textCardiac surgery patients are prone to anemia from several mechanisms: intraoperative blood loss, preexisting anemia, and hemodilution. Patients are very frequently transfused with allogeneic red blood cells (RBC), which in itself is associated with harm. The use of RBC salvage technology has been advocated to salvage blood lost in the operative field and to reduce the need of homologous blood transfusion. Direct cardiotomy suction from the surgical field and unprocessed blood retransfusion is a common practice during cardiopulmonary bypass, but which is associated with a powerful activation of the coagulation and inflammatory systems: thrombin generation, excessive fibrinolysis, and release of proinflammatory cytokines. Compared with direct cardiotomy suction, the use of RBC salvage technology is able to reduce the amount of microparticles and activated proteins of autologous blood before retransfusion. However, when compared with no retransfusion of blood from the operative field, processed blood also triggers coagulopathy and inflammation. Clinical studies are discordant regarding the benefit of RBC salvage use during and after cardiac operations. Meta-analysis suggests reduced need of homologous blood transfusion, but no effects on mortality and morbidity
Minimally invasive redo aortic valve replacement with a sutureless valve implant
No full textReoperations for a dysfunctional mechanical aortic valve prosthesis are usually performed with a repeat sternotomy. Reopening the chest may be associated with a heart structure tear, bleeding, excessive transfusion, and a possible unfavorable outcome. Experience performing a redo aortic valve replacement with a minimally invasive approach and avoiding lysis of the pericardial adhesions is growing. We describe a redo aortic valve replacement procedure performed because of subvalvular pannus formation in a patient with a mechanical prosthesis. A partial J-shaped hemisternotomy at the 3rd intercostal space was performed; the ascending aorta was exposed and the valve was replaced with a sutureless bioprosthesis. The video tutorial shows the surgical approach, cardiopulmonary bypass solutions, and sutureless valve deployment
Mutta: a novel tool for E2E web mutation testing
No full textMutation testing is an important technique able to evaluate the bug-detection effectiveness of existing software test suites. Mutation testing tools exist for several languages, e.g., Java and JavaScript, but no solutions are available for managing the mutation testing process for entire web applications, in the context of end-to-end (E2E) web testing. In this paper, we propose Mutta, a novel tool able to automate the entire mutation testing process. Mutta mutates the various server source files of the target web application, runs the E2E test suite against the mutated web applications, and finally collects the test outcomes. To evaluate Mutta, we designed a case study using the mutated versions of the target web application with the aim of comparing the effectiveness of two different approaches to E2E web testing: (1) test cases based on classical assertions and (2) test cases relying on differential testing. In detail, Mutta has been executed on two web applications, each equipped with different test suites to compare assertions with differential testing. In this scenario, Mutta generated a large number of mutants (more than 15k overall), took into account the coverage information to consider only the mutants actually executed, deployed the mutated web app, ran the entire E2E test suites (about 87k tests runs overall), and finally, it correctly saved the test suite results. Thus, results of the case study show that Mutta can be successfully employed to automate the entire mutation testing process of E2E web test suites and, therefore, can be used in practice to evaluate the effectiveness of different test suites (e.g., based on different techniques, E2E frameworks, or composed by a different number of test scripts)
Perioperative predictive risk factors for early death in surgical repair of acute Type A aortic dissection
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Comparing the Effectiveness of Assertions with Differential Testing in the Context of Web Testing
No full textDifferential testing applied in the Web context compares the current web page under test with a snapshot considered correct taken from a previous version. This technique appears to be promising and an alternative to assertions in catching regressions due to the evolution of the web application under test. This paper empirically compares Selenium WebDriver test scripts equipped with (1) assertions and (2) differential testing implemented in the Recheck tool. The comparison included costs (both test scripts development time and execution time) and effectiveness (bugs detection capability) considering two different versions of differential testing implemented in Recheck, named implicit and explicit. Results show that, on average, Recheck (both explicit and implicit) is able to detect more bugs than classic assertions (up to +34% on complex apps). The development time is similar between the two approaches. The execution time is slightly higher than classic assertions for Recheck explicit (+33%), while it is by far higher when Recheck implicit is adopted (3.6 times). In conclusion, the best choice, considering both the effectiveness and the costs, appears to be Recheck explicit
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