bluuebunny/crossref_metadata_2025 huggingface dataset:
Forward converter using a resonant auxiliary circuit to provide soft‐switching and reset the magnetic core
Authors: Ghorbanian Monireh , Maghsoudi Mohammad , Esteki Morteza , Farzanehfard Hosein
Published: July 2022

In this paper, a new ZVT forward converter is presented in which the third winding of the forward converter is utilised to transfer power from the input to the output, recover the energy of the leakage inductance and snubber capacitance, and also provide ZVS condition for the converter switch. In the proposed converter, the main switch is turned ON and OFF under ZVS condition, and the auxiliary switch operates under ZCS condition. Besides, all the diodes are turned OFF under ZCS condition, and their reverse recovery losses are alleviated. Moreover, in the proposed converter, the voltage stress of the auxiliary switch is limited to the input voltage. As a result, the efficiency is improved. Since both converter switches and the input voltage share the same ground, no isolated gate driver is required in the implementation of the introduced converter. Also, due to the almost flat efficiency curve of the proposed converter, it is suitable for applications where the load range is wide. The proposed converter analysis, operating principals and design considerations are discussed in this paper, and the converter performance is justified by the implementation results from a 240 W prototype converter.
Accelerators for health: From current to dream machines
Authors: Faus-Golfe Angeles , Benedetto Elena
Published: July 2022

Any kind of sculpted particle beams from high-energy photons (X-rays and gamma rays), electrons, protons, neutrons to various atomic nuclei and more exotic species have been used to treat cancer. The development of a next generation of accelerators to face the challenges and issues of Particle Therapy is crucial. What are the most promising accelerator techniques, particles or dose delivery modes?
Lasers for health
Authors: Cerullo Giulio , Vanna Renzo
Published: July 2022

Thanks to its spatial and temporal coherence properties, laser light lends itself to a wealth of biomedical applications. We review the use of lasers in medical sciences, from microscopy for understanding the origin of diseases, to diagnostics for enhancing the accuracy of therapies to surgery of almost any organ of the human body.
Experimental study on influence of ultrasonic vibration on forming limit
Authors: Zha Changli , Zha Shenlong
Published: July 2022

Applying ultrasonic vibration in sheet metal forming can change its forming mechanism and improve its formability. The uniaxial tensile and bulging forming limit experimental setups were designed to study the ultrasonic vibration and forming limit relationship induced by ultrasonic excitation, and the results under different experimental conditions were analyzed. It was found that ultrasonic vibration has different effects on the left and right sides of forming limit diagram (FLD). Under the same ultrasonic vibration frequency, the maximum increment of left and right major limit strain is about 9.3% and 8.7%, respectively. The former is larger than the latter, and the strain increment increases with the increase of ultrasonic vibration frequency, but the basic shapes of FLD are unchanged.
Pferd und Sattel: Passt er, oder passt er nicht?
Authors: Lindsay Caroline
Published: July 2022

Es liegen viele Studien über die Biomechanik des Pferdes vor. Bis zu Beginn
des letzten Jahrzehnts gab es allerdings nur wenige Studien über die
Passform des Sattels. Ein großer Teil dieser Untersuchungen wurde von Dr.
Sue Dyson und ihrem Team des Animal Health Trust in Großbritannien
durchgeführt. Die Ergebnisse könnten zu einem Paradigmenwechsel in
der Sattelbeurteilung führen.
Multiple Drug Hypersensitivity in a Small Child with DRESS Syndrome
– A Case Report
Authors: Gruber Saskia , Gona-Hoepler Livia , Bangert Christine , Diesner Susanne C , Schmidthaler Klara , Szepfalusi Zsolt
Published: July 2022

Introduction

Drug reaction with eosinophilia and systemic symptoms (DRESS) belongs to the group of
severe cutaneous adverse reactions. Here we report a case of drug hypersensitivity
against multiple antibiotics with DRESS in a young child with necrotizing
pneumonia.
The Expression of Methyltransferase-Like 3 in Oral Precancerous Lesions and Oral Squamous Cell Carcinoma
Authors: Udompatanakorn Chatchaphan , Taebunpakul Patrayu
Published: July 2022

Objective N6-methyladenosine is the most frequent mRNA modification in eukaryotic cells. It is catalyzed by the methyltransferase complex, methyltransferase-like 3 (METTL3). Previous studies have revealed that METTL3 plays a role in various cancers. However, there is limited information about the roles of METTL3 in oral epithelial dysplasia (OED). This study determined METTL3 expression in normal oral mucosa (NOM), OED, and oral squamous cell carcinoma (OSCC) by immunohistochemistry.

Materials and Methods Twenty formalin-fixed paraffin embedded specimens each of NOM, OED, and OSCC were included. The expression pattern, the number of positive cells, the staining intensity, and the histochemical score (H-score) of METTL3 were investigated.

Statistical Analysis The data were analyzed by using one-way analysis of variance, chi-squared test, and a Kruskal–Wallis test. A p-value < 0.05 indicated statistically significant.

Results The METTL3 expression in NOM was observed in the basal, parabasal, and lower layers of epithelium. In low-grade OED, METTL3 was expressed in the lower epithelial layers and partially presented in the spinous layer. However, in high-grade OED, METTL3 expression was observed in the lower layers, spinous layers, and upper layers of dysplastic epithelium. For OSCC, METTL3 immunostaining was presented in both the peripheral and central cells of the tumor islands. All NOM samples showed weak-to-moderate METTL3 staining intensity, while the moderate-to-strong METTL3 staining intensity was observed in 95% of both OED and OSCC specimens (p < 0.05). The percentage of METTL3 positive cells and H-score was highest in OSCC, followed by OED and NOM, respectively (p < 0.05). Interestingly, H-score was greater in high-grade OED (209.8 ± 18.61) when compared with low-grade OED (162.1 ± 38.93) (p < 0.05).

Conclusion METTL3 expression in OED and OSCC was more outstanding than in NOM, suggesting possible roles for OED and OSCC pathogenesis. Additionally, METTL3 expression may be an indicator for OED progression to OSCC.
The Predictive Value of Peripheral Immune Cell Counts for the Presence of Brain Metastases in Stage IV Non-Small-Cell Lung Cancer (NSCLC)
Authors: Abuelbeh I , Abu-Shawer O , Abu-Shawer M , Alkderat M , Safi M , Alwazani A , Alkhatib A , Abu-Hussain B , Aladawi M , Ismail S , Altamimi T , Abu Hejleh Taher
Published: July 2022

Background High neutrophil–lymphocyte ratio (NLR) is associated with poor survival in lung cancer. This study evaluates whether NLR is associated with baseline brain metastasis in stage IV non-small cell lung cancer (NSCLC).

Methods Medical records of stage IV NSCLC patients treated at King Hussein Cancer Center (Amman-Jordan) between 2006 and 2016 were reviewed. Patients with baseline brain imaging and complete blood count (CBC) were included. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for the association between NLR and baseline brain metastasis. Association between age, gender, location of the primary tumor, histology, and NLR was assessed using univariate and multivariate logistic regression analyses.

Results A total of 722 stage IV NSCLC patients who had baseline brain imaging were included. Median age was 59 years. Baseline brain metastasis was present in 280 patients (39.3%). Nine patients had inconclusive findings about brain metastasis. The ROC curve value of 4.3 was the best fitting cutoff value for NLR association with baseline brain metastasis. NLR ≥ 4.3 was present in 340 patients (48%). The multivariate analyses showed that high baseline NLR (≥ 4.3) was significantly associated with higher odds of baseline brain metastasis (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2–2.2; p = 0.0042). Adenocarcinoma histology was also associated with baseline brain metastasis (OR: 0.4, 95% CI: 0.25–0.6; p = 0.001).

Conclusion High NLR is associated with baseline brain metastasis in advanced-stage NSCLC. In the era of immunotherapy and targeted therapies, whether high NLR predicts response of brain metastasis to treatment is unknown.
Fundamental physics with a state-of-the-art optical clock in space
Authors: Derevianko Andrei , Gibble Kurt , Hollberg Leo , Newbury Nathan R , Oates Chris , Safronova Marianna S , Sinclair Laura C , Yu Nan
Published: July 2022

Recent advances in optical atomic clocks and optical time transfer have enabled new possibilities in precision metrology for both tests of fundamental physics and timing applications. Here we describe a space mission concept that would place a state-of-the-art optical atomic clock in an eccentric orbit around Earth. A high stability laser link would connect the relative time, range, and velocity of the orbiting spacecraft to earthbound stations. The primary goal for this mission would be to test the gravitational redshift, a classical test of general relativity, with a sensitivity 30 000 times beyond current limits. Additional science objectives include other tests of relativity, enhanced searches for dark matter and drifts in fundamental constants, and establishing a high accuracy international time/geodesic reference.
Electronic control and switching of entangled spin state using anisotropy and exchange in the three-particle paradigm
Authors: Switzer E D , Zhang X-G , Rahman T S
Published: July 2022

We explore the control and switching of the entangled spin states of multi-spin particle qubit coupled to an electron using a three-particle spin model described by S

i
(i = 1, 2, 3), in which

S

1

=

1

2

is an electron and S
2,3 can have any spin with both exchange coupling and magnetic anisotropy. We derive a general formula for the existence of a switching (DJ) resonance for any spin S
2,3. We further contrast the entanglement switching mechanisms for the

S

2,3

=

1

2

and S
2,3 = 1 spin models. We find that while the onsite magnetic anisotropy in the case of

S

2,3

>

1

2

allows full control of their spin states via interaction with S
1, in order to achieve acceptable control of a Bloch vector within the

S

2,3

=

1

2

model, additional mechanisms, such as anisotropic exchange coupling, are required.
Establishment of reference values for plasma neurofilament light based on healthy individuals aged 5–90 years
Authors: Simrén Joel , Andreasson Ulf , Gobom Johan , Suarez Calvet Marc , Borroni Barbara , Gillberg Christopher , Nyberg Lars , Ghidoni Roberta , Fernell Elisabeth , Johnson Mats , Depypere Herman , Hansson Caroline , Jonsdottir Ingibjörg H , Zetterberg Henrik , Blennow Kaj
Published: July 2022

The recent development of assays that accurately quantify neurofilament light, a neuronal cytoskeleton protein, in plasma has generated a vast literature supporting that it is a sensitive, dynamic, and robust biomarker of neuroaxonal damage. As a result, efforts are now made to introduce plasma neurofilament light into clinical routine practice, making it an easily accessible complement to its cerebrospinal fluid counterpart. An increasing literature supports the use of plasma neurofilament light in differentiating neurodegenerative diseases from their non-neurodegenerative mimics and suggests it is a valuable biomarker for the evaluation of the effect of putative disease-modifying treatments (e.g. in multiple sclerosis). More contexts of use will likely emerge over the coming years. However, to assist clinical interpretation of laboratory test values, it is crucial to establish normal reference intervals. In this study, we sought to derive reliable cut-offs by pooling quantified plasma neurofilament light in neurologically healthy participants (5–90 years) from eight cohorts. A strong relationship between age and plasma neurofilament light prompted us to define the following age-partitioned reference limits (upper 95th percentile in each age category): 5–17 years = 7 pg/mL; 18–50 years = 10 pg/mL; 51–60 years = 15 pg/mL; 61–70 years = 20 pg/mL; 70 + years = 35 pg/mL. The established reference limits across the lifespan will aid the introduction of plasma neurofilament light into clinical routine, and thereby contribute to diagnostics and disease-monitoring in neurological practice.
A multiplex pedigree with pathologically confirmed multiple system atrophy and Parkinson’s disease with dementia
Authors: Fanciulli Alessandra , Leys Fabian , Lehner Fabienne , Sidoroff Victoria , Ruf Viktoria C , Raccagni Cecilia , Mahlknecht Philipp , Kuipers Demy J S , van IJcken Wilfred F J , Stockner Heike , Musacchio Thomas , Volkmann Jens , Monoranu Camelia Maria , Stankovic Iva , Breedveld Guido , Ferraro Federico , Fevga Christina , Windl Otto , Herms Jochen , Kiechl Stefan , Poewe Werner , Seppi Klaus , Stefanova Nadia , Scholz Sonja W , Bonifati Vincenzo , Wenning Gregor K
Published: July 2022

Multiple system atrophy is considered a sporadic disease, but neuropathologically confirmed cases with a family history of parkinsonism have been occasionally described. Here we report a North-Bavarian (colloquially, Lion’s tail region) six-generation pedigree, including neuropathologically confirmed multiple system atrophy and Parkinson’s disease with dementia.

Between 2012 and 2020, we examined all living and consenting family members of age and calculated the risk of prodromal Parkinson’s disease in those without overt parkinsonism. The index case and one paternal cousin with Parkinson’s disease with dementia died at follow-up and underwent neuropathological examination. Genetic analysis was performed in both and another family member with Parkinson’s disease. The index case was a female patient with cerebellar variant multiple system atrophy and a positive maternal and paternal family history for Parkinson’s disease and dementia in multiple generations. The families of the index case and her spouse were genealogically related, and one of the spouse's siblings met the criteria for possible prodromal Parkinson’s disease. Neuropathological examination confirmed multiple system atrophy in the index case and advanced Lewy body disease, as well as tau pathology in her cousin. A comprehensive analysis of genes known to cause hereditary forms of parkinsonism or multiple system atrophy lookalikes was unremarkable in the index case and the other two affected family members. Here, we report an extensive European pedigree with multiple system atrophy and Parkinson`s disease suggesting a complex underlying α-synucleinopathy as confirmed on neuropathological examination. The exclusion of known genetic causes of parkinsonism or multiple system atrophy lookalikes suggests that variants in additional, still unknown genes, linked to α-synucleinopathy lesions underlie such neurodegenerative clustering.
Impact of revascularization guided by functional testing in ischaemic cardiomyopathy
Authors: Ródenas-Alesina Eduard , Romero-Farina Guillermo , Jordán Pablo , Herrador Lorena , Espinet-Coll Carina , Pizzi María Nazarena , Ribera Aida , Barrabés José A , Aguadé-Bruix Santiago , Ferreira-González Ignacio
Published: July 2022

Aims

The burden of ischaemia is a risk factor for adverse outcomes in ischaemic cardiomyopathy (ICM) but is not systematically tested when deciding on revascularization. Limited data exists in patients with ICM regarding the interaction between ischaemia and early coronary revascularization (ECR). This study sought to determine if the burden of ischaemia modifies the outcomes of ECR in ICM.

Methods and results

Consecutive patients with ICM (left ventricular ejection fraction < 40%) with a stress-rest gated single-photon emission computed tomography (N = 747) were followed-up for ECR and major cardiovascular events (MACEs, cardiovascular death, myocardial infarction, or heart failure hospitalization). A 1:1 matched population was selected using a propensity score for ECR. The interaction between ischaemia and ECR was evaluated in the matched cohort. In the initial cohort, 131 patients underwent ECR. Of them, 109 were matched to non-ECR patients. After a median follow up of 4.1 years, 102 (46.8%) patients experienced a MACE. The effect of revascularization on MACE was dependent of the percent of ischaemia (P for the interaction at 10% ischaemia = 0.021), so that a trend towards a decreased risk of MACE was seen in patients with >10% of ischaemia [hazard ratio (HR) = 0.59 (0.30–1.18)], whereas a non-significant increase of MACE was observed in those with <10% ischaemia (HR = 1.67 [0.94–2.96]).

Conclusions

In a contemporary cohort of patients with ICM, the beneficial effects of ECR may be mediated by the percent of ischaemia. This study supports stress testing in ICM and an ischaemia-guided approach for ECR.
Weight Loss in Newly Admitted Nursing Home Residents With Obesity
Authors: Zhang Ning , Field Terry , Mazor Kathleen M , Zhou Yanhua , Gurwitz Jerry H
Published: July 2022

Background

The prevalence of obesity (body mass index ≥ 30) among nursing home residents has been increasing, but there has been little research on weight change in this population. We examined resident characteristics associated with substantial weight loss among nursing home residents with obesity.

Methods

Using data from the Minimum Data Set 3.0, this retrospective study included long-stay nursing home residents with obesity newly admitted to a facility in 2014 who had annual assessments in 2015. Substantial weight loss was defined as a loss of ≥10% body weight within a year. Multivariate regression analyses were conducted to identify factors associated with weight loss, including demographic characteristics, medical conditions, and functional limitations in activities of daily living (ADL).

Results

Among 59782 newly admitted nursing home residents with obesity, 23% experienced substantial weight loss during their first year in the nursing home. Moderate ADL dependency (odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.31–1.53), severe ADL dependency (OR = 1.83; 95% CI: 1.67–1.99), severe mobility impairment (OR = 1.15; 95% CI: 1.04–1.23), and severe cognitive impairment (OR = 1.13; 95% CI: 1.07–1.19), as well as cancer (OR = 1.10; 95% CI: 1.01–1.20), heart failure (OR = 1.06; 95% CI: 1.01–1.11), end-stage renal disease (OR = 1.17; 95% CI: 1.11–1.23), and bowel incontinence (OR = 1.19; 95% CI: 1.14–1.25) were associated with weight loss.

Conclusion

Substantial weight loss is common among nursing home residents with obesity over a 1-year period following admission, and these residents have a greater burden of functional and cognitive impairment and specific medical conditions. These findings suggest the need to further elucidate the clinical implications of weight loss among this population.
A new cryptic species of Inachus (Decapoda: Brachyura: Inachidae) from European waters and an updated identification key to the species of Inachus with two protogastric tubercles
Authors: García-Raso José E , González-Ortegón Enrique , Palero Ferran , Cuesta Jose A
Published: July 2022

Integrative taxonomy studies have allowed us to clarify some taxonomic problems in cryptic species within species of InachusWeber, 1795 with two protogastric tubercles found in European waters. Several morphotypes of Inachus phalangium (Fabricius, 1775) are recognized, and a new species is described from the Atlantic coast of the Iberian Peninsula, for which distribution data are provided. Furthermore, two Inachus cf. thoracicus specimens with a unique sternal morphology were collected from Málaga Spain, but their preservation in formaldehyde prevented molecular analyses. Specimens of I. guentheri (Miers, 1879) have been re-examined and the validity of previous reports from tropical and subtropical Atlantic waters is discussed. These results allow us to separate and clarify the status of species within this group. An identification key for Inachus species with two protogastric tubercles is also provided.
Repair of gluteus medius tears with bioinductive collagen patch augmentation: initial evaluation of safety and imaging
Authors: Day Molly A , Hancock Kyle J , Selley Ryan S , Swartwout Erica L , Dooley Matthew , Shamrock Alan G , Nwachukwu Benedict U , Greditzer Harry G , Ranawat Anil S
Published: July 2022

The purpose of this study was to perform an initial, prospective evaluation of imaging findings and outcomes after open surgical repair of gluteus medius tendon tears with bioinductive collagen patch augmentation. A prospective study was performed of patients with clinical and magnetic resonance imaging (MRI) evidence of symptomatic gluteus medius tears who underwent open, double-row suture anchor repair with bioinductive bovine collagen patch augmentation. Preoperative and 6-month postoperative MRIs were reviewed by a fellowship-trained musculoskeletal radiologist, and outcome scores were recorded preoperatively and 6 months postoperatively [Hip Outcome Score (HOS) Sport; HOS Activities of Daily Living (HOS ADL); Modified Harris Hip Score (mHHS) and International Hip Outcomes Tool (iHOT-33)]. Nine patients, four high-grade tears (≥50% tendon thickness) and five low-grade tears (<50% thickness) underwent surgical repair. At 6 months, 7/9 (77.8%) of tendons were qualitatively classified as completely healed on MRI, with no complications. Mean tendon thickness increased significantly: mediolateral dimension by 5.8 mm (P < 0.001), anteroposterior dimension by 4.1 mm (P = 0.02) and cross-sectional area (CSA) by 48.4 mm2 (P = 0.001). Gluteus medius and minimus CSA did not change significantly (P > 0.05). Patients demonstrated improvements in mean scores for HOS ADL, mHHS and iHOT that met defined minimum clinically important differences (P < 0.05). Open surgical repair of gluteus medius tendon tears with bioinductive collagen patch augmentation is safe and associated with increased tendon thickness on postoperative MRI. Early outcome scores are encouraging and should be evaluated after patients have completed postoperative rehabilitation to measure the whole effect of treatment.
Outcomes of internal biliary diversion using cholecystocolostomy for patients with severe Alagille syndrome
Authors: Durgin Jonathan M , Crum Robert , Kim Heung Bae , Cuenca Alex G
Published: July 2022

Alagille syndrome (AGS) is a disorder that leads to increased serum cholesterol and bile acids, which can result in debilitating xanthomas and pruritus. External biliary drainage and transplantation are effective treatments for AGS. Internal biliary diversion with Roux-en-Y cholecystocolostomy has been described for other biliary conditions, but not AGS. Three patients with severe pruritus due to AGS underwent Roux-en-Y cholecystocolostomy for internal biliary drainage. Retrospective analysis compared preoperative and post-operative lab values and symptom scores (0, none–4, severe). Three patients underwent cholecystocolostomy. All patients had at least three diagnostic criteria for AGS. Mean preoperative pruritus score was 3.33 (range, 2–4) and mean post-operative score was 1. Mean preoperative xanthoma score was 1.33 (range, 0–4) and post-operative score was 1 at 2-month follow-up. Roux-en-Y cholecystocolostomy can be considered for AGS, which is refractory to medical management. This procedure accomplishes internal biliary diversion without significant physiologic derangements.
Changes in Subjective Measures of Cognitive Function in Older Adults From the Initiation Through 12 Months After the Receipt of Chemotherapy
Authors: Utne Inger , Stokke Kjersti , Ritchie Christine , Løyland Borghild , Grov Ellen Karine , Rasmussen Hege Lund , Lindemann Kristina , Paul Steven M. , Torstveit Ann Helen , Miaskowski Christine
Published: July 2022

Background

Cognitive impairment has a negative impact on older patients with cancer.

Objectives

The aim of this study was to evaluate for interindividual differences in 2 subjective measures of cognitive function in older patients (n = 112), as well as determine which demographic, clinical, and symptom characteristics, and levels of physical function, were associated with initial levels and with the trajectory of each of these 2 measures.

Methods

Cognitive function was assessed using the cognitive function scale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Attentional Function Index at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess for interindividual differences in and characteristics associated with initial levels and changes in cognitive function.

Results

Characteristics associated with decreases in Quality of Life Questionnaire Core 30 scores at the initiation of chemotherapy were longer time since the cancer diagnosis and higher depression scores. Characteristics associated with poorer Attentional Function Index scores at enrollment were lower levels of education and higher depression scores. No characteristics were associated with worse trajectories of either cognitive function measure.

Conclusion

Some older patients undergoing chemotherapy experience decrements in cognitive function.

Implications for Practice

Our findings suggest that clinicians need to assess for depressive symptoms in older patients before the initiation of chemotherapy. Evidence-based interventions (eg, cognitive stimulation, increased physical activity) can be recommended to maintain and increase cognitive function in older oncology patients.
Chyle Leak After Pancreatoduodenectomy
Authors: Augustinus Simone , Latenstein Anouk E.J. , Bonsing Bert A. , Busch Olivier R. , Groot Koerkamp Bas , de Hingh Ignace H.J.T. , de Meijer Vincent E. , Molenaar I. Quintus , van Santvoort Hjalmar C. , de Vos-Geelen Judith , van Eijck Casper H. , Besselink Marc G. ,   on behalf of the Dutch Pancreatic Cancer Group
Published: July 2022

Objective:

The aim of this study was to assess the clinical impact and risk factors of chyle leak (CL).

Background:

In 2017, the International Study Group for Pancreatic Surgery (ISGPS) published the consensus definition of CL. Multicenter series validating this definition are lacking and previous studies investigating risk factors have used different definitions and showed heterogeneous results.

Methods:

This observational cohort study included all consecutive patients after pancreatoduodenectomy in all 19 centers in the mandatory nationwide Dutch Pancreatic Cancer Audit (2017–2019). The primary endpoint was CL (ISGPS grade B/C). Multivariable logistic regression analyses were performed.

Results:

Overall, 2159 patients after pancreatoduodenectomy were included. The rate of CL was 7.0% (n=152), including 6.9% (n=150) grade B and 0.1% (n=2) grade C. CL was independently associated with a prolonged hospital stay [odds ratio (OR)=2.84, 95% confidence interval (CI): 1.85–4.36, P<0.001] but not with mortality (OR=0.3, 95% CI: 0.0–2.3, P=0.244). In multivariable analyses, independent predictors for CL were vascular resection (OR=2.1, 95% CI: 1.4–3.2, P<0.001) and open surgery (OR=3.5, 95% CI: 1.7–7.2, P=0.001). The number of resected lymph nodes and aortocaval lymph node sampling were not identified as predictors in multivariable analysis.

Conclusions:

In this nationwide analysis, the rate of ISGPS grade B/C CL after pancreatoduodenectomy was 7.0%. Although CL is associated with a prolonged hospital stay, the clinical impact is relatively minor in the vast majority (>98%) of patients. Vascular resection and open surgery are predictors of CL.
The Measurement Reliability of Complications and Patient Satisfaction After Common Surgical Procedures
Authors: Howard Ryan , Thumma Jyothi , Englesbe Michael
Published: July 2022

Objective:

To evaluate the reliability of surgeon outcomes.

Background:

Surgeons’ outcomes are now widely used in public reporting and value-based reimbursement, but the reliability of these measures continues to raise concerns.

Methods:

We performed a retrospective study of surgeons performing cholecystectomy, colectomy, and hernia repair on adult patients between January 1, 2017, and December 31, 2020. Outcomes were risk-adjusted rates of complications and high patient satisfaction. We estimated the reliability of each outcome, its relationship with case volume, and the number of surgeons who reached an acceptable level of reliability (≥0.70).

Results:

A total of 23,533 patients with a mean age of 56.8 (16.2) years and 10,191 (43.3%) females underwent operations by 333 surgeons. Risk-adjusted complication rate was 2.5% [95% confidence interval (CI): 2.2%–2.8%] and risk-adjusted high satisfaction rate was 79.9% (95% CI: 78.7%–81.0%). The reliability of the complication rate was 0.27 (95% CI: 0.25–0.29) and the reliability of the high satisfaction rate was 0.53 (95% CI: 0.50–0.55). Reliability increased with case volume; however, only 5 (1.5%) surgeons performed enough cases to reach acceptable reliability for their complication rate, while 86 (25.8%) surgeons reached acceptable reliability for their patient satisfaction rate. After adjustment for reliability, the range of complication rates decreased 29-fold from 0% to 14.3% to 2.4% to 2.9%, and the range of patient satisfaction decreased 2.6-fold from 25.3% to 100.0% to 64.9% to 92.4%.

Conclusions:

Among surgeons performing common operations, complications and patient satisfaction had relatively low reliability. Although reliability increased with volume, most surgeons had insufficient case volume to achieve acceptable reliability of their outcomes. As such, these measures likely offer little to no meaningful information to inform decision-making.
Recent advances in digital health interventions for substance use disorders
Authors: Boumparis Nikolaos , Schaub Michael P.
Published: July 2022

Purpose of review

The purpose of this review is to provide an update of the recently published randomized controlled trials in the field of digital health interventions for substance use disorders.

Recent findings

Over the past 2 years, five cannabis-specific and seven polysubstance-focused randomized controlled trials were published. No studies were found that focused on opioid or psychostimulant use disorders. Most studies examined feasibility but were underpowered to assess effectiveness. Given the optimistic results of the studies in regards to feasibility more fully powered trials should be conducted. In addition, the literature is in need for an increased focus on comorbidity and outcome standardization.

Although the number of studies targeting new target groups, technologies and new delivery settings has increased – future studies should consider the identified gaps and suggestions to further strengthen the evidence of digital interventions targeting substance use disorders.
From pre- to post-big bang: an (almost) self-dual cosmological history
Authors: Gasperini M.
Published: July 2022

We present a short introduction to a non-standard cosmological scenario motivated by the duality symmetries of string theory, in which the big bang singularity is replaced with a ‘big bounce’ at high but finite curvature. The bouncing epoch is prepared by a long (possibly infinitely extended) phase of cosmic evolution, starting from an initial state asymptotically approaching the string perturbative vacuum.

This article is part of the theme issue ‘The future of mathematical cosmology, Volume 2’.
On space–time structure and the Universe: some issues of concept and principle
Authors: Dadhich Naresh
Published: July 2022

In this discourse, we would like to discuss some issues of concept and principle in the context of the following three aspects. One, how

Λ

arises as a constant of space–time structure on the same footing as the velocity of light. These are the two constants innate to space–time without reference to any force or dynamics whatsoever, and are interwoven in the geometry of ‘free’ homogeneous space–time. Two, how does the vacuum energy gravitate? Could its gravitational interaction in principle be included in general relativity or a new theory of quantum space–time/gravity would be required? Finally, we would like to raise the fundamental question: How does the Universe physically expand? Since there does not lie anything outside into which it can expand, instead it has to expand on its own—maybe by creating new space–time out of nothing at each instant and at every location! Thus not only was the Universe created at some instant in the past marking the beginning in the Big Bang, it is in fact being created continuously at each epoch as it expands. We thus need quantum theory of space–time/gravity for fully understanding the working of the Universe.

This article is part of the theme issue ‘The future of mathematical cosmology, Volume 2’.
Comparative genomics of Nocardia seriolae reveals recent importation and subsequent widespread dissemination in mariculture farms in the South Central Coast region, Vietnam
Authors: Le Cuong T. , Price Erin P. , Sarovich Derek S. , Nguyen Thu T. A. , Powell Daniel , Vu-Khac Hung , Kurtböke D. İpek , Knibb Wayne , Chen Shih-Chu , Katouli Mohammad
Published: July 2022

Between 2010 and 2015, nocardiosis outbreaks caused by

Nocardia seriolae

affected many permit farms throughout Vietnam, causing mass fish mortalities. To understand the biology, origin and epidemiology of these outbreaks, 20

N

.

seriolae

strains collected from farms in four provinces in the South Central Coast region of Vietnam, along with two Taiwanese strains, were analysed using genetics and genomics. PFGE identified a single cluster amongst all Vietnamese strains that was distinct from the Taiwanese strains. Like the PFGE findings, phylogenomic and SNP genotyping analyses revealed that all Vietnamese

N. seriolae

strains belonged to a single, unique clade. Strains fell into two subclades that differed by 103 SNPs, with almost no diversity within clades (0–5 SNPs). There was no association between geographical origin and subclade placement, suggesting frequent

N. seriolae

transmission between Vietnamese mariculture facilities during the outbreaks. The Vietnamese strains shared a common ancestor with strains from Japan and China, with the closest strain, UTF1 from Japan, differing by just 220 SNPs from the Vietnamese ancestral node. Draft Vietnamese genomes range from 7.55 to 7.96 Mbp in size, have an average G+C content of 68.2 % and encode 7 602–7958 predicted genes. Several putative virulence factors were identified, including genes associated with host cell adhesion, invasion, intracellular survival, antibiotic and toxic compound resistance, and haemolysin biosynthesis. Our findings provide important new insights into the epidemiology and pathogenicity of

N. seriolae

and will aid future vaccine development and disease management strategies, with the ultimate goal of nocardiosis-free aquaculture.
Adaptive Unscented Kalman Filter for Neuronal State and Parameter Estimation
Authors: Azzalini Loïc J. , Crompton David , D’Eleuterio Gabriele M. T. , Skinner Frances , Lankarany Milad
Published: July 2022

Data assimilation techniques for state and parameter estimation are frequently applied in the context of computational neuroscience. In this work, we show how an adaptive variant of the unscented Kalman filter (UKF) performs on the tracking of a conductance-based neuron model. Unlike standard recursive filter implementations, the robust adaptive unscented Kalman filter (RAUKF) jointly estimates the states and parameters of the neuronal model while adjusting noise covariance matrices online based on innovation and residual information. We benchmark the adaptive filter’s performance against existing nonlinear Kalman filters and explore the sensitivity of the filter parameters to the system being modelled. To evaluate the robustness of the proposed solution, we simulate practical settings that challenge tracking performance, such as a model mismatch and measurement faults. Compared to standard variants of the Kalman filter the adaptive variant implemented here is more accurate and robust to faults.
Assessment of Human Expertise in First-Person Shooter Games
Authors: Donovan Ian , Saul Marcia A. , DeSimone Kevin , Listman Jennifer B. , Mackey Wayne E. , Heeger David J.
Published: July 2022

Contrary to traditional professional sports, there are few standardized metrics in professional esports (competitive multiplayer video games) for assessing a player’s skill and ability. To begin to address this, we assessed the performance of professional-level players in Aim Lab™, a first-person shooter training and assessment game, within two separate target-shooting tasks. These tasks differed primarily in the relative incentive for fast and imprecise shots versus slow and precise shots. Each player’s motor acuity was measured by characterizing the speed-accuracy trade-off in shot behavior: shot frequency and shot spatial error (distance from center of a target). We also characterized the fine-grained kinematics of players’ mouse movements. Our findings demonstrate that: 1) movement kinematics depended on task demands; and 2) individual differences in motor acuity were significantly correlated with both kinematics and the number of movements needed to hit a target. We demonstrate the importance of transforming from orientation in the virtual environment to centimeters on the mouse pad, as well as accounting for differences in mouse sensitivity across players, for characterizing human performance in first-person shooter games. This approach to measuring motor acuity has widespread application not only in esports assessment and training, but also in basic (motor psychophysics) and clinical (gamified rehabilitation) research.
The decline of COVID-19 severity and lethality over two years of pandemic
Authors: Marziano Valentina , Guzzetta Giorgio , Menegale Francesco , Sacco Chiara , Petrone Daniele , Urdiales Alberto Mateo , Del Manso Martina , Bella Antonino , Fabiani Massimo , Vescio Maria Fenicia , Riccardo Flavia , Poletti Piero , Manica Mattia , Zardini Agnese , d’Andrea Valeria , Trentini Filippo , Stefanelli Paola , Rezza Giovanni , Palamara Anna Teresa , Brusaferro Silvio , Ajelli Marco , Pezzotti Patrizio , Merler Stefano
Published: July 2022

Undernotification of SARS-CoV-2 infections has been a major obstacle to the tracking of critical quantities such as infection attack rates and the probability of severe and lethal outcomes. We use a model of SARS-CoV-2 transmission and vaccination informed by epidemiological and genomic surveillance data to estimate the number of daily infections occurred in Italy in the first two years of pandemic. We estimate that the attack rate of ancestral lineages, Alpha, and Delta were in a similar range (10-17%, range of 95% CI: 7-23%), while that of Omicron until February 20, 2022, was remarkably higher (51%, 95%CI: 33-70%). The combined effect of vaccination, immunity from natural infection, change in variant features, and improved patient management massively reduced the probabilities of hospitalization, admission to intensive care, and death given infection, with 20 to 40-fold reductions during the period of dominance of Omicron compared to the initial acute phase.
Visualizing the stochastic gating of Na+/H+ antiporters in single native bacteria
Authors: Li Yaohua , Li Haoran , Gao Jia , Niu Ben , Wang Huan , Wang Wei
Published: July 2022

Na+/H+ antiporters are the major secondary transporters that regulate pH and sodium homeostasis by enabling transmembrane exchanges of Na+ with H+ in opposite directions, both are essential cations. Although their crystal structures and functions have been well characterized1-3, the transport dynamics of Na+/H+ antiporters during action in living cells remained largely unexplored. Herein, intermittent blinking of the spontaneous bioluminescence from single native bioluminescent bacteria, P. phosphoreum, was reported, investigated and attributed to the stochastic gating of Na+/H+ antiporters between the active and inactive conformations. Each gating event caused the rapid depolarization and recovery of membrane potential within several seconds, accompanying with the intermittent bioluminescence blinking due to the transient inhibitions on the activity of respiratory chain. Temperature-dependent measurements further revealed that the conformational change was thermodynamically driven with an activation energy barrier of 20.3 kJ/mol. While the stochastic gating of ion channels has been well understood for decades4,5, this study uncovered the stochastic gating dynamics of Na+/H+ antiporters, another major pathway for ion transmembrane transports, in single native bacteria without any genetic engineering or chemical labeling. It also opened the door for P. phosphoreum to serve as new model bacteria for reporting the physiological and metabolic status with spontaneous bioluminescence emission.
Efficient End-to-end Learning for Cell Segmentation with Machine Generated Incomplete Annotations
Authors: Shrestha Prem , Kuang Nicholas , Yu Ji
Published: July 2022

Automated cell segmentation from optical microscopy images is usually the first step in the pipeline of single-cell analysis. Recently, deep-learning based algorithms have shown superior performances for the cell segmentation tasks. However, a disadvantage of deep-learning is the requirement for a large amount of fully-annotated training data, which is costly to generate. Weakly-supervised and self-supervised learning is an active research area, but often the model accuracy is inversely correlated with the amount of annotation information provided. Here we focus on a specific subtype of incomplete annotations, which can be generated programmably from experimental data, thus allowing for more annotation information content without sacrificing the annotation speed. We designed a new model architecture for end-to-end training using such incomplete annotations. We benchmarked our method on a variety of publicly available dataset, covering both fluorescence and bright-field imaging modality. We additionally tested our method on a microscopy dataset generated by us, using machine generated annotations. The results demonstrated that our model trained under weak-supervision can achieve segmentation accuracy competitive to, and in some cases surpassing, state-of-the-art models trained under full supervision. Therefore, our method can be a practical alternative to the established full-supervision methods.
Cross-level effects of union practices on extra-role behaviors: the mediating role of industrial relations climate, union commitment and union instrumentality
Authors: Yang Liqian , Zhang Qian , Gong Hao , Cheng Yanyuan
Published: July 2022

Purpose

The purpose of this paper is to investigate the relationship between union practices and two types of employees’ extra-role behaviors, namely, union citizenship behavior (UCB) and employee voice (EV), and the mechanisms that mediate this relationship.

Design/methodology/approach

Using matched data from 46 union leaders and 279 union members of 33 workplaces in China, this study utilized multilevel structural equation modeling to test the cross-level influences of union practices on employees’ extra-role behaviors and the mediation effects.

Findings

The results show that (1) union practices have a positive impact on employees’ UCB and EV, and (2) union practices increase UCB and EV through the improvement of industrial relations (IR) climate at the workplace level, as well as union commitment (UC) and union instrumentality (UI) at the individual level.

Research limitations/implications

Although the authors collected data from multi-sources (i.e. union leaders and members), the cross-sectional data of this study limited the ability to make casual inferences.

Originality/value

This study contributes to the literature by providing theoretical explanation and empirical evidence to illustrate the role of union practices in increasing the extra-role behaviors of employees (i.e. UCB and EV). This is of particular importance in elaborating the effectiveness of enterprise unions under the recent reforms in China. In addition, the authors also unpacked the antecedents of extra-role behaviors in the union context by investigating how IR climate, UC and UI mediate the relationship between union practices and extra-role behaviors of employees.
Institutional investors, political connections and stock recommendations from sell-side analysts: the case of Malaysia
Authors: Qasem Ameen , Wan-Hussin Wan Nordin , Ghaleb Belal Ali Abdulraheem , Bamahros Hasan Mohamad
Published: July 2022

Purpose

The purpose of this study is to investigate the interplay between institutional investors' ownership (IIO), politically connected firms (POC) and sell-side analysts' stock recommendations (ASR).

Design/methodology/approach

This study employs ordinary least square (OLS) regression to test the hypotheses. The sample comprises 280 Malaysian public listed companies (PLC) and encompasses the 2008–2013 time frame (a total of 735 observations).

Findings

The results show a significant and positive link between IIO and ASR. In addition, a negative association is found between POC and ASR. Moreover, the POC weakens the positive relationship between the IIO and ASR.

Research limitations/implications

One important implication of this study is that political involvement in corporate decisions is a prominent characteristic of the Malaysian market, which can significantly affect the information environment and analysts' reactions.

Practical implications

The findings of this study provide useful empirical guidance to the regulators in evaluating the efficacy of recent regulatory initiatives. Investors may also gain useful insights from this study, specifically in recognising the crucial monitoring role played by institutional investors and how politically patronised firms are viewed unfavourably by equity analysts.

Originality/value

This study is one of the first to examine the joint influence of IIO and POC, on ASR.