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rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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world Journal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elijah Dixon Parul J Shukla Shailesh V Shrikhande rahul r Deshpande Fawwaz Mohammed Neil w Pearce wesley Francis Shaneeta Johnson Johann Bujhawan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGrOUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced major post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between January 1,2013 and June 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced major morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from major *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication rescue Failure Morbidity Mortality Pancreaticoduodenectomy

Treat to target in Crohn’s disease:A practical guide for clinicians

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world Journal of Gastroenterology 2024年第1期30卷 50-69页

作者： Ashish r Srinivasan Department of Gastroenterology Austin HealthVictoriaMelbourne 3083Australia Department of Gastroenterology Eastern HealthVictoriaMelbourne 3128Australia Department of Medicine University of MelbourneVictoriaMelbourne 3052Australia

A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's *** Selecting Therapeutic Targets in Inflammatory Bowel Disease(STrIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these *** appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or *** treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic *** the STrIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all *** underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment *** use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural *** randomised clinical trials,namely,CALM and STArDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s *** from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be ***,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world *** the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its *** highlights the need to describe st

关键词： Treat to target Inflammatory bowel disease Crohn’s disease Treatment targets Endoscopic remission Transmural healing Time to response Intestinal ultrasound

Control system design for a pressure-tube-type supercritical water-cooled nuclear reactor via a higher order sliding mode method

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Nuclear Science and Techniques 2024年第1期35卷 145-154页

作者： M.Hajipour G.r.Ansarifar Department of Nuclear Engineering Faculty of PhysicsUniversity of IsfahanIsfahan 81746-73441Iran

Nuclear power plants exhibit non-linear and time-variable ***,designing a control system that sets the reactor power and forces it to follow the desired load is complicated.A supercritical water reactor(SCwr)is a fourth-generation conceptual *** an SCwr,the non-linear dynamics of the reactor require a controller capable of control-ling the *** this study,a pressure-tube-type SCwr was controlled during reactor power maneuvering with a higher order sliding mode,and the reactor outgoing steam temperature and pressure were controlled *** an SCwr,the temperature,pressure,and power must be maintained at a setpoint(desired value)during power *** point kinetics equations with three groups of delayed neutrons were used in the ***-order and classic sliding mode controllers were separately manufactured to control the plant and were compared with the PI controllers speci-fied in previous *** controlled parameters were reactor power,steam temperature,and ***,for these parameters,the PI controller had certain instabilities in the presence of *** classic sliding mode controller had a higher accuracy and stability;however its main drawback was the chattering *** was highly accurate and stable and had a small computational *** reality,it followed the desired values without oscillations and chattering.

关键词： Supercritical water nuclear reactor Higher order sliding mode controller Steam temperature Steam pressure Point kinetics model

Development and application of feature engineered geological layers for ranking magmatic,volcanogenic,and orogenic system components in Archean greenstone belts

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Geoscience Frontiers 2024年第2期15卷 251-273页

作者： r.M.Montsion S.Perrouty M.D.Lindsay M.w.Jessell r.Sherlock Mineral Exploration research Centre Harquail School of Earth SciencesGoodman School of MinesLaurentian UniversitySudburyOntario P3E 2C6Canada Centre for Exploration Targeting School of Earth SciencesThe University of Western Australia35 Stirling HighwayCrawley 6009Australia Commonwealth Scientific and Industrial research Organization Mineral Resources26 Dick Perry AveKensingtonWA 6151Australia ArC Centre for Data Analytics for resources and Environments(DArE) Perth and SydneyAustralia

Geologically representative feature engineering is a crucial component in geoscientific applications of machine *** commonly applied feature engineering techniques used to produce input variables for machine learning apply geological knowledge to generic data science techniques,which can lead to ambiguity,geological oversimplification,and/or compounding subjective *** that utilize minimally processed input variables attempt to overcome these issues,but often lead to convoluted and uninterpretable *** address these challenges,new and enhanced feature engineering methods were developed by combining geological knowledge,understanding of data limitations,and a variety of data science *** include non-Euclidean fluid pre-deformation path distance,rheological and chemical contrast,geologically constrained interpolation of characteristic host rock geochemistry,interpolation of mobile element gain/loss,assemblages,magnetic intensity,structural complexity,host rock physical *** methods were applied to compiled open-source and new field observations from Archean greenstone terranes in the Abitibi and western wabigoon sub-provinces of the Superior Province near Timmins and Dryden,Ontario,*** feature maps represent conceptually significant components in magmatic,volcanogenic,and orogenic mineral systems.A comparison of ranked feature importance from random forests to conceptual mineral system models show that the feature maps adequately represent system components,with a few exceptions attributed to biased training data or limited constraint *** study also highlights the shared importance of several highly ranked features for the three mineral systems,indicating that spatially related mineral systems exploit the same features when *** feature importance when classifying orogenic Au mineralization in Timmins and Dryden provides insights into the possible cause of contrasting endowment be

关键词： Machine learning random forests Mineral systems Magmatic Ni-Cu-PGE Volcanogenic Massive Sulfide(VMS)Cu-Zn-Pb-Ag(-Au) Orogenic Au Abitibi wabigoon

Population dynamics of the tropical oyster Magallana bilineata(Mollusca,Bivalvia,Ostreidae)in Mengkabong Bay,Tuaran,Malaysia

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Aquaculture and Fisheries 2024年第2期9卷 295-305页

作者： Joanna w.Doinsing Julian ransangan Politeknik Sandakan Sabah Education HubBatu 10Jalan Sungai BatangSandakanSabah90000Malaysia Borneo Marine research Institute Universiti Malaysia SabahJalan UMSKota Kinabalu88400Malaysia

Knowledge about the population dynamics within a specific spatial area is vital for the effective planning and management of important fishery *** parameters,including the asymptotic length(L∞),growth coefficient(K),mortalities(Z,F,and M),recruitment pattern,exploitation level(E),and yield per recruit(Y’/r),of the tropical oyster Magallana bilineata in Mengkabong Bay,Tuaran,Malaysia were analyzed by using the FiSAT software,using on the monthly shell length-frequency data collected from April 2019 to March 2020.A total of 435 oysters with shell lengths ranging from 3.64 to 11.16 cm were *** water temperature,salinity,dissolved oxygen,hydrogen ion concentration(pH),and chlorophyll concentration were measured at 29.0-33.7◦C,26.68-35.74 psμ,3.18-6.99 mg/L,6.57-8.29 and 1.51-98.93μg/L,*** logarithmic relationship between the length and weight of Log w=1.9055 Log L+0.1049(r2=0.5431)with exponent b of 1.9055 for combined sexes showed a negative allometric growth(brs in Mengkabong Bay are *** management measures have been proposed to promote high meat growth,including the use of genetically selected seeds,selection of new farming sites and adoption of grow-out methods that favour high meat *** length(L∞)and growth coefficient(K)of the von Bertalanffy Growth Formula(VBGF)for *** were estimated at 12.13 cm and 1.00 yr􀀀1,*** theoretical ages at length zero(t0)(0.0487)were estimated by substituting L∞and K in Pauly’s *** sizes attained by *** were 3.76,5.04,6.13,7.05,7.83,and 8.49 cm at the end of 2,4,6,8,10,and 12 months,*** calculated growth performance index(φ)for *** in Mengkabong Bay was 2.168,while the estimated lifespan was 3 *** recruitment pattern was observed year-round,with higher recruitment activities in September-October 2019 and January *** total mortality(Z)was analyzed using the length-converted

关键词： Crassostrea iredalei Length-weight relationship Growth parameters recruitment Exploitation

Simple collective model for nuclear chiral mode

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Frontiers of physics 2024年第2期19卷 1-5页

作者： r.V.Jolos E.A.Kolganova D.r.Khamitova Joint Institute for Nuclear research 141980 DubnaMoscow regionRussia Dubna State University 141982 DubnaMoscow RegionRussia

A simple semi-analytical collective model that takes into account the limitations of the variation interval of the collective variable is suggested to describe the chiral dynamics in triaxial odd−odd nuclei with a fixed particle−hole *** collective Hamiltonian is constructed with the potential energy obtained using the postulated ansatz for the wave function symmetric with respect to chiral *** diagonalizing the collective Hamiltonian the wave functions of the lowest states are obtained and the evolution of the energy splitting of the chiral doublets in transition from chiral vibration to chiral rotation regime is demonstrated.

关键词： collective model nuclear chiral

Lower limb balance,ankle dorsiflexion,orofacial tissue pressure,and occlusal force of rugby players

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Sports Medicine and Health Science 2024年第2期6卷 173-178页

作者： rafael r.Machado Marcelo Palinkas Paulo B.de Vasconcelos Sara Gollino Veridiana w.Arnoni Marcos Vinicios r.Prandi Isabela H.regalo Selma Siessere Simone C.H.regalo School of Dentistry of ribeirao Preto University of Sao PauloBrazil National Institute for Translational Medicine(INCT-TM) Ribeirao PretoBrazil

This cross-sectional study examined the lower limb balance,ankle dorsiflexion,orofacial tissue pressure,and occlusal strength of rugby ***-six participants were divided into groups:rugby players(n=13)and healthy sedentary adults(n=13).Participants underwent an analysis of lower limb balance using a composite score(Y-Balance Test).Ankle dorsiflexion was measured using the Lunge *** Iowa Oral Performance Instrument was employed to measure orofacial tissue *** force was measured with a dynamometer,and T-Scan assessed occlusal contact *** were analyzed using the t-test(pwith age and weight as covariates,where it is possible to verify that these factors did not influence the results *** differences were observed in the balance of the right(p=0.07)and left(p=0.02)lower limbs,where rugby players had lower composite *** were significant differences in the right(p=0.005)and left(p=0.004)lunges,with rugby players showing lower values,as well as lower tongue pressure(p=0.01)and higher lip pressure(p=0.03),with significant differences to sedentary *** was no significant difference in molar bite force and distribution occlusal contacts between *** seems to reduce lower limb displacement,cause ankle hypomobility,lead to changes in orofacial tissues,particularly the tongue and *** study is significant for identifying significant differences between rugby players and sedentary individuals,providing new insights into the impact of rugby on health and performance,which can benefit sports training and injury prevention.

关键词： rugby Y-balance test Lunge test Orofacial tissues Occlusal force

Audio Enhancement for Computer Audition—An Iterative Training Paradigm Using Sample Importance

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Journal of Computer Science & Technology 2024年第4期39卷 895-911页

作者： Manuel Milling Shuo Liu Andreas Triantafyllopoulos Ilhan Aslan Björn w.Schuller Chair of Embedded Intelligence for Health Care and wellbeing University of AugsburgAugsburg 86159Germany Chair of Health Informatics München rechts der IsarTechnical University of MunichMunich 81675Germany Munich Center for Machine Learning Munich 80333Germany Huawei Technologies MunichMunich 80992Germany Munich Data Science Institute Garching 85748Germany Group on Language Audio and MusicImperial College LondonLondon SW72AZU.K.

Neural network models for audio tasks,such as automatic speech recognition(ASr)and acoustic scene classification(ASC),are susceptible to noise contamination for real-life *** improve audio quality,an enhancement module,which can be developed independently,is explicitly used at the front-end of the target audio *** this paper,we present an end-to-end learning solution to jointly optimise the models for audio enhancement(AE)and the subsequent *** guide the optimisation of the AE module towards a target application,and especially to overcome difficult samples,we make use of the sample-wise performance measure as an indication of sample *** experiments,we consider four representative applications to evaluate our training paradigm,i.e.,ASr,speech command recognition(SCr),speech emotion recognition(SEr),and *** applications are associated with speech and nonspeech tasks concerning semantic and non-semantic features,transient and global information,and the experimental results indicate that our proposed approach can considerably boost the noise robustness of the models,especially at low signal-to-noise ratios,for a wide range of computer audition tasks in everyday-life noisy environments.

关键词： audio enhancement computer audition joint optimisation multi-task learning voice suppression

Developing a two-decadal time-record of rice field maps using Landsat-derived multi-index image collections with a random forest classifier:A Google Earth Engine based approach

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Information Processing in Agriculture 2024年第2期11卷 260-275页

作者： w.Ashane M.Fernando I.P.Senanayake Department of Nano Science Technology Wayamba University of Sri LankaKuliyapitiya 60200Sri Lanka Dchoolf Engineing CllegeoEngineeringSience and EnionmentThe UniversyewcastleCallaghanW2Austraia

Historic maps showing the temporal distribution of rice fields are important for precision agriculture,irrigation optimisation,forecasting crop yields,land use management and formulating ***,mapping rice felds using traditional ground surveys is impractical when high cost,time and labour requirements are considered,and the availability of such detailed records is *** satellite remote sensing appears to be a viable solution,conventional segmentation and classification methods with spectral bands are often unable to contrast the distinct characteristics between rice fields and other vegetation *** this end,we explored a novel,Google Earth Engine(GEE)based multiindex random forest(rF)classification approach to map rice fields over two *** images from 2000 to 2020 of two Sri Lankan rice cultivation districts were extracted from GEE and a multi-index rF classification algorithm was applied to distinguish the rice *** results showed above 80%accuracy for both training and validation,when compared against high spatial resolution Google Earth *** essence,multi-index sampling and rF together synergised the compelling classifcation accuracy by effectively capturing vegetation,water(ponding)and soil characteristics unique to the rice felds using a single-click *** maps developed in this study were further compared against the MODIS land cover type product(MCD12Q1)and the corresponding superior statistics on rice fields demonstrated the robustness of the proposed *** work seeking effective index combinations is recommended,and this approach can potentially be extended to other crop analyses elsewhere.

关键词： Google Earth Engine(GEE) Image classification random forest Mapping rice fields Time series analysis Vegetation index