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Alternating links, rational balls, and cube tilings
No full textWhen does the double cover of the 3-sphere branched along an alternating link bound a rational homology ball? Heegaard Floer homology generates a necessary condition for it to bound: the link’s chessboard lattice must be cubiquitous, implying that its normalized determinant is less than or equal to one. We conjecture that the converse holds and prove it when the normalized determinant equals one. The proof involves flows on planar graphs and the Hajós–Minkowski theorem that a lattice tiling of Euclidean space by cubes contains a pair of cubes which touch along an entire facet. We extend our main results to the study of ribbon cobordism and ribbon concordance
Translation in the Performing Arts: Embodiment, Materiality, and Inclusion
No full textNo abstract available
The rapidly evolving landscape of HCC: Selecting the optimal systemic therapy
Get PDFOver the past years, there has been a remarkable advance in the systemic treatment options for advanced HCC. The overall survival has gradually increased over time, with larger benefits for patients with sensitive tumors and preserved liver function, the latter being an essential condition for the delivery of sequential lines of treatment and optimization of clinical outcomes. With the approval of new first-line agents and the introduction of immune checkpoint inhibitor-based therapies, the treatment landscape of advanced HCC is becoming wider than ever. Atezolizumab plus bevacizumab and, more recently, durvalumab plus tremelimumab have entered the clinical practice and are the current standard of care for treatment-naïve patients, surpassing sorafenib and lenvatinib monopoly. As no head-to-head comparisons are available among all the first-line treatment options, the recommendation for the most appropriate choice and sequence is patient-driven and integrates efficacy data with clinical comorbidities, background liver disease, and the safety profile of available drugs. In addition, predictive biomarkers for successful patients’ stratification are yet to be available and constitute the focus of ongoing research. The treatment algorithm is likely to become even more complex since systemic therapeutic approaches are now being translated into earlier stages of the disease, with an impact on the evolution of the sequential treatment of patients with HCC
Development and validation of a brief measure of sexual wellbeing for population surveys: The Natsal Sexual Wellbeing Measure (Natsal-SW)
Get PDFSexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test–retest reliability. Confirmatory factor analysis indicated that a “general specific model” had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (−0.384), anxiety (−0.340), sexual satisfaction (0.680) and sexual distress (−0.615), and demonstrated good test–retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations
Early-cannulation arteriovenous grafts: Multidisciplinary learning is essential to optimize outcomes
No full textBackground:
It is likely that there will be an increasing role for early-cannulation arteriovenous grafts (ecAVG) with a wider recognition of the need to tailor vascular access to avoid futile procedures and unnecessary TCVC. However, experience of these products is not common and limited to early surgical adopters, with little information on the systemic changes and multi-disciplinary care needed to optimize outcomes. The aim of this study was to report the impact of a multi-disciplinary approach on quantifiable outcomes.
Methods:
A retrospective analysis of a prospectively maintained database of 295 ecAVG implanted over an 8-year time-period was performed. Indicative outcomes were chosen to reflect nephrology (patient selection), nursing care (cannulation complications of infection and pseudoaneurysm) and radiology (thrombosis) on cumulative impact (functional patency) over three distinct time periods.
Results:
The incidence of ecAVG increased 10-fold over the three time periods. The use of ecAVG changed significantly from salvage tertiary access to TCVC avoidance and salvage of existing AVF. Nursing complications reduced markedly with significantly fewer over-cannulation episodes and pseudo-aneurysms. With an improved pro-active surveillance programme, the time to first thrombosis doubled and the risk of thrombosis halved. Ultimately this resulted in significantly improved functional patency with a risk of ecAVG loss less than one-third by the last time-period.
Conclusions:
All aspects of ecAVG use require scrutiny and critical appraisal. Failure or success is not simply achieved by performing good technical surgery with an efficacious product, but by the care taken across a wide range of elements spanning case selection, implantation, use and maintenance
Independence of existence of measurable equilibrium selections
Get PDFWe study the problem of selecting, in a measurable manner, equilibria from each of a family of games. Typical equilibrium selection theorems assume continuity in, and compactness of, actions, while we merely assume equilibria exist for all games in the family, and payoffs are jointly Borel in parameter and actions. The existence of Lebesgue- or universally measurable selectors turns out to be independent of ZFC; the result is robust to restriction to zero-sum games, as well as to allowing mixed strategies. We show, however, that the existence of analytically measurable selections, well-known to exist for single decision makers, fails for families of two-player zero-sum games
Implementation of voxel selective ellipse normalization to enhance radar respiration estimation in metallic chamber
Get PDFCompared to broader physical activities, detecting nuanced respiratory movements poses a significant challenge in indoor health monitoring systems. While respiratory activity can be conceptualized as periodic chest movements akin to mechanical vibrations, uncontrollable environmental factors often introduce noise into detected radar signals. The clutter in the field of view, especially metallic objects such as hospital steel beds, degrades the performance of radar physiological monitoring: (1) amplifying noise of multipath effects and (2) misleading the informative localization module. In this paper, we propose a preprocessing scheme of Search-Voxel Ellipse Normalization for respiratory detection system, including an ellipse normalization method combined with the fitting-cost voxel selection policy, to improve the respiration detection performance using MIMO FMCW radar. The article provides an in-depth assessment of the designed system, including a metal-insulated room test involving 10 participants in different postures. The results show notable performance improvements of our proposed ENDTW-MVMD method, especially in lowering the MAE from the best state-of-the-art 0.93 bpm to 0.75 bpm and stabilization in voxel selection. The proposed approach is thoroughly evaluated against established methods across various dimensions, such as voxel selection, independent performance, frequency estimation, and ablation studies
Mapping and Gap Analysis Report on Freedom of Expression in Bosnia and Herzegovina
No full textNo abstract available
Miniaturized Electro-Optical Modulator Based on Substrate-Free Thin Films
Get PDFWe report on an integrable electro-optic modulator (EOM), exploiting the advantages of substrate-free thin film technology to achieve a small device footprint of less than 30µm along the beam propagation direction. By integrating an electrooptically active layer into a resonant Fabry-Perot (FP) structure with dielectric thin film mirrors, an EOM, which modulates the transmitted amplitude, is manufactured and characterized. We show results on electro-optically active polymers as the FP cavity material, which have revealed an electro-optic coefficient in the three-digit pm/V range at a wavelength of 980nm. Furthermore, we analyze the applicability of piezoelectric zinc oxide (ZnO) as the active layer material, which exhibits high transmission in the visible wavelength region. Fabrication of ZnO using magnetron sputtering under oblique angle deposition conditions has the potential to produce porous, inclined, crystalline thin films with an enhanced piezoelectric coefficient d33, which is otherwise only found in bulk ceramics like lead zirconate titanate. The use of such nanostructured ZnO thin films with an improved electro-mechanical coupling as active cavity layer fosters improved modulation while consuming less energy
Clinical year veterinary students are concerned about calving cows and request more real-life, practical exposure to enhance their confidence
Get PDFBackground:
Newly qualified veterinarians are expected to attend emergencies, for example, cow calving, but their clinical exposure to these scenarios before graduation may be limited. This study aimed to investigate what affects veterinary students' confidence and attitudes regarding calving cows.
Methods:
Paper questionnaires were distributed to veterinary students in their third (n = 240, 2016/2017 and 2017/2018) and fourth years (n = 347, 2016/2017, 2017/2018 and 2018/2019) at one UK university to ascertain their demographic data, confidence regarding calving cows (rated on a scale from 1 to 5) and their concerns and suggestions for improving their confidence.
Results:
Responses were received from 156 and 300 consenting third- and fourth-year students, respectively. The mean total calving confidence score was higher in the fourth year (34.3/65) than in the third year (30.8/65, p < 0.05), and students from both years rarely rated themselves as being ‘confident’ or ‘very confident’ in 13 individual calving tasks. Having some previous experience (odds ratio [OR] 3.34), intending to work with cows (OR 3.25), being from Europe (OR 3) or North America (OR 2.72) and in the fourth year (OR 2.3) increased the odds (p < 0.01) of students having some calving confidence. Four main concerns were identified: myself, the task, the animal and the farmer. The students requested more real-life, practical exposure to improve their confidence.
Limitations:
Students were from a single UK veterinary school, and the study relied on self-reported confidence levels.
Conclusion:
Overall, students lacked confidence in calving cows and were concerned about many aspects of this high-stakes clinical scenario. Veterinary faculty and extramural study providers need to collaborate to develop students' confidence in this area before graduation
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