We present the Lambda Adaptive Multi-Band Deblending Algorithm in R (lambdar), a novel code for calculating matched aperture photometry across images that are neither pixel- nor PSF-matched, using ...prior aperture definitions derived from high-resolution optical imaging. The development of this program is motivated by the desire for consistent photometry and uncertainties across large ranges of photometric imaging, for use in calculating spectral energy distributions. We describe the program, specifically key features required for robust determination of panchromatic photometry: propagation of apertures to images with arbitrary resolution, local background estimation, aperture normalization, uncertainty determination and propagation, and object deblending. Using simulated images, we demonstrate that the program is able to recover accurate photometric measurements in both high-resolution, low-confusion, and low-resolution, high-confusion, regimes. We apply the program to the 21-band photometric data set from the Galaxy And Mass Assembly (GAMA) Panchromatic Data Release (PDR; Driver et al. 2016), which contains imaging spanning the far-UV to the far-IR. We compare photometry derived from lambdar with that presented in Driver et al. (2016), finding broad agreement between the data sets. None the less, we demonstrate that the photometry from lambdar is superior to that from the GAMA PDR, as determined by a reduction in the outlier rate and intrinsic scatter of colours in the lambdar data set. We similarly find a decrease in the outlier rate of stellar masses and star formation rates using lambdar photometry. Finally, we note an exceptional increase in the number of UV and mid-IR sources able to be constrained, which is accompanied by a significant increase in the mid-IR colour–colour parameter-space able to be explored.
Although transcatheter aortic-valve replacement (TAVR) is an accepted alternative to surgery in patients with severe aortic stenosis who are at high surgical risk, less is known about comparative ...outcomes among patients with aortic stenosis who are at intermediate surgical risk.
We evaluated the clinical outcomes in intermediate-risk patients with severe, symptomatic aortic stenosis in a randomized trial comparing TAVR (performed with the use of a self-expanding prosthesis) with surgical aortic-valve replacement. The primary end point was a composite of death from any cause or disabling stroke at 24 months in patients undergoing attempted aortic-valve replacement. We used Bayesian analytical methods (with a margin of 0.07) to evaluate the noninferiority of TAVR as compared with surgical valve replacement.
A total of 1746 patients underwent randomization at 87 centers. Of these patients, 1660 underwent an attempted TAVR or surgical procedure. The mean (±SD) age of the patients was 79.8±6.2 years, and all were at intermediate risk for surgery (Society of Thoracic Surgeons Predicted Risk of Mortality, 4.5±1.6%). At 24 months, the estimated incidence of the primary end point was 12.6% in the TAVR group and 14.0% in the surgery group (95% credible interval Bayesian analysis for difference, -5.2 to 2.3%; posterior probability of noninferiority, >0.999). Surgery was associated with higher rates of acute kidney injury, atrial fibrillation, and transfusion requirements, whereas TAVR had higher rates of residual aortic regurgitation and need for pacemaker implantation. TAVR resulted in lower mean gradients and larger aortic-valve areas than surgery. Structural valve deterioration at 24 months did not occur in either group.
TAVR was a noninferior alternative to surgery in patients with severe aortic stenosis at intermediate surgical risk, with a different pattern of adverse events associated with each procedure. (Funded by Medtronic; SURTAVI ClinicalTrials.gov number, NCT01586910 .).
Consisting of ≈10(14) microbial cells, the intestinal microbiota represents the largest and the most complex microbial community inhabiting the human body. However, the influence of regular diets on ...the microbiota is widely unknown.
We examined faecal samples of vegetarians (n=144), vegans (n=105) and an equal number of control subjects consuming ordinary omnivorous diet who were matched for age and gender. We used classical bacteriological isolation, identification and enumeration of the main anaerobic and aerobic bacterial genera and computed absolute and relative numbers that were compared between groups.
Total counts of Bacteroides spp., Bifidobacterium spp., Escherichia coli and Enterobacteriaceae spp. were significantly lower (P=0.001, P=0.002, P=0.006 and P=0.008, respectively) in vegan samples than in controls, whereas others (E. coli biovars, Klebsiella spp., Enterobacter spp., other Enterobacteriaceae, Enterococcus spp., Lactobacillus spp., Citrobacter spp. and Clostridium spp.) were not. Subjects on a vegetarian diet ranked between vegans and controls. The total microbial count did not differ between the groups. In addition, subjects on a vegan or vegetarian diet showed significantly (P=0.0001) lower stool pH than did controls, and stool pH and counts of E. coli and Enterobacteriaceae were significantly correlated across all subgroups.
Maintaining a strict vegan or vegetarian diet results in a significant shift in the microbiota while total cell numbers remain unaltered.
Shield back-face deformation (BFD) is the result of composite ballistic shields deflecting or absorbing a projectile’s energy and deforming towards the user. BFD can result in localized loading to ...the upper extremity, where the shield is secured to the user. An augmented anthropomorphic test device upper extremity was used to quantify this applied load. Four locations along the upper extremity were tested—the hand, wrist, forearm, and elbow—for investigating differing boundary conditions and their effect on resultant load. Varying stand-off distances, the distance between the back of the shield and the force sensor, were investigated. Digital image correlation was also conducted to measure the dynamic displacement of the shield. The mean peak back-face velocity of the shield was 208.4 ± 38.8 m/s, while the average affected area was 1505 ± 158.3 mm
2
. Impulse was not significantly affected by anatomical location for the same stand-off distance; however, as stand-off distance decreased, the measured force significantly increased (
p
< 0.05). Notably, impact duration did not differ significantly for any of the impact scenarios. This is the first step in developing injury criteria for this region resulting from behind shield blunt trauma, and these data will be used for developing injury thresholds in post-mortem human surrogates.
Aim
To assess the added value of Near InfraRed Fluorescence (NIRF) imaging during laparoscopic cholecystectomy.
Methods
This international multicentre randomized controlled trial included ...participants with an indication for elective laparoscopic cholecystectomy. Participants were randomised into a NIRF imaging assisted laparoscopic cholecystectomy (NIRF-LC) group and a conventional laparoscopic cholecystectomy (CLC) group. Primary end point was time to ‘Critical View of Safety’ (CVS). The follow-up period of this study was 90 postoperative days. An expert panel analysed the video recordings after surgery to confirm designated surgical time points.
Results
A total of 294 patients were included, of which 143 were randomized in the NIRF-LC and 151 in the CLC group. Baseline characteristics were equally distributed. Time to CVS was on average 19 min and 14 s for the NIRF-LC group and 23 min and 9 s for the CLC group (
p
0.032). Time to identification of the CD was 6 min and 47 s and 13 min for NIRF-LC and CLC respectively (
p
< 0.001). Transition of the CD in the gallbladder was identified after an average of 9 min and 39 s with NIRF-LC, compared to 18 min and 7 s with CLC (
p
< 0.001). No difference in postoperative length of hospital stay nor occurrence of postoperative complications was found. ICG related complications were limited to one patient who developed a rash after injection of ICG.
Conclusion
Use of NIRF imaging in laparoscopic cholecystectomy provides earlier identification of relevant extrahepatic biliary anatomy: earlier achievement of CVS, cystic duct visualisation and visualisation of both cystic duct and cystic artery transition into the gallbladder.
The cortical underconnectivity theory asserts that reduced long-range functional connectivity might contribute to a neural mechanism for autism. We examined resting-state blood oxygen level-dependent ...interhemispheric correlation in 53 males with high-functioning autism and 39 typically developing males from late childhood through early adulthood. By constructing spatial maps of correlation between homologous voxels in each hemisphere, we found significantly reduced interhemispheric correlation specific to regions with functional relevance to autism: sensorimotor cortex, anterior insula, fusiform gyrus, superior temporal gyrus, and superior parietal lobule. Observed interhemispheric connectivity differences were better explained by diagnosis of autism than by potentially confounding neuropsychological metrics of language, IQ, or handedness. Although both corpus callosal volume and gray matter interhemispheric connectivity were significantly reduced in autism, no direct relationship was observed between them, suggesting that structural and functional metrics measure different aspects of interhemispheric connectivity. In the control but not the autism sample, there was decreasing interhemispheric correlation with subject age. Greater differences in interhemispheric correlation were seen for more lateral regions in the brain. These findings suggest that long-range connectivity abnormalities in autism are spatially heterogeneous and that transcallosal connectivity is decreased most in regions with functions associated with behavioral abnormalities in autism. Autism subjects continue to show developmental differences in interhemispheric connectivity into early adulthood.
The use of water vapor selective membranes can reduce the energy requirement for extracting water out of humid air by more than 50%. We performed a system analysis of a proposed unit, that uses ...membranes to separate water vapor from other atmospheric gases. This concentrated vapor can then be condensed specifically, rather than cooling the whole body of air. The driving force for the membrane permeation is maintained with a condenser and a vacuum pump. The pump regulates the total permeate side pressure by removing non-condensable gases that leak into the system. We show that by introducing a low-pressure, recirculated, sweep stream, the total permeate side pressure can be increased without impairing the water vapor permeation. This measure allows energy efficiency even in the presence of leakages, as it significantly lowers the power requirements of the vacuum pump.
Such a constructed atmospheric water generator with a power of 62kW could produce 9.19m3/day of water (583MJ/m3) as compared to 4.45m3/day (1202MJ/m3) that can be condensed without membranes. Due to the physical barrier the membrane imposes, fresh water generated in this manner is also cleaner and of higher quality than water condensed directly out of the air.
Display omitted
•Membranes reduce the energy costs of atmospheric water generation by more than 50%.•We propose a model system to concentrate water vapor with membranes prior to cooling.•A system analysis is performed and ideal operational conditions determined.•A low pressure sweep allows energy efficiency even in the presence of leak-ages.•The quality of the condensed water improves by the use of membranes.
Background
Data on chronic pain after kidney donation are sparse. The aim of this study was to assess the incidence of chronic pain after hand‐assisted laparoscopic nephrectomy.
Methods
Living kidney ...donors who donated between 2011 and 2017 at the University Medical Centre Groningen were included. All patients underwent hand‐assisted laparoscopic donor nephrectomy. Postdonation pain and movement disabilities were assessed using the Carolinas Comfort Scale (CCS) and a visual analogue scale (VAS). The prevalence, severity of pain and the need for analgesics were reported.
Results
Some 333 living kidney donors with a mean age of 56 years were included. At a median of 19 (i.q.r. 10–33) months after donation, 82 donors (24·6 per cent) had a CCS score above 0, of which 58 (71 per cent) had a CCS score of at least 2 and 57 (70 per cent) reported movement limitations. Some 110 donors (33·0 per cent) had a VAS score of more than 0. Complaints mainly occurred during bending over (12·3 per cent) and exercising (12·4 per cent). Thirty‐two donors (9·7 per cent) required analgesics during follow‐up between donation and the time of measurement, and six of 82 (7 per cent) reported chronic inguinal pain. In multivariable analysis, donor age (odds ratio (OR) 0·97, 95 per cent c.i. 0·95 to 0·99; P = 0·020) and length of hospital stay (OR 1·21, 1·01 to 1·51; P = 0·041) were independently associated with chronic pain.
Conclusion
One‐quarter of donors experienced chronic postdonation pain or discomfort, most of which was bothersome. Younger donors and those with a longer postoperative hospital stay had more symptoms.
Living donor nephrectomy is associated with chronic pain in 25 per cent of donors. Complaints occur during bending over and exercising. Younger donors and donors with a longer hospital stay had more complaints.
Significant in a quarter of patients
We present an improved analysis of the final data set from the QUaD experiment. Using an improved technique to remove ground contamination, we double the effective sky area and hence increase the ...precision of our cosmic microwave background (CMB) power spectrum measurements by ~30% versus that previously reported. In addition, we have improved our modeling of the instrument beams and have reduced our absolute calibration uncertainty from 5% to 3.5% in temperature. The robustness of our results is confirmed through extensive jackknife tests, and by way of the agreement that we find between our two fully independent analysis pipelines. For the standard six-parameter Delta *LCDM model, the addition of QUaD data marginally improves the constraints on a number of cosmological parameters over those obtained from the WMAP experiment alone. The impact of QUaD data is significantly greater for a model extended to include either a running in the scalar spectral index, or a possible tensor component, or both. Adding both the QUaD data and the results from the Arcminute Cosmology Bolometer Array Receiver experiment, the uncertainty in the spectral index running is reduced by ~25% compared to WMAP alone, while the upper limit on the tensor-to-scalar ratio is reduced from r < 0.48 to r < 0.33 (95% c.l.). This is the strongest limit on tensors to date from the CMB alone. We also use our polarization measurements to place constraints on parity-violating interactions to the surface of last scattering, constraining the energy scale of Lorentz violating interactions to <1.5 X 10-43 GeV (68% c.l.). Finally, we place a robust upper limit on the strength of the lensing B-mode signal. Assuming a single flat band power between = 200 and = 2000, we constrain the amplitude of B-modes to be <0.57 Delta *mK2 (95% c.l.).
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