Background
Pancreaticoduodenectomy (PD) is associated with a high incidence of postoperative complications including pancreatic fistula. This randomized clinical trial compared the incidence of ...pancreatic fistula between the isolated Roux‐en‐Y (IsoRY) and conventional reconstruction (CR) methods.
Methods
Patients admitted for PD between June 2009 and September 2012 in a single centre were assigned randomly to CR or IsoRY. The primary endpoint was the incidence of pancreatic fistula (grade A–C) defined according to the International Study Group on Pancreatic Fistula. Secondary endpoints were complication rates, mortality and hospital stay. Multiple logistic regression analysis was performed to identify factors associated with pancreatic fistula.
Results
Some 153 patients were randomized, 76 to CR and 77 to IsoRY; two patients from the IsoRY group were excluded after randomization. Pancreatic fistula occurred in 26 patients (34 per cent) in the CR group and 25 (33 per cent) in the IsoRY group (P = 0·909). The number of patients with a clinically relevant pancreatic fistula (grade B or C) was similar in the two groups (10 and 11 patients respectively; P = 0·789), as were complication rates (42 versus 40 per cent; P = 0·793) and mortality (none in either group; P = 0·999). Soft pancreas was the only independent risk factor for pancreatic fistula (odds ratio 4·42, 95 per cent confidence interval 1·85 to 10·53; P <0·001).
Conclusion
This study showed that IsoRY reconstruction does not reduce the incidence of pancreatic fistula compared with CR. Registration number: NCT00915863 (http://www.clinicaltrials.gov/) and UMIN000001967 (http://www.umin.ac.jp/).
No difference in pancreatic fistula
We propose EMD-L 1 : a fast and exact algorithm for computing the earth mover's distance (EMD) between a pair of histograms. The efficiency of the new algorithm enables its application to problems ...that were previously prohibitive due to high time complexities. The proposed EMD-L 1 significantly simplifies the original linear programming formulation of EMD. Exploiting the L 1 metric structure, the number of unknown variables in EMD-L 1 is reduced to O(N) from O(N 2 ) of the original EMD for a histogram with N bins. In addition, the number of constraints is reduced by half and the objective function of the linear program is simplified. Formally, without any approximation, we prove that the EMD-L 1 formulation is equivalent to the original EMD with a L 1 ground distance. To perform the EMD-L 1 computation, we propose an efficient tree-based algorithm, Tree-EMD. Tree-EMD exploits the fact that a basic feasible solution of the simplex algorithm-based solver forms a spanning tree when we interpret EMD-L 1 as a network flow optimization problem. We empirically show that this new algorithm has an average time complexity of O(N 2 ), which significantly improves the best reported supercubic complexity of the original EMD. The accuracy of the proposed methods is evaluated by experiments for two computation-intensive problems: shape recognition and interest point matching using multidimensional histogram-based local features. For shape recognition, EMD-L 1 is applied to compare shape contexts on the widely tested MPEG7 shape data set, as well as an articulated shape data set. For interest point matching, SIFT, shape context and spin image are tested on both synthetic and real image pairs with large geometrical deformation, illumination change, and heavy intensity noise. The results demonstrate that our EMD-L 1 -based solutions outperform previously reported state-of-the-art features and distance measures in solving the two tasks
Abstract
The recently discovered kagome superconductors
A
V
3
Sb
5
(
A
= K, Rb, Cs) exhibit unusual charge-density-wave (CDW) orders with time-reversal and rotational symmetry breaking. One of the ...most crucial unresolved issues is identifying the symmetry of the superconductivity that develops inside the CDW phase. Theory predicts a variety of unconventional superconducting symmetries with sign-changing and chiral order parameters. Experimentally, however, superconducting phase information in
A
V
3
Sb
5
is still lacking. Here we report the impurity effects in CsV
3
Sb
5
using electron irradiation as a phase-sensitive probe of superconductivity. Our magnetic penetration depth measurements reveal that with increasing impurities, an anisotropic fully-gapped state changes to an isotropic full-gap state without passing through a nodal state. Furthermore, transport measurements under pressure show that the double superconducting dome in the pressure-temperature phase diagram survives against sufficient impurities. These results support that CsV
3
Sb
5
is a non-chiral, anisotropic
s
-wave superconductor with no sign change both at ambient and under pressure.
Quantitative susceptibility mapping allows overcoming several nonlocal restrictions of susceptibility-weighted and phase imaging and enables quantification of magnetic susceptibility. We compared the ...diagnostic accuracy of quantitative susceptibility mapping and R2* (1/T2*) mapping to discriminate between patients with Parkinson disease and controls.
For 21 patients with Parkinson disease and 21 age- and sex-matched controls, 2 radiologists measured the quantitative susceptibility mapping values and R2* values in 6 brain structures (the thalamus, putamen, caudate nucleus, pallidum, substantia nigra, and red nucleus).
The quantitative susceptibility mapping values and R2* values of the substantia nigra were significantly higher in patients with Parkinson disease (P < .01); measurements in other brain regions did not differ significantly between patients and controls. For the discrimination of patients with Parkinson disease from controls, receiver operating characteristic analysis suggested that the optimal cutoff values for the substantia nigra, based on the Youden Index, were >0.210 for quantitative susceptibility mapping and >28.8 for R2*. The sensitivity, specificity, and accuracy of quantitative susceptibility mapping were 90% (19 of 21), 86% (18 of 21), and 88% (37 of 42), respectively; for R2* mapping, they were 81% (17 of 21), 52% (11 of 21), and 67% (28 of 42). Pair-wise comparisons showed that the areas under the receiver operating characteristic curves were significantly larger for quantitative susceptibility mapping than for R2* mapping (0.91 versus 0.69, P < .05).
Quantitative susceptibility mapping showed higher diagnostic performance than R2* mapping for the discrimination between patients with Parkinson disease and controls.
Background
The appropriate surgical procedure for patients with upper third early gastric cancer is controversial. We compared total gastrectomy (TG) with proximal gastrectomy (PG) in this patient ...population.
Methods
A multicenter, non-randomized trial was conducted, with patients treated with PG or TG. We compared short- and long-term outcomes between these procedures.
Results
Between 2009 and 2014, we enrolled 254 patients from 22 institutions; data from 252 were included in the analysis. These 252 patients were assigned to either the PG (
n
= 159) or TG (
n
= 93) group. Percentage of body weight loss (%BWL) at 1 year after surgery, i.e., the primary endpoint, in the PG group was significantly less than that of the TG group (− 12.8% versus − 16.9%;
p
= 0.0001). For short-term outcomes, operation time was significantly shorter for PG than TG (252 min versus 303 min;
p
< 0.0001), but there were no group-dependent differences in blood loss and postoperative complications. For long-term outcomes, incidence of reflux esophagitis in the PG group was significantly higher than that of the TG group (14.5% versus 5.4%;
p
= 0.02), while there were no differences in the incidence of anastomotic stenosis between the two (5.7% versus 5.4%;
p
= 0.92). Overall patient survival rates were similar between the two groups (3-year survival rates: 96% versus 92% in the PG and TG groups, respectively;
p
= 0.49).
Conclusions
Patients who underwent PG were better able to control weight loss without worsening the prognosis, relative to those in the TG group. Optimization of a reconstruction method to reduce reflux in PG patients will be important.
Enhanced electrochemical performance of LiFePO4 for Li-ion batteries has been anticipated by anion doping at the O-site rather than cation doping at the Fe-site. We report on the electrochemical ...performance of S-doped LiFePO4 nanoparticles synthesized by a solvothermal method using thioacetamide as a sulfur source. S-doping into the LiFePO4 matrix expands the lattice due to the larger ionic radius of S2− than that of O2−. The lattice parameters a and b increase by around 0.2% with sulfur content, while that of c remains almost unchanged with only 0.03% increase. The S-doping also contributes to the suppression of antisite defects (Fe occupying Li sites), which facilitates the easy migration of Li in the diffusion channels without blockage. Owing to these effects of S-doping, the S-doped LiFePO4 nanoparticles show enhanced electrochemical properties with a high discharge capacity of ∼113 mA h g−1 even at a high rate of 10C.
We have been developing a noncontact nondestructive testing technique for STPG370 pipes without removing insulation using magnetostrictive ultrasonic guided wave transceiver technology and a ...high-temperature superconducting (HTS)-superconducting quantum interference device (SQUID) gradiometer. In this study, a method to generate longitudinal guided waves by applying an excitation field parallel to the magnetization in a pipe was examined based on the magnetostrictive effect. For the magnetization, the entire circumference of the pipe is axially magnetized using two short cylindrical electromagnets. The magnetization conditions were computationally analyzed. The analysis results showed that an STPG370 pipe can be magnetized to a saturation flux density of approximately 1.7 T, even assuming practical insulation with a thickness of 20 mm. In experiments, the magnetic signals derived from the longitudinal guided waves generated by our method on an STPG370 pipe were measured by a differential pickup coil, which was set on the receiver part on the pipe, based on the inverse magnetostrictive effect. The signal measured by the coil was read by the HTS-SQUID gradiometer, which was inductively coupled with the coil. Consequently, a slit on the pipe was detected.
In this study, rainfall data are prepared at a 0.01° scale using 16-yr spaceborne radar data over the area of 36.13°S–36.13°N as provided by the Tropical Rainfall Measuring Mission (TRMM) ...Precipitation Radar (PR). A spatial resolution that is finer than the field of view is obtained by assuming rainfall uniformity within an instantaneous footprint centered on the PR footprint geolocation. These ultra-high-resolution data reveal local rainfall concentrations over slope areas. A new estimate of the maximum rainfall at Cherrapunji, India, was observed on the valley side, approximately 5 km east of the gauge station, and is approximately 50% higher than the value indicated by the 0.1°-scale data. A case study of Yakushima Island, Japan, indicates that several percent of the sampling error arising from the spatial mismatch may be contained in conventional 0.05°-scale datasets generated without footprint areal information. The differences attributable to the enhancement in the resolution are significant in complex terrain such as the Himalayas. The differences in rainfall averaged for the 0.1° and 0.01° scales exceed 10 mm day−1 over specific slope areas. In the case of New Guinea, the mean rainfall on a mountain ridge can be 30 times smaller than that on an adjacent slope at a distance of 0.25°; this is not well represented by other high-resolution datasets based on gauges and infrared radiometers. The substantial nonuniformity of rainfall climatology highlights the need for a better understanding of kilometer-scale geographic constraints on rainfall and retrieval approaches.
Calves are fed milk and milk replacer for their growth until approximately 2 mo after birth. During this period, their abomasa produce curd and whey from milk. It has been thought that curd formation ...is important for digestion and absorption of milk nutrients and immune substances in calves. However, no study has been done observing abomasal contents in neonatal calves after first ingestion of first milking colostrum. Here we report curd formation in neonatal calves and its physiological function with a focus on immunoglobulin absorption. We first examined curd formation by ultrasonography in 3 neonatal calves after first ingestion of first-milking colostrum. Between 0.5 and 8 h after colostrum ingestion, a curd was visualized as a large echogenic image with a clear outline, which was surrounded by an anechoic image corresponding to whey. We next compared serum IgG and IgA concentrations in 10 calves fed the pooled colostrum and 7 calves fed the whey solution that did not coagulate into curds. Serum from 1 calf in the pooled colostrum sample set was excluded due to incomplete curd formation in that the whole colostrum did not coagulate into a large mass of curd and a portion of the colostrum remained as its residue caseins detectable from the abomasal fluid. Serum IgG and IgA concentrations were significantly higher in the 9 calves fed the colostrum than the 7 calves fed the whey solution. One calf exhibiting incomplete curd formation showed low levels of serum IgG and IgA after ingestion, similar to the calves fed the whey solution. These results indicate that curd formation is associated with IgG and IgA absorption in neonatal calves after first ingestion of colostrum.
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