关键词： Group identification   Social choice   Decisiveness   Classification   Liberalism  

摘要： Group identification problems are introduced as the issue of classifying the members of a group in terms of the opinions of their potential members. This involves a finite set of agentsN= {1, 2, horizontal ellipsis ,n}, each one having an opinion about which agents should be classified as belonging to a specific subgroupJ. ACollective Identity Function(CIF) aggregates those opinions yielding the class of members deemedJ. A social planner postulate axioms, intended to ensure fair and socially desirable outcomes, characterizing different CIFs. We postulate axioms (classical and different to the ones found in the literature) constraining the spheres of influence of the agents. We show that some of them lead to different characterizations of the CIFs while in another instance we find an impossibility result.

摘要： BACKGROUND The hormonal response to surgical trauma can have detrimental effects on patients. Transversus abdominis plane (TAP) block, which can improve analgesia after total abdominal hysterectomy (TAH) might attenuate the peri-operative stress response. OBJECTIVE To evaluate the ability of the TAP block to reduce stress response, opioid consumption and pain following TAH and multimodal analgesia. DESIGN Randomised, placebo-controlled double-blind study. SETTING The current study was conducted at a university hospital from July 2016 to September 2017. PATIENTS Fifty patients scheduled for TAH were included. Anaesthesia and postoperative analgesia were standardised. INTERVENTION After induction of anaesthesia, patients were allocated into two groups: ultrasound-guided bilateral mid-axillary TAP block with 20 ml of bupivacaine 0.25% (Group T) or 0.9% saline (Group C). MAIN OUTCOME MEASURES Levels of free serum cortisol, metanephrine and normetanephrine at 60 min and 6, 12 and 24 h after surgical incision. Pain scores and opioid consumption during the first 24 h after surgery. RESULTS There was no statistically significant difference between the median [IQR] peri-operative levels of stress hormones and pain scores between groups. Compared with baseline value 9.90 [4.2 to 23.1], free serum median cortisol levels were significantly high at 6 h in Group T, 23.6 [10.1 to 42.9] P = 0.015 and Group C 23.6 [9.9 to 46.3] P = 0.014. Only Group C showed significant elevation from the baseline median levels of plasma metanephrine at 60 min, 52.8 [33.4 to 193.2] P = 0.001, 6 h, 92.70 [2.4 to 202.6] P = 0.005 and normetanephrine at 60 min 83.44 [28.98 to 114.86] P = 0.004, 6 h 78.62 [36.6 to 162.31] P = 0.0005 and 24 h 80.96 [8.6 to 110.5] P = 0.025. Mean +/- SD opioid consumption was similar in both groups: 39.60 +/- 14.87 in Group T vs. 43.68 +/- 14.93 in Group C (P = 0.338). CONCLUSION Mid-axillary TAP block does not improve stress response and analgesia in patients undergoing

摘要： We thank Ravnskov [1] for his interest in our recent publication [2]. In our study, low-density lipoprotein cholesterol (LDL-C) and Apolipoprotein B-100 (ApoB) almost doubled in young, healthy women when they followed the ketogenic low-carbohydrate high-fat (LCHF) diet. According to the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS) Guidelines for the management of dyslipidaemias [3] “…there is no longer an ‘LDL-C hypothesis’, but established facts that increased LDL-C values are causally related to atherosclerotic cardiovascular disease, and that lowering LDL particles and other ApoB-containing lipoproteins as much as possible reduces cardiovascular events.” Therefore, we think it is reasonable to conclude that the alterations in blood lipids reported in our study should be a cause for concern in young women following this kind of LCHF diet.

关键词： CDKN2A mutation   Metastatic renal cell carcinoma   Alternative splicing   p16   p14 expression   Percent-splice-in  

摘要： Objective: Metastatic renal cell carcinoma (mRCC) is the important factor for patient mortality, meanwhile gene mutation constantly changes cancer prognosis in tumor process. Exploring the driver mutation in mRCC process become more and more important. Materials and methods: We obtained the 15 paired primary and metastatic mRCC samples and analyzed specific mutation genes in the metastatic foci (SMGs) by next generation sequencing. Moreover, we explored the Correlated networks, Pathway and Gene Ontology (GO) enrichment results, prediction analysis of AS sites and prognosis of survival. Results: We identify EPCAM, TMEM127, EZH2, EXT1, CDKN2A, PRF1, AIP, CDK4, PRKARIA as SMGs and find that CDKN2A mutation sites affect the prognosis of mRCC by altering splicing elements. Based on the differential analysis for SMGs in KIRC, we found that EPCAM, PRF1 and EZH2 were differential expression in both primary tumors with metastasis compared to primary tumors without metastasis or metastatic tissues. By the AS prediction analysis, we suggest that CDKN2A mutation sites play an important role for RCC metastasis by affecting the p16/p14 expression. Conclusions: The SMGs could provide new molecular cues associated with tumor metastasis and have potential clinical implications for cancer prognosis and treatment. Definitive conclusions await further validation and follow up.

关键词： data compression   digital holography   phase unwrapping   optical field data  

摘要： We analyze several representations for holographic data and determine the effectiveness of a common lossy compression algorithm for each representation. We demonstrate that a phase-amplitude representation, when used to represent holograms of diffuse objects, can be combined with a phase unwrapping algorithm to achieve much higher compression ratios (CRs) than direct compression of the complex valued holographic data. We compare the compression performance of the JPEG algorithm for several conventional and alternative holographic data representations. Additionally, we test two different phase unwrapping algorithms to improve phase compression performance. In particular, we propose and evaluate an alternative phase representation based on a quality guided phase unwrapping algorithm. This alternative representation offers higher performance to the other tested approaches, achieving CRs over 6 with a limited quality loss after reconstruction. We add the experimental reconstruction of the processed holograms to further validate our proposal.

关键词： coronavirus   covid-19   diagnostics   nasal   nasopharyngeal   review   saliva   SARS-CoV-2  

摘要： The collection of nasopharyngeal swabs to test for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an invasive technique with implications for patients and clinicians. Alternative clinical specimens from the upper respiratory tract may offer benefits in terms of collection, comfort and infection risk. The objective of this review was to synthesise the evidence for detection of SARS-CoV-2 ribonucleic acid (RNA) using reverse transcription polymerase chain reaction (RT-PCR) tested saliva or nasal specimens compared with RT-PCR tested nasopharyngeal specimens. Searches were conducted in PubMed, Embase, Europe PMC and NHS evidence from December 2019 to 20 July 2020. Eighteen studies were identified;12 for saliva, four for nasal and two included both specimen types. For saliva-based studies, the proportion of saliva samples testing positive relative to all positive samples in each study ranged from 82.9% to 100%;detection in nasopharyngeal specimens ranged from 76.7% to 100%;positive agreement between specimens for overall detection ranged from 65.4% to 100%. For nasal-based studies, the proportion of nasal swabs testing positive relative to all positive samples in each study ranged from 81.9% to 100%;detection in nasopharyngeal specimens ranged from 70% to 100%;positive agreement between specimens for overall detection ranged from 62.3% to 100%. The results indicate an inconsistency in the detection of SARS-CoV-2 RNA in the specimen types included, often with neither the index nor the reference of interest detecting all known cases. Depending on the test environment, these clinical specimens may offer a viable alternative to standard. However, at present the evidence is limited, of variable quality, and relatively inconsistent.

摘要： Educators use entrustment, a common framework in competency-based medical education, in multiple ways, including frontline assessment instruments, learner feedback tools, and group decision making within promotions or competence committees. Within these multiple contexts, entrustment decisions can vary in purpose (i.e., intended use), stakes (i.e., perceived risk or consequences), and process (i.e., how entrustment is rendered). Each of these characteristics can be conceptualized as having 2 distinct poles: (1) purpose has formative and summative, (2) stakes has low and high, and (3) process has ad hoc and structured. For each characteristic, entrustment decisions often do not fall squarely at one pole or the other, but rather lie somewhere along a spectrum. While distinct, these continua can, and sometimes should, influence one another, and can be manipulated to optimally integrate entrustment within a program of assessment. In this article, the authors describe each of these continua and depict how key alignments between them can help optimize value when using entrustment in programmatic assessment within competency-based medical education. As they think through these continua, the authors will begin and end with a case study to demonstrate the practical application as it might occur in the clinical learning environment.

摘要： BACKGROUND Transversus abdominis plane (TAP) blocks have been shown to successfully reduce pain and opioid consumption after general and gynaecological surgery. OBJECTIVE To evaluate whether TAP blocks alleviate pain and opioid consumption after urological procedures. DESIGN A systematic review and meta-analysis. DATA SOURCES MEDLINE, Embase and CENTRAL. ELIGIBILITY CRITERIA Without language restriction, randomised controlled trials (RCTs) that compared the effects of TAP blocks with placebo or no treatment in urological surgery. MAIN OUTCOME MEASURES Primary outcomes were pain intensities at rest and movement at 6, 12 and 24 h after surgery. Secondary outcomes were postoperative opioid consumption in the first 24 h after surgery and postoperative nausea and vomiting. We performed meta-analyses using random effects models. Effect sizes were expressed as mean differences for continuous variables. We used the Cochrane risk of bias tool (RoB 2.0) to assess risk of bias. RESULTS We analysed 20 RCTs comprising a total of 1239 patients. The risk of bias of the studies was relatively high. TAP blocks significantly reduced postoperative pain at all time points compared with placebo or no treatment. Mean differences on an 11-point pain intensity scale were between 0.55 (95% CI: -0.90, to -0.21;P = 0.002;I-2 = 94%) to 1.13 (95% CI: -1.62 to -0.65;P I-2 = 95%) less at rest and 0.74 (95% CI: -1.25 to -0.23;P = 0.005;I-2 = 79%) to 1.32 (95% CI: -1.83 to -0.81;P I-2 = 68%) less on movements. TAP blocks also reduced opioid consumption in the first 24 h after surgery significantly by 12.25 mg (95% CI: -17.99 to -6.52 mg;P I-2 = 99%) morphine equivalents. Possibly, this had no influence on postoperative nausea and vomiting (risk ratio: 0.98;95% CI: 0.66 to 1.45;P = 0.91;I-2 = 30%). CONCLUSION TAP blocks seem to offer improved analgesia when used after urological surgery. However, due to the large heterogeneity between and the considerable risk of bias within the included studies res

关键词： heat stress   high temperature   high-light   net CO2 assimilation   PSII efficiency   Vigna unguiculata  

摘要： We explored the effects, on photosynthesis in cowpea (Vigna unguiculata) seedlings, of high temperature and light-environmental stresses that often co-occur under field conditions and can have greater impact on photosynthesis than either by itself. We observed contrasting responses in the light and carbon assimilatory reactions, whereby in high temperature, the light reactions were stimulated while CO2 assimilation was substantially reduced. There were two striking observations. Firstly, the primary quinone acceptor (Q(A)), a measure of the regulatory balance of the light reactions, became more oxidized with increasing temperature, suggesting increased electron sink capacity, despite the reduced CO2 fixation. Secondly, a strong, O-2-dependent inactivation of assimilation capacity, consistent with down-regulation of rubisco under these conditions. The dependence of these effects on CO2, O-2 and light led us to conclude that both photorespiration and an alternative electron acceptor supported increased electron flow, and thus provided photoprotection under these conditions. Further experiments showed that the increased electron flow was maintained by rapid rates of PSII repair, particularly at combined high light and temperature. Overall, the results suggest that photodamage to the light reactions can be avoided under high light and temperatures by increasing electron sink strength, even when assimilation is strongly suppressed.