Operational Interpretation Research Articles

Post-graduate training in Laboratory Medicine: Potential to fill a crucial gap in Indian healthcare system

Quality Laboratory services with a widespread reach is the core of a healthcare system of the country. Diagnostic services at all levels requires technical expertise of different laboratory specialists. However the presence of all specialist together in one setup is always not possible due to limited number of trained manpower. Even today, diagnostic laboratory services remain unsupervised. To void this gap, All India Institute of Medical Sciences (AIIMS) New Delhi, in 1988, opened up the patient-centric department of Laboratory Medicine with a centralised specimen collection centre and a core laboratory performing the majority of the routine laboratory investigations, offering a one-window solution to both patients and clinicians. In 1997, a three-year postgraduate Masters degree (MD) in Laboratory Medicine was started. This medical specialty encompasses the art of test selection, test operation, and test interpretation to manage patients. It aligns with the recent technological advancement of automation and advanced instrumentation that are breaking boundaries of the traditional medical laboratories of pathology, biochemistry, and microbiology. This postgraduate model ensures that the laboratory services are accessible, affordable, and available to both patients and clinicians without compromising quality care. Laboratory Medicine is emerging as an answer to one of the several inadequacies and pitfalls of the Indian health system.

Post-infarct VT substrate ablation based on evoked delayed potential elimination as well-defined target : results from a prospective multicenter study

Abstract Funding Acknowledgements Type of funding sources: None. Background Substrate ablation is superior to approaches that target clinical and tolerated VTs in patients with post-myocardial infarction (MI) VT. Different substrate modification strategies have been reported. However, proposed ablation targets are prone to operator interpretation (e.g. abnormal electrograms). Accordingly, ablation results can also be operator dependent. Evoked delayed potentials (EDP) are a well-defined target. Elimination of EDP has been effective to prevent VT recurrence in a retrospective, single center cohort. Aim (1)To evaluate the outcome of EDP ablation in a prospective cohort of patients included on an intention-to-treat principle and (2)to assess the outcome of EDP ablation following one uniform protocol when performed in centers without prior experience with this strategy. Methods Consecutive patients referred for post-MI VT ablation were prospectively enrolled in one center with extensive experience in EDP ablation and 5 centers with no prior experience. Substrate mapping focused on EDP identification followed a uniform protocol across all centers. In brief, all electrograms located within the infarct area were analyzed during sinus rhythm, RV pacing at a fixed rate and during the application of one short-coupled RV extra (S2). Sites showing low-voltage, nearfield electrograms with >10ms delay or block in response to S2 were categorized as EDP and targeted for ablation. After ablation, re-mapping to confirm EDP elimination and a complete stimulation protocol (up to 4 extra’s from RV and LV) were performed. Results 131 patients (69±10 years, 87% men, 42% anterior MI, LVEF 33±11%, 70% NYHA II-III, 43% on amiodarone, 52% ≥1 ICD shock, 34% with electrical storm or incessant VT) were included. Multipolar catheters or catheters with micro-electrodes in the tip were used in 53%. The extra-stimulation protocol was systematically conducted in 127 (97% ) patients and in 121 (92%), EDPs were identified. EDPs were successfully eliminated in 117/121 (97%) patients. After 23 (IQR 14-35) min of RF, 101 (77%) patients were rendered non-inducible. Median procedural duration was 213 (IQR 180-267) min. During follow-up of 14 (IQR 8-19) months, 36 (27%) patients had VT recurrence and 14 (11%) died or received a LVAD. VT-free survival was 78% (CI95% 71-85) and 71% (CI95% 63-80) at 6 and 12 months follow-up. Of note, VT-free survival at 12 month was not significantly different between patients undergoing the procedure in centers with and without prior experience in EDP ablation (76% (CI95% 62-90) vs. 69% (CI95% 59-80); P=0.269). Conclusion In a large prospective cohort of patients with post-MI VT, substrate ablation based on EDP elimination resulted in excellent long-term outcome. Of importance, procedural outcomes were similar in centers with or without experience in EDP ablation, indicating that this approach can be easily reproduced by operators previously not familiar with the technique.

An Operational Environment for Quantum Self-Testing

Observed quantum correlations are known to determine in certain cases the underlying quantum state and measurements. This phenomenon is known as (quantum) self-testing.Self-testing constitutes a significant research area with practical and theoretical ramifications for quantum information theory. But since its conception two decades ago by Mayers and Yao, the common way to rigorously formulate self-testing has been in terms of operator-algebraic identities, and this formulation lacks an operational interpretation. In particular, it is unclear how to formulate self-testing in other physical theories, in formulations of quantum theory not referring to operator-algebra, or in scenarios causally different from the standard one.In this paper, we explain how to understand quantum self-testing operationally, in terms of causally structured dilations of the input-output channel encoding the correlations. These dilations model side-information which leaks to an environment according to a specific schedule, and we show how self-testing concerns the relative strength between such scheduled leaks of information. As such, the title of our paper has double meaning: we recast conventional quantum self-testing in terms of information-leaks to an environment – and this realises quantum self-testing as a special case within the surroundings of a general operational framework.Our new approach to quantum self-testing not only supplies an operational understanding apt for various generalisations, but also resolves some unexplained aspects of the existing definition, naturally suggests a distance measure suitable for robust self-testing, and points towards self-testing as a modular concept in a larger, cryptographic perspective.

Bilateral bifid canines in mandible: A CBCT study of a rare case

Developmental disturbances such as change in tooth shape, size and number are recognized conditions. One such anomaly is supernumerary root. The condition is more common in molars than in anterior teeth. The studies have however shown the variation in the morphology of single rooted mandibular canine. Adding to the literature is this case report which presents impacted mandibular canine with two roots and root canals using CBCT. The awareness of these variations through varying research materials is a must. The success of treatment depends on internal and external anatomy of tooth as well. Thereby, lack of knowledge of these anatomical aberrations could lead to failure of treatment, especially endodontic treatment. Proper pre operative imaging and interpretation is a key to hike success rates with anatomical complexities and variabilities.

Evaluation of inter-user variability in indocyanine green fluorescence angiography to assess gastric conduit perfusion in esophageal cancer surgery.

Indocyanine Green Fluorescence Angiography (ICGFA) has been deployed to tackle malperfusion-related anastomotic complications. This study assesses variations in operator interpretation of pre-anastomotic ICGFA inflow in the gastric conduit. Utilizing an innovative online interactive multimedia platform (Mindstamp), esophageal surgeons completed a baseline opinion-practice questionnaire and proceeded to interpret, and then digitally assign, a distal transection point on 8 ICGFA videos of esophageal resections (6 Ivor Lewis, 2 McKeown). Annotations regarding gastric conduit transection by ICGFA were compared between expert users versus non-expert participants using ImageJ to delineate longitudinal distances with Shapiro Wilk and t-tests to ascertain significance. Expert versus non-expert correlation was assessed via Intraclass Correlation Coefficients (ICC). Thirty participants (13 consultants, 6 ICGFA experts) completed the study in all aspects. Of these, a high majority (29 participants) stated ICGFA should be used routinely with most (21, including 5/6 experts) stating that 11-50 cases were needed for competency in interpretation. Among users, there were wide variations in dosing (0.05-3mg/kg) and practice impact. Agreement regarding ICGFA video interpretation concerning transection level among experts was 'moderate' (ICC = 0.717) overall but 'good' (ICC = 0.871) among seven videos with Leave One Out (LOO) exclusion of the video with highest disagreement. Agreement among non-experts was moderate (ICC = 0.641) overall and in every subgroup including among consultants (ICC = 0.626). Experts choose levels that preserved more gastric conduit length versus non-experts in all but one video (P = 0.02). Considerable variability exists with ICGFA interpretation and indeed impact. Even adept users may be challenged in specific cases. Standardized training and/or computerized quantitative fluorescence may help better usage.

Quantum channel marginal problem

Given a set of local dynamics, are they compatible with a global dynamics? We systematically formulate these questions as quantum channel marginal problems. These problems are strongly connected to the generalization of the no-signaling conditions to quantized inputs and outputs and can be understood as a general toolkit to study notions of quantum incompatibility. In fact, they include as special cases channel broadcasting, channel extendibility, measurement compatibility, and state marginal problems. After defining the notion of compatibility between global and local dynamics, we provide a solution to the channel marginal problem that takes the form of a semidefinite program. Using this formulation, we construct channel incompatibility witnesses, discuss their operational interpretation in terms of an advantage for a state-discrimination task, prove a gap between classical and quantum dynamical marginal problems and show that the latter is irreducible to state marginal problems.

Probabilistic Transformations of Quantum Resources.

The difficulty in manipulating quantum resources deterministically often necessitates the use of probabilistic protocols, but the characterization of their capabilities and limitations has been lacking. We develop a general approach to this problem by introducing a new resource monotone that obeys a very strong type of monotonicity: it can rule out all transformations, probabilistic or deterministic, between states in any quantum resource theory. This allows us to place fundamental limitations on state transformations and restrict the advantages that probabilistic protocols can provide over deterministic ones, significantly strengthening previous findings and extending recent no-go theorems. We apply our results to obtain a substantial improvement in bounds for the errors and overheads of probabilistic distillation protocols, directly applicable to tasks such as entanglement or magic state distillation, and computable through convex optimization. In broad classes of resources, we strengthen our results to show that the monotone completely governs probabilistic transformations-it serves as a necessary and sufficient condition for state convertibility. This endows the monotone with a direct operational interpretation, as it can exactly quantify the highest fidelity achievable in resource distillation tasks by means of any probabilistic manipulation protocol.

A Novel Approach to the Partial Information Decomposition.

We consider the “partial information decomposition” (PID) problem, which aims to decompose the information that a set of source random variables provide about a target random variable into separate redundant, synergistic, union, and unique components. In the first part of this paper, we propose a general framework for constructing a multivariate PID. Our framework is defined in terms of a formal analogy with intersection and union from set theory, along with an ordering relation which specifies when one information source is more informative than another. Our definitions are algebraically and axiomatically motivated, and can be generalized to domains beyond Shannon information theory (such as algorithmic information theory and quantum information theory). In the second part of this paper, we use our general framework to define a PID in terms of the well-known Blackwell order, which has a fundamental operational interpretation. We demonstrate our approach on numerous examples and show that it overcomes many drawbacks associated with previous proposals.

A template for the validation of DART-MS for qualitative seized drugs analysis

Direct analysis in real time mass spectrometry (DART-MS) is an increasingly employed tool for a wide range of forensic applications, including seized drug analysis. A significant body of research surrounds DART-MS for the analysis of seized drugs and how it can be used to address many of the challenges caused by the increased presence of emerging drugs and novel psychoactive substances. A lack of available resources to help address validation, operation, training, and data interpretation needs is just one of the hurdles that laboratories face when adopting new technologies, such as DART-MS. To provide additional resources to assist in validation development, this paper provides a template that can be adopted or adapted for implementation of DART-MS, or other ambient ionization mass spectrometry techniques, for qualitative seized drug analysis. The template, which was created as a result of recent implementation efforts, provides a description of validation studies with a focus on understanding the potential challenges and limitations caused by the prevalence of novel psychoactive substances and other emerging drugs. The studies address accuracy and precision, reproducibility, specificity, sensitivity, environmental factors, use in casework, and robustness. In addition to providing a template for validation, the results obtained from completing these studies on two high-resolution DART-MS systems are also presented. This work, and the corresponding supplemental information, was compiled to add to the available resources that laboratories can leverage to assist in overcoming the hurdles of adopting ambient ionization mass spectrometry methods such as DART-MS.

What is entropy? A perspective from games of chance.

The crucial role of channels in physics and information theory motivates the task of characterizing the entropy, or uncertainty, of a channel. Games of chance become a natural candidate for this task, as a system's performance in a gambling game depends solely on the uncertainty of its output. In this work, we construct families of games that induce preorders corresponding to majorization, conditional majorization, and channel majorization. Finally, we provide operational interpretations for all preorders, show the relevance of these results to dynamical resource theories, and find the only asymptotically continuous classical channel entropy.

Properties of Noncommutative Rényi and Augustin Information

R\'enyi and Augustin information are generalizations of mutual information defined via the R\'enyi divergence, playing a significant role in evaluating the performance of information processing tasks by virtue of its connection to the error exponent analysis. In quantum information theory, there are three generalizations of the classical R\'enyi divergence -- the Petz's, sandwiched, and log-Euclidean versions, that possess meaningful operational interpretation. However, the associated quantum R\'enyi and Augustin information are much less explored compared with their classical counterpart, and lacking crucial properties hinders applications of these quantities to error exponent analysis in the quantum regime. The goal of this paper is to analyze fundamental properties of the R\'enyi and Augustin information from a noncommutative measure-theoretic perspective. Firstly, we prove the uniform equicontinuity for all three quantum versions of R\'enyi and Augustin information, and it hence yields the joint continuity of these quantities in order and prior input distributions. Secondly, we establish the concavity of the scaled R\'enyi and Augustin information in the region of $s\in(-1,0)$ for both Petz's and the sandwiched versions. This completes the open questions raised by Holevo [IEEE Trans.~Inf.~Theory, 46(6):2256--2261, 2000], and Mosonyi and Ogawa [Commun.~Math.~Phys., 355(1):373--426, 2017]. For the applications, we show that the strong converse exponent in classical-quantum channel coding satisfies a minimax identity, which means that the strong converse exponent can be attained by the best constant composition code. The established concavity is further employed to prove an entropic duality between classical data compression with quantum side information and classical-quantum channel coding, and a Fenchel duality in joint source-channel coding with quantum side information.

Power Normalizations in Fine-Grained Image, Few-Shot Image and Graph Classification.

Power Normalizations (PN) are useful non-linear operators which tackle feature imbalances in classification problems. We study PNs in the deep learning setup via a novel PN layer pooling feature maps. Our layer combines the feature vectors and their respective spatial locations in the feature maps produced by the last convolutional layer of CNN into a positive definite matrix with second-order statistics to which PN operators are applied, forming so-called Second-order Pooling (SOP). As the main goal of this paper is to study Power Normalizations, we investigate the role and meaning of MaxExp and Gamma, two popular PN functions. To this end, we provide probabilistic interpretations of such element-wise operators and discover surrogates with well-behaved derivatives for end-to-end training. Furthermore, we look at the spectral applicability of MaxExp and Gamma by studying Spectral Power Normalizations (SPN). We show that SPN on the autocorrelation/covariance matrix and the Heat Diffusion Process (HDP) on a graph Laplacian matrix are closely related, thus sharing their properties. Such a finding leads us to the culmination of our work, a fast spectral MaxExp which is a variant of HDP for covariances/autocorrelation matrices. We evaluate our ideas on fine-grained recognition, scene recognition, and material classification, as well as in few-shot learning and graph classification.

Bringing anatomy to life: Evaluating a novel ultrasound curriculum in the anatomy laboratory.

As point-of-care ultrasound (POCUS) invades medical specialties, more students covet earlier ultrasound (US) training programs in medical school. Determining the optimal placement and format in the curriculum remains a challenge. This study uses student perceptions and confidence in interpreting and acquiring images to evaluate the effectiveness of an US curriculum and assesses their performance on US content. A unique US curriculum was incorporated into first-year clinical anatomy at Tufts University School of Medicine (TUSM). Students completed surveys evaluating changes in US confidence and perceptions. Mean ratings on pre- and post-surveys were compared using Mann-Whitney U tests. Performance on US examination questions was evaluated. Two independent evaluators coded narrative responses and NVivo software was used to identify common themes. Two hundred eleven students completed the US curriculum. Students reported higher post-curriculum mean confidence ratings on US comprehension, operation, image acquisition, artifact recognition, and normal image interpretation (P < 0.0001). US reinforced anatomy concepts and clinical correlates (9.56, ±0.97 SD; 9.60, ±1.05). Students disagreed with items stating learning US is too difficult (1.2, ±2.2) and that it interferes with learning anatomy (0.68, ±1.7). Students scored above passing on practical US knowledge questions, supporting survey data, and the relation to learning spatial relationships. Qualitative analysis identified seven major themes and additional subthemes. Limited integration of US breaks barriers in students' perceptions and confidence in performing POCUS. The TUSM US curriculum is a natural marriage of anatomy and POCUS applications, serving as a template for medical schools.

Quantum postselective measurements: Sufficient condition for overcoming the Holevo bound and the role of max-relative entropy

The operation of unambiguous state discrimination (USD) plays an important role in quantum information theory. Here, we study the generalization for this operation which can be applied where USD is not available, including the case of completely coinciding supports. We demonstrate the effect of overcoming the Holevo bound after postselective measurements, which works for a class of ensembles, including two arbitrary noncommuting quantum states. We also discuss the role of max-relative entropy in postselective measurements and give an alternative operational interpretation for this function.

A Recursive Algorithm for the Forward Kinematic Analysis of Robotic Systems Using Euler Angles

Forward kinematics is one of the main research fields in robotics, where the goal is to obtain the position of a robot’s end-effector from its joint parameters. This work presents a method for achieving this using a recursive algorithm that builds a 3D computational model from the configuration of a robotic system. The orientation of the robot’s links is determined from the joint angles using Euler Angles and rotation matrices. Kinematic links are modeled sequentially, the properties of each link are defined by its geometry, the geometry of its predecessor in the kinematic chain, and the configuration of the joint between them. This makes this method ideal for tackling serial kinematic chains. The proposed method is advantageous due to its theoretical increase in computational efficiency, ease of implementation, and simple interpretation of the geometric operations. This method is tested and validated by modeling a human-inspired robotic mobile manipulator (CHARMIE) in Python.

Информационные операции НАТО и их влияние на современную международную политику

The article examines the definition of NATO information operations and specifics of their conduct pertaining to certain examples, including those against the Russian Federation. The scientific relevance of the chosen research topic is due to its insufficient study in political science in view of the novelty of the chosen issues. The purpose of this study is to analyze the features of NATO information operations as well as their main international consequences with special regard to issues associated with Russia. This policy analysis is achievable through the application of an interdisciplinary approach to highlighting the various stages of defining NATO information operations through historical, political and psychological analysis of the distinct aspects of such operations. The theory of information operations is based on the works of the classics of political communication, such as G. D. Lasswell and B. McNair, who discussed in detail the tactics of manipulation and propaganda, as well as P. Lazarsfeld and R. K. Merton, C. E. Merriam, T. V. Adorno, and G. Marcuse, whose research is concerned with explaining the spread of ideas through various media in order to influence the mass consciousness within a collective social entity. Among the Russian authors, it is worth noting the works of M. M. Lebedeva on the stereotypes of mass consciousness in the conditions of international conflicts. The research of T. V. Evgen’eva can be used as a basic guide to the interpretation of modern information operations. To support their standpoint, the author provides detailed analysis of how information operations can be defined and divided into stages. The analysis is entwined with vivid examples of information operations conduct, particularly, amid NATO humanitarian interventions, the Sergey Skripal attack, the HMS Defender incident and diminishing the USSR’s role in WWII. The author concludes that the deterioration of diplomatic relations is provoked by an overall imperception of the information operations’ definition and the clear laws governing NATO information operations, though some space for activating Russia–NATO cooperation still exists.

Relating Semantics for Epistemic Logic

The aim of this paper is to explore the advantages deriving from the application of relating semantics in epistemic logic. As a first step, I will discuss two versions of relating semantics and how they can be differently exploited for studying modal and epistemic operators. Next, I consider several standard frameworks which are suitable for modelling knowledge and related notions, in both their implicit and their explicit form and present a simple strategy by virtue of which they can be associated with intuitive systems of relating logic. As a final step, I will focus on the logic of knowledge based on justification logic and show how relating semantics helps us to provide an elegant solution to some problems related to the standard interpretation of the explicit epistemic operators.

Development and application of a colloidal-gold dual immunochromatography strip for detecting African swine fever virus antibodies.

African swine fever (ASF) is an acute and highly contagious infectious disease caused by the African swine fever virus (ASFV). Currently, there is no vaccine against ASF worldwide, and no effective treatment measures are available. For this reason, developing a simple, rapid, specific, and sensitive serological detection method for ASFV antibodies is crucial for the prevention and control of ASF. In this study, a 1:1 mixture of gold-labeled p30 and p72 probes was used as the gold-labeled antigen. The p30 and p72 proteins and their monoclonal antibodies were coated on a nitrocellulose membrane (NC) as a test (T) line and control (C) line, respectively. A colloidal-gold dual immunochromatography strip (ICS) for ASFV p30 and p72 protein antibodies was established. The results showed that the colloidal-gold dual ICS could specifically detect ASFV antibodies within 5-10min. There was no cross-reaction after testing healthy pig serum; porcine reproductive and respiratory syndrome virus (PRRSV), foot-and-mouth disease type A virus (FMDV-A), foot-and-mouth disease type O virus (FMDV-O), porcine circovirus type 2 (PCV-2), and classical swine fever virus (CSFV) positive sera. A positive result was obtained only for the positive control P1. The sensitivity of the test strips was 1:256, which was equivalent to that of commercially ELISA kits. Their coincidence rate with the two commercial ASFV ELISA antibodies detection kits was higher than 98%. The test strips were stably stored at 18-25°C and 4°C for 4 and 6months, respectively. The colloidal-gold dual ICS prepared in this study had high sensitivity and specificity and were characterized by rapid detection, simple operation, and easy interpretation of results. Therefore, they are of great significance to diagnose, prevent, and control African swine fever. KEY POINTS: • We establish an antibody detection that is quick and can monitor an ASF infection. • We observe changes in two protein antibodies to dynamically monitor ASF infection. • We use diversified detection on a single test strip to detect both antibodies.

Geometric block-coherence and quantum state discrimination

Quantum coherence with respect to orthonormal bases has been studied extensively in the past few years. From the perspective of operational meaning, geometric coherence can be equal to the minimum error probability to discriminate a set of pure states (2018 J. Phys. A: Math. Theor. 51 414005). By regarding coherence as a physical resource, Baumgratz et al (2014 Phys. Rev. Lett. 113 140401) presented a comprehensive framework for coherence. Recently, geometric block-coherence as an effective block-coherence measure has been proposed. In this paper, we reveal an equivalence relationship between mixed quantum state discrimination (QSD) task and geometric block-coherence, which provides an operational interpretation for geometric block-coherence and generalizes the main result in coherence resource theory. Meanwhile, we show that partial coherence is a special case of block-coherence. By linking the relationship between geometric partial coherence and QSD tasks, we show that the value range of the two measures is the same. Finally, we reveal the relationship between geometric positive operator-valued measure-based coherence and QSD task.

ON EDGINGTON’S FORMALIZATION OF THE PRINCIPLE OF KNOWABILITY

The formalization of the principle of knowability suggested by Dorothy Edgington is examined. This formalization has been suggested as a solution to the Fitch problem. It is interesting in that it blocks the Fitch argument and, in informal reading, makes a clear and intuitively appealing sense. On the other hand, as is shown in the paper, the semantic theory behind this formalization has two significant gaps: 1) it does not define the interpretation of actuality operator, and 2) it does not define the semantic way of representing the agent’s knowledge. The main outcome of the papers is critical. It is to the effect that unless those gaps are filled, Edgington’s theory cannot count as a solution to the Fitch problem.