Unexpected Loss Research Articles

In Memoriam Tribute to Jeffrey Robbins, PhD (1950-2022).

In Memoriam Tribute to Jeffrey Robbins, PhD (1950-2022).

Plasma cell neoplasm with initial presentation as an ovarian mass: a rare case report

Abstract Introduction/Objective Plasmacytoma is a discrete, solitary mass of neoplastic plasma cells. Extramedullary plasmacytoma (EMP) is a rare entity arising in tissues other than bone and it constitutes about 1% of all plasma cell neoplasms. Most cases of reported EMPs are in the upper aerodigestive tract (~80%). We present a very rare case with the initial presentation as an ovarian mass with metastasis into the peritoneal and pleural cavity. Methods/Case Report This is a 66-year-old female who presented with generalized abdominal pain, unexpected weight loss, and occasional fever and night sweats. Computed tomography (CT) scan of abdomen and pelvis showed an extensive metastatic disease including bilateral cardiophrenic angle lymphadenopathy, peritoneal spread encasing the bowel loops, bladder, and uterus as well as moderate right pleural effusion. The positron emission tomography (PET)-CT showed an ill-defined soft tissue density in the pelvis with hypermetabolism. The pelvic ultrasound showed a 2.6 x 2.2 x 1.1 cm hypoechoic mass in the left adnexa. The patient's serum cancer antigen (CA-125) was elevated at 123 U/mL and the post-thoracentesis chest x-ray was unremarkable with no acute osseous abnormalities. Other clinical data were not available. Results (if a Case Study enter NA) Cytopathologic evaluation of the pleural fluid showed abundant atypical cells with eccentrically located nuclei, scant to moderate cytoplasm with a paranuclear hof, frequent binucleation and mitoses. The cells ranged in size from small to large. Further immunohistochemical (IHC) analysis on the cell block showed that the tumor cells diffusely positive for CD138 and lambda light chain and negative for MOC31, BerEP4, calretinin, D2-40, WT1, HHV8, ALK1, and EBER in situ hybridization (ISH). The biopsy of the left adnexal mass showed a diffuse proliferation of tumor cells with frequent mitotic figures. The IHC analysis on the biopsy specimen showed tumor cells positive for CD79a and CD56 (weak) and negative for CD20 and PAX5. Kappa/lambda ISH analysis confirmed lambda light chain restriction of the tumor cells. These morphological and immunophenotypic features were consistent with plasma cell neoplasm. Conclusion The ovary is an unusual location to be involved by plasma cell neoplasm. We use this case to remind the pathologists and clinicians that ovarian plasmacytoma can be the initial presentation of the plasma cell neoplasm, although rare, and to aid the patients to receive an appropriate treatment. A thorough workup is needed to make an accurate diagnosis of this entity.

Optimal cost-sensitive credit scoring using a new hybrid performance metric

This paper aims to provide an optimal credit rating by using a new hybrid performance metric, including several performance metrics, referred to as the probability of credit scoring correctness. There have been several credit-scoring models proposed in the banking system. These models, either single classifiers or hybrid and ensemble models determine the class of customers (good or bad accounts). The banks need the probability of default to calculate the expected loss and the unexpected loss and then determine whether their capital is adequate. Generally speaking, the proposed model can utilize n classifiers and m performance metrics, the larger n, and m, the more diverse and more reliable the model is as an estimate of customer classes. We evaluated the proposed model using five common classifiers, namely k-nearest neighbors (KNN), support vector machine (SVM), decision tree (DT), AdaBoost, and probabilistic neural network (PNN), and eight performance metrics. To extract the feature, an optimization approach using genetic algorithms and nine different scenarios were used. We have then calculated the optimal parameters of each algorithm simultaneously by defining the cost-sensitive objective function based on the probability of correctly classifying it into two classes 0 (good) and 1 (bad). We evaluated the performance of the proposed hybrid model using the Iranian dataset and the UCI German and Australian datasets. The results indicate the proposed method provides very good scoring performance. Using this approach, the bank can filter its bad customers based on the tolerance it considers for the probability value, so it can decide whether it should provide loans to that customer.

Abstract 14985: Artificial Intelligence Based Heart Rate Variability Analysis for Sudden Cardiac Arrest Risk Prediction

Introduction: Sudden Cardiac Arrest (SCA) is an unexpected life-threatening loss of cardiac function potentially leading to sudden cardiac death (SCD). It accounts for a half of cardiac mortality, posing a major public health problem. While SCA can be treated with implantable cardioverter defibrillators (ICD), most (80%) SCDs occur in relatively low risk patients, for whom risk benefit ratio of an ICD is unfavorable. Therefore, novel methods to identify high risk individuals and the time on which their risk is high may facilitate prevention of SCD. Methods : Long (~24h) ECG recordings from individuals who had an SCA on record (n=20), patients with other arrhythmias (n=84) and from healthy individuals (n=17) from PhysioNet databases were analyzed to extract inter beat intervals (IBI). For each step in the IBI series, 120 last IBIs were used to calculate 19 indices that quantify short term heart rate variability (HRV). An artificial intelligence model named temporal convolutional network (TCN) was used to continuously assess the risk of a future VF event based on the current HRV estimate combined with few hours of history of previous HRV estimates. Training and testing of the TCN was done using Leave One Out testing done twice. Patients being classified at any point in the record as high risk were considered high risk. Results : Only patients from the SCA population, and none from the other arrythmia and healthy patients, were classified as high risk (PPV=100%). On average, sensitivity and specificity were 62.5% and 100% respectively Conclusions : In this preliminary retrospective analysis, artificial intelligence based HRV analysis identified risk for a SCA event in the following 24 hours with high specificity. Larger cohort and prospective testing are needed to assess the clinical utility of such systems.

Millimeter-scale ultrathin suspended metasurface integrated high-finesse optomechanical cavity.

A typical optomechanical system is a cavity with one movable mirror and one fixed mirror. However, this configuration has been considered incapable of integrating sensitive mechanical elements while maintaining high cavity finesse. Although the membrane-in-the-middle solution seems to be able to overcome this contradiction, it introduces additional components that will lead to unexpected insertion loss, resulting in reduced cavity quality. Here we propose a Fabry-Perot optomechanical cavity composed of an ultrathin suspended Si3N4 metasurface and a fixed Bragg grating mirror, with a measured finesse up to 1100. Transmission loss of this cavity is very low as the reflectivity of this suspended metasurface tends to unity around 1550 nm. Meanwhile, the metasurface has a millimeter-scale transverse dimension and a thickness of only 110 nm, which guarantees a sensitive mechanical response and low cavity diffraction loss. Our metasurface-based high-finesse optomechanical cavity has a compact structure, which facilitates the development of quantum and integrated optomechanical devices.

S1789 Pancreatic Sarcoidosis Masquerading as Pancreatic Adenocarcinoma

Introduction: Sarcoidosis is a rare, systemic disease that can affect any organ but is most associated with pulmonary manifestations. Excluding the liver, gastrointestinal involvement of sarcoidosis is rare. PS can masquerade as underlying malignancy which poses a diagnostic and therapeutic challenge. Clinical presentation includes symptoms secondary to pancreatic duct obstruction or pancreatic parenchymal infiltration from enlarged lymph nodes that can result in abdominal pain, jaundice, weight loss, and nausea or emesis. However, these non-specific symptoms can be present in patients with pancreatitis or malignancy. This case highlights the rare finding of pancreatic sarcoidosis masquerading as a pancreatic adenocarcinoma Case Description/Methods: A 52-year-old African American female with a past medical history of hypertension and pulmonary sarcoidosis presented with one month of epigastric pain. She denied any fatigue, early satiety, diarrhea, nausea, vomiting, obstructive symptoms, or unexpected weight loss. Computed tomography (CT) of the abdomen demonstrated an approximately 2.0 cm low-density lesion within the body of the pancreas with mild pancreatic ductal dilatation in the more distal body and tail of the pancreas concerning a pancreatic neoplasm. She underwent additional imaging for staging including a CT chest that demonstrated cervical lymphadenopathy and progressive hilar adenopathy consistent with her history of pulmonary sarcoidosis. She underwent endoscopic ultrasound which demonstrated a poorly defined 23 mm x 18 mm mass within the pancreatic body with many enlarged lymph nodes in the upper abdomen without any pancreatic duct abnormalities. Fine needle aspiration (FNA) demonstrated epithelioid cells with evidence of atypia and minimal mitotic activity; however, concerning for an adenocarcinoma (Figure). Given the concern of an underlying neoplastic process secondary to distal pancreatic duct changes and the presence of atypical epithelioid cells, the patient underwent a distal pancreatectomy and splenectomy. Pathology demonstrated one large, primary mass measuring 2.4 cm and multiple additional masses forming areas of sarcoidosis. There was no evidence of malignancy. Her postoperative course was uncomplicated with plans for surveillance imaging in 1 year. Discussion: Although most cases of PS are asymptomatic, the risk of an underlying malignancy needs to be weighed against the risk of PS. Sharing this knowledge with patients can help guide decision-making.Figure 1.: Histologic analysis of the distal pancreatectomy and splenectomy specimen demonstrating no evidence of malignancy.

Acreage Response to Price Support and Price Risk under Trade Liberalization

An unexpected surge in sugar imports in 2008 under NAFTA resulted in a large U.S. sugar price fluctuation. This study explores the acreage decision for U.S. sugar beets in an environment where both price support and trade liberalization takes place at the same time. Our empirical analysis is based on county-level data for sugar beets and three substitute crops (corn, soybean and wheat) in twelve U.S. sugar beet growing states over 1997-2018. While we find that an increase in price fluctuation overall has adverse impacts on acreage, the results indicate that farmers respond to price risk differently before and after NAFTA and to the level of price risk. This suggests a need for more precise policy instruments that better protect against unexpected income loss rather than a fixed level of support and enable producers to deal with future extreme events.

Distributed Economic Dispatch Control Method with Frequency Regulator for Smart Grid under Time-Varying Directed Topology

The paper studies a new distributed control method to solve the economic dispatch problem (EDP) under directed topology based on consensus protocol. Electrical equipment is closely related to frequency, and the frequency of each generator varies independently during operation. Therefore, it hinders the realization of economic dispatch. To solve the problem, we combine a frequency regulator with a consensus protocol, which eliminates the effect of frequency variation on the designed consensus algorithm. Meanwhile, considering the problem of excessive communication cost and low computational efficiency in large-scale power systems, an event-triggered mechanism is introduced into the designed algorithm. Furthermore, in order to overcome the unexpected loss of communication links, the time-varying topology mechanism is employed to develop the distributed economic dispatch (DED) algorithm to improve the robustness. Then, the stability of the above algorithm is proved by graph theory and convergence analysis. Finally, several simulations illustrate that our proposed methods are effective.

Serious disease risk among patients with unexpected weight loss: a matched cohort of over 70000 primary care presentations.

Unexpected weight loss (UWL) in patients consulting in primary care presents dilemmas for management because of the broad differential diagnoses associated with UWL. Research on the risks of serious disease among patients with UWL to date has largely taken place in secondary care, limiting generalizability to primary care patients. In this study, we use a large matched cohort study to estimate the risks of 12 serious diseases among patients presenting to primary care with UWL where this was recorded, stratified by age and sex, in order to inform a rational clinical approach to patients presenting with UWL. This was a retrospective matched cohort study using electronic health records (EHRs) from the UK Clinical Practice Research Datalink (CPRD). Each patient with UWL (ascertained from EHR coding) was matched to five patients without UWL and followed until the earliest of a diagnosis of the serious disease, date of death, exit from the CPRD database, or end of the study. Observed absolute risks of the 12 serious diseases were estimated as probabilities, and hazard ratios (HRs) were estimated with Cox proportional hazards models. Between 2000 and 2012, 70193 patients in CPRD had at least one record of UWL and were matched with 295579 patients without UWL. Patients with UWL had significantly higher risk of nearly all serious diseases examined compared with patients without. HRs ranged from 1.43 for congestive heart failure [95% confidence interval (CI): 1.27-1.62] to 9.70 for malabsorption (95% CI: 6.81-13.82). The absolute risks of any given serious disease were relatively low (<6% after 1year). The magnitude and rank order of absolute risks varied by age and sex. Depression was the most common diagnosis among women aged <80 with UWL (3.74% of women aged <60 and 2.46% of women aged 60-79), whereas diabetes was the most common in men <60 with UWL (2.96%) and cancer was the most common in men aged 60 and over with UWL (3.79% of men aged 60-70 and 5.28% of men aged ≥80). This analysis provides new evidence to patients and clinicians about the risks of serious disease among patients presenting with UWL in primary care. Depending on age and sex, the results suggest that workup for UWL should include screening for diabetes, thyroid dysfunction, depression, and dementia. If performed in a timely manner, this workup could be used to triage patients eligible for cancer pathway referral.

Novel Memristor-based Non-volatile D Latch and Flip Flop Designs

Abstract: Serial devices are the fundamental building elements of all digital electronic systems with memory. The non-volatile quality of sequential devices is necessary for quick data recovery after unexpected data loss, such as an unintentional power outage, which has sparked ongoing research and development into integrating a non-volatile memristor into CMOS devices. In this article, we examine using this technique to raise the caliber of nonvolatile D-latch. One memristor, a few transfer gates, and CMOS transducers are the sole components of the proposed D-latch, which sets it apart from conventional designs. Our design minimizes the negative impact of transistor threshold loss. In addition, a variety of memristor threshold values are available with our design

Potential Applications of Somatic Experiencing® in Applied Sport Psychology

In recent years, applied sport psychologists have become more open to “third wave therapies” that focus on the holistic promotion of human well-being. In this article, the potential application of body psychotherapy, Somatic Experiencing® (SE™), is presented within the sport context. SE™ focuses on resolving the symptoms of chronic stress and post-traumatic stress, among other things by directing the client’s attention to internal sensations, both visceral (interoception) and musculoskeletal (proprioception and kinesthesis) to resolve a dysfunctional state of the autonomic nervous system. The basic tenets of the SE™ framework are initially described with a short account of its effectiveness. Then, SE™ intervention context and ethical considerations are discussed, followed by a hypothetical example of its application with a judoka who experienced stress following an unexpected loss in a competition. Reflections and recommendations for practitioners are provided.

A Dynamic Wear Prediction Model for Studying the Interactions between Surface Wear and Dynamic Response of Spur Gears

Surface wear, as a major failure mode of gear systems, is an unavoidable phenomenon during the whole life of gears. It also induces other gear damages, such as fatigue cracks, surface pitting and spalling. Ultimately, those defects may result in the sudden failure of a gearbox transmission system, which can lead to a serious accident and unexpected economic loss. Therefore, it can provide huge cost and safety benefits to industries to monitor gear wear and predict its propagation. Gear wear raises the error rate of gear transmission systems, typically leading to improvements in dynamic loads, vibration, and noise. In return, the increased load conversely aggravates wear, creating a feedback cycle between dynamic responses and surface wear. For this purpose, a wear prediction model was incorporated into a tribo-dynamic model for quantitatively investigating how surface wear and gear vibration are mutually affected by each other. To obtain more precise dynamic responses, the tribo-dynamic model integrates the time-varying mesh stiffness, load-sharing ratio and friction parameters. To improve the computational efficiency and guarantee the calculation precision, an improved and updated wear depth methodology is constructed in the wear prediction model. This paper demonstrates the capability of the proposed dynamic wear prediction model in the investigation of the interaction effects between gear dynamics and surface wear, allowing for the development of improved gear wear prediction tools. The obtained results indicate that the surface wear impacts the dynamic characteristics, even with slight wear. In the initial stage of wear, the friction coefficient decreases slightly, largely due to the reduction in surface roughness; but the friction force increases because of the improved dynamic meshing force. Although the initial wear depth distributions of a pinion under dynamic and static conditions are similar, the wear depth distributions under dynamic conditions becomes significantly different compared to the those under static conditions with the wear process. The maximum wear depth of a pinion under dynamic conditions is about 1.6 times as the corresponding static conditions, when the wear cycle comes to 4 × 104. Similarly, the maximum accumulative wear depth of a pinion under dynamic conditions reaches 1.2 times of that under static conditions. Therefore, the proposed dynamic wear prediction model is more appropriate to be applied to the surface wear of gears.

Prevalence of M. tuberculosis and Associated Risk Factors Among Suspected Patients in Federal Medical Centre Birnin Kudu, Jigawa State.

Tuberculosis (TB) stands as a major global health problem, ranking as the second highest cause of death from an infectious disease globally, after the human immunodeficiency virus (HIV). The aim of this study was to identify mycobacteria tuberculosis at the molecular level in symptomatic presumptive TB subjects in Federal Medical Centre, Birnin Kudu Jigawa State, Nigeria. A cross-sectional study was conducted between April to December, 2019 at the Federal Medical Centre Birnin – Kudu (FMC, BKD), Jigawa State. Subjects presenting with any of the following symptoms were recruited: the presence of symptoms suggestive of TB like chronic cough for a period of ≥ 2 weeks, night sweats, fatigue, unexpected loss of weight, and fever. Each eligible subject (272) who signed written consent and provided clinical specimens were recruited into the study. Four milliliters (4ml) of sputum sample were collected. In the case of presumptive extra-pulmonary TB, four milliliters of either pus, CSF samples was collected. Samples were immediately processed for Gene Xpert MTB/RIF assay. Testing for HIV was done according to the current national algorithm recommended by the Federal Ministry of Health of Nigeria. Total number of 52 subjects were M. tuberculosis positive with a total prevalence of 19.1% and total prevalence of 1.1% rifampicin resistance. Most 157 (57.7%) were males. Age groups 20-29, 30-39, and 40-49 have TB positivity rate of 33.5%, 26.5%, and 12.9% respectively. Majority 194 (71.3%) of participants were rural dwellers. Prevalence of HIV was 50 (18.4%) among study participants. The measure of association showed that there was significant association (p&lt;0.05) between TB positivity with type of residence, history of previous TB treatment and reason for diagnosis. Urban residents were 3.23 times likely of being TB positive compared to rural dwellers. The prevalence of Rifampicin-resistant M. tuberculosis is low in pulmonary tuberculosis cases in the study area.

A single residue confers selective loss of sugar sensing in wrynecks

Sensory receptors evolve, and changes to their response profiles can directly impact sensory perception and affect diverse behaviors, from mate choice to foraging decisions.1-3 Although receptor sensitivities can be highly contingent on changes occurring early in a lineage's evolutionary history,4 subsequent shifts in a species' behavior and ecology may exert selective pressure to modify and even reverse sensory receptor capabilities.5-7 Neither the extent to which sensory reversion occurs nor the mechanisms underlying such shifts is well understood. Using receptor profiling and behavioral tests, we uncover both an early gain and an unexpected subsequent loss of sugar sensing in woodpeckers, a primarily insectivorous family of landbirds.8,9 Our analyses show that, similar to hummingbirds10 and songbirds,4 the ancestors of woodpeckers repurposed their T1R1-T1R3 savory receptor to detect sugars. Importantly, whereas woodpeckers seem to have broadly retained this ability, our experiments demonstrate that wrynecks (an enigmatic ant-eating group sister to all other woodpeckers) selectively lost sugar sensing through a novel mechanism involving a single amino acid change in the T1R3 transmembrane domain. The identification of this molecular microswitch responsible for a sensory shift in taste receptors provides an example ofthe molecular basis of a sensory reversion in vertebrates and offers novel insights into structure-function relationships during sensory receptor evolution.

Unexpected high carbon losses in a continental glacier foreland on the Tibetan Plateau

Closely related with microbial activities, soil developments along the glacier forelands are generally considered a carbon sink; however, those of continental glacier forelands remain unclear. Continental glaciers are characterized by dry conditions and low temperature that limit microbial growth. We investigated the carbon characteristics along a chronosequence of the Laohugou Glacier No. 12 foreland, a typical continental glacier on the Tibetan Plateau, by analyzing soil bacterial community structure and microbial carbon-related functional potentials. We found an unexpected carbon loss in which soil organic carbon decreased from 22.21 g kg−1 to 10.77 g kg−1 after receding 50 years. Structural equation modeling verified the important positive impacts from bacterial community. Lower carbon fixation efficiency along the chronosequence was supported by less autotrophic bacteria and carbon fixation genes relating to the reductive tricarboxylic acid cycle. Lower carbon availability and higher carbon requirements were identified by an increasing bacterial copy number and a shift of the dominant bacterial community from Proteobacteria and Bacteroidetes (r-strategists) to Actinobacteria and Acidobacteria (K-strategists). Our findings show that the carbon loss of continental glacier foreland was significantly affected by the changes of bacterial community, and can help to avoid overestimating the carbon sink characteristics of glacier forelands in climate models.

Benchmarking and Configuring Security Levels in Intermittent Computing

Intermittent computing derives its name from the intermittent character of the power source used to drive the computing, typically an energy harvester of ambient energy sources. Intermittent computing is characterized by frequent transitions between the powered and the non-powered state. To enable the processor to quickly recover from unexpected power loss, regular checkpoints store the run-time state of the program, including variables, control information, and machine state. In sensitive applications such as logged measurements, checkpoints must be secured against tamper and replay. We investigate the overhead of creating, securing, and restoring checkpoints with respect to the application. We propose a configurable checkpoint security setting that leverages application properties to reduce overhead of checkpoint security and implement the same using a secure checkpointing protocol. We discuss a prototype implementation for a FRAM-based micro-controller, and we characterize the cost of adding and configuring security to traditional checkpointing using a suite of embedded benchmark applications.

Measured weight loss as a precursor to cancer diagnosis: retrospective cohort analysis of 43302 primary care patients.

BackgroundUnexpected weight loss is a presenting feature of cancer in primary care. Data from primary care are lacking to quantify how much weight loss over what period should trigger further investigation for cancer. This research aimed to quantify cancer diagnosis rates associated with measured weight change in people attending primary care.MethodsRetrospective cohort study of primary care electronic health records data linked to the Surveillance, Epidemiology, and End Results cancer registry (Integrated healthcare delivery system in Washington State, United States). Multivariable Cox regression incorporating time varying covariates using splines to model non‐linear associations (age, percentage weight change, and weight change interval). Fifty thousand randomly selected patients aged 40 years and over followed for up to 9 years (1 January 2006 to 31 December 2014). Outcome measures are hazard ratios (95% confidence intervals) to quantify the association between percentage weight change and cancer diagnosis for all cancers combined, individual cancer sites and stages; percentage risk of cancer diagnosis within 6 months of the end of each weight change episode; and the positive predictive value for cancer diagnosis.ResultsThere were 43 302 included in the analysis after exclusions. Over 287 858 patient‐years of follow‐up, including 24 272 (56.1%) females, 23 980 (55.4%) aged 40 to 59 years, 15 113 (34.9%) 60 to 79 years, and 4209 (9.7%) aged 80 years and over. Adjusted hazard ratios (95% confidence interval) for cancer diagnosis in a 60 years old ranged from 1.04 (1.02 to 1.05, P < 0.001) for 1% weight loss to 1.44 (1.23 to 1.68, P < 0.001) for 10%. An independent linear association was observed between percentage weight loss and increasing cancer risk. The absolute risk of cancer diagnosis increased with increasing age (up to 85 years) and as the weight change measurement interval decreased (<1 year). The positive predictive value for a cancer diagnosis within 1 year of ≥5% measured weight loss in a 60 to 69 years old was 3.41% (1.57% to 6.37%) in men and 3.47% (1.68% to 6.29%) in women. The risk of cancer diagnosis was significantly increased for pancreatic, myeloma, gastro‐oesophageal, colorectal, breast, stage II and IV cancers.ConclusionsWeight loss is a sign of undiagnosed cancer regardless of the interval over which it occurs. Guidelines should resist giving an arbitrary cut‐off for the interval of weight loss and focus on the percentage of weight loss and the patient's age. Future studies should focus on the association between diagnostic evaluation of weight change and risk of cancer mortality.

Identifying a core symptom set triggering radiological and endoscopic investigations for suspected recurrent esophago-gastric cancer: a modified Delphi consensus process.

There is currently a lack of evidence-based guidelines regarding surveillance for recurrence after esophageal and gastric (OG) cancer surgical resection, and which symptoms should prompt endoscopic or radiological investigations for recurrence. The aim of this study was to develop a core symptom set using a modified Delphi consensus process that should guide clinicians to carry out investigations to look for suspected recurrent OG cancer in previously asymptomatic patients. A web-based survey of 42 questions was sent to surgeons performing OG cancer resections at high volume centers. The first section evaluated the structure of follow-up and the second, determinants of follow-up. Two rounds of a modified Delphi consensus process and a further consensus workshop were used to determine symptoms warranting further investigations. Symptoms with a 75% consensus agreement as suggestive of recurrent cancer were included in the core symptom set. 27 surgeons completed the questionnaires. A total of 70.3% of centers reported standardized surveillance protocols, whereas 3.7% of surgeons did not undertake any surveillance in asymptomatic patients after OG cancer resection. In asymptomatic patients, 40.1% and 25.9% of centers performed routine imaging and endoscopy, respectively. The core set that reached consensus, consisted of eight symptoms that warranted further investigations included; dysphagia to solid food, dysphagia to liquids, vomiting, abdominal pain, chest pain, regurgitation of foods, unexpected weight loss and progressive hoarseness of voice. There is global variation in monitoring patients after OG cancer resection. Eight symptoms were identified by the consensus process as important in prompting radiological or endoscopic investigation for suspected recurrent malignancy. Further randomized controlled trials are necessary to link surveillance strategies to survival outcomes and evaluate prognostic value.

Unexpected Motherhood-Triggered Hearing Loss in the Two-Pore Channel (TPC) Mutant Mouse.

Calcium signaling is crucial for many physiological processes and can mobilize intracellular calcium stores in response to environmental sensory stimuli. The endolysosomal two-pore channel (TPC), regulated by the second messenger nicotinic acid adenine dinucleotide phosphate (NAADP), is one of the key components in calcium signaling. However, its role in neuronal physiology remains largely unknown. Here, we investigated to what extent the acoustic thresholds differed between the WT mice and the TPC KO mice. We determined the thresholds based on the auditory brainstem responses (ABRs) at five frequencies (between 4 and 32 kHz) and found no threshold difference between the WT and KO in virgin female mice. Surprisingly, in lactating mothers (at P9–P10), the thresholds were higher from 8 to 32 kHz in the TPC KO mice compared to the WT mice. This result indicates that in the TPC KO mice, physiological events occurring during parturition altered the detection of sounds already at the brainstem level, or even earlier.

A novel similarity-based status characterization methodology for gear surface wear propagation monitoring

The gearbox is a vital component for rotating machinery and has been used in many critical engineering applications. Surface wear is a common but inevitable phenomenon during the lifespan of the gearbox. Its propagation can result in some catastrophic failures and cause unexpected economic loss. Therefore, it is vital to evaluate the degradation process of the gear system caused by surface wear propagation in order to make reliable predictive maintenance-based decisions to ensure the safe operation of the gearbox transmission system. The vibration analysis technique is a prevailing tool for rotating machine condition monitoring. However, research on vibration-based gear wear monitoring is relatively rare as the dynamic interactions between gear surface wear and gear system dynamic characteristics would produce complex gear dynamic responses and vibration features. Therefore, this paper presents a novel similarity-based status characterization methodology for gear wear monitoring. In this proposed methodology, a novel gear wear monitoring indicator is developed to evaluate gear tooth contact characteristics at different wear severities, which could significantly benefit gear systems' health management. The effectiveness of the proposed method for gear wear propagation process monitoring is presented and proven through a series of run-to-failure tests with different lubrications and operational conditions.