Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly

AbstractIntroductionAccurate prediction of outcome after emergency surgery in elderly patients may assist decision-making. Many scoring systems require post-operative data (e.g. P-POSSUM) whilst others have failed to gain widespread use. Recent reports suggest that C-reactive protein (CRP) and the neutrophil lymphocyte (N/L ratio) ratio may predict surgical outcome.MethodsA retrospective review of all patients aged 80 years or over undergoing emergency abdominal surgery over a 22 month period was conducted. Outcome and clinical data were collected. Univariate, multivariate and recursive analyses were performed for outcome at 30 days, 6 months and 12 months. Findings were validated in a second independent dataset.Results88 patients were included in the test dataset, median age 84 years. 30-day mortality was 31%, 6-month mortality 43% and 12-month mortality 50%. Univariate analysis identified N/L ratio, CRP, midline laparotomy, and surgical risk score to predict outcome at each time point. Recursive analysis showed, N/L ratio ≥22 best predicted 30-day outcome (p=0.0018). Multivariate analysis identified N/L ratio to be an independent predictor of 30-day outcome (p=0.004) yet CRP did not predict outcome at any time point. An independent dataset (n=84) confirmed N/L ratio to be a prognostic factor at 30 days (p=0.001), 6 months (p<0.001) and 12 months (p=0.001).ConclusionN/L ratio is an easily calculable pre-operative measure that may have utility in the prediction of outcome after emergency abdominal surgery in the elderly. Further work to validate this measure in a larger, prospective setting and determine the underlying mechanisms that mediate outcome are necessary

Light Higgs Boson in the Spontaneously CP Violating NMSSM

We consider spontaneous CP violation in the Next to Minimal Supersymmetric Standard Model, without the usual $Z_3$ discrete symmetry. CP violation can occur at tree level, raising a potential conflict with the experimental bounds on the electric dipole moments of the electron and neutron. One escape from this is to demand that the CP violating angles are small, but we find that this entails a light neutral Higgs particle. This is almost pseudoscalar, can have a high singlet content, and will be hard to detect experimentally.Comment: 14 page LaTeX fil

Surface Instabilities on Liquid Oxygen in an Inhomogeneous Magnetic Field

Liquid oxygen exhibits surface instabilities when subjected to a sufficiently strong magnetic field. A vertically oriented magnetic field gradient both increases the magnetic field value at which the pattern forms and shrinks the length scale of the surface patterning. We show that these effects of the field gradient may be described in terms of an ``effective gravity'', which in our experiments may be varied from 1g to 360g.Comment: 4 pages, 5 embedded figures in eps forma

Exploring sources of variation in thermoluminescence emissions and anomalous fading in alkali feldspars

Alkali feldspar is routinely used in retrospective dosimetry using luminescence methods. However there is a signal loss over time, termed ‘anomalous fading’, which results in age underestimation if uncorrected. Although significant improvements have been made in recent years, luminescence dating of feldspars remains challenging. This paper investigates the relationships between chemistry, structural state and the scale of exsolution with thermoluminescence (TL) emission spectra and infrared stimulated luminescence (IRSL) fading rates. We measure TL emission spectra, where possible linking the recombination site to physical features of the feldspar crystals. We show that fading rates are lowest in ordered end-member Na- and K-feldspars but significantly greater in disordered end-members, showing that Al–Si order influences fading. As well as having very low fading rates, ordered end-member samples have distinctive TL emission spectra, with the yellow-green emission dominant, while all other samples have a dominant blue emission. Perthite, i.e. exsolved members of the (Na,K)-feldspar solid solution, show greater fading than disordered end-members and fading is greatest in semi-coherent macroperthite. We propose that the state of Al–Si-order, and the occurrence of defects and dislocations at the perthite lamellar interfaces influence anomalous fading rates in feldspar

Electroweak Baryogenesis in the Next to Minimal Supersymmetric Model

In the electroweak phase transition there arises the problem of baryon number washout by sphaleron transitions, which can be avoided if the phase transition is strongly enough first order. The minimal supersymmetric standard model has just two Higgs doublets H1 and H2, while the next to minimal model, NMSSM, has an additional singlet, N, this latter giving rise to the helpful feature that the Higgs potential contains a tree level trilinear field term. We use the tunneling criterion for the existence of a first order electroweak phase change. A quantitative statistical analysis indicates that with parameters of the NMSSM satisfying the experimental constraints a strong first order phase change occurs in about 50% of cases.Comment: 15 pages, plain LaTe

Optimal topological simplification of discrete functions on surfaces

We solve the problem of minimizing the number of critical points among all functions on a surface within a prescribed distance {\delta} from a given input function. The result is achieved by establishing a connection between discrete Morse theory and persistent homology. Our method completely removes homological noise with persistence less than 2{\delta}, constructively proving the tightness of a lower bound on the number of critical points given by the stability theorem of persistent homology in dimension two for any input function. We also show that an optimal solution can be computed in linear time after persistence pairs have been computed.Comment: 27 pages, 8 figure

Neutral Higgs sector of the next-to-minimal supersymmetric standard model with explicit CP violation

The neutral Higgs sector of the next-to-minimal supersymmetric standard model (NMSSM) with explicit CP violation is investigated at the 1-loop level, using the effective potential method; not only the loops involving the third generation of quarks and scalar quarks, but also the loops involving $W$ boson, charged Higgs boson, and chargino are taken into account. It is found that for some parameter values of the NMSSM the contributions from the $W$ boson, charged Higgs boson, and chargino loops may modify the masses of the neutral Higgs bosons and the mixings among them significantly, depending on the CP phase. In $e^+e^-$ collisions, the prospects for discovering neutral Higgs bosons are investigated within the context of the NMSSM with explicit CP violation when the dominant component of the lightest neutral Higgs boson is the Higgs singlet field of the NMSSM.Comment: Latex, 23 pages, 6 figure

Science policies: How should science funding be allocated? An evolutionary biologists’ perspective

In an ideal world, funding agencies could identify the best scientists and projects and provide them with the resources to undertake these projects. Most scientists would agree that in practice, how funding for scientific research is allocated is far from ideal and likely compromises research quality. We, nine evolutionary biologists from different countries and career stages, provide a comparative summary of our impressions on funding strategies for evolutionary biology across eleven different funding agencies. We also assess whether and how funding effectiveness might be improved. We focused this assessment on 14 elements within four broad categories: (a) topical shaping of science, (b) distribution of funds, (c) application and review procedures, and (d) incentives for mobility and diversity. These comparisons revealed striking among‐country variation in those elements, including wide variation in funding rates, the effort and burden required for grant applications, and the extent of emphasis on societal relevance and individual mobility. We use these observations to provide constructive suggestions for the future and urge the need to further gather informed considerations from scientists on the effects of funding policies on science across countries and research fields

A calcium-based plasticity model for predicting long-term potentiation and depression in the neocortex

Pyramidal cells (PCs) form the backbone of the layered structure of the neocortex, and plasticity of their synapses is thought to underlie learning in the brain. However, such long-term synaptic changes have been experimentally characterized between only a few types of PCs, posing a significant barrier for studying neocortical learning mechanisms. Here we introduce a model of synaptic plasticity based on data-constrained postsynaptic calcium dynamics, and show in a neocortical microcircuit model that a single parameter set is sufficient to unify the available experimental findings on long-term potentiation (LTP) and long-term depression (LTD) of PC connections. In particular, we find that the diverse plasticity outcomes across the different PC types can be explained by cell-type-specific synaptic physiology, cell morphology and innervation patterns, without requiring type-specific plasticity. Generalizing the model to in vivo extracellular calcium concentrations, we predict qualitatively different plasticity dynamics from those observed in vitro. This work provides a first comprehensive null model for LTP/LTD between neocortical PC types in vivo, and an open framework for further developing models of cortical synaptic plasticity.We thank Michael Hines for helping with synapse model implementation in NEURON; Mariana Vargas-Caballero for sharing NMDAR data; Veronica Egger for sharing in vitro data and for clarifications on the analysis methods; Jesper Sjöström for sharing in vitro data, helpful discussions, and feedback on the manuscript; Ralf Schneggenburger for helpful discussions and clarifications on the NMDAR calcium current model; Fabien Delalondre for helpful discussions; Francesco Casalegno and Taylor Newton for helpful discussion on model fitting; Daniel Keller for helpful discussions on the biophysics of synaptic plasticity; Natali Barros-Zulaica for helpful discussions on MVR modeling and generalization; Srikanth Ramaswamy, Michael Reimann and Max Nolte for feedback on the manuscript; Wulfram Gerstner and Guillaume Bellec for helpful discussions on synaptic plasticity modeling. This study was supported by funding to the Blue Brain Project, a research center of the École polytechnique fédérale de Lausanne, from the Swiss government’s ETH Board of the Swiss Federal Institutes of Technology. E.B.M. received additional support from the CHU Sainte-Justine Research Center (CHUSJRC), the Institute for Data Valorization (IVADO), Fonds de Recherche du Québec–Santé (FRQS), the Canada CIFAR AI Chairs Program, the Quebec Institute for Artificial Intelligence (Mila), and Google. R.B.P. and J.DF. received support from the Spanish “Ministerio de Ciencia e Innovación” (grant PGC2018-094307-B-I00). M.D. and I.S. were supported by a grant from the ETH domain for the Blue Brain Project, the Gatsby Charitable Foundation, and the Drahi Family Foundation