Angular dependence of 12-kHz seafloor acoustic backscatter

The angular dependence of seafloor acoustic backscatter,measured with a 12‐kHz multi narrow‐beam echo‐sounder at two sites in the central North Pacific with water depths of 1500 and 3100 m, respectively, has been determined for incidence angles between 0° and 20°. The acoustic data consist of quadrature samples of the beamformed echoes received on each of the 16 2.66° beams of a Sea Beam echo‐sounder. These data are subjected to adaptive noise cancelling for sidelobe interference rejection, and the centroid of each echo is determined. After corrections for the ship’s roll and raybending effects through the water column, the angles of arrival are converted to angles of incidence by taking athwartships apparent bottom slopes into account. For each beam, the mean echo power received is normalized by the corresponding insonified area that depends on the transmit and receive beam patterns, the ship’s roll angle and the local bottom slope. For lack of system calibration, the data are presented as relative mean energy levels in 1° bins. Comparison of these results with theoretical angular dependence functions, based on the Helmholtz–Kirchhoff model for backscatter from a rough surface, indicates that a good fit is obtained in the angular sector from 5° to 20° incidence. In the near‐nadir sector (0° to 5°), the data suffer from high variance making the estimate unreliable. The data processing methods presented constitute one of the elements necessary to compile a map of seafloor acoustic backscatter from acoustic measurements made with a multinarrow beam echo‐sounder. The angular dependence function obtained will ultimately be used to normalize the backscattermeasurements in the athwartships direction

Evaluation and Verification of Bottom Acoustic Reverberation Statistics Predicted by the Point Scattering Model

The point scatteringmodel offers a parameterization of the reverberation probability density function (pdf) in terms of the coefficient of excess (kurtosis) and a coherent component represented by a harmonic process with random phase. In this paper the potential utility of this parametrization is investigated in the context of seafloor characterization. The problem of separating out the effect of each parameter is discussed. Computer simulations are used to verify model predictions on the reverberation quadrature, envelope, and phase pdf. As part of the verification study, the scatterer density was determined from the kurtosis of the reverberation quadrature pdf. A statistical analysis of this procedure points to reduced estimate accuracy with decreasing kurtosis. Additional computer simulations show that the chosen pdf family, developed under the assumption of a Poissonscatterer distribution, is flexible enough to fit reverberation data generated by non‐Poisson scatterer distributions exhibiting a degree of clustering or regularity. A computer experiment demonstrates how this parametrization can be used in conjunction with a simple sonar geometry to generate acoustic signatures for seafloor classification. In addition, real reverberation data collected by a Sea Beam sonar system in two different seafloor areas are interpreted according to the chosen parametrization

Preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with HER2-positive early breast cancer (PHranceSCa): a randomized, open-label phase II study

Aim The aim of the study was to assess patient preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection (PH FDC SC) in patients with HER2-positive early breast cancer in PHranceSCa (NCT03674112). Materials and methods Patients who completed neoadjuvant P + H + chemotherapy + surgery were randomised 1:1 to three intravenous (IV) P + H cycles followed by three cycles of PH FDC SC or vice versa (crossover) and then chose subcutaneous (SC) injection or IV infusion to continue up to 18 cycles (continuation). Assessments were via patient and healthcare professional (HCP) questionnaires. Results One hundred and sixty patients were randomised (cut-off: 24 February 2020); 136 (85.0%, 95% confidence interval: 78.5–90.2%) preferred SC; 22 (13.8%) preferred IV; 2 (1.3%) had no preference. The main reasons for SC preference were reduced clinic time (n = 119) and comfort during administration (n = 73). One hundred and forty-one patients (88.1%) were very satisfied/satisfied with SC injection versus 108 (67.5%) with IV infusion; 86.9% chose PH FDC SC continuation. HCP perceptions of median patient treatment room time ranged from 33.0–50.0 min with SC and 130.0–300.0 min with IV. Most adverse events (AEs) were grade 1/2 (no 4/5s); serious AE rates were low. AE rates before and after switching were similar (cycles 1–3 IV → cycles 4–6 SC: 77.5% → 72.5%; cycles 1–3 SC → cycles 4–6 IV: 77.5% → 63.8%). Conclusion Most patients strongly preferred PH FDC SC over P + H IV. PH FDC SC was generally well tolerated, with no new safety signals (even when switching), and offers a quicker alternative to IV infusion

Adaptive Noise Canceling Applied to Sea Beam Sidelobe Interference Rejection

Sidelobe interference has been a source of difficulty in the study of seafloor acoustic backscattering properties based on Sea Beam acoustic records. The filtering scheme used in Sea Beam adversely affects the underlying acoustic return and may also lead to bathymetric artifacts. Adaptive noise canceling (ANC) offers the potential for sidelobe interference cancellation coupled with signal preservation, provided both amplitude and phase information are available. The joint-process deterministic least-squares lattice is the adaptive filter of choice because of its superior transient response in the presence of power discontinuities. A REVGEN simulation of the Sea Beam system provided support for the proposed filtering technique. A complex data acquisition system was designed and built to record the in-phase and quadrature component of Sea Beam returns. Initial ANC processing of these recorded Sea Beam data provided satisfactory sidelobe interference cancellation with no noticeable degradation of the actual bottom returns

Application of high-resolution beamforming to multibeam swath bathymetry

n the context of swath bathymetry with multibeam echo-sounders, seafloor echoes received at regularly spaced elements of a hydrophone array are summed coherently to form a number of directional beams from which athwartships depth measurements are derived. This process can be implemented as a conventional beamformer leading to estimates of the direction of arrival of the echoes for each time sample. The process is inadequate in resolving closely spaced synchronous returns and the accuracy of these estimates is proportional to the number of acoustic data samples used in the process. To improve the angular resolution we have considered a number of high-resolution algorithms well known in power spectral estimation applications: autoregressive techniques (i.e. Yule-Walker , and unconstrained least squares), minimum variance methods (i.e. Capon\u27s method), and eigenanalysis algorithms (i.e. MUSIC). Comparisous of results obtained with realistic multibeam sonar siinulations show that these algorithms have higher accuracy and better potential for high-resolution bathymetry thau the conventional beamformer under nominal SNR levels

Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI -Group I (BMI < 50 kg/m2), Group II (BMI 50-60 kg/m2), and Group III (BMI > 60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 & PLUSMN; 24.4 Kgs and 43.03 & PLUSMN; 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively.The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = < 0.001). A significantly higher proportion of patients in group III received Sleeve Gastrectomy or One Anastomosis Gastric Bypass compared to other groups. Patients with a BMI of > 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

BACKGROUND There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. METHODS We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. RESULTS Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. CONCLUSIONS BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Background Age >= 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients >= 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 +/- 2.5 years, 119.5 +/- 24.5 kg, and 43 +/- 7 in Group I and 39.8 +/- 11.3 years, 117.7 +/- 20.4 kg, and 43.7 +/- 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I ( 11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those >= 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups