A Peer to Peer Protocol for Online Dispute Resolution over Storage Consumption

In bilateral accounting of resource consumption both the consumer and provider independently measure the amount of resources consumed by the consumer. The problem here is that potential disparities between the provider's and consumer's accountings, might lead to conflicts between the two parties that need to be resolved. We argue that with the proper mechanisms available, most of these conflicts can be solved online, as opposite to in court resolution; the design of such mechanisms is still a research topic; to help cover the gap, in this paper we propose a peer--to--peer protocol for online dispute resolution over storage consumption. The protocol is peer--to--peer and takes into consideration the possible causes (e.g, transmission delays, unsynchronized metric collectors, etc.) of the disparity between the provider's and consumer's accountings to make, if possible, the two results converge.Comment: 12 pages, 7 figure

IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a Modified Delphi Study

Background: One-anastomosis gastric bypass (OAGB-MGB) is currently the third performed primary bariatric surgical procedure worldwide. However, the procedure is hampered by numerous controversies and there is considerable variability in surgical technique, patient selection, and pre- and postoperative care among the surgeons performing this procedure. This paper reports the results of a modified Delphi consensus study organized by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO). Methods: Fifty-two internationally recognized bariatric experts from 28 countries convened for voting on 90 consensus statements over two rounds to identify those on which consensus could be reached. Inter-voter agreement of ≥ 70% was considered consensus, with voting participation ≥ 80% considered a robust vote. Results: At least 70% consensus was achieved for 65 of the 90 questions (72.2% of the items), 61 during the first round of voting and an additional four in the second round. Where consensus was reached on a binary agree/disagree or yes/no item, there was agreement with the statement presented in 53 of 56 instances (94.6%). Where consensus was reached on a statement where options favorable versus unfavorable to OAGB-MGB were provided, including statements in which OAGB-MGB was compared to another procedure, the response option favorable to OAGB-MGB was selected in 13 of 23 instances (56.5%). Conclusion: Although there is general agreement that the OAGB-MGB is an effective and usually safe option for the management of patients with obesity or severe obesity, numerous areas of non-consensus remain in its use. Further empirical data are needed

Esophageal and Gastric Malignancies After Bariatric Surgery: a Retrospective Global Study

Background: Bariatric surgery can influence the presentation, diagnosis, and management of gastrointestinal cancers. Esophagogastric (EG) malignancies in patients who have had a prior bariatric procedure have not been fully characterized. Objective: To characterize EG malignancies after bariatric procedures. Setting: University Hospital, United Kingdom. Methods: We performed a retrospective, multicenter observational study of patients with EG malignancies after bariatric surgery to characterize this condition. Results: This study includes 170 patients from 75 centers in 25 countries who underwent bariatric procedures between 1985 and 2020. At the time of the bariatric procedure, the mean age was 50.2 ± 10 years, and the mean weight 128.8 ± 28.9 kg. Women composed 57.3% (n = 98) of the population. Most (n = 64) patients underwent a Roux-en-Y gastric bypass (RYGB) followed by adjustable gastric band (AGB; n = 46) and sleeve gastrectomy (SG; n = 43). Time to cancer diagnosis after bariatric surgery was 9.5 ± 7.4 years, and mean weight at diagnosis was 87.4 ± 21.9 kg. The time lag was 5.9 ± 4.1 years after SG compared to 9.4 ± 7.1 years after RYGB and 10.5 ± 5.7 years after AGB. One third of patients presented with metastatic disease. The majority of tumors were adenocarcinoma (82.9%). Approximately 1 in 5 patients underwent palliative treatment from the outset. Time from diagnosis to mortality was under 1 year for most patients who died over the intervening period. Conclusion: The Oesophago-Gastric Malignancies After Obesity/Bariatric Surgery study presents the largest series to date of patients developing EG malignancies after bariatric surgery and attempts to characterize this condition.info:eu-repo/semantics/publishedVersio

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients

30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts

The Epidemiology and Pharmacoepidemiology of Multiple Sclerosis in Saskatchewan

My PhD project involved examining the epidemiology and pharmacoepidemiology of multiple sclerosis (MS) in Saskatchewan through the use of health administrative data. First, I validated a case definition of MS for administrative data, and then used the validated definition to determine the incidence and prevalence of MS in Saskatchewan. Prior to my studies, Saskatchewan was thought to have one of the highest rates of MS in Canada, but province-wide estimates were not available. I utilized the provincial MS cohort to then describe trends of healthcare utilization and the potential associations with comorbidities and use of disease-modifying therapies (DMTs) for MS using various study designs and methodologies. Both all-cause and MS-specific hospitalizations have decreased over time, but still remain higher than the general population. DMTs were associated with a minimal reduction in all-cause and MS-specific hospitalizations, and did not impact the number of physician services used. Higher rates of all-cause hospitalizations were observed in individuals that are older, have a higher comorbidity burden, and have previous hospitalizations, whereas the rate of MS-related hospitalizations increased with male sex and younger age. Comorbidity burden increased the rate of all-cause hospitalizations in a dose-response manner, but did not impact MS-related admissions. Finally, decreases in both all-cause and MS-specific hospitalizations was observed with an increase in disease duration. My research confirms that Saskatchewan has one of the highest rates of MS worldwide. While the introduction of DMTs has dramatically changed the management of MS, future research is needed to evaluate their true impact on subsequent healthcare utilization. Specific predictors, including individual comorbidities can be useful for identifying individuals with MS who are at higher risk for hospitalization, and can help guide collaborative efforts to manage the disease and prevent future hospitalizations

Automated re-invention of six patented optical lens systems using genetic programming

This paper describes how genetic programming was used as an invention machine to automatically synthesize complete designs for six optical lens systems that duplicated the functionality of previously patented lens systems. The automatic synthesis was done “from scratch”—that is, without starting from a preexisting good design and without pre-specifying the number of lenses, the physical layout of the lenses, the numerical parameters of the lenses, or the non-numerical parameters of the lenses. One of the six genetically evolved lens systems infringed a previously issued patent; three contained many of the essential features of the patents, without infringing; and the others were non-infringing novel designs that duplicated (or improved upon) the performance specifications contained in the patents. One of the six patents was issued in the 21 st-century. The six designs were created in a substantially similar and routine way, suggesting that the approach used may have widespread utility. The genetically evolved designs are instances of humancompetitive results produced by genetic programming in the field of optical design

Effect of Calcium and Potassium on Antioxidant System of <em>Vicia faba</em> L. Under Cadmium Stress

Cadmium (Cd) in soil poses a major threat to plant growth and productivity. In the present experiment, we studied the effect of calcium (Ca<sup>2+</sup>) and/or potassium (K<sup>+</sup>) on the antioxidant system, accumulation of proline (Pro), malondialdehyde (MDA), and content of photosynthetic pigments, cadmium (Cd) and nutrients, <em>i.e.</em>, Ca<sup>2+</sup> and K<sup>+</sup> in leaf of <em>Vicia faba </em>L. (cv. TARA) under Cd stress. Plants grown in the presence of Cd exhibited reduced growth traits [root length (RL) plant<sup>−1</sup>, shoot length (SL) plant<sup>−1</sup>, root fresh weight (RFW) plant<sup>−1</sup>, shoot fresh weight (SFW) plant<sup>−1</sup>, root dry weight (RDW) plant<sup>−1</sup> and shoot dry weight (SDW) plant<sup>−1</sup>] and concentration of Ca<sup>2+</sup>, K<sup>+</sup>, Chlorophyll (Chl) <em>a</em> and Chl <em>b </em>content, except content of MDA, Cd and (Pro). The antioxidant enzymes [peroxidase (POD) and superoxide dismutase (SOD)] slightly increased as compared to control under Cd stress. However, a significant improvement was observed in all growth traits and content of Ca<sup>2+</sup>, K<sup>+</sup>, Chl <em>a</em>, Chl <em>b </em>,Pro and activity of antioxidant enzymes catalase (CAT), POD and SOD in plants subjected to Ca<sup>2+</sup> and/or K<sup>+</sup>. The maximum alleviating effect was recorded in the plants grown in medium containing Ca<sup>2+</sup> and K<sup>+</sup> together. This study indicates that the application of Ca<sup>2+</sup> and/or K<sup>+</sup> had a significant and synergistic effect on plant growth. Also, application of Ca<sup>2+</sup> and/or K<sup>+</sup> was highly effective against the toxicity of Cd by improving activity of antioxidant enzymes and solute that led to the enhanced plant growth of faba bean plants. <strong> </strong> <strong> </strong&gt