Deformations of symplectic foliations

We develop the deformation theory of symplectic foliations, i.e. regular foliations equipped with a leafwise symplectic form. The main result of this paper is that each symplectic foliation has an attached $L_\infty$-algebra controlling its deformation problem. Indeed, viewing symplectic foliations as regular Poisson structures, we establish a one-to-one correspondence between the small deformations of a given symplectic foliation and the Maurer-Cartan elements of the associated $L_\infty$-algebra. Using this, we show that infinitesimal deformations of symplectic foliations can be obstructed. Further, we relate symplectic foliations with foliations on one side and with (arbitrary) Poisson structures on the other, showing that obstructed infinitesimal deformations of the former may give rise to unobstructed infinitesimal deformations of the latter

Features and prognostic impact of distant metastases in 45 dogs with de novo stage IV cutaneous mast cell tumours: A prospective study

BACKGROUND: Distant metastases in dogs with cutaneous mast cell tumors (cMCT) are rare and incurable. The aims of this prospective study were to clarify the clinico-pathological features of stage IV cMCTs and to identify possible prognostic factors for progression-free interval (PFI) and survival time (ST). MATERIAL AND METHODS: Dogs were eligible for recruitment if they had a previously untreated, histologically confirmed cMCT and if they underwent complete staging demonstrating stage IV disease. Dogs were uniformly followed-up, whereas treatment was not standardized and included no therapy, surgery, radiation therapy, chemotherapy, tyrosine-kinase inhibitors or a combination of these. RESULTS: 45 dogs with stage IV cMCT were enrolled. All dogs had distant metastatic disease, and 41 (91.1%) dogs had also metastasis in the regional lymph node. Histopathological grade and mutational status greatly varied among dogs. Median ST was 110 days. Notably, PFI and ST were independent of well-known prognostic factors, including anatomic site, histological grade, and mutational status. Conversely, tumor diameter >3\u2009cm, more than 2 metastatic sites, bone marrow infiltration, and lack of tumor control at the primary site were confirmed to be negative prognostic factors by multivariate analysis. CONCLUSION: Currently, there is no satisfactory treatment for stage IV cMCT. Asymptomatic dogs with tumor diameter <3\u2009cm and a low tumor burden, without bone marrow infiltration may be candidates for multimodal treatment. Stage IV dogs without lymph node metastasis may enjoy a surprisingly prolonged survival. The achievement of local tumor control seems to predict a better outcome in dogs with stage IV cMCT

MyPHRMachines: Lifelong Personal Health Records in the Cloud

Personal Health Records (PHRs) should remain the lifelong property of patients and should be showable conveniently and securely to selected caregivers. Regarding interoperability, current solutions for PHRs focus on standard data exchange formats and transformations to move data across health information systems. In this paper we propose MyPHRMachines, a patient-centric system that takes a radically new architectural solution to health record interoperability. We propose to deploy besides the medical data also the related software to the PHR system. After uploading their medical data to MyPHRMachines, patients can access them again from remote virtual machines that contain the right software to visualize and analyze them without any conversion. Patients can share their remote virtual machine session with a selected health provider, who will need only a Web browser to access the pre-loaded fragments of the lifelong PHR. We illustrate how our prototype already supports the use case of a real-world patient and discuss the research agenda required to translate this prototype into a viable solution for the international healthcare industry

Proposition of a method for stochastic analysis of value streams

This article aims at proposing a method to stochastically analyze values streams taking into consideration the effect of critical uncertainty sources on lead time. The proposed method combines value stream mapping (VSM) and Monte Carlo simulation to identify improvement opportunities. To illustrate this approach, we carried out a case study in the special nutrition value stream of a Brazilian public hospital. Results show that the proposed method allows the identification of improvement opportunities that would not be considered in the classical deterministic VSM approach. Further, the integration of the stochastic analysis enables the determination of a more realistic lead time, which supports a more assertive planning and scheduling of the value stream. The proposed method addresses a fundamental gap in traditional VSM without adding much complexity to the analysis procedure, which is a common practical issue in previous works that integrated other stochastic methods into VSM

Eating disorders: What age at onset?

Age at onset (AAO) of eating disorders has classically been described in adolescence. We analyzed data from 806 subjects with anorexia nervosa (AN) or bulimia nervosa (BN) and performed a normal distribution admixture analysis to determine their AAO. No significant differences were found concerning the AAO functions of AN and BN subjects. Both groups had a mean AAO of about 18 years. Most of the subjects with AN (75.3%) and BN (83.3%) belonged to the early onset group. The definition of AAO for ED may be crucial for planning treatment modalities, with specific consideration of their clinical history and course

An exploration of operational excellence methodologies implementation in the logistics sectors: a global study

Purpose: The aim of this study reported in this paper was to explore the application of operational excellence methodologies in a global context. Design/methodology/approach: A qualitative interview approach was used to understand the current state, benefits, challenges, success factors, tools, and techniques of operational excellence methodology implementation with relevance to logistics companies worldwide. Sixteen interviews were undertaken with practitioners working in leading companies and with leading academics in Asia, Europe, Africa, North America, South America and Australia. Findings: The findings show that operational excellence methodologies including Lean, Six Sigma, Lean Six Sigma, and Agile can apply in logistics firms to improve operations and productivity, and save costs. Top management support and involvement play an important role in the success of operational excellence projects in the logistics service. Research limitations/implications: The findings will be of interest to top and middle managers and logistics practitioners, with a dual aim of improving logistics performance and saving cost. Originality: The present study has been one of the first global study attempts to explore the implementation of operational excellence methodologies in Logistics sectors

(2-Aminobenzothiazole)-Methyl-1,1-bisphosphonic acids: Targeting matrix metalloproteinase 13 inhibition to the bone

Matrix Metalloproteinases (MMPs) are a family of secreted and membrane-bound enzymes, of which 24 isoforms are known in humans. These enzymes degrade the proteins of the extracellular matrix and play a role of utmost importance in the physiological remodeling of all tissues. However, certain MMPs, such as MMP-2, -9, and -13, can be overexpressed in pathological states, including cancer and metastasis. Consequently, the development of MMP inhibitors (MMPIs) has been explored for a long time as a strategy to prevent and hinder metastatic growth, but the important side effects linked to promiscuous inhibition of MMPs prevented the clinical use of MMPIs. Therefore, several strategies were proposed to improve the therapeutic profile of this pharmaceutical class, including improved selectivity toward specific MMP isoforms and targeting of specific organs and tissues. Combining both approaches, we conducted the synthesis and preliminary biological evaluation of a series of (2-aminobenzothiazole)-methyl-1,1-bisphosphonic acids active as selective inhibitors of MMP-13 via in vitro and in silico studies, which could prove useful for the treatment of bone metastases thanks to the bone-targeting capabilities granted by the bisphosphonic acid group

Unlocking the potential: a study on the role of operational excellence in Oman’s energy sector

Purpose: Operational Excellence (OpEx) is a proven philosophy focusing on continuous improvement in processes and systems for superior performance and efficiency. It plays a crucial role in the energy sector, acting as a catalyst for safety, customer satisfaction, sustainability, and competitiveness. This research assesses OpEx methodologies in Oman's energy sector, examining methods, approaches, motivations, and sustainability. Methodology: This study applies qualitative analysis methodology, involving interviews with 18 industry experts, from the energy sector in a sizable energy country. Findings: The analysis revealed a growing demand, particularly in the oil and gas industry, driven by emerging business needs. Qualitative data analysis has identified 10 themes such as implemented methodologies, motivation drivers, deployment approaches, sustainability factors, benefits, and challenges. Additionally, new themes emerged, including influencers to start OpEx, resource requirements, enablers for successful OpEx, and system. Implications These findings contribute to understanding OpEx dynamics in the Omani energy sector, offering valuable insights for effective utilization and organizational goal achievement. Furthermore, the study offers valuable insights on how to effectively employ OpEx initiatives in the energy sector to achieve their goals and create value. It is addressing the lack of knowledge, offers a framework for successful OpEx implementation, bridging the theory-practice gap and providing insights for optimal utilization. Originality: This is the first empirical study on assessing OpEx methodologies in the energy sector, and therefore it serves as a foundation for many future studies. The study provides a theoretical foundation for the OpEx methodologies in terms of organizational readiness for successful OpEx implementation. Limitations: This research was limited to Oman and the findings drawn from Omani energy companies may have limited applicability to energy companies in other regions. Therefore, if these findings were to be used, the validation of the findings in relation to other countries should be conducted, to ensure the validity of the context and outcome

Human cytomegalovirus US28 facilitates cell-to-cell viral dissemination

Human cytomegalovirus (HCMV) encodes a number of viral proteins with homology to cellular G protein-coupled receptors (GPCRs). These viral GPCRs, including US27, US28, UL33, and UL78, have been ascribed numerous functions during infection, including activating diverse cellular pathways, binding to immunomodulatory chemokines, and impacting virus dissemination. To investigate the role of US28 during virus infection, two variants of the clinical isolate TB40/E were generated: TB40/E-US28(YFP) expressing a C-terminal yellow fluorescent protein tag, and TB40/E-FLAG(YFP) in which a FLAG-YFP cassette replaces the US28 coding region. The TB40/E-US28(YFP) protein localized as large perinuclear fluorescent structures at late times post-infection in fibroblasts, endothelial, and epithelial cells. Interestingly, US28(YFP) is a non-glycosylated membrane protein throughout the course of infection. US28 appears to impact cell-to-cell spread of virus, as the ΔUS28 virus (TB40/E-FLAG(YFP)) generated a log-greater yield of extracellular progeny whose spread could be significantly neutralized in fibroblasts. Most strikingly, in epithelial cells, where dissemination of virus occurs exclusively by the cell-to-cell route, TB40/E-FLAG(YFP) (ΔUS28) displayed a significant growth defect. The data demonstrates that HCMV US28 may contribute at a late stage of the viral life cycle to cell-to-cell dissemination of virus