R-local Delaunay inhibition model

Let us consider the local specification system of Gibbs point process with inhib ition pairwise interaction acting on some Delaunay subgraph specifically not con taining the edges of Delaunay triangles with circumscribed circle of radius grea ter than some fixed positive real value $R$. Even if we think that there exists at least a stationary Gibbs state associated to such system, we do not know yet how to prove it mainly due to some uncontrolled "negative" contribution in the expression of the local energy needed to insert any number of points in some large enough empty region of the space. This is solved by introducing some subgraph, called the $R$-local Delaunay graph, which is a slight but tailored modification of the previous one. This kind of model does not inherit the local stability property but satisfies s ome new extension called $R$-local stability. This weakened property combined with the local property provides the existence o f Gibbs state.Comment: soumis \`{a} Journal of Statistical Physics 27 page

Learning about pain from others: an observational learning account

Although direct experience and verbal instruction are important sources in the development of pain-related beliefs and behaviors, accumulating evidence indicates that observation of others in pain may be equally as important. Taking a contemporary view on learning as a starting point, we discuss available evidence on observational learning in the context of pain, highlight its importance for both development and management of chronic pain problems, and discuss potential moderators of observational learning effects. We argue that the capacity to understand and appreciate the experience of another person is fundamental to observational learning, including use of this information to establish the association between pain and antecedent or consequent stimuli. A main objective of this paper is to stimulate research on the role of learning about pain from others. Several lines for further research, including clinical applications, are delineated. Perspective: Based upon a contemporary view on learning, this focus article delineates how pain-related beliefs and behaviors may be learnt by observing others. It is discussed how further research on the acquisition of pain-related beliefs/behaviors might further our understanding of pain and disability. (PsycINFO Database Record (c) 2011 APA, all rights reserved) (journal abstract

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Lean body mass changes in cancer patients with weight loss

Background and Aims: Metabolic measurements (e.g. resting energy expenditure) are adjusted to lean body mass to account for body composition differences. Usually lean body mass is estimated from total body water. However, this may be compromised in weight-losing cancer patients owing to alterations in the degree of hydration of the lean body mass. This study examined the relationship between two independent estimates of lean body mass in healthy subjects and cancer patients with weight loss. Methods and Results: Height, weight, total body water and total body potassium were measured in healthy subjects (n = 9) and weight losing cancer patients (n = 13). They were similar in terms of age and gender. However, the cancer group had a significantly lower percentage ideal body weight (P lt 0.001). The measured total body water values in both groups were similar to those predicted. In contrast, measured total body potassium values in the cancer group were significantly lower than predicted (P lt 0.001). There was a correlation between the ratio of measured lean body mass (water/lean bodymass (potassium) and the percentage weight loss (r = 0.698, P lt 0.001). Conclusions: These results suggest that total body water significantly overestimates metabolically active tissue in weight-losing cancer patients and therefore its use as the basis for metabolic requirements in this group of patients is questionable

Longitudinal study of body cell mass depletion and the inflammatory response in cancer patients

There is recent evidence that the inflammatory response may be important in the disproportionate loss of body cell mass in cancer patients. To examine this further, 18 male patients with lung or gastrointestinal cancer were studied over a 12-week period. In addition to weight, anthropometry, C-reactive protein (marker of the inflammatory response), albumin, and total body potassium were measured at baseline and 12 weeks. When those patients who lost total body potassium were compared with those who had not, there was a significant increase in the baseline and 12-week C-reactive protein concentrations (p &#60; 0.05). The reduction in total body potassium was also associated with a reduction in triceps skinfold thickness (p &#60; 0.05). There were significant correlations between the mean C-reactive protein concentration and the relative (r = -0.846, p &#60; 0.001) and absolute (r = -0.806, p &#60; 0.001) change in total body potassium over the follow-up period. This study demonstrates the association of a chronic inflammatory response with the rate of loss of body cell mass observed in cancer patients