International Consensus Statement on Allergy and Rhinology: Rhinosinusitis

BACKGROUND: The body of knowledge regarding rhinosinusitis (RS) continues to expand, with rapid growth in number of publications yet substantial variability in the quality of those presentations. In an effort to both consolidate and critically appraise this information, rhinologic experts from around the world have produced the International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR:RS). This executive summary consolidates the findings of the ICAR:RS document. METHODS: ICAR:RS presents over 140 topics in the forms of evidence-based reviews with recommendations (EBRRs) and evidence-based reviews (EBR). The structured recommendations of the EBRR sections are summarized in this executive summary. RESULTS: This summary compiles the EBRRs regarding medical and surgical management of acute RS (ARS) and chronic RS with and without nasal polyps (CRSwNP and CRSsNP). CONCLUSION: This ICAR:RS Executive Summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS

Webs of Lagrangian Tori in Projective Symplectic Manifolds

For a Lagrangian torus A in a simply-connected projective symplectic manifold M, we prove that M has a hypersurface disjoint from a deformation of A. This implies that a Lagrangian torus in a compact hyperk\"ahler manifold is a fiber of an almost holomorphic Lagrangian fibration, giving an affirmative answer to a question of Beauville's. Our proof employs two different tools: the theory of action-angle variables for algebraically completely integrable Hamiltonian systems and Wielandt's theory of subnormal subgroups.Comment: 18 pages, minor latex problem fixe

Forecasting Value-at-Risk Using Nonlinear Regression Quantiles and the Intraday Range

Value-at-Risk (VaR) is commonly used for financial risk measurement. It has recently become even more important, especially during the 2008-09 global financial crisis. We propose some novel nonlinear threshold conditional autoregressive VaR (CAViar) models that incorporate intra-day price ranges. Model estimation and inference are performed using the Bayesian approach via the link with the Skewed-Laplace distribution. We examine how a range of risk models perform during the 2008-09 financial crisis, and evaluate how the crisis affects the performance of risk models via forecasting VaR. Empirical analysis is conducted on five Asia-Pacific Economic Cooperation stock market indices and two exchange rates????. We examine violation rates, back-testing criteria, market risk charges and quantile loss function to measure the forecasting performance of a variety of risk models. The proposed threshold CAViaR model, incorporating range information, is shown to forecast VaR more efficiently than other models, which should be useful for financial practitioners

Modular Nucleic Acid Assembled p/MHC Microarrays for Multiplexed Sorting of Antigen-Specific T Cells

The human immune system consists of a large number of T cells capable of recognizing and responding to antigens derived from various sources. The development of peptide-major histocompatibility (p/MHC) tetrameric complexes has enabled the direct detection of these antigen-specific T cells. With the goal of increasing throughput and multiplexing of T cell detection, protein microarrays spotted with defined p/MHC complexes have been reported, but studies have been limited due to the inherent instability and reproducibility of arrays produced via conventional spotted methods. Herein, we report on a platform for the detection of antigen-specific T cells on glass substrates that offers significant advantages over existing surface-bound schemes. In this approach, called “Nucleic Acid Cell Sorting (NACS)”, single-stranded DNA oligomers conjugated site-specifically to p/MHC tetramers are employed to immobilize p/MHC tetramers via hybridization to a complementary-printed substrate. Fully assembled p/MHC arrays are used to detect and enumerate T cells captured from cellular suspensions, including primary human T cells collected from cancer patients. NACS arrays outperform conventional spotted arrays assessed in key criteria such as repeatability and homogeneity. The versatility of employing DNA sequences for cell sorting is exploited to enable the programmed, selective release of target populations of immobilized T cells with restriction endonucleases for downstream analysis. Because of the performance, facile and modular assembly of p/MHC tetramer arrays, NACS holds promise as a versatile platform for multiplexed T cell detection

Charmed Baryons with J=3/2J = 3/2

The width of a recently discovered excited charmed-strange baryon, a candidate for a state $\Xi_c^*$ with spin 3/2, is calculated. In the absence of configuration mixing between the ground-state (spin-1/2) charmed-strange baryon $\Xi_c^{(a)}$ and the spin-1/2 state $\Xi_c^{(s)}$ lying about 95 MeV above it, one finds $\tilde \Gamma(\Xi^*_c \to \Xi_c^{(a)} \pi) = (3/4) \tilde \Gamma(\Xi^* \to \Xi \pi)$ and $\tilde \Gamma(\Xi^*_c \to \Xi_c^{(s)} \pi) = (1/4) \tilde \Gamma(\Xi^* \to \Xi \pi)$, where the tilde denotes the partial width with kinematic factors removed. Assuming a kinematic factor for P-wave decay of $p_{\rm cm}^3$, one predicts $\Gamma(\Xi^*_c \to \Xi_c^{(a)} \pi) = 2.3$ MeV, while the $\Xi^*_c \to \Xi_c^{(s)} \pi$ channel is closed. Some suggestions are given for detecting the $\Sigma_c^*$, the spin-3/2 charmed nonstrange baryon, and the $\Omega_c^*$, the spin-3/2 charmed doubly-strange baryon.Comment: 11 pages, latex, 2 uuencoded figures sent separatel

Scalar mesons in the Nambu--Jona-Lasinio model with 't Hooft interaction

We calculate the mass spectra of the pseudoscalar and scalar meson nonets in the Nambu--Jona-Lasinio model with the 't Hooft interaction. We obtain satisfactory result for the pseudoscalar mesons. For the scalar mesons, the 't Hooft interaction somewhat increases the values of the masses. However, it is not sufficient to explain the whole scalar mass spectrum. The situation could be improved for the $\sigma$ and $f_0$ mesons through mixing with the glueball state. For the description of the masses of $a_0$ and \kstar mesons, it is necessary to involve the other models. The strong decay widths of the scalar mesons are described.Comment: LaTeX text, 8 page

Flip chip packaging of digital silicon photonics MEMS Switch for cloud computing and data centre

We report on the flip chip packaging of Micro-Electro-Mechanical System (MEMS)-based digital silicon photonic switching device and the characterization results of 12 × 12 switching ports. The challenges in packaging N2 electrical and 2N optical interconnections are addressed with single-layer electrical redistribution lines of 25 µm line width and space on aluminum nitride interposer and 13° polished 64-channel lidless fiber array (FA) with a pitch of 127 µm. 50 µm diameter solder spheres are laser-jetted onto the electrical bond pads surrounded by suspended MEMS actuators on the device before fluxless flip-chip bonding. A lidless FA is finally coupled near-vertically onto the device gratings using a 6-degree-of-freedom (6-DOF) alignment system. Fiber-to-grating coupler loss of 4.25 dB/facet, 10–11 bit error rate (BER) through the longest optical path, and 0.4 µs switch reconfiguration time have been demonstrated using 10 Gb/s Ethernet data stream

MBE grown GaAsBi/GaAs multiple quantum well structures: Structural and optical characterization

A series of GaAsBi/GaAs multiple quantum well p–i–n diodes were grown by molecular beam epitaxy. Nomarski images showed evidence of sub-surface damage in each diode, with an increase in the cross-hatching associated with strain relaxation for the diodes containing more than 40 quantum wells. X-ray diffraction ω–2θ scans of the (004) reflections showed that multiple quantum well regions with clearly defined well periodicities were grown. The superlattice peaks of the diodes containing more than 40 wells were much broader than those of the other diodes. The photoluminescence spectra showed a redshift of 56 meV and an attenuation of nearly two orders of magnitude for the 54 and 63 well diodes. Calculations of the quantum confinement and strain induced band gap modifications suggest that the wells in all diodes are thinner than their intended widths and that both loss of quantum confinement and strain probably contributed to the observed redshift and attenuation in the 54 and 63 well diodes. Comparison of this data with that gathered for InGaAs/GaAs multiple quantum wells, suggests that the onset of relaxation occurs at a similar average strain–thickness product for both systems. Given the rapid band gap reduction of GaAsBi with Bi incorporation, this data suggests that GaAsBi is a promising photovoltaic material candidate

The ENIGMA Stroke Recovery Working Group: Big data neuroimaging to study brain–behavior relationships after stroke

The goal of the Enhancing Neuroimaging Genetics through Meta‐Analysis (ENIGMA) Stroke Recovery working group is to understand brain and behavior relationships using well‐powered meta‐ and mega‐analytic approaches. ENIGMA Stroke Recovery has data from over 2,100 stroke patients collected across 39 research studies and 10 countries around the world, comprising the largest multisite retrospective stroke data collaboration to date. This article outlines the efforts taken by the ENIGMA Stroke Recovery working group to develop neuroinformatics protocols and methods to manage multisite stroke brain magnetic resonance imaging, behavioral and demographics data. Specifically, the processes for scalable data intake and preprocessing, multisite data harmonization, and large‐scale stroke lesion analysis are described, and challenges unique to this type of big data collaboration in stroke research are discussed. Finally, future directions and limitations, as well as recommendations for improved data harmonization through prospective data collection and data management, are provided

Clinical Practice Recommendations on Genetic Testing of CYP2C9 and VKORC1 Variants in Warfarin Therapy

Objective: To systematically review evidence on genetic variants influencing outcomes during warfarin therapy and provide practice recommendations addressing the key questions: (1) Should genetic testing be performed in patients with an indication for warfarin therapy to improve achievement of stable anticoagulation and reduce adverse effects? (2) Are there subgroups of patients who may benefit more from genetic testing compared with others? (3) How should patients with an indication for warfarin therapy be managed based on their genetic test results? Methods: A systematic literature search was performed for VKORC1 and CYP2C9 and their association with warfarin therapy. Evidence was critically appraised, and clinical practice recommendations were developed based on expert group consensus. Results: Testing of VKORC1 (-1639G\u3eA), CYP2C92, and CYP2C93 should be considered for all patients, including pediatric patients, within the first 2 weeks of therapy or after a bleeding event. Testing for CYP2C95, 6, 8, or 11 and CYP4F2 (V433M) is currently not recommended. Testing should also be considered for all patients who are at increased risk of bleeding complications, who consistently show out-of-range international normalized ratios, or suffer adverse events while receiving warfarin. Genotyping results should be interpreted using a pharmacogenetic dosing algorithm to estimate the required dose. Significance: This review provides the latest update on genetic markers for warfarin therapy, clinical practice recommendations as a basis for informed decision making regarding the use of genotype-guided dosing in patients with an indication for warfarin therapy, and identifies knowledge gaps to guide future research.