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Björner and Wachs introduced CL-shellability as a technique for studying the topological structure of order complexes of partially ordered sets. They also introduced the notion of recursive atom ordering, and they proved that a finite bounded poset is CL-shellable if and only if it admits a recursive atom ordering.In this paper, a generalization of the notion of recursive atom ordering is introduced. A finite bounded poset is proven to admit such a generalized recursive atom ordering if and only if it admits a traditional recursive atom ordering. This is also proven equivalent to admitting a CC-shelling (a type of shelling introduced by Kozlov) with a further property called self-consistency. Thus, CL-shellability is proven equivalent to self-consistent CC-shellability. As an application, the uncrossing posets, namely the face posets for stratified spaces of planar electrical networks, are proven to be dual CL-shellable.Mathematics Subject Classifications: 05E45, 06A07Keywords: Poset topology, lexicographic shellability, EC-shellability, recursive atom ordering, uncrossing order

We consider the Atiyah-Patodi-Singer (APS) index theorem corresponding to the chiral symmetry of a continuum formulation of staggered fermions called K\"ahler-Dirac fermions, which have been recently investigated as an ingredient in lattice constructions of chiral gauge theories. We point out that there are two notions of chiral symmetry for K\"ahler-Dirac fermions, both having a mixed perturbative anomaly with gravity leading to index theorems on closed manifolds. By formulating these theories on a manifold with boundary, we find the APS index theorems corresponding to each of these symmetries, necessary for a complete picture of anomaly inflow, using a recently discovered physics-motivated proof. We comment on a fundamental difference between the nature of these two symmetries by showing that a sensible local, symmetric boundary condition only exists for one of the two symmetries. This sheds light on how these symmetries behave under lattice discretization, and in particular on their use for recent symmetric-mass generation proposals., Comment: 12 pages, 1 figure

BACKGROUND: Surgical revascularization decreases the long-term risk of stroke in children with moyamoya arteriopathy but can be associated with an increased risk of stroke during the perioperative period. Evidence-based approaches to optimize perioperative management are limited and practice varies widely. Using a modified Delphi process, we sought to establish expert consensus on key components of the perioperative care of children with moyamoya undergoing indirect revascularization surgery and identify areas of equipoise to define future research priorities. METHODS: Thirty neurologists, neurosurgeons, and intensivists practicing in North America with expertise in the management of pediatric moyamoya were invited to participate in a three-round, modified Delphi process consisting of a 138-item practice patterns survey, anonymous electronic evaluation of 88 consensus statements on a 5-point Likert scale, and a virtual group meeting during which statements were discussed, revised, and reassessed. Consensus was defined as ≥ 80% agreement or disagreement. RESULTS: Thirty-nine statements regarding perioperative pediatric moyamoya care for indirect revascularization surgery reached consensus. Salient areas of consensus included the following: (1) children at a high risk for stroke and those with sickle cell disease should be preadmitted prior to indirect revascularization; (2) intravenous isotonic fluids should be administered in all patients for at least 4 h before and 24 h after surgery; (3) aspirin should not be discontinued in the immediate preoperative and postoperative periods; (4) arterial lines for blood pressure monitoring should be continued for at least 24 h after surgery and until active interventions to achieve blood pressure goals are not needed; (5) postoperative care should include hourly vital signs for at least 24 h, hourly neurologic assessments for at least 12 h, adequate pain control, maintaining normoxia and normothermia, a

While high circulating tumor DNA (ctDNA) levels are associated with poor survival for multiple cancers, variant-specific differences in the association of ctDNA levels and survival have not been examined. Here we investigate KRAS ctDNA (ctKRAS) variant-specific associations with overall and progression-free survival (OS/PFS) in first-line metastatic pancreatic ductal adenocarcinoma (mPDAC) for patients receiving chemoimmunotherapy (PRINCE, NCT03214250), and an independent cohort receiving standard of care (SOC) chemotherapy. For PRINCE, higher baseline plasma levels are associated with worse OS for ctKRAS G12D (log-rank p = 0.0010) but not G12V (p = 0.7101), even with adjustment for clinical covariates. Early, on-therapy clearance of G12D (p = 0.0002), but not G12V (p = 0.4058), strongly associates with OS for PRINCE. Similar results are obtained for the SOC cohort, and for PFS in both cohorts. These results suggest ctKRAS G12D but not G12V as a promising prognostic biomarker for mPDAC and that G12D clearance could also serve as an early biomarker of response.

Chimeric antigen receptor (CAR) T cells have made a tremendous impact in the clinic, but potent signaling through the CAR can be detrimental to treatment safety and efficacy. The use of protein degradation to control CAR signaling can address these issues in preclinical models. Existing strategies for regulating CAR stability rely on small molecules to induce systemic degradation. In contrast to small molecule regulation, genetic circuits offer a more precise method to control CAR signaling in an autonomous cell-by-cell fashion. Here, we describe a programmable protein degradation tool that adopts the framework of bioPROTACs, heterobifunctional proteins that are composed of a target recognition domain fused to a domain that recruits the endogenous ubiquitin proteasome system. We develop novel bioPROTACs that utilize a compact four-residue degron and demonstrate degradation of cytosolic and membrane protein targets using either a nanobody or synthetic leucine zipper as a protein binder. Our bioPROTACs exhibit potent degradation of CARs and can inhibit CAR signaling in primary human T cells. We demonstrate the utility of our bioPROTACs by constructing a genetic circuit to degrade the tyrosine kinase ZAP70 in response to recognition of a specific membrane-bound antigen. This circuit can disrupt CAR T cell signaling only in the presence of a specific cell population. These results suggest that bioPROTACs are powerful tools for expanding the CAR T cell engineering toolbox.

Purpose: Living alone is increasing and associated with health and social risks. Aphasia compounds these risks but there is little research on how living alone interacts with aphasia. This study is a preliminary exploration of this issue. Method: Five people with aphasia who lived alone participated in two supported semi-structured interviews, with the second interview including sharing an artefact that held significance for living alone with aphasia. Interviews were recorded, transcribed verbatim, and analysed through reflexive thematic analysis. Result: Four themes encompassed meaning-making about living alone with aphasia: relationships and reliance on others; risk, vulnerability, and uncertainty; loneliness and time alone; self-reliance and the need to keep busy. Participants had to continuously manage and renegotiate daily challenges around living alone with aphasia. Conclusion: Living alone increases the risk of loneliness. For people with aphasia, the buffer against loneliness provided by social connection and meaningful activity may be more difficult to achieve because of communication challenges. While experiences vary, reliance on others, managing practical and administrative tasks, and negotiating risks are all important issues when alone. The intersection of living alone, loneliness, and living with aphasia needs more research, and more explicit clinical focus when discussing and planning intervention and support.

INTRODUCTION: People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. METHODS AND ANALYSIS: This research aims to deliver a comprehensive quality assessment toolkit for poststroke aphasia services in four studies. A multicentre pilot study (study 1) will test the administration of the MEASuRES minimum dataset within five Australian health services. An embedded mixed-methods process evaluation (study 2) will evaluate the performance of the minimum dataset and explore its clinical applicability. A consensus study (study 3) will establish consumer-informed thresholds of meaningful change on core aphasia outcome constructs, which will then be used to establish minimal important change values for corresponding core outcome measurement instruments (study 4). ETHICS AND DISSEMINATION: Studies 1 and 2 have been registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12623001313628). Ethics approval has been obtained from the Royal Brisbane and Women's Hospital (HREC/2023/MNHB/95293) and The University of Queensland (2022/HE001946 and 2023/HE001175). Study findings will be disseminated through peer-reviewed publications, conference presentations and engagement with relevant stakeholders including healthcare providers, policy-makers, stroke and rehabilitation audit and clinical quality registry cus

Multi-modal sensor data fusion takes advantage of complementary or reinforcing information from each sensor and can boost overall performance in applications such as scene classification and target detection. This paper presents a new method for fusing multi-modal and multi-resolution remote sensor data without requiring pixel-level training labels, which can be difficult to obtain. Previously, we developed a Multiple Instance Multi-Resolution Fusion (MIMRF) framework that addresses label uncertainty for fusion, but it can be slow to train due to the large search space for the fuzzy measures used to integrate sensor data sources. We propose a new method based on binary fuzzy measures, which reduces the search space and significantly improves the efficiency of the MIMRF framework. We present experimental results on synthetic data and a real-world remote sensing detection task and show that the proposed MIMRF-BFM algorithm can effectively and efficiently perform multi-resolution fusion given remote sensing data with uncertainty., Comment: 4 pages, 3 figures, 2 tables; Accepted to International Geoscience and Remote Sensing Symposium (IGARSS) 2023; Code available at https://github.com/hvak/MIMRF-BFM

Computer-aided diagnosis systems hold great promise to aid radiologists and clinicians in radiological clinical practice and enhance diagnostic accuracy and efficiency. However, the conventional systems primarily focus on delivering diagnostic results through text report generation or medical image classification, positioning them as standalone decision-makers rather than helpers and ignoring radiologists' expertise. This study introduces an innovative paradigm to create an assistive co-pilot system for empowering radiologists by leveraging Large Language Models (LLMs) and medical image analysis tools. Specifically, we develop a collaborative framework to integrate LLMs and quantitative medical image analysis results generated by foundation models with radiologists in the loop, achieving efficient and safe generation of radiology reports and effective utilization of computational power of AI and the expertise of medical professionals. This approach empowers radiologists to generate more precise and detailed diagnostic reports, enhancing patient outcomes while reducing the burnout of clinicians. Our methodology underscores the potential of AI as a supportive tool in medical diagnostics, promoting a harmonious integration of technology and human expertise to advance the field of radiology.

This report is based on the first international education indicators produced by the Organization for Economic Co-operation and Development (OECD). The 16 indicators were chosen to take advantage of data available in "Education at a Glance," the most up-to-date set of international educational indicators. Indicators are grouped into categories of: (1) background; (2) participation; (3) outcomes; and (4) finance. In addition, results from the National Assessment of Educational Progress study of mathematics achievement of eighth graders have been statistically linked to results from a similar international study. The presentation of each indicator includes an explanation of what it means, why it is important, and key results from a comparison of countries and states. Comparisons are most often made among "like-size" entities. For each indicator, tables are included for states and countries along with a graph that displays this data together. The indicators are policy-relevant and problem-oriented measures of the state of a system. A commitment to reaching world-class education performance is expressed in the National Education Goals of 1990. These indicators provide information necessary to plan for these goals. Eighteen figures and 32 tables present indicators. An appendix provides technical information about the comparison process and includes standard error tables for indicators. A glossary and technical notes are attached. (SLD)

We give a general derivation of Ginsparg-Wilson relations for both Dirac and Majorana fermions in any dimension. These relations encode continuous and discrete chiral, parity and time reversal anomalies and will apply to the various classes of free fermion topological insulators and superconductors (in the framework of a relativistic quantum field theory in Euclidean spacetime). We show how to formulate the exact symmetries of the lattice action and the relevant index theorems for the anomalies., Comment: 14 pages. Submitted Version. Section III.D revised, and other minor improvements

Item does not contain fulltext, Emotion regulates our memory in daily life. Previous studies have shown that extrinsic emotion during encoding impairs the memory for target stimulus. However, most previous studies focused on the effects of emotion on the typical encoding without intentional retrieval. It remains unclear how emotion affects the retrieval-based encoding and memory. In the present study, we examined how encoding type (restudy versus retrieval practice) regulates emotional memory retention. We adopted a typical retrieval practice paradigm with an initial study phase, a second phase with either a restudy or a retrieval practice task, and a final recognition test. In order to create extrinsic emotional background, emotional pictures were used during the restudy and retrieval practice tasks. The recognition test was carried out 5 min or 24 h after the restudy or retrieval practice task. We found an emotional impairment effect on familiarity (5-min retention interval) under the retrieval practice condition, but not under the restudy condition, and an emotional enhancement effect on item memory (24-h retention interval) under the restudy condition, but not under the retrieval practice condition. The present study demonstrated the effect of encoding type on emotional memory and suggested a retention interval dependent effect of encoding type, contributing to the theory of emotional memory by highlighting the role of encoding type and retention interval.

BackgroundChronic obstructive pulmonary disease (COPD) varies significantly in symptomatic and physiologic presentation. Identifying disease subtypes from molecular data, collected from easily accessible blood samples, can help stratify patients and guide disease management and treatment.MethodsBlood gene expression measured by RNA-sequencing in the COPDGene Study was analyzed using a network perturbation analysis method. Each COPD sample was compared against a learned reference gene network to determine the part that is deregulated. Gene deregulation values were used to cluster the disease samples.ResultsThe discovery set included 617 former smokers from COPDGene. Four distinct gene network subtypes are identified with significant differences in symptoms, exercise capacity and mortality. These clusters do not necessarily correspond with the levels of lung function impairment and are independently validated in two external cohorts: 769 former smokers from COPDGene and 431 former smokers in the Multi-Ethnic Study of Atherosclerosis (MESA). Additionally, we identify several genes that are significantly deregulated across these subtypes, including DSP and GSTM1, which have been previously associated with COPD through genome-wide association study (GWAS).ConclusionsThe identified subtypes differ in mortality and in their clinical and functional characteristics, underlining the need for multi-dimensional assessment potentially supplemented by selected markers of gene expression. The subtypes were consistent across cohorts and could be used for new patient stratification and disease prognosis., QC 20230303

Indigenous Standpoint Theory forms the epistemological foundation for this study and methodological choices were made within this theoretical framework to ensure culturally responsive research processes that engaged the Indigenous agenda of self-determination and rights. The objectives of this research were to determine: (i) Indigenous perceptions of the facilitators and barriers to exercise; (ii) The potential feasibility and sustainability of an exercise intervention. In this context, Participatory Action Research methods were used to design the data-gathering instrument for the study-a questionnaire, co-designed with the Noongar Aboriginal community of Perth, Western Australia. This self-administered questionnaire, distributed to participants by email, post and manual delivery, sought to elicit the factors that impact uptake and retention of regular exercise activities. Questionnaire data included individual demographic detail and specific question responses on labelled 5 point Likert Scales. Specific question responses were tabulated by Likert Scale label category and the response distribution for each question was enumerated. Simple descriptive statistics (measures of central tendency and variance) were used to characterize the data set and the Chi squared test was used to evaluate frequency differences between males and females. A total of 133 participants (71 females) completed the questionnaire. The results indicated that people valued exercise. The most common barriers indicated by participants were exercising with an injury (63%), changing diet (58%), finding time to exercise every day (55%) and exercising the next day with pain from exercising the day before (54%). A larger proportion of males (34%) than females (24%) reported greater ease in finding time to exercise every day (p < 0.05). Facilitators mainly related to the potential social and community benefits of exercising with other people, preferably in small groups, and the importance of a culturall

Contains fulltext : 296108.pdf (Publisher’s version ) (Open Access), Rhythmicity in the millisecond to second range is a fundamental building block of communication and coordinated movement. But how widespread are rhythmic capacities across species, and how did they evolve under different environmental pressures? Comparative research is necessary to answer these questions but has been hindered by limited crosstalk and comparability among results from different study species. Most acoustics studies do not explicitly focus on characterising or quantifying rhythm, but many are just a few scrapes away from contributing to and advancing the field of comparative rhythm research. Here, we present an eight-level rhythm reporting framework which details actionable steps researchers can take to report rhythm-relevant metrics. Levels fall into two categories: metric reporting and data sharing. Metric reporting levels include defining rhythm-relevant metrics, providing point estimates of temporal interval variability, reporting interval distributions, and conducting rhythm analyses. Data sharing levels are: sharing audio recordings, sharing interval durations, sharing sound element start and end times, and sharing audio recordings with sound element start/end times. Using sounds recorded from a sperm whale as a case study, we demonstrate how each reporting framework level can be implemented on real data. We also highlight existing best practice examples from recent research spanning multiple species. We clearly detail how engagement with our framework can be tailored case-by-case based on how much time and effort researchers are willing to contribute. Finally, we illustrate how reporting at any of the suggested levels will help advance comparative rhythm research. This framework will actively facilitate a comparative approach to acoustic rhythms while also promoting cooperation and data sustainability. By quantifying and reporting rhythm metrics more consistently and broadly, new avenues of inquiry and several long-standing, big picture research

BackgroundChronic obstructive pulmonary disease (COPD) varies significantly in symptomatic and physiologic presentation. Identifying disease subtypes from molecular data, collected from easily accessible blood samples, can help stratify patients and guide disease management and treatment.MethodsBlood gene expression measured by RNA-sequencing in the COPDGene Study was analyzed using a network perturbation analysis method. Each COPD sample was compared against a learned reference gene network to determine the part that is deregulated. Gene deregulation values were used to cluster the disease samples.ResultsThe discovery set included 617 former smokers from COPDGene. Four distinct gene network subtypes are identified with significant differences in symptoms, exercise capacity and mortality. These clusters do not necessarily correspond with the levels of lung function impairment and are independently validated in two external cohorts: 769 former smokers from COPDGene and 431 former smokers in the Multi-Ethnic Study of Atherosclerosis (MESA). Additionally, we identify several genes that are significantly deregulated across these subtypes, including DSP and GSTM1, which have been previously associated with COPD through genome-wide association study (GWAS).ConclusionsThe identified subtypes differ in mortality and in their clinical and functional characteristics, underlining the need for multi-dimensional assessment potentially supplemented by selected markers of gene expression. The subtypes were consistent across cohorts and could be used for new patient stratification and disease prognosis.

Energy storage within hypersonic aircraft is becoming increasingly important with the development of more sophisticated electronic components and is an integral piece of expanding their overall capabilities. Hypersonics not only produce large external thermal loads, but also an abundance of internal thermal loads from components such as power electronics, avionics, and batteries. Additionally, limited volume within such vehicles introduces additional constraints. Thus, having efficient heat sinks that are capable of storing much of these heat loads is imperative. Passive thermal management systems, i.e., heat sinks, are preferable in most applications because they do not require power input to operate, and they are typically smaller than active systems such as coolant loops. In identifying and developing heat sinks with increased energy storage capability, an exhaustive search of available phase change materials (PCMs) is conducted. PCMs have been used in hypersonic vehicles in the past as a means of energy storage. Additionally, the use of energy-consuming endothermic reactions is considered. An innovative PCM-endothermic reaction hybrid approach is also developed. Both thermodynamic and transient/quasi-stationary models are developed for each of these proposed heat sink technologies. Prototypes are then developed for the best candidates to validate the models and draw conclusions on each heat sink's performance. Both the thermodynamic modeling and experimental results presented in this paper suggest that PCMs, endothermic reactions, and, especially, the hybrid system show greater energy storage capabilities than what is being used in hypersonic vehicles currently.

Diagnosing of tuberculous arthritis can be challenging due to its insidious onset and non-specific clinical presentation. A high index of suspicion is required for early diagnosis. A 54-year-old butcher was admitted to an orthopedic clinic with complaints of pain, paresthesia and an enlarging mass in the left wrist, which limited finger flexion. Initially the patient was diagnosed with carpal tunnel syndrome (CTS); the patient had no history of tuberculosis (TB), but had direct contact with animals. On clinical examination, a small mass was found in the distal volar region of the forearm and no lymphadenopathy was observed. Despite the diagnosis the patient refused to receive TB treatment. After a period of 4 months, the patient once again exhibited symptoms of CTS. This case highlights the importance of considering TB as a potential etiology for persistent symptoms of carpal tunnel surgery. Early diagnosis and prompt initiation of TB treatment can result in favorable outcomes and can prevent future recurrence., Journal of Surgical Case Reports, 2023(8), art. no. rjad353; 2023

Objectives: Seeing Voices was an interprofessional, technology-enabled, large-scale, teaching and learning event developed to address the need to improve voice students’ knowledge of laryngeal anatomy and physiology toward understanding and maintaining vocal health. Seeing Voices trialed a novel interprofessional educational approach, collected both quantitative and qualitative data about student experiences of laryngostroboscopic examination, and built a databank of laryngeal recordings for future student learning. Methods: Seeing Voices involved two 3-hour seminars in a large, university lecture space, run by an interprofessional team (speech-language pathologists, vocal coach, Ear Nose and Throat consultant) with quality equipment projecting laryngeal images to large screens with expert commentary in real time. Participants were 18 students who volunteered for laryngeal examination (9 per seminar) and student attendees (n = 175) from performing arts courses (classical singing, contemporary, jazz, musical theater, acting) and a speech-language pathology course. A quantitative evaluation of knowledge gained was undertaken using a Qualtrics survey. Results from pre (n = 175; performing arts = 120; speech-language pathology (SLP) = 55) and postevent (n = 99; performing arts = 56; SLP = 43) questionnaires were received from the students who attended. Interviews were collected from 15 of the 18 student volunteers about their experiences of nasendoscopic evaluation and data were analyzed using qualitative description and qualitative content analysis. Results: Quantitative results demonstrated a strong trend toward increased knowledge following attendance at the event across year cohorts for both student groups. Qualitative interviews highlighted the value in seeing multiple examples of normal laryngeal functioning across different vocal techniques in real time. For those undertaking nasendoscopic examination, simultaneously seeing and feeling laryngeal maneuvers used in

Qubit regularization provides a rich framework to explore quantum field theories. The freedom to choose how the important symmetries of the theory are embedded in the qubit regularization scheme allows us to construct new lattice models with rich phase diagrams. Some of the phases can contain topological terms which lead to critical phases. In this work we introduce and study the SU(3)-F qubit regularization scheme to embed the SO(3) spin-symmetry. We argue that qubit models in this regularization scheme contain several phases including a critical phase which describes the k = 1 Wess-Zumino-Witten (WZW) conformal field theory (CFT) at long distances, and two massive phases one of which is trvially gapped and the other which breaks the lattice translation symmetry. We construct a simple space-time Euclidean lattice model with a single coupling U and study it using the Monte Carlo method. We show the model has a critical phase at small U and a trivially massive phase at large U with a first order transition separating the two. Another feature of our model is that it is symmetric under space-time rotations, which means the temporal and spatial lattice spacing are connected to each other. The unitary time evolution operator obtained by a Wick rotation of the transfer matrix of our model can help us compute the physics of the k = 1 WZW CFT in real time without the need for tuning the temporal lattice spacing to zero. We use this idea to introduce the concept of a relativistic quantum circuit on a discrete space-time lattice., Comment: 15 pages

Indigenous Standpoint Theory forms the epistemological foundation for this study and methodological choices were made within this theoretical framework to ensure culturally responsive research processes that engaged the Indigenous agenda of self-determination and rights. The objectives of this research were to determine: (i) Indigenous perceptions of the facilitators and barriers to exercise; (ii) The potential feasibility and sustainability of an exercise intervention. In this context, Participatory Action Research methods were used to design the data-gathering instrument for the study—a questionnaire, co-designed with the Noongar Aboriginal community of Perth, Western Australia. This self-administered questionnaire, distributed to participants by email, post and manual delivery, sought to elicit the factors that impact uptake and retention of regular exercise activities. Questionnaire data included individual demographic detail and specific question responses on labelled 5 point Likert Scales. Specific question responses were tabulated by Likert Scale label category and the response distribution for each question was enumerated. Simple descriptive statistics (measures of central tendency and variance) were used to characterize the data set and the Chi squared test was used to evaluate frequency differences between males and females. A total of 133 participants (71 females) completed the questionnaire. The results indicated that people valued exercise. The most common barriers indicated by participants were exercising with an injury (63%), changing diet (58%), finding time to exercise every day (55%) and exercising the next day with pain from exercising the day before (54%). A larger proportion of males (34%) than females (24%) reported greater ease in finding time to exercise every day (p < 0.05). Facilitators mainly related to the potential social and community benefits of exercising with other people, preferably in small groups, and the importance of a culturall

Purpose: The healthcare experience is a multifaceted and varied process, particularly for people living with complex conditions such as primary progressive aphasia (PPA). Different experiences influence pathways through the health system, impacting client outcomes. To our knowledge, no previous studies have directly explored the healthcare experiences of people with PPA and their families. This study aimed to explore the experiences of people living with PPA from the perspective of both the person with PPA and their families during diagnostic and post-diagnostic phases, and to identify factors influencing service access and perceptions of quality of care. Method: The study followed an Interpretive Phenomenological Analysis (IPA) approach. In-depth, semi-structured interviews were completed with three people with PPA and their primary care partner, and two further care partners of people with PPA. Result: Five superordinate themes were identified: characterising the assessment experience, getting a diagnosis, moving beyond the diagnosis, participant interactions with clinicians, and overall service provision. The five superordinate themes comprised 14 subthemes. Conclusion: The study provides preliminary insights into the complexity of the PPA healthcare journey, and the need for increased accessibility of information and supports following diagnosis. The findings inform recommendations for improving quality of care and the development of a PPA service framework or care pathway.

Background: : Group singing for people with Parkinson's disease (PD) is an established intervention not only to improve voice and speech difficulties but also for emotional and social benefit. Less is known about the experiences of group singing on the couple—the person with PD and their spouse or partner together—and studies have not specifically tracked impact through time or in combination with songwriting. Aims: : To understand the impact of group singing/songwriting on couples (participants with PD and their spouses) to unpack whether this broader view might help explain why such interventions are reported as beneficial. Using a trajectory approach, a form of longitudinal research and focused ethnography, the research sought a deeper appreciation of participation through time for the couple in a singing/songwriting group. Methods & Procedures: : Four couples attending a singing/songwriting programme were observed for 10 weeks, and interviewed formally and informally weekly. Data were analysed thematically across-case through framework analysis but also within-case to explore the couples’ experiences and narratives over time. Outcomes & Results: : The theme of ‘improved relationships’ between the couples was new and extended previous studies’ findings of positivity, physical benefit, sense of self and social opportunity. The stories of each couple highlighted the importance of musical reminiscence and emotional respite, and demonstrated changes with time through the singing and songwriting group. Conclusions & Implications: : The benefits of offering singing/songwriting groups may be felt not only by participants with PD but also by their spouses/partners even if they choose not to attend themselves. Such benefits may include improved relationships related to the shared joy of music, musical reminiscence and emotional respite. The addition of songwriting encourages creativity and agency. A longitudinal trajectory approach is one way to appreciate how these benef

Odontoid fractures are common, often presenting in the elderly after a fall and infrequently associated with traumatic spinal cord injury (tSCI). The goal of this study was to analyze predictors of mortality and neurological outcome when odontoid fractures were associated with signal change on magnetic resonance imaging (MRI) at admission. Over an 18-year period (2001-2019), 33 patients with odontoid fractures and documented tSCI on MRI were identified. Mean age was 65.3 years (standard deviation [SD] = 17.2), and 21 patients were male. The mechanism of injury was falls in 25 patients, motor vehicle accidents in 5, and other causes in 3. Mean Injury Severity Score (ISS) was 40.5 (SD = 30.2), Glasgow Coma Scale (GCS) score was 13 (SD = 3.4), and American Spinal Injury Association (ASIA) motor score (AMS) was 51.6 (SD = 42.7). ASIA Impairment Scale (AIS) grade was A, B, C, and D in 9, 2, 3, and 19 patients, respectively. Mean intramedullary lesion length was 32.3 mm (SD = 18.6). The odontoid peg was displaced ventral or dorsal in 15 patients. Twenty patients had surgical intervention: anterior odontoid screw fixation in 7 and posterior spinal fusion in 13. Eleven (33.3%) patients died in this series: withdrawal of medical care in 5; anoxic brain injury in 4; and failure of critical care management in 2. Univariate logistic regression indicated that GCS score (p<0.014), AMS (p<0.002), AIS grade (p<0.002), and ISS (p<0.009) were risk factors for mortality. Multi-variate regression analysis indicated that only AMS (p<0.002) had a significant relationship with mortality when odontoid fracture was associated with tSCI (odds ratio, 0.963; 95% confidence interval, 0.941–0.986).

Early detection of many life-threatening diseases (e.g., prostate and breast cancer) within at-risk population can improve clinical outcomes and reduce cost of care. While numerous disease-specific "screening" tests that are closer to Point-of-Care (POC) are in use for this task, their low specificity results in unnecessary biopsies, leading to avoidable patient trauma and wasteful healthcare spending. On the other hand, despite the high accuracy of Magnetic Resonance (MR) imaging in disease diagnosis, it is not used as a POC disease identification tool because of poor accessibility. The root cause of poor accessibility of MR stems from the requirement to reconstruct high-fidelity images, as it necessitates a lengthy and complex process of acquiring large quantities of high-quality k-space measurements. In this study we explore the feasibility of an ML-augmented MR pipeline that directly infers the disease sidestepping the image reconstruction process. We hypothesise that the disease classification task can be solved using a very small tailored subset of k-space data, compared to image reconstruction. Towards that end, we propose a method that performs two tasks: 1) identifies a subset of the k-space that maximizes disease identification accuracy, and 2) infers the disease directly using the identified k-space subset, bypassing the image reconstruction step. We validate our hypothesis by measuring the performance of the proposed system across multiple diseases and anatomies. We show that comparable performance to image-based classifiers, trained on images reconstructed with full k-space data, can be achieved using small quantities of data: 8% of the data for detecting multiple abnormalities in prostate and brain scans, and 5% of the data for knee abnormalities. To better understand the proposed approach and instigate future research, we provide an extensive analysis and release code.

Background: Assessment is an essential part of aphasia management. There are many tools available for aphasia assessment, but relatively scant attention has been paid to how speech pathologists carry out their assessment sessions, or how these sessions are experienced by people with aphasia and their families. The evidence that is available suggests that people with aphasia do not always understand the purposes of the assessments they undertake or receive much useful feedback on their performance. Connections between adult learning and aphasia therapy are being made more explicit, such as through the Life Participation Approach to Aphasia, but the potential for a relationship between adult learning and aphasia assessment has not yet been fully recognised. Aims: This paper aims to stimulate thinking to improve current aphasia assessment practices. It uses an adult learning lens and explores theoretical approaches underpinning assessment in adult education contexts. Main Contribution: In this commentary paper, we summarise the current, dominant practices around aphasia assessment and then briefly review evidence-based recommended practice for assessment in higher and professional education. We explore useful parallels between the two fields and discuss how we might reassess assessment in aphasia rehabilitation. Conclusions: Aphasia assessments have greater potential to be therapeutic than we currently assume. Ideas from adult education are useful to challenge clinicians to reconsider aspects of their practice. Assessments can be a powerful motivator for learning and engagement in therapy. Through a greater focus on formative and sustainable assessment, and changed feedback practices, there are opportunities to capitalise more fully on the potential for learning during these sessions. Attention to the rich development of ideas about assessment in education is a useful way to challenge our assumptions and perhaps prepare our clients with aphasia for a more productive an

The low-energy states of quantum many body systems, such as spin chains, are entangled. Using tensor network computations, we demonstrate a protocol that distills Bell pairs out of the ground state of the prototypical transverse-field Ising model. We explore the behavior of rate of entanglement distillation in various phases, and possible optimizations of the protocol. Finally, we comment on the protocol as we approach quantum criticality defining a continuum field theory., Comment: 21 pages, 8 figures, 5 tables

Purpose: Speech-language pathologists (SLPs) assess people with primary progressive aphasia (PPA) through measurements of speech, language, communication, and well-being, with the aims of identifying challenges and strengths, monitoring change, and informing treatment directions and supports. The purpose of this clinical focus article is to highlight the necessity for person-centered assessment specific to PPA and to conceptualize a framework that acknowledges the multifaceted nature of assessment for this population. In this framework, the unique challenges posed by a diagnosis of PPA are addressed with the aim to provide practical guidance for clinicians and to support reflection on current practices. Method: In clinical and research practice, assessment of people with PPA requires an ever-evolving approach that is centered on the client. In this clinical focus article, a discussion-based consensus process was used to synthesize authentic longitudinal experiences of people with PPA to explore assessment approaches, tools, and philosophies. Results: This analysis of person-centered assessment identifies seven essential components of assessment in PPA that set the foundation for the five steps of the R.A.I.S.E. Assessment framework. These components each contribute to a clear definition of assessment that reveals clients' competencies with a strengths-based focus; prioritizes the reciprocity of benefits; promotes dynamic assessment; and recognizes the complexity, evolution of assessment over time, and advocacy. Conclusions: This clinical focus article takes a novel look at assessment in PPA by stepping away from assessment practices that focus on revealing deficits and decline and, instead, provides practical recommendations through the conceptualization of a PPA-specific assessment framework. The R.A.I.S.E. Assessment framework is grounded in principles of uplifting clients through person-centered assessment, keeps pace with best practice in PPA intervention, and c

The fastMRI brain and knee dataset has enabled significant advances in exploring reconstruction methods for improving speed and image quality for Magnetic Resonance Imaging (MRI) via novel, clinically relevant reconstruction approaches. In this study, we describe the April 2023 expansion of the fastMRI dataset to include biparametric prostate MRI data acquired on a clinical population. The dataset consists of raw k-space and reconstructed images for T2-weighted and diffusion-weighted sequences along with slice-level labels that indicate the presence and grade of prostate cancer. As has been the case with fastMRI, increasing accessibility to raw prostate MRI data will further facilitate research in MR image reconstruction and evaluation with the larger goal of improving the utility of MRI for prostate cancer detection and evaluation. The dataset is available at https://fastmri.med.nyu.edu., Comment: 4 pages, 1 figure

As machine learning algorithms are deployed ubiquitously to a variety of domains, it is imperative to make these often black-box models transparent. Several recent works explain black-box models by capturing the most influential features for prediction per instance; such explanation methods are univariate, as they characterize importance per feature. We extend univariate explanation to a higher-order; this enhances explainability, as bivariate methods can capture feature interactions in black-box models, represented as a directed graph. Analyzing this graph enables us to discover groups of features that are equally important (i.e., interchangeable), while the notion of directionality allows us to identify the most influential features. We apply our bivariate method on Shapley value explanations, and experimentally demonstrate the ability of directional explanations to discover feature interactions. We show the superiority of our method against state-of-the-art on CIFAR10, IMDB, Census, Divorce, Drug, and gene data.

Sibling relationships remain understudied in typically developing adolescents who have siblings with autism spectrum disorder (ASD). This study explored the lived experiences and perceptions of adolescents who have a brother or a sister with a diagnosis of ASD using semi-structured interviews. Using thematic analysis, the participants reported having difficulties communicating with their siblings. Feeling a mixture of emotions was common when interacting with their siblings with ASD and emotional self-regulation was a typical coping strategy utilized by these adolescents. Despite the challenges, having a sibling with ASD led to closer relationships between the siblings. These findings offer insights into these adolescents’ needs and how they may be best supported, informing the practice of speech-language pathology and other health professions.

Purpose: Colonisation and continuing discrimination have significantly and negatively impacted the physical, social and emotional wellbeing of First Nations peoples globally. In Australia, Aboriginal cultures thrive despite ongoing barriers to health care. This paper describes challenges and new initiatives for Australian Aboriginal people with acquired communication disability after brain injury and their alignment with the global aims forming the Sustainable Development Goals. Result: Research undertaken by an Aboriginal and non-Aboriginal multidisciplinary team over a decade in Western Australia identified and responded to mismatches between community needs and services. Initiatives described include the Missing Voices, Healing Right Way, Brain Injury Yarning Circles and Wangi/Yarning Together projects. Recommendations implemented related to (a) greater incorporation of Aboriginal cultural protocols and values within services, (b) more culturally secure assessment and treatment tools, (c) support after hospital discharge, (d) Aboriginal health worker involvement in support. Implementation includes cultural training of hospital staff, trialling new assessment and treatment methods, and establishing community-based Aboriginal Brain Injury Coordinator positions and relevant peer support groups. Conclusion: Culturally secure brain injury rehabilitation in Australia is in its infancy. Our initiatives challenge assumptions about worldviews and established Western biomedical models of healthcare through incorporating Indigenous methodologies and leadership, and community-driven service delivery. This commentary paper focuses on Sustainable Development Goals 3, 16 and 17.

Purpose: Primary progressive aphasia (PPA) is a language-led dementia associated with Alzheimer’s pathology and fronto-temporal lobar degeneration. Multiple tailored speech and language interventions have been developed for people with PPA. Speech and language therapists/speech-language pathologists (SLT/Ps) report lacking confidence in identifying the most pertinent interventions options relevant to their clients living with PPA during their illness trajectory. Materials and methods: The aim of this study was to establish a consensus amongst 15 clinical-academic SLT/Ps on best practice in selection and delivery of speech and language therapy interventions for people with PPA. An online nominal group technique (NGT) and consequent focus group session were held. NGT rankings were aggregated and focus groups video recorded, transcribed, and reflexive thematic analysis undertaken. Results: The results of the NGT identified 17 items. Two main themes and seven further subthemes were identified in the focus groups. The main themes comprised (1) philosophy of person-centredness and (2) complexity. The seven subthemes were knowing people deeply, preventing disasters, practical issues, professional development, connectedness, barriers and limitations, and peer support and mentoring towards a shared understanding. Conclusions: This study describes the philosophy of expert practice and outlines a set of best practice principles when working with people with PPA. Implications for rehabilitation Primary progressive aphasia (PPA) describes a group of language led dementias which deteriorate inexorably over time. Providing speech and language therapy for people with PPA is complex and must be person centred and bespoke. This study describes the philosophy of expert practice and outlines a set of best practice principles for speech and language therapists/pathologists working with people with people with PPA.

Objective: Information retrieval (IR, also known as search) systems are ubiquitous in modern times. How does the emergence of generative artificial intelligence (AI), based on large language models (LLMs), fit into the IR process? Process: This perspective explores the use of generative AI in the context of the motivations, considerations, and outcomes of the IR process with a focus on the academic use of such systems. Conclusions: There are many information needs, from simple to complex, that motivate use of IR. Users of such systems, particularly academics, have concerns for authoritativeness, timeliness, and contextualization of search. While LLMs may provide functionality that aids the IR process, the continued need for search systems, and research into their improvement, remains essential., Comment: 7 pages, no figures

We provide quantitative evidence suggesting social learning in sperm whales across socio-cultural boundaries, using acoustic data from the Pacific and Atlantic Oceans. Traditionally, sperm whale populations are categorized into clans based on their vocal repertoire: the rhythmically patterned click sequences (codas) that they use. Among these codas, identity codas function as symbolic markers for each clan, accounting for 35-60% of codas they produce. We introduce a computational method to model whale speech, which encodes rhythmic micro-variations within codas, capturing their vocal style. We find that vocal style-clans closely align with repertoire-clans. However, contrary to vocal repertoire, we show that sympatry increases vocal style similarity between clans for non-identity codas, i.e. most codas, suggesting social learning across cultural boundaries. More broadly, this subcoda structure model offers a framework for comparing communication systems in other species, with potential implications for deeper understanding of vocal and cultural transmission within animal societies.

ObjectiveTo evaluate the diagnostic value of still images of needle arthroscopy (SNAR), still images of traditional arthroscopy (STAR), and computed tomography (CT) to diagnose medial coronoid process (MCP) pathology.Study designProspective clinical trial.AnimalsDogs (n = 17) presented for evaluation of elbow dysplasia.MethodsFor each case, two SNAR and STAR images of the MCP were reviewed independently and in random order by three board-certified surgeons. Computed tomographic images were reviewed by one board-certified radiologist. Reviewers were blinded to surgical and clinical findings. Surgical findings from real-time TAR with palpation were used as the gold standard. Receiver operating characteristic (ROC) curves and concordance statistics tests for the diagnostic accuracy of MCP fissure, MCP fragment, medial compartment condition, and cartilage score were calculated.ResultsImages of 27 elbows joints were reviewed. For MCP fissure detection, areas under the ROC curves for CT (0.84), STAR (0.73), and SNAR (0.57) did not differ. For the detection of MCP fragment, STAR had a larger area under the ROC curve (0.93) compared with SNAR (0.74, P = .015) and CT (0.54, P < .001). Still images of TAR and SNAR had comparable concordance for cartilage score (0.80 and 0.77, respectively) and medial compartment pathology (0.80 and 0.73, respectively).ConclusionStill images of NAR, STAR, and CT had similar diagnostic value to identify MCP fissures. Still images of TAR was superior to SNAR and CT to identify MCP fragments.Clinical significanceThe diagnostic accuracy of SNAR varied on the basis of the coronoid lesion being evaluated.

Rubicon is a potent negative regulator of autophagy and a potential target for autophagy-inducing therapeutics. Rubicon-mediated inhibition of autophagy requires the interaction of the C-terminal Rubicon homology (RH) domain of Rubicon with Rab7-GTP. Here we report the 2.8-Å crystal structure of the Rubicon RH domain in complex with Rab7-GTP. Our structure reveals a fold for the RH domain built around four zinc clusters. The switch regions of Rab7 insert into pockets on the surface of the RH domain in a mode that is distinct from those of other Rab-effector complexes. Rubicon residues at the dimer interface are required for Rubicon and Rab7 to colocalize in living cells. Mutation of Rubicon RH residues in the Rab7-binding site restores efficient autophagic flux in the presence of overexpressed Rubicon, validating the Rubicon RH domain as a promising therapeutic target.

Asthma-COPD overlap (ACO) is a common clinical syndrome, yet there is no single objective definition. We hypothesized that immunoglobulin E (IgE) measurements could be used to refine the definition of ACO. In baseline plasma samples from 2870 participants in the COPD Genetic Epidemiology (COPDGene®) study, we measured total IgE levels and specific IgE levels to 6 common allergens. Compared to usual chronic obstructive pulmonary disease (COPD), participants with ACO (based on self-report of asthma) had higher total IgE levels (median 67.0 versus 42.2 IU/ml) and more frequently had at least one positive specific IgE (43.5% versus 24.5%). We previously used a strict definition of ACO in participants with COPD, based on self-report of a doctor's diagnosis of asthma before age 40. This strict ACO definition was refined by the presence of atopy, determined by total IgE > 100 IU/ml or at least one positive specific IgE, as was the broader definition of ACO based on self-reported asthma history. Participants with all 3 ACO definitions were younger (mean age 60.0-61.3 years), were more commonly African American (36.8%-44.2%), had a higher exacerbation frequency (1.0-1.2 in the past year), and had more airway wall thickening on quantitative analysis of chest computed tomography (CT) scans. Among participants with ACO, 37%-46% did not have atopy; these individuals had more emphysema on chest CT scan. Based on associations with exacerbations and CT airway disease, IgE did not clearly improve the clinical definition of ACO. However, IgE measurements could be used to subdivide individuals with atopic and non-atopic ACO, who might have different biologic mechanisms and potential treatments.

Conventional lattice formulations of $\theta$ vacua in the $1+1$-dimensional $\text{O}(3)$ nonlinear sigma model suffer from a sign problem. Here, we construct the first sign-problem-free regularization for arbitrary $\theta$. Using efficient lattice Monte Carlo algorithms, we demonstrate how a Hamiltonian model of spin-$\tfrac12$ degrees of freedom on a 2-dimensional spatial lattice reproduces both the infrared sector for arbitrary $\theta$, as well as the ultraviolet physics of asymptotic freedom. Furthermore, as a model of qubits on a two-dimensional square lattice with only nearest-neighbor interactions, it is naturally suited for studying the physics of $\theta$ vacua and asymptotic freedom on near-term quantum devices. Our construction generalizes to $\theta$ vacua in all $\text{CP}(N-1)$ models, solving a long standing sign problem., Comment: 7 pages, 4 figures

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) surveillance rates are suboptimal in clinical practice. We aimed to elicit providers opinions on the following aspects of HCC surveillance: preferred strategies, barriers and facilitators, and the impact of a patients HCC risk on the choice of surveillance modality. METHODS: We conducted a web-based survey among gastroenterology and hepatology providers (40% faculty physicians, 21% advanced practice providers, 39% fellow-trainees) from 26 US medical centers in 17 states. RESULTS: Of 654 eligible providers, 305 (47%) completed the survey. Nearly all (98.4%) of the providers endorsed semi-annual HCC surveillance in patients with cirrhosis, with 84.2% recommending ultrasound ± alpha fetoprotein (AFP) and 15.4% recommending computed tomography (CT) or magnetic resonance imaging (MRI). Barriers to surveillance included limited HCC treatment options, screening test effectiveness to reduce mortality, access to transportation, and high out-of-pocket costs. Facilitators of surveillance included professional society guidelines. Most providers (72.1%) would perform surveillance even if HCC risk was low (≤0.5% per year), while 98.7% would perform surveillance if HCC risk was ≥1% per year. As a patients HCC risk increased from 1% to 3% to 5% per year, providers reported they would be less likely to order ultrasound ± AFP (83.6% to 68.9% to 57.4%; P < .001) and more likely to order CT or MRI ± AFP (3.9% to 26.2% to 36.1%; P < .001). CONCLUSIONS: Providers recommend HCC surveillance even when HCC risk is much lower than the threshold suggested by professional societies. Many appear receptive to risk-based HCC surveillance strategies that depend on patients estimated HCC risk, instead of our current one-size-fits all strategy.

Objective: Develop and test a person-centred goal-setting package for discharge care planning in acute and rehabilitation stroke units. Methods: A multidisciplinary, expert working group (n = 15), and consumer group (n = 4) was convened. A multistage iterative approach was used to develop and test the package. Stages included: (i) contextual understanding, (ii) package development, and (iii) clinician training and field-testing in acute and rehabilitation settings. Observational field notes were taken and clinicians' perspectives captured using semi-structured focus groups post-testing. Results: The final package included a 34-item menu aligned with a manual containing: guideline summaries; common goals; goal metrics based on the SMART Goal Evaluation Method (SMART-GEM); evidence-based strategies; and worked examples. Twenty-three clinicians attended training. Clinician observations (n = 5) indicated that: the package could be incorporated into practice; a range of person-centred goals were set; and opportunities provided to raise additional issues. Clinician feedback (n = 8) suggested the package was useful and facilitated person-centred goal-setting. Enablers included potential for incorporation into existing processes and beliefs that it promoted person-centred care. Barriers included additional time. Conclusion: The package demonstrated potential to facilitate comprehensive person-centred goal-setting for patients with stroke. Innovation: We developed an innovative approach to support structured person-centred goal setting in clinical and research settings.

Recent work using a large-charge expansion for the $O(N)$ Wilson-Fisher conformal field theory has shown that the anomalous dimensions of large-charge operators can be expressed in terms of a few low-energy constants (LECs) of a large-charge effective field theory (EFT). By performing lattice Monte Carlo computations at the $O(N)$ Wilson-Fisher fixed point, we compute the anomalous dimensions of large-charge operators up to $N=8$ and charge $Q=10$, and extract the leading and subleading LECs of the $O(N)$ large-charge EFT. To alleviate the signal-to-noise ratio problem present in the large-charge sector of conventional lattice formulations of the $O(N)$ theory, we employ a recently developed qubit formulation of the $O(N)$ nonlinear sigma models with a worm algorithm. This enables us to test the validity of the large-charge expansion and the recent large-$N$ predictions for the coefficients of the large-charge EFT., Comment: 12 pages, 9 figures

Purpose: Primary progressive aphasia (PPA) is a language-led dementia associated with Alzheimer’s pathology and fronto-temporal lobar degeneration. Multiple tailored speech and language interventions have been developed for people with PPA. Speech and language therapists/speech-language pathologists (SLT/Ps) report lacking confidence in identifying the most pertinent interventions options relevant to their clients living with PPA during their illness trajectory. Materials and methods: The aim of this study was to establish a consensus amongst 15 clinical-academic SLT/Ps on best practice in selection and delivery of speech and language therapy interventions for people with PPA. An online nominal group technique (NGT) and consequent focus group session were held. NGT rankings were aggregated and focus groups video recorded, transcribed, and reflexive thematic analysis undertaken. Results: The results of the NGT identified 17 items. Two main themes and seven further subthemes were identified in the focus groups. The main themes comprised (1) philosophy of person-centredness and (2) complexity. The seven subthemes were knowing people deeply, preventing disasters, practical issues, professional development, connectedness, barriers and limitations, and peer support and mentoring towards a shared understanding. Conclusions: This study describes the philosophy of expert practice and outlines a set of best practice principles when working with people with PPA.Implications for rehabilitation Primary progressive aphasia (PPA) describes a group of language led dementias which deteriorate inexorably over time. Providing speech and language therapy for people with PPA is complex and must be person centred and bespoke. This study describes the philosophy of expert practice and outlines a set of best practice principles for speech and language therapists/pathologists working with people with people with PPA.

Anomalies are a powerful way to gain insight into possible lattice regularizations of a quantum field theory. In this work, we argue that the continuum anomaly for a given symmetry can be matched by a manifestly-symmetric, local, lattice regularization in the same spacetime dimensionality only if (i) the symmetry action is offsite, or (ii) if the continuum anomaly is reproduced exactly on the lattice. We consider lattice regularizations of a class of prototype models of QCD: the (1+1)-dimensional asymptotically-free Grassmannian nonlinear sigma models (NLSMs) with a $\theta$ term. Using the Grassmannian NLSMs as a case study, we provide examples of lattice regularizations in which both possibilities are realized. For possibility (i), we argue that Grassmannian NLSMs can be obtained from $\mathrm{SU}(N)$ antiferromagnets with a well-defined continuum limit, reproducing both the infrared physics of $\theta$ vacua and the ultraviolet physics of asymptotic freedom. These results enable the application of new classical algorithms to lattice Monte Carlo studies of these quantum field theories, and provide a viable realization suited for their quantum simulation. On the other hand, we show that, perhaps surprisingly, the conventional lattice regularization of $\theta$ vacua due to Berg and L\"uscher reproduces the anomaly exactly on the lattice, providing a realization of the second possibility., Comment: 10 pages + appendices

BackgroundChronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are characterized by shared exposures and clinical features, but distinct genetic and pathologic features exist. These features have not been well-studied using large-scale gene expression datasets. We hypothesized that there are divergent gene, pathway, and cellular signatures between COPD and IPF.MethodsWe performed RNA-sequencing on lung tissues from individuals with IPF (n = 231) and COPD (n = 377) compared to control (n = 267), defined as individuals with normal spirometry. We grouped the overlapping differential expression gene sets based on direction of expression and examined the resultant sets for genes of interest, pathway enrichment, and cell composition. Using gene set variation analysis, we validated the overlap group gene sets in independent COPD and IPF data sets.ResultsWe found 5010 genes differentially expressed between COPD and control, and 11,454 genes differentially expressed between IPF and control (1% false discovery rate). 3846 genes overlapped between IPF and COPD. Several pathways were enriched for genes upregulated in COPD and downregulated in IPF; however, no pathways were enriched for genes downregulated in COPD and upregulated in IPF. There were many myeloid cell genes with increased expression in COPD but decreased in IPF. We found that the genes upregulated in COPD but downregulated in IPF were associated with lower lung function in the independent validation cohorts.ConclusionsWe identified a divergent gene expression signature between COPD and IPF, with increased expression in COPD and decreased in IPF. This signature is associated with worse lung function in both COPD and IPF.