Background: The use and effect of most infection control measures (ICMs) in breast implant surgery are still debated, likely resulting in undesired variation in current practices. Objectives: This... Show moreBackground: The use and effect of most infection control measures (ICMs) in breast implant surgery are still debated, likely resulting in undesired variation in current practices. Objectives: This study investigated the relationship between the number and combinations of ICMs used and the infection-related revision incidence after breast implant surgery. Additionally, national variation between Dutch healthcare institutions in ICM use was evaluated. Methods: For this multicentre, population-based study, all patients who received a primary breast implant or tissue expander for breast augmentation or reconstruction between 2015 and 2019 were identified from the Dutch Breast Implant Registry. Seven prospectively collected ICMs were investigated: preoperative antibiotics, implant and/or pocket irrigation, glove change, nipple guards, insertion sleeve, postoperative drains, and postoperative antibiotics. Results: This study included 52,415 implants (85% augmentation, 15% reconstruction).The median (IQR) number of ICMs used was 3 (3-4) for augmentation and 4 (4-5) for reconstruction. Median follow-up was 30 months for augmentation and 34 months for reconstruction. Infection-related revision incidence was 0.1% for augmentation and 2.1% for reconstruction. Most infection-related revisions occurred within 2 months for augmentation and 2.5 months for reconstruction. The impact of ICM use on infection-related revision incidence remained unclear, given its low incidence. A significant variation was observed between institutions in the use of postoperative antibiotics and drains. Conclusions: Although the use of different ICMs varied considerably between institutions, the infection-related revision incidence after breast implant surgery was generally low. Most surgeons used four ICMs for breast reconstruction and three ICMs for breast augmentation. Further studies on the causes and effects of the observed variation are needed. (c) 2022The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. Show less
Lifelong person re-identification (LReID) is a challenging and emerging task, which concerns the ReID capability on both seen and unseen domains after learning across different domains continually.... Show moreLifelong person re-identification (LReID) is a challenging and emerging task, which concerns the ReID capability on both seen and unseen domains after learning across different domains continually. Existing works on LReID are devoted to introducing commonlyused lifelong learning approaches, while neglecting a serious side effect caused by using normalization layers in the context of domainincremental learning. In this work, we aim to raise awareness of the importance of training proper batch normalization layers by proposing a new meta reconciliation normalization (MRN) method specifically designed for tackling LReID. Our MRN consists of grouped mixture standardization and additive rectified rescaling components, which are able to automatically maintain an optimal balance between domain-dependent and domain-independent statistics, and even adapt MRN for different testing instances. Furthermore, inspired by synaptic plasticity in human brain, we present a MRNbased meta-learning framework for mining the meta-knowledge shared across different domains, even without replaying any previous data, and further improve the model’s LReID ability with theoretical analyses. Our method achieves new state-of-the-art performances on both balanced and imbalanced LReID benchmarks. Show less
Decisions made in the early phases of ship design have a large influence on the capital and operational expenses of a vessel. In order to support decision making in this phase, big data and machine... Show moreDecisions made in the early phases of ship design have a large influence on the capital and operational expenses of a vessel. In order to support decision making in this phase, big data and machine learning techniques can be of great use. This work shows how Explainable Artificial Intelligence (XAI) and Global Sensitivity Analysis (GSA) combined with Autonomous Identification System (AIS) and static ship data can be used to find important design characteristics of ships. A data collection framework is setup that collects AIS data over a five month time period. Static ship design data is used to predict performance related target features that are calculated from AIS data. By applying XAI and GSA methods to the regression models that predict these target features, insight can be gained on how design features influence the performance of ships. Experiments showed that for most ship types, the overall length is the most important design feature for speed related target features. Besides the overall length, the draught also has a significant impact on the rotation capabilities. Show less
Does life exist outside our Solar System? A first step towards searching for life outside our Solar System is detecting life on Earth by using remote sensing applications. One powerful and... Show moreDoes life exist outside our Solar System? A first step towards searching for life outside our Solar System is detecting life on Earth by using remote sensing applications. One powerful and unambiguous biosignature is the circular polarization resulting from the homochirality of biotic molecules and systems. We aim to investigate the possibility of identifying and characterizing life on Earth by using airborne spectropolarimetric observations from a hot air balloon during our field campaign in Switzerland, May 2022. In this proceeding we present the optical-setup and the data obtained from aerial circular spectropolarimetric measurements of farmland, forests, lakes and urban sites. We make use of the well-calibrated FlyPol instrument that measures the fractionally induced circular polarization (V /I) of (reflected) light with a sensitivity of < 10−4 . The instrument operates in the visible spectrum, ranging from 400 to 900 nm. We demonstrate the possibility to distinguish biotic from abiotic features using circular polarization spectra and additional broadband linear polarization information. We review the performance of our optical-setup and discuss potential improvements. This sets the requirements on how to perform future airborne spectropolarimetric measurements of the Earth’s surface features from several elevations. Show less
One of the reasons why early modern people chronicled current events in their communities, was to search for patterns. Chroniclers frequently recorded odd weather patterns (scorching summers or... Show moreOne of the reasons why early modern people chronicled current events in their communities, was to search for patterns. Chroniclers frequently recorded odd weather patterns (scorching summers or frigid winters), famines, troop movements, wars, epidemics, prices, prodigies, monstrous births, and other premonitions to search for elements that could help them to comprehend current, and to anticipate on, future events. In this paper I will explore how chroniclers from the Low Countries constructed causal relations between various phenomena and events, and how that changed between 1500 and 1850. I will do so by combining computational and historical methods to analyse 250 early modern Dutch chronicles, focusing especially on authors of the middling sort (e.g., farmers, merchants, and local officials). As a result, we gain insight on how they tried to get grip on current events in their attempt to limit future harm.In this paper I will focus especially on how chroniclers collected data on epidemics, meteorological phenomena, and food- and fuel prices, knowledge which they regarded as useful. Using this evidence, I will argue that throughout the period, this group continued to believe in the idea that disruptive events could have both human and natural but also supernatural origins. Both faith and reason conditioned responses to potential hazards, and the solutions chosen were discussed side-by-side, usually without an apparent sense of conflict. However, natural explanations became more complex over time, which resulted in more detailed explanations on the causes and consequences of (future) hazards. By focussing on the information that chroniclers regarded as useful, and studying the causal relations they constructed, we can not only reconstruct how chroniclers coped with contemporary hazards and crises, but also how they used their chronicle as a compass and anchor to get some grip on events as they sailed into an uncertain future. Show less
Gómez Maureira, M.A.; Duin, M. van; Rieffe, C.J.; Plaat, A. 2022
Real-world optimization scenarios under uncertainty and noise are typically handled with robust optimization techniques, which re-formulate the original optimization problem into a robust... Show moreReal-world optimization scenarios under uncertainty and noise are typically handled with robust optimization techniques, which re-formulate the original optimization problem into a robust counterpart, e.g., by taking an average of the function values over different perturbations to a specific input. Solving the robust counterpart instead of the original problem can significantly increase the associated computational cost, which is often overlooked in the literature to the best of our knowledge. Such an extra cost brought by robust optimization might depend on the problem landscape, the dimensionality, the severity of the uncertainty, and the formulation of the robust counterpart.This paper targets an empirical approach that evaluates and compares the computational cost brought by different robustness formulations in Kriging-based optimization on a wide combination (300 test cases) of problems, uncertainty levels, and dimensions. We mainly focus on the CPU time taken to find robust solutions, and choose five commonly-applied robustness formulations: `"mini-max robustness'', "mini-max regret robustness'', "expectation-based robustness'', ``dispersion-based robustness'', and "composite robustness'' respectively. We assess the empirical performance of these robustness formulations in terms of a fixed budget and a fixed target analysis, from which we find that "mini-max robustness'' is the most practical formulation w.r.t.~the associated computational cost. Show less
Objectives: Although the impact of prosthesis-patient mismatch (PPM) on survival has been widely studied, there has been little debate about whether the current definition of PPM truly reflects... Show moreObjectives: Although the impact of prosthesis-patient mismatch (PPM) on survival has been widely studied, there has been little debate about whether the current definition of PPM truly reflects hemodynamic obstruction. This study aimed to validate the categorization of indexed effective orifice area (EOAi) for the classification of PPM.Methods: In total, 2171 patients who underwent aortic valve replacement with a surgical stented bioprosthesis in 5 trials (CoreValve US High-Risk, SURTAVI [Surgical Replacement and Transcatheter Aortic Valve Implantation Trial], Evolut Low Risk, PERIGON [PERIcardial SurGical AOrtic Valve ReplacemeNt] Pivotal Trial for the Avalus valve, and PERIGON Japan) were used for this analysis. The echocardiographic images at the 1-year follow-up visit were evaluated to explore the association between EOAi and mean aortic gradient and its interaction with other patient characteristics, including obesity. In addition, different criteria of PPM were compared with reflect elevated mean aortic gradients (>= 20 mm Hg).Results: A relatively smaller exponential decay in mean aortic gradient was found for increasing EOAi, as the slope on the log scale was -0.83 versus -2.5 in the publication from which the current cut-offs for PPM originate. The accuracy of the American Society of Echocardiography, Valve Academic Research Consortium-2, and European Association of Cardiovascular Imaging definitions of PPM to reflect elevated mean aortic gradients was 49%, 57%, and 57%, respectively. The relation between EOAi and mean aortic gradient was not significantly different between obese and non-obese patients (P = .20).Conclusions: The use of EOAi thresholds to classify patients with PPM is undermined by a less-pronounced exponential relationship between EOAi and mean aortic gradient than previously demonstrated. Moreover, recent adjustment for obesity in the definition of PPM is not supported by these data. Show less
OBJECTIVES: The objective was to analyse associations between obesity and outcomes after left ventricular assist device (LVAD) implantation.METHODS: A retrospective analysis of the EUROMACS... Show moreOBJECTIVES: The objective was to analyse associations between obesity and outcomes after left ventricular assist device (LVAD) implantation.METHODS: A retrospective analysis of the EUROMACS Registry was performed. Adult patients undergoing primary implantation of a continuous-flow LVAD between 2006 and 2019 were included (Medtronic HeartWare((R)) HVAD((R)), Abbott HeartMate II (R), Abbott HeartMate 3 (TM)). Patients were classified into 4 different groups according to body mass index at the time of surgery (body mass index <20 kg/m(2): n = 254; 20-24.9 kg/m(2): n = 1281; 25-29.9 kg/m(2): n = 1238; >= 30 kg/m(2): n = 691).RESULTS: The study cohort was comprised of 3464 patients. Multivariable Cox proportional cause-specific hazards regression analysis demonstrated that obesity (body mass index >= 30 kg/m(2)) was independently associated with significantly increased risk of mortality (body mass index >= 30 vs 20-24.9 kg/m(2): hazard ratio 1.36, 95% confidence interval 1.18-1.57, overall P < 0.001). Moreover, obesity was associated with significantly increased risk of infection and driveline infection. The probability to undergo heart transplantation was significantly decreased in obese patients (body mass index >= 30 vs 20-24.9 kg/m(2): hazard ratio 0.59, 95% confidence interval 0.48-0.74, overall P < 0.001).CONCLUSIONS: Obesity at the time of LVAD implantation is associated with significantly higher mortality and increased risk of infection as well as driveline infection. The probability to undergo heart transplantation is significantly decreased. These aspects should be considered when devising a treatment strategy before surgery. Show less
Vermetten, D.L.; Caraffini, F.; Stein, B. van; Kononova, A.V. 2022
Genetic algorithms have unique properties which are useful when applied to black-box optimization. Using selection, crossover, and mutation operators, candidate solutions may be obtained without... Show moreGenetic algorithms have unique properties which are useful when applied to black-box optimization. Using selection, crossover, and mutation operators, candidate solutions may be obtained without the need to calculate a gradient. In this work, we study results obtained from using quantum-enhanced operators within the selection mechanism of a genetic algorithm. Our approach frames the selection process as a minimization of a binary quadratic model with which we encode fitness and distance between members of a population, and we leverage a quantum annealing system to sample low-energy solutions for the selection mechanism. We benchmark these quantum-enhanced algorithms against classical algorithms over various black-box objective functions, including the OneMax function, and functions from the IOHProfiler library for black-box optimization. We observe a performance gain in the average number of generations to convergence for the quantum-enhanced elitist selection operator in comparison to classical on the OneMax function. We also find that the quantum-enhanced selection operator with ∗Corresponding author email: David.VonDollen@vw.com non-elitist selection outperforms benchmarks on functions with fitness perturbation from the IOHProfiler library. Additionally, we find that in the case of elitist selection, the quantum-enhanced operators outperform classical benchmarks on functions with varying degrees of dummy variables and neutrality Show less
Story characters not only perform actions, they typically also perceive, feel, think, and communicate. Here we are interested in how children render characters’ perspectives when freely telling a... Show moreStory characters not only perform actions, they typically also perceive, feel, think, and communicate. Here we are interested in how children render characters’ perspectives when freely telling a fantasy story. Drawing on a sample of 150 narratives elicited from Dutch children aged 4-12, we provide an inventory of 750 instances of character-perspective representation (CPR), distinguishing fourteen different types. Firstly, we observe that character perspectives are ubiquitous in freely told children’s stories and take more varied forms than traditional frameworks can accommodate. Secondly, we discuss variation in the use of different types of CPR across age groups, finding that character perspectives are being fleshed out in more advanced and diverse ways as children grow older. Thirdly, we explore whether such variation can be meaningfully linked to automatically extracted linguistic features, thereby probing the potential for using automated tools from NLP to extract and classify character perspectives in children’s stories. Show less
