On Vietoris-Rips complexes of Finite Metric Spaces with Scale 22

We examine the homotopy types of Vietoris-Rips complexes on certain finite metric spaces at scale $2$. We consider the collections of subsets of $[m]=\{1, 2, \ldots, m\}$ equipped with symmetric difference metric $d$, specifically, $\mathcal{F}^m_n$, $\mathcal{F}_n^m\cup \mathcal{F}^m_{n+1}$, $\mathcal{F}_n^m\cup \mathcal{F}^m_{n+2}$, and $\mathcal{F}_{\preceq A}^m$. Here $\mathcal{F}^m_n$ is the collection of size $n$ subsets of $[m]$ and $\mathcal{F}_{\preceq A}^m$ is the collection of subsets $\preceq A$ where $\preceq$ is a total order on the collections of subsets of $[m]$ and $A\subseteq [m]$ (see the definition of $\preceq$ in Section~\ref{Intro}). We prove that the Vietoris-Rips complexes $\mathcal{VR}(\mathcal{F}^m_n, 2)$ and $\mathcal{VR}(\mathcal{F}_n^m\cup \mathcal{F}^m_{n+1}, 2)$ are either contractible or homotopy equivalent to a wedge sum of $S^2$'s; also, the complexes $\mathcal{VR}(\mathcal{F}_n^m\cup \mathcal{F}^m_{n+2}, 2)$ and $\mathcal{VR}(\mathcal{F}_{\preceq A}^m, 2)$ are either contractible or homotopy equivalent to a wedge sum of $S^3$'s. We provide inductive formula for these homotopy types extending the result of Barmak in \cite{Bar13} about the independence complexes of Kneser graphs \text{KG}$_{2, k}$ and the result of Adamamszek and Adams in \cite{AA22} about Vietoris-Rips complexes of hypercube graphs with scale $2$

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Severe nonbacterial preseptal cellulitis from adenovirus detected via pooled meta‐genomic testing

Abstract Preseptal cellulitis is a serious diagnosis that can progress to postseptal cellulitis leading to grave consequences. Clinically, viral and bacterial cellulitis can be indistinguishable from each other. Using rapid DNA/RNA sequencing can be helpful

iTRAQ-based mass spectrometry screen to identify serum biomarkers in systemic lupus erythematosus

Objective Systemic lupus erythematosus (SLE) is a complex systemic autoimmune disorder with no reliable serum biomarkers currently available other than autoantibodies.Methods In the present study, isobaric tags for relative and absolute quantitation-based mass spectrometry was used to screen the sera of patients with SLE to uncover potential disease biomarkers.Results 85 common proteins were identified, with 16 being elevated (≥1.3) and 23 being decreased (≤0.7) in SLE. Of the 16 elevated proteins, serum alpha-1-microglobulin/bikunin precursor (AMBP), zinc alpha-2 glycoprotein (AZGP) and retinol-binding protein 4 (RBP4) were validated in independent cross-sectional cohorts (Cohort I, N=52; Cohort II, N=117) using an orthogonal platform, ELISA. Serum AMBP, AZGP and RBP4 were validated to be significantly elevated in both patients with inactive SLE and patients with active SLE compared with healthy controls (HCs) (p<0.05, fold change >2.5) in Cohort I. All three proteins exhibited good discriminatory power for distinguishing active SLE and inactive SLE (area under the curve=0.82–0.96), from HCs. Serum AMBP exhibited the largest fold change in active SLE (5.96) compared with HCs and correlated with renal disease activity. The elevation in serum AMBP was validated in a second cohort of patients with SLE of different ethnic origins, correlating with serum creatinine (r=0.60, p<0.001).Conclusion Since serum AMBP is validated to be elevated in SLE and correlated with renal disease, the clinical utility of this novel biomarker warrants further analysis in longitudinal cohorts of patients with lupus and lupus nephritis