Spectra of the D2O dimer in the O-D fundamental stretch region: The acceptor symmetric stretch fundamental and new combination bands.

The O-D stretch fundamental region of the deuterated water dimer, (D2O)2, is further studied using a pulsed supersonic slit jet and a tunable optical parametric oscillator infrared source. The previously unobserved acceptor symmetric O-D stretch fundamental vibration is detected, with Ka = 0 ← 0 and 1 ← 0 sub-bands at about 2669 and 2674 cm-1, respectively. The analysis indicates that the various water dimer tunneling splittings generally decrease in the excited vibrational state, similar to the three other previously observed O-D stretch fundamentals. Two new (D2O)2 combination bands are observed, giving information on intermolecular vibrations in the excited O-D stretch states. The likely vibrational assignments for these and a previously observed combination band are discussed.

Transformer-Based Spatio-Temporal Analysis for Classification of Aortic Stenosis Severity From Echocardiography Cine Series.

Aortic stenosis (AS) is characterized by restricted motion and calcification of the aortic valve and is the deadliest valvular cardiac disease. Assessment of AS severity is typically done by expert cardiologists using Doppler measurements of valvular flow from echocardiography. However, this limits the assessment of AS to hospitals staffed with experts to provide comprehensive echocardiography service. As accurate Doppler acquisition requires significant clinical training, in this paper, we present a deep learning framework to determine the feasibility of AS detection and severity classification based only on two-dimensional echocardiographic data. We demonstrate that our proposed spatio-temporal architecture effectively and efficiently combines both anatomical features and motion of the aortic valve for AS severity classification. Our model can process cardiac echo cine series of varying length and can identify, without explicit supervision, the frames that are most informative towards the AS diagnosis. We present an empirical study on how the model learns phases of the heart cycle without any supervision and frame-level annotations. Our architecture outperforms state-of-the-art results on a private and a public dataset, achieving 95.2% and 91.5% in AS detection, and 78.1% and 83.8% in AS severity classification on the private and public datasets, respectively. Notably, due to the lack of a large public video dataset for AS, we made slight adjustments to our architecture for the public dataset. Furthermore, our method addresses common problems in training deep networks with clinical ultrasound data, such as a low signal-to-noise ratio and frequently uninformative frames. Our source code is available at: https://github.com/neda77aa/FTC.git.

Understanding the high-resolution spectral signature of the N2-H2O van der Waals complex in the 2OH stretch region.

We present the observation of the N2-H2O van der Waals complex in the 2OH stretch overtone region. The high-resolution jet cooled spectra were measured using a sensitive continuous wave cavity ringdown spectrometer. Several bands were observed and vibrationally assigned in terms of ν1, ν2, and ν3, the vibrational quantum numbers of the isolated H2O molecule, as (ν1'ν2'ν3')←(ν1″ν2″ν3″)=(200)←(000) and (101) ← (000). A combination band involving the excitation of the in-plane bending motion of N2 and the (101) vibration of water is also reported. The spectra were analyzed using a set of four asymmetric top rotors, each associated with a nuclear spin isomer. Several local perturbations of the (101) vibrational state were observed. These perturbations were assigned to the presence of the nearby (200) vibrational state and to the combination of (200) with intermolecular modes.

Doped rare gas clusters up to completion of first solvation shell, CO2-(Rg)n, n = 3-17, Rg = Ar, Kr, Xe.

Spectra of rare gas atom clusters containing a single carbon dioxide molecule are observed using a tunable mid-infrared (4.3 µm) source to probe a pulsed slit jet supersonic expansion. There are relatively few previous detailed experimental results on such clusters. The assigned clusters include CO2-Arn with n = 3, 4, 6, 9, 10, 11, 12, 15, and 17, and CO2-Krn and CO2-Xen with n = 3, 4, and 5. Each spectrum has (at least) a partially resolved rotational structure, and each yields precise values for the shift of the CO2 vibrational frequency (ν3) induced by the nearby rare gas atoms, together with one or more rotational constants. These results are compared with theoretical predictions. The more readily assigned CO2-Arn species tend to be those with symmetric structures, and CO2-Ar17 represents completion of a highly symmetric (D5h) solvation shell. Those not assigned (e.g., n = 7 and 13) are probably also present in the observed spectra but with band structures that are not well-resolved and, thus, are not recognizable. The spectra of CO2-Ar9, CO2-Ar15, and CO2-Ar17 suggest the presence of sequences involving very low frequency (≈2 cm-1) cluster vibrational modes, an interpretation which should be amenable to theoretical confirmation (or rejection).

Spectra of CO2-Rg2 and CO2-Rg-He trimers (Rg = Ne, Ar, Kr, and Xe): Intermolecular CO2 rock, vibrational shifts and three-body effects.

Weakly bound CO2-Rg2 trimers are studied by high-resolution (0.002 cm-1) infrared spectroscopy in the region of the CO2 ν3 fundamental band (≈2350 cm-1), using a tunable optical parametric oscillator to probe a pulsed supersonic slit jet expansion with an effective rotational temperature of about 2 K. CO2-Ar2 spectra have been reported previously, but they are extended here to include Rg = Ne, Kr, and Xe as well as new combination and hot bands. For Kr and Xe, a unified scaled parameter scheme is used to account for the many possible isotopic species. Vibrational shifts of CO2-Rg2 trimers are compared to those of CO2-Rg dimers, and in all cases the trimer shifts are slightly more positive (blue-shifted) than expected on the basis of linear extrapolation from the dimer. Combination bands directly measure an intermolecular vibrational mode (the CO2 rock) and give values of about 32.2, 33.8, and 34.7 cm-1 for CO2-Ar2, -Kr2, and -Xe2. Structural parameters derived for CO2-Rg2 trimers are compared with those of CO2-Rg and Rg2 dimers. Spectra of the mixed trimers CO2-Rg-He are also reported.

Magnetic Field Annihilation in a Magnetotail Electron Diffusion Region With Electron-Scale Magnetic Island.

We present observations in Earth's magnetotail by the Magnetospheric Multiscale spacecraft that are consistent with magnetic field annihilation, rather than magnetic topology change, causing fast magnetic-to-electron energy conversion in an electron-scale current sheet. Multi-spacecraft analysis for the magnetic field reconstruction shows that an electron-scale magnetic island was embedded in the observed electron diffusion region (EDR), suggesting an elongated shape of the EDR. Evidence for the annihilation was revealed in the form of the island growing at a rate much lower than expected for the standard X-type geometry of the EDR, which indicates that magnetic flux injected into the EDR was not ejected from the X-point or accumulated in the island, but was dissipated in the EDR. This energy conversion process is in contrast to that in the standard EDR of a reconnecting current sheet where the energy of antiparallel magnetic fields is mostly converted to electron bulk-flow energy. Fully kinetic simulation also demonstrates that an elongated EDR is subject to the formation of electron-scale magnetic islands in which fast but transient annihilation can occur. Consistent with the observations and simulation, theoretical analysis shows that fast magnetic diffusion can occur in an elongated EDR in the presence of nongyrotropic electron effects. We suggest that the annihilation in elongated EDRs may contribute to the dissipation of magnetic energy in a turbulent collisionless plasma.

Observing the Completion of the First Solvation Shell of Carbon Dioxide in Argon from Rotationally Resolved Spectra.

Widespread interest in weakly bound molecular clusters of medium size (5-50 molecules) is motivated by their complicated energy landscapes, which lead to hundreds or thousands of distinct isomers. But most studies are theoretical in nature, and there are no experimental results which provide definitive structural information on completion of the first solvation shell. Here we assign rotationally resolved mid-infrared spectra to argon clusters containing a single carbon dioxide molecule, CO2-Ar15 and CO2-Ar17. These mark the completion of the first solvation shell for CO2 in argon. The assignments are confirmed by nuclear spin intensity alternation in the spectra, a marker of highly symmetric structures for these clusters. Precise values are determined for rotational parameters and for shifts of the CO2 vibrational frequency induced by the argon atoms. The spectra indicate possible low-frequency (∼2 cm-1) vibrational modes in these clusters, posing a challenge for future cluster theory.

Weakly-bound clusters of atmospheric molecules: infrared spectra and structural calculations of (CO2)n-(CO)m-(N2)p, (n,m,p) = (2,1,0), (2,0,1), (1,2,0), (1,0,2), (1,1,1), (1,3,0), (1,0,3), (1,2,1), (1,1,2).

Structural calculations and high-resolution infrared spectra are reported for trimers and tetramers containing CO2 together with CO and/or N2. Among the 9 clusters studied here, only (CO2)2-CO was previously observed by high-resolution spectroscopy. The spectra, which occur in the region of the ν3 fundamental of CO2 (≈2350 cm-1), were recorded using a tunable optical parametric oscillator source to probe a pulsed supersonic slit jet expansion. The trimers (CO2)2-CO and (CO2)2-N2 have structures in which the CO or N2 is aligned along the symmetry axis of a staggered side-by-side CO2 dimer unit. The observation of two fundamental bands for (CO2)2-CO and (CO2)2-N2 shows that this CO2 dimer unit is non-planar, unlike (CO2)2 itself. For the trimers CO2-(CO)2 and CO2-(N2)2, the CO or N2 monomers occupy equivalent positions in the 'equatorial plane' of the CO2, pointing toward its C atom. To form the tetramers CO2-(CO)3 and CO2-(N2)3, a third CO or N2 monomer is then added off to the 'side' of the first two. In the mixed tetramers CO2-(CO)2-N2 and CO2-CO-(N2)2, this 'side' position is taken by N2 and not CO. In addition to the fundamental bands, combination bands are also observed for (CO2)2-CO, CO2-(CO)2, and CO2-(N2)2, yielding some information about their low-frequency intermolecular vibrations.

Spectroscopic study of the tunneling dynamics in N2-water observed in the O-D stretch region.

The O-D stretch rovibrational spectra of N2-D2O and N2-DOH were measured and analyzed. A combination band involving the in-plane N2 bending vibration was also observed. These bands were recorded using a pulsed-slit supersonic jet expansion and a mid-infrared tunable optical parametric oscillator. The spectra were analyzed by considering the feasible tunneling motions, and transitions were fitted to independent asymmetric rotors for each tunneling state. The rotational constants of the four tunneling components of N2-D2O were retrieved for the excited vibrational states. A two order of magnitude increase in the tunneling splittings is observed for the asymmetric O-D stretch (ν3 in D2O) excitation compared to the symmetric stretch (ν1 in D2O) and to the ground vibrational state. This last finding indicates that the ν3 vibrational state is likely perturbed by a combination state that includes ν1. Finally, the observation of a local perturbation in the ν3 vibrational band, affecting the positions of few rovibrational levels, provides an experimental lower limit of the dissociation energy of the complex, D0 > 120 cm-1.

Exploring the next step in micro-solvation of CO in water: Infrared spectra and structural calculations of (H2O)4-CO and (D2O)4-CO.

We extend studies of micro-solvation of carbon monoxide by a combination of high-resolution IR spectroscopy and ab initio calculations. Spectra of the (H2O)4-CO and (D2O)4-CO pentamers are observed in the C-O stretch fundamental region (≈2150 cm-1). The H2O containing spectrum is broadened by predissociation, but that of D2O is sharp, enabling detailed analysis that gives a precise band origin and rotational parameters. Ab initio calculations are employed to confirm the assignment to (water)4-CO and to determine the structure in which the geometry of the (water)4 fragment is a cyclic ring very similar to the isolated water tetramer. The CO fragment is located "above" the ring plane, with a partial hydrogen bond between the C atom and one of the "free" protons (deuterons) of the water tetramer. Together with the previous results on D2O-CO, (D2O)2-CO, and (D2O)3-CO, this represents a probe of the four initial steps in the solvation of carbon monoxide at a high resolution.

Symmetry breaking of the bending mode of CO2 in the presence of Ar.

The weak infrared spectrum of CO2-Ar corresponding to the (0111) ← (0110) hot band of CO2 is detected in the region of the carbon dioxide ν3 fundamental vibration (≈2340 cm-1), using a tunable OPO laser source to probe a pulsed supersonic slit jet expansion. While this method was previously thought to cool clusters to the lowest rotational states of the ground vibrational state, here we show that under suitable jet expansion conditions, sufficient population remains in the first excited bending mode of CO2 (1-2%) to enable observation of vibrationally hot CO2-Ar, and thus to investigate the symmetry breaking of the intramolecular bending mode of CO2 in the presence of Ar. The bending mode of the CO2 monomer splits into an in-plane and an out-of-plane mode, strongly linked by a Coriolis interaction. Analysis of the spectrum yields a direct measurement of the in-plane/out-of-plane splitting measured to be 0.8770 cm-1. Calculations were carried out to determine if key features of our results, i.e., the sign and magnitude of the shift in the energy for the two intramolecular bending modes, are consistent with a quantum chemical potential energy surface. This aspect of intramolecular interactions has received little previous experimental and theoretical consideration. Therefore, we provide an additional avenue by which to study the intramolecular dynamics of this simplest dimer in its bending modes. Similar results should be possible for other weakly-bound complexes.

Association of vitamin D with the modulation of the disease severity in COVID-19.

In late 2019, SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number of lives. Results obtained from several investigations have explained the virus origin, pathogenicity, and transmission. Similar to SARS coronavirus, the pulmonary angiotensin converting enzyme (ACE) 2 was introduced as the virus receptor for entering the cell. An increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in lung injuries through several mechanisms. Several clinical symptoms as well as molecular factors have shown to be related to the disease transmission and severity. In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients' group. Contribution of those factors with the prognosis and severity of the disease has been shown.

The mortality rate from self-harm in Iran.

BACKGROUND: Self-harm-related death is one of the most unfortunate, tragic, and regrettable types of death owing to injuries with a variety of socio-economic and cultural causes. The study aimed to determine the trend in the mortality of self-harm by sex and age at national and provincial levels in Iran over a period of 26 years. METHODS: The Iran Death Registration System (DRS), cemetery databanks in Tehran and Esfahan, and the national population and housing censuses of Iran were used for this study. Using a growth model, the population was estimated in the age groups. Incompleteness, misalignment, and misclassification in the DRS were all considered and addressed accordingly. We used a spatio-temporal and Gaussian process regression model to estimate mortality rates in children and adults. RESULTS: Over the study period, 67,670 deaths were estimated owing to self-harm across the country. The overall age-standardized mortality rate decreased from 4.32 per 100,000 (95% unit interface (UI): 3.25-5.75) to 2.78 (2.15-3.59) per 100,000 between 1990 and 2015, a reduction of approximately 35.65%. The M/F ratio was 2.03:1 with an annual percent change of -2.38% and -1.37% for women and men, respectively. The annual self-harm mortality rate was higher among individuals aged 15-24 years, as well as it was more in men during the study period. CONCLUSION: Mortality from self-harm has declined over the study period in Iran. Higher rates in men and in population aged 15-24 years, with considerable variation by province, were the distinguishing features of self-harm. Iran needs to improve monitoring through a comprehensive multisectoral strategy; and most importantly, provide timely, effective and low-cost preventive interventions.

Spectra of CO2-N2 dimer in the 4.2 µm region: Symmetry breaking of the intramolecular CO2 bend, the intermolecular bend, and higher K-values for the fundamental.

Infrared spectra of the CO2-N2 dimer are observed in the carbon dioxide ν3 asymmetric stretch region (≈2350 cm-1) using a tunable infrared optical parametric oscillator to probe a pulsed slit jet supersonic expansion. Previous results for the b-type fundamental band are extended to higher values of Ka. An a-type combination band involving the lowest in-plane intermolecular bending mode is observed. This yields a value of 21.4 cm-1 and represents the first experimental determination of an intermolecular mode for CO2-N2. This intermolecular frequency is at odds with the value of 45.9 cm-1 obtained from a recent 4D intermolecular potential energy surface. In addition, two weak bands near 2337 cm-1 are assigned to the CO2 hot band transition (v1, v2 l2, v3) = (0111) ← (0110). They yield a value of 2.307 cm-1 for the splitting of the degenerate CO2 ν2 bend into in-plane and out-of-plane components due to the presence of the nearby N2. The in-plane mode lies at a lower energy relative to the out-of-plane mode.

Electron Heating by Debye-Scale Turbulence in Guide-Field Reconnection.

We report electrostatic Debye-scale turbulence developing within the diffusion region of asymmetric magnetopause reconnection with a moderate guide field using observations by the Magnetospheric Multiscale mission. We show that Buneman waves and beam modes cause efficient and fast thermalization of the reconnection electron jet by irreversible phase mixing, during which the jet kinetic energy is transferred into thermal energy. Our results show that the reconnection diffusion region in the presence of a moderate guide field is highly turbulent, and that electrostatic turbulence plays an important role in electron heating.

Is neoadjuvant chemoradiotherapy sufficient in patients with advanced rectal malignancy and positive extra-mesorectal lateral lymph nodes?

AIM: There is current debate about the optimal management of lateral pelvic lymph nodes (LPLNs) in rectal cancer between Western and Eastern centres. This paper aims to report the rate of histologically proven positive LPLNs in a group of patients undergoing the conventional Western approach to primary and recurrent rectal cancer. METHOD: A retrospective cohort review of all patients who underwent LPLN dissection at Royal Prince Alfred Hospital in Sydney, Australia. This included patients who underwent pelvic exenteration who had LPLNs excised either en bloc for laterally invasive or recurrent tumours or as part of selective node dissection for suspicious lymph nodes on preoperative imaging. Histopathological results for these patients were compared with node status at preoperative imaging. RESULTS: Seventy-one patients satisfied the inclusion criteria. Of those patients with positive nodes on histology, 27% (9/33) with radiologically positive LPLNs were treated with preoperative radiotherapy and 75% (9/12) with radiologically positive LPLNs were not treated with preoperative radiotherapy (P = 0.004). None of the 12 patients with radiologically negative nodes treated with radiotherapy had positive nodes; 25% (3/12) of the patients with radiologically negative nodes who were not treated with radiotherapy had positive nodes. Fifty-three per cent of patients developed postoperative complications. CONCLUSION: Our study suggests that in patients with radiologically positive LPLNs chemoradiotherapy may not be enough to sterilize these extra-mesorectal lymph nodes as a large proportion (27%) will have residual viable adenocarcinoma cells. In patients with radiologically negative LPLNs, however, the addition of chemoradiotherapy may serve to adequately sterilize these lymph nodes without the need for prophylactic LPLN dissection.

The Ethylene-Carbon Dioxide Complex and the Double Rotor Model.

The infrared spectrum of the weakly bound C2H4-CO2 complex is investigated in the region of the ν3 fundamental band of CO2 (≈2350 cm-1), using a tunable OPO laser source to probe a pulsed supersonic slit jet expansion. The spacing of the various K-subbands in this perpendicular (ΔK = ±1) spectrum is very irregular, and the pattern of irregularity is quite different from that observed previously in another C2H4-CO2 band by Bemish et al. [ J. Chem. Phys. 1995 , 103 , 7788 ]. But by allowing for the different symmetry of the ν3 (CO2) upper vibrational state, both results can be strikingly well explained using the "double internal rotor" model as described by Bemish et al.

Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus.

PURPOSE: The aim of the present study is to investigate the impact of the near-infrared (NIRF) technology with indocyanine green (ICG) in robotic urologic surgery by performing a systematic literature review and to provide evidence-based expert recommendations on best practices in this field. METHODS: All English language publications on NIRF/ICG-guided robotic urologic procedures were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus® and Web of Science™ databases (up to April 2019). Experts in the field provided detailed pictures and intraoperative video-clips of different NIRF/ICG-guided robotic surgeries with recommendations for each procedure. A unique QRcode was generated and linked to each underlying video-clip. This new exclusive feature makes the present the first "dynamic paper" that merges text and figure description with their own video providing readers an innovative, immersive, high-quality and user-friendly experience. RESULTS: Our electronic search identified a total of 576 papers. Of these, 36 studies included in the present systematic review reporting the use of NIRF/ICG in robotic partial nephrectomy (n = 13), robotic radical prostatectomy and lymphadenectomy (n = 7), robotic ureteral re-implantation and reconstruction (n = 5), robotic adrenalectomy (n = 4), robotic radical cystectomy (n = 3), penectomy and robotic inguinal lymphadenectomy (n = 2), robotic simple prostatectomy (n = 1), robotic kidney transplantation (n = 1) and robotic sacrocolpopexy (n = 1). CONCLUSION: NIRF/ICG technology has now emerged as a safe, feasible and useful tool that may facilitate urologic robotic surgery. It has been shown to improve the identification of key anatomical landmarks and pathological structures for oncological and non-oncological procedures. Level of evidence is predominantly low. Larger series with longer follow-up are needed, especially in assessing the quality of the nodal dissection and the feasibility of the identification of sentinel nodes and the impact of these novel technologies on long-term oncological and functional outcomes.

Micro-solvation of CO in water: infrared spectra and structural calculations for (D2O)2-CO and (D2O)3-CO.

The weakly-bound molecular clusters (D2O)2-CO and (D2O)3-CO are observed in the C-O stretch fundamental region (≈2150 cm-1), and their rotationally-resolved infrared spectra yield precise rotational parameters. The corresponding H2O clusters are also observed, but their bands are broadened by predissociation, preventing detailed analysis. The rotational parameters are insufficient in themselves to determine cluster structures, so ab initio calculations are employed, and good agreement between the experiment and theory is found for the most stable cluster isomers, yielding the basic cluster geometries as well as confirming the assignments to (D2O)2-CO and (D2O)3-CO. The trimer, (D2O)2-CO, has a near-planar geometry with one D atom from each D2O slightly out of the plane. The tetramer, (D2O)3-CO, has the water molecules arranged in a cyclic quasi-planar ring similar to the water trimer, with the carbon monoxide located 'above' the ring and roughly parallel to its plane. The tunneling effects observed in the free water dimer and trimer are quenched by the presence of CO. The previously observed water-CO dimer together with the trimer and tetramer reported here represent the first three steps in the solvation of carbon monoxide.

The water-carbon monoxide dimer: new infrared spectra, ab initio rovibrational energy level calculations, and an interesting in-termolecular mode.

Bound state rovibrational energy level calculations using a high-level intermolecular potential surface are reported for H2O-CO and D2O-CO. They predict the ground K = 1 levels to lie about 20 (12) cm-1 above K = 0 for H2O-CO (D2O-CO) in good agreement with past experiments. But the first excited K = 1 levels are predicted to lie about 3 cm-1 below their K = 0 counterparts in both cases. Line strength calculations also indicate that mid-infrared transitions from the K = 0 ground state to this seemingly anomalous excited K = 1 state should be observable. These predictions are strikingly verified by new spectroscopic measurements covering the C-O stretch region around 2200 cm-1 for H2O-CO, D2O-CO, and HOD-CO, and the O-D stretch region around 2700 cm-1 for D2O-CO, HOD-CO, and DOH-CO. The experiments probe a pulsed supersonic slit jet expansion using tunable infrared quantum cascade laser or optical parametric oscillator sources. Discrete perturbations in the O-D stretch region give an experimental lower limit to the binding energy D0 of about 340 cm-1 for D2O-CO, as compared to our calculated value of 368 cm-1. Wavefunction plots are presented to help understand the intermolecular dynamics of H2O-CO. Coriolis interactions are invoked to explain the seemingly anomalous energies of the first excited K = 1 levels.