Carmel (Israel)

Abstract We revise the notion of the blobbed topological recursion by extending it to the setting of generalized topological recursion as well as allowing blobs which do not necessarily admit topological expansion. We show that the so-called non-perturbative differentials form a special case of this revisited version of blobbed topological recursion. Furthermore, we prove the KP integrability of the differentials of blobbed topological recursion for the input data that include KP-integrable blobs. This result generalizes, unifies, and gives a new proof of the KP integrability of nonperturbative differentials conjectured by Borot–Eynard and recently proved by the authors.

Inter-brain synchrony, the co-activation of brain regions between interacting individuals, is increasingly recognized as a key mechanism underlying social connectedness. This study examined whether dyadic neurofeedback training can enhance inter-brain synchrony in the inferior frontal gyrus and causally increase connectedness. We developed a real-time dyadic neurofeedback platform using functional near-infrared spectroscopy, where unacquainted dyads underwent three training sessions receiving either real neurofeedback or sham feedback. Although we initially anticipated a gradual increase across sessions, the neurofeedback group showed a significant enhancement in IFG inter-brain synchrony only in the third session, with effects extending to additional regions. These neural changes coincided with increased feelings of connectedness and shifts in intra-brain co-activation. While the precise strategies underlying dyadic regulation remain unclear, and additional sessions are needed to fully characterize the learning trajectory, the present findings provide preliminary evidence for the plasticity of inter-brain synchrony and its potential relevance for improving social outcomes.

Total hip arthroplasty (THA) reliably restores function and quality of life in patients with end-stage hip disease. Individuals with end-stage renal disease (ESRD) requiring dialysis are vulnerable to perioperative complications due to immune dysfunction, hemodynamic instability, and impaired wound healing. Evidence on risk-adjusted outcomes remains limited. A retrospective cohort study was conducted using the Nationwide Inpatient Sample (2016-2022). Dialysis dependence was identified using ICD-10-CM Z99.2. Primary outcomes included in-hospital mortality, length of stay (LOS), and hospital charges; secondary outcomes were major complications. Propensity score matching (10:1 nearest neighbour) balanced baseline demographics and comorbidities. Survey weights were used for national estimates. Post-matching outcomes were compared using risk ratios (RR) with 95% CIs. Among 1,957,284 THA patients, 2,730 (0.1%) were dialysis dependent. In unmatched analysis, dialysis dependence was associated with substantially increased in-hospital mortality (1.3% vs. 0.03%; crude RR: 31.9, 95% CI: 22.7-44.9). After 10:1 propensity-score matching, dialysis-dependent patients had 62.5% longer LOS (3.9 vs. 2.4 days, p < 0.01), 95.8% higher hospital charges ($98,454 vs. $60,741, p < 0.01), and persistently elevated in-hospital mortality (matched RR: 10.1, 95% CI: 6.3-16.2). Major complications were significantly more frequent. Dialysis dependence is a strong independent predictor of higher perioperative morbidity, mortality, and cost following THA. Targeted multidisciplinary optimization and enhanced perioperative care pathways are warranted.

Remnant cholesterol (RC), the cholesterol content of triglyceride-rich lipoproteins, is an emerging residual risk factor for atherosclerotic cardiovascular disease. Data on the prognostic significance after an ischemic stroke are limited. To investigate the association between RC and risk for cardiac events following hospitalization for an ischemic stroke. Data were collected for 5697 patients (39.5% women) affiliated with Clalit Health Services and hospitalized with an acute ischemic stroke. Adjusted Cox-regression models were used to estimate the association between RC percentiles, calculated using a routine post-discharge lipid profile, and risk for future myocardial infarction (MI) or coronary revascularization. Mean age was 69 ± 10 years; 78% were treated by lipid-lowering therapies. During median follow-up of 22 months, a MI or coronary revascularization event occurred in 243 patients. After multivariable adjustment including lipid-lowering therapies and non-HDL-C, RC was associated with higher MI or revascularization risk: hazard ratio (95% confidence interval): 1.42 (1.10-1.85), 1.50 (1.11-2.02), 1.62 (1.09-2.40), and 1.93 (1.22-3.06), in those with RC percentiles ≥ 50th (23.3 mg/dl), ≥ 75th (31.8 mg/dl), ≥ 90th (42.1 mg/dl), and ≥ 95th (49.1 mg/dl), compared to < 50th percentile. When RC and non-HDL-C levels were discordant, the level of RC better reflected higher risk for adverse cardiac events. Elevated RC following acute ischemic stroke is a risk factor for MI or coronary revascularization, independent of lipid-lowering therapies and non-HDL-C and may serve as a residual cardiovascular risk marker and potential treatment target in patients with ischemic stroke.

Abstract Powdery mildews are obligate biotrophic phytopathogenic fungi with a worldwide distribution. Advances in sequencing and molecular analyses have enabled the identification of cryptic species that were previously indistinguishable through morphological methods alone. Consequently, the discovery of new species continues to increase. This study brings together a comprehensive molecular phylogenetic analysis based on the amplification of ITS and IGS regions and a morphological analysis conducted on a broad spectrum of powdery mildew samples collected on various representatives of the genus Lactuca. Our dataset consisted of 200 accessions of herbaria leaves of Lactuca spp. infected with powdery mildew from different habitats worldwide. Microscopic examination revealed the presence of asexual states observable as conidiophores with two types of conidia, with fibrosin bodies (Podosphaera xanthii), and without fibrosin bodies (Golovinomyces bolayi). In some cases, chasmothecia were also recorded. Molecular identifications based on the ITS region confirmed this conclusion. Among 148 concatenated sequences of ITS and IGS regions, we discovered 12 ribotypes in Lactuca samples infected by G. bolayi. A single ribotype was observed for samples with the presence of P. xanthii. The principal component analysis revealed the pathogen’s host-specificity as an important factor determining host-dependent morphological variability in the case of samples from L. sativa and L. serriola.

Midurethral slings (MUS), including retropubic (tension-free vaginal tape [TVT]) and transobturator tape (TVTO) approaches, are commonly used surgical treatments for female stress urinary incontinence (SUI). Although both techniques have demonstrated high short-term success rates, long-term durability and recurrence remain critical concerns. This systematic review was aimed at comparing long-term outcomes of TVT and TVTO based on studies with a minimum of 5 years of follow-up. A systematic search of PubMed and Embase was conducted for studies published between 2000 and 2024. Eligible studies included those reporting long-term clinical outcomes, recurrence rates, and complications following TVT or TVTO procedures with ≥5 years of follow-up. Data extraction included cure or improvement rates, recurrence, adverse events, and reoperation rates. Study selection followed PRISMA guidelines. Both TVT and TVTO showed sustained effectiveness in treating female SUI over long-term follow-up. However, recurrence appeared more common following TVTO, particularly beyond 10 years. TVT was associated with higher long-term durability, whereas TVTO demonstrated a slightly lower rate of pain and erosion-related complications. Reintervention rates varied across studies, and inconsistency in outcome definitions limited direct comparison in some cases. Both TVT and TVTO remain effective options for the surgical management of female SUI. TVT may offer greater long-term durability and lower recurrence, whereas TVTO may be associated with a more favorable short-term complications profile. These findings highlight the importance of individualized surgical planning and underscore the need for standardized long-term outcome reporting in future research.

Objectives: This study examined the association between three sexual motivations—rewarding, intimacy, and enhancement—and their relationship to sexual and relationship satisfaction. A novel conceptualization of sexual reward was introduced and tested. Methods: The sample included 675 individuals in steady intimate relationships (12+ months). Participants completed measures assessing sexual motives and satisfaction levels. A newly developed scale for sexual reward motivation was validated. Findings: The rewarding motive was present among many participants, with approximately 10% reporting frequent use. Rewarding was negatively associated with both relationship satisfaction and sexual satisfaction. It also showed a negative correlation with enhancement motivation and no significant correlation with intimacy motivation. Conclusions: While occasional sexual reward may not impact relationship dynamics, frequent use of this motive appears to undermine both sexual and relational well-being. The findings suggest that sexual reward is a distinct and measurable motivation with potential implications for couple dynamics and therapeutic intervention.

Background: Hepatic resection is performed for liver lesions and requires careful preoperative planning to minimize bleeding. Blood type O, associated with lower von Willebrand factor (vWF) levels, may increase bleeding risk. This study investigates the relationship between the ABO blood type and perioperative bleeding in partial hepatectomy for colorectal liver metastases (CRLMs). Methods: Out of 563 patients who underwent hepatectomy, 135 cases were analyzed for CRLM at Carmel Medical Center (2013-2023). Patients were categorized into blood type O (61 patients) and non-O (74 patients) groups. Data on perioperative hemoglobin levels, blood loss, coagulation parameters, transfusion needs, and complications were assessed using χ2, t-tests, and ANOVA (p < 0.05). Results: No significant differences were observed for estimated blood loss (474.3 ± 696 mL for O vs. 527.8 ± 599 mL for non-O; p = 0.29), intraoperative hemoglobin drop (p = 0.613), or transfusion rates (24.59% for O vs. 28.37% for non-O; p = 0.698). Although non-O patients had a higher postoperative INR (p = 0.035), this did not correlate with increased bleeding or transfusion needs. Conclusions: Blood type O does not significantly affect perioperative bleeding or transfusion requirements in partial hepatectomy for CRLM. Further research is needed to better understand the significance of the ABO blood type.