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We prove that in a strongly pseudoconvex domain with smooth boundary, then the length of a geodesic for the Kobayashi-Royden infinitesimal metric between two points is bounded by a constant multiple of the Euclidean distance between the points.

International audience; Objective: To assess the impact of global physician empathy and its three subdimensions (establishing rapport, emotional and cognitive processes) on the severity of postoperative complications in a sample of cancer patients.Methods: We retrospectively analyzed data on 256 patients with esogastric cancer from the French national FREGAT database. Empathy and its subdimensions were assessed using the patient-reported CARE scale and the severity of medical and surgical complications was reported with the Clavien-Dindo classification system. The usual covariates were included in multinomial logistic regression analyses.Results: Physician empathy predicted the odds of reporting major complications. When patients perceived high empathy, they were less likely to report major complications compared to no complications (OR = .95, 95% CI = [.91-.99], p = .029). Among the three dimensions, only "establishing rapport" (OR = .84, 95% CI = [.73-.98], p = .019) and the "emotional process" (OR = .85, 95% CI = [.74-.98], p = .022) predicted major complications.Conclusions: Physician empathy is essential before surgery. Further research is needed to understand the mechanisms associating empathy with health outcomes in cancer. Physicians should be trained to establish good rapport with patients, especially in the preoperative period.

Background Physiotherapy is a major cornerstone of enhanced rehabilitation after surgery (ERAS) and reduces the development of atelectasis after thoracic surgery. By initiating physiotherapy in the post-anaesthesia care unit (PACU), the aim was to evaluate whether the ultra-early initiation of rehabilitation (in the first hour following tracheal extubation) would improve the outcomes of patients undergoing elective thoracic surgery. Methods A case–control study with a before-and-after design was conducted. From a historical control group, patients were paired at a 3:1 ratio with an intervention group. This group consisted of patients treated with the ultra-early rehabilitation programme after elective thoracic surgery (clear fluids, physiotherapy, and ambulation). The primary outcome was the incidence of postoperative atelectasis and/or pneumonia during the hospital stay. Results After pairing, 675 patients were allocated to the historical control group and 225 patients to the intervention group. A significant decrease in the incidence of postoperative atelectasis and/or pneumonia was found in the latter (11.4 versus 6.7 per cent respectively; P = 0.042) and remained significant on multivariate analysis (OR 0.53, 95 per cent c.i. 0.26 to 0.98; P = 0.045). A subgroup analysis of the intervention group showed that early ambulation during the PACU stay was associated with a further significant decrease in the incidence of postoperative atelectasis and/or pneumonia (2.2 versus 9.5 per cent; P = 0.012). Conclusions Ultra-early rehabilitation in the PACU was associated with a decrease in the incidence of postoperative atelectasis and/or pneumonia after major elective thoracic surgery.

We introduce the notion of locally visible and locally Gromov hyperbolic domains in $\mathbb C^d$. We prove that a bounded domain in $\mathbb C^d$ is locally visible and locally Gromov hyperbolic if and only if it is (globally) visible and Gromov hyperbolic with respect to the Kobayashi distance. This allows to detect, from local information near the boundary, those domains which are Gromov hyperbolic and for which biholomorphisms extend continuously up to the boundary., Comment: 25 pages

In this note, we introduce the notion of visible boundary points with respect to Kobayashi distance for domains in complex euclidean space. Following the work of Sarkar, we obtain additive and multiplicative localization results about Kobayashi distance near visible boundary points. Then using the additive localization result, we show that visibility property with respect to Kobayashi distance is a local property of the boundary points and it does not depend on the domain.

OBJECTIVES The aim of this study was to analyse the outcomes of an international cohort of patients affected by Masaoka stage III thymic epithelial tumours with vascular involvement and treated by surgery. METHODS Study design was the observational multicentre retrospective cohort study. Data were extracted from the European Society of Thoracic Surgeons thymic database; additional variables were collected. Inclusion criteria were as follows: stage III (Masaoka–Koga) thymic epithelial tumours; surgery with radical intention; clinical or pathological great vessels involvement; and radiologically suspected or diagnosed intraoperatively. Outcome items were analysed. RESULTS Sixty-five patients submitted to surgery from 2001 to 2017 fulfilled inclusion criteria. Thymoma and thymic carcinoma patients did not differ for demographics and clinical characteristics. The majority of great vessel treated were superior vena cava or innominate veins (72.3%). Eleven patients (16.9%) had postoperative cardiopulmonary complications; vascular stenosis was observed in 3 patients (4.6%). The multivariable Cox analysis for disease-free survival showed an increased hazard of recurrence for thymic carcinoma (hazard ratio = 3.59; 95% confidence interval: 1.66–7.78, P = 0.001). The 1-, 3-, 5- and 10-year overall survival rates were 0.86, 0.84, 0.81, and 0.53, respectively. There was no significant difference in overall survival according to resection status or between thymoma and thimic carcinoma. The univariable Cox regression model did not show an increased hazard of death for myasthenic patients considering all resection status and for patients who received neoadjuvant therapy. CONCLUSIONS We observed that clinical outcomes of patients treated for stage III thymic epithelial tumours with vascular involvement are satisfactory suggesting to increase the confidence in dealing with these complex surgeries. Complete resection should be achieved, even though extensive vascular reconstructions are required.

The Lempert function for a set of poles in a domain of Cn at a point z is obtained by taking a certain infimum over all analytic disks going through the poles and the point z, and majorizes the corresponding multi-pole pluricomplex Green function. Coman proved that both coincide in the case of sets of two poles in the unit ball. We give an example of a set of three poles in the unit ball where this equality fails.

We consider the problem of whether a union of complex hyperplanes can be a subset of a zero variety for the Hardy classes of the ball. A sufficient condition is found, consisting in a strong geometric separatedness requirement, together with a quantitative requirement slightly stronger than the necessary condition for Nevanlinna class zero varieties.

A complex analytic space is said to have the D*-extension property if and only if any holomorphic map from the punctured disk to the given space extends to a holomorphic map from the whole disk to the same space. A Hartogs domain H over the base X (a complex space) is a subset of X × C where all the fibers over X are disks centered at the origin, possibly of infinite radius. Denote by [phi] the function giving the logarithm of the reciprocal of the radius of the fibers, so that, when X is pseudoconvex, H is pseudoconvex if and only if [phi] is plurisubharmonic. We prove that H has the D*-extension property if and only if (i) X itself has the D*-extension property, (ii) [phi] takes only finite values and (iii) [phi] is plurisubharmonic. This implies the existence of domains which have the D*-extension property without being (Kobayashi) hyperbolic, and simplifies and generalizes the authors' previous such example.

Additional file 1. Survey sent to the lung transplantation centers.

JCTCV:23(3)

Best post-lung transplant Forced expiratory volume in 1 s (FEV1) in the three groups: GNB recolonization, GNB de-novo colonization, exempt of GNB. Best post-lung transplant Forced expiratory volume in 1 s (FEV1) in the three groups: GNB recolonization, GNB de-novo colonization, exempt of GNB expressed in percentage of the expected value. (DOCX 13 kb)

Pre and post-lung transplant airway colonization. Pre and post lung transplant airway colonization at the individual level for all forty patients. (DOCX 13Â kb)

JCTCV:22(1), Introduction: After esophagectomy, part of the viscera can migrate through the hiatus to surround the gastric tube, creating hiatal hernias (HH) which eventually lead to abdominal occlusion and bowel ischemia. Methods: This retrospective multicenter study investigated the diagnosis, surgical management and follow-up of HH after esophagectomy in French-speaking European departments. Results: From 2000 to 2016, 19 departments performed 6608 esophagectomies. During follow-up, 78 cases of HH (1.2%) required surgery. These were more frequent after the laparoscopic approach than after laparotomy (1.4% vs. 0.7%; p = 0.03). The appearance of HH occurred during early follow-up (≤90 days) for 17 patients (21.5%), 21 underwent surgery during the first year (26.6%) and 41 after the first year (51.9%), with 13, 13 and 17 urgent surgeries, respectively. The surgical approaches included laparotomy (n = 35, 45%), especially when bowel resection was needed, laparoscopy (n = 19, 24%), a thoracic approach (n = 13, 17%) or a thoracophrenolaparotomy (n = 11, 14%). Complications arose in 36 patients, with one death and 13 secondary surgeries (three for secondary HH). Eight patients presented with recurrent HH (between 6 days and 26 months). Conclusion: Development of HH after esophagectomy can have a wide range of presentations, and can lead to thoracic or abdominal complications requiring specialized management.

Pseudomonas aeruginosa dendrogram. MSP dendrogram performed using Biotyper v 3.0, including 52 spectra of Pseudomonas aeruginosa isolated before, at one month, six months or twelve months after lung transplant for the 13 patients for which data were available. * indicates isolates of the same patient belonging to the same strain. Each color is specific for one patient. (DOCX 120Â kb)

It is proved that for any domain in $\mathbb C^n$ the Caratheodory--Eisenman volume is comparable with the volume of the indicatrix of the Caratheodory metric up to small/large constants depending only on $n.$ Then the "multidimensional Suita conjecture" theorem of Blocki and Zwonek implies a comparable relationship between these volumes and the Bergman kernel., 5 pages

We prove the Gromov non-hyperbolicity with respect to the Kobayashi distance for 𝒞 1 , 1 ${\mathcal{C}^{1,1}}$ -smooth convex domains in ℂ 2 ${\mathbb{C}^{2}}$ which contain an analytic disc in the boundary or have a point of infinite type with rotation symmetry. The same is shown for “generic” product spaces, as well as for the symmetrized polydisc and the tetrablock. On the other hand, examples of smooth, non-pseudoconvex, Gromov hyperbolic domains in ℂ n ${\mathbb{C}^{n}}$ are given.

JCTCV:21(4), The purpose of this study was to compare our initial experience with RATS pulmonary lobectomy with that of our well-established VATS program. Methods: We compared the early outcomes of those 81 patients having had a 3-port full thoracoscopic lobectomy performed by the most experienced VATS surgeon with those 91 patients having had a 3-arm RATS lobectomy performed by a single surgeon during a 24-month period. Results: Operative time was longer in the RATS group (mean: 134.5 ± 154.2 minutes vs. 37.7 ± 47.3 minutes; p = 0.004). Overall morbidity was similar (43.4% vs. 39.1%; p = 0.57). Five patients in the VATS group required blood transfusions and only one in the RATS group (p = 0.12). Readmission rates at 90 days were similar (3.9% vs. 6.9%; p = 0.38). The 90-day mortality rates were 2.6% and 0% (p = 0.12). More N2 nodes were removed in the VATS group (mean: 9.92 ± 5.41 vs. 6.24 ± 5.584; p < 0.0001). The proportion of lymph node upstaging was similar in both groups (16% vs. 13%; p = 0.65). Conclusions: Our early experience of pulmonary lobectomy by RATS appears to be as safe and more mature than VATS, with regards to the 90-day postoperative period.

International audience; Lung transplantation (LTx) is a valid therapeutic option for selected patients with end-stage lung disease. HLA-E seems to play a major role in the immune response to different viral infections and to affect transplantation outcome, in Hematopoietic Stem Cell Transplantation, for example. Two nonsynonymous alleles, HLA-E(⁎)01:01 and HLA-E(⁎)01:03, have functional differences, involving relative peptide affinity, cell surface expression, and potential lytic activity of NK cells. The aim of this retrospective study was to determine the impact of these two alleles for LTx recipients on anti-HLA alloimmunization risk, overall survival, and chronic rejection (CLAD). HLA-E was genotyped in 119 recipients who underwent LTx from 1998 to 2010 in a single transplantation center. In univariate analysis, both HLA-E homozygous states were associated with impaired overall survival compared to heterozygous HLA-E alleles (p = 0.01). In multivariate analysis, HLA-E(⁎)01:03 allele showed increased CLAD occurrence when compared to homozygous HLA-E(⁎)01:01 status (HR: 3.563 (CI 95%, 1.016-12), p = 0.047). HLA-E allele did not affect pathogen infection or the production of de novo DSA. This retrospective study shows an uninvestigated, deleterious association of HLA-E alleles with LTx and requires verification using a larger cohort.

Epithelioid angiosarcoma is a rare malignant vascular tumor with poor prognosis. Pleural or pericardial angiosarcomas are usually secondary tumors. We report a unique case of primary epithelioid angiosarcoma of the pleura and the pericardium in a 28-year-old man who was admitted for Pancoast Tobias syndrome. Thoracoscopy revealed a multifocal neoplasm and pleural biopsy showed a malignant tumor which histological and immunophenotypical features were characteristic of epithelioid angiosarcoma.

Following Gorkin, Mortini, and Nikolski, we say that an inner function $I$ in $H^\infty$ of the unit disc has the WEP property if its modulus at a point $z$ is bounded from below by a function of the distance from $z$ to the zero set of $I$. This is equivalent to a number of properties, and we establish some consequences of this for $H^\infty/IH^\infty$. The bulk of the paper is devoted to "wepable" functions, i.e. those inner functions which can be made WEP after multiplication by a suitable Blaschke product. We prove that a closed subset $E$ of the unit circle is of finite entropy (i.e. is a Beurling-Carleson set) if and only if any singular measure supported on $E$ gives rise to a wepable singular inner function. As a corollary, we see that singular measures which spread their mass too evenly cannot give rise to wepable singular inner functions. Furthermore, we prove that the stronger property of porosity of $E$ is equivalent to a stronger form of wepability ("easy wepability") for the singular inner functions with support in $E$. Finally, we find out the critical decay rate of masses of atomic measures (with no restrictions on support) guaranteeing that the corresponding singular inner functions are easily wepable., Comment: 25 p

We study the limits of pluricomplex Green functions with four poles tending to the origin in a hyperconvex domain, and the (related) limits of the ideals of holomorphic functions vanishing on those points. Taking subsequences, we always assume that the directions defined by pairs of points stabilize as they tend to $0$. We prove that in a generic case, the limit of the Green functions is always the same, while the limits of ideals are distinct (in contrast to the three point case). We also study some exceptional cases, where only the limits of ideals are determined. In order to do this, we establish a useful result linking the length of the upper or lower limits of a family of ideals, and its convergence., Comment: 16 pages

It is shown that a domain in $\C^n$ which is locally convex and has $\mathcal C^1$-smooth Levi-flat boundary is locally linearly equivalent to a Cartesian product of a planar domain and $\C^{n-1}.$ This result does not extend to the case where the Levi form has locally constant rank for some $k, Comment: We learned that the main result of the paper is a special case of the result by V. K. Beloshapka and S. N. Bychkov in "A property of convex hypersurfaces in C^n", Mat. Zametki 40 (1986), no. 5. Interested readers should refer to that work

The Nevanlinna-Pick problem and the simplest case of the Carath��odory-Fej��r problem on the spectral ball $\Om_3$ are reduced to interpolation problems on the symmetrized three-disc $\G_3.$, v2: minor changes

The Lempert function for several poles $a_0, ..., a_N$ in a domain $\Omega$ of $\mathbb C^n$ is defined at the point $z \in \Omega$ as the infimum of $\sum^N_{j=0} \log|\zeta_j|$ over all the choices of points $\zeta_j$ in the unit disk so that one can find a holomorphic mapping from the disk to the domain $\Omega$ sending 0 to $z$. This is always larger than the pluricomplex Green function for the same set of poles, and in general different. Here we look at the asymptotic behavior of the Lempert function for three poles in the bidisk (the origin and one on each axis) as they all tend to the origin. The limit of the Lempert functions (if it exists) exhibits the following behavior: along all complex lines going through the origin, it decreases like $(3/2) \log |z|$, except along three exceptional directions, where it decreases like $2 \log |z|$. The (possible) limit of the corresponding Green functions is not known, and this gives an upper bound for it., Comment: 16 pages; references added to related work of the author

Parastomal hernia develops after ileostomy or colostomy in 10% to 50% of cases. 1,2 Long-term parietal defects after continent urinary diversion through an ileal or colonic conduit have not been well evaluated due to the lack of data and different methods of urinary diversion. Such hernias also require difficult therapeutic management. In fact, recurrence and postoperative infection have often been observed after parietal restoration by an anterior or local procedure.3 Therefore, Helal et al proposed parietal reconstruction by laparotomy associated with stomal transposition.4 Based on our experience with laparoscopic postoperative hernia repair using intraperitoneal mesh we report this procedure in a patient who presented with a noncontinent urinary diversion parastomal hernia.

The aim of this paper is to overcome the well-known lack of p-optimality in hp-version discontinuous Galerkin (DG) discretizations for the numerical approximation of linear elliptic problems. For this purpose, we shall present and analyze a class of hp-DG methods that is closely related to other DG schemes, however, combines both p-optimal jump penalty as well as lifting stabilization. We will prove that the resulting error estimates are optimal with respect to both the local element sizes and polynomial degrees.

A method for blocking an optical lens (10) comprising a moving step in which the optical lens (10) is moved from a first reference position (Pl) to a second reference position (P2), so as to be in contact with a blocking material (14), the blocking material (14) being in a molding block (16), the second reference position (P2) being a function of the first reference position (P1), wherein the method further comprises an orienting step in which the optical lens (10) is oriented in the first reference position (P1) and placed on a plurality of pre-located pins (18) which are vertically translated into a preset position (Z1, Z2, Z3), so that, when the optical lens (10) is placed on the plurality of pre-located pins (18), the optical lens (10) is oriented in the first reference position (P1) where the prism of the optical lens (10) corresponds to a desired prism (af, ßf, Zf).

We show that a sequence a:= {ak}k in the unit ball of Cn is sampling for the Hardy spaces Hp, 0 < p < ∞ , if and only if the admissible accumulation set of a in the unit sphere has full measure. For p = ∞ the situation is quite different. While this condition is still sufficient, when n > 1 (in contrast to the one dimensional situation) there exist sampling sequences for H∞ whose admissible accumulation set has measure 0. We also consider the sequence a(ω ) obtained by applying to each ak a random rotation, and give a necessary and sufficient condition on {|ak|}k so that, with probability one, a(ω ) is of sampling for Hp, p < ∞ .