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Glass transition, commonly manifested upon cooling a liquid, is continuous and cooling rate dependent. For decades, the thermodynamic basis in liquid–glass transition has been at the center of debate. Here, long-time isothermal annealing was conducted via molecular dynamics simulations for metallic glasses to explore the connection of physical aging in supercooled liquid and glassy states. An anomalous two-step aging is observed in various metallic glasses, exhibiting features of supercooled liquid dynamics in the first step and glassy dynamics in the second step, respectively. Furthermore, the transition potential energy is independent of initial states, proving that it is intrinsic for a metallic glass at a given temperature. We propose that the observed dynamic transition from supercooled liquid dynamics to glassy dynamics could be glass transition manifested isothermally. On this basis, glass transition is no longer cooling rate dependent, but is shown as a clear phase boundary in the temperature-energy phase diagram. Hence, a modified out-of-equilibrium phase diagram is proposed, providing new insights into the nature of glass transition. [ABSTRACT FROM AUTHOR]

Copyright of Rare Metals is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In dietary assessment using a single-view food image, an object of known size, such as a checkerboard, is often placed manually in the camera's view as a scale reference to estimate food volume. This traditional scale reference is inconvenient to use because of the manual placement requirement. Consequently, utensils, such as plates and bowls, have been suggested as alternative references. Although these references do not need a manual placement procedure, there is a unique challenge when a dining bowl is used as a reference. Unlike a dining plate, whose shallow shape does not usually block the view of the food, a dining bowl does obscure the food view, and its shape may not be fully observable from the single-view food image. As a result, significant errors may occur in food volume estimation due to the unknown shape of the bowl. To address this challenge, we present a novel method to premeasure both the size and shape of the empty bowl before it is used in a dietary assessment study. In our method, an image is taken with a labeled paper ruler adhered to the interior surface of the bowl, a mathematical model is developed to describe its shape and size, and then an optimization method is used to determine the bowl parameters based on the locations of observed ruler makers from the bowl image. Experimental studies were performed using both simulated and actual bowls to assess the reliability and accuracy of our bowl measurement method. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to investigate the presence of astrocyte antibodies in patients, excluding aquaporin‐4 or glial fibrillary acidic protein (GFAP) antibodies, while evaluating associated biomarkers and pathologies. Methods: Patient serum and cerebrospinal fluid (CSF) were tested for antibodies using tissue‐ and cell‐based assays. Neurofilament light chain (NFL) and GFAP in the CSF were detected using single‐molecule array (SIMOA). Results: 116 patients accepted SIMOA. Fifteen functional neurological disorders patients without antibodies were designated as controls. Thirty‐five patients were positive for astrocyte antibodies (Anti‐GFAP: 7; Anti‐AQP4: 7; unknown antibodies: 21, designed as the double‐negative group, DNAP). The most frequent phenotype of DNAP was encephalitis (42.9%), followed by myelitis (23.8%), movement disorders (19.0%), and amyotrophic lateral sclerosis‐like (ALS‐like) disease (14.2%). The levels of CSF GFAP and NFL in DNAP were higher than in the control (GFAP: 1967.29 [776.60–13214.47] vs 475.38 [16.80–943.60] pg/mL, p < 0.001; NFL: 549.11 [162.08–2462.61] vs 214.18 [81.60–349.60] pg/mL, p = 0.002). GFAP levels decreased in DNAP (n = 5) after immunotherapy (2446.75 [1583.45–6277.33] vs 1380.46 [272.16–2005.80] pg/mL, p = 0.043), while there was no difference in NFL levels (2273.78 [162.08–2462.61] vs 890.42 [645.06–3168.06] pg/mL, p = 0.893). Two brain biopsy patterns were observed: one exhibited prominent tissue proliferation and hypertrophic astrocytes, with local loss of astrocytes, while the other showed severe astrocyte depletion with loss of neurofilaments around the vessels. Eighteen patients received immunotherapy, and improved except one with ALS‐like symptoms. We identified anti‐vimentin in this patient. Discussion: There are unidentified astrocyte antibodies. The manifestations of double‐negativity are heterogeneous; nevertheless, the pathology and biomarkers remain consistent with astrocytopathy. Immunotherapy is effective. [ABSTRACT FROM AUTHOR]

Two polyamine-diarylidenyl piperidone (DAP) derivatives, dimer polyamine-H-4073 and tetrameric polyamine-H-4073, were designed and synthesized as antitumor agents by coupling the bifluoro-substituted DAP STAT3 inhibitor H-4073 to two different polyamines through the binary fatty acid chains, respectively. MTT assay and a SW480 xenograft model identified dimer polyamine-H-4073 as good candidate antitumor agent with good efficacy, limited toxicity, and low resistance, in comparison with H-4073, cisplatin, and doxorubicin. Western blot analysis results indicated that dimer polyamine-H-4073 exhibited effectively inhibition on signal transducer and activator of transcription 3 (STAT3), indicating that it may be a STAT3 inhibitor. [ABSTRACT FROM AUTHOR]

Personality has constituted a significant psychological component predicting physical exercise. Prior research mostly focused on how personality domains are associated with exercise behaviour. Yet, focusing more closely on combinations of personality domains may be valuable in the future. The present cross‐sectional study aimed to bridge this gap by investigating the associations between Big Five personality profiles and exercise behaviour based on a person‐centred approach in adults. Data from the China Family Panel Studies (CFPS) were used (N = 28,304), in which participants reported their Big Five personality and exercise behaviour. Latent profile analyses, grounded in young adulthood, middle adulthood, and later adulthood sub‐samples, identified five personality profiles: moderate, reserved, confident, resilient, and vulnerable. Across three age groups, significant differences between the five personality profiles in relation to exercise behaviour were revealed. Individuals with the resilient or confident profiles generally had longer exercise duration while people with the vulnerable profile tended to exercise less. Our findings give greater insight into the relationship between exercise and personality, suggesting that different combinations of personality traits may determine individuals' exercise behaviour. It opens promising avenues for identification of adults at risk of lacking exercise, and for development of personality‐targeted exercise interventions. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that type 2 diabetes (T2D) is an independent risk factor for Alzheimer's disease (AD), sharing similar pathophysiological traits like impaired insulin signaling. Objective: To test the association between plasma insulin and cerebrospinal fluid (CSF) AD pathology. Methods: A total of 304 participants were included in the Alzheimer's Disease Neuroimaging Initiative, assessing plasma insulin and CSF AD pathology. We explored the cross-sectional and longitudinal associations between plasma insulin and AD pathology and compared their associations across different AD clinical and pathological stages. Results: In the non-demented group, amyloid-β (Aβ)+ participants (e.g., as reflected by CSF Aβ42) exhibited significantly lower plasma insulin levels compared to non-demented Aβ–participants (p < 0.001). This reduction in plasma insulin was more evident in the A+T+ group (as shown by CSF Aβ42 and pTau181 levels) when compared to the A–T– group within the non-dementia group (p = 0.002). Additionally, higher plasma insulin levels were consistently associated with more normal CSF Aβ42 levels (p < 0.001) across all participants. This association was particularly significant in the Aβ–group (p = 0.002) and among non-demented individuals (p < 0.001). Notably, baseline plasma insulin was significantly correlated with longitudinal changes in CSF Aβ42 (p = 0.006), whereas baseline CSF Aβ42 did not show a similar correlation with changes in plasma insulin over time. Conclusions: These findings suggest an association between plasma insulin and early Aβ pathology in the early stages of AD, indicating that plasma insulin may be a potential predictor of changes in early Aβ pathology. [ABSTRACT FROM AUTHOR]

Objectives: This meta‐analysis aimed to examine the relationship between automatic processes and behavior as well as their moderators. Methods: There were 126 effect sizes (Fisher's Z) extracted from 55 independent research studies involving 10,432 participants. Meta‐analyses were conducted using Comprehensive Meta‐Analysis Version 3.3. Univariate meta‐regression models were used to analyze underlying moderators. Results: Meta‐analysis after correction found that automatic processes could significantly and positively predict behavior, but the effect size was small (Fisher's Z = 0.057, p < 0.001, 95% CI [0.043, 0.070]). Conclusions: Different components of automatic processes, task reliability, and study design moderated the relationship between automatic processes and behavior. Future research could explore automatic measures at a neurophysiological level or use population‐matched stimuli for specific populations to improve measure validity. In addition, future research should accumulate evidence on how to reduce sedentary behavior. [ABSTRACT FROM AUTHOR]

Background: Antibiotic-associated diarrhea (AAD) can prolong hospitalization, increase medical costs, and even lead to higher mortality rates. Therefore, it is essential to predict the incidence of AAD in elderly intensive care unit(ICU) patients. The objective of this study was to create a prediction model that is both interpretable and generalizable for predicting the incidence of AAD in elderly ICU patients. Methods: We retrospectively analyzed data from the First Medical Center of the People's Liberation Army General Hospital (PLAGH) in China. We utilized the machine learning model Extreme Gradient Boosting (XGBoost) and Shapley's additive interpretation method to predict the incidence of AAD in elderly ICU patients in an interpretable manner. Results: A total of 848 adult ICU patients were eligible for this study. The XGBoost model predicted the incidence of AAD with an area under the receiver operating characteristic curve (ROC) of 0.917, sensitivity of 0.889, specificity of 0.806, accuracy of 0.870, and an F1 score of 0.780. The XGBoost model outperformed the other models, including logistic regression, support vector machine (AUC = 0.809), K-nearest neighbor algorithm (AUC = 0.872), and plain Bayes (AUC = 0.774). Conclusions: While the XGBoost model may not excel in absolute performance, it demonstrates superior predictive capabilities compared to other models in forecasting the incidence of AAD in elderly ICU patients categorized based on their characteristics. [ABSTRACT FROM AUTHOR]

Background: One‐fourth of Parkinson's disease (PD) patients suffer from cognitive impairment. However, few neuroimaging markers have been identified regarding cognitive impairment in PD. Objective: This study aimed to explore the association between third ventricular width by transcranial sonography (TCS) and cognitive decline in PD. Method: Participants with PD were recruited from one medical center in China. Third ventricular width was assessed by TCS, and cognitive function was analyzed by the Mini‐Mental State Examination (MMSE). Receiver operating characteristic (ROC) analysis and Cox model analysis were utilized to determine the diagnostic and predictive accuracy of third ventricular width by TCS for cognitive decline in PD patients. Result: A total of 174 PD patients were recruited. Third ventricular width was negatively correlated with MMSE scores. ROC analysis suggested that the optimal cutoff point for third ventricular width in screening for cognitive impairment in PD was 4.75 mm (sensitivity 62.7%; specificity 75.6%). After 21.5 (18.0, 26.0) months of follow‐up in PD patients without cognitive impairment, it was found that those with a third ventricular width greater than 4.75 mm exhibited a 7.975 times higher risk of developing cognitive impairment [hazard ratio = 7.975, 95% CI 1.609, 39.532, p = 0.011] compared with patients with a third ventricular width less than 4.75 mm. Conclusion: Third ventricular width based on TCS emerged as an independent predictor of developing cognitive impairment in PD patients. [ABSTRACT FROM AUTHOR]

Objectives: Trait mindfulness refers to the general ability to be mindful across contexts and times. Affective exercise experience represents the summary affective valence of individuals' past exercise experiences. The purpose of this study was to explore the relationship between trait mindfulness and affective exercise experience in a person-centered research approach (latent profiles analysis) and to explore the mediation effect of intrinsic motivation in this relationship. Method: Participants were 663 college students (58.6% female; Mage = 20.40; SD = 3.13) who completed measures of the Five Facet Mindfulness Questionnaire (FFMQ), the Affective Exercise Experiences (AFFEXX) questionnaire, and Behavioral Regulation in Exercise Questionnaire (BREQ-II) and exercise level (IPAQ). Results: Four profiles emerged: non-judgmentally aware, moderately mindful, non-reactively observing, and highly mindful. The highly mindful profile demonstrated significantly more positive exercise experiences as well as higher level of intrinsic motivation. Furthermore, the mediation analysis suggested that intrinsic motivation partially mediated the relationship between highly mindful and affective exercise experience, and fully mediated the relationship between non-reactively observing and affective exercise experience, controlling for exercise level. Conclusions: This research revealed that trait mindfulness is highly associated with individuals' exercise experience and intrinsic motivation, indicating that mindfulness would be a promising strategy to increase individuals' positive exercise experiences through improving intrinsic exercise motivation. Preregistration: This study is not pre-registered. [ABSTRACT FROM AUTHOR]

This document is an editorial for a special issue of the journal Sensors titled "Sensing-Based Biomedical Communication and Intelligent Identification for Healthcare." The editorial highlights the importance of integrating sensor technology in healthcare for disease diagnosis and treatment. It discusses the development of various types of sensors and data processing algorithms, as well as advancements in artificial intelligence (AI) and sensing technology. The special issue includes original research articles and reviews that explore the latest developments and challenges in sensor-based information extraction for disease diagnosis and health monitoring. The articles cover topics such as innovative sensors for healthcare applications, processing algorithms for wearable sensors, analysis of public datasets, and the application of machine learning techniques for disease monitoring and management. The editorial concludes by stating that the special issue provides readers with a comprehensive view of the latest prospects of sensors for healthcare applications. [Extracted from the article]

The design and development of highly permeable, selective and stable polymer membranes are great challenges in the gas separation industry. Herein, we constructed two intrinsic microporous polyimides (6FPCA and 6FMCA) derived from two isometric diamines (PCA and MCA), which were synthesized by palladium catalyzed C—N coupling reaction. The PCA and MCA diamines contain a hollow beaded structure of 2,2′-paracyclophane as a building block with a specified window size of 3.09 Å. The chemical structures of monomers, polyimides were confirmed by NMR, FTIR, and elementary analysis. 6FPCA and 6FMCA exhibit good solubility, excellent thermal stability, and mechanical properties. 6FPCA exhibits much larger microporosity (434 versus 120 m2·g−1), FFV (0.22 versus 0.15), d-spacing (6.9 versus 5.9 Å), and over 10 times higher permeability with a very little decrease in selectivity than the corresponding polyimide (6FpA) with a plane structure, which remarkably increased their separation performance from far below the 2008 Robeson Upper bounds to reach these limitations for O2/N2 and CO2/CH4. Additionally, the 6FPCA also demonstrates good plasticization resistance, moderate aging properties, and high CO2/CH4 mixed-gas separation performance. These results indicate that paracyclophane subunit can be successfully incorporated into polymers to enhance their ultra-microporosity and separation properties, which open a new avenue for developing high performance gas separation membranes with topological ultra-micropores. [ABSTRACT FROM AUTHOR]

Chiral B,N-doped polycyclic aromatic hydrocarbons with circularly polarized luminescence (CPL) and small full-width at half-maxima (FWHM) are promising multiple resonance (MR) emitters for CP organic light-emitting diodes (CP-OLEDs). This work presents a pair of chiral MR enantiomers, P/M-o[B-N]2N2, featuring B-N bonds incorporated within a [7]-helicene skeleton. These enantiomers exhibit narrow 0–0 and 0–1 electronic transition bands, whose relative intensity can be fine-tuned by increasing doping concentrations, resulting in redshifts of the emission peak from 542 to 592 nm. The enantiomers show mirror-symmetric CPL spectra with an asymmetry factor (∣gPL∣) of 1.0 × 10−3. The hyperfluorescent CP-OLEDs with double-sensitized emitting layers display a FWHM of 33 nm, an external quantum efficiency of 25.1%, and a ∣gEL∣ factor of 7.7 × 10−4. Notably, the CP-OLEDs realize color-tunable CP electroluminescence peak from 553 to 613 nm by regulating the vibrational coupling. This work provides a novel concept for the design of helical CP-MR materials and CP-OLEDs, highlighting their potential for future applications in advanced optoelectronic devices. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes and other metabolic diseases have been linked to the development of periodontitis, but little research has been done to determine whether serum uric acid (SUA) levels and hyperuricemia play a role. This study aimed to investigate the relationship between SUA, hyperuricemia, and periodontitis. Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014, we created a nationally representative data set. We used multivariable logistic regression models to assess the relationship between SUA, hyperuricemia, and periodontitis and presented odds ratios (OR) in women and men, respectively. Results: In women, adjusted multivariable regression models showed that SUA (4.1–4.3mg/dl) was associated with higher odds of periodontitis (OR = 1.43; 95% confidence interval (CI):1.0 ~ 2.03, p = 0.047) with SUA (≤ 3.3mg/dl) as reference. The risk of periodontitis tended to increase slightly but insignificantly with increasing SUA levels, and the adverse effects occurred only when SUA increased to a certain level, and then reached a plateau. In men, the adjusted OR values for SUA (4.9–5.2mg/dl), SUA (5.3–5.5mg/dl), SUA (5.9–6.2mg/dl), and SUA (6.3–6.5mg/dl) were 0.66 (95% CI: 0.45 ~ 0.96, p = 0.029), 0.58 (95% CI: 0.40 ~ 0.85, p = 0.006), 0.67(95% CI: 0.47 ~ 0.97, p = 0.035), and 0.67 (95% CI: 0.45 ~ 0.99, p = 0.043), respectively, with SUA (≤ 4.3mg/dl) as reference. The elevated SUA levels are protective against periodontitis, but there is a range within which the risk of periodontitis decreases, followed by a non-significant tendency to increase. Conclusions: The levels of SUA that are linked to the risk of periodontitis. Future prospective longitudinal studies and strategies are required to further confirm whether controlled SUA treatment is an effective adjunct to systematic periodontal therapy and whether SUA can be used as a diagnostic biomarker to assess the risk or progression of periodontitis. [ABSTRACT FROM AUTHOR]

This study examined the placebo and nocebo effects of conditioning and induced expectations on executive function after acute aerobic exercise. The results showed that the benefits of exercise on executive function were influenced by both conditioning and induced expectations. Further, positive conditioning or expectations enhanced cognitive benefits, negative conditioning or expectations reduced cognitive benefits, but induced expectations on executive function were not moderated by conditioning. This study revealed and quantitively estimated the placebo and nocebo effects in improving executive function after acute aerobic exercise, providing evidence to advance the understanding of the cognitive benefits of exercise. [ABSTRACT FROM AUTHOR]

Copyright of Rare Metals is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives This study aimed to develop and validate an easy-to-use intensive care unit (ICU) illness scoring system to evaluate the in-hospital mortality for very old patients (VOPs, over 80 years old). Methods We performed a multicenter retrospective study based on the electronic ICU (eICU) Collaborative Research Database (eICU-CRD), Medical Information Mart for Intensive Care Database (MIMIC-III CareVue and MIMIC-IV), and the Amsterdam University Medical Centers Database (AmsterdamUMCdb). Least Absolute Shrinkage and Selection Operator regression was applied to variables selection. The logistic regression algorithm was used to develop the risk score and a nomogram was further generated to explain the score. Results We analyzed 23 704 VOPs, including 3 726 deaths (10 183 [13.5% mortality] from eICU-CRD [development set], 12 703 [17.2%] from the MIMIC, and 818 [20.8%] from the AmsterdamUMC [external validation sets]). Thirty-four variables were extracted on the first day of ICU admission, and 10 variables were finally chosen including Glasgow Coma Scale, shock index, respiratory rate, partial pressure of carbon dioxide, lactate, mechanical ventilation (yes vs no), oxygen saturation, Charlson Comorbidity Index, blood urea nitrogen, and urine output. The nomogram was developed based on the 10 variables (area under the receiver operating characteristic curve: training of 0.792, testing of 0.788, MIMIC of 0.764, and AmsterdamUMC of 0.808 [external validating]), which consistently outperformed the Sequential Organ Failure Assessment, acute physiology score III, and simplified acute physiology score II. Conclusions We developed and externally validated a nomogram for predicting mortality in VOPs based on 10 commonly measured variables on the first day of ICU admission. It could be a useful tool for clinicians to identify potentially high risks of VOPs. [ABSTRACT FROM AUTHOR]

Strawberry is a worldwide demanded edible fruit with high economic and nutritional value; however, a very short storage life largely limits its supply and marketing. In this study, strawberries were treated using sodium selenite with different concentrations (6, 12, 18, and 24 mg/L), and the postharvest fruit quality and resistance to Botrytis cinerea were substantially assessed. Among all concentrations, 12 mg/L Se was the most effective treatment, which maintained fruit skin brightness, reduced natural decay incidence, severity, and weight loss, increased the Se content in fruit, and thus maintained the postharvest fruit quality of the strawberry. Furthermore, strawberries treated with 12 mg/L Se had lower flavonoid, phenolic, anthocyanins, proanthocyanidins, H2O2, and O2− contents compared to the control and, correspondingly, lower antioxidant capacity; moreover, 12 mg/L Se treatment decreased the decay incidence and severity caused by the infection of B. cinerea. Collectively, our findings may provide a reference for developing safe and environmentally friendly alternative methods to sustain quality and manage gray mold in postharvest strawberries as well as other horticultural crops. [ABSTRACT FROM AUTHOR]

In this paper, a robust adaptive grid method is developed for solving first-order nonlinear singularly perturbed Fredholm integro-differential equations (SPFIDEs). Firstly such SPFIDEs are discretized by the backward Euler formula for differential part and the composite numerical quadrature rule for integral part. Then both a prior and an a posterior error analysis in the maximum norm are derived. Based on the prior error bound and the mesh equidistribution principle, it is proved that there exists a mesh gives optimal first-order convergence which is robust with respect to the perturbation parameter. Finally, the posterior error bound is used to choose a suitable monitor function and design a corresponding adaptive grid generation algorithm. Numerical results are given to illustrate our theoretical result. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury (AKI) is a global disease with high morbidity and mortality. At present, the treatment of AKI still lacks targeted measures. Ferroptosis, a form of regulated cell death, plays an essential role in the initiation and progression of AKI. Current evidence proves that targeting ferroptosis is supposed to be a novel potential strategy to cure AKI. In this study, we aim to use bibliometric analysis to identify research trends and hotspots in the field of "ferroptosis in AKI". Methods: We chose the Science Citation Index Expanded (SCI-EXPANDED) index of the Web of Science Core Collection (WoSCC) as the source database for data retrieval. Data were retrieved from the WoSCC on May 24, 2022. Full records and cited references of all the documents in WoSCC were collected. The R software and the Online Analysis Platform of Literature Metrology were used for data analysis and visual analysis. Results: There were 120 documents on "ferroptosis in AKI" in the WOSCC from 2014 to 2022 (May 24, 2022). There was a clear upward trend each year in the number of documents published. According to WoS report, China, the United States, and Germany were the top three countries involved in this research area, the majority of publications were included in the subject area "Cell Biology". Technical University of Dresden contributed the most publications, followed by Central South University and University of Pittsburgh. The Journal of Cell Death and Disease had the highest H-index and contributed the most publications. Linkermann A authored 16 articles and had the highest H-index. Multifactorial analysis of the keywords show that the research field is divided into two clusters. The most contributing publications and the most cited publications were also determined by factorial analysis. Conclusion: This bibliometric analysis provides a comprehensive analysis of research trends and hot spots on the topic of "ferroptosis in AKI". The study of ferroptosis-related AKI research remains in its early stages. There will be a dramatically increasing number of publications on this field. Further research should focus on exploring the mechanisms of crosstalk between ferroptosis and other programmed cell deaths, and improves clinical applications and therapeutic effects against AKI. [ABSTRACT FROM AUTHOR]

There is a growing demand for intensive care units, but there is a relative shortage of medical staff. Intensive care work is heavy and stressful. Optimizing the working conditions and processes of the intensive care unit is of great significance for improving the work efficiency and the level of diagnosis and treatment in the intensive care unit. The intelligent intensive care unit is a new ward management model gradually developed on the basis of modern science and technology such as communication technology, internet of things, artificial intelligence, robots, and big data. Under this model, the potential risks caused by human factors are greatly reduced, and the monitoring and treatment of patients has been significantly improved. This paper reviews the progress in related fields. [ABSTRACT FROM AUTHOR]

Objective: To investigate aquaporin‐4 antibody (AQP4‐IgG) dynamics and relapse risk in patients with seropositive neuromyelitis optica spectrum disorder treated with immunosuppressants. Methods: This observational cohort study with prospectively collected data included 400 neuromyelitis optica spectrum disorder patients seropositive for AQP4‐IgG and treated with immunosuppressants. Serum AQP4‐IgG was detected by fixed cell‐based assay every 6 months. Results: After treatment with immunosuppressants, 128 patients became AQP4‐IgG seronegative. The median time to become seronegative for 400 patients was 76.4 months (61.4 months, NA). Among those patients with negative change of AQP4‐IgG, the mean annualized relapse rate significantly decreased after patients became seronegative (0.20 vs 0.77, p < 0.001), and a positive correlation was observed between time to become seronegative and relapse (OR 1.018, 95% CI 1.001–1.035, p < 0.05). Independent risk factors for AQP4‐IgG becoming seronegative were older age at onset, initiation of immunosuppressants at onset, and shorter disease duration before maintenance therapy. Independent risk factors for relapse included younger age (≤46.4 years) at onset, poly‐system involvement in the first attack, and unchanged or increased AQP4‐IgG titer. The relapse risk was not associated with sex, combination with connective tissue disease, seropositivity for systemic autoimmune antibodies, or incomplete recovery from the first attack. Interpretation: Patients with younger age at onset, poly‐system involvement in the first attack, and unchanged or increased titer of AQP4‐IgG are most likely to experience relapse under treatment with immunosuppressants. Time to AQP4‐IgG becoming seronegative and change of AQP4‐IgG titer may become the surrogate efficacy biomarkers in clinical trials. ANN NEUROL 2023;93:1069–1081 [ABSTRACT FROM AUTHOR]

With the development of cloud-native technologies, Kubernetes becomes the standard of fact for container scheduling. Kubernetes provides service discovery and scheduling of containers, load balancing, service self-healing, elastic scaling, storage volumes, etc. Although Kubernetes is mature with advanced features, it does not consider reducing the cost in Kubernetes clouds using the factor of communication frequent between pods while scheduling pods, nor does it have a rescheduling mechanism to save cost. Hence, we propose a cost-efficient scheduling algorithm and a rescheduling algorithm to reduce the cost of communication-intensive and periodically changing web applications deployed in Kubernetes, respectively. Network communication-intensive pods are scheduled to the same node by the scheduling algorithm based on Improved Beetle Antennae Search. According to the changing pod intimacy relationship, the rescheduling algorithm is completed through the replacement of new and old pods to reduce the cost. In addition, this paper evaluates the proposed algorithms in terms of cost and performance on a Kubernetes cloud. The result shows that the cost consumption of Kubernetes clusters in cloud environment is reduced by 20.97% on average compared with the default Kubernetes framework. [ABSTRACT FROM AUTHOR]

Sleep disorders are significant health concerns affecting a large population. Related clinical studies face the deficiency in sleep data and challenges in data analysis, which requires enormous human expertise and labor. Moreover, in current clinical practice, sleep data acquisition processes usually cover only one night's sleep history, which is too short to recognize long-term sleep patterns. To address these challenges, we propose a semi-supervised learning (cluster-then-label) approach for sleep stage classification, integrating clustering algorithms into the supervised learning pipeline. We test the effectiveness of the proposed semi-supervised learning approach on two architectures: an advanced architecture using deep learning for classification and k-means for clustering, and a relatively naive Gaussian-based architecture. Also, we introduce two novel Gaussian transformations to improve the robustness and accuracy of the Gaussian-based architecture: assembled-fixed transformation and neural network based transformation. We reveal the effectiveness of the proposed algorithm via experiments on whole-night electroencephalogram (EEG) data. The experiments demonstrate that the proposed learning strategy improves the accuracy and F1 score over the state-of-the-art baseline on out-of-distribution human subjects. The experiments also confirm that the proposed Gaussian transformations can significantly gain normality to EEG band-power features and in turn facilitate the semi-supervised learning process. This cluster-then-label learning approach, combined with novel Gaussian transformations, can significantly improve the accuracy and efficiency of sleep stage classification, enabling more effective diagnosis of sleep disorders. [ABSTRACT FROM AUTHOR]

This research analyzes the area required for the conflict resolution between aircraft in two flows impacted by a convective weather cell (CWC). The CWC is introduced as a constrained area, forbidden to flight through, which affects the air traffic flows. Prior the conflict resolution, two flows and their intersection are relocated away from the CWC area (thus enabling circumvention of the CWC), which is followed by a tuning of the relocated flows intersection angle in order to create the minimal size of the conflict zone (CZ—a circular area centered at the intersection of two flows, which provides aircraft enough space to completely resolve the conflict within). Therefore, the essence of the proposed solution is in providing conflict free trajectories for the aircraft in intersecting flows that are affected by the CWC, with the goal of minimizing the CZ size, so the finite occupied airspace for the conflict resolution and the CWC circumvention could be reduced. Compared to the best solutions and current industry practice, this article is focused in reduction of the airspace required for aircraft to aircraft and aircraft to weather conflict resolution, and not to distance travelled, time savings, and fuel consumption minimization. The conducted analysis in the MicrosoftExcel2010 confirmed the relevance of the proposed model and demonstrated variations in efficiency of the utilized airspace. The proposed model's transdisciplinary nature makes it potentially applicable in other fields of study, such as the conflict resolution between unmanned aerial vehicles (UAVs) and fixed objects like buildings. Building on this model and taking in consideration large and complex data sets, such as weather related data and flight data (aircraft position, speed, and altitude), we believe it is possible to conduct more sophisticated analyses that would take advantage of Big Data. [ABSTRACT FROM AUTHOR]

As a primary computation unit, a processing element (PE) is key to the energy efficiency of a convolutional neural network (CNN) accelerator. Taking advantage of the inherent error tolerance of CNNs, approximate computing with high hardware efficiency has been considered for implementing the computation units of CNN accelerators. However, individual approximate designs such as multipliers and adders can only achieve limited accuracy and hardware improvements. In this paper, an approximate PE is dedicatedly devised for CNN accelerators by synergistically considering the data representation, multiplication and accumulation. An approximate data format is defined for the weights using stochastic rounding. This data format enables a simple implementation of multiplication by using small lookup tables, an adder and a shifter. Two approximate accumulators are further proposed for the product accumulation in the PE. Compared with the exact 8-bit fixed-point design, the proposed PE saves more than 29% and 20% in power-delay product for 3 × 3 and 5 × 5 sum of products, respectively. Also, compared with the PEs consisting of state-of-the-art approximate multipliers, the proposed design shows significantly smaller error bias with lower hardware overhead. Moreover, the application of the approximate PEs in CNN accelerators is analyzed by implementing a multi-task CNN for face detection and alignment. We conclude that 1) an approximate PE is more effective for face detection than for alignment, 2) an approximate PE with high statistically-measured accuracy does not necessarily result in good quality in face detection, and 3) properly increasing the number of PEs in a CNN accelerator can improve its power and energy efficiency. [ABSTRACT FROM AUTHOR]

Background Multiple organ dysfunction syndrome (MODS) is associated with a high risk of mortality among older patients. Current severity scores are limited in their ability to assist clinicians with triage and management decisions. We aim to develop mortality prediction models for older patients with MODS admitted to the ICU. Methods The study analyzed older patients from 197 hospitals in the United States and 1 hospital in the Netherlands. The cohort was divided into the young-old (65–80 years) and old-old (≥80 years), which were separately used to develop and evaluate models including internal, external, and temporal validation. Demographic characteristics, comorbidities, vital signs, laboratory measurements, and treatments were used as predictors. We used the XGBoost algorithm to train models, and the SHapley Additive exPlanations (SHAP) method to interpret predictions. Results Thirty-four thousand four hundred and ninety-seven young-old (11.3% mortality) and 21 330 old-old (15.7% mortality) patients were analyzed. Discrimination AUROC of internal validation models in 9 046 U.S. patients was as follows: 0.87 and 0.82, respectively; discrimination of external validation models in 1 905 EUR patients was as follows: 0.86 and 0.85, respectively; and discrimination of temporal validation models in 8 690 U.S. patients: 0.85 and 0.78, respectively. These models outperformed standard clinical scores like Sequential Organ Failure Assessment and Acute Physiology Score III. The Glasgow Coma Scale, Charlson Comorbidity Index, and Code Status emerged as top predictors of mortality. Conclusions Our models integrate data spanning physiologic and geriatric-relevant variables that outperform existing scores used in older adults with MODS, which represents a proof of concept of how machine learning can streamline data analysis for busy ICU clinicians to potentially optimize prognostication and decision making. [ABSTRACT FROM AUTHOR]

How glasses relax at room temperature is still a great challenge for both experimental and simulation studies due to the extremely long relaxation time-scale. Here, by employing a modified molecular dynamics simulation technique, we extend the quantitative measurement of relaxation process of metallic glasses to room temperature. Both energy relaxation and dynamics, at low temperatures, follow a stretched exponential decay with a characteristic stretching exponent β = 3/7, which is distinct from that of supercooled liquid. Such aging dynamics originates from the release of energy, an intrinsic nature of out-of-equilibrium system, and manifests itself as the elimination of defects through localized atomic strains. This finding is also supported by long-time stress-relaxation experiments of various metallic glasses, confirming its validity and universality. Here, we show that the distinct relaxation mechanism can be regarded as a direct indicator of glass transition from a dynamic perspective. The mechanism governing structural relaxation in metallic glasses remains elusive, hampering their stability and engineering applications. Here, the authors reveal a distinct relaxation mechanism with a stretching exponent of 3/7, providing new insight for understanding the nature of glass. [ABSTRACT FROM AUTHOR]

To prepare porous core–shell composite particles (PCPs) in order to improve the flowability and compactibility of powder materials for direct compaction (DC), as well as the dissolution of tablets. The results obtained are meaningful to boosting the development and further research of PCPs on DC. Methods: In this study, hydroxypropyl methylcellulose (HPMC E3) and polyvinylpyrrolidone (PVP K30) were selected as shell materials, the Xiao Er Xi Shi formulation powder (XEXS) was used as the core materials, ammonium bicarbonate (NH4HCO3), and sodium bicarbonate (NaHCO3) were employed as pore-forming agent. Using co-spray drying method to prepare composite particles (CPs). Then, the physical properties and comparison between different CPs were characterized comprehensively. Finally, the different CPs were directly compacted as tablets to explore the effect on the dissolution behavior of DC tablets, respectively. (i) The XEXS PCPs were prepared successfully by co-spray drying, and the yield of PCPs is almost 80%; (ii) The TS values of PCP-X-P-Na, PCP-X-P-NH4, PCP-X-H-Na and PCP-X-P-Na were 5.70, 7.56, 3.98, and 6.88 times higher than that of raw material (X); (iii) The disintegration time of PCPs tablets decreased 10–25% when compared with CPs tablets; (iv) The values of Carr's index (CI), Hausner ratio (HR), Caking strength (CS), and Cohesion index (CoI) of PCP-X-H-NH4 were 19.16%, 19.29%, 40.14%, and 6.39% lower than that of X, respectively. The PCPs prepared by co-spray drying did improve the flowability and compactibility of powder, as well as the dissolution of tablets. [ABSTRACT FROM AUTHOR]

How glasses relax at room temperature is still a great challenge for both experimental and simulation studies due to the extremely long relaxation time-scale. Here, by employing a modified molecular dynamics simulation technique, we extend the quantitative measurement of relaxation process of metallic glasses to room temperature. Both energy relaxation and dynamics, at low temperatures, follow a stretched exponential decay with a characteristic stretching exponent β = 3/7, which is distinct from that of supercooled liquid. Such aging dynamics originates from the release of energy, an intrinsic nature of out-of-equilibrium system, and manifests itself as the elimination of defects through localized atomic strains. This finding is also supported by long-time stress-relaxation experiments of various metallic glasses, confirming its validity and universality. Here, we show that the distinct relaxation mechanism can be regarded as a direct indicator of glass transition from a dynamic perspective. The mechanism governing structural relaxation in metallic glasses remains elusive, hampering their stability and engineering applications. Here, the authors reveal a distinct relaxation mechanism with a stretching exponent of 3/7, providing new insight for understanding the nature of glass. [ABSTRACT FROM AUTHOR]

To investigate the hydrogen evolution ability of the cluster ConMoS (n = 1–5), this paper based on density functional theory, using the B3LYP generalization and def2-TZVP basis set. In this paper, the cluster was structurally optimized and theoretically analyzed by the Gaussian09 package under multiple spin multiplexes. The optimized conformation of the cluster was mostly in stereo form; in the first step of the hydrogen evolution reaction, the analysis of the cluster HOMO diagram and the water molecule LUMO diagram, the energy level difference, the d-band center, Gibbs free energy and adsorption energy showed that the electrons of configurations 5-a and 4-a were more likely to jump from the HOMO orbital to the water molecule LUMO orbital, and 5-a and 4-a showed excellent activity, they finally formed the ConMoS-Hads model; in the second step of the hydrogen evolution reaction, the Co atom were a potential active site, and analysis of energy level differences and bond level revealed that the configurations 5a-Hads and 4a-Hads showed good desorption capacity compared to the other configurations, and their adsorbed H atoms were more readily shed to complete the reaction with more rapid hydrogen evolution; in summary, configurations 5-a and 4-a were determined to be the favored configurations of the cluster with excellent catalytic activity. [ABSTRACT FROM AUTHOR]

Background: Acute kidney injury (AKI) is common among elderly patients after a first hospitalized AKI. Patients who recover are at risk for recurrence, but recurrent geriatric AKI is not well-studied. Methods: This was a retrospective, 12-month cohort study using data from the National Clinical Research Center for Geriatric Diseases. Recurrent AKI was defined as a new spontaneous rise of ≥ 0.3 mg/dl (≥ 26.5 µmol/L) within 48 h or a 50% increase in serum creatinine (Scr) from the baseline within 7 days after the previous AKI episode. The outcome measured was 12-month mortality. Results: Among 1711 study patients, 652 developed AKI. Of the 429 AKI survivors in whom recovery could be assessed, 314 patients recovered to their baseline renal function, and 115 patients developed chronic kidney disease (CKD). Of the group that recovered renal function, 90 patients (28.7%) subsequently developed recurrent AKI, while 224 (71.3%) did not. Of the 429 survivors with AKI, 103 patients (24.0%) died within 12 months. Multivariate logistic regression analysis revealed that recurrent AKI was significantly associated with coronary disease (odds ratio [OR = 2.008; 95% confidence interval [CI] 1.024–3.938; P = 0.042), a need for mechanical ventilation (OR = 2.265; 95% CI 1.267–4.051; P = 0.006) and high blood urea nitrogen levels (OR = 1.036; 95% CI 1.002–1.072; P = 0.040) at the first AKI event. Kaplan–Meier curves showed the 12-month survival of patients with non-recurrent AKI was better than that of patients with CKD, and survival of patients with recurrent AKI was worse than that of patients with CKD (log rank P < 0.001). In the multivariate Cox regression analysis, mortality at 12 month was higher in the patient with recurrent AKI as compared with those with a single episode (HR = 3.375; 95% CI 2.241–5.083; P < 0.001). Conclusion: Recurrent AKI is common among elderly patients who recovered their renal function post-AKI and is associated with significantly higher 12-month mortality compared with CKD patients. [ABSTRACT FROM AUTHOR]

The wireless-powered communication paradigm brings self-sustainability to the on-vehicle sensors by harvesting the energy from radiated radio frequency (RF) signals. This paper proposes a novel transmission and resource allocation strategy for the scenario where multiple wireless powered vehicle area networks (VAN) co-existed with high density. The considered multi-VAN system consists of a remote master access point (MAP), multiple on-vehicle hybrid access points (HAPs) and sensors. Unlike previous works, we consider that the sensors can recycle the radiated radio frequency energy from all the HAPs when HAPs communicate with MAP, so the dedicated signals for energy harvesting (EH) are unnecessary. The proposed strategy can achieve simultaneous wireless information and power transfer (SWIPT) without complex receiver architecture requirements. The extra EH and interference caused by the dense distribution of VANs, which are rarely explored, are fully considered. To maximize the sum throughput of all the sensors while guaranteeing the transmission from HAPs to the MAP, we jointly optimize the time allocation, system energy consumption, power allocation, and receive beamforming. Due to the non-convexity of the formulated problem, we address the sub-problems separately through the Rayleigh quotient, Frobenius norm minimization and convex optimization. Then an efficient iterative algorithm to obtain sub-optimal solutions. The simulation results and discussions illustrate the proposed scheme's effectiveness and advantages. [ABSTRACT FROM AUTHOR]

An unhealthy diet is strongly linked to obesity and numerous chronic diseases. Currently, over two-thirds of American adults are overweight or obese. Although dietary assessment helps people improve nutrition and lifestyle, traditional methods for dietary assessment depend on self-report, which is inaccurate and often biased. In recent years, as electronics, information, and artificial intelligence (AI) technologies advanced rapidly, image-based objective dietary assessment using wearable electronic devices has become a powerful approach. However, research in this field has been focused on the developments of advanced algorithms to process image data. Few reports exist on the study of device hardware for the particular purpose of dietary assessment. In this work, we demonstrate that, with the current hardware design, there is a considerable risk of missing important dietary data owing to the common use of rectangular image screen and fixed camera orientation. We then present two designs of a new camera system to reduce data loss by generating circular images using rectangular image sensor chips. We also present a mechanical design that allows the camera orientation to be adjusted, adapting to differences among device wearers, such as gender, body height, and so on. Finally, we discuss the pros and cons of rectangular versus circular images with respect to information preservation and data processing using AI algorithms. [ABSTRACT FROM AUTHOR]

This article investigates using optical fibers with enhanced backscattering profiles to improve distributed fiber sensor performance and reduce instrumentation costs. Using a femtosecond (fs) laser direct writing technique, the Rayleigh backscattering profile of a standard telecom fiber was enhanced by more than 40 dB to improve the signal-to-noise ratio (SNR) for optical frequency domain reflectometry (OFDR). The enhanced backscattering signals enable effectively distributed strain measurements using a low-cost tunable laser (TL). Median filtering is applied to denoise cross correlation results to further improve measurement outcomes. Results presented in this article show that a TL with a 1-nm tuning range, which is far less than the tuning range used in commercial OFDR interrogators, can perform effectively distributed strain measurements using sensing fibers with enhanced backscattering profiles. The sensing fiber with over 40-dB backscattering enhancement achieved 4.8-cm spatial resolution in strain measurements with a root mean square accuracy of less than 2.70 $\mu \varepsilon $ when 10–50 $\mu \varepsilon $ were exerted to the sensing fiber. Results presented in this article reveal both the potential and limitations of sensing fibers with enhanced backscattering for OFDR-based distributed fiber sensors. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) is a neutrophil-associated disease. Delayed neutrophil apoptosis and increased levels of neutrophil extracellular traps (NETs) have been described in ARDS. We aimed to investigate the relationship between these phenomena and their potential as inflammation drivers. We hypothesized that delayed neutrophil apoptosis might enhance NET formation in ARDS.Method: Our research was carried out in three aspects: clinical research, animal experiments, and in vitro experiments. First, we compared the difference between neutrophil apoptosis and NET levels in healthy controls and patients with ARDS and analyzed the correlation between neutrophil apoptosis and NET levels in ARDS. Then, we conducted animal experiments to verify the effect of neutrophil apoptosis on NET formation in Lipopolysaccharide-induced acute lung injury (LPS-ALI) mice. Furthermore, this study explored the relationship between neutrophil apoptosis and NETs at the cellular level. Apoptosis was assessed using morphological analysis, flow cytometry, and western blotting. NET formation was determined using immunofluorescence, PicoGreen assay, SYTOX Green staining, and western blotting.Results: ARDS neutrophils lived longer because of delayed apoptosis, and the cyclin-dependent kinase inhibitor, AT7519, reversed this phenomenon both in ARDS neutrophils and neutrophils in bronchoalveolar lavage fluid (BALF) of LPS-ALI mice. Neutrophils in a medium containing pro-survival factors (LPS or GM-CSF) form more NETs, which can also be reversed by AT7519. Tissue damage can be reduced by promoting neutrophil apoptosis.Conclusions: Neutrophils with extended lifespan in ARDS usually enhance NET formation, which aggravates inflammation. Enhancing neutrophil apoptosis in ARDS can reduce the formation of NETs, inhibit inflammation, and consequently alleviate ARDS. [ABSTRACT FROM AUTHOR]

Background: We evaluated the prognostic impact of AKI duration on the 1-year mortality rate in elderly patients diagnosed based on the 48-hour and 7-day changes in serum creatinine (Scr) levels recommended by the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Methods: This retrospective study was conducted from 2007 to 2018 on elderly patients in the Geriatric Department of the Chinese PLA General Hospital. Based on the two diagnostic criteria in the KDIGO guidelines, the patients were divided into a 48-hour diagnostic window and a 7-day diagnostic window group, and into transient AKI (lasting 1–2 days) and persistent AKI (lasting 3–6 days, and ≥ 7 days) based on the time at which the Scr level returned to the baseline value. The primary outcome was the 1-year mortality rate after AKI. Results: In total, 688 patients were enrolled, including 367 (53.3%) with a 48-hour and 321 (46.7%) with a 7-day diagnostic window. Of the 688 patients, in the 48-hour window group, 12.0% had transient AKI, 31.1% had lasting 3–6 days, and 56.9% had lasting ≥ 7 days; in the 7-day window group, 5.3% had transient AKI, 24.0% had lasting 3–6 days, and 70.7% had lasting ≥ 7 days. Overall, 332 patients (33.6%) died within 1 year, including 189 (51.5%) in the 48-hour and 143 (44.5%) in the 7-day diagnostic window group. After adjusting for multiple covariates, AKI duration was associated with a significantly higher 1-year mortality rate (3–6 days: HR = 3.535; 95% CI = 1.685–7.417, P = 0.001; ≥ 7 days: HR = 2.400; 95% CI = 1.152–5.001, P = 0.019) in the 48-hour diagnostic window group, but it did not differ in the 7-day diagnostic window group (P = 0.452). Conclusions: Persistent AKI was common in elderly hospitalized patients, accounting for 88% and 95% of patients with 48-hour and 7-day diagnostic windows, respectively. Moreover, AKI duration was associated with different clinical outcomes depending on the diagnostic window. Further studies should focus on the mechanism underlying the relationship of AKI outcomes with diagnostic criteria. [ABSTRACT FROM AUTHOR]

Background: Treatment of functional dyspepsia (FD) in children is generally symptomatic and unsatisfactory. Traditional Chinese medicines, such as Shenqu Xiaoshi Oral Liquid (SXOL), have been recommended to alleviate dyspeptic symptoms. However, evidence of their safety and efficacy remains limited to date. AIM: To assess whether 2 weeks of therapy with SXOL was non-inferior to domperidone syrup in children with FD. Methods: In this randomized, double-blind, double-simulated, non-inferiority, multi-center clinical trial, we recruited children (3–14 years) with FD according to the Rome IV criteria from 17 tertiary medical centers across China. Patients were randomly allocated (1:1) to receive SXOL or domperidone syrup for 2 weeks. We compared the participants' clinical scores from both groups based on the severity and frequency of dyspepsia symptoms according to Rome IV criteria (0, 1, 2, and 4 weeks after randomization). The primary endpoint was the total response rate, which was defined as the proportion of patients with a decrease of 30% or more in the FD symptoms clinical score from baseline, at the end of the 2-weeks treatment. A non-inferiority margin of -10% was set. Secondary endpoints and adverse events were assessed. This trial is registered with www.Chictr.org.cn, number ChiCTR1900022654. Results: Between February 2019 and March 2021, a total of 373 patients were assessed for eligibility, and 356 patients were enrolled and randomized. The clinical response rate at week two was similar for SXOL [118 (83.10%) of 142] and domperidone [128 (81.01%) of 158]; difference 2.09; 95% CI −6.74 to 10.71, thereby establishing non-inferiority. The total FD symptom scores were significantly improved in the two groups at 1-, 2-, and 4-weeks follow-up periods (p < 0.005). The decrease in symptom score compared with the baseline were similar between these two groups. Over the total study period, 10 patients experienced at least one treatment-related adverse event [six (3.37%)] in the SXOL group, four [(2.25%) in the domperidone group], although no serious adverse event was noted. Conclusion: Treatment with SXOL effectively improves dyspeptic symptoms and is well tolerated. In addition, it is not inferior to domperidone syrup and leads to sustained improvement in Chinese children with FD. [ABSTRACT FROM AUTHOR]

Background: Sepsis is a systemic inflammatory response due to infection, resulting in organ dysfunction. Timely targeted interventions can improve prognosis. Inflammation plays a crucial role in the process of sepsis. To identify potential sepsis early, we developed and validated a nomogram model and a simple risk scoring model for predicting sepsis in critically ill patients. Methods: The medical records of adult patients admitted to our intensive care unit (ICU) from August 2017 to December 2020 were analyzed. Patients were randomly divided into a training cohort (70%) and a validation cohort (30%). A nomogram model was developed through multivariate logistic regression analysis. The continuous variables included in nomogram model were transformed into dichotomous variables. Then, a multivariable logistic regression analysis was performed based on these dichotomous variables, and the odds ratio (OR) for each variable was used to construct a simple risk scoring model. The receiver operating characteristic curves (ROC) were constructed, and the area under the curve (AUC) was calculated. Results: A total of 2074 patients were enrolled. Finally, white blood cell (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR) were included in our models. The AUC of the nomogram model and the simple risk scoring model were 0.854 and 0.842, respectively. The prediction performance of the two models on sepsis is comparable (p = 0.1298). Conclusion: This study combining five commonly available inflammatory markers (WBC, CRP, IL-6, PCT and NLR) developed a nomogram model and a simple risk scoring model to predict sepsis in critically ill patients. Although the prediction performance of the two models is comparable, the simple risk scoring model may be simpler and more practical for clinicians to identify potential sepsis in critically ill patients at an early stage and strategize treatments. [ABSTRACT FROM AUTHOR]

Purpose: This is a retrospective case–control study to ascertain the factors influencing nosocomial infection (NI) in elderly patients with hip fractures. Methods: A total of 80,174 patients (≥ 60 years) who suffered hip fractures between 2006 and 2017 were identified through a national inquiry of 94 hospitals. The patients were divided into an NI group and control group according to the occurrence or lack of occurrence of NI within 48 hours after surgery, respectively. Age, gender, hip fracture pattern, whether to operate, surgical treatments, and comorbidities were recorded as variables. Results: A total of 9806 elderly hip fracture patients (60 years) were included, 1977 of whom were patients diagnosed with NI. The control group consisted of randomly drawn cases from the 9806 patients from different hospitals with a rate of one NI patient: four patients without NI. Patient gender, age, and in particular the number of comorbidities were associated with occurrence of NI. Using regression models to predict infection outcomes based on the number of comorbidities had an area under the curve (AUC) of 0.714, while using the Charlson comorbidity index (CCI) yielded a smaller value of 0.694. The most common comorbidities of this elderly cohort were chronic respiratory disease, hypertension, diabetes mellitus, cerebrovascular disease, and coronary heart disease. Conclusions: Older age, male gender, and greater number of comorbidities were found to be associated with the occurrence of NI. In particular, the number of comorbidities was the most accurate predictor of NI occurrence, and when used to build a regression model, it had greater predictive capability than CCI to predict NI in elderly hip fracture patients. Additionally, the common diseases of the elderly should be primarily considered when investigating the relationship between comorbidities and NI in older patients. [ABSTRACT FROM AUTHOR]

Background: The morbidity of rifampicin/multidrug-resistant tuberculous meningitis (RR/MDR-TBM) has shown an increasing trend globally. Its mortality rate is significantly higher than that of non-rifampicin/multidrug-resistant tuberculous meningitis (NRR/MDR-TBM). This article aimed to explore risk factors related to RR/MDR-TBM, and compare therapeutic effects of linezolid (LZD)- and non-linezolid-containing regimen for RR/MDR-TB patients in Shenzhen city. Furthermore, we aimed to find a better therapy for pathogen-negative TBM with RR/MDR-TBM related risk factors.Methods: We conducted a retrospective study enrolling 137 hospitalized cases with confirmed TBM from June 2014 to March 2020. All patients were divided into RR/MDR-TBM group (12 cases) and NRR/MDR-TBM group (125 cases) based on GeneXpert MTB/RIF and (or) phenotypic drug susceptibility test results using cerebral spinal fluid (CSF). The risk factors related to RR/MDR-TBM were investigated through comparing clinical and examination features between the two groups. The mortality rate of RR/MDR-TBM patients treated with different regimens was analyzed to compare their respective therapeutic effects. A difference of P < 0.05 was considered statistically significant.Results: Most patients (111/137, 81%) were from southern or southwestern China, and a large proportion (72/137, 52.55%) belonged to migrant workers. 12 cases were RR/MDR-TBM (12/137, 8.8%) while 125 cases were NRR/MDR-TBM (125/137, 91.2%). The proportion of patients having prior TB treatment history in the RR/MDR-TBM group was significantly higher than that of the NRR/MDR-TBM group (6/12 vs. 12/125, 50% vs. 10.5%, P < 0.01). No significant difference was observed on other clinical and examination features between the two groups. Mortality was significantly lower in RR/MDR-TBM patients on linezolid-containing treatment regimen than those who were not (0/7 versus 3/5, 0% versus 60%, P = 0.045).Conclusions: The main related risk factor of RR/MDR-TBM is the history of anti-tuberculosis treatment. Linezolid-containing regimen appears to lower mortality rate of RR/MDR-TBM significantly in our study. We think Linezolid should be evaluated prospectively in the treatment of RR/MDR-TBM. [ABSTRACT FROM AUTHOR]

The rapid development of autonomous driving in recent years presents many challenges for scene understanding. As an essential step towards scene understanding, semantic segmentation has received increased attention in the past few years. Although deep learning based approaches have achieved great success in improving the segmentation accuracy, most of them suffer from an inefficiency problem and can hardly be applied to real-time applications. In this paper, we analyze the computational cost of Convolutional Neural Network (CNN) and find that the inefficiency of CNNs is mainly caused by their wide structure rather than deep structure. In addition, the success of pruning based model compression methods proves that there are many redundant channels in CNNs. Thus, we design a narrow while deep backbone network to improve the efficiency of semantic segmentation. By casting our network to fully convolutional network (FCN32) segmentation architecture, the basic structure of most segmentation methods, we achieve 61.5% mIoU on Cityscapes validation dataset with only 4.2G floating-point operations (FLOPs) on 1024 × 2048 inputs, which already outperforms one of the earliest real-time deep learning based segmentation methods: ENet (58.3% mIoU, 3.8G FLOPs on 640 × 360 inputs). By further refining the output resolution of our network to the 1/8 of the input resolution with a simple encoder-decoder structure, we achieve 65.3% mIoU on Cityscapes test set with 14.0G FLOPs and 39.9 frames per second (FPS) on Titan X card. We have made our model publicly available at https://github.com/zgyang-hnu/NDNet. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of neurophysiological monitoring in extended endoscopic transsphenoidal surgery for cavernous sinus and clivus tumors. Methods We monitored the oculomotor nerve, trochlear nerve, trigeminal nerve and abducent nerve in 18 patients with cavernous sinus and clivus tumors by recording the free-electromyography (f-EMG) and triggered-electromyography (t-EMG) from August 2019 to December 2020. Two needle electrodes were inserted percutaneous into the levator palpebrae superioris muscle, superior oblique muscle, extraocular rectus muscle and masticatory muscle. To evaluate spontaneous muscle activity and complex muscle action potentials after cranial nerve stimulation. We evaluated the safety of cranial nerves and provided objective information for neurosurgeon. Results All the 18 patients with cavernous sinus and clivus tumors were treated by extended endoscopic transsphenoidal surgery, including 10 pituitary adenomas, 5 chordomas, 2 craniopharyngiomas and one cystic schwannoma. Total resection rate achieved 9/18, subtotal resection rate was 4/18, and partial resection rate was 5/18. There was no postoperative internal carotid artery (ICA) injury and cerebrospinal fluid leakage. A total of 20 oculomotor nerves, 3 trochlear nerves, 27 trigeminal nerves and 26 abducent nerves were recorded. There were one patient with left abducent nerve palsy and one patient with right abducent nerve paresis before surgery. The median follow - up time was 8.63 months, postoperative brain nerve injury occurred in 2 patients, the brain nerve injury rate was 2/18, all of which recovered 3 months after surgery. No patients with postoperative impaired trigeminal nerve function. Conclusions Monitoring of oculomotor nerve, trochlear nerve, trigeminal nerve and abducent nerve in extended endoscopic transsphenoidal surgery for cavernous sinus and clivus tumors is a safe and effective method. By monitoring and evaluating intraoperative f-EMG and t - EMG, neurosurgeons can adjust surgical procedures and strategies during tumor resection and reduce cranial nerve injuries. [ABSTRACT FROM AUTHOR]

Multilabel feature extraction (FE) is an effective preprocessing step to cope with some possible irrelevant, redundant, and noisy features, to reduce computational costs and even improve classification performance. Original normalized cross-covariance operator represents a kernel-based nonlinear dependence measure between features and labels, whose empirical estimator is formulated as a trace operation including two inverse matrices of feature and label kernels with a regularization constant. Due to such a complicated expression, it is impossible to derive an eigenvalue problem for linear FE directly. In this paper, we approximate this measure using Moore–Penrose inverse matrix, linear kernel for feature space, and delta kernel for label space, and then symmetrize the entire matrix in the trace operation, resulting in an effective approximated and symmetrized representation. According to orthonormal projection direction constraints, maximizing such a modified form induces a novel eigenvalue problem for multilabel linear FE. Experiments on 12 data sets illustrate that our proposed method works the best, compared with seven existing FE techniques, according to eight multilabel classification performance metrics and three statistical tests. [ABSTRACT FROM AUTHOR]