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BackgroundTraditional Chinese medicine (TCM) has been shown to be an efficient mode to manage advanced lung cancer, and accurate syndrome differentiation is crucial to treatment. Documented evidence of TCM treatment cases and the progress of artificial intelligence technology are enabling the development of intelligent TCM syndrome differentiation models. This is expected to expand the benefits of TCM to lung cancer patients. ObjectiveThe objective of this work was to establish end-to-end TCM diagnostic models to imitate lung cancer syndrome differentiation. The proposed models used unstructured medical records as inputs to capitalize on data collected for practical TCM treatment cases by lung cancer experts. The resulting models were expected to be more efficient than approaches that leverage structured TCM datasets. MethodsWe approached lung cancer TCM syndrome differentiation as a multilabel text classification problem. First, entity representation was conducted with Bidirectional Encoder Representations from Transformers and conditional random fields models. Then, five deep learning–based text classification models were applied to the construction of a medical record multilabel classifier, during which two data augmentation strategies were adopted to address overfitting issues. Finally, a fusion model approach was used to elevate the performance of the models. ResultsThe F1 score of the recurrent convolutional neural network (RCNN) model with augmentation was 0.8650, a 2.41% improvement over the unaugmented model. The Hamming loss for RCNN with augmentation was 0.0987, which is 1.8% lower than that of the same model without augmentation. Among the models, the text-hierarchical attention network (Text-HAN) model achieved the highest F1 scores of 0.8676 and 0.8751. The mean average precision for the word encoding–based RCNN was 10% higher than that of the character encoding–based representation. A fusion model of the text-convolutional neural network, text-recurrent neural network, and Text-HAN models achieved an F1 score of 0.8884, which showed the best performance among the models. ConclusionsMedical records could be used more productively by constructing end-to-end models to facilitate TCM diagnosis. With the aid of entity-level representation, data augmentation, and model fusion, deep learning–based multilabel classification approaches can better imitate TCM syndrome differentiation in complex cases such as advanced lung cancer.

In this paper, targeting the problem that it is difficult to deal with the time-varying sideslip angle of an underactuated unmanned surface vehicle (USV), a line–of–sight (LOS) guidance law based on an improved extended state observer (ESO) is proposed. A reduced-order ESO is introduced into the identification of the sideslip angle caused by the environmental disturbance, which ensures a fast and accurate estimation of the sideslip angle. This enables the USV to follow the reference path with high precision, despite external disturbances from wind, waves, and currents. These unknown disturbances are modeled as drift, which the modified ESO-based LOS guidance law compensates for using the ESO. In the guidance subsystem incorporating the reduced-order state observer, the observer estimation and track errors are proved uniformly ultimately bounded. Simulation and experimental results are presented to validate the effectiveness of the proposed method. The simulation and comparison results demonstrate that the proposed ELOS guidance can help a USV track different types of paths quickly and smoothly. Additionally, the experimental results confirm the feasibility of the method. [ABSTRACT FROM AUTHOR]

Fiber sand control is widely used on site due to its advantages such as easy operation, significant effects, and low cost. However, the mechanism of fiber control proppant flowback is currently unclear, and the main controlling factors affecting the critical flow velocity are not yet clear. There is a lack of relevant theoretical support to optimize the design of fiber sand control. This article uses composite material theory to analogically calculate the tensile strength of fiber-reinforced sand and friction reinforcement theory to analogically calculate the shear strength of fiber-reinforced sand. The relationship between fiber strength force and tensile strength and shear strength is proposed, combined with the different stress conditions of proppant particles before and after fracture closure, and a fiber-controlled proppant flowback strength model is established based on the force arm balance. The critical velocity of proppant was calculated and compared through the stability experiment of fiber-reinforced proppant filling layer, and the accuracy of the model was verified and the influencing factors were analyzed. The results show that the influence of tensile strength and shear strength on fiber strength at the early stage of fracture closure is 0.2 and 0.8, respectively, and that after fracture closure is 0.1 and 0.9, respectively. The critical velocity calculated by the model is basically consistent with the experimental results. The critical velocity is most affected by the particle size and closure pressure of proppant, followed by the amount of fiber, and the influence of fiber length and diameter is relatively small. [ABSTRACT FROM AUTHOR]

This study aims to determine whether CYP2C19 loss‐of‐function (LoF) variants were associated with long‐term ischemic stroke risk in Chinese primary care patients treated with clopidogrel. Patients treated with clopidogrel were ascertained from Chinese electronic medical records linked with a biobank for a retrospective cohort study. Their medical information was examined for the period from January 2018 to December 2021. Two CYP2C19 major loss of function variants (*2:rs4244285 and *3: rs4986893) were genotyped. The clinical outcome was ischemic stroke event. Cox regression analysis was used to evaluate the association between the occurrence of ischemic stroke events and CYP2C19 LoF variants. Covariates included age, gender, body mass index, prior ischemic stroke, transient ischemic attack, hypertension, diabetes mellitus, hyperlipoidemia, smoke status, aspirin use, proton‐pump inhibitor use, and statin use. Of the 1,141 patients included in the clopidogrel therapy cohort, 61.9% carried at least one CYP2C19 LoF variant. During a median follow‐up period of 12 months, 103 patients (9.0%) had an ischemic stroke. After adjusting for other risk factors, carriers of CYP2C19 LoF variants had significantly higher risk of ischemic stroke compared with non‐carriers (hazard ratio: 1.64, 95% confidence interval: 1.06–2.53, P = 0.025). This pharmacogenetic study of clopidogrel provides novel insights into the association between the CYP2C19 LoF variant and long‐term stroke risk. We established that there is still a need for CYP2C19 genotype‐guided personalized antiplatelet therapy in those who have returned to the primary care setting for clopidogrel prescription. [ABSTRACT FROM AUTHOR]

Author(s): Ziqing Liu [1, 2]; Li Wang [1, 2]; Joshua D. Welch [3]; Hong Ma [1, 2]; Yang Zhou [1, 2]; Haley Ruth Vaseghi [1, 2]; Shuo Yu [1, 2]; [...]

Purpose: Positive interpersonal interactions are indispensable for employees to engage in organizational citizenship behavior (OCB) that benefits teamwork; however, co-worker ostracism triggers interpersonal isolation, inhibiting OCB. This research aims to leverage the intervention of ethical leadership in the ostracism–OCB relationship to moderate the harmful ostracism and promote ostracized employees' OCB through employee self-identity.Methods: This research chose 122 MBA to participate in Study 1's scenario experiment to verify the causality between variables. Study 2 used 295 valid questionnaires from full-time employees to generalize the experimental results to field settings and compensate for external validity. Two studies used Hayes's conditional process model to test the conditional direct and indirect relationships.Findings: This research revealed that high levels of ethical leadership effectively transitioned the harmful ostracism and promoted ostracized employees' OCB by satisfying ostracized employees' needs for identity recognition. Accordingly, the direct and indirect effects of co-worker ostracism on OCB through employee self-identity would be positive at high levels of ethical leadership, but negative at low levels.Originality: This research first introduces an identity perspective on ethical leadership in moderating the ostracism–OCB relationship. Based on the social identity theory of leadership, this research fills the gap in ostracism and OCB research calling for leadership interventions. It extends a novel insight into inspiring ostracized employees' participation in OCB through employee self-identity.Practical Implications: This research provides the managerial applications of ethical leadership for China organizations to reduce inadvertent inactions, accept employees' identities, and value interpersonal communication for effectively transitioning harmful ostracism. [ABSTRACT FROM AUTHOR]

Biominerals can exhibit exceptional mechanical properties owing to their hierarchically‐ordered organic/inorganic nanocomposite structure. However, synthetic routes to oriented artificial biominerals of comparable complexity remain a formidable technical challenge. Herein we design a series of soft, deformable nanogels that are employed as particulate additives to prepare nanogel@calcite nanocomposite crystals. Remarkably, such nanogels undergo a significant morphological change—from spherical to pseudo‐hemispherical—depending on their degree of cross‐linking. This deformation occurs normal to the growth direction of the (104) face of the calcite and the underlying occlusion mechanism is revealed by in situ atomic force microscopy studies. This model system provides new mechanistic insights regarding the formation of oriented structures during biomineralization and offers new avenues for the design of synthetic nanocomposites comprising aligned anisotropic nanoparticles. [ABSTRACT FROM AUTHOR]

A new type of large-diameter iron-based shape memory alloy (Fe-SMA) stranded wire was developed, and its stress recovery behaviour was experimentally investigated in this study. The produced Fe-SMA stranded wires had a diameter of 15.2 mm, which were the same as the most commonly used steel-stranded wires. This kind of large-diameter Fe-SMA stranded wire matched the existing prestressed anchorage system to reduce application cost and accelerate the field application of the Fe-SMA in civil engineering. The effects of prestrain levels (4%, 6%, 8%, 10%), activation temperatures (200°C, 300°C, 400°C, 500°C), and secondary activation effect on the recovery stress of Fe-SMA stranded wires were analysed. Test results showed that the recovery stresses of the Fe-SMA stranded wire were 223–357 MPa. The maximum recovery stress was measured for the specimen with a prestrain of 8% and an activation temperature of 500°C. With increasing activation temperature, the recovery stress increased, but the increment decreased gradually. An increased prestrain level resulted in a first increase and a second decrease in the recovery stress, which was highest at the 8% prestrain level. If the shape memory effect (SME) was not fully used during the first activation, then the remaining martensitic phase changed on the second activation. The recovery stress generated by the first activation was essentially the same as those generated by the second activation at the same activation temperature. Taking the Nanshao River concrete box girder bridge in China as an example, the effect of using Fe-SMA stranded wires to compensate the prestressing loss was calculated. The results showed that the Fe-SMA stranded wire developed was able to compensate the vertical prestress loss of the prestressed box girder bridge web well and maintain the main tensile stresses at a low level during the service life of the bridge. [ABSTRACT FROM AUTHOR]

The R package Continuous Glucose Monitoring Time Series Data Analysis (CGMTSA) was developed to facilitate investigations that examine the continuous glucose monitoring (CGM) data as a time series. Accordingly, novel time series functions were introduced to (1) enable more accurate missing data imputation and outlier identification; (2) calculate recommended CGM metrics as well as key time series parameters; (3) plot interactive and three-dimensional graphs that allow direct visualizations of temporal CGM data and time series model optimization. The software was designed to accommodate all popular CGM devices and support all common data processing steps. The program is available for Linux, Windows, and Mac at GitHub. [ABSTRACT FROM AUTHOR]

Background. The aging population is increasingly susceptible to cardiovascular disease (CVD). Visit-to-visit variability in glucose and lipid levels both contributed to CVD risk independent of their mean values. However, whether variability in the triglyceride-glucose (TyG) index is a risk factor for CVD remains unknown. Research Design and Methods. In this retrospective study of electronic health records, 27,520 participants aged over 60 years were enrolled. The visit-to-visit variability of TyG index was calculated from annual health examination data and defined as average real variability (ARV), standard deviation (SD), or the coefficient of variability (CV). CVD events were identified from the chronic disease registry or follow-up database and included myocardial infarction, angina, coronary, and stroke. Multivariate Cox regression was used to examine the correlation between TyG variability and incident CVD. Results. Over a median follow-up of 6.2 years, there were 2,178 CVD events. When participants were divided into four quartiles according to their TyG variability, after adjusting for established CVD risk factors, subjects in the top quartile had (HR = 1.18, 95% CI 1.05–1.34, P = 0.005) significantly higher CVD risk than those in the bottom quartile. The association remained significant in overweight individuals or those without diabetes (P < 0.005 and P < 0.01 , respectively). Conclusions. High variability in TyG was significantly associated with elevated CVD risk in the elderly, independent of average TyG and other risk factors. Close monitoring variability in TyG might be informative to identify old individuals at high risk of CVD. [ABSTRACT FROM AUTHOR]

This paper presents mechanical properties of fast-growing poplar specimens reinforced with carbon fibers. A total of 90 specimens including 10 contrast specimens were tested to investigate the influence from the following parameters: (a) different carbon fiber ratios (0.167%, 0.251%, 0.334%, 0.401%, and 0.501%) and (b) different fiber locations. The failure mode, compressive strength, elastic modulus, and axial deformation of specimens were analyzed. The test results indicate the following: (1) The compressive strength, elastic modulus, and axial deformation of specimens reinforced with carbon fiber were significantly improved compared with that of fast-growing poplar specimens. The compressive strength, elastic modulus, and axial deformation increased by 54.1–76.03%, 11.58–22.89%, and 24.86–60.06%, respectively. (2) There was little effect on the compressive strength of the specimen with the increase of carbon fiber ratio. With the increase of carbon fiber ratio, the elastic modulus of specimens slightly decreased and the axial deformation increased. The elastic modulus decreased by 1.39–18.69%, and the axial deformation increased by 10%–48%. (3) The different locations of the carbon fiber distribution resulted in a large difference in the compressive strength of the specimens, while the effects on the modulus of elasticity and axial deformation were not significant. Finally, the compressive strength calculation formula was proposed. [ABSTRACT FROM AUTHOR]