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Background Few studies documented incidence rates of different types of stroke among patients with polycystic kidney disease (PKD). Materials and methods We conducted a retrospective cohort study based on the National Health Insurance (NHI) Database of Taiwan. The PKD cohort comprised patients aged≥20 years diagnosed with PKD using inpatient claims from 1998 to 2011, excluding prior stroke. The reference cohort was established by inpatients without PKD using 1:4 frequency-matched with age, gender, and baseline comorbidities. The two cohorts were followed-up until stroke hospitalization, death, withdrawal from the NHI program, or the end of 2012. To account for competing risks of death, we used multivariable competing risks regression models to estimate sub-distribution hazard ratio (SHR) adjusted for age, gender, baseline comorbidities and end stage renal disease. Results 7837 PKD patients and 31,211 reference subjects were followed up through 2012. A total of 955 cases of stroke were identified in the PKD cohort, including 441 ischemic stroke (IS), 289 intracranial hemorrhage (ICH), 73 subarachnoid hemorrhage (SAH) and 232 other stroke. The incidence rates of overall stroke, IS, ICH, and SAH were 21.3, 10.2, 6.8, and 1.7 per 1000 person-years, respectively. The SHR for overall stroke was 1.39 [95% confidence interval (CI) 1.28–1.50]. SAH had the highest SHR, 4.55 [95% CI 3.26–6.37], followed by ICH (1.84), other stroke (1.24), and IS (1.22). Conclusions This study illustrated the incidence rates of stroke among inpatient of PKD. The PKD patients had a significantly increased risk of all kinds of stroke after adjusting baseline comorbidities.

We design and fabricate the suspended silicon microring with racetrack and spiral structure to exploit the resonantly enhanced stimulated Brillouin scattering (SBS). The designed photonic-phononic waveguide can provide the independent control on the optical and acoustic modes by introducing the silicon ridge waveguide into the phononic crystal slab as a line defect. We demonstrate efficient forward SBS in the two kinds of microrings and extract the characteristic Brillouin parameters through the heterodyne four-wave mixing measurement. The stronger inhomogeneous broadening effect in the spiral microring due to the structural variations is also observed. In addition, our microrings show the single mode transmission spectrum and high quality factor, which is beneficial to the enhanced intramodal forward SBS. This design can readily extend to other silicon-based platforms and paves the way toward on-chip photonic-phononic signal processing and Brillouin amplifier technologies.

BACKGROUND Drainage tube removal is difficult when the greater omentum becomes incarcerated in the drainage tube through the side holes. Currently, known removal methods are either ineffective or will cause additional damage to the patient in a secondary operation. Ureteroscopy and the holmium laser have been used in various surgical techniques in urology, and in theory, they are expected to be a good strategy for solving the problem of tissue incarceration. CASE SUMMARY Four patients diagnosed with difficult removal of an abdominal drainage tube following abdominal surgery are reported. All patients underwent surgery to remove the incarcerated greater omentum in the drainage tube using a holmium laser and a ureteroscope, and a new 16-F drain was then placed in the abdominal or pelvic cavity. The efficacy of this technique was evaluated by intraoperative conditions, success rate, and operating time; safety was evaluated by perioperative conditions and the probability of postoperative complications. All four operations went smoothly, and the drains were successfully removed in all patients. The average operating time was 24.5 min. Intraoperatively, the average irrigation volume was 892.0 mL, the average drainage volume was 638.5 mL, and no bleeding or damage to surrounding tissues was observed. Postoperatively, the average drainage volume was 32.8 mL and the new drains were removed within 36 h. All patients were able to get out of bed and move around within 12 h. Their visual analogue pain scores were all below 3. The average follow-up duration was 12.5 mo and no complications such as fever or bleeding were noted. CONCLUSION Ureteroscopic holmium laser surgery is an effective, safe and minimally invasive technique for removing drains where the greater omentum is incarcerated in the abdominal drain.

In order to reduce the energy consumption of the cloud computing system while ensuring the response performance of the cloud users, a task scheduling strategy is proposed. In the strategy, the local processor of the mobile device continues to work, the virtual machines in a physical machine sleep synchronously, and the virtual machines in different physical machine sleep asynchronously. For the heterogeneous physical machines in cloud computing, a queueing model with a synchronous multiple vacation is established. By using the quasi-birth-death process and the matrix geometric solution, the steady-state distribution of the queueing model is given, and the expressions of the average response time of the tasks and the average power of the system are derived. The numerical results show that there is a power-performance trade-off for cloud computing when setting the assigning probability of the tasks to the local processor. Through the improved whale optimization algorithm, the task scheduling strategy is optimized with the minimum system cost.

Background and Purpose: We explored whether high-degree magnetic resonance imaging–visible perivascular spaces in centrum semiovale (CSO) are more prevalent in cerebral amyloid angiopathy (CAA) than hypertensive small vessel disease and their relationship to brain amyloid retention in patients with primary intracerebral hemorrhage (ICH). Methods: One hundred and eight spontaneous ICH patients who underwent magnetic resonance imaging and Pittsburgh compound B were enrolled. Topography and severity of enlarged perivascular spaces were compared between CAA-related ICH (CAA-ICH) and hypertensive small vessel disease–related ICH (non-CAA ICH). Clinical and image characteristics associated with high-degree perivascular spaces were evaluated in univariate and multivariable analyses. Univariate and multivariable models were performed to evaluate associations between the severity of perivascular spaces in CSO and amyloid retention in CAA-ICH and non–CAA-ICH cases. Results: Patients with CAA-ICH (n=29) and non–CAA-ICH (n=79) had similar prevalence of high-degree perivascular spaces in CSO (44.8% versus 36.7%; P =0.507) and in basal ganglia (34.5% versus 51.9%; P =0.131). High-degree perivascular spaces in CSO were independently associated with the presence of lobar microbleed (odds ratio, 3.0 [95% CI, 1.1–8.0]; P =0.032). The amyloid retention was higher in those with high-degree than those with low-degree CSO-perivascular spaces in CAA-ICH (global Pittsburgh compound B standardized uptake value ratio, 1.55 [1.33–1.61] versus 1.13 [1.01–1.48]; P =0.003) but not in non–CAA-ICH. In CAA-ICH, the association between cerebral amyloid retention and the degree of perivascular spaces in CSO remained significant after adjustment for age and lobar microbleed number ( P =0.004). Conclusions: Although high-degree magnetic resonance imaging–visible perivascular spaces are equally prevalent between CAA-ICH and non–CAA-ICH in the Asian cohort, the severity of magnetic resonance imaging–visible CSO-perivascular spaces may be an indicator of higher brain amyloid deposition in patients with CAA-ICH.

We analyze theoretically and verify experimentally an effective approach to detect slight wavelength shift based on stimulated Brillouin scattering (SBS) effect. The concerned wavelength variation in an actively mode-locked fiber laser (MLFL) is caused by a π -phase-shifted fiber Bragg grating ( π- PSFBG) under different temperatures. Based on the microwave photonics technology, the weak variations of the MLFL wavelength are converted into the amplitude changes of the beat signal generated by the mode-locked fiber laser. With the aid of the SBS effect, the beat signal is amplified larger than 20 dB, enhancing the measurement sensitivity. Through seeking the maximum beat signal, approximately 359.6 MHz modulation frequency shift of pump light with 0.2 °C temperature raise, corresponding to 2.876 pm wavelength shift in the 1550 nm band, is experimentally realized. Our proposed scheme achieves detection of minute wavelength shift with ultrahigh accuracy and convenient operation, which has potential applications for optical spectrum analysis of silicon-based integrated chips, biomedical fields and high sensitive optical sensing.

To a certain extent, automated fruit sorting systems reflect the degree of automated production in modern food industry, and boast a certain theoretical and application value. The previous studies mostly concentrate on the design of robot structure, and the control of robot motions. There is little report on the feature extraction of fruits in specific applications of fruit sorting. For this reason, this paper explores the target positioning and sorting strategy of fruit sorting robot based on image processing. Firstly, the authors constructed a visual sorting system for fruit sorting robot, and explained the way to recognize objects in three-dimensional (3D) scene and to reconstruct the spatial model based on sorting robot. Next, the maturity of the identified fruits was considered the prerequisite of dynamic sorting of fruit sorting robot. Finally, the program flow of the fruit sorting robot was given. The effectiveness of our strategy was verified through experiments.

This pilot, randomized, open-label controlled study compared the basal–bolus regimens of insulin glargine (IG) and neutral protamine Hagedorn (NPH) insulin in stroke patients with hyperglycemia receiving intensive care. The study recruited acute stroke patients requiring intensive care within 72 h (h) of onset and had blood glucose > 200 mg/dL. 50 patients received IG (n = 26) or NPH (n = 24) with added short-acting prandial regular insulin over a 72-h period. The primary end point was the percentage of glucose within 80–180 mg/dL assessed through continuous glucose monitoring. The baseline characteristics were comparable, except the IG had higher glucose pre-randomization than the NPH (290.69 ± 82.31 vs. 246.04 ± 41.76 mg/dL, P = 0.021). The percentage of time with glucose between 80 and 180 mg/dL was 45.88 ± 27.04% in the IG and 53.56 ± 22.89% in the NPH (P = 0.341) and the percentage of glucose reduction was 31.47 ± 17.52% in the IG and 27.28 ± 14.56% in the NPH (P = 0.374). The percentage of time with glucose Trial registration ClinicalTrials.gov, NCT02607943. Registered 18/11/2015, https://clinicaltrials.gov/ct2/show/NCT02607943.

Background: The medical endoscope is a major functional component of medical equipment that has become the focus of study around the world. Objective: By comparing and discussing the patents of the medical endoscope, some valuable conclusions have been drawn to predict the future research and development of the medical endoscope. Methods: By analyzing the patent features of the medical endoscope in the mechanical structure, image display, and endoscope system, the function of the medical endoscope on the detection of human internal tissues has been explained. In combination with the key technology of the medical endoscope, related patents have been studied. Results: With the rapid development of technology in the medical industry and the need for practical applications, there is an increase in the requirements for medical endoscopes. Medical endoscopes have undergone a lot of innovations in mechanical structure, imaging, and endoscopic systems. By comparing the characteristics of various patents of medical endoscopes, the main problems of current medical endoscopes, such as complicated structure and poor lighting imaging effect, are analyzed and summarized. The further development trend of medical endoscopes has also been discussed. Conclusion: By improving and optimizing the mechanical structure of the medical endoscope, the lighting method, and the three directions of the system, the performance of the medical endoscope can be improved, and the loopholes in the current technology can be solved. Moreover, it will be more practical.

This meta-analysis aimed at investigating the impact of oral vitamin C supplementation on the post-procedural recovery of orthopedic patients, including functional outcomes and complex regional pain syndrome type I (CRPS I). Literature search using the Medline, Cochrane Library, and Embase databases from inception till March 2021 identified seven eligible randomized controlled trials with 1,361 participants. Forest plot revealed no significant difference in the functional outcomes at 6–12 months [standardized mean difference (SMD) = −0.00, 95% CI − 0.19 to 0.18, 467 patients], risk of overall complications (RR = 0.98, 95% CI 0.68 to 1.39, 426 patients), and pain severity at 3–6 months (SMD = − 0.18, 95% CI − 0.49 to 0.12, 486 patients) between patients with and without oral vitamin C supplementation. Pooled analysis showed that vitamin C treatment reduced the risk of CRPS I regardless of dosage (RR = 0.46, 95% CI 0.25 to 0.85, 1143 patients). In conclusion, the current meta-analysis demonstrated that oral vitamin C supplementation may reduce the risk of complex regional pain syndrome type I but did not improve the functional outcomes in orthopedic patients. Nevertheless, because of the small number of trials included in the present study, further large-scale clinical studies are warranted to support our findings.

Background Nuclear receptor interaction protein (NRIP) co‐localizes with acetylcholine receptor (AChR) at the neuromuscular junction (NMJ), and NRIP deficiency causes aberrant NMJ architecture. However, the normal physiological and pathophysiological roles of NRIP in NMJ are still unclear. Methods We investigated the co‐localization and interaction of NRIP with AChR‐associated proteins using immunofluorescence and immunoprecipitation assay, respectively. The binding affinity of AChR‐associated proteins was analysed in muscle‐restricted NRIP knockout mice and NRIP knockout muscle cells (C2C12). We further collected the sera from 43 patients with myasthenia gravis (MG), an NMJ disorder. The existence and features of anti‐NRIP autoantibody in sera were studied using Western blot and epitope mapping. Results NRIP co‐localized with AChR, rapsyn and α‐actinin 2 (ACTN2) in gastrocnemius muscles of mice; and α‐bungarotoxin (BTX) pull‐down assay revealed NRIP with rapsyn and ACTN2 in complexes from muscle tissues and cells. NRIP directly binds with α subunit of AChR (AChRα) in vitro and in vivo to affect the binding affinity of AChR with rapsyn and rapsyn with ACTN2. In 43 patients with MG (age, 58.4 ± 14.5 years; female, 55.8%), we detected six of them (14.0%) having anti‐NRIP autoantibody. The presence of anti‐NRIP autoantibody correlated with a more severe type of MG when AChR autoantibody existed (P = 0.011). The higher the titre of anti‐NRIP autoantibody, the more severe MG severity (P = 0.032). The main immunogenic region is likely on the IQ motif of NRIP. We also showed the IgG subclass of anti‐NRIP autoantibody mainly to be IgG1. Conclusions NRIP is a novel AChRα binding protein and involves structural NMJ formation, which acts as a scaffold to stabilize AChR–rapsyn–ACTN2 complexes. Anti‐NRIP autoantibody is a novel autoantibody in MG and plays a detrimental role in MG with the coexistence of anti‐AChR autoantibody.

We design and demonstrate an asymmetric Ge/SiGe coupled quantum well (CQW) waveguide modulator for both intensity and phase modulation with a low bias voltage in silicon photonic integration. The asymmetric CQWs consisting of two quantum wells with different widths are employed as the active region to enhance the electro-optical characteristics of the device by controlling the coupling of the wave functions. The fabricated device can realize 5 dB extinction ratio at 1446 nm and 1.4 × 10−3 electrorefractive index variation at 1530 nm with the associated modulation efficiency V π L π of 0.055 V cm under 1 V reverse bias. The 3 dB bandwidth for high frequency response is 27 GHz under 1 V bias and the energy consumption per bit is less than 100 fJ/bit. The proposed device offers a pathway towards a low voltage, low energy consumption, high speed and compact modulator for silicon photonic integrated devices, as well as opens possibilities for achieving advanced modulation format in a more compact and simple frame.

Cerebral microbleeds (MBs) have been found in patients with cognitive decline. We aimed to examine whether MBs are associated with motor or cognitive decline in patients with Parkinson’s disease (PD). We enrolled 135 PD patients and 34 healthy controls. All participants underwent brain MRI and plasma biomarker assays, including tau, Aβ42, Aβ40, and α-synuclein. PD with dementia (PDD) was operationally defined as Mini-Mental State Examination (MMSE) score p = 0.031). PDD patients had more lobar MBs (33.3% vs. 15.6%, p = 0.034), more white matter hyperintensity (p = 0.021) and reduced hippocampal volume (p = 0.001) than PD with normal cognition. The presence of lobar MB (odds ratio = 2.83 [95% confidence interval 1.04–7.70], p = 0.042) and severe white matter hyperintensity (3.29 [1.21–8.96], p = 0.020) was independently associated with PDD after adjusting for vascular risk factors and other confounders. Furthermore, plasma Aβ40 levels were associated the MMSE score (p = 0.004) after adjusting for age and sex. Our findings demonstrated that lobar MBs, reduced hippocampal volume, and elevated plasma Aβ40 levels are associated with PDD.

Considering the variable cross section thickness of longitudinal profiled plate and the dynamic reductions of straightening rolls, an analytical model combining curvature integral method with linear decreasing straightening scheme was proposed to investigate the longitudinal profiled plate straightening process. Moreover, the calculation flow and solution algorithm of longitudinal profiled plate straightening process were presented. To verify the proposed model, calculated straightening forces were compared with the measured values, and very good agreements were achieved. Then, the reduction, contact angle, reverse bending curvature, residual curvature, straightening force and straightening moment of longitudinal profiled plate in the straightening process were calculated and analyzed, and the calculated results show that the curvature integral method can be used to reveal the mechanism of longitudinal profiled plate straightening.

Aim Chronic kidney disease (CKD) is associated with unfavorable outcomes in patients with ischemic stroke. One major metabolic derangement of CKD is dyslipidemia, which can be managed by statins. This study aimed to investigate whether the association of statins with post-stroke outcomes would be affected by renal function. Methods We evaluated the association of statin therapy at discharge with 3-month outcomes according to the estimated glomerular filtration rate (eGFR) of 50,092 patients with acute ischemic stroke from the Taiwan Stroke Registry from August 2006 to May 2016. The outcomes were mortality, functional outcome as modified Rankin Scale (mRS), and recurrent ischemic stroke at 3 months after index stroke. Results Statin therapy at discharge was associated with lower risks of mortality (adjusted hazard ratio [aHR], 0.41; 95% confidence interval [CI], 0.34 to 0.50) and unfavorable functional outcomes (mRS 3-5; aHR, 0.80; 95% CI, 0.76 to 0.84) in ischemic stroke patients. After stratification by eGFR, the lower risk of mortality associated with statins was limited to patients with an eGFR above 15 mL/min/1.73 m2. Using statins at discharge was correlated with a lower risk of unfavorable functional outcomes in patients with an eGFR of 60-89 mL/min/1.73 m2. Statin therapy in patients with an eGFR of 60-89 mL/min/1.73 m2 may be associated with a higher risk of recurrent ischemic stroke compared with nonusers (aHR, 1.29; 95% CI, 1.07 to 1.57). Conclusions In patients with acute ischemic stroke, the associations of statins with mortality and functional outcomes was dependent on eGFR.

© 2020 Elsevier Ltd. All rights reserved., Background: Hereditary transthyretin-mediated amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We assessed the safety and efficacy of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Methods: This multicentre, open-label extension (OLE) trial enrolled patients at 43 hospitals or clinical centres in 19 countries as of Sept 24, 2018. Patients were eligible if they had completed the phase 3 APOLLO or phase 2 OLE parent studies and tolerated the study drug. Eligible patients from APOLLO (patisiran and placebo groups) and the phase 2 OLE (patisiran group) studies enrolled in this global OLE trial and received patisiran 0·3 mg/kg by intravenous infusion every 3 weeks with plans to continue to do so for up to 5 years. Efficacy assessments included measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress, with analysis by study groups (APOLLO-placebo, APOLLO-patisiran, phase 2 OLE patisiran) based on allocation in the parent trial. The global OLE is ongoing with no new enrolment, and current findings are based on the interim analysis of the patients who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received one or more dose of patisiran up to the data cutoff. This study is registered with ClinicalTrials.gov, NCT02510261. Findings: Between July 13, 2015, and Aug 21, 2017, of 212 eligible patients, 211 were enrolled: 137 patients from the APOLLO-patisiran group, 49 from the APOLLO-placebo group, and 25 from the phase 2 OLE patisiran group. At the data cutoff on Sept 24, 2018, 126 (92%) of 137 patients from the APOLLO-patisiran group, 38 (78%) of 49 from the APOLLO-placebo group, and 25 (100%) of 25 from the phase 2 OLE patisiran group had completed 12-month assessments. At 12 months, improvements in mNIS+7 with patisiran were sustained from parent study baseline with treatment in the global OLE (APOLLO-patisiran mean change -4·0, 95 % CI -7·7 to -0·3; phase 2 OLE patisiran -4·7, -11·9 to 2·4). Mean mNIS+7 score improved from global OLE enrolment in the APOLLO-placebo group (mean change from global OLE enrolment -1·4, 95% CI -6·2 to 3·5). Overall, 204 (97%) of 211 patients reported adverse events, 82 (39%) reported serious adverse events, and there were 23 (11%) deaths. Serious adverse events were more frequent in the APOLLO-placebo group (28 [57%] of 49) than in the APOLLO-patisiran (48 [35%] of 137) or phase 2 OLE patisiran (six [24%] of 25) groups. The most common treatment-related adverse event was mild or moderate infusion-related reactions. The frequency of deaths in the global OLE was higher in the APOLLO-placebo group (13 [27%] of 49), who had a higher disease burden than the APOLLO-patisiran (ten [7%] of 137) and phase 2 OLE patisiran (0 of 25) groups. Interpretation: In this interim 12-month analysis of the ongoing global OLE study, patisiran appeared to maintain efficacy with an acceptable safety profile in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Continued long-term follow-up will be important for the overall assessment of safety and efficacy with patisiran.

We analyze theoretically and verify experimentally a high-resolution and low-cost method to detect wavelength shift induced by an Erbium-doped fiber Bragg grating. A π -phase-shifted fiber Bragg grating on a temperature controlling setup is employed to achieve tunable single-sideband modulation. To further enhance measurement stability and diminish operational complexity, an asymmetric phase-shifted fiber Bragg grating is developed to reflect wide single-sideband modulation signals and avoid the tuning of the optical carrier wavelength. Through the using of microwave photonics technique, the wavelength shift of the Erbium-doped fiber Bragg grating induced by laser pumping is mapped onto the amplitude variation of the beat signal. The results indicate 1 GHz frequency shift, corresponding to 0.008 nm wavelength shift in the 1550 nm band, is able to be detected. The resolution can be further improved by using a more accurate temperature controlling system. Furthermore, our approach offers an alternative method to detect weak temperature and strain changes on chips or other sensing systems with high accuracy.

Cryptogenic stroke comprises about one-quarter of ischemic strokes with high recurrence rate; however, studies specifically investigating the features and treatment of this stroke subtype are rare. The concept of ‘embolic stroke of undetermined source’ (ESUS) may facilitate the development of a standardized approach to diagnose cryptogenic stroke and improve clinical trials. Since recent large randomized control trials failed to demonstrate a reduction in stroke recurrence with anticoagulants, anti-platelet agents remain the first-line treatment for ESUS patients. Nevertheless, patients with high risk of stroke recurrence (e.g., those with repeated embolic infarcts despite aspirin treatment) require a more extensive survey of stroke etiology, including cardiac imaging and prolonged cardiac rhythm monitoring. Anticoagulant treatments may still benefit some subgroups of high-risk ESUS patients, such as those with multiple infarcts at different arterial territories without aortic atheroma, the elderly, or patients with high CHA2D2-VASc or HOVAC scores, atrial cardiopathy or patent foramen ovale. Several important ESUS clinical trials are ongoing, and the results are anticipated. With rapid progress in our understanding of ESUS pathophysiology, new subcategorizations of ESUS and assignment of optimal treatments for each ESUS subgroup are expected in the near future.

An inner electric field generated between the electrode and the counter electrode when DSSCs work has an inevitable effect on the conversion efficiency, and it is important to reveal the influence of the electric field direction and strength on the performance of DSSCs. Theoretical calculations based on density functional theory (DFT) and time-dependent DFT (TD-DFT) were employed to analyze the electronic structures, optical properties and electron transfer processes under on-field and off-field conditions. The interfacial electron transfer (IET) processes across the semiconductor interface were evaluated, which have been less investigated previously. Compared to the off-field condition, the conversion efficiency of DSSCs is increased when the electric field acted on the +X axis due to the broader absorption spectra, larger ICT parameters, and larger short-circuit photocurrent density governed by the injection driving force. In addition, the further increased conversion efficiency with increased electric field strength indicates that the POM-based dye has self-promoting properties, meaning that the generated inner electric field increases the light harvesting properties of the POM-based-dye, which in turn forms stronger electric field strengths, and finally improves the performance of DSSCs. It is expected that the present study could establish the relationship between the electric field and DSSC efficiency.

ObjectiveTo determine whether mixed location intracerebral hemorrhages/microbleeds (mixed ICH) is a risk factor for vascular unfavorable outcome compared to cerebral amyloid angiopathy–related ICH (CAA-ICH) or strictly deep hypertensive ICH/microbleeds (HTN-ICH).MethodsA total of 300 patients with spontaneous ICH were included. Clinical data, neuroimaging markers, and follow-up outcomes (recurrent ICH, ischemic stroke, and vascular death) were compared among mixed ICH (n = 148), CAA-ICH (n = 32), and HTN-ICH (n = 120). The association between follow-up events and neuroimaging markers was explored using multivariable Cox regression models.ResultsPatients with mixed ICH were older (65.6 ± 12.1 years vs 58.1 ± 13.3 years, p < 0.001) than patients with HTN-ICH, but younger than patients with CAA-ICH (73.3 ± 13.8 years, p = 0.001). Compared to CAA-ICH, mixed ICH had similar incidence of vascular events (all p > 0.05). Compared to HTN-ICH, mixed ICH is associated with higher ICH recurrence (hazard ratio [HR] 3.0, 95% confidence interval [CI] 1.2–7.7), more ischemic stroke (HR 8.2, 95% CI 1.0–65.8), and vascular composite outcome (HR 3.5, 95% CI 1.5–8.2) after adjustment for age and sex. In patients with mixed ICH, the presence of cortical superficial siderosis (cSS) is associated the development of ICH recurrence (HR 4.8, 95% CI 1.0–23.2), ischemic stroke (HR 8.8, 95% CI 1.7–45.5), and vascular composite outcome (HR 6.2, 95% CI 1.9–20.2). The association between cSS and ischemic stroke (p = 0.01) or vascular composite outcome (p = 0.003) remained significant after further adjustment for other radiologic markers.ConclusionsMixed ICH harbors higher risk of unfavorable vascular outcome than HTN-ICH. Presence of cSS in mixed ICH independently predicts vascular event, suggesting the contribution of detrimental effect due to coexisting CAA.

Background A considerable portion of the elderly population are increasingly afflicted by degenerative spinal deformity (DSD), which seriously affects patient health-related quality of life (HRQoL). HRQoL index is used across many studies to show correlations between radio-graphical alignment, disability, and pain in patients with DSD. However, imaged structural deformity represents only one aspect for consideration, namely, the disability effect of DSD. We assessed the isokinetic strength of trunk muscle in patients with degenerative spinal deformity (DSD), and investigated its relationship with HRQoL. Methods In total, 38 patients with DSD (DSD group) and 32 healthy individuals (control group) were recruited. Both groups were homogeneous for age, weight, height and body mass index (BMI). Assessments were performed using the isokinetic dynamometer IsoMed-2000; trunk extensor, flexor strength and flexion/extension (F/E) ratios were explored concentrically at speeds of 30°, 60° and 120° per second. The grip strength of both hands was measured using a hand-held dynamometer. Visual analogue scale (VAS) scores, the Oswestry Disability Index (ODI), a Roland-Morris disability questionnaire (RDQ), and a 36-item Short Form Health Survey (SF-36) evaluated patient HRQoL. Correlations between trunk strength and HRQoL were analyzed. Results When compared with the control group, the DSD group showed lower trunk extensor strength at three velocity movements, and higher F/E ratios at 60° and 120°/s (p p > 0.05). In DSD group, trunk extensor strength at 60°/s was negatively associated with ODI and RDQ (p p p Conclusions We identified isolated trunk extensor myopathy in DSD, which causes an imbalance in trunk muscle strength. Isokinetic trunk extensor strength at 60°/s and trunk flexor strength at 120°/s can predict disability, and decrease physical HRQoL in DSD patients.

The COVID-19 pandemic had an enormous impact on the vegetable supply chain in China. Effective evaluation of the pandemic's influences on vegetable production is vital for policy settings to enhance the security of vegetable supply. Based on first-hand data from 526 households, we explored regional differences in different types of loss and potential factors affecting the severity farmer households suffered during the pandemic. The results underline that sales contraction and price volatility in the context of interruption of supply chain dominate the total losses during the pandemic. Such losses differ across provinces and are more substantial in provinces with stricter confinement measures. Farmer households' participation in local market and modern marketing methods helps mitigate the negative effects of the COVID-19 shock, while labor hiring and facilities adoption in production widen the losses due to the shortage in the workforce. In the future, the vegetable industry practitioners and relevant government departments should work together to coordinate the development of short and long supply chains and strengthen the stability and security of the vegetable supply chain.

Background/purpose As the incidence of fungal infections in China increases, the demand for rapid and accurate diagnosis of mycoses is growing. Yet, information on current diagnostic capacity is scarce. Methods An online survey was conducted in February 2018 to collect information on mycology testing from tertiary care hospitals across China. Responses from 348 hospitals were analyzed, and a scoring system was designed and employed to assess the overall diagnostic capacity. Results Most of the surveyed hospitals did not have separate laboratory space, manpower, or equipment dedicated for fungal testing. Conventional staining methods were widely available (>70%), whereas GMS and fluorescent staining were less common. Fungal identification services were offered mostly with chromogenic medium, morphological characterization or automated identification systems, other than more advanced methods such as MALDI-TOF MS and DNA sequencing. Fungal serology testing was available in 81.1%, with G test being the most often used. Though 91.8% of the respondents had the ability to perform antifungal susceptibility testing for yeasts, less than 13% conducted such testing for molds. The percentage of laboratories participating in External Quality Assessment programs and research was 57.5% and 32.5%, respectively. The average score for the 348 surveyed hospitals was 37.2 (out of a maximum of 89 points), with only 15 hospitals scoring >60, suggesting a general lack of high-quality mycology laboratories. Conclusions The overall clinical testing capacity for fungal infection in China is insufficient. More investment and training efforts are warranted to establish centers of excellence and promote access to high-quality diagnostic services.

Background While electronic health records have been collected for many years in Taiwan, their interoperability across different health care providers has not been entirely achieved yet. The exchange of clinical data is still inefficient and time consuming. Objectives This study proposes an efficient patient-centric framework based on the blockchain technology that makes clinical data accessible to patients and enable transparent, traceable, secure, and effective data sharing between physicians and other health care providers. Methods Health care experts were interviewed for the study, and medical data were collected in collaboration with Ministry of Health and Welfare (MOHW) Chang-Hua hospital. The proposed framework was designed based on the detailed analysis of this information. The framework includes smart contracts in an Ethereum-based permissioned blockchain to secure and facilitate clinical data exchange among different parties such as hospitals, clinics, patients, and other stakeholders. In addition, the framework employs the Logical Observation Identifiers Names and Codes (LOINC) standard to ensure the interoperability and reuse of clinical data. Results The prototype of the proposed framework was deployed in Chang-Hua hospital to demonstrate the sharing of health examination reports with many other clinics in suburban areas. The framework was found to reduce the average access time to patient health reports from the existing next-day service to a few seconds. Conclusion The proposed framework can be adopted to achieve health record sharing among health care providers with higher efficiency and protected privacy compared to the system currently used in Taiwan based on the client–server architecture.

Background and Purpose: We aim to investigate whether histopathologic examination of thrombi retrieved from acute ischemic stroke patients undergoing endovascular treatment could distinguish cancer-related stroke from other etiologies. Methods: Thrombi from patients undergoing endovascular treatment were analyzed. The etiology of stroke was divided into cardioembolism, large artery atherosclerosis, and active cancer groups. All selected thrombi were subjected to hematoxylin and eosin staining. The percentages of fibrin/platelets, red blood cells, and white blood cells within a thrombus were quantified. Results: One-hundred fifty-two patients (active cancer, 19; cardioembolism, 107; large artery atherosclerosis, 26) were included. Thrombi from the active cancer group exhibited a higher fibrin/platelet composition than did those from the cardioembolism and large artery atherosclerosis groups (median, 85.7% versus 43.9% and 42.5%; P P Conclusions: In thrombi retrieved from patients undergoing endovascular treatment, a high fibrin/platelet composition was a probable indicator of cancer-related stroke.

In order to reasonably evaluate the ecological environment of Dari County in the source region of the Yellow River, the characteristics and actual conditions of Dari County's ecological environment are taken into account, and the principles of representativeness, scientificity, operability and systematicness of index are followed. An evaluation index system is established for Dari County based on the Pressure-State-Response (PSR) conceptual framework. Combining the Analytic Hierarchy Process (AHP) with the cloud model, an ecological environment evaluation model for Dari County is established, and the ecological environment of Dari County is quantitatively evaluated. The model organically combines the ambiguity and randomness of the uncertainty concept. It not only describes the ambiguity of the evaluation level with a membership function, but also considers the randomness of the membership itself using the concept of superentropy, which is more in line with the actual evaluation object. The results indicate that the ecological situation of Dari County is in a ‘general’ state that should be urgently protected for sustainable development, and land degradation is the most important factor affecting the ecological environment of Dari County. HIGHLIGHTS A model method combining AHP and cloud model.; The ecological environment of Dari County is in a general state.; The evaluation index system of Dari County based on PSR framework is proposed.; Land degradation is an important factor affecting the ecology of Dari County.; The evaluation model can take into account both ambiguity and randomness.

Early recanalization for acute ischemic stroke (AIS) due to large vessel occlusion (LVO) by endovascular thrombectomy (EVT) is strongly related to improved functional outcomes. With data obtained from the Taiwan registry, the factors associated with mTICI 3 recanalization and clinical outcomes in EVT are investigated. From January 2014 to September 2016, 108 patients who underwent EVT for AIS due to LVO in 11 medical centers throughout Taiwan were included. Complete recanalization is defined as achieving modified thrombolysis in cerebral infarction (mTICI) grade 3. Good clinical outcomes are defined by the modified Rankin scale (mRS) 0–2 at 3 months after EVT. Clinical and imaging parameters for predicting mTICI 3 recanalization and good clinical outcomes are analyzed. Of the 108 patients who received EVT, 54 (50%) patients had mTICI 3 recanalization. Having received aspiration only and the use of IV-tPA are shown to be significant predictors for mTICI 3 recanalization with odds ratios of 2.61 and 2.53 respectively. Forty-six (42.6%) patients experienced good 3-month clinical outcomes (mRS 0–2). Pretreatment collateral statuses, NIHSS scores, time lapses between symptoms to needle, and the occurrence of hemorrhage at 24 h are all significant predictors for good outcomes with odds ratios of 2.88, 0.91, 0.99, and 0.31 respectively. Prediction of mTICI 3 recanalization and clinical outcomes offer valuable clinical information for treatment planning in EVT.

Image super‐resolution reconstruction refers to a technique of recovering a high‐resolution (HR) image (or multiple images) from a low‐resolution (LR) degraded image (or multiple images). Due to the breakthrough progress in deep learning in other computer vision tasks, people try to introduce deep neural network and solve the problem of image super‐resolution reconstruction by constructing a deep‐level network for end‐to‐end training. The currently used deep learning models can divide the SISR model into four types: interpolation‐based preprocessing‐based model, original image processing based model, hierarchical feature‐based model, and high‐frequency detail‐based model, or shared the network model. The current challenges for super‐resolution reconstruction are mainly reflected in the actual application process, such as encountering an unknown scaling factor, losing paired LR–HR images, and so on.

Objective To investigate whether dynamic cerebral autoregulation (CA) and neuroimaging characteristics are determinants of poststroke cognitive impairment (PSCI). Methods Eighty patients within 7 days of acute ischemic stroke and 35 age‐ and sex‐matched controls were enrolled. In the patients with stroke, brain magnetic resonance imaging and dynamic CA were obtained at baseline, and dynamic CA was followed up at 3 months and 1 year. Montreal Cognitive Assessment (MoCA) was performed at 3 months and 1 year. Patients with a MoCA score

This study assessed the severity of building fires in 17 villages that comprise Taishan District, New Taipei City, Taiwan. A literature review was performed to discuss the impact of fire severity assessment criteria in order to develop items and factors for the analytic hierarchy process (AHP). We identified six items for the building fire severity assessment: rescue response time, narrow road density, water-sacristy area density, building risk, hazardous materials’ place density, and fire safety inspection-regulated premises density. Big data analysis and remote sensing were employed to facilitate devising the AHP structure with items and factors. We also compared the annual average burned area from 2005 to 2015 through the building fire severity assessment to validate assessment accuracy. The actual yearly average burned area in each village of Taishan District was used to verify the building fire severity assessment, and the compliance rate of the rating (i.e., high, moderate, and low) was, respectively, 60%, 67%, and 67%. The proposed assessment is evidently feasible and can act as a reference for quantitative analyses for assessments of building fire severity.

Genomics-based neoantigen discovery can be enhanced by proteomic evidence, but there remains a lack of consensus on the performance of different quality control methods for variant peptide identification in proteogenomics. We propose to use the difference between accurately predicted and observed retention times for each peptide as a metric to evaluate different quality control methods. To this end, we develop AutoRT, a deep learning algorithm with high accuracy in retention time prediction. Analysis of three cancer data sets with a total of 287 tumor samples using different quality control strategies results in substantially different numbers of identified variant peptides and putative neoantigens. Our systematic evaluation, using the proposed retention time metric, provides insights and practical guidance on the selection of quality control strategies. We implement the recommended strategy in a computational workflow named NeoFlow to support proteogenomics-based neoantigen prioritization, enabling more sensitive discovery of putative neoantigens., Identifying mutation-derived neoantigens by proteogenomics requires robust strategies for quality control. Here, the authors propose peptide retention time as an evaluation metric for proteogenomics quality control methods, and develop a deep learning algorithm for accurate retention time prediction.

Lightweight steel structure buildings are a special type of illegal building in Taiwan. There are many different types of these illegal structures in Taiwan used for various purposes. The number of factories operating in one of these illegal lightweight steel buildings alone is as high as 130,000 according to the 2017 statistics. The construction of such structures is easy, fast, and the cost is low, which is why they are widely accepted by the people.[1] The materials of a lightweight steel structure are mostly steel or C-shaped steel. When this type of steel structure is exposed to temperatures above 600 °C, the structure will begin to break and bend, causing deformation and eventually collapse. Additionally, the rapid growth of the fire, the lack of establishment on fire zones, and a fierce fire, etc., all present more challenges for onsite employees to extinguish the initial fires as well as the later fire rescue attempt by firefighters. In recent years, fatal fire incidents have been rampant, causing deaths and injury to foreign workers, highlighting fire safety issues. Therefore, “whether worker accommodation should be separated from the factory” is the subject of this paper. This study is aimed at the statistical survey of lightweight steel structures for industrial and residential use (current status): using data from project investigations to present the site overview and hazard risk factors. Risk assessment for buildings with accommodation inside the factory (validation): through the statistical survey data (34 of the 188 surveyed have accommodations inside the factory, a ratio of 18.1%), the hazard risk is assessed, and the potential risks are analyzed. Fire simulation on buildings with accommodation inside the factory (hazard): use fire simulation to analyze the effective evacuation time with residential fire alarms. To develop a disaster reduction strategy based on the results of the parametric analysis of this study for buildings with accommodation inside the factory (improvement): utilizing factory fire prevention analysis, factory symposium, fire prevention announcement, fire equipment inspection and maintenance, etc., to achieve disaster reduction. Based on the results of the parametric analysis of this study, we will develop an accommodation and disaster reduction strategy (improvement): use plant fire prevention diagnosis, factory symposium, fire prevention announcement, fire equipment inspection and maintenance, etc., to achieve disaster reduction.

Background and Purpose— The differentiation between cerebral amyloid angiopathy (CAA) and hypertensive small vessel disease in primary intracerebral hemorrhage is mainly based on hemorrhagic neuroimaging markers in the supratentorial regions, and the cause for cerebellar microbleeds remains unknown. Our aim was to investigate whether superficial cerebellar microbleeds are more likely to be related to CAA rather than hypertensive small vessel disease. Methods— Two hundred seventy-five consecutive patients with intracerebral hemorrhage were retrospectively reviewed from a prospectively maintained hospital-based stroke registry. Eighty-five (33.1%) patients had cerebellar microbleeds and were categorized into superficial (gray matter, vermis), deep (white matter, deep nucleus, cerebellar peduncle), or mixed type based on the location of cerebellar hemorrhagic lesions. Amyloid imaging was obtained using 11C-Pittsburgh Compound B–positron emission tomography in a subgroup of patients. The associations between cerebellar microbleed locations and the type of small vessel disease (CAA versus hypertensive small vessel disease) based on distribution of supratentorial hemorrhagic lesions as well as other magnetic resonance imaging and positron emission tomography markers were analyzed. Results— The presence of cerebellar microbleed was independently associated with supratentorial microbleed and lacunar infarcts (both P P P P =0.03). Of 33 patients assessed by amyloid positron emission tomography, cerebral and cerebellar amyloid load (standardized uptake value ratio) was higher in patients with superficial cerebellar microbleeds compared with deep/mixed cerebellar microbleeds (cerebrum standardized uptake value ratio [reference: cerebellum] 1.33±0.24 versus 1.05±0.09, P P =0.03). Conclusions— Patients with strictly superficial cerebellar microbleeds are associated with a clinicoradiological diagnosis of CAA as well as increased cerebral and cerebellar amyloid deposition on Pittsburgh Compound B–positron emission tomography, suggesting underlying CAA pathology.

Background: The application of non-vitamin K antagonist oral anticoagulant (NOAC) reduces the risk of intracerebral hemorrhage (ICH) in comparison with vitamin K antagonist (VKA). However, the features and outcomes of NOAC-associated ICH are still unclear, especially for Asian populations. Methods: We retrospectively analyzed 49 consecutive patients who had spontaneous ICH while using NOAC or VKA. We compared the clinical characteristics, ICH volume, 7-day and 3-month mortality, and functional outcomes at discharge and 3 months post-stroke using the modified Rankin Scale (mRS) between NOAC- and VKA-associated ICH. The clinical features, ICH volume, ICH location, and/or treatment methods were statistically adjusted. Results: Among the 49 ICH patients, 15 (30.6%) were using NOAC and 34 (69.4%) were taking VKA. There were no significant differences in the initial ICH volume between groups (mean volume 34.2 ± 43.8 vs. 59.4 ± 46.5 mL, p = 0.061). The percentage of early mortality (within 7 days post-ICH) was significantly lower in the NOAC group (13.3% vs. 44.1%; p = 0.047), but the 3-month mortality was similar (33.3% vs. 47.1%; p = 0.294). The functional outcome was equally poor in both groups at discharge (p = 0.670) and 3 months post-ICH (mean mRS score 4.7 ± 1.3 vs. 4.6 ± 1.7, p = 0.766). Conclusion: There were no significant differences in initial ICH volume, 90-day mortality, or functional outcomes between NOAC and VKA-associated ICH in Asians. Keywords: Intracerebral hemorrhage, Non-vitamin K antagonist oral anticoagulant, Outcome, Vitamin K antagonist

Due to the wide adoption of photovoltaic power generation, non-isolated high step-up DC–DC converters are becoming more and more popular. Among these converters, the switched/coupled-inductor-based converter is more attractive due to the fact that it has fewer power devices and a high efficiency. This paper presents a three-level high step-up DC–DC topology with a three-winding coupled-inductor. When compared with a conventional switched/coupled-inductor-based converter, a higher efficiency can be achieved, owing to low voltage stresses devices, fewer semiconductors in the power loop, lower current stresses, and ZCS of the main switches. The operating principle of the proposed topology is analyzed in detail via equivalent circuits, where a theoretical analysis is carried out using state space modelling. Experimental results obtained on a 24–300 V, 360 W lab prototype have verified the excellent performance of the proposed DC–DC converter.

Background: In Alzheimer’s disease (AD), cognitive impairment begins 10–15 years later than neurodegeneration in the brain. Plasma biomarkers are promising candidates for assessing neurodegeneration in people with normal cognition. It has been reported that subjects with the concentration of plasma amyloid-β 1-42×total tau protein higher than 455 pg2/ml2 are assessed as having a high risk of amnesic mild impairment or AD, denoted as high risk of AD (HRAD). Objective: The prevalence of high-risk for dementia in cognitively normal controls is explored by assaying plasma biomarkers. Methods: 422 subjects with normal cognition were enrolled around Taiwan. Plasma Aβ1-40, Aβ1-42, and T-Tau levels were assayed using immunomagnetic reduction to assess the risk of dementia. Results: The results showed that 4.6% of young adults (age: 20–44 years), 8.5% of middle-aged adults (age: 45–64 years), and 7.3% of elderly adults (age: 65–90 years) had HRAD. The percentage of individuals with HRAD dramatically increased in middle-aged and elderly adults compared to young adults. Conclusion: The percentage of HRAD in cognitively normal subjects are approximately 10%, which reveals that the potentially public-health problem of AD in normal population. Although the subject having abnormal levels of Aβ or tau is not definitely going on to develop cognitive declines or AD, the risk of suffering cognitive impairment in future is relatively high. Suitable managements are suggested for these high-risk cognitively normal population. Worth noting, attention should be paid to preventing cognitive impairment due to AD, not only in elderly adults but also middle-aged adults.

Objective The Addenbrooke’s Cognitive Examination III (ACE-III) is a 100-points cognitive test used in detecting dementia in many countries. There has been no validation study of the ACE-III in patients with suspected dementia in a Taiwanese population, where the language is traditional Chinese. We aimed to culturally adapt and validate the ACE-III as a cognitive assessment tool for differentiating between people with and without dementia presenting to healthcare professionals in Taiwan with possible dementia. Methods We culturally adapted the ACE-III for Taiwan (T-ACE-III) and tested it with consenting patients with suspected dementia in northern Taiwan who had been through the diagnostic process. We calculated receiver operating characteristic (ROC) curves to test the ability of the T-ACE-III to differentiate between dementia and non-dementia cases using clinician diagnosis as the gold standard. We generated the Youden Index to determine the best cut-off score. Results We recruited 90 Taiwanese individuals aged 49–93 years: 24 males and 33 females had dementia and 12 males and 21 females did not. The area under the ROC curve was 0.99 for distinguishing dementia from non-dementia. The T-ACE-III had a sensitivity of 100% and specificity of 78.8% when the cut-off score was 86/87. With a cut-off value of 73/74, the specificity was 100.0%, and sensitivity 89.5%. The highest Youden Index was 0.895, indicating the best overall cut-off point to be 73/74. Conclusions The T-ACE-III is an acceptable cognitive test with excellent psychometric properties for discriminating dementia from non-dementia in Taiwanese populations in memory clinic settings.

Interferons (IFNs) are cytokines secreted by infected cells that can interfere with viral replication. Besides activating antiviral defenses, type I IFNs also exhibit diverse biological functions. IFN-β has been shown to have a protective effect against neurotoxic and inflammatory insults on neurons. Therefore, we aimed to investigate the possible role of IFN-β in reducing mechanical allodynia caused by Complete Freund’s Adjuvant (CFA) injection in rats. We assessed the antinociceptive effect of intrathecal IFN-β in naïve rats and the rats with CFA–induced inflammatory pain. After the behavioral test, the spinal cords of the rats were harvested for western blot and immunohistochemical double staining. We found that intrathecal administration of IFN-β in naïve rats can significantly increase the paw withdrawal threshold and paw withdrawal latency. Further, the intrathecal injection of a neutralizing IFN-β antibody can reduce the paw withdrawal threshold and paw withdrawal latency, suggesting that IFN-β is produced in the spinal cord in normal conditions and serves as a tonic inhibitor of pain. In addition, intrathecal injection of IFN-β at dosages from 1000 U to 10000 U demonstrates a significant transient dose-dependent inhibition of CFA-induced inflammatory pain. This analgesic effect is reversed by intrathecal naloxone, suggesting that IFN-β produces an analgesic effect through central opioid receptor-mediated signaling. Increased expression of phospho-µ-opioid receptors after IFN-β injection was observed on western blot, and immunohistochemical staining showed that µ-opioids co-localized with IFN-α/βR in the dorsal horn of the spinal cord. The findings of this study demonstrate that the analgesic effect of IFN-β is through µ-opioid receptors activation in spial cord.

Background People with cognitive impairment are susceptible to fall. Previous studies regarding balance and gait enrolled patients with various severity of dementia. Quantification of the balance and gait performance of people with cognitive impairment may help identify their postural instability and fall risks. Aim We investigated the differences in balance and gait among older adults with preserved cognition, amnestic mild cognitive impairment, and mild dementia due to Alzheimer's disease. Design Prospective observational study. Setting Outpatient department of neurology or psychology. Population Older adults (aged ≥65 years) with independent gait were evaluated using the Mini-Mental State Examination and Clinical Dementia Rating scale. People with other neurological or musculoskeletal disorders were excluded. Methods Participants were classified into three groups: 30 healthy controls, 30 mild cognitive impairment and 30 mild dementia. Balance were evaluated through functional test (Berg Balance Scale, BBS) and laboratory test (posturography). Gait was assessed by wearable device. Muscle strength and mass were measured through grip force, calf circumstance, and body composition. Results The BBS (p = 0.04), posturography of fall risk index (FR, p = 0.01) and sensory integration indices in eyes open and firm surface (EOFIS, p = 0.009), eyes open and foam surface (EOFOS, p = 0.003) were substantially different among three groups. EOFIS and EOFOS indices of balance in mild dementia were significantly worse than in MCI. The gait speed (p = 0.04) and stride length (p = 0.04) were significantly different among three groups. The post-hoc analyses revealed that all above balance and gait indices in subjects with cognitive impairments were significantly worse than in healthy controls. The grip force, calf circumstance and body composition-muscle mass did not significantly differ among three groups. Conclusions It is a piece of evidence that cognitive dysfunction, even in early stage of memory decline, may have some bad impact on balance and gait regardless of the effect of musculoskeletal problems. Clinical rehabilitation impact Understanding the difference of specific indices of balance and gait among different severity of cognitive impairments and healthy controls could help to develop better balance-oriented rehabilitation programs in older adults at early-stage cognitive impairment.

Image recognition technology is an important field in artificial intelligence. With the development of society and the progress of technology, image recognition technology has gradually been more widely used. This paper introduces the principle of image recognition technology and discusses the advantages of image recognition technology in artificial intelligence. The main function of image recognition technology is to liberate manpower. By using this technology to identify and process all kinds of information, labor intensity can be reduced, and labor efficiency and work quality can be improved. Based on this, this paper discusses the artificial intelligence image recognition technology and its specific application based on the principle of image recognition technology, hoping to help more people understand this technology and maximize the use value of this technology.

In today’s digital era, the number of digital artefacts produced by students in universities around the world continues to rise. This paper describes a project that developed a digital artefacts platform to showcase students’ projects at an international level, aiming to increase the visibility of students’ work to global audiences. Due to the COVID-19 pandemic, a large proportion of the software engineering project development took place remotely, with students and staff at University of Nottingham Ningbo China (UNNC), a Sino-foreign Higher Education Institution in Mainland China, adopting remote collaboration tools and techniques. This paper presents the background, software engineering development, and the project’s unique characteristics. In addition, the challenges to project completion and remote collaboration, future recommendations, and the potential to extend this project into an Open Educational Resource (OER) are also discussed.