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Currently, effective Intrusion-detection systems (IDS) still represent one of the important security tools. However, hybrid models based on the IDS achieve better results compared with intrusion detection based on a single algorithm. But even so, the hybrid models based on traditional algorithms still face different limitations. This work is focused on providing two main goals; firstly, analysis based on the main methods and limitations of the most-recent hybrid model-based on intrusion detection, secondly, to propose a novel hybrid IDS model called TLBO-ELM based on the Firefly algorithm and Fast Learning Network.

Many studies focusing on integrating reviews with ratings to improve recommendation performance have been quite successful. However, these works still face several shortcomings: (1) The importance of dynamically integrating review and interaction data features is typically ignored, yet treating these fusion features equally may lead to an incomplete understanding of user preferences. (2) Some forms of soft attention methods are adopted to model the local semantic information of words. As features thus captured may contain irrelevant information, the generated attention map is neither discriminatory nor detailed. In this paper, we propose a novel Adaptive Hierarchical Attention-enhanced Gated network integrating reviews for item recommendation, named AHAG. AHAG is a unified framework to capture the hidden intentions of users by adaptively incorporating reviews. Specifically, we design a gated network to dynamically fuse the extracted features and select the features that are most relevant to user preferences. To capture distinguishing fine-grained features, we introduce a hierarchical attention mechanism to learn important semantic information features and the dynamic interaction of these features. Besides, the high-order non-linear interaction of neural factorization machines is utilized to derive the rating prediction. Experiments on seven real-world datasets show that the proposed AHAG significantly outperforms state-of-the-art methods.

X-ray computed tomography (CT), as one of the most widely used noninvasive imaging modalities, can provide three-dimensional anatomic details with high resolution, which plays a key role in disease diagnosis and treatment assessment. However, although they are the most prevalent and FDA-approved contrast agents, iodinated water-soluble molecules still face some challenges in clinical applications, such as fast clearance, serious adverse effects, nonspecific distribution, and low sensitivity. Because of their high biocompatibility, tunable designability, controllable biodegradation, facile synthesis, and modification capability, the polymers have demonstrated great potential for efficient delivery of iodinated contrast agents (ICAs). Herein, we comprehensively summarized the applications of multifunctional polymeric materials for ICA delivery in terms of increasing circulation time, decreasing nephrotoxicity, and improving the specificity and sensitivity of ICAs for CT imaging. We mainly focused on various iodinated polymers from the aspects of preparation, functionalization, and application in medical diagnosis. Future perspectives for achieving better imaging and clinical translation are also discussed to motivate new technologies and solutions.

In an age where e-commerce can provide a huge variety of different products online, customers still face the issue of the last mile challenge. The purpose of this paper is to find out if the last-m...

We report the impact of a Gentle Touch Stimulation (GTS) program. Forty-three mothers provided daily 10-min GTS with C-tactile (CT) afferent optimal stroking touch, for 4 weeks to their 3-12 weeks old infants. CT-afferents are cutaneous unmyelinated, low-threshold mechanosensitive nerves hypothesized to underly the regulatory impact of affective touch. We compared physiological and behavioral responses during a no-touch-baseline (BL), static-touch-baseline (BL-T), intervention/control (GTS/CTRL), Still Face (SF) and Reunion (RU) condition for GTS-infants versus a control-group (CTRL) at the start (T1) and end of (T2) of the program. We collected mother-infant ECG, respiration, cortisol, video-recordings, and diary-reports. At T1, physiological arousal significantly increased during SF in both groups, that is, decreased respiratory sinus arrhythmia (RSA) and R-R interval (RRI). At T2, GTS-infants showed significantly increased RSA, RRI, decreased respiration during GTS, buffering SF-arousal and allowing complete recovery during RU; CTRL-infants showed higher SF-arousal and small recovery, under initial BL-levels. Maternal cardio-respiratory showed a metabolic investment during RU. Cortisol and behavioral analyses showed higher arousal in CTRL-infants than GTS-infants at T2. We suggest that the combination of phasic short-term and tonic long-term responses to CT-optimal stroking touch, delivered in a structured daily manner, contribute to the building of infant stress regulation and resilience.Reportamos el impacto del programa de Estimulación Táctil Suave (GTS). Cuarenta y tres madres les dieron a sus infantes de 3-12 semanas 10 minutos de GTS con un toque táctil-C (CT) aferente óptimo de caricias por 4 semanas. Los aferentes CT son nervios cutáneos amielínicos mecano-sensibles de bajo impacto que según hipótesis rigen el impacto regulatorio del toque afectivo. Comparamos las respuestas fisiológicas y de comportamiento durante un momento de referencia no táctil (BL), un momento de referencia táctil estático (BL-T), intervención/control (GTS-CTRL), la Cara Seria (SF) y la condición de Reunión (RU) para infantes GTS versus un grupo de control (CTRL) al principio (T1) y al final (T2) del programa. Recogimos información ECG de madre-infante, respiración, cortisol, grabaciones en vídeo, y reportes de un diario. Al T1, la estimulación fisiológica significativamente aumentó durante SF en ambos grupos, v.g., una baja en la arritmia respiratoria paranasal (RSA) y el intervalo R-R (RRI). Al T2, los infantes GTS significativamente mostraron un aumento de RSA, RRI, una baja en la respiración durante GTS, amortiguando la estimulación SF y permitiendo un completo recobro durante RU; los infantes de CTRL mostraron una más alta estimulación SF y un pequeño recobro, bajo los niveles BL iniciales. El aspecto cardio-respiratorio materno mostró inversión metabólica durante RU. Los análisis de cortisol y de comportamiento mostraron más altas estimulaciones de infantes de CTRL que en infantes GTS al T2. Proponemos que la combinación de las respuestas fásicas a corto plazo y tónicas a largo plazo a las caricias táctiles óptimas CT, ofrecidas de una manera estructural diaria, contribuyen a moldear la regulación del estrés y capacidad de resistencia del infante.Cet article fait état de l'impact du programme Stimulation Toucher en Douceur (an anglais Gentle Touch Stimulation, que nous abrégeons ici GTS). Quarante-trois mères ont procédé chaque jour à un GTS de 10 minutes avec un toucher par caresse optimale C-tactile (CT) afférent, pendant 4 semaines à leurs nourrissons de 3-12 semaines. Les afférents CD sont des nerfs cutanés amyéliniques, à faible seuil et mécano-sensibles, dont on pense qu'ils sous-tendent l'impact régulatoire du toucher affectif. Nous comparons les réponses physiologiques et les réponses comportementales durant la condition à un niveau de référence NR sans toucher, un niveau de référence toucher statique (NR-T), un contrôle/intervention (GTS/CTRL), Visage Impassible (Still Face, soit SF) et la Réunion (RU) pour les bébés GTS par rapport aux bébés du groupe de contrôle (CTRL) au commencement (T1) et à la fin (T2) du programme. Nous avons recueilli l’électrocardiogramme mère-bébé, la respiration, le niveau de cortisol et les rapports-journaux. Au T1 la stimulation physiologique a augmenté de façon importante durant le SF pour les deux groupes, c'est-à-dire une arythmie des sinus respiratoires (RSA) décrue et un intervalle R-R décru (RRI). Au T2 les bébés GTS ont fait preuve d'une RSA et d'un RRI bien plus élevés, une respiration décrue durant le GTS, un éveil SF tampon et ont fait preuve d'un rétablissement complet durant la RU. Les bébés contrôle ont fait preuve de plus d’éveil SF et d'un petit rétablissement, moins élevés que les niveaux BL initiaux. La cardio-respiration maternelle a fait preuve un investissement métabolique durant la RU. Les analyses de cortisol et les analyses comportementales ont montré un éveil plus élevé chez les bébés-CTRL que chez les bébés GTS au T2. Nous suggérons que la combinaison de réactions phasiques à court terme et de réponses toniques à long terme au toucher caresse CT-optimal, donné chaque jour de manière structurée, contribue à la construction de la régulation du stress du bébé et de sa résilience.Warum sehnen wir uns nach Berührung? Die Auswirkungen täglicher sanfter Berührungsstimulation auf die physiologische und verhaltensbezogene Regulation sowie Resilienz von Mutter und Kind Wir berichten über die Auswirkungen eines Programms zur sanften Berührungsstimulation (Gentle Touch Stimulation; GTS). Dreiundvierzig Mütter wendeten bei ihren 3-12 Wochen alten Säuglingen 4 Wochen lang täglich 10 Minuten GTS an, d.h. eine C-taktile (CT) afferente optimale streichelnde Berührung. Bei den CT-Afferenzen handelt es sich um kutane, nicht-myelinisierte, niedrigschwellig mechanosensorische Nerven, von denen angenommen wird, dass sie den regulierenden Auswirkungen affektiver Berührungen zugrunde liegen. Wir verglichen die physiologischen und verhaltensbezogenen Reaktionen von GTS-Säuglingen im Vergleich zu einer Kontrollgruppe (CTRL) zu Beginn (T1) und am Ende (T2) des Programms während einer berührungsfreien Baseline (BL), einer statischen Berührungsbaseline (BL-T), einer Interventions-/Kontrollbedingung (GTS/CTRL), einer „Still Face“ Bedingung (SF) und einer Wiedervereinigung (RU). Erhoben wurden Mutter-Kind EKG, Atmung, Cortisol, Videoaufzeichnungen und Tagebucheinträge. Zu T1 nahm die physiologische Erregung während der SF in beiden Gruppen signifikant zu, d. h. die respiratorische Sinusarrhythmie (RSA) und das R-R-Intervall (RRI) nahmen ab. Zu T2 zeigten die GTS-Säuglinge signifikant erhöhte RSA, RRI und verringerte Atmung während der GTS, was die SF-Erregung abpufferte und eine vollständige Erholung während der RU ermöglichte. Die CTRL-Säuglinge zeigten eine höhere SF-Erregung und eine geringe Erholung unter den ursprünglichen BL-Werten. Die mütterliche kardio-respiratorische Aktivität zeigte eine metabolische Investition während der RU. Cortisol- und Verhaltensanalysen zeigten eine höhere Erregung bei CTRL-Säuglingen als bei GTS-Säuglingen zu T2. Die Ergebnisse weisen darauf hin, dass die Kombination von phasischen Kurzzeit- und tonischen Langzeitreaktionen auf CT-optimale streichelnde Berührungen, die täglich strukturiert durchgeführt werden, zum Aufbau der Stressregulation und Resilienz von Säuglingen beitragen.なぜ私たちはタッチングを希求するか−毎日の優しいタッチングの刺激が、母Ȁ子の身体生理および行動の調節と レジリエンス(復元力)に及ぼす影響 ジェントルタッチスティミュレーション(GTS)プログラムの効果について報告する。 43人の母親が、生後3〜12週の母親の乳児に、C-tactile(CT)求心性の最適ななでるタッチングを含む10分間のGTSを4週間毎日行った。CT求心性神経は、情緒的なタッチングの調整的な影響を過小評価していると仮定される皮膚の無髄鞘の低閾値のメカノセンシチブ神経である。GTSの非タッチベースライン(BL)、静的タッチベースライン(BL-T)、介入/制御(GTS / CTRL)、スティルフェイス(SF)、および再会(RU)状態での身体生理および行動の反応を、GTS-乳児と対照群(CTRL-乳児)で、プログラムの開始時(T1)と終了時(T2)に比較した。母と子の心電図、呼吸の状態、コルチゾール、ビデオ録画、および日記を記録した。T1では、両グループとも、SF中において身体生理的に有意に覚醒した。つまり、呼吸性洞性不整脈(RSA)とR-R間隔(RRI)が減少した。T2では、GTS-乳児は、RSA、RRIが有意に増加し、GTS中に呼吸数が減少し、SF覚醒は緩まり、RU中に完全に回復を示した。一方、CTRL-乳児は、初期のBLレベル下で、より高いSF覚醒とわずかな回復を示した。母親の心肺系は、RU中に代謝投資を示した。コルチゾールと行動分析では、T2ではGTS-乳児よりもCTRL-乳児でより高い覚醒を示した。構造化され毎日提供されるCT最適なストロークタッチングに対する相性の短期的および強壮性の長期的反応の組み合わせが、乳児のストレス調節と回復の構築に寄与するとした。.我们报告了一项“温和触摸刺激” (GTS) 项目的影响。43位母亲利用“C组触觉 (CT) 传入神经”的最佳轻抚触摸方式每天为其3-12周大的婴儿提供10分钟的GTS, 为期4周。C组触觉传入神经是皮肤无髓鞘、低阈值的机械敏感性神经, 被认为是情感触摸调节影响的基础。我们在项目开始 (T1) 和结束 (T2) 阶段比较了GTS-婴儿与对照组在无接触基线 (BL)、静态接触基线 (BL-T)、干预/对照 (GTS/CTRL)、静止面孔 (SF) 以及重聚 (RU) 条件下的生理和行为反应。我们收集了母婴心电图、呼吸、皮质醇、录像和日记报告。在T1阶段, 两组婴儿在SF期间的生理唤醒显著增加, 即呼吸性窦性心律不齐 (RSA) 和R-R间期 (RRI) 减少。在T2阶段, GTS-婴儿的RSA、RRI显著增加, GTS期间呼吸减少, SF-唤醒减缓, 并在RU期间呈现完全恢复;在初始BL水平下, CTRL-婴儿表现出更高的SF-唤醒和微小恢复程度。在RU期间, 母亲的心肺功能显示出代谢消耗。皮质醇和行为分析显示, 在T2阶段, CTRL-婴儿的唤醒程度高于GTS-婴儿。我们建议, 对CT的最佳轻抚触摸方式应结合阶段性短期反应和强直长期反应, 以结构化的日常方式开展, 这有助于建立婴儿压力调节和复原力。.لماذا نتوق إلى اللمس؟ تأثير تحفيز اللمسة اللطيفة اليومية على التنظيم الفسيولوجي والسلوكي للأم والطفل والمرونة نعرض في هذه الدراسة تأثير برنامج تحفيز اللمسة اللطيفة (GTS). اشتركت مجموعة من 43 أمًا في الدراسة حيث طلب منهم تقديم 10 دقائق يومياً من اللمسة المثالية مع التمسيد لمدة 4 أسابيع لأطفالهن الذين تتراوح أعمارهم بين 3-12 أسبوعًا. المستقبلات العصبية منخفضة العتبة في الحساسية الميكانيكية و يُفترض أنها تتحكم في التأثير التنظيمي لللمس العاطفي. قمنا بمقارنة الاستجابات الفسيولوجية والسلوكية خلال حالة عدم وجود اللمس (BL) ، واللمس الثابت (T-BL) ، ومجموعة التدخل / المجموعة الضابطة (GTS / CTRL) ، والوجه الثابت (SF) ، ومجموعة Reunion (RU) للأطفال في برنامج اللمسة اللطيفة (GTS) مقارنة بالمجموعة الضابطة (CTRL) في نقطة البداية (T1) ونقطة النهاية (T2) من البرنامج. قمنا بجمع بيانات رسم القلب ، والتنفس ، والكورتيزول ، وتسجيلات الفيديو ، وتقارير اليوميات. في نقطة البداية (T1) ، زادت الاستثارة الفسيولوجية بشكل ملحوظ خلال حالة الوجه الثابت (SF) في كلا المجموعتين ، أي انخفاض عدم انتظام ضربات القلب التنفسي (RSA) و (RRI). وفي نقطة النهاية (T2) ، أظهر الرضع في برنامج (GTS) زيادة ملحوظة في RSA ، RRI ، وانخفاض التنفس أثناء GTS ؛ بينما أظهر الرضع في المجموعة الضابطة استثارة أعلى للوجه الثابت (SF) وفترة انتعاش قصيرة ، تحت مستويات BL الأولية. وأظهرت تحليلات الكورتيزول والسلوكية إثارة أعلى عند الرضع في المجموعة الضابطة عن الرضع في مجموعة التدخل عند نقطة النهاية (T2). تقترح الدراسة أن الجمع بين الاستجابات المرحلية قصيرة المدى وطويلة المدى للمس التمسيدي الأمثل الذي يقدم بشكل يومي ونظامي ، يمكن أن يساهم في بناء المرونة وتنظيم الإجهاد لدى الرضع.

The risk of stroke in diabetic patients is significantly higher than in non-diabetic patients. Appropriate studies on the prevalence and characteristics of the onset of elderly diabetes with stroke in many countries are still lacking. Effective prevention and control still face enormous challenges. Older diabetic patients with osteoporosis need sensible intervention and treatment based on an individualised comprehensive assessment.

Despite technological and immunological innovations, living-donor liver transplant (LDLT) recipients still face substantial risk of postoperative complications. Sarcopenia is being recognized more and more as a biomarker that correlates with poor outcomes in surgical patients. The purpose of this study was to evaluate the relationship between sarcopenia and significant surgical complications in LDLT recipients. This retrospective review included patients who had received LDLT at our institute from 2005 to 2017. Sarcopenia was assessed using the psoas muscle index (PMI) in cross-sectional images. ROC curve analysis was used to determine the ability of PMI to predict postoperative complications. Correlations between major postoperative complications and sarcopenia were evaluated using regression analysis. A total of 271 LDLT recipients were included. No significant differences were found between PMI and major postoperative complications in male patients. Female recipients with major postoperative complications had significantly lower mean PMI values (P = 0.028), and the PMI cut-off value was 2.63 cm2/m2. Postoperative massive pleural effusion requiring pigtail drainage occurred more frequently in the sarcopenia group than in the non-sarcopenia group (P = 0.003). 1-, 3-, 5- and 10-year overall survival rates in female were significantly poorer in the sarcopenia group (n = 14) compared with the non-sarcopenia group (n = 108), at 92.9% versus 97.2%, 85.7% versus 95.4%, 85.7% versus 92.5% and 70.1 versus 82.0%, respectively (P = 0.041) and 94.6%, 89.9%, 85.9% and 78.5% in male patients. Sarcopenia is associated with a significantly higher risk of major postoperative complications in females. PMI and sarcopenia together are predictive of major postoperative complications and survival rates in female LDLT recipients.

Summary The electrification of mass transportation is hailed as a solution for reducing global greenhouse-gas emissions and dependence on unsustainable energy sources. The annual sales of electric vehicles (EVs) has continued to rise since 2011, with a global sale of EVs of 2.1 million in 2019. This increase in sales is mainly due to continued improvement in the cost and performance of commercial EVs, increased EV options available to consumers, and environmental awareness. However, despite the positive outlook, EVs still face major challenges that hinder their rapid and widespread adoption: limited driving range, long charging times, and a lack of sufficient charging infrastructure. This review outlines the recent advances in EVs and related infrastructure, mainly from artificial intelligence (AI), which makes EVs a more attractive consumer option. The application of AI in improving EVs, facilitating EV charging stations, and EV integration with the smart grid is critically analyzed and reviewed. Finally, future trends and prospects in the area are discussed.

Gluten-free products have emerged in response to the increasing prevalence of gluten-related disorders, namely celiac disease. Therefore, the quantification of gluten in products intended for consumption by individuals who may suffer from these pathologies must be accurate and reproducible, in a way that allows their proper labeling and protects the health of consumers. Immunochemical methods have been the methods of choice for quantifying gluten, and several kits are commercially available. Nevertheless, they still face problems such as the initial extraction of gluten in complex matrices or the use of a standardized reference material to validate the results. Lately, other methodologies relying mostly on mass spectrometry-based techniques have been explored, and that may allow, in addition to quantitative analysis, the characterizationof gluten proteins. On the other hand, although the level of 20 mg/kg of gluten detected by these methods is sufficient for a product to be considered gluten-free, its immunogenic potential for celiac patients has not been clinically validated. In this sense, in vitro and in vivo models, such as the organoid technology applied in gut-on-chip devices and the transgenic humanized mouse models, respectively, are being developed for investigating both the gluten-induced pathogenesis and the treatment of celiac disease. Due to the ubiquitous nature of gluten in the food industry, as well as the increased prevalence of gluten-related disorders, here we intend to summarize the available methods for gluten quantification in food matrices and for the evaluation of its immunogenic potential concerning the development of novel therapies for celiac disease to highlight active research and discuss knowledge gaps and current challenges in this field.

Although cancer survival rates are improving, pediatric patients with cancer still face numerous stressors. Using an integrative approach, a literature review was conducted to identify stressors and synthesize effective coping strategies among pediatric patients with cancer. The CINAHL® Complete, ProQuest, and PubMed® databases were searched for relevant studies using key terms. Eight studies were included in the final analysis. Three factors contributing to everyday stressors of pediatric patients with cancer and four major coping categories were identified.

Industrial-scale pharmaceutical applications still face many challenges in overcoming the low absorption and bioavailability of poorly water-soluble drugs. Hot-melt extrusion has emerged as a promising approach with continuous processing on an industrial scale for the preparation of drug delivery systems. Many reviews have mentioned the potential applications, processes, principles and advantages and disadvantages of hot-melt extrusion in the pharmaceutical industry. However, a focus on the recent progress of hot-melt extrusion, which investigates the impacts of processes and formulations of solid dispersions of poorly water-soluble drugs, is missing. In this review, various factors, including polymers, drug properties, additives and surfactants, in solid dispersion SD formulations by hot-melt extrusion will be discussed. Moreover, the effects of the hot-melt extrusion process on the physicochemical properties of solid dispersions will be mentioned. The utilization of molecular interactions in hot-melt extrusion to improve drug stability will also be described. Overall, this summary of recent studies on solid dispersion by hot-melt extrusion will provide perspectives and effectiveness for the development of formulations containing poorly water-soluble drugs.

Despite global commitments of policy makers to improve maternal health through capacity strengthening and provision of high-quality reproductive health services, family planning services still face great challenges in Africa. A nationwide cross-sectional study conducted in 2019 in Benin involving health facilities showed gaps in Knowledge Attitudes and Practices (KAP) in meeting family planning guidelines. A total of 446 health providers were interviewed. Data analysis relied on the calculation of tertiles and chi-square tests were computed to assess the differences at 5% level of significance. Results reveal that most health providers (92.9%) showed a good knowledge of the standard guidelines of FP, one fourth (23.4%) showed a wrong knowledge of the advantages and about half (51.6%) of them lacked extended knowledge of FP methods. Results also underscore discrepancies between most providers' attitudes and existing FP guidelines which were in line with the inadequate practices showed by half of respondents. Results underscore the need for the development and implementation of basic training programs and capacity strengthening interventions toward health providers in order to improve performances of FP services in Benin.

Coordinating breast cancer treatment is a complex task that can overwhelm patients and their support networks. Though the Cancer Patient Navigator (CPN) program in Nova Scotia (NS) provides professional assistance to patients, certain groups of patients may still face barriers to accessing its services. Employing interviews and a modified Delphi approach with CPN participants, this study sought to identify factors associated with the need for navigation to help better target CPN program referrals among breast cancer patients. Six CPNs were recruited directly through the CPN program manager for interviews and surveys. The CPNs identified 27 different factors, which were divided into 4 categories: sociodemographic, psychological, clinical and health systems. While these patient factors (particularly sociodemographic) are not directly modifiable, awareness of their association with the need for navigation could be used to better target patients with a high need for navigation for referral to CPN services.

The diagnosis and treatment of respiratory disease in pet guinea pigs, chinchillas, and degus still face profoundly serious challenges owing to their relatively small size, conspicuous clinical signs, difficulty for sampling, and insufficient scientific evidence to correlate signs and particular pathologies. This article is intended to summarize the available information on the relevant anatomy, physiology, and respiratory pathology in these species.

Proper adoption of International Financial Reporting Standard (IFRS) has been inextricably linked to global financial market penetration and economic development. Yet most of the developing countries still face some challenges in its adoption. Various studies have examined the benefits and challenges of IFRS adoption. The organization and culture, resistance to change, knowledge of IFRS and government policy has dominated the discourse on the challenges of IFRS adoption in developing countries. As we consider the shift in discourse towards the developing countries, this paper explore the empirical analysis studies that analyzing the challenges hindering the proper adoption of IFRS, and its implication for financial market development and economic growth. This paper develops the main issues that pose a challenge to IFRS adoption in developing country like Iraq by reviewing the existing empirical evidence in the literature

Women academics have represented half of the academic body at Chinese higher education institutions since 2018. However, national and international scientific research on women academics in China has been limited, in contrast with the numerous international publications on women academics working in European, Oceanian, and North American higher education systems. Motivated by this relative lack, this study takes a historical perspective to analyze the role played and the expectations and challenges faced by women academics in Chinese higher education. We organize this history into three periods: (1) the emergence of the modern, Western-influenced university, starting at the beginning of the twentieth century; (2) the creation of the People’s Republic of China in 1949; and (3) the contemporary period, beginning with China’s opening up in the late 1970s. For each of these periods, the study identifies how traditions, changing cultural and societal beliefs concerning gender, and the development of the higher education system in China transformed the role, positioning and activities of women academics. This study contributes to a better understanding of the current status of women academics in China, what has changed, and the challenges they still face to gain further prominence in the country’s fast-developing higher education system.

Despite extensive evidence-based guidelines, clinicians still face many barriers to reducing the incidence of obesity. Recognizing that obesity is a chronic disease will allow clinicians to properly treat patients and bill for reimbursement. With enhanced education, knowledge of reimbursement, and a push for legislation, physician assistants can pave the way to reducing rates of obesity in adults.

Concept-cognitive learning (CCL) is an emerging field of concerning incremental concept learning and dynamic knowledge processing in the context of dynamic environments. Although CCL has been widely researched in theory, the existing studies of CCL have one problem: the concepts obtained by CCL systems do not have generalization ability. In the meantime, the existing incremental algorithms still face some challenges that: 1) classifiers have to adapt gradually and 2) the previously acquired knowledge should be efficiently utilized. To address these problems, based on the advantage that CCL can naturally integrate new data into itself for enhancing flexibility of concept learning, we first propose a new CCL model (CCLM) to extend the classical methods of CCL, which is not only a new classifier but also good at incremental learning. Unlike the existing CCL systems, the theory of CCLM is mainly based on a formal decision context rather than a formal context. In learning concepts from dynamic environments, we show that CCLM can naturally incorporate new data into itself with a sufficient theoretical guarantee for incremental learning. For classification task and knowledge storage, our results on various data sets demonstrate that CCLM can simultaneously: 1) achieve the state-of-the-art static and dynamic classification task and 2) directly accomplish preservation of previously acquired knowledge (or concepts) under dynamic environments.

Assessing and monitoring benthic communities is increasingly important in view of global alteration of marine environments. Deep learning has proven to effectively detect marine specimen in underwater imagery but still face problems with small input datasets, unconstrained environments and class imbalance. This study evaluates a data augmentation strategy to alleviate these limitations. Through synthetically derived image compositions, the entire input dataset was greatly extended from 700 to 12700 images. Additionally, specimen numbers of brittle stars, soft corals and glass sponges are equalized resulting in a mean average precision increase of 24 %. The overall mean average precision for box detections yields 76.7 and for instance segmentation 67.7 at an intersection over union threshold of 0.5. This study shows that deep architectures such as the deployed CenterMask via ResNeXt-101 model can successfully be trained with few original images from varying underwater scenes.

A recent survey found that the unadjusted average hourly net wage rate of female employees in Kosovo exceeded that of male employees. This reverse gender wage gap makes Kosovo a curiosity, though results from other countries suggest that there is an inverse relationship between the size of the gender pay gap in a country and its female labour force participation rate. In the analysis below we estimate earning functions for female and male employees in Kosovo. Using decomposition analyses we then examine the size of the explained and unexplained gender wage gaps. A novel feature of the investigation is that we incorporate into the analysis gender differences in the allocation of time. We find that the superior productivity-related characteristics of female employees in Kosovo hides the magnitude of the difficulties they still face in the labour market. Hence, we conclude that once we focus on workers with similar observed productivity-related characteristics, women in Kosovo are paid significantly less than men.

Organ transplantation has become an established and life-saving treatment for patients with end-stage organ failure. However, patients still face constraints when it comes to access to transplantation, as well as its efficacy. One major concern is the global shortage of organs for transplantation. The World Health Organization estimates that only 10% of the worldwide need for organ transplantation is being met [1] and, according to United Network for Organ Sharing, an average of 20 Americans die each day while waiting for a transplant [2] . In addition, even after an organ is transplanted, long-term outcomes remain uncertain. Half of organ transplants fail within ten years of being transplanted, including as many as 75% of intestines and lungs [1] . To prevent rejection of a donor organ, transplant recipients must adhere to lifelong immunosuppressant drug regimens, the side effects of which include increased risk for life-threatening infections.

European drug regulations aim for a patient-centered approach, including involving patients in the pharmacovigilance (PV) systems. However many patient organizations have little experience on how they can participate in PV activities. Aim The aim of this study was to understand patient organizations’ perceptions of PV, the barriers they face when implementing PV activities, and their interaction with other stakeholders and suggest methods for the stimulation of patient organizations as promoters of PV. Methods A sequential qualitative method study was conducted and integrated with the quantitative study performed by Matos, Weits, and van Hunsel to complete a mixed method study. Results The qualitative phase expands the understanding of the quantitative results from a previous study by broadening the knowledge on external barriers and internal barriers that patient organizations face when implementing PV activities. The strategies to stimulate patient-organization participation are the creation of more awareness campaigns, more research that creates awareness, education for patient organizations, communication of real PV examples, creation of a targeted PV system, creation of a PV communication network that provides feedback to patients, improvement of understanding of all stakeholders, and a more proactive approach from national competent authorities. Conclusion Both study phases show congruent results regarding patients’ involvement and the activities patient organizations perform to promote drug safety. Patient organizations progressively position themselves as stakeholders in PV, carrying out many activities that stimulate awareness and participation of their members in drug safety, but still face internal and external barriers that can hamper their involvement. UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones Farmacéuticas (INIFAR)

In Flanders (Belgium), there is a growing awareness among city administrations and governments to turn their cities into smart cities by transforming their policy decisions into evidence-based and data-driven policymaking. Nonetheless, many Flemish cities still face several challenges related to the integration of data-driven policy evaluation research at different stages of their policy making processes. For that reason, the ‘Smart Retail Dashboard’-project was set up, which aims to develop a dashboard for helping Flemish cities in transforming their retail policies into data-driven policies. This paper reports on the initial findings of this project. The most important finding is the varying degrees of maturity across cities regarding their smart retail policies. This is illustrated by the current state of data-driven policy making in the retail sector in Flanders. Subsequently we provide an overview of the current challenges reported by mature and less mature cities, which range from the cost and the usability of data to the analysis and interpretation of such data. We discuss how a Smart Retail Dashboard could provide answers to these challenges. This discussion helps city administrations to transform their policymaking processes into data-driven processes and dashboard developers to optimise their development processes.

Wire-shaped supercapacitors (WSCs) are promising in wearable electronics but still face critical challenges of limited energy density. Nanostructured materials are dominant in high-performance active materials for improving energy density but are generally limited to wire-shaped electrodes (WSEs) with low mass loading (0.5 mg cm

La implementación y aplicación de las Tecnologías de la Información y Comunicación en la educación enfrenta aún muchos desafíos; consideradas como herramientas que dan soporte al proceso enseñanza-aprendizaje presencial, ofrecen excelentes escenarios para que su efectividad y eficacia mejoren la calidad de la educación superior. El objetivo de esta investigación es analizar cómo la aplicación de estas herramientas tecnológicas dentro del aula de clases mejora en el rendimiento académico promedio de los estudiantes que cursaron la materia de Matemáticas Financieras de la carrera de Administración de Empresas de la Universidad de Guayaquil en el periodo académico 2018 – 2019 ciclos I y II, para esto se hizo un análisis descriptivo de dos muestras independientes y una aplicación de la regla de Bayes. Los resultados que arrojó esta investigación concluyen que los estudiantes que acceden y aplican herramientas tecnológicas dentro del aula tienen un mejor rendimiento académico que aquellos estudiantes que no lo aplican.

While the demands for greater engagement in science in general and regulatory science in particular have been steadily increasing, we still face limited understanding of the empirical resonance of these demands. Against this context, this paper presents findings from a recent study of a potential participatory opening of the German Federal Institute for Risk Assessment (“Bundesinstitut für Riskobewertung” [BfR]), a prominent regulatory scientific organization in the field of risk governance. Drawing upon quantitative surveys of the public and selected professional experts as well as in-depth qualitative expert interviews, we identify a general support for greater engagement in science-based risk assessment. However, we also find significant contestation concerning its potential enactment and its normative and strategic merit. Underlying these contestations, we identify the persistence of a normal view of science and decisionist understanding of risk assessment, which create conflicting legitimacy demands for BfR and other regulatory scientific organizations. Together with concerns about imbalances in the power to participate, especially in highly specialized engagement processes, these pose significant challenges for the institutionalization of more participatory practices.

Two-dimensional Fourier transform (2D FT) spectroscopy is an important technology that developed in recent decades and has many advantages over other ultrafast spectroscopy methods. Although 2D FT spectroscopy provides great opportunities for studying various complex systems, the experimental implementation and theoretical description of 2D FT spectroscopy measurement still face many challenges, which limits their wide application. Recently, the 2D FT spectroscopy reaches maturity due to many new developments which greatly reduces the technical barrier in the experimental implementation of the 2D FT spectrometer. There have been several different approaches developed for the optical design of the 2D FT spectrometer, each with its own advantages and limitations. Thus, a procedure to help an experimentalist to build a 2D FT spectroscopy experimental apparatus is needed. This tutorial review is intending to provide an accessible introduction for a beginner to build a 2D FT spectrometer.

Clustering is an important unsupervised learning method in machine learning and data mining. Many existing clustering methods may still face the challenge in self-identifying clusters with varying shapes, sizes and densities. To devise a more generic clustering method that considers all the aforementioned properties of the natural clusters, we propose a novel clustering algorithm named Anchor Points based Clustering (APC). The anchor points in APC are characterized by having a relatively large distance from data points with higher densities. We take anchor points as centers to obtain intermediate clusters, which can divide the whole dataset more appropriately so as to better facilitate further grouping. In essence, based on the analysis of the identified anchor points, the relationship among the corresponding intermediate clusters can be better revealed. In short, the difference in local densities (densities within neighboring data points) of the anchor points characterizes their different properties, that is to say, all the intermediate clusters may fall into one or multiple identified levels with different densities. Finally, based on the properties of anchor points, APC spontaneously chooses the appropriate clustering strategies and reports the final clustering results. To evaluate the performances of APC, we conduct experiments on twelve two-dimensional synthetic datasets and twelve multi-dimensional real-world datasets. Moreover, we also apply APC to the Olivetti Face dataset to further assess its effectiveness in terms of face recognition. All experimental results indicate that APC outperforms four classical methods and two state-of-the-art methods in most cases. AI Singapore Ministry of Health (MOH) National Research Foundation (NRF) Accepted version This research is supported by the National Natural Science Foundation of China (61772227,61572227), the Science & Technology Development Founda- tion of Jilin Province (20180201045GX) and the Social Science Foundation of Education Department of Jilin Province (JJKH20181315SK). This research is also supported, in part, by the National Research Foundation Singapore under its AI Singapore Programme (Award Number: AISG-GC-2019-003), the Singapore Ministry of Health under its National Innovation Challenge on Active and Confident Ageing (NIC Project No. MOH/NIC/COG04/2017), and the Joint NTU-WeBank Research Centre on Fintech, Nanyang Technological University, Singapore.

This review was conducted to gain insight into the history, present and future of bariatric and/or metabolic surgery and endoscopic treatments of obesity. The challenges that have been overcome, the challenges we still face and our recommendations for the future are discussed. Over the last few decades, a number of treatment strategies have emerged for the treatment of obesity. Both endoscopic and surgical options are available and they lead to significant weight loss and comorbidity reduction. However, to remain a credible treatment alternative to the obesity pandemic, we need to perform these procedures in much larger numbers than we currently do. Even though significant gains have been made in reducing the morbidity and mortality of surgical interventions, there is further room for improvement, especially when it comes to long-term issues. Due to its impact on almost every single organ system in the human body, bariatric surgery has attracted the attention of academics from a variety of medical disciplines. This has led to a rapidly enlarging body of high-quality scientific literature, supporting its wider use and cost-effectiveness. Despite the advances made in bariatric surgery, the criteria determining suitability of patients for bariatric surgery in most parts of the world are still based on a consensus agreed upon in the USA in 1991. There is a need to formulate some new consensus and guidelines that would allow for a significant expansion of the pool of patients that can be offered these procedures.

Women football broadcasters still face challenges in obtaining careers and advancing professionally. The researchers sought to bridge the gap in research to better understand the audience’s percept...

Muharani L, Yazid M, Adriani D. 2020. Evaluation of smallholder oil palm plantation sustainability in tidal lowlands of Pulau Rimau Sub-District of Banyuasin Regency. Jurnal Lahan Suboptimal: Journal of Suboptimal Lands 9(1): 80-88.Oil palm is one of the estate commodities that has an important role in the economic activities of the people. Smallholder oil palm plantation as part of the estate still face several constraints, including lack of productivity, institutional inactivity, plantation management that do not meet the standard, farmers' lack of knowledge, and difficulty in obtaining credit. Due to these constraints, oil palm plantation sustainability is put into priority. Oil palm development issues are discussed not only on the economic aspects but also on the environmental aspects. This research is aimed at analyzing the level of oil palm sustainability and evaluating the condition of smallholder oil palm plantations according to the stages of plant development. This research used survey method and was carried out in tidal lowlands of Pulau Rimau Sub-district, Banyuasin Regency in August-September 2019. Smallholder oil palm households were selected using proportionate stratified random sampling. The results showed that there were three aspects of sustainability that were in low criteria, namely institutional, social, and technical aspects. Whereas, economic and environmental aspects were in medium criteria. The average sustainability value of non productive and productive oil palm plantations was in low criteria. Smallholder oil palm households were expected to understand and follow the standards set by ISPO, with the support from local governments and related agencies.

Do our neurodiverse colleagues still face a world of isolation, stonewalling and discrimination?

The purpose of this study is to identify how accounting and finance professionals perceive the leadership styles adopted by their male and female leaders. In order to analyze the hypothesis that there are differences in leadership styles between men and women, a bibliographical review of leadership style and contingency theories was carried out. For the data collection, an electronic survey was carried out, using an adapted version of the EAEG (Escala de Avaliação do Estilo Gerencial) scale proposed by Melo (2004), totaling 278 valid responses. Although the general hypothesis has been rejected, the results indicate that women still face differences in their chances of assuming leadership positions.

A major problem we still face today in this connected world, where more than 100 Quadrillion bytes of data are created every day, accelerating with the growth of the Internet of Things (IoT), needs...

Despite much effort, synthetic small diameter vascular grafts still face limited success due to vascular wall thickening known as intimal hyperplasia (IH). Compliance mismatch between graft and native vessels has been proposed to be one of a key mechanical factors of the synthetic vascular grafts that could contribute to the formation of IH. While many methods have been developed to determine compliance both in vivo and in vitro, the effects of compliance mismatch still remain uncertain. This review aims to explain the biomechanical factors that are responsible for the formation and development of IH and their relationship with compliance mismatch. Furthermore, this review will address the current methods used to measure compliance both in vitro and in vivo. Lastly, current limitations in understanding the connection between the compliance of the vascular grafts and the role it plays with the development and progression of IH will be discussed.

Lesbians are pursuing parenthood in greater numbers than ever, but their family-building journey is significantly more challenging than it is for heterosexual couples. Extensive research has debunked the myth that children raised in lesbian families show higher rates of psychopathology or difficulty with adjustment. Despite this, lesbians pursuing parenthood still face overt and subtle discrimination in society generally and in healthcare specifically. They must engage in a multifaceted decision-making process, navigate a more complex logistical process, and cope with greater financial expense. The aim of this chapter is to outline the unique experiences and needs of lesbians becoming parents, identify barriers to care, and highlight strategies to address them.

The objective of this research is to assess the impact of market orientation on business performance in the petrol stations in Timor-Leste. In our study, we used questionnaire from previous authors to collect data. Hypothesis was tested using Smart-PLS 3.0. The result shows that market orientation reflected by consumer orientation, competitor orientation, and inter-functional coordination had a positive and significant impact on business performance. This study contributes to the literature on market orientation and business performance which still face inconsistent results from previous researches. This study is also expected to be considered by the government in developing policies related to small and medium enterprise (SMEs) management. In the middle of this, market orientation could be one determinant factor to be considered as strategic fitness to improve SME’s financial and nonfinancial performances in Timor-Leste. In addition, SME’s managers could look at market orientation as a business strategy to improve their business performance.

Partner of the community partnership program on this study is a group of cassava chips processing located in the village of Ibra, Southeast Maluku district. Partners can be classified into economically productive societies, but they still face many problems in the production and marketing process. The purpose of this activity was to increase the income of the cassava chip processing group partners, and to increase the added value of cassava root by adding seaweed into high fiber cassava chips. The activity was carried out in three stages, firstly producing cassava flour with an improved press method, secondly producing cassava plates, and thirdly producing cassava krispi seaweed chips(SKRL). The results of the activity showed that SKRL products were quite attractive to consumers. With the improvement of the form, taste and packaging of SKRL had become one of the typical souvenirs of the Kei community. The marketing strategy adopted was to increase packaging using two types of packaging, namely primary packaging with propilen plastic (PP) and secondary packaging using paper boxes. Seaweed cassava produced was very preferred by consumers because it tastes good and crispy. The use of a screw press produced cassava chips with very low HCN levels so it is very safe to consume. The partner's income increased, the sales during the 6 months of activities reached 600 boxes with a value of IDR 10,000,000.

Osteoarthritis (OA) is a joint degenerative disease, which is prominent in the middle-aged and elderly population, often leading to repeated pain in the joints of patients and seriously affecting the life quality of patients. At present, the treatment of OA mainly depends on the surgery and drug treatment. Nevertheless, these treatments still face many problems, such as surgical safety, complications, and drug side effects. Exosomes can be secreted and released by multiple cell types and have lipid bilayer membranes and contain abundant biological molecules, including proteins, lipids, and nucleic acids. Moreover, exosomes play a critical role in local and distal intercellular and intracellular communication. In recent years, several studies have found that exosomes can regulate the progression of OA and have a potential efficacy for OA treatment. Thus, in this article, we summarize and review the relevant research of exosomes in OA and emphasize the importance of exosomes in the development of OA.

The present study was conducted in the state of Maharashtra with an objective to analyze the farmers’ perceptions on Farmer Producer Companies (FPCs) in the state of Maharashtra, India. Indian farmers still face many challenges as majority of them are small and marginal farmers accounting for more than 86 per cent of the farming population. Member farmers were selected as sample respondents for the study. The results of the present study revealed that after association with producer company, there has been an improvement in the yields as stated by 96.66 per cent of the farmers under category I, 82.73 per cent of the farmers in category II and 77.50 per cent of the farmers under category III. It was also observed that there was an improvement in the quality of the produce and a majority of the farmers were happy with the price for their produce received after joining FPCs. It was also interesting to note that the problems faced by the farmers were different in all the three categories of FPCs. However, the common problem faced by the farmers in category II and III was manipulation of quotas and quality specifications by some of the companies. The SWOT analysis revealed that the major strengths identified by the farmers were more or less same in the selected FPCs like provision of inputs and production services, higher yields due to better management, minimizing the prices risk and better bargaining for small holders. The adoption of new production technology was a common weakness and pro-government policy was an important opportunity of all the producer companies as perceived by the farmers. The common threats to the producer companies of all categories include problem of sustaining long term operations, cut throat competition among companies, social and cultural constraints.

We estimate the potential remaining COVID-19 burden in 19 European countries by estimating the proportion of each country’s population that has acquired immunity to severe disease through infection or vaccination. Our results suggest that many European countries could still face a substantial burden of hospitalisations and deaths, particularly those with lower vaccination coverage, less historical transmission, and/or older populations. Continued non-pharmaceutical interventions and efforts to achieve high vaccination coverage are required in these countries to limit severe COVID-19 outcomes.

In this era, use of credit has increased extensively. People are using credit cards more frequently in their daily lives. Millions of dollars were lost in forgery, however fraud detection methods have been developed to fix such types of problems. However, Nevertheless, we still face such problems through imbalance data. There is a requirement for a centralized claims database to collect views of holistic view of fraudulent characteristic behaviour. Credit card supervised learning are widely used to detect fraud based on the assumption that the pattern of fraud would depend on past transaction. This paper will give succinct understanding to avoid such problems. And will elaborate how we can use unsupervised techniques in forgery or fraud detection. In the beginning all the supervised techniques are given, types of anomalies and classification of anomaly detection techniques are given. In addition to that a project is done with the use of raw bank data and forgery is detected with unsupervised techniques.

With the rise of Deep Learning (DL), numerous DL-based SAR ship detectors, represented by Faster R-CNN, is constantly breaking the record of detection accuracy. However, these detectors still face huge challenges in modeling the geometric transformation of shape-changeable ships, due to their used conventional convolution kernels whose structure is fixed. Therefore, to address this problem, we propose an improved Faster R-CNN by using deformable convolution kernels for SAR ship detection. We substitute some conventional shape-changeless convolution kernels in Faster R-CNN with deformable convolution ones that can adaptively learn additional 2-D offsets of the raw convolution kernels, to better model the geometric transformation of shape-changeable ships. Finally, the experimental results on the open SAR Ship Detection Dataset (SSDD) reveal that our improved Faster R-CNN achieves a 2.02% mean Average Precision (mAP) improvement than the raw Faster R-CNN.

The potential harms and drawbacks of automated decision making has become a challenge as data science blends into our lives. In particular, fairness issues with deployed machine learning models have drawn significant attention from the research community. Despite the myriad of algorithmic fairness work in various research communities, in practice data scientists still face many roadblocks in ensuring the fairness of their machine learning models. This is primarily because there does not exist an end-to-end system that guides the users in building a fair machine learning model in a responsible way from model auditing, to model explanation, to bias mitigation. We propose a explorative model building system FairRover for responsible fair model building. FairRover guides users in (1) discovering the potential biases in the model; (2) providing explanation to the discovered biases so as to help users in understanding potential causes of the biases; and (3) mitigating the most important biases selected by the users. Because of the impossibility theorem of fairness, and the well-known trade-off between fairness and accuracy, it is generally impossible to achieve a completely fair and accurate machine learning model. Therefore, this responsible model building process is naturally performed iteratively until a satisfying trade-off is reached. Human users are involved in the loop to make various decisions guided by FairRover. We demonstrate a case study on the Adult Census dataset, which shows how FairRover guides users in iteratively building a fair income prediction model in a responsible way. We discuss the current limitations of FairRover and future work.

Optical microcavities have become an attractive platform for precision measurement with merits of ultrahigh sensitivity, miniature footprint and fast response. Despite the achievements of ultrasensitive detection, optical microcavities still face significant challenges in the measurement of biochemical and physical processes with complex dynamics, especially when multiple effects are present. Here we demonstrate operando monitoring of the transition dynamics of a phase-change material via a self-referencing optofluidic microcavity. We use a pair of cavity modes to precisely decouple the refractive index and temperature information of the analyte during the phase-transition process. Through real-time measurements, we reveal the detailed hysteresis behaviors of refractive index during the irreversible phase transitions between hydrophilic and hydrophobic states. We further extract the phase-transition threshold by analyzing the steady-state refractive index change at various power levels. Our technology could be further extended to other materials and provide great opportunities for exploring on-demand dynamic biochemical processes., Operando monitoring transition dynamics of responsive polymer via a self-referencing optofluidic microcavity is demonstrated. The refractive index and temperature information of the analyte during the phase-transition process are precisely decoupled.

As current therapies for cardiovascular disease (CVD), predominantly based on lipid lowering, still face an unacceptable residual risk, novel treatment strategies are being explored. Besides lipids, inflammatory processes play a major role in the pathogenesis of atherosclerosis, the underlying cause of the majority of CVD. The first clinical trials targeting the interleukin-1β-inflammasome axis have shown that targeting this pathway is successful in reducing cardiovascular events but did not decrease overall CVD mortality. Hence, novel and improved immunotherapeutics to treat CVD are being awaited. In this review we highlight novel immunotherapeutic approaches in CVD as well as future challenges ahead.

Technology-enhanced methods of dietary assessment may still face common limitations of self-report. This study aimed to assess foods and beverages omitted when both a 24 h recall and a smartphone app were used to assess dietary intake compared with camera images. For three consecutive days, young adults (18–30 years) wore an Autographer camera that took point-of-view images every 30 seconds. Over the same period, participants reported their diet in the app and completed daily 24 h recalls. Camera images were reviewed for food and beverages, then matched to the items reported in the 24 h recall and app. ANOVA (with post hoc analysis using Tukey Honest Significant Difference) and paired t-test were conducted. Discretionary snacks were frequently omitted by both methods (p &lt, 0.001). Water was omitted more frequently in the app than in the camera images (p &lt, 0.001) and 24 h recall (p &lt, 0.001). Dairy and alternatives (p = 0.001), sugar-based products (p = 0.007), savoury sauces and condiments (p &lt, 0.001), fats and oils (p &lt, 0.001) and alcohol (p = 0.002) were more frequently omitted in the app than in the 24 h recall. The use of traditional self-report methods of assessing diet remains problematic even with the addition of technology and finding new objective methods that are not intrusive and are of low burden to participants remains a challenge.

Repairing tooth defects with dental resin composites is currently the most commonly used method due to their tooth-colored esthetics and photocuring properties. However, the higher than desirable failure rate and moderate service life are the biggest challenges the composites currently face. Secondary caries is one of the most common reasons leading to repair failure. Therefore, many attempts have been carried out on the development of a new generation of antimicrobial and therapeutic dental polymer composite materials to inhibit dental caries and prolong the lifespan of restorations. These new antimicrobial materials can inhibit the formation of biofilms, reduce acid production from bacteria and the occurrence of secondary caries. These results are encouraging and open the doors to future clinical studies on the therapeutic value of antimicrobial dental resin-based restoratives. However, antimicrobial resins still face challenges such as biocompatibility, drug resistance and uncontrolled release of antimicrobial agents. In the future, we should focus on the development of more efficient, durable and smart antimicrobial dental resins. This article focuses on the most recent 5 years of research, reviews the current antimicrobial strategies of composite resins, and introduces representative antimicrobial agents and their antimicrobial mechanisms.

Background Most patients with head and neck cancer successfully undergo oncologic resection followed by free or local flap reconstruction, depending on the tumor’s size and location. Despite effective curative resection and reconstruction, head and neck cancer patients still face a high risk of recurrence and the possibility of a second primary cancer. Moreover, surgeons hesitate to perform sequential reconstruction following curative resection for several reasons. Few large-scale studies on this subject are available. Therefore, we retrospectively evaluated the outcome of sequential head and neck reconstruction to determine the possible risks. Methods In total, 467 patients underwent head and neck reconstruction following cancer resection at our center from 2008 to 2017. Of these cases, we retrospectively reviewed the demographic and clinical features of 58 who had sequential head and neck reconstruction following resection of recurrent cancer. Results Our study included 43 males (74.1%) and 15 females (25.9%). The mean age at the initial operation was 55.4±15.3 years, while the mean age at the most recent operation was 59.0±14.3 years. The interval between the first and second operations was 49.2±62.4 months. Twelve patients (20.7%) underwent surgery on the tongue, and 12 (20.7%) had procedures on the oropharynx. Thirty-four patients (58.6%) received a sequential free flap reconstruction, and 24 patients (41.4%) were treated using locoregional flaps. No cases of flap failure occurred. Conclusions Our findings suggest that patients who need additional operations with recurrent head and neck cancer could optimally benefit from sequential curative resections and reconstructions.

The article focuses on a few central issues of dialogic competence-in-performance which are still beyond the reach of models of Artificial Intelligence (AI). Learning machines have made an amazing step forward but still face barriers which cannot be crossed yet. Linguistics is still described at the level of Chomsky’s view of language competence. Modelling competence-in-performance requires a holistic model, such as the Mixed Game Model (Weigand 2010), which is capable of addressing the challenge of the ‘architecture of complexity’ (Simon 1962). The complex cannot be ‘the ontology of the world’ (Russell and Norwig 2016). There is no autonomous ontology, no hierarchy of concepts; it is always human beings who perceive the world. ‘Anything’, in the end, depends on the human brain.