Search

Business cloud workflows are often designed with multiple time constraints for timely response to business requests. To ensure on-time completion of workflow instances, workflow temporal conformance state needs to be constantly monitored and verified at runtime. Considering the fact that there are a large number of workflow instances running in a parallel fashion in many business scenarios, conventional verification approaches for time-related properties using such as temporal logic or timed Petri nets are not feasible due to the limitation of low efficiency at runtime. To address this issue, we propose a new approach to automated runtime verification of temporal conformance for parallel workflow instances in a cloud environment. Instead of using response time to verify temporal conformance of every single workflow as in conventional strategies, workflow throughput is employed as the performance measurement to efficiently monitor a large number of parallel workflow instances. On this basis we present a novel conformance verification strategy. This strategy considers the effect of time delay propagation in the cloud workflow systems to accurately verify workflow runtime temporal conformance. Our verification strategy is implemented in a prototype cloud workflow system and the evaluation results show that it outperforms the state-of-the-art workflow temporal verification strategy.

Background Levels of inflammatory markers are elevated in patients with psychological disorders. However, anti-psychological drugs have an effect on proinflammatory cytokine production and disturb their relationship. Limited evidence focuses on the inflammatory marker profile of psychological status before treatment. This study aimed to investigate the inflammatory biomarker profiles of psychological treatment-naive individuals. Methods We included 790 psychological treatment-naive individuals from a longitudinal cohort study of Midlife in the United States (MIDUS). Symptoms of depression, anxiety, and stress were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) subscales, the Social Anxiety Scale (STAI), and Liebowitz Social Anxiety Scale (LSAS), the Perceived Stress Scale (PSS), respectively. Results Spearman correlation analysis showed that a higher CESD total score was correlated with higher CRP (p=0.009), IL-6 (p=0.007), fibrinogen (p=0.036), E-selectin (p=0.018), ICAM-1 (p=0.013), and IL-8 (p=0.05) levels. Multivariate linear regression analysis showed that the CESD total score was positively associated with the levels of IL-6 (p=0.024) after adjustments. Moreover, the perceived stress score (PSS) was negatively associated with the levels of IL-8 (p=0.025). However, these associations were not significant after multiple testing (p=0.088, 0.091, respectively). Limitations The casual relationship cannot be drawn due to the cross-sectional design Conclusion Overall, our results suggested IL-6 and IL-8 might play a important role in the pathogenesis of psychological disorder. Larger and longitude studies are needed to confirm our results.

Supplemental Digital Content is available in the text., It remains debated whether pulse pressure is associated with left ventricular traits and adverse outcomes over and beyond mean arterial pressure (MAP) in patients with heart failure (HF) with preserved ejection fraction. We investigated these associations in 3428 patients with HF with preserved ejection fraction (51.5% women; mean age, 68.6 years) enrolled in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist). We computed association sizes and hazards ratios with 1-SD increase in MAP and pulse pressure. In multivariable-adjusted analyses, association sizes (P≤0.039) for MAP were 0.016 cm and 0.014 cm for septal and posterior wall thickness, −0.15 for E/A ratio, −0.66 for E/e′, and −0.64% for ejection fraction, independent of pulse pressure. With adjustment additionally applied for MAP, E/A ratio and longitudinal strain increased with higher pulse pressure with association sizes amounting to 0.067 (P=0.026) and 0.40% (P=0.023). In multivariable-adjusted analyses of both placebo and spironolactone groups, lower MAP and higher pulse pressure predicted the primary composite end point (P≤0.028) and hospitalized HF (P≤0.002), whereas MAP was also significantly associated with total mortality (P≤0.007). Sensitivity analyses stratified by sex, median age, and region generated confirmatory results with exception for the association of adverse outcomes with pulse pressure in patients with age ≥69 years. In conclusion, the clinical application of MAP and pulse pressure may refine risk estimates in patients with HF with preserved ejection fraction. This finding may help further investigation for the development of HF with preserved ejection fraction preventive strategies targeting pulsatility and blood pressure control.

Current cryptocurrencies, such as Bitcoin and Ethereum, enable anonymity by using public keys to represent user accounts. On the other hand, inferring blockchain account types (i.e., miners, smart contracts or exchanges), which are also referred to as blockchain identities, is significant in many scenarios, such as risk assessment and trade regulation. Existing work on blockchain deanonymization mainly focuses on Bitcoin that supports simple transactions of cryptocurrencies. As the popularity of decentralized application (DApp) platform blockchains with Turing-complete smart contracts, represented by Ethereum, identity inference in blockchain faces new challenges because of user diversity and complexity of activities enabled by smart contracts. In this paper, we propose $I^2 GL$ , an identify inference approach based on big graph analytics and learning to address these challenges. Specifically, $I^2 GL$ constructs a transaction graph and aims to infer the identity of nodes using the graph learning technique based on Graph Convolutional Networks. Furthermore, a series of enhancement has been proposed by exploiting unique features of blockchain transaction graph. The experimental results on Ethereum transaction records show that $I^2 GL$ significantly outperforms other state-of-the-art methods.

Deep neural networks have been widely applied to hyperspectral image (HSI) classification areas, in which recurrent neural network (RNN) is one of the most typical networks. Most of the existing RNN-based classifiers treat the spectral signature of pixels as an ordered sequence, in which only unidirectional correlation along the wavelength direction of adjacent bands is considered. However, each band image is related to not only its preceding band images but also its successive band images. In order to fully explore such bidirectional spectral correlation within an HSI, in this article, a bidirectional long short-term memory (Bi-LSTM)-based network is designed for HSI classification. Moreover, a spatial-spectral attention mechanism is designed and implemented in the proposed Bi-LSTM network to emphasize the effective information and reduce the redundant information among spatial-spectral context of pixels, by which the performance of classification can be greatly improved. Experimental results over three benchmark HSIs, i.e., Salinas Valley, Pavia Centre, and Pavia University, demonstrate that our proposed Bi-LSTM obviously outperforms several state-of-the-art unidirectional RNN-based classification algorithms. Moreover, the proposed spatial-spectral attention mechanism can further improve the classification accuracy of our proposed Bi-LSTM algorithm by effectively weighting spatial and spectral context of pixels. The source code of the proposed Bi-LSTM algorithm is available at https://github.com/MeiShaohui/Attention-based-Bidirectional-LSTM-Network.

Consumers’ choices about health products are heavily influenced by public information, such as news articles, research articles, online customer reviews, online product discussion, and TV shows. Dr. Oz, a celebrity physician, often makes medical recommendations with limited or marginal scientific evidence. Although reputable news agencies have traditionally acted as gatekeepers of reliable information, they face the intense pressure of “the eyeball game.” Customer reviews, despite their authenticity, may come from deceived consumers. Therefore, it remains unclear whether public information sources can correct the misleading health information. In the context of over-the-counter weight loss products, the authors carefully analyze the cascading of information post endorsement. The analysis of extensive textual content with deep-learning methods reveals that legitimate news outlets respond to Dr. Oz's endorsement by generating more news articles about the ingredient; on average, articles after the endorsement contain higher sentiment, so news agencies seem to amplify rather than rectify the misleading endorsement. The finding highlights a serious concern: the risk of hype news diffusion. Research articles react too slowly to mitigate the problem, and online customer reviews and product discussions provide only marginal corrections. The findings underscore the importance of oversight to mitigate the risk of cascading hype news.

Key Points A risk score model (BATAP) was established to facilitate the prognostic stratification of patients with TA-TMA following allo-HSCT.The BATAP prognostic model showed robust predictive capacity through internal and external temporal validation., Visual Abstract, Transplant-associated thrombotic microangiopathy (TA-TMA) is a potentially life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Information on markers for early prognostication remains limited, and no predictive tools for TA-TMA are available. We attempted to develop and validate a prognostic model for TA-TMA. A total of 507 patients who developed TA-TMA following allo-HSCT were retrospectively identified and separated into a derivation cohort and a validation cohort, according to the time of transplantation, to perform external temporal validation. Patient age (odds ratio [OR], 2.371; 95% confidence interval [CI], 1.264-4.445), anemia (OR, 2.836; 95% CI, 1.566-5.138), severe thrombocytopenia (OR, 3.871; 95% CI, 2.156-6.950), elevated total bilirubin (OR, 2.716; 95% CI, 1.489-4.955), and proteinuria (OR, 2.289; 95% CI, 1.257-4.168) were identified as independent prognostic factors for the 6-month outcome of TA-TMA. A risk score model termed BATAP (Bilirubin, Age, Thrombocytopenia, Anemia, Proteinuria) was constructed according to the regression coefficients. The validated c-statistic was 0.816 (95%, CI, 0.766-0.867) and 0.756 (95% CI, 0.696-0.817) for the internal and external validation, respectively. Calibration plots indicated that the model-predicted probabilities correlated well with the actual observed frequencies. This predictive model may facilitate the prognostication of TA-TMA and contribute to the early identification of high-risk patients.

Aims To identify the metabolic pattern and prognostic predictors in anti‐gamma‐aminobutyric‐acid B (GABAB) receptor encephalitis using 18F‐fluorodeoxy‐glucose positron emission tomography (18F‐FDG‐PET). Methods Twenty‐one patients diagnosed anti‐GABAB receptor encephalitis who underwent 18F‐FDG‐PET at first hospitalization were retrospectively reviewed. 18F‐FDG‐PET images were analyzed in comparison with controls. Further group comparisons of 18F‐FDG‐PET data were carried out between prognostic subgroups. Results 18F‐FDG‐PET was abnormal in 81% patients with anti‐GABAB receptor encephalitis and was more sensitive than MRI (81% vs. 42.9%, p = 0.025). Alter limbic lobe glucose metabolism (mostly hypermetabolism) was observed in 14 patients (66.7%), of whom 10 (10/14, 71.4%) demonstrated hypermetabolism in the medial temporal lobe (MTL). Group analysis also confirmed MTL hypermetabolism in association with relative frontal and parietal hypometabolism was a general metabolic pattern. After a median follow‐up of 33 months, the group comparisons revealed that patients with poor outcome demonstrated increased metabolism in the MTL compared to those with good outcome. Conclusion 18F‐FDG‐PET may be more sensitive than MRI in the early diagnosis of anti‐GABAB receptor encephalitis. MTL hypermetabolism was associated with relative frontal or parietal hypometabolism and may serve as a prognostic biomarker in anti‐GABAB receptor encephalitis., First, we revealed pronounced MTL hypermetabolism detected by semi‐quantitative brain 18F‐FDG‐PET in patients with anti‐GABAB receptor encephalitis compared to controls, and 18F‐FDG‐PET should be considered when patients with normal MRI in suspected anti‐GABAB receptor encephalitis; second, MTL hypermetabolism may be a sensitive diagnostic and prognostic biomarker for anti‐GABAB receptor encephalitis.

To evaluate whether skin tests are suitable to predict the allergy reactions induced by Chinese herbal injections (CHIs). The skin tests including skin prick tests (SPT), intradermal tests (IDT) and provocation tests including subcutaneous tests and intravenous tests were administered to 249 healthy subjects and 180 allergic patients for 3 CHIs, including ginkgolide injection, diterpene ginkgolide meglumine injection and Salvianolate lyophilized injection. The results of the provocation tests were used as the “gold standard” to determine the sensitivity and specificity of the skin tests. The results did not show any significant differences between the healthy and allergy groups in both skin tests and provocation tests (P>0.05). The specificities of SPT and IDT were 0.976 and 0.797, respectively, and the sensitivities of both SPT and IDT were 0. Skin tests are insufficient to predict the likelihood of allergic reactions resulting from CHIs. (ChiCTR-CPC-15006921)

Two-dimensional material MoS2 has excellent optical and electrical characteristics and a controllable energy band structure, leading to a high potential value for designing photodetectors. In this ...

This paper presents the numerical analysis of prestressed reinforced concrete (PRC) beams strengthened with near-surface mounted (NSM) carbon fiber reinforced polymers (CFRP). ABAQUS finite element software was used to simulate the existing test beams to investigate the flexural behaviors of PRC beams strengthened with NSM CFRP strips. The finite element model of beams strengthened with NSM CFRP strips was established. The finite element calculation results were compared with the experimental results to verify the accuracy and effectiveness of the model. Based on this model, the influences of concrete strength grade and amount of CFRP strips on the flexural behaviors of directly strengthened beams and the cycle numbers and overload amplitude on the flexural behaviors of damaged strengthened beam were further analyzed, and the load-carrying capacity calculation formula of PRC beam strengthened with NSM CFRP strips was established. The results showed that the simulation results and the theoretical calculation were consistent with the test results. With the increase of concrete strength grade and amount of CFRP strips, the ultimate load of directly strengthened beams increased significantly, with a maximum increase of 21.3% and 23.0%, respectively. When the concrete strength grade exceeded C50, the improvement of the ultimate load was limited. When the overload amplitude was less than 60% of the ultimate load, the cycle numbers (within 500 times) had little effect on the yield load, ultimate load, and deformation. When the overload amplitude was higher than 60% of the ultimate load, the deformation increased, and the ultimate load decreased with the increase of the cycle numbers. The larger the overload amplitude, the smaller the ultimate load, and the larger the deformation under the same cycle numbers.

Objective To report the 30-day outcomes of patients with perioperative SARS-CoV-2 infection undergoing surgery in the USA. Summary background data Uncertainty regarding the postoperative risks of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exists. Methods As part of the COVIDSurg multicenter study, all patients aged ≥17 years undergoing surgery between January 1 and June 30, 2020 with perioperative SARS-CoV-2 infection in 70 hospitals across 27 states were included. The primary outcomes were 30-day mortality and pulmonary complications. Multivariable analyses (adjusting for demographics, comorbidities, and procedure characteristics) were performed to identify predictors of mortality. Results A total of 1,581 patients were included; more than half of them were males (n= 822, 52.0%) and older than 50 years (n=835, 52.8%). Most procedures (n=1,261, 79.8%) were emergent, and laparotomies (n= 538, 34.1%). The mortality and pulmonary complication rates were 11.0 and 39.5%, respectively. Independent predictors of mortality included age ≥70 years (OR 2.46, 95% CI [1.65-3.69]), male sex (2.26 [1.53-3.35]), ASA grades 3-5 (3.08 [1.60-5.95]), emergent surgery (2.44 [1.31-4.54]), malignancy (2.97 [1.58-5.57]), respiratory comorbidities (2.08 [1.30-3.32]), and higher Revised Cardiac Risk Index (1.20 [1.02-1.41]). While statewide elective cancelation orders were not associated with a lower mortality, a sub-analysis showed it to be associated with lower mortality in those who underwent elective surgery (0.14 [0.03-0.61]). Conclusions Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.

Objective To compare the outcomes of mini percutaneous nephrolithotomy (mPNL) and retrograde intrarenal surgery (RIRS) for the management of 2-3 cm lower pole renal calculi (LPC) in obese patients. Patients and methods 120 obese patients with 2-3 cm LPC were randomly divided into mPNL group and RIRS group. Demography, clinical characteristics, perioperative complications, and stone free rate (SFR) were recorded. Stone-free status means no stone on computed tomography 3 months after surgery, or residual fragments were less than 3 mm. Results Baseline characteristics were similar between the two groups. The mean stone burden was 585.39 ± 131.06 mm2 in the mPNL group and 548.64 ± 123.55 mm2 in the RIRS group (P = 0.125). The SFR of mPNL group was significantly better than that of RIRS group (86.2% vs 61.4%, P = 0.002). Besides, the overall complication rate was 22.4% in the mPNL group and 7% in the RIRS group (P = 0.02). Patients performed with mPNL required longer length of hospital stay than those with RIRS (P = 0.001). There were no significant differences in operative time and stone composition between the two groups. Conclusion In our study, both mPNL and RIRS are safe and effective techniques for the treatment of 2-3 cm LPC in obese patients. Compared to RIRS, mPNL has better SFR at the expense of the higher incidence of complications and prolonged length of hospital stay.

The variable-speed hydropower generation technology of small hydropower plants has great potential because of abundant water resources and the low overall efficiency of the traditional constant speed plants. In this article, we investigate a converter-fed synchronous generator system capable of variable-speed operation (VSO) in the full power range. First, the hydraulic turbine, permanent magnet synchronous generator, and power electronic converter in the system are modeled, respectively. Next, based on the system model, a three-layer control system is proposed to realize the multiobjective control. To automatically track the optimal speed under different inflow rates, a modified “perturb and observe” algorithm is proposed, which is easy to implement and able to track the maximum power point quickly and accurately compared with the classical method. In addition, the proposed system is used to reconstruct one of the two parallel hydropower sets with the same hydrological conditions. And the performance tests and comparative experiments between the fixed-speed operation and VSO sets were extensively performed. It shows that a considerable increase in energy production is achieved in the VSO set.

In this study, we examine the impact of monetary incentives on user engagement and learning outcomes in massive open online courses (MOOCs). While MOOCs offer high-quality interactive educational resources to users worldwide, maintaining user engagement and enthusiasm on these platforms is a challenge. To address this issue, we conduct a field experiment in which users are given monetary incentives to engage in online learning. Our results show that those given a monetary incentive are more likely to submit homework and to gain higher homework grades. We further find that the effect persists even after we remove the monetary incentives and that it spills over into learning behavior in other courses in the same and subsequent semester. Overall, our findings suggest that monetary incentives counteract engagement decay and may help online users form persistent learning habits.

BACKGROUND Since December 2019, there have been cases of infectious pneumonia of unknown cause in Wuhan, Hubei Province, China. On January 12, 2020, the World Health Organization (WHO) named it COVID-19. There are few studies on the clinical characteristics of patients with COVID-19, and results vary widely in sample sizes. METHODS Chinese and English databases were searched with "Infectious pneumonia", "COVID-19", "CT", "SARS-COV-2", and "Diagnose" as keywords. Rev Man 5.3 software provided by the Cochrane system was used to assess the quality of the included literature. RESULTS Of the 18 included studies, ground-glass shadow was the most common computed tomography (CT) sign [95% confidence interval (CI): 0.79-0.97], followed by thickening of the blood vessels (95% CI: 0.63-0.78), and pleural thickening (95% CI: 0.02-0.15). Of the 18 studies, 12 reported that the lesions were externally subpleural (95% CI: 0.132-0.173), and 6 reported that the lesions were distributed in a single lobe (95% CI: 0.598-0.841). The heterogeneity test results showed that the morphology of the lesions was cord-like (95% CI: 0.092-0.172), grid-like (95% CI: 0.152-0.193), patchy (95% CI: 0.192-0.313), and nodular (95% CI: 0.591-0.745). DISCUSSION Ground-glass opacity was a typical CT manifestation for patients with infectious pneumonia, and CT signs were instrumental in diagnosing this disease.

BACKGROUND Myopia, as one of the common ocular diseases, often occurs in adolescence. In addition to the harm from itself, it may also lead to serious complications. Thus, prevention and control of myopia are attracting more and more attention. Previous research revealed that single-focal glasses and orthokeratology lenses (OK lenses) played an important part in slowing down myopia and preventing high myopia. AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens. METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients (124 eyes) wearing OK lenses for 1 year (group A) and 59 adolescent myopia patients (113 eyes) wearing frame glasses (group B). Refractive states of their retina were inspected through multispectral refraction topography. The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus. RESULTS Teenagers in groups A and B were divided into low myopia (0D - -3.00 D) and moderate myopia (-3.25D - -6.00 D), without statistical differences among gender and age. After 1-year treatment, the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B. According to the multiple linear analysis, the retinal defocus in the upper, lower, nasal, and temporal directions had almost the same effect on the total defocus. The amount of peripheral retinal defocus (15°-53°) in group A was significantly lower than that in group B. CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.

Highlights • KCNV2-associated retinopathy is a slowly progressive disease with early retinal changes, which are predominantly symmetric between eyes. • Disease course can be unpredictable and may severely affect children and young adults. • Findings suggest a potential window for intervention until 40 years of age, albeit with variability between patients due to macular atrophy., Purpose To describe the detailed retinal phenotype of KCNV2-associated retinopathy. Study design Multicenter international retrospective case series. Methods Review of retinal imaging including fundus autofluorescence (FAF) and optical coherence tomography (OCT), including qualitative and quantitative analyses. Results Three distinct macular FAF features were identified: (1) centrally increased signal (n = 35, 41.7%), (2) decreased autofluorescence (n = 27, 31.1%), and (3) ring of increased signal (n = 37, 44.0%). Five distinct FAF groups were identified based on combinations of those features, with 23.5% of patients changing the FAF group over a mean (range) follow-up of 5.9 years (1.9-13.1 years). Qualitative assessment was performed by grading OCT into 5 grades: (1) continuous ellipsoid zone (EZ) (20.5%); (2) EZ disruption (26.1%); (3) EZ absence, without optical gap and with preserved retinal pigment epithelium complex (21.6%); (4) loss of EZ and a hyporeflective zone at the foveola (6.8%); and (5) outer retina and retinal pigment epithelium complex loss (25.0%). Eighty-six patients had scans available from both eyes, with 83 (96.5%) having the same grade in both eyes, and 36.1% changed OCT grade over a mean follow-up of 5.5 years. The annual rate of outer nuclear layer thickness change was similar for right and left eyes. Conclusions KCNV2-associated retinopathy is a slowly progressive disease with early retinal changes, which are predominantly symmetric between eyes. The identification of a single OCT or FAF measurement as an endpoint to determine progression that applies to all patients may be challenging, although outer nuclear layer thickness is a potential biomarker. Findings suggest a potential window for intervention until 40 years of age.

Objective To observe whether wrist-ankle acupuncture can reduce propofol dosage in painless bronchoscopy of elderly patients or not and its potential effect mechanism. Methods A total of 60 patients undergoing painless bronchoscopy were randomized into a wrist-ankle acupuncture group and a control group, 30 cases in each one. In the wrist-ankle acupuncture group, wrist-ankle acupuncture was received and the needles were retained for 30 min before entering to the operating room. In the control group, no any intervention was provided. The patients in two groups all received venous administration of midazolam, nalorphine and lidocaine and target controlled infusion of propofol. When the patient's consciousness was lost and the eyelash reflex disappeared, bronchoscopy was performed and the propofol dosage was increased accordingly during operation. Propofol dosage, vital signs and occurrence of adverse reactions, bronchoscopist satisfaction, operation time and recovering time were recorded in the patients of two groups. Results Propofol dosage in induction period and the total dosage of propofol in the wrist-ankle acupuncture group were lower than those in the control group, indicating the statistical differences (both P Conclusion In painless bronchoscopy, wrist-ankle acupuncture may effectively reduce propofol dosage, alleviate respiratory suppression, reduce adverse reaction and shorten the recovering time in elderly patients.

As the urban population grows and the global economy develops, municipal solid waste management (MSWM) has become an increasingly prominent global issue. MSWM is particularly difficult in developing countries due to its high cost and time-consuming nature. The Environment-based design (EBD) can potentially contribute to global MSWM by reducing costs and increasing efficiency, especially in helping developing countries identify critical issues in MSWM. This paper uses and demonstrates the effectiveness and efficiency of the EBD method to analyze and identify critical issues in MSWM, using the city of Nairobi as a case study. This paper contains the first two of EBD's three activities: environment analysis and conflict identification, during the design problem period, design knowledge, and design solutions simultaneously and interdependently evolve as a part of the environment. The comparison with the existing literature confirms that the conclusions reached are, to some extent, reliable, time-saving, and less costly, which will offer a possibility to solve the problem of MSWM in impoverished areas.

Arsenic trioxide (ATO) combined with all trans retinoic acid (ATRA) is the first choice for the treatment of low and medium risk acute promyelocytic leukemia (APL). Clinical studies reported that the combination of ATO and ATRA could achieve a significant curative effect. However, the retinoic acid syndrome, serious drug resistance and the short half-life in vivo which lead to frequent and large dose administration limit the application of ATRA. In addition, the preparations of arsenic are conventional injections and tablets in clinic, which has poor patients' compliance caused by frequent long-term administration and serious side effects. In order to overcome the above limitations, a phospholipid phase separation gel (PPSG) loaded with ATO and ATRA was developed. ATO+ATRA-PPSG (AAP), as a biodegradable sustained-release delivery system, was the first achievement of co-delivery of hydrophilic ATO and lipophilic ATRA with high drug loading which is the main problem in the application of nano preparation. The prepared PPSG displayed high safety and biocompatibility. The drug in PPSG was released slowly and continuously in vivo and in vitro for up to 10 d, which could reduce the side effects caused by the fluctuation of blood drug concentration and solve the problem of the long treatment cycle and frequent administration. In vivo pharmacokinetics depicted that PPSG could improve the bioavailability, decrease the peak concentration, and prolong the t1/2 of ATO and ATRA. Particularly, AAP significantly inhibited the tumor volume, extended the survival period of tumor-bearing mice, and promoted the differentiation of APL cells into normal cells. Therefore, ATO+ATRA-PPSG not only could co-load hydrophilic ATO and lipophilic ATRA according to the clinical dosage, but also possessed the sustained-release and long-acting treatment effect which was expected to reduce administration time and ameliorate compliance of patients. Thus, it had great potential for clinical transformation and application.

Objectives To summarize the clinical characteristics of post-traumatic epilepsy (PTE), and to identify the factors affecting the latency of PTE after traumatic brain injury (TBI). Methods We conducted a retrospective clinical analysis in patients with PTE who visited the outpatient Department of Epilepsy, Beijing Tiantan Hospital from January 2013 to December 2018. The clinical characteristics, including gender, age distribution, seizure type, and latency were summarized. Factors affecting the latency of PTE were evaluated using Kaplan-Meier curves and Cox proportional hazard regression analysis. Results Complete clinical information was available for 2862 subjects, of which 78.48% were males. The mean age at TBI was 21.4 ± 15.1 years and peaked in the 0 to 12-year-old and 15 to 27-year-old groups. Generalized onset seizure was the most frequent seizure type (72.82% of patients). Approximately 19.95% PTE patients developed drug-resistant epilepsy. The latency of PTE ranged from 8 days to 20 years, with a median of 24.0 (IQR, 5.0–84.0) months. The Kaplan-Meier curves demonstrated that gender, age at TBI, severity of TBI, multiple craniocerebral injuries, post-TBI treatments, acute seizures, and residual disability were associated with PTE latency. The Cox regression model indicated that age ≥ 18 years old, severe TBI with multiple surgical operations, acute seizures, and residual disability were risk factors for shorter PTE latency. Conclusions PTE is more common in males than females, and peaked in the 0 to 12-year-old and 15 to 27-year-old groups. Generalized onset seizure was the most common seizure type and 19.95% of participants developed drug-resistant epilepsy. Patients aged ≥18 years old, who suffered severe TBI followed by multiple surgical operations, experienced acute seizures, or with residual disabilities had shorter PTE latency.

Unconventional surgical procedures may be utilized in treating complicated middle aortic syndrome (MAS), the outcome and prognosis of which remain largely undetermined due to limited numbers and significant heterogeneity of this population. Using computational fluid dynamics (CFD) analysis, this study aimed to assess the dynamic changes of postoperative aortic flow in seeking to unveil the relationship between hemodynamics and vascular remodeling and thrombotic events. One patient with middle aortic syndrome complicated with aortic rupture was treated with hybrid repair of extra-anatomic bypass and fenestrated endovascular aortic repair. The patient was followed-up for 8 months by computational tomography angiography and Doppler ultrasound. Thoracoabdominal aortic blood flow and locations with ongoing thrombosis at 1, 3, and 6 months postoperatively were simulated and analyzed. Remodeling processes, including low wall shear-mediated constrictive remodeling of non-stented aorta, neointimal hyperplasia at suture lines, and minimal thrombosis at various locations, were evident. Meanwhile, abdominal blood flow was tri-phasic at 1 month after surgery, and was reversed and stabilized at 6 months. The distribution of newly formed thrombus vary at different follow-up stages, which were in line with the numerical simulation of thrombosis from different postoperative time points. CFD-based sequential monitoring is of promising value in capturing dynamic changes of vascular outcome.

To investigate the effect of adenotonsillectomy on OSAS symptoms based on a data-driven approach and thereby identify criteria that may help avoid unnecessary surgery in children with OSAS. In 323 children enrolled in the Childhood Adenotonsillectomy Trial, randomised to undergo either early adenotonsillectomy (eAT; N = 165) or a strategy of watchful waiting with supportive care (WWSC; N = 158), the apnea-hypopnea index, heart period pattern dynamics, and thoraco-abdominal asynchrony measurements from overnight polysomnography (PSG) were measured. Using machine learning, all children were classified into one of two different clusters based on those features. The cluster transitions between follow-up and baseline PSG were investigated for each to predict those children who recovered spontaneously, following surgery and those who did not benefit from surgery. The two clusters showed significant differences in OSAS symptoms, where children assigned in cluster A had fewer physiological and neurophysiological symptoms than cluster B. Whilst the majority of children were assigned to cluster A, those children who underwent surgery were more likely to stay in cluster A after seven months. Those children who were in cluster B at baseline PSG were more likely to have their symptoms reversed via surgery. Children who were assigned to cluster B at both baseline and 7 months after surgery had significantly higher end-tidal carbon dioxide at baseline. Children who spontaneously changed from cluster B to A presented highly problematic ratings in behaviour and emotional regulation at baseline. Data-driven analysis demonstrated that AT helps to reverse and to prevent the worsening of the pathophysiological symptoms in children with OSAS. Multiple pathophysiological markers used with machine learning can capture more comprehensive information on childhood OSAS. Children with mild physiological and neurophysiological symptoms could avoid AT, and children who have UAO symptoms post AT may have sleep-related hypoventilation disease which requires further investigation. Furthermore, the findings may help surgeons more accurately predict children on whom they should perform AT.

Billions of mobile sensing devices in Internet of Things (IoT) collect data from surrounding environment in which the Medium Access protocol is employed. Quorum-based protocols are most important medium access control protocol (MAC) for wake-up based devices. However, existing quorum-based protocols cannot achieve both low latency and long lifetime at the same time. In this paper, a novel Element Shift Quorum (ESQ) based MAC is proposed in the sensor based systems. Data transmission is usually launched from the periphery of the network through multi hop routing to the data collector (DC), thus the data operation time of devices are different based on the distance from the DC. In the ESQ protocol, the Quorum time slot (QTS) of sensing devices is scheduled in the time when the devices just have data to process, then the latency and energy consumption can be reduced. In this way, sufficient QTS are allocated for nodes when data operation is needed, and nodes can stay at sleeping state when no data forwarding is required, thus enhancing the energy efficiency and lowering the network delay. Theoretical analysis and experimental results show that, the lifetime is increased by 16% using the proposed method. Meanwhile, the latency is reduced by a factor between 9.08%-29.32%.

While morphine has long been widely used in treating acute heart failure (AHF) due to its vasodilatory properties and anticipated anxiolysis, it remains unclear whether the application of morphine to those patients is reasonable. We aim to conduct a systematic review and meta‐analysis to assess the safety of morphine in patients with AHF. We searched PubMed, Cochrane Library, and Embase electronic databases from inception through March 2020. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the outcomes. Seven studies with 172, 226 patients were included. The results showed that morphine usage was not associated with increased in‐hospital mortality (OR: 1.94; 95% CI 0.93 to 4.03; p = 0.08). However, the use of morphine significantly increased the risk of invasive ventilation (OR: 2.72; 95% CI 1.09 to 6.80; p = 0.03). Furthermore, the subgroup analysis indicated that the application of morphine was not associated with increased 7‐day all‐cause mortality in patients with AHF (OR: 1.69; 95% CI 0.80 to 3.22; p = 0.11) but significantly increased the risk of 30‐day all‐cause mortality (OR: 1.59; 95% CI 1.16 to 2.17; p = 0.004). Based on current evidence, our results suggested that although morphine therapy did not significantly increase the risk of short‐term death (in the hospital or within 7 days) in patients with AHF, the risk of long‐term death and invasive ventilation were significantly increased. This result needs to be further confirmed by an ongoing randomized control trial.

Aim: To explore the clinical utility of the systemic immune-inflammation index (SII) for predicting the prognosis of esophageal squamous cell carcinoma (ESCC). Patients & methods: After calculating the SII in 180 patients with ESCC, the relationship between SII values and the pre-/post-radiotherapy SII ratio and overall survival was determined. Results: The median overall survival was 649 days for the entire group and 909 and 466 days for the high and low pre-/post-radiotherapy SII ratio groups, respectively. Multivariate analysis identified Karnofsky performance status (p = 0.045), lymphatic metastasis (p = 0.032), mid-radiotherapy SII (p < 0.001) and pre-/post-radiotherapy SII ratio (p = 0.003) as independent prognostic factors. Conclusion: The pre-/post-radiotherapy SII ratio and mid-radiotherapy SII are potentially effective markers for predicting ESCC prognosis.

Background Pseudomonas fluorescens (P. fluorescens) has been detected in respiratory samples from patients. However, no previous reports have been published about these P. fluorescens cultures from lung tissues. Case presentation Here, we report a case of pneumonia caused by P. fluorescens. P. fluorescens was identified from lung biopsy specimens for the first time in this case. According to the antibiotic susceptibility testing (AST) of P. fluorescens, the patient was given ciprofloxacin treatment. The temperature of the patient then returned to normal. Chest CT examination revealed improvements in pulmonary inflammation. Conclusions These findings suggest that the patients with pneumonia caused by P. fluorescens should be treated in a timely manner according to the AST results.

To explore the changes in amplitude-integrated electroencephalography (aEEG), neuron-specific enolase (NSE), and S100B in neonates with brain injury induced by neonatal hyperbilirubinemia (NHB).67 neonates with brain injury induced by NHB admitted to our hospital from March 2016 to October 2018 were included in a brain injury group (BIG), and 82 neonates with NHB but without brain injury in our hospital during the same period were included in a non-BIG. The two groups were compared regarding the rates of normal and abnormal aEEG results.The proportion of normal aEEG results in the BIG was significantly lower than that in the non-BIG, and the proportion of moderately and severely abnormal aEEG results in the BIG were both significantly higher than those in the non-BIG. The BIG showed significantly higher NSE and S100B levels than those of the non-BIG. The ROC curve for predicting prognosis showed that the AUC of aEEG, NSE, S100B, and the combined detection are 0.780, 0.754, 0.743, 0.788. The AUC0.700 indicated a good predictive value for the prognosis.The combination of aEEG, NSE, and S100B has good value in diagnosing injury induced by NHB and can predict prognosis moderately well.

Frequent droughts can cause severe losses to economy, society, and environment. This study aims to develop a remote sensing-based drought monitoring and information management system (RDMIMS) to help managers to better understand the regional drought situation and define quick and responsive measures. RDMIMS includes four modules for data management, drought monitoring and analysis, business operation, and information inquiry. Furthermore, RDMIMS combines the ground observation data of soil moisture content with the remote sensing inversion parameters to obtain regional drought information with increased accuracy. It provides users with more flexible operation methods that can obtain more accurate monitoring results by changing the weight coefficients of each monitoring model. Additionally, the business operation mode can provide monitoring results by “single click” thus enabling the managers to have more choices under different requirements. The results showed that the system can effectively monitor the drought situation in the study area and can meet the needs and expectations of manager's for information inquiry.

A novel framework is proposed to integrate communication, control and computing (3C) into the fifth-generation and beyond (5GB) wireless networks for satisfying the ultra-reliable low-latency connectivity requirements of remote-e-Health systems. Non-orthogonal multiple access (NOMA) enabled 5GB network architecture is envisioned, while the benefits of bringing to the remote-e-Health systems are demonstrated. Firstly, the application of NOMA into e-Health systems is presented. To elaborate further, a unified NOMA framework for e-Health is proposed. As a further advance, NOMA-enabled autonomous robotics (NOMA-ARs) systems and NOMA-enabled edge intelligence (NOMA-EI) towards remote-e-Health are discussed, respectively. Furthermore, a pair of case studies are provided to show the great performance enhancement with the use of NOMA technique in typical application scenarios of 5GB in remote-e-Health systems. Finally, potential research challenges and opportunities are discussed., Comment: 8 pages, 6 figures

ImportanceAlthough a few studies have reported the effects of several polymorphisms on major adverse cardiovascular events (MACE) in patients with acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention (PCI), these genotypes account for only a small fraction of the variation and evidence is insufficient. This study aims to identify new genetic variants associated with MACE by large-scale sequencing data.ObjectiveTo identify the genetic variants that caused MACE.DesignAll patients in this study were allocated to dual antiplatelet therapy for up to 12 months and have the follow-up duration of 18 months.SettingA two-stage association study was performed.ParticipantsWe evaluated the associations of genetic variants and MACE in 1961 patients with ACS undergoing PCI (2009-2012), including high-depth whole exome sequencing of 168 patients in the discovery cohort and high-depth targeted sequencing of 1793 patients in the replication cohort.Main Outcomes and MeasureThe primary clinical efficacy endpoint was the major adverse cardiovascular events (MACE) composite endpoint, including cardiovascular death, myocardial infarction (MI), stroke (CT or MR scan confirmed) and repeated revascularization (RR).ResultsWe discovered and confirmed six new genotypes associated with MACE in patients with ACS. Of which, rs17064642 at MYOM2 increased the risk of MACE (hazard ratio [HR] 2.76; P = 2.95 × 10-9) and reached genome-wide significance. The other five suggestive variants were KRTAP10-4 (rs201441480), WDR24 (rs11640115), ECHS1 (rs140410716), AGAP3 (rs75750968) and NECAB1 (rs74569896). Notably, the expressions of MYOM2 and ECHS1 are down-regulated in both animal models and patients with phenotypes related to MACE. Importantly, we developed the first superior classifier for predicting MACE and achieved high predictive accuracy (0.809).Conclusions and RelevanceWe identified six new genotypes associated with MACE and developed a superior classifier for predicting MACE. Our findings shed light on the pathogenesis of cardiovascular outcomes and may help clinician to make decision on the therapeutic intervention for ACS patients.Trial RegistrationThis study has been registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn, Registration number: ChiCTR-OCH-11001198).

Red mud and coal gangue are industrial solid wastes discharged during alumina extraction and coal mining, respectively. As these are hazardous materials, their disposal leads to serious environmental issues. In this study, an innovative utilization of red mud through co-roasting with coal gangue for separation and recycling of iron and aluminum minerals is presented. Under optimum co-roasting conditions (550 °C for 50 min), an iron concentrate containing 57.25% TFe (total iron content) with the recovery of 65.22%, and an aluminum-rich product containing 27.26% Al2O3 with the recovery of 71.37% were obtained after magnetic separation. The characteristics of mixed raw material and products all indicated that the goethite and hematite phases in the mixed raw material were transformed into a magnetite phase after co-roasting, although some of the magnetite generated during co-roasting was oxidized to hematite again. This study demonstrates that co-roasting of coal gangue and red mud is a promising technology for the reduction of iron and activation of aluminum to realize resource recycling without additional materials.

The free vibration characteristics of steel-concrete composite continuous beams (SCCCBs) are analyzed based on the Euler–Bernoulli beam theory. A modified dynamic direct stiffness method has been developed, which can be used to analyze the SCCCBs with some lumped masses and elastic boundary conditions. The results obtained by the proposed method are exact due to the elimination of approximated displacement and force fields in derivation. The proposed method is verified by comparing its results with those obtained by ANSYS software and laboratory tests. Then, the influencing factors on the reduction of natural frequency are analyzed and discussed in detail using the proposed method. The results show that stronger interfacial interaction results in higher values of natural frequency as well as larger steel subbeam and thinner concrete slab. The smaller the natural frequency of the SCCCBs is, the more significant effect the interfacial interaction on the natural frequency is. The reduction of natural frequency is not affected by the different numbers of spans but the equal single-span length and various ratios of the side span to the main span but equal total length, but it is influenced by the extra single-span length and different ratios of the side span to the main span but equal main span length. And it is only affected by bending stiffness. Furthermore, the reasonable ratio of the side span to the main span is 0.9∼1.0.

BACKGROUND Deposition and spreading of misfolded proteins (α-synuclein and tau) have been linked to Parkinson's disease cognitive dysfunction. The glymphatic system may play an important role in the clearance of these toxic proteins via cerebrospinal fluid (CSF) flow through perivascular and interstitial spaces. Recent studies discovered that sleep-dependent global brain activity is coupled to CSF flow, which may reflect glymphatic function. OBJECTIVE The objective of this current study was to determine if the decoupling of brain activity-CSF flow is linked to Parkinson's disease cognitive dysfunction. METHODS Functional and structural MRI data, clinical motor (Unified Parkinson's Disease Rating Scale), and cognitive (Montreal Cognitive Assessment [MoCA]) scores were collected from 60 Parkinson's disease and 58 control subjects. Parkinson's disease patients were subgrouped into those with mild cognitive impairment (MoCA

This paper presents a facial emotion recognition technique using two newly defined geometric features, landmark curvature and vectorized landmark. These features are extracted from facial landmarks associated with individual components of facial muscle movements. The presented method combines support vector machine (SVM) based classification with a genetic algorithm (GA) for a multi-attribute optimization problem of feature and parameter selection. Experimental evaluations were conducted on the extended Cohn-Kanade dataset (CK+) and the Multimedia Understanding Group (MUG) dataset. For 8-class CK+, 7-class CK+, and 7-class MUG, the validation accuracy was 93.57, 95.58, and 96.29%; and the test accuracy resulted in 95.85, 97.59, and 96.56%, respectively. Overall precision, recall, and F1-score were about 0.97, 0.95, and 0.96. For further evaluation, the presented technique was compared with a convolutional neural network (CNN), one of the widely adopted methods for facial emotion recognition. The presented method showed slightly higher test accuracy than CNN for 8-class CK+ (95.85% (SVM) vs. 95.43% (CNN)) and 7-class CK+ (97.59 vs. 97.34), while the CNN slightly outperformed on the 7-class MUG dataset (96.56 vs. 99.62). Compared to CNN-based approaches, this method employs less complicated models and thus shows potential for real-time machine vision applications in automated systems.

Poor adherence to inhaled drug therapy is considered to be a major factor in asthma related morbidity and it has been shown, in a significant number of patients, that estimates of adherence by patients or parents of children is not accurate. Inaccurate reporting may lead to higher dose of drug or more potent drugs being prescribed. A number of adherence sensors are available for some commercial inhaler devices. However, existing adherence monitoring mainly focuses on how the hardware of an inhaler has been actuated and does not provide evidence of drug aerosol inhalation. Valved holding chambers are now first choice for aerosol drug delivery for young children, who inhale drug by breathing in and out of the device several times and are increasingly used by older children and adults who inhale drug aerosol by taking a single deep breath. To the best knowledge of the authors, there is no adherence sensor in the market that provides evidence of actuation of the drug into a valved holding chamber and evidence that it is inhaled by different age groups. We therefore developed a novel adherence sensor system embedded into a valved holding chambers to achieve this. Our customised algorithm ensures that correct use is recorded, and incorrect use flagged. It also distinguishes a deep breath from tidal breaths and in combination measurement of actuation into the device triggers different classifiers for registering usage as good technique or not. A good technique or poor technique is immediately fed back to users using a visual light signal, while the data recorded is Bluetoothed to a paired mobile device for historical recording and statistical analysis. The entire system, including battery, micro-controller, sensors and Bluetooth, is integrated on a $66 \times 22$ mm2 printed circuit board and weighs only 8 grams. The system has been evaluated on a custom-made artificial lung which mimics the breathing patterns confirming recognition of tidal and deep breaths. The low-power device operates from a 3.3 V, 560 mAh battery and lasts 14 months if used daily.

Background To investigate the survival benefit of concurrent chemoradiotherapy (CCRT) for patients with locally advanced esophageal squamous cell carcinoma (ESCC) during the years of intensity‐modulated radiotherapy (IMRT). Methods Medical records of 1089 patients with ESCC who received IMRT from January 2005 to December 2017 were retrospectively reviewed. A total of 617 patients received CCRT, 472 patients received radiotherapy (RT) alone. Propensity score matching (PSM) method was used to eliminate baseline differences between the two groups. Survival and toxicity profile were evaluated afterward. Results After a median follow‐up time of 47.9 months (3.2–149.8 months), both overall survival (OS) and progression‐free survival (PFS) of the CCRT group were better than those of the RT alone group, either before or after PSM. After PSM, the 1‐, 3‐, and 5‐year OS of RT alone and CCRT groups were 59.0% versus 70.2%, 27.7% versus 40.5% and 20.3% versus 33.1%, respectively (p, Concurrent chemoradiotherapy versus radiotherapy alone in the era of intensity modulated radiotherapy retrospective analysis of more than 1000 patients.

Building Integrated Concentrating Photovoltaic (BICPV) window represents a promising alternative approach for improving the electricity generation of photovoltaic cells when integrated into building windows. As a new concept, BICPV smart window consisting of an optically switchable thermotropic layer with integrated PV cells offers the potential to simultaneously generate electricity and control solar heat and visible light into buildings. In this study, a BICPV smart window system with a Hydroxypropyl Cellulose (HPC) based thermotropic hydrogel membrane has been developed and characterised. The system was designed with the aid of a validated wavelength-dependent optical model based on a Monte-Carlo ray-tracing technique, where the thermal and optical properties of the thermotropic layer used for the optical model prediction were obtained from experimental measurement. Subsequently, a prototype of the BICPV smart window system has been fabricated and characterised under controlled indoor conditions. From the experiments, it was found that the maximum power output of the BICPV smart window (6 wt% HPC) increases by 17.1% with the membrane temperature increasing from 40 °C (the transition temperature) to 54 °C; meanwhile, a 70.9% reduction in the light transmittance is observed. This indicated that the BICPC smart window might potentially reduce the solar heat gain in hot periods and therefore reduce the building energy demand. In addition, the effect of different concentrations of HPC polymer (2, 4 and 6 wt%) on the electrical and optical performance of the system has been investigated.

Web API is an efficient and cost-effective method for service-oriented software development, and Mashup is a popular technology which combines multiple services to create more powerful services to address the increasing complexity of business requirements and speed up the software development process. Here, accurate and efficient API recommendation is vital for successful Mashup development. Currently, many existing methods combine various technologies and adopt diverse features, which results in complex models at the cost of higher computational overhead but with very limited improvement on recommendation accuracy. To address such an issue, in this paper, we propose an unsupervised API recommendation method based on deep random walks on knowledge graph. Specifically, we first construct a refined knowledge graph utilizing Mashup-API co-invocation patterns and service category attributes, and then we learn implicit low-dimensional embedding representations of entities from truncated random walks by treating walks as the equivalent of sentences. Meanwhile, to improve the recommendation accuracy, we design an entity bias procedure to reflect different entity preference (namely API-based neighborhood or Mashup-based neighborhood). Finally, we estimate the relevance between Mashup requirements and the existing services (Mashups and APIs) to obtain the API recommendation list. Since the API recommendation results can be obtained through unsupervised feature learning, automatic API recommendation can be provided for Mashup developers in real time. Comprehensive experimental results on a real-world dataset demonstrate that our proposed method can outperform several state-of-the-art methods in both recommendation accuracy and efficiency.

Purpose To investigate genetics, electrophysiology, and clinical course of KCNV2-associated retinopathy in a cohort of children and adults. Study design This was a multicenter international clinical cohort study. Methods Review of clinical notes and molecular genetic testing. Full-field electroretinography (ERG) recordings, incorporating the international standards, were reviewed and quantified and compared with age and recordings from control subjects. Results In total, 230 disease-associated alleles were identified from 117 patients, corresponding to 75 different KCNV2 variants, with 28 being novel. The mean age of onset was 3.9 years old. All patients were symptomatic before 12 years of age (range, 0-11 years). Decreased visual acuity was present in all patients, and 4 other symptoms were common: reduced color vision (78.6%), photophobia (53.5%), nyctalopia (43.6%), and nystagmus (38.6%). After a mean follow-up of 8.4 years, the mean best-corrected visual acuity (BCVA ± SD) decreased from 0.81 ± 0.27 to 0.90 ± 0.31 logarithm of minimal angle of resolution. Full-field ERGs showed pathognomonic waveform features. Quantitative assessment revealed a wide range of ERG amplitudes and peak times, with a mean rate of age-associated reduction indistinguishable from the control group. Mean amplitude reductions for the dark-adapted 0.01 ERG, dark-adapted 10 ERG a-wave, and LA 3.0 30 Hz and LA3 ERG b-waves were 55%, 21%, 48%, and 74%, respectively compared with control values. Peak times showed stability across 6 decades. Conclusion In KCNV2-associated retinopathy, full-field ERGs are diagnostic and consistent with largely stable peripheral retinal dysfunction. Report 1 highlights the severity of the clinical phenotype and established a large cohort of patients, emphasizing the unmet need for trials of novel therapeutics., Highlights • The current study established the largest and most characterized cohort of molecularly confirmed patients with KCNV2-associated retinopathy. • Report 1 highlights the genetic background, evidence of electroretinography stability over a broad age range, and the severe phenotype of the disease.

Scalable server-grade nonvolatile RAM (NVRAM) DIMMs are commercially available with the release of Intel’s Optane DIMM. Recent studies on Optane DIMM-based systems unveil discrepant performance characteristics, compared with what many researchers thought before the product release. To thoroughly analyze the source of the discrepancy and facilitate real-NVRAM-aware system design, we develop an NVRAM microarchitecture characterization and modeling framework, consisting of a Low-level profilEr for Non-volatile memory Systems (LENS) and a Validated cycle-Accurate NVRAM Simulator (VANS). LENS allows users to comprehensively analyze NVRAM performance attributes and reverse engineer NVRAM microarchitectures. We use LENS to reverse engineer the sophisticated microarchitecture design of Optane DIMM and generate a set of architecture implications of industrial NVRAMs. VANS models Optane DIMM microarchitecture and is validated by comparing with the detailed performance characteristics of Optane DIMM-attached servers. VANS adopts a modular design that can be easily modified to extend to other NVRAM architecture designs.

Capturing the underlying semantic relationships of sentences is helpful for machine translation. Variational neural machine translation approaches provide an effective way to model the uncertain underlying semantics in languages by introducing latent variables. Multitask learning is applied in multimodal machine translation to integrate multimodal data. However, these approaches usually lack a strong interpretation in utilizing out-of-text information in machine translation tasks. In this paper, we propose a novel architecture-free multimodal translation model, called variational multimodal machine translation (VMMT), under the variational framework which can model the uncertainty in languages caused by ambiguity through utilizing visual and textual information. In addition, the proposed model can eliminate the discrepancy between training and prediction in the existing variational translation models by constructing encoders only relying on source data. More importantly, the proposed multimodal translation model is designed as multitask learning in which the shared semantic representation for different modes is learned and the gap among semantic representation from various modes is reduced by incorporating additional constraints. Moreover, the information bottleneck theory is adopted in our variational encoder–decoder model, which helps the encoder to filter redundancy and the decoder to concentrate on useful information. Experiments on multimodal machine translation demonstrate that the proposed model is competitive.

In order to determine the reasonable empty roof distance during roadway excavation, a mechanical model of the direct roof rock beam was established, and the relationship between the direct roof tensile stress and the empty roof distance was obtained. According to the criterion of roof stability, that is, the tensile stress of the roof does not exceed the tensile strength, the expression of the empty roof distance during the roadway excavation is determined. Taking the 150,802 roadway in Liuzhuang coal mine as the research background, the horizontal and vertical stress distribution characteristics of the direct roof under different supporting forces are analyzed, and combined with the direct roof surplus safety factor, the reasonable empty roof distance during roadway excavation is determined as 2.0 m. By using FLAC3D numerical simulation software to analyze the distribution law of vertical stress and plastic zone when the empty roof distance is 2.0 m, it is obtained that the overall stability of the roadway surrounding rock within the empty roof area is better when the empty roof distance is 2.0 m, and it is applied to Liuzhuang Coal mine 150,802 roadway. The field application results show that when the empty roof distance is selected as 2.0 m during roadway excavation, the deformation of the roof and bottom of the roadway and the two sides are small, the stability is good, and the roadway excavation speed is increased by about 30%.

The smoothness of smartphone operations is essential to user perceptual experience. However, the underlying mechanism of how smoothness can impact user experience has not been elucidated. In this paper, we conducted two experiments to explore factors that may potentially affect user perceptual experience of smoothness in smartphone operation and examined how these factors contributed. In experiment 1, ten participants were invited and they were sensitive to the smoothness of the smartphone. Participants used swiping gesture to manipulate 27 sequences with different forms of frame loss on the microblog simulation interface, and gave mean opinion scores (MOS) according to self perception. According to the experimental results, three factors that affect smoothness perception were found: single frame-loss number (SFLN), frame-loss time (FLT), and frame-loss interval (FLI). But the effect of each factor was effective only in some conditions. In experiment 2, 20 participants gave their MOS of 84 sequences, and these sequences were divided into three parts by three factors of experiment 1. Participants’ electrophysiological data was also collected to verify the validity of the participants’ scores. The results of an analysis of variance and Student–Newman–Keuls (SNK) test showed that a SFLN, FLT, and their interaction results significantly affected the user perception of smoothness in smartphone operation. Specifically, the effect of a SFLN was more significant than that of FLT. The effect of the FLI on user perceptual experience was relatively low, but the interactive effect of FLT and interval was significant. Finally, regression analyses were conducted to obtain the fitting formulas. Our research results reflect some preliminary suggestions, so as to guide developers to configure the performance of smart phones, in order to control the frame loss of smart phones and avoid bad user evaluation.

Background/AimsTo investigate the utility of a data-driven deep learning approach in patients with inherited retinal disorder (IRD) and to predict the causative genes based on fundus photography and fundus autofluorescence (FAF) imaging.MethodsClinical and genetic data from 1302 subjects from 729 genetically confirmed families with IRD registered with the Japan Eye Genetics Consortium were reviewed. Three categories of genetic diagnosis were selected, based on the high prevalence of their causative genes: Stargardt disease (ABCA4), retinitis pigmentosa (EYS) and occult macular dystrophy (RP1L1). Fundus photographs and FAF images were cropped in a standardised manner with a macro algorithm. Images for training/testing were selected using a randomised, fourfold cross-validation method. The application program interface was established to reach the learning accuracy of concordance (target: >80%) between the genetic diagnosis and the machine diagnosis (ABCA4, EYS, RP1L1 and normal).ResultsA total of 417 images from 156 Japanese subjects were examined, including 115 genetically confirmed patients caused by the three prevalent causative genes and 41 normal subjects. The mean overall test accuracy for fundus photographs and FAF images was 88.2% and 81.3%, respectively. The mean overall sensitivity/specificity values for fundus photographs and FAF images were 88.3%/97.4% and 81.8%/95.5%, respectively.ConclusionA novel application of deep neural networks in the prediction of the causative IRD genes from fundus photographs and FAF, with a high prediction accuracy of over 80%, was highlighted. These achievements will extensively promote the quality of medical care by facilitating early diagnosis, especially by non-specialists, access to care, reducing the cost of referrals, and preventing unnecessary clinical and genetic testing.

Coal and coal gangue spontaneous combustion (CGSC) occurs globally, causing significant environmental pollution. However, its emissions are poorly quantified and are overlooked in global or regional air pollutant emission inventories in previous studies, resulting in the underestimation of its impacts on climate, environment, and public health. This study quantified the emissions of various air pollutants originating from CGSC in Wuhai, a city in China, investigated emission characteristics, and estimated the contribution of CGSC emissions to fine particulate matter (PM2.5) air pollution and related health impacts on a regional scale. The results revealed that the CGSC-related PM2.5 emissions were approximately 4643 t a-1 (95% confidence interval (95% CI): 721; 10447), accounting for 26.3% of the total PM2.5 emissions. Alkanes, alkenes, and aromatics accounted for 69.4, 17.9, and 2.9%, respectively, of the total emissions of volatile organic compounds (VOCs). Due to CGSC emissions, the ambient PM2.5 concentration in Wuhai increased by 5.7 μg m-3 on average, while the nitrate concentration decreased. The number of premature deaths caused by exposure to ambient PM2.5 associated with CGSC reached 381 (95% CI: 290; 452) in Wuhai and surrounding cities in 2017. Urgent control strategies and engineering techniques are needed to mitigate CGSC to protect public health.

As the inputs of investment and employees in real estate sectors have continued to increase in recent years, it is crucial to study the evaluation of real estate performance. However, these rarely ...

Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term immunosuppressive therapy. Multiple organs were involved, and there was cutaneous dissemination of the lesions. Histopathology revealed abundant yeast-like cells with wide capsular halos in subcutaneous tissue, suggesting Cryptococcus spp. infection. Laser capture microdissection (LCM)-PCR on skin biopsies confirmed Cryptococcus neoformans var. grubii. A literature review of 17 cases of disseminated cryptococcosis with cutaneous cellulitis or panniculitis in HIV-negative individuals found that over half the patients (52.9%, 9/17) had a history of glucocorticoid therapy, and that the most common site was the legs (76.5%, 13/17). C. neoformans was the main pathogenic species, accounting for 88.2% (15/17) of cases. Fungal cellulitis should be included in the differential diagnosis of cellulitis that fails to respond to antimicrobial therapy in HIV-negative immunosuppressed individuals. Non-culture-based molecular techniques aid in rapid pathogen identification in histologically positive, unculturable specimens.