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Background This study aims to investigate the temporal trend as well as the burden of primary liver cancer among Mongol and non-Mongol in China. Materials and methods The registered data from up to 20 monitoring points in the periods of 2008 to 2015 in Inner Mongolia were used to calculate and model the trend of liver cancer among Mongol and non-Mongol using log-linear regression. Logistic regression was used to characterise the risk of liver cancer by using hospitalization records from 2008 to 2017. Results Over the study period, significant reduction of liver cancer mortality was found among non-Mongol population (4.8/100,000 from 23.7/100,000 to 18.9/100,000, p=0.04), while the increase of liver cancer mortality was observed among the Mongolian population (8.4/100,000 from 10.7/100,000 to 19.1/100,000, p=0.02), particularly the Mongol from East (25.5/100,000 from 11.2/100,000 to 36.7/100,000, p=0.005). Comparing to the non-Mongol patients with primary liver cancer, the Mongolian patients were more likely to be from East Inner Mongolia (aOR=3.65, 95% CI:2.75-4.87) and those residing in urban area (aOR=2.11, 95%CI: 1.55-2.91). In 2015, a total of 3056 primary liver cancer deaths could be converted if the four known risk factors (HBV, Hepatitis C Virus, alcohol consumption and smoking) could be prevented. HBV remained to be the leading risk factor of liver cancer (PAF=56%, contributing to 2616 deaths) with the highest among the Mongol from East (PAF=65.1%, contributing to 763 deaths). Conclusion The continuing increase of primary liver cancer among Mongol suggested further interventions were needed to combat its burden.

NEW FINDINGS What is the central question of this study? Vascular endothelial growth factor A (VEGFA) is an important growth factor involved in changes in the bronchial microvascular and airway inflammation in chronic obstructive pulmonary disease (COPD) progression. What is the association of single nucleotide polymorphisms (SNPs) in VEGFA with the risk of COPD in the Chinese Han and Mongolian populations? What is the main finding and its importance? The effect of five SNPs in the VEGFA gene was analysed and compared between the Chinese Han and Mongolian populations. A contribution of risk alleles rs833068, rs833070 and rs3024997 to COPD was detected in the Chinese Mongolian population only. The study provided data from different populations to validate the role of VEGFA polymorphisms in COPD and provided reliable SNPs to predict the risk of COPD. ABSTRACT We attempted to define the associations between single nucleotide polymorphisms (SNPs) in the vascular endothelial growth factor A (VEGFA) gene and chronic obstructive pulmonary disease (COPD) in Chinese Han and Mongolian cohorts. Five SNPs were genotyped in cohorts of 684 COPD patients (350 Mongolian and 334 Han) and 784 healthy controls (350 Mongolian and 434 Han) using SNPscan multiplex PCR. SNP frequencies, genetic models and haplotypes were analysed using the chi-square test. The associations of SNPs with COPD and linkage disequilibrium were analysed using logistic regression and HaploView, respectively. We found that only rs833068G>A, rs833070T>C and rs3024997G>A were significantly associated with the risk of COPD in the Mongolian population (rs833068: P

Purpose To determine the relationship between refractive error and diabetic retinopathy (DR). Design Clinical trial. Participants Type I diabetes individuals with serial refractive error and DR stage measurements over 30 years in the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study. Methods Stage of DR was measured every 6 months from standard fundus photographs, and refractive error was measured annually during the 6.5 years of DCCT; then, both were staggered every fourth year during EDIC with the full cohort measured at EDIC years 4 and 10. Outcomes of DR were 2- or 3-step progression, presence of proliferative DR (PDR), clinically significant macular edema (CSME), diabetic macular edema (DME), or ocular surgery. Myopia, emmetropia, and hyperopia were defined as a spherical equivalent of ≤−0.5, >−0.5 and Main Outcome Measures For each outcome separately, Cox proportional hazard (PH) models assessed the association between the refractive error status and the subsequent risk of that outcome, both without and with adjustment for potential risk factors. Results Hyperopia was associated with a higher risk of 2-step progression (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.05–1.59), 3-step progression (HR, 1.35; 95% CI, 1.05–1.73), and PDR (HR, 1.40; 95% CI, 1.02–1.92) compared with emmetropia in unadjusted models. These associations remained significant after adjustment for DCCT treatment group, cohort, age, sex, smoking, duration of diabetes, systolic and diastolic blood pressures, pulse, low-density lipoprotein, high-density lipoprotein, triglycerides, albumin excretion rate, and DCCT/EDIC mean updated hemoglobin A1c (HbA1c) (2-step progression: HR, 1.28; 95% CI, 1.03–1.58; 3-step progression: HR, 1.30; 95% CI, 1.00–1.68; PDR: HR, 1.38; 95% CI, 1.00–1.90). Myopia was not associated with any of the 5 DR outcomes in the unadjusted models and only marginally associated with 2-step progression (HR, 1.11; 95% CI, 1.00–1.24) in the adjusted models. Conclusions Myopia is not associated with DR progression risk. Hyperopia is an independent risk factor for 2-step and 3-step DR progression and PDR.

The bifid mandibular canal is an anatomical variation, which causes anesthetic failure and surgical accidents occasionally. The purpose of this study is to observe the prevalence and anatomical location of bifid mandibular canals, providing clinical value in reducing the occurrence of surgical accidents and postoperative complications. A total of 321 outpatients were selected in this study. Their CBCT images were observed, and the prevalence of bifid mandibular canals as well as the composition ratios of each branch type was evaluated according to the classification of Naitoh. The bifid mandibular canals and their branches’ diameter, length, horizontal distance to the buccal/lingual wall of the mandible, and vertical distance to the mandibular alveolar ridge were measured. Furthermore, 194 dry adult mandibles from the Department of Oral Anatomy and Physiology of Tianjin Medical University were observed to evaluate the prevalence and the average diameter of retromolar foramina. Of all the 321 patients, 84 (26.17%) cases of bifid mandibular canals and 105 (16.36%) sides of unilateral bifurcation were observed. Based on Naitoh’s classification, the retromolar canals were the most common types (46.67%), followed by the forward canals (40.00%), the dental canals (10.48%) and the buccolingual canals (2.86%). In 194 dry adult mandibles, 23 cases (11.86%) and 29 sides (7.47%) of retromolar foramina were found and the average diameter of retromolar foramina was 0.94 ± 0.30 mm. More than a quarter of the population has the bifid mandibular canal, which is a potential factor of the onset of surgery accidents. CBCT is an effective method to identify the branches of mandibular canals. Preoperative CBCT examination can help reduce various postoperative complications.

Crawling is recommended for avoiding high heat and toxic fumes and for obtaining more breathable air during evacuations. Few studies have evaluated the effects of crawling on physical joints and velocity, especially in children. Based on motion capture technology, this study proposes a novel method of using wearable sensors to collect exposure (e.g., mean duration, frequency) on children’s joints to objectively quantify the impacts of different locomotion methods on physical characteristics. An on-site experiment was conducted in a kindergarten with 28 children (13 boys and 15 girls) of different ages (4–6 years old) who traveled up to 22 m in three different postures: upright walking (UW), stoop walking (SW), and knee and hand crawling (KHC). The results showed that: (1) The level of joint fatigue for KHC was heavier than bipedal walking (p &lt, 0.05), which was evidenced by higher mean duration and frequency. There was no significant difference between UW and SW (p &gt, 0.05). (2) The physical characteristics of the children in the different postures observed in this study were different (p &lt, 0.05). The ankle was more fatigued than other joints during bipedal walking. Unlike infants, the wrists and hips of the children became fatigued while crawling. The key actions flexion/extension are more likely to induce joint fatigue vs. other actions. (3) Crawling velocity was significantly slower than the bipedal velocities, and UW was 10.6% faster than SW (p &lt, 0.05). The bipedal walking velocity started to decrease after the children had travelled up to 13 m, while the KHC velocity started to decrease after traveling up to 11.6 m. (4) In a severe fire, the adoption of SW is suggested, as the evacuees can both evacuate quickly and avoid overworking their joints. (5) There were no significant differences in the age (p &gt, 0.05) and gender (p &gt, 0.05) of the children on the joints in any of the three postures. To conclude, KHC causes more damage to body joints compared to bipedal walking, as evidenced by higher exposure (mean duration, frequency), whereas UW and SW are similar in terms of the level of joint fatigue. The above findings are expected to provide a useful reference for future applications in the children’s risk assessment and in the prevention design of buildings.

Anomaly detection is of great importance due to its wide application in industrial areas. Deep auto-encoders have enabled significant advances in anomaly detection over the past decade. However, it has been observed that sometimes the auto-encoder are likely to reconstruct anomalies due to the “excellent” generalization ability, resulting in the miss detection of anomalies. To mitigate this deficiency, scholars have proposed the memory-augmented deep auto-encoder method recently. However, more recent work on memory-augmented uses continuous memory representations or key-values pairs in memory for read/write without forgetting mechanism, and it is assumed that data such as early access to the network are normal data. To deal with those imperfectness, we present a VAE-based memory-augmented network with a trained memory network: MEMVAE, addressing scheme to provide a strong guarantee to detect anomalous. In particular, Gated Recurrent Unit (GRU) cells are employed as the encoder and decoder to capture latent temporal structure. We then train an external memory module that records common patterns of the prototype. In addition, we present a weighted regular score that simply updates our memory entries. Our detector reports a reconstruction probability as the anomaly score. Experimental results on tabular data and time series data show that MEMVAE demonstrates significant improvements and better performance.

The grading evaluation of metacarpophalangeal rheumatoid arthritis (RA) ultrasonic images is a diagnostic challenge that heavily relies on the expertise of trained sonographers. This study presents a grading method for detecting and estimating the geometric and texture features of synovium thickening and bone erosion. Unlike previous studies in this area, this work uses the metrics and texture features of region of interest (ROI). The highlighted feature of metacarpophalangeal bone and the dark feature of the synovial thickening are extracted simultaneously by the segmented method based on the Gaussian scale space. The segmented results are analyzed to extract three quantitative geometric parameters, which are combined with gray-level co-occurrence matrix (GLCM) statistic texture features to describe the ultrasonic image of metacarpophalangeal RA. To obtain the preferable ability of classification, we applied a support vector machine (SVM) and various feature descriptors, including GLCM, local binary patterns (LBP), and GLCM + LBP, to grade the ultrasonic image of metacarpophalangeal RA. Results show that the SVM, based on our feature descriptor, provides the highest accuracy of up to 92.50%, of the four descriptors. The SVM based on GLCM+LBP descriptor shows better accuracy (86.55%) than either SVM + LBP (85.43%) or SVM+GLCM (82.51%) for discriminating among four grade RA ultrasonic images. Overall, this methodology points to a significant grading of metacarpophalangeal RA ultrasound images without medical expert analysis or blood sample analysis, such as detecting C-reactive protein, measuring erythrocyte sedimentation rate, and testing rheumatoid factor.

Doxorubicin is a chemotherapeutic agent commonly used to treat breast cancer. However, breast cancer often develops drug resistance, leading to disease recurrence and poor prognosis. Delineating the mechanisms underlying drug resistance is imperative for overcoming the challenge of treating doxorubicin-resistant breast cancer. In this study, by identifying the possible role of Sentrin/SUMO-specific proteases (SENPs) in doxorubicin resistance, we show here that among the 6 members of SENPs, only SENP2 is downregulated in doxorubicin-resistant MCF-7 (MCF-7/adr) and MDA-MB-231 (dr) breast cancer cells, as compared with sensitive counterparts. In addition, functionally, SENP2 overexpression resensitizes resistant breast cancer cells to doxorubicin treatment, and its knockdown confers doxorubicin resistance in sensitive ones. Moreover, NF-κB pathway is activated in MCF-7/adr cells, however, treatment with Bay 11-7085, one specific inhibitor of this pathway, reverses resistance to doxorubicin, suggesting that NF-κB pathway activation contributes to doxorubicin resistance in MCF-7/adr cells. We further show that SENP2 overexpression enhances NEMO deSUMOylation and suppresses NF-κB activation particularly in MCF-7/adr cells. Furthermore, SENP2 overexpression-induced sensitivity of MCF-7/adr cells to doxorubicin is drastically abrogated when treated with NF-κB pathway activator, thus establishing a causal link between SENP2-suppressed NF-κB pathway and enhanced doxorubicin sensitivity in breast cancer cells. Overall, this study reveals a novel function of SENP2 in counteracting doxorubicin resistance in breast cancer, and highlights the critical role of NF-κB suppression in mediating this effect.

BACKGROUND Chemokines are important in inflammation, immunity, tumor progression, and metastasis. The purpose of this research was to find an integrated-RNA signature of chemokine family genes to predict the survival prognosis in head and neck squamous carcinoma (HNSC) patients. MATERIAL AND METHODS Relevant data of 504 HNSC patients were extracted from The Cancer Genome Atlas (TCGA) database. Through analyzing RNA sequencing data, the univariate Cox model was used to identify chemokine family genes associated with survival and then to develop a multiple-RNA signature in the training set. The prediction value of this multiple-RNA signature was further verified in the validation and entire sets. The receiver operating characteristic curves were used to assess the predictive value of this multiple-RNA signature. RESULTS Eleven chemokines were included in this prognostic signature. Based on this 11-chemokine signature, we further categorized patients as high or low risk. Compared with low-risk patients, high-risk patients had shorter overall survival (OS) time in the training set [hazard ratio (HR)=3.497, 95% confidence interval (CI)=2.142-5.711, p

Background and objectives Glomerular hyperfiltration has been considered to be a contributing factor to the development of diabetic kidney disease (DKD). To address this issue, we analyzed GFR follow-up data on participants with type 1 diabetes undergoing 125 I-iothalamate clearance on entry into the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications study. Design, setting, participants, & measurements This was a cohort study of DCCT participants with type 1 diabetes who underwent an 125 I-iothalamate clearance (iGFR) at DCCT baseline. Presence of hyperfiltration was defined as iGFR levels ≥140 ml/min per 1.73 m 2 , with secondary thresholds of 130 or 150 ml/min per 1.73 m 2 . Cox proportional hazards models assessed the association between the baseline hyperfiltration status and the subsequent risk of reaching an eGFR 2 . Results Of the 446 participants, 106 (24%) had hyperfiltration (iGFR levels ≥140 ml/min per 1.73 m 2 ) at baseline. Over a median follow-up of 28 (interquartile range, 23, 33) years, 53 developed an eGFR 2 . The cumulative incidence of eGFR 2 at 28 years of follow-up was 11.0% among participants with hyperfiltration at baseline, compared with 12.8% among participants with baseline GFR 2 . Hyperfiltration was not significantly associated with subsequent risk of developing an eGFR 2 in an unadjusted Cox proportional hazards model (hazard ratio, 0.83; 95% confidence interval, 0.43 to 1.62) nor in an adjusted model (hazard ratio, 0.77; 95% confidence interval, 0.38 to 1.54). Application of alternate thresholds to define hyperfiltration (130 or 150 ml/min per 1.73 m 2 ) showed similar findings. Conclusions Early hyperfiltration in patients with type 1 diabetes was not associated with a higher long-term risk of decreased GFR. Although glomerular hypertension may be a mechanism of kidney injury in DKD, higher total GFR does not appear to be a risk factor for advanced DKD.

OBJECTIVE The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy reduced the development and progression of retinopathy in type 1 diabetes (T1D) compared with conventional therapy. The Epidemiology of Diabetes Interventions and Complications (EDIC) study observational follow-up showed persistent benefits. In addition to glycemia, we now examine other potential retinopathy risk factors (modifiable and nonmodifiable) over more than 30 years of follow-up in DCCT/EDIC. RESEARCH DESIGN AND METHODS The retinopathy outcomes were proliferative diabetic retinopathy (PDR), clinically significant macular edema (CSME), and ocular surgery. The survival (event-free) probability was estimated using the Kaplan-Meier method. Cox proportional hazards models assessed the association between risk factors and subsequent risk of retinopathy. Both forward- and backward-selection approaches determined the multivariable models. RESULTS Rate of ocular events per 1,000 person-years was 12 for PDR, 14.5 for CSME, and 7.6 for ocular surgeries. Approximately 65%, 60%, and 70% of participants remained free of PDR, CSME, and ocular surgery, respectively. The greatest risk factors for PDR in descending order were higher mean HbA1c, longer duration of T1D, elevated albumin excretion rate (AER), and higher mean diastolic blood pressure (DBP). For CSME, risk factors, in descending order, were higher mean HbA1c, longer duration of T1D, and greater age and DBP and, for ocular surgeries, were higher mean HbA1c, older age, and longer duration of T1D. CONCLUSIONS Mean HbA1c was the strongest risk factor for the progression of retinopathy. Although glycemic control is important, elevated AER and DBP were other modifiable risk factors associated with the progression of retinopathy.

OBJECTIVE We examined whether the presence of microvascular complications was associated with increased subsequent risk of cardiovascular disease (CVD) among participants with type 1 diabetes in the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study followed for >35 years. RESEARCH DESIGN AND METHODS Standardized longitudinal data collection included: 1) stereoscopic seven-field retinal fundus photography centrally graded for retinopathy stage and clinically significant macular edema; 2) urinary albumin excretion rate (AER) and estimated glomerular filtration rate (eGFR); 3) cardiovascular autonomic neuropathy (CAN) reflex testing; and 4) adjudicated CVD events, including death from CVD, nonfatal myocardial infarction, stroke, subclinical myocardial infarction on electrocardiogram, confirmed angina, or coronary artery revascularization. Cox proportional hazards models assessed the association of microvascular complications with subsequent risk of CVD. RESULTS A total of 239 participants developed CVD, including 120 participants who suffered major adverse cardiovascular events (MACE) defined as nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. The presence of microvascular disease (diabetic retinopathy, kidney disease, or CAN) was associated with increased risk of subsequent CVD and MACE (hazard ratios 1.86 to 3.18 and 2.09 to 3.63, respectively), associations that remained significant after adjusting for age and HbA1c. After adjustment for traditional CVD risk factors, however, only sustained AER ≥30 mg/24 h occurring alone and/or with eGFR CONCLUSIONS Advanced microvascular disease, especially moderate to severe albuminuria or eGFR

Crop water requirements are crucial for agricultural water management and redistribution. Based on meteorological and agricultural observation data, the effective precipitation (Pe), water requirements (ETc), and irrigation water requirements (Ir) in the maize growing areas of Inner Mongolia were calculated. Furthermore, climatic trends of these variables were analysed to reveal their temporal and spatial distributions. The research results are as follows: the average Pe of maize in Inner Mongolia during the entire growth period was 125.9 mm, with an increasing trend from west to east. The Pe in the middle growth period of maize was the highest and was small in the early and late growth stages. The Pe climate exhibited a negative slope with a decreasing trend. The average ETc of maize during the entire growth period was 480.6 mm. The high-value areas are mainly distributed in the Wulatzhongqi and Linhe areas. The average Ir of maize during the entire growth period was 402.9 mm, and the spatial distribution is similar to that of ETc. In each growth period, Ir showed an increasing trend. Supplemental irrigation should be added appropriately during each growth period to ensure the normal growth of maize. This study can provide an effective basis for the optimisation of irrigation and regional water conservation in the maize cultivation area of Inner Mongolia.

The energy demand of the district heating system (DHS) occupies an important part in urban energy consumption, which has a great impact on the energy security and environmental protection of a city. With the gradual improvement of people&rsquo, s economic conditions, different groups of people now have different demands for thermal energy for their comfort. Hence, heat metering has emerged as an imperative for billing purposes and sustainable management of energy consumption. Therefore, forecasting the heat load of buildings with heat metering on the demand side is an important management strategy for DHSs to meet end-users&rsquo, needs and maintain energy-saving regulations and safe operation. However, the non-linear and non-stationary characteristics of buildings&rsquo, heat load make it difficult to predict consumption patterns accurately, thereby limiting the capacity of the DHS to deliver on its statutory functions satisfactorily. A novel ensemble prediction model is proposed to resolve this problem, which integrates the advantages of Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) and support vector regression (SVR), called CEEMDAN-SVR in this paper. The proposed CEEMDAN-SVR algorithm is designed to automatically decompose the intrinsic mode according to the characteristics of heat load data to ensure an accurate representation of heat load patterns on multiple time scales. It will also be useful for developing an accurate prediction model for the buildings&rsquo, heat load. In formulating the CEEMDAN-SVR model, the heat load data of three different buildings in Xingtai City were acquired during the heating season of 2019&ndash, 2020 and employed to conduct detailed comparative analysis with modern algorithms, such as extreme tree regression (ETR), forest tree regression (FTR), gradient boosting regression (GBR), support vector regression (SVR, with linear, poly, radial basis function (RBF) kernel), multi-layer perception (MLP) and EMD-SVR. Experimental results reveal that the performance of the proposed CEEMDAN-SVR model is better than the existing modern algorithms and it is, therefore, more suitable for modeling heat load forecasting.

OBJECTIVE The role of genetic factors in the risk of cardiovascular disease (CVD) for patients with type 1 diabetes (T1D) remains unknown. We therefore examined whether previously identified genetic factors for coronary artery disease (CAD) are associated with the risk of CVD above and beyond established demographic and clinical factors in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study. RESEARCH DESIGN AND METHODS Polygenic risk scores (PRS) and individual genetic variants identified in previous studies were obtained from genome-wide genotyping performed in 1,371 DCCT/EDIC participants. Two composite CVD outcomes were considered: major adverse cardiovascular events (MACE) (CVD death or nonfatal myocardial infarction [MI] or stroke) and any CVD (MACE plus confirmed angina, silent MI, revascularization, or congestive heart failure). Cox proportional hazards models assessed the association between the genetic factors and the risk of CVD with adjustment for other factors (including age, lipids, blood pressure, and glycemia). RESULTS CAD PRS was strongly associated with the subsequent risk of any CVD (42% and 38% higher risk per 1-SD increase in unadjusted and fully adjusted models, respectively; P < 0.0001) and with the risk of MACE (50% and 40% higher risk per 1-SD increase in unadjusted and fully adjusted models, respectively; P < 0.0001). Several individual single nucleotide polymorphisms were also nominally associated with the risk of any CVD and MACE. CONCLUSIONS Genetic factors are associated with the risk of subsequent CVD in individuals with T1D above and beyond the effect of established risk factors such as age, lipids, blood pressure, and glycemia.

Background and purpose The prevalence and characteristics of intraprocedural back pain is not well studied in awake patients undergoing neuroendovascular procedures. Methods We performed a prospective study as part of quality improvement initiative in which all patients who underwent neuroendovascular procedures in awake state were inquired regarding presence, severity (using a numeric rating scale score ranging from 0 [no pain] to 10 [worst pain possible]), and location (using anatomical chart) of back pain immediately after the procedure. The primary endpoint was the proportion of patients with moderate to severe pain (score of ≥3). Results A total of 100 (41.3%) of 242 patients reported intraprocedural back pain with a median severity of 5/10 (range 1-10). The mean age was 58.7 ± 16.2 years. The mean duration of the procedure was 82.3 minutes (range 15-410 minutes). The pain was classified as moderate to severe in 86 of 100 patients. The locations of pain were identified in lumbar (n = 77), thoracic (n = 6), cervical (n = 7), cervical and lumbar (n = 8), and cervical with thoracolumbar (n = 2) regions. There was a significant relationship between patients' history of the previous neck and/or back surgery and frequency of moderate to severe back pain (P = .02). No significant relationship was observed between frequency of none to mild and moderate to severe back pain among the strata by patients' age, body mass index, or duration of procedures. Conclusions The relatively high prevalence of intraprocedural back pain in patients undergoing neuroendovascular procedures in awake state must be recognized, and strategies to reduce the occurrence need to be identified.

Due to their superior properties, high-entropy alloys (HEAs) are considered as novel structural materials that can substitute conventional alloys. From the viewpoint of future applications, it is important to explore methods for producing complex shaped and homogeneous HEAs. In this study, laser 3D printing technology is employed to fabricate CoCrFeMnNi HEA. The microstructure and mechanical properties of laser 3D printed HEA are also evaluated. An equiaxed-to-columnar transition structure can be observed in the melt pool of the printed sample. The fine BCC phase is found to distribute at the grain boundaries of the FCC matrix, which is the major phase of the printed sample. The printed HEA exhibits an outstanding combination of high strength and excellent ductility.

Suboptimal platelet inhibition by clopidogrel (clopidogrel resistance) may be associated with high rates of stent thrombosis and ischemic events. Our objective was to determine if ticagrelor, a P2YA thromboelastography-platelet mapping assay was used in all patients undergoing neuroendovascular procedures requiring oral clopidogrel. In patients with suboptimal platelet inhibition (60%) on clopidogrel, ticagrelor was imitated after an oral bolus of 180 mg followed by 90 mg twice daily and the platelet mapping assay was repeated. The primary endpoint was hemorrhagic complications classified as major (hemoglobin decrease5 g/dL or intracranial hemorrhage with deficits), minor (hemoglobin decrease 3-5 g/dL or intracranial hemorrhage without residual deficits), or insignificant.Suboptimal platelet inhibition on clopidogrel was seen in 70 of 106 patients undergoing neuroendovascular procedures. There was a significantly higher magnitude of platelet inhibition with ticagrelor compared with clopidogrel in patients with clopidogrel resistance (mean ± SD: 85.90 ± 10.74% vs. 29.26 ± 17.71%; P .001); 50 of 70 patients showed optimal inhibition. Two patients had major (fatal) hemorrhagic events (both received either intravenous thrombolytics and/or eptifibatide infusion). Three patients had minor hemorrhagic events, and two patients had insignificant hemorrhagic events. Four of seven hemorrhagic events occurred in patients with optimal response to clopidogrel, two occurred in patients with suboptimal response to ticagrelor, and one occurred in a patient with optimal response to ticagrelor.Oral ticagrelor can augment platelet inhibition in patients who have clopidogrel resistance.

Background Many CpGs become hyper or hypo-methylated with age. Multiple methods have been developed by Horvath et al. to estimate DNA methylation (DNAm) age including Pan-tissue, Skin & Blood, PhenoAge, and GrimAge. Pan-tissue and Skin & Blood try to estimate chronological age in the normal population whereas PhenoAge and GrimAge use surrogate markers associated with mortality to estimate biological age and its departure from chronological age. Here, we applied Horvath’s four methods to calculate and compare DNAm age in 499 subjects with type 1 diabetes (T1D) from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study using DNAm data measured by Illumina EPIC array in the whole blood. Association of the four DNAm ages with development of diabetic complications including cardiovascular diseases (CVD), nephropathy, retinopathy, and neuropathy, and their risk factors were investigated. Results Pan-tissue and GrimAge were higher whereas Skin & Blood and PhenoAge were lower than chronological age (p < 0.0001). DNAm age was not associated with the risk of CVD or retinopathy over 18–20 years after DNAm measurement. However, higher PhenoAge (β = 0.023, p = 0.007) and GrimAge (β = 0.029, p = 0.002) were associated with higher albumin excretion rate (AER), an indicator of diabetic renal disease, measured over time. GrimAge was also associated with development of both diabetic peripheral neuropathy (OR = 1.07, p = 9.24E−3) and cardiovascular autonomic neuropathy (OR = 1.06, p = 0.011). Both HbA1c (β = 0.38, p = 0.026) and T1D duration (β = 0.01, p = 0.043) were associated with higher PhenoAge. Employment (β = − 1.99, p = 0.045) and leisure time (β = − 0.81, p = 0.022) physical activity were associated with lower Pan-tissue and Skin & Blood, respectively. BMI (β = 0.09, p = 0.048) and current smoking (β = 7.13, p = 9.03E−50) were positively associated with Skin & Blood and GrimAge, respectively. Blood pressure, lipid levels, pulse rate, and alcohol consumption were not associated with DNAm age regardless of the method used. Conclusions Various methods of measuring DNAm age are sub-optimal in detecting people at higher risk of developing diabetic complications although some work better than the others.

Feature selection usually takes unsupervised way to preprocess the data before clustering. In the unsupervised feature selection, the embedding based method can capture more discriminative information contained in data compared to the other methods. Considering many existing methods learn a cluster indicator matrix which may bring noise, and at the same time, these kinds of methods does not make good use of the geometry structure of the data. In order to address the existing problems, we propose a novel model based on joint self-expression model with adaptive graph constraint. The joint self-expression module is utilized to explore the relationship between features. Different from the conventional self-expression, our joint self-expression module contains two types self-expression, i.e., conventional self-expression and the convex non-negative matrix factorization (CNMF) which can extract more representative features. Furthermore, we introduce manifold learning to maintain the structural characteristics of the original data. Adaptive graph regularization term is also incorporated based on the principle of maximum entropy into our model. In order to solve the final model, an alternative algorithm is well designed. Finally, experiment is well designed on five benchmark datasets and the experimental results show that the model proposed in this paper is more effectiveness than the state-of-the-art comparison models.

Rationale: The Miller Fisher syndrome (MFS) is an acute polyradiculoneuritis regarded as an uncommon clinical variant of the Guillain-Barre syndrome (GBS). It is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia. The diagnosis of MFS is based on clinical presentation, presence of albuminocytologic dissociation in the cerebrospinal fluid (CSF), and normal brain imaging results. The presence of anti-ganglioside antibodies (GQlb) in the serum is helpful for the diagnosis. A history of upper respiratory tract infection or diarrhea 3 days to 6 weeks before the onset of MFS is common. However, there are some patients with atypical manifestations who are difficult to diagnose. Here, we present an incomplete form of MFS where antibodies against GQ1b were detected in the serum following an Epstein Barr virus (EBV) infection. Patient concerns: A 77-year-old Chinese woman was admitted to the hospital with acute diplopia and right blepharoptosis. She had a history of mild upper respiratory tract infection 2 weeks ago. In 1 week, the symptoms rapidly progressed into bilateral ophthalmoplegia and hyporeflexia of the limbs without ataxia. CSF analysis on the third day after onset was normal, without albuminocytologic dissociation. EBV immunoglobulin G (IgG) antibodies were detected in the CSF. GQ1b and GD1b IgG antibodies were positive in the serum and negative in the CSF. No responsible lesion was found on brain imaging examination. Diagnoses: In accordance with the progressive bilateral ophthalmoplegia and hyporeflexia, the history of upper respiratory tract infection, the detection of EBV and GQ1b antibodies, and the negative brain imaging examination, the diagnosis of MFS was confirmed. Interventions: The patient was administered intravenous immunoglobulin for 5 days. Outcomes: She had a favorable outcome after treatment. At the 6-week follow-up, bilateral ocular movement limitation and tendon reflexes had recovered. Lessons: The diagnosis of MFS can be challenging, especially when encountered with incomplete symptoms and normal CSF results. Attention should be paid to the presence of anti-GQ1b IgG antibodies when the clinical manifestations are incomplete. Furthermore, EBV primary infection could be associated with MFS and considered a potential causative agent.

We examined if urinary angiotensinogen (uAOG), a marker of intrarenal renin‐angiotensin system activity, antedates stage 3 chronic kidney disease (CKD) using samples from participants in the Diabetes Control and Complications Trial (DCCT) and later in the Epidemiology of Diabetes Intervention and Complications (EDIC) trial. In a nested case–control design, cases were matched at the outcome visit (eGFR less than 60, 21‐59 mL/min per 1.73 m2) on age, gender, and diabetes duration, with controls: eGFR (95, 75‐119, mL/min per 1.73 m2.) Additionally, in an exploratory analysis progressive renal decline (PRD), defined as eGFR loss >3.5 mL/min per 1.73m2/year, was evaluated using only data from EDIC because no progressions were observed during DCCT. At the EDIC visit, which antedated the GFR outcome visit by 2 years (range 1–7years) the median uAOG/creatinine was markedly higher in cases than in controls (13.9 vs. 3.8 ng/mg P = 0.003) whereas at the DCCT visit, which antedated the GFR outcome by 17 to 20 years it was not (2.75 vs. 3.16 ng/mg, respectively). The Odds Ratio for uAOG and CKD stage 3 development was significant after adjusting for eGFR, HbA1c, and systolic blood pressure 1.82 (1.00–3.29) but no longer significant when Albumin Excretion Ratio (AER) was included 1.21 (0.65–2.24).In the PRD analysis, uAOG/creatinine was sixfold higher in participants who experienced PRD than in those who did not (26 vs. 4.0 ng/mg, P = 0.003). The Odds Ratio for uAOG and PRD was significant after adjusting for eGFR, HbA1c, and systolic blood pressure 2.48 (1.46–4.22) but no longer significant when AER was included 1.32 (0.76–2.30). In people with type1 diabetes, a robust increase in uAOG antedates the development of stage 3 CKD but is not superior to AER in predicting this renal outcome. Increased uAOG moreover is associated with PRD, an index of progression to End Stage Kidney Disease (ESKD).

Objective: Studies have demonstrated that glycated hemoglobin (HbA1c) is a significant predictor of hearing impairment in type 1 diabetes. We identified additional factors associated with hearing impairment in participants with type 1 diabetes from the Diabetes Control and Complications Trial and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. Methods: A total of 1,150 DCCT/EDIC participants were recruited for the Hearing Study. A medical history, physical measurements, and a self-administered hearing questionnaire were obtained. Audiometry was performed by study-certified personnel and assessed centrally. Logistic regression models assessed the association of risk factors and comorbidities with speech- and high-frequency hearing impairment. Results: Mean age was 55 ± 7 years, duration of diabetes 34 ± 5 years, and DCCT/EDIC HbA1c 7.9 ± 0.9% (63 mmol/mol). In multivariable models, higher odds of speech-frequency impairment were significantly associated with older age, higher HbA1c, history of noise exposure, male sex, and higher triglycerides. Higher odds of high-frequency impairment were associated with older age, male sex, history of noise exposure, higher skin intrinsic florescence (SIF) as a marker of tissue glycation, higher HbA1c, nonprofessional/nontechnical occupations, sedentary activity, and lower low-density-lipoprotein cholesterol. Among participants who previously completed computed tomography and carotid ultrasonography, coronary artery calcification (CAC) >0 and carotid intima-medial thickness were significantly associated with high-but not speech-frequency impairment. Conclusion: Consistent with previous reports, male sex, age, several metabolic factors, and noise exposure are independently associated with hearing impairment. The association with SIF further emphasizes the importance of glycemia-as a modifiable risk factor-over time. In addition, the macrovascular contribution of CAC is novel and important. Abbreviations: AER = albumin excretion rate; CAC = coronary artery calcification; CVD = cardiovascular disease; DCCT/EDIC = Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications; eGFR = estimated glomerular filtration rate; ETDRS = Early Treatment Diabetic Retinopathy Study; HbA1c = glycated hemoglobin; HDL = high-density lipoprotein; IMT = intima-media thickness; LDL = low-density lipoprotein; NHANES = National Health and Nutrition Examination Survey; OR = odds ratio; SIF = skin intrinsic fluorescence; T1D = type 1 diabetes.

We investigated whether the composition of modified forms of LDL in circulating immune complexes (LDL-ICs) was associated with cardiovascular disease (CVD) outcomes, including any CVD, major adverse cardiac and cerebrovascular events (MACCE), myocardial infarction (MI), and coronary artery disease, in type 1 diabetes (T1D). Our results demonstrate that the baseline levels of oxidized LDL (oxLDL), MDA-modified LDL (MDA-LDL), and advanced glycosylation–modified LDL (AGE-LDL) in circulating ICs were associated with the four CVD outcomes in unadjusted models, and adjustment by age and mean HbA1c only resulted in minimal reduction of these associations. After adjustments were made for other cardiovascular risk factors, particularly LDL cholesterol, oxLDL-IC and MDA-LDL-IC remained independently associated with the risk of CVD, and oxLDL-IC was independently associated with the risk of MACCE and MI. In the majority of cases, the baseline levels of modified LDL-IC (measured many years before the occurrence of any CVD event) were associated with the risk of CVD over a 25-year period even after adjustment for other risk factors (including LDL cholesterol). Therefore, modified LDL biomarkers may help identify patients with T1D at high risk for MACCE and CVD events very early in the evolution of the disease, before other signals of disease are apparent.

INTRODUCTION Glomerular hyperfiltration has long been considered to be a major contributing factor to the development of diabetic kidney disease but most studies assessed increased albumin excretion rather than reduced GFR as an outcome. To address whether early glomerular hyperfiltration results in subsequent increased risk of clinically significant loss of GFR, namely Stage 3 CKD (eGFR

The globally recognized need to advance more sustainable agriculture and food systems has motivated the emergence of transdisciplinary solutions, which include methodologies that utilize the properties of materials at the nanoscale to address extensive and inefficient resource use. Despite the promising prospects of these nanoscale materials, the potential for large-scale applications directly to the environment and to crops necessitates precautionary measures to avoid unintended consequences. Further, the effects of using engineered nanomaterials (ENMs) in agricultural practices cascade throughout their life cycle and include effects from upstream-embodied resources and emissions from ENM production as well as their potential downstream environmental implications. Building on decades-long research in ENM synthesis, biological and environmental interactions, fate, transport and transformation, there is the opportunity to inform the sustainable design of nano-enabled agrochemicals. Here we perform a screening-level analysis that considers the system-wide benefits and costs for opportunities in which ENMs can advance the sustainability of crop-based agriculture. These include their on-farm use as (1) soil amendments to offset nitrogen fertilizer inputs, (2) seed coatings to increase germination rates and (3) foliar sprays to enhance yields. In each analysis, the nano-enabled alternatives are compared against the current practice on the basis of performance and embodied energy. In addition to identifying the ENM compositions and application approaches with the greatest potential to sustainably advance crop production, we present a holistic, prospective, systems-based approach that promotes emerging alternatives that have net performance and environmental benefits. A screening-level analysis that considers system-wide benefits and costs is used to identify opportunities where engineered nanomaterials can advance the sustainability of crop-based agriculture.

The shale portion of Chang 7 member (C7M) can be divided into two sub-members (SM): the Chang 7-2 sub-member (C7-2SM) and Chang 7-3 sub-member (C7-3SM). An analysis of trace elements shows that C7M shale developed under a freshwater sedimentary environment. C7-3SM shale was formed under conditions of comparatively higher salinity and a much deeper waterbody than C7-2SM shale. C7-3SM shale exhibits a larger content of an illite/smectite mixed layer (70.35%) and reducing minerals (12.94%), but less quartz content (22.31%). Although C7-3SM shale has lower Ro values, it displays much higher S1 values and productivity of hydrocarbon per gram of total organic carbon (TOC) due to Type II1 kerogen, which are mainly Type II2 and possibly Type III in C7-2SM shale. Samples with a drilling orientation perpendicular to sedimentary stratification (“vertical” samples) display relatively lower porosity and permeability. Although no apparent difference of permeability occurs between the two shale sections, C7-2SM shale exhibits higher porosity for both “vertical” and “parallel” samples. Moreover, C7-3SM shale displays lower values of specific surface area and adsorption quantity. The composition of minerals, together with residual hydrocarbon, leads to the lower porosity and adsorption quantity for C7-3SM shale. Compared with C7-2SM shale, C7-3SM shale is not good at generating and storing natural gas. Overpressure may be the reason for the increase in acoustic travel time (AC) values with progressive burial depth for C7-3SM shale.

Reversible splenial lesion syndrome (RESLES) is a clinico-radiological entity that defines a reversible lesion in the splenium of the corpus callosum (SCC) on magnetic resonance imaging (MRI). The clinical and radiological characteristics of RESLES are poorly defined and most RESLES literature is in the form of case reports. We reviewed the clinical and radiological data from 11 RESLES patients in order to more clearly describe the characteristics of this disorder in adults. Patients included in this study were diagnosed with RESLES from May 2012 to March 2018. We collected clinical, imaging, and laboratory data of 11 adult patients from Neurology Department of the Affliated Yantai Yuhuangding Hospital of Qingdao University. After analyzing various clinico-radiological features and laboratory parameters, including serum sodium, pathogen testing, cerebrospinal fluid (CSF) studies, electroencephalography (EEG), and MRI findings, we made a diagnosis of RESLES based on the criteria proposed previously by Garcia-Monco et al. Of the 11 patients, 7 (63.63%) were male and 4 (36.36%) were female, ranging in age from 24 to 62 years with an average age of 31.48 ± 11.47 years. Seven cases occurred in the months of winter and spring (December–March). The primary clinical symptoms were headache, seizure, disturbance of consciousness, mental abnormality, and dizziness. All 11 patients had lesions in the SCC and all the lesions disappeared or significantly improved on follow-up imaging that was done within a month of symptom resolution. We found 5 (45.45%) patients had a CSF opening pressure >180 mmH2O, in addition to elevated protein and(or) leukocytes levels in 3 (27.27%) patients. The serum sodium concentration in 6 (54.55%) patients was low (

This paper focuses on the feature-based image stitching technology. The algorithm has been studied and experimented based on the steps of sample acquisition, image preprocessing, feature point detection, matching, transformation model, fusion, etc. In the feature point detection part, the SURF algorithm with better overall performance than Harris, FAST, SIFTS, and ORB algorithms were selected. In the matching part, different algorithms are analyzed and the best solution is selected. Based on the initially formulated image stitching scheme, the algorithm is optimized and the container image is stitched. The quality and reason of the output image are analyzed, and the scheme is revised according to them. Stitching experiments are performed on multiple images based on simple image splicing.

Design of pixel circuit for current AMOLED display driven by LTPS TFT are reviewed. Technical challenges and trends for future AMOLED display commercialization are discussed.

As the main actuator of the robot, DC servo motor plays an important role in the development of the robotics. In this paper, PID controller is used to control the DC servo motor, and the firefly algorithm (FA) is used to self-tune the parameters of PID. Enhancing the control ability of PID. This paper focuses on the problem that the general FA converges too slowly and the precision is not high. Inertia weight and adjustment factor are introduced to form an improved FA. The inertia weight enhances the influence of the current position of the firefly on the next position. The adjustment factor accelerates the convergence speed in the early iteration and improves the precision of the later optimization. experimental result at MATLAB shows that the improved FA has a significant improvement on the PID parameter tuning problem compared with the traditional ZN method and the original FA.

OBJECTIVE To evaluate the prevalence of hearing impairment in participants with type 1 diabetes enrolled in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study and compare with that of a spousal control group without diabetes. Among participants with type 1 diabetes, to evaluate the association of hearing impairment with prior DCCT therapy and overall glycemia. RESEARCH DESIGN AND METHODS DCCT/EDIC participants (n = 1,150) and 288 spouses without diabetes were recruited for the DCCT/EDIC Hearing Study. All subjects completed a self-administered questionnaire, medical history, and physical measurements. Audiometry was performed by study-certified personnel; audiograms were assessed centrally. Speech-frequency (pure-tone average [PTA] thresholds at 500, 1,000, 2,000, and 4,000 Hz) and high-frequency impairment (PTA thresholds at 3,000, 4,000, 6,000, and 8,000 Hz) were defined as PTA >25 dB hearing loss. Logistic regression models were adjusted for age and sex. RESULTS DCCT/EDIC participants and spousal control subjects were similar in age, race, education, smoking, and systolic blood pressure. There were no statistically significant differences between groups in the prevalence or adjusted odds of speech- or high-frequency impairment in either ear. Among participants with type 1 diabetes, for every 10% increase in the time-weighted mean HbA1c, there was a 32% (95% CI 1.15–1.50) and 19% (95% CI 1.07–1.33) increase in speech- and high-frequency hearing impairment, respectively. CONCLUSIONS We found no significant difference in the prevalence of hearing impairment between the group with type 1 diabetes and the spousal control group. Among those with type 1 diabetes, higher mean HbA1c over time was associated with hearing impairment.

Fungal sphenoid sinusitis is easily misdiagnosed in clinic, particularly for patients with normal immunological status. Due to the anatomic characteristics of sphenoid sinus, patients presented with various nonspecific symptoms and complications. Headache is the most common presentation, but location of headache is not fixed. We intended to analyze 6 cases of headache secondary to the isolated sphenoid sinus fungus ball (SSFB) which were first diagnosed in the Neurology Department. There was significant female predominance with mean ages of 55 years. They had repeatedly headache history from months to years. The headache was unilateral and usually on the side of lesions. Medication of pain relievers worked well in the beginning of SSFB, but not in the late stage of disease. Notably, all patients did not present positive nervous systemic signs. A preoperative computed tomography (CT) scan or magnetic resonance imaging (MRI) demonstrated the inflammation in sphenoid sinus. Some cases showed calcification in soft tissue or bone lesions of sinus wall. All of 6 patients undertook transnasal endoscopic sphenoidotomy without antifungal therapy after operation. Characteristic fungus ball (FB) was detected after histopathological examination. No headache recurrence was found after average 15.5 months follow-up. Our results suggested that transnasal endoscopic sphenoidotomy is the treatment of choice to remove the FB in sphenoid sinus with a low rate of morbidity and recurrence.

For conventional active-matrix organic light-emitting diode (AMOLED) flat panel displays, low temperature poly-silicon thin-film transistor (LTPS TFT) on rigid glass substrate process has already been well established. However, this technology cannot be applied directly on polyimide (PI) substrate for flexible display. This is because PI has the different coefficient of thermal expansion (CTE) from the glass, which will result in PI film peeling-off and/or warpage issues under conventional LTPS-TFT process technology. In this paper, a process flow of LTPS TFT on PI substrate for flexible display application was discussed. A flexible display demo system was successfully made by optimizing the LTPS TFT process.

Intensive diabetes treatment reduces the risk of developing albuminuria in individuals with type 1 diabetes. Effects on the long-term clinical course of kidney disease remain to be defined. We aimed to compare the long-term effects of intensive versus conventional treatment on incident albuminuria.For this long-term follow-up study of the Diabetes Control and Complications Trial (DCCT) we assessed the effect of intensive diabetes treatment on albuminuria during 18 years after the completion of the trial. During the DCCT (1983-1993), 1441 participants with type 1 diabetes were randomly assigned to receive either intensive treatment (with the goal of achieving levels of glycaemia as close to the non-diabetic range as safely possible) or conventional treatment (aimed at prevention of symptoms of hyperglycaemia and hypoglycaemia). At the end of the DCCT, all participants were instructed in intensive treatment, and all participants were invited to join the observational Epidemiology of Diabetes Interventions and Complications (EDIC) study. Mean HbA1c during the EDIC study was similar in the two groups of patients who differed in their treatment assignment during the DCCT. Albumin excretion rate was measured every other year during the EDIC study. Microalbuminuria was defined as an albumin excretion rate of 30 mg per 24 h or higher on two consecutive study visits and macroalbuminuria as an albumin excretion rate of 300 mg per day or higher. We estimated glomerular filtration rate from annual serum creatinine measurements throughout DCCT and the EDIC study. The DCCT is registered with ClinicalTrials.gov, number NCT00360815, and the EDIC study, with number NCT00360893.During years 1-18 of EDIC, we noted 191 new cases of microalbuminuria (71 in the group receiving intensive treatment during DCCT and 120 in the group receiving conventional treatment during DCCT; risk reduction 45%, 95% CI 26-59) and 117 new cases of macroalbuminuria (31 intensive, 86 conventional; 61%, 41-74). At year 17-18 of EDIC, the prevalence of albumin excretion rate of 30 mg per 24 h or higher was 18·4% in participants assigned to intensive treatment during the DCCT, compared with 24·9% in participants assigned to conventional treatment (p=0·02). During years 1-18 of EDIC, we recorded 84 cases of sustained estimated glomerular filtration rate lower than 60 mL/min per 1·73m(2) (31 intensive, 53 conventional; risk reduction 44%, 95% CI 12-64).In individuals with type 1 diabetes, intensive diabetes treatment yields durable renal benefits that persist for at least 18 years after its application. Ultimately, such benefits should result in fewer patients requiring renal replacement therapy.National Institute of Diabetes and Digestive and Kidney Disease.

Six skin collagen advanced glycation end products (AGEs) originally measured near to the time of the Diabetes Control and Complications Trial (DCCT) closeout in 1993 may contribute to the “metabolic memory” phenomenon reported in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. We have now investigated whether the addition of four originally unavailable AGEs (i.e., glucosepane [GSPNE], hydroimidazolones of methylglyoxal [MG-H1] and glyoxal, and carboxyethyl-lysine) improves associations with incident retinopathy, nephropathy, and neuropathy events during 13–17 years after DCCT. The complete 10-AGE panel is associated with three-step Early Treatment of Diabetic Retinopathy Study scale worsening of retinopathy (P ≤ 0.002), independent of either mean DCCT or EDIC study A1C level. GSPNE and fructose-lysine (furosine [FUR]) correlate with retinopathy progression, independently of A1C level. The complete panel also correlates with microalbuminuria (P = 0.008) and FUR with nephropathy independently of A1C level (P ≤ 0.02). Neuropathy correlates with the complete panel despite adjustment for A1C level (P ≤ 0.005). MG-H1 and FUR are dominant, independent of A1C level (P < 0.0001), whereas A1C loses significance after adjustment for the AGEs. Overall, the added set of four AGEs enhances the association of the original panel with progression risk of retinopathy and neuropathy (P < 0.04) but not nephropathy, while GSPNE and MG-H1 emerge as the principal new risk factors. Skin AGEs are robust long-term markers of microvascular disease progression, emphasizing the importance of early and sustained implementation of intensive therapy.

Prognostics of the remaining useful life (RUL) of lithium-ion batteries is a crucial role in the battery management systems (BMS). An artificial neural network (ANN) does not require much knowledge from the lithium-ion battery systems, thus it is a prospective data-driven prognostic method of lithium-ion batteries. Though the ANN has been applied in prognostics of lithium-ion batteries in some references, no one has compared the prognostics of the lithium-ion batteries based on different ANN. The ANN generally can be classified to two categories: the shallow ANN, such as the back propagation (BP) ANN and the nonlinear autoregressive (NAR) ANN, and the deep ANN, such as the long short-term memory (LSTM) NN. An improved LSTM NN is proposed in order to achieve higher prediction accuracy and make the construction of the model simpler. According to the lithium-ion data from the NASA Ames, the prognostics comparison of lithium-ion battery based on the BP ANN, the NAR ANN, and the LSTM ANN was studied in detail. The experimental results show: (1) The improved LSTM ANN has the best prognostic accuracy and is more suitable for the prediction of the RUL of lithium-ion batteries compared to the BP ANN and the NAR ANN, (2) the NAR ANN has better prognostic accuracy compared to the BP ANN.

In trials of people with type 2 diabetes, albuminuria reduction with renin-angiotensin system inhibitors is associated with lower risks of cardiovascular events and CKD progression. We tested whether progression or remission of microalbuminuria is associated with cardiovascular and renal risk in a well characterized cohort of type 1 diabetes.We studied 1441 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications study. Albumin excretion rate (AER) was quantified annually or biennially for up to 30 years. For each participant, albuminuria status was defined over time as normoalbuminuria (AER continuously30 mg/d), sustained microalbuminuria (AER, 30-299 mg/d on two consecutive visits), macroalbuminuria (AER≥300 mg/d), or remitted microalbuminuria (transition from sustained microalbuminuria to AER30 mg/d on two consecutive visits). We tested associations of time-updated albuminuria status with adjudicated clinical cardiovascular events, the development of reduced GFR (60 ml/min per 1.73 mAt least one cardiovascular event occurred in 184 participants, and 98 participants developed reduced eGFR. Compared with normoalbuminuria, sustained microalbuminuria, remitted microalbuminuria, and macroalbuminuria were each associated with higher risk of cardiovascular events (adjusted hazard ratios [HRs] and 95% confidence intervals [95% CIs]: 1.79 [1.13 to 2.85], 2.62 [1.68 to 4.07], and 2.65 [1.68 to 4.19], respectively) and reduced eGFR (adjusted HRs [95% CIs], 5.26 [2.43 to 11.41], 4.36 [1.80 to 10.57], and 54.35 [30.79 to 95.94], respectively). Compared with sustained microalbuminuria, remission to normoalbuminuria was not associated with reduced risk of cardiovascular events (adjusted HR, 1.33; 95% CI, 0.68 to 2.59) or reduced eGFR (adjusted HR, 1.75; 95% CI, 0.56 to 5.49). Compared with normoalbuminuria, sustained microalbuminuria, remitted microalbuminuria, and macroalbuminuria were associated with greater carotid intima-media thickness, and macroalbuminuria was associated with a greater degree of coronary artery calcification.In type 1 diabetes, microalbuminuria and macroalbuminuria are associated with higher risks of cardiovascular disease and reduced eGFR, but achieving a remission of established microalbuminuria to normoalbuminuria does not appear to improve outcomes.

AMOLED on plastic substrates is expected to be the best candidate for foldable display. However, for small bending radius foldable AMOLED display modules, researches on module process and stress resistance material still remain essential and challenging. In this paper, recent work on a 7 inch full-function foldable AMOLED display module is introduced. In addition, the failure modes after 100k times folding cycle under bending radius less than 3mm are also discussed.

A major challenge for machine translation and cross-lingual applications is the lack of corresponding relationships among characters, words, and grammars of different languages, unless they are homological. This article reviews a theory based on semantic units (SUs) and their representation to address this challenge. SUs share the same meaning across languages, so the unified linguistics theory described here has the potential to greatly simplify natural language processing with rich semantics.

Rationale: The present study explored the relationship between the adenosine triphosphate (ATP)-binding cassette A1 (ABCA1) gene, atherosclerosis, and cerebral infarction. The diagnosis and treatment ideas of stroke caused by Tangier disease via the summary of the diagnosis and treatment process of one case with juvenile stroke were explored. The relevant literature on the clinical manifestations, laboratory examinations, and treatment of Tangier disease was reviewed. Patient concerns: The brain magnetic resonance imaging (MRI) of a juvenile man with acute onset of sudden right limb weakness and speechlessness revealed infarct lesions. The laboratory tests found low serum high-density lipoprotein (HDL), while further genetic testing identified ABCD1 gene mutation. The mother also carried the mutant gene. Diagnoses: Tangier disease was diagnosed. Interventions: Statin treatment was administered for platelet aggregation. Outcomes: After 3 years of follow-up, the patient was declared to be in a stable condition. Lessons: ABCA1 gene mutation caused early onset of atherosclerosis, leading to the occurrence of cerebral infarction. The cerebral infarction associated with reduced high-density lipoprotein (HDL), was under intensive focus with respect to ABCA1 gene. Child and Juvenile stroke patients with low HDL should not be excluded from the possibility of Tangier disease.

To express semantic knowledge of natural languages accurately and unify the processing of languages, the style transformation of natural languages is discussed in an all-round way. The discussion covers purpose, voice, modal, tense, narrow sense of style, number and case. All style transformations may be described accurately by a four-element Descriptive Language of Style Transformation (STDL). The transformation between representation of semantic units without style and with style can be converted through style transformation function. Each style transformation function is a difference function in multiple natural languages. Such difference functions can be used to simplify language processing procedure and improve processing quality.

The syntax of different natural languages are different, hence the parsing of different natural languages are also different, thus leadings to structures of their parsing-trees being different. The reason that the sentences in different natural languages can be translated to each other is that they have the same meaning. This paper discusses a new sentence parsing, called semantic-parsing, based on semantic units theory. It is a new theory where a sentence of a natural language is not regarded as of words and phrases arranged linearly; rather it is expected to consist of semantic units with or without type-parameters. This is a new parsing approach where the syntax-parsing-tree and semantic-parsing-tree are isomorphic. It is also a new approach in which the structure-trees of the sentences in all different natural languages can correspond.

For the automatic recognition of pointer instrument, the method for the automatic recognition of pointer instrument based on improved Hough Transform was proposed in this paper. The automatic recognition of pointer instrument is applied to all kinds of lighting conditions, but the accuracy of it binaryzation will be influenced when the light is too strong or too dark. Therefore, the improved Ostu method was suggested to realize recognition for adaptive thresholding of pointer instrument under all kinds of lighting conditions. On the basis of dial image characteristics, Otsu method is used to get the value of maximum between-cluster variance and initial threshold than analyze its maximum between-cluster variance value to determine the light and shade of the image. When the images are too bright or too dark, the smaller pixels should be given up and then calculate the initial threshold by Otsu method again and again until the best binaryzation image was obtained. Hence, transform the pointer straight line of the binaryzation image to Hough parameter space through improved Hough Transform to determine the position of the pointer straight line by searching the maximum value of arrays of the same angle. Finally, according to angle method, the pointer reading was obtained by the linear relationship for the initial scale and angle of the pointer instrument. Results show that the improved Otsu method make pointer instrument possible to obtained the accuracy binaryzation image even though the light is too bright or too dark , which improves the adaptability of pointer instrument to automatic recognize the light under different conditions. For the pressure gauges with range of 60MPa, the relative error identification reached to 0.005 when use the improved Hough Transform Algorithm.

The motion blur is one of the common factors leading to blurred images, the parameters of the point spread function (PSF) estimation is the key and prerequisite of motion blurred image restoration. Based on motion blur image characteristics of spectrum and cepstrum analysis, a automatic detection algorithm based on frequency domain and cepstrum domain algorithms is proposed in the paper, which can automatically detect the blur length and blur angle, then we can restorate the motion blur image. Experiments show that when the blur length is 15 ~ 80 pixels noiselessly, In addition to the individual blur length/angle (e.g. 30 pixels/300, 75 pixels/300), blur length estimation error is 0 ~ 0.2 pixels and blur angle estimation error is almost 0. The detection range is greater than some other methods, and the quality of image restoration is good.

Background We recently reported strong associations between eight skin collagen AGEs and two solubility markers from skin biopsies obtained at DCCT study closeout and the long-term progression of microvascular disease in EDIC, despite adjustment for mean glycemia. Herein we investigated the hypothesis that some of these AGEs (fluorescence to be reported elsewhere) correlate with long-term subclinical cardiovascular disease (CVD) measurements, i.e. coronary artery calcium score (CAC) at EDIC year 7–9 (n = 187), change of carotid intima-media thickness (IMT) from EDIC year 1 to year 6 and 12 (n = 127), and cardiac MRI outcomes at EDIC year 15–16 (n = 142). Methods Skin collagen AGE measurements obtained from stored specimens were related to clinical data from the DCCT/EDIC using Spearman correlations and multivariable logistic regression analyses. Results Spearman correlations showed furosine (early glycation) was associated with future mean CAC (p 0 (p = 0.39), but not with CAC score 100. Glucosepane and pentosidine crosslinks, methylglyoxal hydroimidazolones (MG-H1) and pepsin solubility (inversely) correlated with IMT change from year 1 to 6(all P

Alien hand syndrome (AHS) is characterized by involuntary and autonomous activity of the affected limbs, and consists of the frontal, callosal and posterior AHS variants. The callosal subtype, resulting from damage to the corpus callosum, frequently features intermanual conflict. However, infarction of the corpus callosum is rare due to abundant blood supply. The present study reported a case of AHS (callosal subtype, in the right hand) caused by callosal infarction. Infarction of the left corpus callosum was confirmed with magnetic resonance imaging. In addition, magnetic resonance angiography and digital subtraction angiography examinations revealed multiple lesions in the feeding arteries. Subsequent to antiplatelet therapy for 2 weeks following admission, the patient gradually recovered. Furthermore, the current study reviewed 31 previously reported cases of AHS following callosal infarction in the literature.

In this paper, the reasons for the shortcoming of Zadeh's fuzzy set theory — it cannot correctly reflect different kinds of fuzzy phenomenon in the natural world — are discussed. In addition, the proof of the error of Zadeh's fuzzy set theory — it incorrectly defined the set complement that cannot exist in Zadeh's fuzzy set theory — is proposed. This error of Zadeh's fuzzy set theory causes confusion in thinking, logic and conception. It causes the seriously mistaken belief that logics of fuzzy sets necessarily go against classical and normal thinking, logic and conception. Two new fuzzy set theories, C-fuzzy set theory and probability-like fuzzy set theory, the N-fuzzy set theory, are proposed. The two are equivalent, and both overcome the error and shortcoming of Zadeh's fuzzy set theory, and they are consistent with normal, natural and classical thinking, logic and concepts. The similarities of N-fuzzy set theory with probability theory are also examined.