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

Flexible sensors and photodetectors are among the robust and powerful strategies for advanced and smart devices. Meanwhile, wide band-gap metal oxides are competitive candidates for fabricating flexible solar-blind photodetectors (SBPDs) but still challenging in both fundamental and practical fields. Here, we demonstrate the amorphous ALD-Ga2O3 (am-ALD-Ga2O3) thin films realized at a moderate temperature toward flexible SBPDs. The bandgap (Eg) of 4.88-5.04 eV depends on and changes with the thickness of am-ALD-Ga2O3 thin films during atomic layer deposition (ALD) processes. The SBPDs are fabricated with the as-grown am-ALD-Ga2O3 thin films on desired substrates and exhibit an Ilight/Idark ratio of up to ∼4.5 × 104 and dark current down to ∼10-13 A. Subsequently, decorating the ALD-Ga2O3 channels with MoS2 multilayers helps improve the photocurrent of SBPDs that worked in the deep ultraviolet region. We expect that our work will offer more opportunities to understand and exploit am-ALD-Ga2O3 thin films toward advanced flexible SBPDs and functional sensors.

PURPOSE To explore whether there is an association between dietary choline intake and odds of diabetic retinopathy (DR) in the US diabetic population. METHODS A cross-sectional study was conducted using the combined data of the National Health and Nutrition Examination Survey (NHANES) 2005-2008 of a complex, multistage, and probability-sampling design. Energy-adjusted choline intake was calculated separately for men and women using the residual method. Binary logistic regression adjusting for covariates was used to identify the variables associated with DR. RESULTS We included 644 male and 628 female diabetic subjects, which were equivalent to a weighted survey sample of 9,339,124 for males and 10,109,553 for females respectively. Female DR patients consumed more choline than non-DR patients (268.6 mg/d vs 250.9 mg/d; p = .046). The estimated prevalence of DR was 17.4%, 21.9%, and 29.7% across three levels of dietary choline intake in females, respectively. In multivariable logistic-regression models, the odds ratio (OR) of DR for female patients in the highest choline intake group was 2.14 (95% confidence interval [CI], 1.38-3.31; p = .001) compared with those in the lowest intake group. This association was positive but not statistically significant in males. CONCLUSION Higher intake of dietary choline is associated with increased odds of DR in females, but not in males. Further studies are warranted to investigate the direct role of choline in DR development and determine the recommended daily intake of choline for diabetic patients weighing the pros and cons of dietary choline consumption.

Prussian blue (PB) is a well-known electrochromic material due to its fast response and high cycle stability. We used the multi-step electrodeposition to prepare the PB films (S-PB) with different thickness. SEM image shows that as-grown film has small particles on its surface, which is beneficial for improving electrochromic properties of thicker PB film. The S-PB film with a thickness of 410 nm shows a high transmittance modulation of 82.04% at λ = 680 nm. S-PB and CeO2-TiO2-Li films were used as working electrode and counter electrode separately to prepare electrochromic devices (ECDs), both of which are inorganic anode materials. At 680 nm wavelength, the device based on double anode materials changes transmittance from 71.25 to 11.71% and the coloration efficiency is 73.5 cm2/C. Moreover, the optical modulation of ECD does not change significantly when performing 10,000 cycles.

Objective For patients with severe traumatic brain injury (sTBI) with bilateral fixed dilated pupils (BFDP), the value of aggressively decompressive craniectomy (DC) treatment is still controversial. The objective of this study was to analyze and validate the outcome of DC in patients with sTBI with BFDP. Methods We retrospectively collected data from 44 patients with sTBI with BFDP who underwent DC treatment from July 2011 to June 2018. Outcomes used as indicators were mortality and favorable outcome. The analysis was based on the Glasgow Outcome Scale score recorded at discharge, 6, and 12 months after trauma. Results The overall survival was 36.4% (16/44) at discharge and 25.0% (11/44) at 6 and 12 months, and the favorable outcome (Glasgow Outcome Scale score = 4–5) at discharge, 6, and 12 months after injury was 9.1% (4/44), 13.6% (6/44), and 20.5% (9/44), respectively. Sex (P = 0.046), preoperative Glasgow Coma Scale (GCS) score (P = 0.031), injury–surgery intervals (P = 0.022), and tracheotomy (P = 0.017) were independent associations to 6 and 12 months follow-up survival, whereas only preoperative GCS score (odds ratio, 6.088; confidence interval, 1.172–31.612; P = 0.032) and injury–surgery intervals (odds ratio, 0.241; confidence interval, 0.065–0.893; P = 0.033) were independent associations with 12 months follow-up favorable outcome. Conclusions BFDP indicates a grave prognostic sign after sTBI, but the higher preoperative GCS score and shorter injury–surgery intervals in patients who underwent DC treatment might independently predict favorable outcome for patients with sTBI with BFDP, and patients might benefit more than expected if the DC treatment were applied more aggressively and positively.

Objective This study aimed to summarize the experience with the management of transorbital brain injury (TOBI) at our institution that may help inform surgical decision-making. Methods Four adults with TOBIs were admitted to our hospital and received surgical treatment. The patients’ clinical manifestations, physical findings, imaging data, surgical treatment, and postoperative outcome were prospectively collected and subject to retrospective analysis. Results All patients were male. In 2 patients, the entry point of the cranium was the superior orbital fissure, whereas in the other 2, the entry point was the orbital roof. Thorough physical examination and comprehensive diagnostic imaging were performed preoperatively in all patients for careful assessment of the foreign body and its surrounding important structures. In collaboration with our multidisciplinary trauma team, individualized surgeries were successfully designed and performed in the 4 patients to remove the foreign bodies along the path of their trajectories. Three patients had uneventful postoperative courses, whereas 1 patient died because of severe cerebral ischemia and refractory brain swelling after decompressive craniectomy. Conclusions A comprehensive understanding of the regional anatomy of the trajectory is the cornerstone for surgical management of TOBIs. Adequate preoperative imaging examinations are essential for the evaluation of surgical risks and for making a tailored management strategy. Early surgical exploration through multidisciplinary collaboration is highly recommended for achieving a favorable outcome.

Purpose. To assess whether renin-angiotensin system inhibitor (RASI) utilization is associated with age-related macular degeneration (AMD) prevalence among hypertensive patients. Methods. A US population-based, cross-sectional study was conducted. 3,023 hypertensive participants aged 40 years and older with gradable retinal images and ascertained RASI usage in the National Health and Nutrition Examination Survey (NHANES), 2005–2008, were finally enrolled into the study. RASI usage was obtained by interview, and AMD was determined through retinal image assessment. We performed multivariable analyses to assess the relationship between utilization of RASIs and AMD prevalence. We also took drug treatment duration into account, in order to better understand the effects of RASIs. Results. Multivariable logistic regression analyses revealed that AMD prevalence had no significant association with RASI usage but was inversely correlated with RASI treatment duration (odds ratio (OR) = 0.87, 95% confidence interval (CI) = 0.78–0.98, p=0.02). Long-term usage (>5 years) of RASIs was significantly associated with not only reduced overall risk of AMD (OR = 0.23, 95% CI = 0.14–0.38, p<0.001) but also lower propensity to have early (OR = 0.23, 95% CI = 0.14–0.37, p<0.001) and late (OR = 0.25, 95% CI = 0.07–0.87, p=0.03) AMD. Furthermore, long-term RASI users were less prone to develop soft drusen (OR = 0.67, 95% CI = 0.45–0.99, p=0.04) and geographic atrophy (GA) (OR = 0.39, 95% CI = 0.22–0.71, p=0.003). Conclusions. Evidence supporting that RASI utilization could directly protect against AMD in hypertensive patients was still insufficient, but long-term RASI treatment seemed to be beneficial for both early and late AMD, implicating a promising therapeutic approach that RASIs might offer for AMD prevention and management.

Wet age-related macular degeneration (AMD), which can cause progressive blindness, is characterised by choroid neovascularization (CNV) in the macular area. Although close attention has been paid to AMD, and anti-vascular endothelial growth factor (VEGF) drugs are available, its complex pathogenesis is still elusive. Tie2-expressing macrophages (TEMs) have been found to promote angiogenesis in remodel tissues and tumours. This study aimed to elucidate the role of macrophage Tie2 signalling in laser-induced CNV (LCNV). We observed that TEMs were responsible for the severity of CNV. Mechanistically, TEM deletion resulted in impaired LCNV due to the suppression of inflammatory angiogenesis and the promotion of apoptosis. We also observed that TEMs prevented apoptosis of b.End3 cells, but promoted their migration, proliferation and tube formation via VEGF, extracellular signal-regulated kinase (ERK) and v-akt murine thymoma viral oncogene (AKT)-dependent signalling pathways. The flow cytometry results comparing dry AMD patients and healthy controls with wet AMD patients showed that the percentage of Tie2+CD14+ cells was higher in the wet AMD patients’ peripheral blood. This study demonstrates that Tie2 expression by macrophages intensifies CNV in LCNV murine models, thereby proposing an additional intervention option to inhibit CNV.

Platform Screen Doors (PSDs) have been widely used in modern Asian and European metro systems due to the advantages of safety, comfort for passengers. Unfortunately, someone or something will be caught by PSDs and metro doors occasionally, which may lead to serious accidents. Therefore, the foreign object detection between PSDs and metro doors is a burning problem. Moreover, this problem is a challenging and still largely under-explored topic. In recent years, we have seen significant improvements in generic object detection built on deep learning techniques. Accordingly, this paper adopts deep learning technologies to address the problem of foreign object detection between PSDs and metro doors. To the best of our knowledge, this is the first attempt to use deep learning to solve the problem. To realize this, a dataset including 984 real-world images (with 600 × 480 pixels) labeled for six types of foreign objects (bag, bottle, person, plastic bag, umbrella, other) is developed. Then, we compared the performance of some state-of-the-art object detection algorithms (such as You Only Look Once -YOLOv3, Single Shot MultiBox Detector -SSD, and CenterNet) on the dataset. Experimental results demonstrate that the foreign object detection algorithms based on deep neural networks have achieved excellent results, which not only improves the accuracy of detection but also give the categories of foreign objects. YOLOv3 - tiny can achieve the fastest detection speed, up to 200 Frame Per Second (FPS); CenterNet can achieve the best detection results, up to 99.7% mean Average Precision (mAP).

The rapid development of China Railway High-speed (CRH) has provided safe and comfortable transportation for many people. The fastening bolts (FB) on the sides of CRH fall off occasionally, which might cause serious traffic accidents. However, the automatic inspection of multiple missing FBs on the sides of CRH is seldom conducted. In this study, an automated visual inspection system based on space-scale normalization is proposed to inspect the status of FBs on the sides of CRH. To locate the missing FBs in sequence images, the exact alignment of the target image and its reference image must be ensured. This problem can be solved by normalizing the target image according to its reference image. First, the FBs are located in a specific CRH region, which is called the region of interest (ROI). The target image is cropped according to the size of the ROI. Second, the keypoints are extracted and matched by using the gradient-enhanced scale-invariant feature transform (GESIFT). Furthermore, the horizontal shift between the target image and its reference image is obtained during keypoint matching. Third, the target image and its neighboring image are stitched according to the horizontal shift. Then, the target image is resegmented according to its reference image to complete the normalization of the target image. Finally, the normalized target image can be exactly aligned with its reference image. We propose an image subtraction method to locate the potential missing FBs. The FBs that may be lost are finally determined according to prior knowledge, and the state of the FBs is determined by using high-level image understanding knowledge. Experimental results show that our presented method performs excellently in monitoring the missing FBs on the sides of CRH.

Objective Chronic subdural hematomas (CSDHs) in young people are uncommon, rupture of arachnoid cysts (ACs) is one of the reasons for young patients. The detailed features of CSDHs associated with ACs remain poorly understood. The objective of this study is to analyze the characteristics of risks for the rupture of ACs with CSDH in Adults. Methods The CT scans of 1231 patients who were diagnosed as CSDH were reviewed between Jan 2009 and Jan 2019 in the Department of Neurotrauma in Beijing Tian Tan Hospital, Capital Medical University/China National Clinical Research Center for Neurological Diseases. The clinical features, treatments, and prognosis of 32 patients with ACs were analyzed. Results Ruptured ACs with CSDH were diagnosed in 32 patients in 1231 CSDH cases, which account for 2.60%. Headache was the commonest presenting symptom. According to the Takizawa' classification, there were 22 cases for Type A, 9 for Type B and 1 for Type C. Thinning or external convex of the calvarium was demonstrated in 17/32 cases (53.1%). Thirty-one patients were treated with burr hole irrigation. Favorable outcomes were achieved in all patients. Conclusions The presence of ACs should be taken into consideration in young and middle-aged patients with CSDH. For those patients were found ACs in conventional medical examination, especially those whose imaging examinations demonstrated thinning or external convex of the calvarium, it was crucial to remind them to avoid the occurrence of traumatic brain injury (TBI). Burr hole irrigation is still the preferred treatment for ruptured ACs with CSDH.

Background Scalp metastases from anaplastic oligodendroglioma (AO) are extremely rare and mostly involve intracranial recurrence or widely metastatic disease. Here we describe an exceptional case of histopathologically proven scalp metastasis of AO 6 years after surgical resection and postoperative adjuvant radiation. Case Description A 42-year-old woman presented with several months of progressive headache and dizziness. Preoperative magnetic resonance imaging (MRI) showed an irregular enhancing lesion in the left frontal lobe extending to the ependymal surface. Left frontal craniotomy was performed through a coronal approach, and gross total resection was achieved. Pathologic examination confirmed a World Health Organization grade III AO. The patient subsequently received 60 Gy of external beam radiotherapy in 30 fractions over 6 weeks. During 8 years of follow-up, the patient remained symptom free, and no evidence of intracranial recurrence was found. However, 6 years after intracranial tumor resection, the patient noticed a subcutaneous mass in her right frontal scalp, which was the site contralateral to her craniotomy. MRI revealed a homogeneously marked enhancing nodular lesion in the subcutaneous tissue of the right frontal scalp without intracranial recurrence. Gross total resection was performed, and the pathologic findings, which identified the mass as an AO, were consistent with those of the primary left frontal tumor. Conclusions This study presents a rare case of long-term AO scalp metastasis without intracranial recurrence. Intraoperative seeding and longer survival for oligodendroglial tumors may cause this rare entity. Optimal surgical strategies and standard operative procedures can promote the prevention of iatrogenic seeding.

Although several prognostic factors for traumatic brain injury (TBI) have been evaluated, a useful predictive scoring model for the outcomes has not been developed for patients with severe TBI who undergo decompressive craniectomy (DC). The aim of the present study was to determine independent predictors and develop a multivariate logistic regression equation to predict the early outcome and discharge status for patients with severe TBI who have undergone DC.A total of 13 different variables were evaluated. The data from all 278 patients with severe TBI who had undergone DC in the present study were retrospectively evaluated from July 2011 to June 2017. Using univariate, multiple logistic regression and prognostic regression scoring equations it was possible to draw receiver operating characteristic curves to predict the early outcomes and discharge status after TBI.We found that younger age (P = 0.012), no significant medical history (P = 0.044), diameter of both pupils4 mm (P = 0.032), higher admission Glasgow coma scale score (P = 0.004), no tracheotomy (P0.001), and DC for severe TBI were associated with a favorable early outcome and discharge status. Using receiver operating characteristic curves to predict the probability of a favorable outcome, the sensitivity was 80.0% and the specificity was 79.5%.Our preliminary findings have shown that 5 variables can be used as independent predictors in assessing the early outcome and discharge status for patients with severe TBI after DC.

Predictive modelling of mineral prospectivity using GIS is a valid and progressively more accepted tool for delineating reproducible mineral exploration targets. In this study, machine learning methods, including support vector machine (SVM), artificial neural networks (ANN) and random forest (RF), were employed to conduct GIS-based mineral prospectivity mapping of the Tongling ore district, eastern China. The mineral systems approach was used to translate our understanding of the skarn Cu mineral system into mappable exploration criteria, resulting in 12 predictor maps that represent source, transport, physical trap and chemical deposition processes critical for ore formation. Predictive SVM, ANN and RF models were trained by way of predictor maps, and corroborated using a 10-fold cross-validation. The overall performance of the resulting predictive models was assessed in both training and test datasets using a confusion matrix, set of statistical measurements, receiver operating characteristic curve, and success-rate curve. The assessment results indicate that the three machine learning models presented in this study achieved satisfactory performance levels characterized by high predictive accuracy. In addition, all models exhibited well interpretability that provided consistent ranking information about the relative importance of the evidential features contributing to the final predictions. In comparison, the RF model outperformed the SVM and ANN models, having achieved greater consistency with respect to variations in the model parameters and better predictive accuracy. Importantly, the RF model exhibited the highest predictive efficiency capturing most of the known deposits within the smallest prospective tracts. The above results suggest that the RF model is the most appropriate model for Cu potential mapping in the Tongling ore district, and, therefore, was used to generate a prospectivity map containing very-high, high, moderate, and low potential areas in support of follow-up exploration. The prospective areas delineated in this map occupy 13.97% of the study area and capture 80.95% of the known deposits. The fact that two newly discovered deposits occur within the prospective areas predicted by the prospectivity model indicates that the model is robust and effective regarding exploration target generation.

Background: This meta-analysis assessed the safety and effectiveness of retreatment with trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (HER2+MBC). Materials and methods: Randomized controlled trials (RCTs) and cohort studies that compared the clinical outcomes of continuation and termination of trastuzumab treatment in HER2+MBC after failure of trastuzumab-based regimens were analyzed. Pooled estimates of time to progression (TTP) survival, overall survival (OS), the incidence of adverse events and central nervous system (CNS) perturbations were determined. Results: Four RCTs and six cohort studies with 2,409 patients were identified. The continuation of trastuzumab presented a statistical significance in prolonging TTP (HR 0.88; 95% CI: 0.82-0.94; P

Diabetic retinopathy (DR) is an important microvascular complication of diabetes mellitus (DM) and a leading cause of visual impairment and blindness among people of working age. Physical activity (PA) or exercise is critical and beneficial for DM patients, whereas studies evaluating the relationship between PA and DR have yielded inconsistent and inconclusive results. The American Diabetes Association’s “Standards of Medical Care in Diabetes” has also pointed out the indeterminate roles of PA in DR prevention. The purpose of this systematic review and meta-analysis was to explore the association between PA and DR risk. Medline (accessed by PubMed), EmBase, and Cochrane Library were systematically searched for studies up to June 2018, and the reference lists of the published articles were searched manually. The association between PA and DR risk was assessed using random-effect meta-analysis. Twenty-two studies were included in this meta-analysis. PA was found to have a protective association with DR [risk ratio (RR) = 0.94, 95% confidence interval (95% CI) 0.90–0.98, p = 0.005] in diabetic patients, and the impact was more pronounced on vision-threatening DR (RR = 0.89, 95% CI 0.80–0.98, p = 0.02). Sedentary behavior could increase the risk of DR (RR = 1.18, 95% CI 1.01–1.37, p = 0.04). Moderate-intensity PA was likely to have a slight protective effect (RR = 0.76, 95% CI 0.58–1.00, p = 0.05). PA is associated with lower DR risk, and more studies should focus on the causality between them.

To investigate clinical characteristics and outcomes of chronic subdural hematomas (CSDHs) in different age ranges.A retrospective collection of data from CSDH patients ≤40 years, 41-79 years, and ≥80 years of age between August 2011 and May 2017 was performed. The differences and similarities of clinical data and outcomes among three groups were analyzed.A total of 1118 CSDH patients were included. We found that 64.5% patients had arachnoid cyst/ventriculoperitoneal shunt in patients ≤40 years, 4.3% in the 41-79 years group, and 3.2% in the ≥80 years group (P 0.001). Headache was the most frequent symptom in the ≤40 years group (88.2%) and the 41-79 years group (60.9%), while the most frequent symptom in the ≥ 80 years group was limb weakness (80.4%). The history of head trauma was not significantly different between the three groups. After burr hole drainage craniostomy, the disappearance or alleviation of symptoms, duration of catheter drainage, and length of hospital stay were not significantly different, while the recurrence rate was also not significantly different between the three groups. Post-operation complications are an independent risk factor contributing to the death of patients of 41-79 years (P0.001, B = 3.140, Exp (B) = 23.103, 95% CI = 5.142-103.809) and of ≥ 80 years (P = 0.001, B=2.831, Exp (B) = 16.970, 95% CI = 3.365-85.567). The history of antithrombotic drug was an independent risk factor of complications in patients of 41-79 years (P = 0.042, B =1.341, Exp (B) =3.823, 95% CI = 1.048-13.942) and patients of ≥ 80 years (P = 0.026, B=1.399, Exp (B) = 4.052, 95% CI = 1.178-13.933), while complications were also an independent risk factor contributing to the outcome in patients of 41-79 years (P 0.001, B =2.254, Exp (B) =0.314, 95% CI = 0.089-1.103) and patients of ≥ 80 years (P = 0.006, B=2.074, Exp (B) = 7.953, 95% CI = 1.791-35.313). In the ≤40 years group, all patients had a good outcome (MRS score 0-3), while 98.2% (851/867) of the cases in the 41-79 years group and 94.3% (149/158) of the cases in the ≥ 80 years group saw a good outcome (P = 0.001).Our results clearly display the common and different clinical data of CSDH in all age ranges, which is crucial to improve the management and treatment of patients with CSDH.

Chronic subdural hematoma (CSDH) is a common neurosurgical disease. Many patients with CSDH take antiplatelet (AP) drugs. Several studies have focused merely on the relationship between AP drug use and recurrence without deeply analyzing the specific clinical features of these patients. The primary objective of this study was to investigate the detailed clinical characteristics and outcomes of CSDH patients with a history of AP therapy.A total of 1181 CSDH patients over 40 years of age who received burr-hole craniostomy were enrolled. Clinical information, computed tomographic findings, and data on long-term outcomes and recurrence among these patients were gathered. We divided these patients into two groups according to whether they had a history of AP therapy. Percentages and χ2 tests were applied for categorical variables. Standard deviations and 2-sided unpaired t-tests were applied for continuous variables. Univariate and multivariate logistic regression analyses were performed to identify independent factors of the outcomes (6 months after discharge).AP therapy was not related to the outcomes of patients with CSDH (P = 0.48), and there were no differences in recurrence between the AP and non-AP group. Only Bender grade (P 0.01, B = -3.14, Exp (B) = 0.04, 95% CI 0.01-0.29) was associated with the outcomes of patients in the AP group. The incidence of complications in the AP group was higher than that in the non-AP group (P 0.01). Postoperative thrombotic events may be more likely to occur in the AP group than in the non-AP group (P = 0.02). Patients in the AP group were older (P 0.01) and had more comorbidities (P 0.01).Patients treated with AP therapy had more complications. The outcomes of patients treated with AP therapy were associated with their status of admission. Patients treated with AP therapy were at greater risk for postoperative thrombotic events. The recurrence rate of CSDH did not appear to be affected by AP therapy.

This paper presents a theoretical demonstration of diverse microstructure fabrication by changing the angle of incidence of a six-beam laser interference lithography system. Different combinations are formed with transverse electric (TE) and transverse magnetic (TM) polarizations and various microstructures are simulated by controlling the high-reflectivity mirror group to adjust the incidence angle. This study indicates that the incidence angle has a considerable influence on the shape and period of the lattice, thereby contributing to the fabrication of microstructures with different arrangements. These structures include donut, circle, D-type, rectangular, triangular, U-type, and honeycomb lattices. The six-beam laser interference lithography technique is expected to benefit microstructure fabrication because of its simple operation, large writing area, and low cost, thereby promoting the development of micro-optics.

Aimed at problem of that shadow elimination methods based on model or single feature are all having inherent drawbacks. A shadow removal algorithm based on multiple feature differences between pixels and the reference background pixels is proposed. The multi feature differences of the current pixel and the corresponding pixel of the background are inputted into GLVQ to classify the current pixel.The experiments proved the proposed method has better performance than that of some other methods.

Relation reasoning between objects plays a vital role in image captioning. A joint common sense and relation reasoning model is proposed, which has the ability to generate more informative and diverse sentences for dense relational captioning. Our proposed model consists of two stages, region features extraction and relational captioning generation. The features of regions including object, union and subject are encoded by Region Proposal Network (RPN). Afterwards, they are fed to triple-stream Long Short-Term Memory (LSTM) respectively where object-predicate-subject categories are used as the prior information to lead the proper sequence of words in the descriptions generation. Moreover, we present the memory-augmented union operation where the image features and union features are leveraged to learn common sense and relation reasoning. Our experimental results on VG relationship captioning datasets demonstrate the validity of the joint common sense and relation reasoning model, which achieves competitive performance in dense relational captioning.

Aim of Study: Four hundred million people live at high altitude worldwide. Prevalence and risk factors for COPD in these populations are poorly documented. We examined the prevalence and risk factors for COPD in residents living at an altitude of 2,100–4,700 m.Methods: We performed a cross-sectional survey in Xinjiang and Tibet autonomous region. A multistage stratified sampling procedure was used to select a representative population aged 15 years or older from eight high altitude regions. All participants underwent pre- and post-bronchodilator measurement of forced expiratory volumes. COPD was diagnosed according to 2019 Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.Results: Between June, 2015 and August 2016, 4,967 subjects were included. Median age was 38.0 years (range: 15–91 years; inter-quartile range: 28–49 years); 51.4% participants were female. Overall prevalence of spirometry-defined COPD was 8.2% (95% CI 7.4–8.9%): 9.3% in male (95% CI 8.2–10.4%), and 7.1% in female (95% CI 6.1–8.2%). By multivariable logistic regression analysis, COPD was significantly associated with being aged ≥40 years (odds ratio: 2.25 [95% CI 1.72–2.95], P < 0.0001), exposure to household air pollution (OR: 1.34 [95% CI 1.01–1.79], P = 0.043), and a history of tuberculosis (OR: 1.79 [95% CI 1.23–2.61], P = 0.030), while living at a higher altitude (OR: 0.45 [95% CI 0.33–0.61], P < 0.0001) and having a higher educational level (OR: 0.64 [95% CI 0.43–0.95], P = 0.025) were associated with a lower prevalence of COPD.Conclusions: Our results show that the spirometry-defined COPD is a considerable health problem for residents living at high altitudes and COPD prevalence was inversely correlated with altitude. Preventing exposure to household air pollution and reducing the incidence of tuberculosis should be public health priorities for high altitude residents.

Background: The clinical features of chronic subdural hematomas (CSDHs) in patients with and without a history of head trauma have remained unclear. Here, we investigated differences in clinical characteristics in CSDH patients with and without head trauma.Methods: We retrospectively collected clinical characteristics of CSDH patients who had undergone exhaustive drainage strategies via burr-hole craniostomies from August 2011 to May 2019. We divided patients into a trauma group (i.e., head trauma) and a no-trauma group. Chi-square tests or t-tests were used to analyze differences in clinical characteristics between the two groups. Multiple linear regression analysis was performed to analyze the relationships between the clinical characteristics and either reduction of the hematoma cavity or length of the hospital stay in CSDH patients with trauma.Results: We collected data from 1,307 CSDH patients, among whom 805 patients had a history of head trauma whereas 502 patients did not. The mean age of patients with head trauma was 64.0 ± 16.1 years, while that of patients without head trauma was significantly younger at 61.5 ± 17.9 years (p = 0.010). Furthermore, more patients in the no-trauma group had a history of hypertension compared to those in the trauma group (40.2 vs. 32.9%, p = 0.007). Dizziness occurred in 29.2% of patients with trauma and in 23.1% of patients without trauma (p = 0.016). A greater number of patients with trauma showed a reduction of hematoma cavity after surgery compared to that of patients without trauma (p = 0.002). The length of hospital stay in patients with trauma was 7.9 ± 4.5 days, which was longer than that of patients without trauma (7.3 ± 3.7 days, p = 0.016). In contrast, there were no significant different differences between the two groups in terms of the densities of hematomas on computed-tomography scans, complications, mortality rates, recurrence rates, or outcomes.Conclusion: Our findings indicate that there were some noteworthy differences in the clinical and pathogenic characteristics of CSDH patients with and without head trauma. However, our findings also indicate that if an optimal treatment method is employed, such as our exhaustive drainage strategy, similar treatment outcomes can be achieved between these groups.

Traced back to December 2019, an unexpected outbreak of a highly contagious new coronavirus pneumonia (COVID-19) has rapidly swept around China and the globe. There have now been an estimated 2 580 000 infections and more than 170 000 fatal cases around the world. The World Health Organization (WHO) estimated that approximately 14% of infections developed into severe disease, 5% were critically ill, and the mortality rate of critically ill patients is reported to be over 50%. The shortage of specific anti-viral treatment and vaccines remains a huge challenge. In COVID-19, refractory hypoxemia is common among the critically ill with acute respiratory distress syndrome (ARDS) despite invasive mechanical ventilation, and is further complicated by respiratory and circulatory failure. This difficult situation calls for the use of extracorporeal membrane oxygenation (ECMO) for assisting respiration and circulation if necessary. This article reviews the pertinent clinical literature, technical guidance, and expert recommendations on use of ECMO in critically ill cases of COVID-19. Here, we present basic knowledge and opinions about COVID-19 and ECMO, review the evidence on ECMO use in Middle East Respiratory Syndrome (MERS) and H1N1 influenza, share the technical guidance and recommendations on use of ECMO in COVID-19, summarize the current use of ECMO against COVID-19 in China, and discuss the issues in use of ECMO in COVID-19.

Aims To determine the relationship between plasma levels of trimethylamine-N-oxide (TMAO) and odds of diabetic retinopathy (DR). Methods A cross-sectional study was conducted. Blood samples were obtained from 122 type 2 diabetes mellitus (T2DM) patients with or without DR. Multivariable logistic regression analyses were performed to identify the association between plasma TMAO and DR. The diagnostic value of plasma TMAO was assessed by the area under the receiver operating characteristic curve (AUROC) and integrated discrimination improvement (IDI). Results In the T2DM patients, plasma levels of TMAO were significantly higher in patients with DR compared with those without DR (P = 0.001). As logarithmic (ln) transformation of TMAO increased per standard deviation (SD), there was higher probability to have DR [odds ratio (OR) = 2.31; P = 0.005]. As ln-transformed TMAO increased per SD, the severity of DR was more likely to get worse (OR = 2.05; P = 0.004). In the diagnostic model, the addition of TMAO contributed to the improvement in AUROC from 0.646 to 0.734 (P = 0.043), and the IDI was 10.7% (P Conclusion Elevated levels of plasma TMAO were associated with higher odds and worse severity of DR in T2DM patients, and further investigation is required for the causality of this association.

The purpose of this study is to improve the teaching quality of music classrooms more scientifically, track the learning status of students, and manage teaching resources and teaching projects more efficiently, thus improving the teaching effect. In this study, the Internet of Things technology and data mining technology was applied to develop and design the project teaching method management system, which effectively manages the teaching work under the open laboratory project teaching method, the statistical teaching log of teachers, and the comprehensive management of teachers and students and teaching resources. The dual-chip compound RFID school badge with unique identification, remote identification, information storage and other one-card functions designed on the perception layer is used to realize the comprehensive induction of different activity states of teachers and students in the classroom, laboratory and training base. After that, the Internet, campus network, local area network and other technologies are used to realize the storage, exchange and sharing functions of campus data and cloud data, which is conducive to the non-differentiated management of different places. Finally, when processing information and data in the cloud, corresponding countermeasures can be formulated according to different locations and teaching activities, and existing resources can be mobilized to meet teaching requirements. The results showed that after applying the system proposed in this study, the students' attendance rate, evaluation of teaching satisfaction, average assessment scores, and teaching resource utilization rate in the classroom have been significantly improved. Therefore, this study has great practical application value in music teaching.

Metasurfaces exhibit promising capacities in the manipulation of electromagnetic (EM) waves, as to diverse dimensions like amplitude, phase, and polarization. Despite many methods have been used to improve regulatory capabilities of EM waves, the efficiency and working bandwidth has yet to be developed. In this paper, an ultra-wideband and high-efficiency reflective polarization converter metasurface (PCM) is proposed. Both theoretical analysis and simulation results show that the polarization conversion ratio (PCR) is above 89% in the ultra-wideband from 2.28 THz to 6.75 THz, and the relative bandwidth reaches 99%. Moreover, the multi-bit digital coding metasurface elements are designed by using Pancharatnam–Berry (PB) phase principle. The coding metasurface arrays are designed by using different coding sequences, which can be used to realize the free adjustment of scattering angle of the reflected EM waves. In addition, the radar cross section (RCS) reduction performances of the designed metasurface array antennas based on different coding elements are studied. The results present that it can significantly reduce the RCS by −20 dB over a wide frequency range from 2.1 THz to 6.9 THz. The proposed metasurface has great application potential in manipulation of terahertz wave and contributes to RCS reduction.

Predicting the thermophysical properties of the skin tumor is a great challenge in the field of biomedical engineering, which is helpful for the diagnostic of the tumor. In this paper, the relationship between thermophysical properties of the tumor and the time-dependent skin surface temperature could be revealed through dynamic thermography and deep learning. The deep learning model for the inverse bio-heat conduction problem is used to identify the overall thermophysical properties of the skin tumor, including the depth, size, thermal conductivity, heat generation and blood perfusion of the skin tumor. Firstly, a 3D numerical skin model with different layers, including the tumor, muscle, fat, dermis and epidermis, is constructed to calculate the surface temperature under different thermophysical properties of the skin tumor. And the numerical model is verified by comparing the time-dependent skin surface temperature of Clark II and Clark IV tumors. Then the deep learning model is established to relate the time-dependent surface temperature with the thermophysical properties and trained by the numerical simulation data. The performances of the deep learning model are examined by the Clark II and Clark IV tumors with different measurement errors. The results show that the deep learning model can learn the abstract features of the time-dependent surface temperature and estimate the tumor properties by the skin surface temperature. Compared with the Clark IV tumor, the measurement errors have more influence on the Clark II tumor. At last, the influences of seven thermophysical properties of the tumor on the skin surface temperature are further numerically analyzed to understand the deep learning model predictions. Interestingly, it is found that the deep learning model can well predict the tumor heat generation and blood perfusion of the skin tumor. The numerical simulation results show that the surface temperature profiles are influenced by the properties mentioned. However, the normalized temperature variation profiles do not. The proposed method provides a useful diagnostic tool for estimating the thermophysical properties of the skin tumor.

This paper proposed a visual servo framework for the tower-crane-like Gravity Compensation System that is widely used in various aerospace ground tests. In this framework, a real-time detection algorithm is proposed to measure the position of the target. Using this algorithm, the target's original position is marked firstly in a well-designed calibration step, and then compared to its real-time position to calculate the offset for tracking. To realize the high precision tracking, a 2-level servo mechanism is investigated, in which a large-inertia crane servo system is utilized for the rough tracking and a 2-DOF (2 Direction Of Freedom) platform is used for the precise localization. The proposed method leads to a high responding speed and low time-drift in wide range tracking, and greatly decreases the compensation error in the microgravity simulation for space manipulator and moon vehicle.

Objective We aimed to identify the factors that can predict the risk of occipital lobe damage preoperatively when resecting tumors located at the tentorial or pineal regions with the occipital-transtentorial approach (Poppen approach). Methods In 27 consecutive patients who underwent tumor resection with the Poppen approach for tentorial or pineal region meningiomas, the following morphologic parameters were assessed on a preoperative magnetic resonance imaging: (1) tentorial angle, (2) tentorial length, and (3) the shortest distance from the confluence of the sinus to the tumor. These parameters, together with tumor size, texture, and resection extent, were correlated with occipital lobe damage by using the one-way analysis of variance, χ 2 , or Fisher's exact tests. Results The mean value was 55.3° ± 5.6° (range, 45°–66°) for the tentorial angle, which was significantly associated with the occipital lobe damage grades ( P = 0.008), but this was not the case for the tentorial length ( P = 0.802) and the shortest distance from the confluence of the sinus to the tumor ( P = 0.695). Interestingly, age was also strongly associated with occipital lobe damage risk ( P = 0.020). The patients in the subgroup with no occipital damage (grade 4) were the youngest (aged 47.3 years), compared with other grades, with age of 58.0 years for grade 1, 54.3 years for grade 2, and 58.6 years for grade 3. These 2 parameters were also significant after multivariate analysis. No correlation was observed between either tumor nature or the extent of resection and damage grades. Conclusions The risk of occipital lobe damage increases in the presence of a steep tentorial angle during the Poppen approach for tentorial or pineal area tumors. Awareness of such anatomic features preoperatively is important for minimizing operative complications.

Graphene, as a new nano-material, according to the physical properties of electric field localization and selective absorption on light of surface plasmon resonance (SPR), a tunable, multi-band and wide-angle perfect absorber based on crosshair-shaped graphene is devised by using the Finite Difference in Time Domain (FDTD) method. In this paper, the effects of chemical potential, relaxation time, and incident angle of light on the absorptivity of graphene are systematically discussed. The simulation experiment shows that there are two absorption peaks with perfect absorption rate appeared in the study range, and the maximum modulation index can be obtained by changing the relaxation time. Finally, it proves that the absorber is insensitive to wide-angle of light. Thus, it is able to be concluded that the absorber has a great reference value to sensor, wireless communication, biomedical and other fields.

In this paper, a polarization and angle-insensitive multi-band adjustable terahertz absorber is proposed and numerically investigated, which is composed of a kind of periodic array square graphene ring with a Jerusalem cross graphene sheet. The numerical results indicate that the peaks absorptivity reach 99.9%, 99.9%, and 98.5% at 2.02THz, 3.44 THz, and 7.58 THz, respectively. The three resonance frequencies can be dynamically tuned by varying the chemical potential. Its physical mechanism can be analyzed by using Coupled Mode Theory (CMT) and electric field distribution. Moreover, the designed absorber is insensitive to polarization state and has the capability of wide-angle absorptivity. As a sensing application, the sensing characteristics of this monolayer graphene metasurface structure were investigated. In addition, we can achieve multi-spectral absorption peaks by applying bilayer graphene composite structure arrays. The proposed terahertz absorber may benefit branches of science such as refractive sensors, solar absorption, stealth, and other optoelectronic devices.

Water pipe leakage detection is of great significance to the protection of water resources in our country. However, the detection accuracy of water pipe vibration signals is easily affected by external noise. Existing detection technologies are difficult to reduce the influence of noise signals, and some machine learning based outlier detection models are not very robust. Variation Bayesian neural network Autoencoder (VBAE) replaces the fully connected layer network in encoder and decoder with Bayesian neural network (BNN) on the basis of Variation Autoencoder (VAE). VAE has a strong generalization ability, while BNN has an uncertainty quantification ability. VBAE combines the advantages of the two models and is very robust. Experiments have proved that, compared with other models, VBAE for water leakage detection can greatly reduce the influence of noise on the output of the model, and has a better detection effect.

Based on the transmission characteristic of surface plasmon polaritons (SPPs), a compact plasmonic system based on a sub-wavelength metal-insulator-metal (MIM) waveguide coupled with P-shaped cavity is proposed. The results show that double Fano resonance peaks are generated in the transmission spectra, which has been studied by the finite-element method (FEM). The transmission spectrum of the system is theoretically verified by the multimode interference coupled mode theory (MICMT) perfectly. In addition, the simulation results show that the position of the resonance peaks can be adjusted by changing the structural parameters. The sensing characteristics of the resonant cavity are also studied, and the refractive index sensitivity and the figure of merit (FOM) are 2100 nm /RIU and 189.97. The results effectively improve the sensitivity and FOM of nano-scale plasmonic sensors and provide significant guidance for the application of tunable multiple Fano resonance in refractive index sensors, biosensors, optical switches and other plasmonic devices.

Deep reinforcement learning (DRL) methods has been widely applied on more and more challenging learning tasks, and achieved excellent performance. However, the efficiency of deep reinforcement learning is notoriously sensitive to their own hyperparameter configuration. The optimization process of deep reinforcement learning is highly dynamic and non-stationary, rather than a simple fitting process. So, its optimal hyperparameter should be adaptively adjusted according to the current learning process, rather than using a fixed set of hyperparameter configurations from beginning to end. DeepMind innovatively proposed a population based training (PBT) method for deep reinforcement learning, which achieved hyperparameter adaptation and made the model better trained. However, we assume that at the early stage when the learning model has little knowledge of the environment, frequent hyperparameter change will not be helpful for the model to learn efficiently, while learning with a reasonable fixed hyperparameter configuration will help the model obtain necessary knowledge as quick as possible, which we consider is more important for reinforcement learning at early stage. In this paper, we verified our hypothesis through experiments, and a Two-Stage Population Based Training (TS-PBT) method is proposed, which is a more efficient population based training method for deep reinforcement learning. Experiments show that at the same computational budget, our TS-PBT method makes the final performance of the model significantly better than the PBT method. TS-PBT achieved 40%, 310%, 2%, 53%, 30% and 38% performance improvement over PBT separately in six test environments.

Early detection of diabetic microvascular complications is of great significance for disease prognosis. This systematic review and meta-analysis aimed to investigate the correlation among diabetic microvascular complications which may indicate the importance of screening for other complications in the presence of one disorder. PubMed, Embase, and the Cochrane Library were searched and a total of 26 cross-sectional studies met our inclusion criteria. Diabetic retinopathy (DR) had a proven risk association with diabetic kidney disease (DKD) [odds ratio (OR): 4.64, 95% confidence interval (CI): 2.47–8.75, p

With the development of the Internet, the increase of information sources and speed of information release and transmission have led to a sharp increase in the amount of information. To enable users finding more accurate and reliable information in the large heterogeneous multi-source data, data fusion technology becomes more and more important. Data fusion technology structuralizes and integrates heterogeneous data from different sources which greatly improves the comprehensiveness, availability and extensibility of data. This paper proposes a general multi-source data fusion framework. The framework transforms multi-source structured data, semi-structured data and unstructured data into unified data format described by RDF (Resource Description Framework) standard, and then realizes information fusion through data fusion algorithm, to solve the heterogeneity and semantic conflict in multi-source data fusion under the big data environment.

To introduce an effective strategy to treat patients with chronic subdural hematoma (CSDH) that can achieve a low recurrence rate and good outcome.Surgical patients with CSDH from August 2011 to May 2017 in our hospital were collected retrospectively. An exhaustive drainage strategy to treat CSDH with burr-hole craniostomy was conducted. All patients were drained, and catheter was removed when natural drainage ceased or when drainage was complete using urokinase. Clinical characteristics were reviewed and analyzed. Following this strategy, predictors of recurrence requiring reoperation and outcome were analyzed.In total, 1126 patients with CSDH who were treated with burr-hole craniostomy were included. Using the exhaustive drainage strategy, recurrence rate was only 1.9% (21/1117) with follow-up rate of 99.2%. 97.0% (1092/1117) of patients gained good outcome (modified Rankin scale scores 0-3) at 6 months after discharge. Postoperative hematoma volume (P = 0.001, B = 0.028, Exp (B) = 1.028, 95% CI 1.011-1.046), diabetes (P = 0.022, B = 1.082, Exp (B) = 2.950, 95% CI 1.169-7.440), bilateral hematoma (P = 0.011, B = 1.213, Exp (B) = 3.363, 95% CI 1.323-8.547), and complications (P = 0.013, B = 1.483, Exp (B) = 4.408, 95% CI 1.365-14.235) significantly increased the probability of recurrence. In contrast, use of urokinase (P = 0.007, B = -1.435, Exp (B) = 0.238, 95% CI 0.085-0.671) reduced recurrence. Finally, age (P = 0.026, B = 0.056, Exp (B) = 1.057, 95% CI 1.007-1.110), complications (P0.001, B = 1.710, Exp (B) = 5.529, 95% CI 2.104-14.531), and Bender grade (P0.001, B = 1.165, Exp (B) = 3.205, 95% CI 1.325-7.750) were significant predictors of outcome.The exhaustive drainage strategy is safe and effective for reducing recurrence rate and achieving good outcome in patients with CSDH. This procedure merits recommendation in clinical practice.

Background: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach. Methods: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries. Results: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval. Conclusions: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction. publishedVersion

Deep Reinforcement Learning (DRL) has shown its extraordinary performance on a variety of challenging learning tasks, especially those in games. It has been recognized that DRL process is a high-dynamic and non-stationary optimization process even in the static environments, their performance is notoriously sensitive to the hyperparameter configuration which includes learning rate, discount coefficient, and step size, etc. The situation will be more serious when DRL is conducting in a changing environment. The most ideal state of hyperparameter configuration in DRL is that the hyperparameter can self-adapt to the best values promptly for their current learning state, rather than using a fixed set of hyperparameters for the whole course of training like most previous works did. In this paper, an efficient online hyperparameter adaptation method is presented, which is an improved version of Population-based Training (PBT) method on the promptness of adaptation. A recombination operation inspired by GA is introduced into the population adaptation to accelerating the convergence of the population towards the better hyperparameter configurations. Experiment results have shown that in four test environments, the presented method has achieved 92%, 70%, 2% and 15% performance improvement over PBT.

In the era of big data, data has gradually become an important productivity driving social progress. Accelerating the development and sharing of data resources is an inherent requirement of government transformation. Named entity recognition has a wide range of applications in the fields of information extraction and information retrieval, so its research is of great significance. Due to the complexity of Chinese structure and the lack of mature domestic corpora, the research on Chinese named entity recognition faces enormous challenges. Based on the analysis of the actual characteristics of named entities in Chinese text, this paper proposes a Chinese named entity recognition method based on rules and conditional random fields. The rule-based method is used to identify the named entities of digital expressions and time expressions. Named entity recognition of names of people, places, and organizations by combining rules and conditional random fields. Through the experiment, the results are analyzed, the best template is adjusted, and a complete and accurate Chinese named entity recognition method is designed and implemented. The experimental results show that the new method can effectively identify the named entities, improve the processing speed and efficiency, and has certain practical value.

When the power plant fails, in order to reduce the excessive inrush current generated by the switching of the backup power supply to the electrical equipment, the backup power supply was unable to switch quickly. This article mainly studies and analyzes a power supply method based on TSPST to adjust the phase of the standby power transmission line and make corresponding design and calculation for the theory and structure of the process. According to the actual parameters of the project, the power supply method is simulated and analyzed. According to simulation experiments, the feasibility and reliability of the proposed power supply method are verified.

To reduce the traffic accident death rate effectively and alleviate the traffic congestion phenomenon, this study proposes a new type of car-following model under the influence of drivers’ time-varying delay response time. Based on Lyapunov function theory, this paper reduces the traffic accident rate problem to the stability issues of the new model. By constructing suitable Lyapunov functions and using the linear matrix inequality method, the stability problem of the new car-following model is studied. The model, under the action of the controller, can effectively restrain traffic congestion. Using the traffic accident rate model proposed by Solomon, compared with the car-following model without the controller, the model under the controller shows a stronger convergence. This also means that the traffic congestion phenomenon has been effectively suppressed while greatly reducing the mortality rate of traffic accidents.