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Purpose To discuss whether the dome or anterior wall of bladder adenocarcinoma (BAC) should be classified into urachal carcinoma (UrC) and the relationship of primary tumor location (PTL) as well as treatment with survival. Methods Surveillance, Epidemiology, and End Results 18 database was examined for eligible patients from 1975 to 2016. Patients were classified into adenocarcinoma originating from the urachus (UAC), the dome (D‐BAC), the anterior wall (A‐BAC), and the other sites adenocarcinoma of the bladder (O‐BAC). The clinicopathological features, treatment, and survival were compared among the groups. Results Comparable clinicopathologic features were obtained between UAC and D‐BAC, which were different from those of A‐BAC and O‐BAC; otherwise, the latter two had similar clinicopathologic features. Univariable and multivariable Cox regression analyses indicated that PTL was an independent predictor for survival. O‐BAC conferred the worst prognosis then followed by A‐BAC, D‐BAC, and UAC. For non‐metastatic UAC or D‐BAC, partial cystectomy (with an en bloc resection of the urachus and umbilicus) is optimal for survival. However, the worse survival of non‐metastatic D‐BAC (compared with UAC) suggested different modalities, maybe more intensive surgery approaches, should be considered for D‐BAC. Conclusion This study illustrates that PTL of UAC and BAC was an independent predictor for survival. A‐BAC had comparable characters and prognosis with O‐BAC and should not be classified into and treated as UrC. For non‐metastatic disease, non‐metastatic D‐BAC may need more intensive modality., Anterior wall of bladder adenocarcinoma (A‐BAC) had comparable characters and prognosis with other sites of bladder adenocarcinoma, while dome adenocarcinoma of the bladder is similar to urachal adenocarcinoma arising from the urachus. A‐BAC should be classified into and treated as BAC, instead of urachal carcinoma.

Background Accurate estimation of fetal weight is important for prenatal care and for detection of fetal growth abnormalities. Prediction of fetal weight entails the indirect measurement of fetal biometry by ultrasound that is then introduced into formulae to calculate the estimated fetal weight. The aim of our study was to evaluate the accuracy of fetal weight estimation of Chinese fetuses in the third trimester using an automated three-dimensional (3D) fractional limb volume model, and to compare this model with the traditional two-dimensional (2D) model. Methods Prospective 2D and 3D ultrasonography were performed among women with singleton pregnancies 7 days before delivery to obtain 2D data, including fetal biparietal diameter, abdominal circumference and femur length, as well as 3D data, including the fractional arm volume (AVol) and fractional thigh volume (TVol). The fetal weight was estimated using the 2D model and the 3D fractional limb volume model respectively. Percentage error was defined as (estimated fetal weight - actual birth weight) divided by actual birth weight and multiplied by 100. Systematic errors (accuracy) were evaluated as the mean percentage error (MPE). Random errors (precision) were calculated as ±1 SD of percentage error. The intraclass correlation coefficient (ICC) was used to analyze the inter-observer reliability of the 3D ultrasound measurements of fractional limb volume. Results Ultrasound examination was performed on 56 fetuses at 39.6 ± 1.4 weeks’ gestation. The average birth weight of the newborns was 3393 ± 530 g. The average fetal weight estimated by the 2D model was 3478 ± 467 g, and the MPE was 3.2 ± 8.9. The average fetal weights estimated by AVol and TVol of the 3D model were 3268 ± 467 g and 3250 ± 485 g, respectively, and the MPEs were − 3.3 ± 6.6 and − 3.9 ± 6.1, respectively. For the 3D TVol model, the proportion of fetuses with estimated error ≤ 5% was significantly higher than that of the 2D model (55.4% vs. 33.9%, p p p Conclusion In this cohort, the automated 3D fractional limb volume model improves the accuracy of weight estimation in most third-trimester fetuses. Prediction accuracy of the 3D model for neonatal BW, particularly

Background To compare the efficacy of first‐line bevacizumab plus chemotherapy with cetuximab plus chemotherapy based on the stratification of metastatic colorectal cancer (mCRC) patients with mucinous adenocarcinoma (MA) or mucinous component (MC). Methods A retrospective study involving all mCRC patients receiving first‐line bevacizumab‐based or cetuximab‐based chemotherapy at our hospital from September 2013 to January 2020 was conducted. Overall survival (OS), progression‐free survival (PFS), and objective response rate (ORR) were compared between the cetuximab‐chemotherapy group and the bevacizumab‐chemotherapy group on the basis of the conventional pathological classification of MA or MC. Results A total of 620 patients with mCRC were included in our study, consisting of 141 (22.7%) patients with MA/MC and 479 (77.3%) patients with non‐mucinous adenocarcinoma (NMA). In the MA/MC cohort, patients who were treated with bevacizumab‐based chemotherapy were associated with significantly better OS than those treated with cetuximab‐base chemotherapy (30.0 vs. 26.3 months, p = 0.002), irrespective of tumor sites. The efficacy of bevacizumab‐based chemotherapy was higher in nearly all subgroups as shown in the subgroup analysis. In the NMA cohort, median OS was better in the cetuximab plus chemotherapy group than that in the bevacizumab plus chemotherapy group (32.2 vs. 27.0 months, p = 0.005) for left‐side mCRC patients, whereas OS was significantly longer in the bevacizumab plus chemotherapy group for right‐side mCRC patients (26.0 vs. 20.9 months, p = 0.013). Conclusion Conventional pathological classification (e.g. MA/MC) should be considered when tailoring the individualized optimal treatment for mCRC. Bevacizumab plus chemotherapy as first‐line therapy may be the optimal option for patients with MA/MC.

Objectives As a rare malformation of the female reproductive system, Herlyn-Werner-Wunderlich syndrome (HWWS) was categorized into 3 classifications. It was recommended recently that, on the basis of the past classification, cervicovaginal atresia without communicating uteri should be newly added as classification 4. The surgical intervention will differ by type. To better optimize patient counseling as well as the preoperative evaluation and planning, our objective was to describe the ultrasound characteristics of each type of HWWS, including the new type. Methods From January 1995 to November 2015, 37 cases of HWWS in with complete ultrasound information confirmed by surgery in the Peking Union Medical College Hospital were reviewed. We analyzed their ultrasound features, including hematometra, hematocervix, hematocolpos, and an ovarian chocolate cyst. Results All of the ultrasound images of the 37 patients showed uterus didelphys with ipsilateral renal agenesis. Compared with the other 3 types, classification 4 showed distinctive ultrasound characteristics. Most cases of classification 4 showed hematometra (5 of 7 [71.4%]) and an ipsilateral ovarian chocolate cyst (6 of 7 [85.7%]), which was significantly higher than in the other 3. A rudimentary uterine horn was also a distinctive characteristic in this type. Meanwhile none of the classification 4 cases showed hematocervix or hydrocolpos, which were common signs of the other 3. Conclusions According to this new classification criteria for HWWS, ultrasound characteristics of the new classification 4 differ from the others. As classification 4 was suggested to have a different surgical option, we should pay attention to its ultrasound characteristics, which might help in providing more information about the treatment and prognosis to the gynecologist.

Introduction Different categories of hospitals in China have varying levels of patient education. Stroke recognition and emergency medical services (EMS) usage in patients appears to be closely associated with patient education in hospital. This study aimed to explore the effect of hospital classification in China on a patient's ability to recognise stroke symptoms and the likelihood of using the EMS. Material and methods A cross-sectional, community-based study was conducted from January to May 2017, and 1,426 residents who had previously been hospitalised were analysed. The patients involved in the study were from 69 administrative areas in China. Multivariable logistic regression models were developed separately for primary, secondary, and tertiary hospitals to identify the associations between hospital grades and patient stroke recognition or the prospects of them using the EMS. Results Among the 1,426 patients studied, 725 had been admitted to tertiary hospitals, 448 to secondary hospitals, and 253 to primary hospitals. According to univariate analysis, tertiary hospital patients were more likely to use the EMS than patients in primary and secondary hospitals. The difference therein was still significant after full adjustment. Conclusions Patients in tertiary hospitals were significantly more likely to use the EMS promptly compared to patients in primary or secondary hospitals. Therefore, patient education on timely EMS usage at stroke onset should be enhanced in primary and secondary hospitals in China.

Background: To develop an ultrasonographic dating formula for predicting gestational age (GA) based on fetal crown–rump length (CRL) in a Chinese population, evaluate its systematic prediction error and compare it with existing formulae.Methods: This was a prospective cross-sectional study of spontaneously conceived singleton pregnancies among women with a regular menstrual cycle in the preceding year. Ultrasound examinations were performed at 11–14 weeks according to the date of the last menstrual cycle. The CRL was measured three times for each fetus, and the mean was used to derive the best-fit fractional polynomial regression model for estimation of GA in relation to CRL. For each fetus, the GA was compared with the GA calculated using six established dating formulae based on CRL measurements. The means of the differences between estimated and menstrual age were calculated for each formula. All the women were followed up routinely until the birth of the fetus. Results: Of the 4710 subjects recruited, the mean and standard deviation values of CRL changed linearly with GA. The corresponding regression equation and its correlation coefficient (R2) was GA = 59.361513 + 0.461425 ´ CRL (R2 = 0.8028). The mean difference between estimated and menstrual age was 0.22 days (95% confidence interval 0.05–0.21), lower than that of the six existing CRL dating formulae.Conclusions: We have derived a CRL-based dating formula suitable for naturally conceived pregnancies for GA between 11+0 and 13+6 weeks. The formula has no systematic prediction error, comparing favorably with the existing published dating formulae.

Purpose: The purpose of this study was to compare the diagnostic performance of breast lesions between deep learning-based computer-aided diagnosis (deep learning-based CAD) system and experienced radiologists and to compare the performance between symptomatic and asymptomatic patients. Methods: From January to December 2018, a total of 451 breast lesions in 389 consecutive patients were examined (mean age 46.86 ± 13.03 years, range 19-84 years) by both ultrasound and deep learning-based CAD system, all of which were biopsied, and the pathological results were obtained. The lesions were diagnosed by two experienced radiologists according to the fifth edition Breast Imaging Reporting and Data System (BI-RADS). The final deep learning-based CAD assessments were dichotomized as possibly benign or possibly malignant. The diagnostic performances of the radiologists and deep learning-based CAD were calculated and compared for asymptomatic patients and symptomatic patients. Results: There were 206 asymptomatic screening patients with 235 lesions (mean age 45.06 ± 10.90 years, range 21-73 years) and 183 symptomatic patients with 216 lesions (mean age 50.03 ± 14.97 years, range 19-84 years). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and area under the receiver operating characteristic curve (AUC) of the deep learning-based CAD in asymptomatic patients were 93.8, 83.9, 75.0, 96.3, 87.2, and 0.89%, respectively. In asymptomatic patients, the specificity (83.9 vs. 66.5%, p < 0.001), PPV (75.0 vs. 59.4%, p = 0.013), accuracy (87.2 vs. 76.2%, p = 0.002) and AUC (0.89 to 0.81, p = 0.0013) of CAD were all significantly higher than those of the experienced radiologists. The sensitivity (93.8 vs. 80.0%), specificity (83.9 vs. 61.8%,), accuracy (87.2 vs. 73.6%) and AUC (0.89 vs. 0.71) of CAD were all higher for asymptomatic patients than for symptomatic patients. If the BI-RADS 4a lesions diagnosed by the radiologists in asymptomatic patients were downgraded to BI-RADS 3 according to the CAD, then 54.8% (23/42) of the lesions would avoid biopsy without missing the malignancy. Conclusion: The deep learning-based CAD system had better performance in asymptomatic patients than in symptomatic patients and could be a promising complementary tool to ultrasound for increasing diagnostic specificity and avoiding unnecessary biopsies in asymptomatic screening patients.

In this article we explore Ni/HfO 2 /TiN resistive random access memory (RRAM) as ultralow power synaptic element in deep neural networks (DNN) for artificial intelligence applications. Low power RRAM devices are fabricated and measured, with very low RESET current and 2–3 orders of resistance window. The SET-RESET current-voltage characteristics, high- and low-resistance state statistical distribution, and analog programming characteristics are calibrated to analytical models. Training and inference for the MNIST handwritten digits dataset using a multilayer perceptron was simulated based on the calibrated model using CIMulator, a novel neuromorphic simulation platform for compute-in-memory circuitry to predict DNN inference accuracy and energy consumption. Despite larger inherent device-to-device variability due to low on current, 97% inference accuracy is achieved with only 2-bit for the weights using weight update accumulation technique.

Rationale: The significant ultrasonic characteristics of amniotic band syndrome (ABS) are the malformations of fetal affected parts and the band—like echoes in amniotic cavity. This article first suggests that the fetal hand adhered to umbilical cord with restricted movement provides some values in the diagnosis of ABS in early gestational weeks especially when the fetal malformation is not obvious and amniotic band is thin and fine. Patient concerns: Two pregnant women had no discomfort and underwent routine ultrasound examination at 11 to 14 gestational weeks. Diagnosis: Only the fetal hand adhered to umbilical cord with restricted movement was detected during the first ultrasound examination at 11∼14 gestational weeks, and the floating band-like echos were detected in the amniotic cavity with follow-up examinations 2 to 3 weeks later. Both of the 2 fetus were diagnosed as ABS by ultrasound Interventions: The two pregnant women underwent the prenatal counseling and were recommended closely follow-up and further examination. Outcomes: Two fetuses died in utero between 17 and 19 weeks. After induction of labor, it was found that the hands and umbilical cord of the fetuses were wrapped by amniotic bands, which was proved pathologically as ABS. Lessons: The adhesion of the fetal hand and umbilical cord is an important ultrasonic sign suggesting ABS with poor prognosis in early pregnancy. We hope that this study can provide some guidance for the early diagnosis of ABS during 11 to 14 week's ultrasound examination.

Recently, re-identification tasks in computer vision field draw attention. Vehicle re-identification can be used to find the suspect car (target) from a vast surveillance video dataset. One of the most critical issues in the vehicle re-identification task is how to learn the effective feature representation. In general, pairwise learning such as the contrastive and triplet loss functions is adopted to learn the discriminative feature based on the convolution neural network. A good backbone network will lead to a significant improvement in the car re-identification task. In this paper, a stronger baseline method is proposed to achieve a better feature representation ability. First, we integrate the shift-invariant convolutional neural network with ResNet backbone to enhance the consistency feature learning. Afterward, a multi-layer feature fusion module is proposed to incorporate the middle- and high-level features to further improve the performance of car re-identification. Experimental results demonstrated that the proposed stronger baseline method achieves state-of-the-art performance in terms of mean averaging precision.

The incidence of colorectal cancer (colorectal cancer, CRC) in China has increased in recent years, and its mortality rate has become one of the highest among all cancers. CRC also increasingly affects people’s health and quality of life, and the workloads of medical doctors have further increased due to the lack of sufficient medical resources in China. The goal of this study was to construct an automated expert system using a deep learning technique to predict the probability of early stage CRC based on the patient’s case report and the patient’s attributes. Compared with previous prediction methods, which are either based on sophisticated examinations or have high computational complexity, this method is shown to provide valuable information such as suggesting potentially important early signs to assist in early diagnosis, early treatment and prevention of CRC, hence helping medical doctors reduce the workloads of endoscopies and other treatments.

Rationale: We report a case of fetal lingual cyst that was diagnosed prenatally using 2-dimensional and 3-dimensional images during routine second trimester screening. To the best of our knowledge, this is the first description of a cystic lesion disappearing before birth. Patient concerns: A 36-year-old woman at 22 weeks’ gestation showed the presence of an oral cystic lesion in routine second trimester ultrasound screening. The lesion measured 18 × 15 × 15 mm. Interventions: A follow-up ultrasound examination was performed every 4 to 6 weeks. Outcomes: The cyst disappeared in a follow-up ultrasound examination at 35 and 37 weeks of gestation. A male newborn who weighed 3480 g was delivered with no feeding difficulties. The boy was followed to 6 years after birth. The child had normal growth and development, and there was no recurrence of the cyst. Lessons: Prenatally diagnosed lingual cysts are uncommon findings that can include many different pathologies with a wide spectrum of severity. Lingual cysts usually have a good prognosis.

This paper proposes a novel arrangement of RC infill walls made possible by RC infill wall mega braces (RCIWMBs). The seismic behavior of a reinforced concrete (RC) frame structure retrofitted by the RCIWMB was investigated through 1/5-scale shaking table tests. The seismic damage characteristics and the dynamic responses of the model structure under different input ground motions are presented in detail. The results show that the presence of the RCIWMB has a slight effect on the failure of beam-column joints, but it can lead to punching shear failure of its connected frame columns. When the RC walls are arranged diagonally, the RCIWMB can form a macroscopic brace effect, serving as the first seismic line of defense. Compared with traditional RC infill wall retrofitted frame structures, the drawback is obvious failure, which appears on the lower stories of this novel type of structure and is prone to forming a weak story. This indicates a poor structural story ductility and more severe damage to the integral structure. However, the addition of the RCIWMB resulted in a substantial increase in the integral lateral bearing capacity, integral lateral stiffness and integral ductile behavior, a decrease in lateral displacement, and a reduction in damage to the original frame structure. The novel structural system performed better under extensive seismic tests, providing a new method for upgrading the seismic performance of existing buildings.

With the rapid growth of generative adversarial networks (GANs), a photo-realistic image can be easily generated from a low-dimensional random vector nowadays. However, the generated image can be used to synthesize several persons who may have a potential effect on society with radical contents. Considering that many techniques to produce a photo-realistic facial image based on different GANs are already available, collecting training images of all possible generative models is difficult; hence, the learning-based approach would not effectively detect a fake image generated using an excluded generative model. To overcome this shortcoming, we propose a two-step pairwise learning approach to learn common fake features over the training images generated by using different generative models. First, the triplet loss will be used to simulate the relation between fake and real images and utilized to learn the discriminative features to determine whether an image is real or fake. Then, we propose a novel coupled network to accurately capture local and global image features of the fake or real images. The experimental results demonstrate that the proposed method outperforms the baseline supervised learning methods for fake facial image detection.

In recent years, BIM technology has been widely used in construction projects, and it has greatly benefited from design modeling to construction check and virtual reality project information integration. However, BIM's commercial modeling software lacks the function of managing queries in the general operation process. This study attempts to build a model of school dormitories and public facilities using BIM. Combined with GIS query function and QR code identification and network communication function. Establish a visual management system with inquiry and maintenance notification functions. The research results show that by integrating related software and identification methods, the functions of query and management can be effectively accelerated.

Thyroid function abnormality (TFA) is a common immune-related adverse event (irAEs), but the association between it and the efficacy of programmed cell death protein 1 (PD-1) inhibitor in advanced non-small cell lung cancer (NSCLC) is finitely understood.We conducted a single center, retrospective study of advanced NSCLC patients who were treated with PD-1 inhibitors between 10 October 2016 and 1 April 2020. TFA was characterized as new onset subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism and overt hyperthyroidism. Frequency of development of TFA-irAEs, and its relationship with overall survival (OS) and progression free survival (PFS) were evaluated.In our study, 191 patients were treated with PD-1 inhibitors. Among them, forty patients (20.9%) developed TFA, of whom 10 (5.2%) presented with subclinical hypothyroidism, 15 (7.9%) with overt hypothyroidism, 6 (3.1%) with subclinical hyperthyroidism and 9 (4.7%) with overt hyperthyroidism. Survival analysis showed that the OS (16.8 months vs. 11.1 months, p 0.001) and PFS (10.4 months vs. 5.5 months, p 0.001) were significantly longer in patients with TFA-irAEs than in those without TFA-irAEs. In subgroup analysis of hypothyroidism and hyperthyroidism groups, similar trends were also obtained for both OS and PFS. After adjusting for potential confounding variables, patients with TFA-irAEs had a lower mortality risk (HR 0.334, 95%CI 0.196-0.571) than those without TFA-irAEs.TFA-irAEs is associated with enhanced PD-1 inhibitor efficacy in advanced NSCLC patients and it may be a biomarker for antitumor immune response.

Background: Traditional Chinese medicine (TCM) is widely integrated into cancer care in China. An overview in 2011 identified 2384 randomized and non-randomized controlled trials (RCTs, non-RCTs) on TCM for cancer published in the Chinese literature. This article summarizes updated evidence of RCTs on TCM for cancer care. Methods: We searched 4 main Chinese databases: China National Knowledge Infrastructure, Chinese Scientific Journal Database, SinoMed, and Wanfang. RCTs on TCM used in cancer care were analyzed in this bibliometric study. Results: Of 5834 RCTs (477 157 cancer patients), only 62 RCTs were indexed in MEDLINE. The top 3 cancers treated were lung, stomach, and breast cancer. About 4752 RCTs (81.45%) tested TCM combined with conventional treatment, and 1082 RCTs (18.55%) used TCM alone for treating symptoms and side-effects. Herbal medicine was the most frequently used TCM modality (5087 RCTs; 87.20%). The most frequently reported outcome was symptom improvement (3712 RCTs; 63.63%) followed by quality of life (2725 RCTs; 46.71%), and biomarkers (2384 RCTs; 40.86%). The majority of RCTs (4051; 69.44%) concluded there were beneficial effects using either TCM alone or TCM plus conventional treatment compared with conventional treatment. Conclusion: Substantial randomized trials demonstrated different types/stages of cancer were treated by various TCM modalities, alone or in combination with conventional medicine. Further evaluation on the effects and safety of TCM modalities focusing on outcomes such as quality of life is required.

Cowell’s method of extracting barrier heights of top and bottom electrode metals in asymmetric metal-insulator-metal (MIM) tunneling diodes exhibiting Fowler-Nordheim tunneling is successfully automated. Pt-Al2O3-TiN MIM diodes with 5 nm insulator thickness are used in demonstration. Conditions assuring successful application of Cowell’s method and its automation are discussed.

Background It has been reported that carnosic acid (CA) exhibits a range of biological activities including hepatoprotective, antioxidant and anti-inflammatory. However, the effect of carnosic acid in neuropathic pain remained elusive. Methods A neuropathic pain model of chronic constriction injury (CCI) was established in adult male Sprague–Dawley rats. Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were recorded, and western blot was performed to detect sirtuin1 and p66shc content. Results Intrathecal administration of carnosic acid attenuated mechanical allodynia and thermal hyperalgesia in rats following chronic constriction injury. Interestingly, carnosic acid analgesic effect was positively associated with spinal sirtuin1 activation; however, p66shc was inhibited by carnosic acid in the spinal cord. In additional, sirtuin1 inhibitor EX-527 reversed the anti-nociceptive effect of carnosic acid. Conclusions Carnosic acid is effective in the treatment of the established CCI-induced pain. It may be possible that spinal sirtuin1 activition by carnosic acid attenuates neuropathic pain through a mechanism involving the down-regulation of p66shc expression.

There is a lack of data on treatment and prognosis of pemphigus in China. The aim of this study was to evaluate long-term follow-up and prognosis of pemphigus. Forty-seven inpatients with pemphigus vulgaris (PV) and 22 with pemphigus foliaceus (PF) were recruited in this retrospective study. The average age at onset was 51.6 and 54.9 years in PV and PF, respectively. High-dose systemic steroids were administered in 47 PV and 21 PF, of which 18 PV and 8 PF with adjuvant therapies. CD4 lymphocytopenia was found in 5 PV and 2 PF patients at admission and successfully treated by intravenous thymopentin daily. During a mean follow-up of 37.1 months, 41 PV and 19 PF reached remission, 30 PV and 9 PF relapsed, 4 PV and 2 PF died. Major causes of death were relapse of pemphigus due to discontinuation of oral steroids by the patients themselves (four cases) and severe infections (two cases, one with severe CD4 lymphocytopenia). The 1-year mortality rate of PV and PF was 8.5% and 4.5%, respectively. Cox regression analysis indicated that age at onset of pemphigus was an independent risk factor related to the elevated mortality. Our report confirmed the high mortality rate of pemphigus in a Chinese population and stressed that patient education was urgently needed to prevent relapses and deaths.

Generative adversarial networks (GANs) can be used to generate a photo-realistic image from a low-dimension random noise. Such a synthesized (fake) image with inappropriate content can be used on social media networks, which can cause severe problems. With the aim to successfully detect fake images, an effective and efficient image forgery detector is necessary. However, conventional image forgery detectors fail to recognize fake images generated by the GAN-based generator since these images are generated and manipulated from the source image. Therefore, in this paper, we propose a deep learning-based approach for detecting the fake images by using the contrastive loss. First, several state-of-the-art GANs are employed to generate the fake&ndash, real image pairs. Next, the reduced DenseNet is developed to a two-streamed network structure to allow pairwise information as the input. Then, the proposed common fake feature network is trained using the pairwise learning to distinguish the features between the fake and real images. Finally, a classification layer is concatenated to the proposed common fake feature network to detect whether the input image is fake or real. The experimental results demonstrated that the proposed method significantly outperformed other state-of-the-art fake image detectors.

Fetal adducted thumbs have been described in association with hydrocephalus and other abnormalities, but in cases without other structural malformations the determination of prognosis and recurrence risk is challenging. The aim of our study is to analyze the characteristics, natural history, and postnatal outcome of such cases. A retrospective study was conducted over a period of 4 years in a tertiary referral center. All fetuses diagnosed as adducted thumbs without other structural malformations comprised the study group. Prenatal sonographic features and neonatal outcome are documented. There were 4 cases of fetal adducted thumbs diagnosed during the study period. No cases demonstrated other structural malformations throughout the gestation. A smaller head was noted in 2 cases during the follow-up, and all cases presented with polyhydramnios on the first or ensuing scans. Three cases died after birth due to swallowing or breathing difficulty, and the surviving 1 showed convulsion and mental retardation. Fetal adducted thumb might be an early and specific sonographic marker of impaired neurodevelopment. Close follow-up and genetic investigation should be performed in these cases. Ultrasound examination plays an important role in the prenatal diagnosis and counseling of cases without detailed prenatal genetic analysis.

GDP is a classic indicator of the extent of national economic development. Research based on the World Trade Network has found that a country&rsquo, s GDP depends largely on the products it exports. In order to increase the competitiveness of a country and further increase its GDP, a crucial issue is finding the right direction to upgrade the industry so that the country can enhance its competitiveness. The proximity indicator measures the similarity between products and can be used to predict the probability that a country will develop a new industry. On the other hand, the Fitness&ndash, Complexity algorithm can help to find the important products and developing countries. In this paper, we find that the maximum of the proximity between a certain product and a country&rsquo, s existing products is highly correlated with the probability that the country exports this new product in the next year. In addition, we find that the more products that are related to a certain product, the higher probability of the emergence of the new product. Finally, we combine the proximity indicator and the Fitness&ndash, Complexity algorithm and then attempt to provide a recommendation list of new products that can help developing countries to upgrade their industry. A few examples are given in the end.

Although Generative Adversarial Network (GAN) can be used to generate the realistic image, improper use of these technologies brings hidden concerns. For example, GAN can be used to generate a tampered video for specific people and inappropriate events, creating images that are detrimental to a particular person, and may even affect that personal safety. In this paper, we will develop a deep forgery discriminator (DeepFD) to efficiently and effectively detect the computer-generated images. Directly learning a binary classifier is relatively tricky since it is hard to find the common discriminative features for judging the fake images generated from different GANs. To address this shortcoming, we adopt contrastive loss in seeking the typical features of the synthesized images generated by different GANs and follow by concatenating a classifier to detect such computer-generated images. Experimental results demonstrate that the proposed DeepFD successfully detected 94.7% fake images generated by several state-of-the-art GANs., Comment: 4 pages to appear in IEEE IS3C Conference (IEEE International Symposium on Computer, Consumer and Control Conference), Dec. 2018

This study aimed to construct new reference charts and equations for fetal biometry from Chinese fetuses at 15-40 weeks and to compare them with previous references.This was a prospective, cross-sectional study of singleton pregnancies in patients with a confirmed gestational age who underwent ultrasound examinations between the 15th and 40th weeks of gestation. Each woman was selected only once for this study. Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were recorded. For each measurement, separate regression models were fitted to estimate the mean and standard deviation at each menstrual age. Z-scores were calculated with our reference equations for comparison with other references.New charts and reference equations involving 7553 Chinese women were created for BPD, HC, AC, and FL. Reference equations were cubic models. Prediction intervals for the new reference charts were similar to those of previous references, but with some slight differences. The main difference in our fetal biometric measurements compared with those of Korea and Hong Kong was the FL.We report new Chinese reference charts and equations for fetal biometry. These reference charts and equations are available for clinical use in obstetric ultrasound studies for the Chinese population.

Based on a systemic analysis of the factors which might influence building energy efficiency, a cluster of corresponding indicators are proposed and screened for different stages in the whole life-cycle of buildings. A questionnaire survey was conducted to confirm the weights of the selected indicators and identify critical control objects for building energy saving. This research provides the methodology for selecting appropriate control objects for building energy-efficiency under various management scenarios.

The current card attendance check system in colleges has the problems of low efficiency and accuracy, and severe condition of taking attendance for others. To solve these problems, we have designed attendance check system for college students based on fingerprint identification technology. This system can share information with educational administration system, offering such functions as academic year and semester management, classroom management, lesson management, and schedule management, and attendance check authority management, etc. This system utilizes the characteristics of fingerprints, which carries uniqueness and stability and adopts the increasingly mature fingerprint identification technology. It can improve the quality and efficiency of attendance management for college students, and promote the information construction on campus.

Reinforced concrete (RC) shear walls have been widely applied in high-rise buildings. DBSD (Displacement-Based Seismic Design) of shear wall structures requires more accurate deformation evaluation theories and methods. Boundary elements of RC walls have been found to have a significant impact on the seismic behaviours, but the strain-stress development details including plane section assumption and linear curvature distribution are seldom investigated by specialized experiments. To investigate the failure mechanism of shear walls and the influence of the boundary element, 6 RC wall specimens with different boundary elements are studied in this paper. Strain development data of the shear wall section and along wall height were collected during the loading procedure. The failure mechanism of the RC walls with different boundary elements is studied by discussing the development of the strain. Study emphasis is laid on the adaption of plane-section assumption during the whole service procedure, the curvature development along the wall height during the whole service procedure, the influence of boundary element to moment-curvature relationship. Test results indicate that boundary element can restrain the growth of the strain, enhance the horizontal bearing capacity, and improve the seismic resistant capacity. The study also re-evaluates the plane section assumption and linear curvature distribution currently used based on the results of the deformation of the shear walls by the experimental investigation of the shear walls with different boundary element.

Using modal analysis to train and bridges and piers for dynamics analysis, we got a theoretical solution. Using wireless sensor network architecture monitoring system for Bridges and piers of the acceleration and the settlement monitoring, in considering static load loading situation, through contrast train before and after the settlement of piers the quantity change and Bridges and piers acceleration size, draw piers vertical stiffness of the bridge vibration impact is not significant. Study of the bridge piers and transverse vibration characteristics, it is concluded that the piers lateral stiffness is far less than that of the vertical stiffness, piers and bridges in transverse have larger dynamic response to produce.

A molecular understanding of drug resistance mechanisms enables surveillance of the effectiveness of new antimicrobial therapies during development and deployment in the field. We used conventional drug resistance selection as well as a regime of limiting dilution at early stages of drug treatment to probe two antimalarial imidazolopiperazines, KAF156 and GNF179. The latter approach permits the isolation of low-fitness mutants that might otherwise be out-competed during selection. Whole-genome sequencing of 24 independently derived resistant Plasmodium falciparum clones revealed four parasites with mutations in the known cyclic amine resistance locus (pfcarl) and a further 20 with mutations in two previously unreported P. falciparum drug resistance genes, an acetyl-CoA transporter (pfact) and a UDP-galactose transporter (pfugt). Mutations were validated both in vitro by CRISPR editing in P. falciparum and in vivo by evolution of resistant Plasmodium berghei mutants. Both PfACT and PfUGT were localized to the endoplasmic reticulum by fluorescence microscopy. As mutations in pfact and pfugt conveyed resistance against additional unrelated chemical scaffolds, these genes are probably involved in broad mechanisms of antimalarial drug resistance.

We retrospectively compared detection rates and consistency for diagnosis of peritoneal carcinomatosis (PC) of primary ovarian cancer (OC) between ultrasound (US) and computed tomography (CT) scans in 41 patients whose PC of OC (stages IIC-IV) had been diagnosed by histopathology findings. Compared with CT detection rates, those for US were significantly higher for metastases to the pelvic area (92.3% vs. 43.6%, p 0.001) and bowel surface (64.0% vs. 16.0%, p = 0.002); however, they did not significantly differ for other sites: omentum, diaphragm, lateral peritoneum, mesenteric, hepatic and splenic surfaces. Diagnostic consistency between US and CT scans were fair to moderate for splenic (κ = 0.806), hepatic (κ = 0.485), lateral peritoneum (κ = 0.450) and diaphragm (κ = 0.338) surfaces, but poorly consistent for other parts (κ = 0.144-0.229). In summary, US can complement CT scans, especially for detecting PC of primary OC metastases in pelvic and bowel surfaces.

BACKGROUND:This therapeutic drug monitoring (TDM) study aimed to determine the role of olanzapine (OLZ) and N-desmethyl-OLZ (DMO) levels in the therapeutic efficacy of OLZ in patients with schizophrenia. METHOD:Plasma concentrations of OLZ (COLZ) and DMO (CDMO) in schizophrenic patients 12 hours post-dose were assessed. The correlations of COLZ and CDMO with the various scores of the Positive and Negative Syndrome Scale (PANSS) were evaluated. A receiver operating characteristic curve (ROC) was utilized to identify the threshold COLZ and COLZ/CDMO ratio for maintenance of satisfactory efficacy. RESULTS:A total of 151 samples from patients with schizophrenia were analyzed for individual COLZ and CDMO levels. The mean COLZ and CDMO levels were 37.0 ± 25.6 and 6.9 ± 4.7 ng/mL, respectively, and COLZ was ~50% higher in female or nonsmokers (p

OBJECTIVE:To retrospectively compare the sonographic and clinical features of papillary thyroid microcarcinoma (PTMC) ≤5 mm and PTMC >5 mm to improve the diagnostic value of ultrasonography. METHODS:A total of 367 cases of PTMC between January 2013 and December 2014 was included in this study. The patients were classified into group A (≤5 mm, n = 181) or group B (>5 mm, n = 186), and the sonographic and clinical features were reviewed and compared between the two groups. RESULTS:There was no significant difference in the shape, ratio of length/width, boundary, peripheral halo ring, echogenicity, cystic change and accompanying Hashimoto's thyroiditis between these two groups. However, the calcification (61.3% vs. 72.6%) and hypervascularity (13.8% vs. 24.7%) were more frequent in group B (p = 0.026 and 0.008, respectively). The patients were younger, and more patients were aged less than 45 years (41.4% vs. 57.0%) in group B. Capsular invasion (7.2% vs. 34.4%), multifocality (21.5% vs. 48.9%), bilaterality (17.1% vs. 39.8%), central lymph node metastasis (13.8% vs. 38.2%) and lateral lymph node metastasis (1.1% vs. 5.4%) were more frequent in group B. No clinical or sonographic feature was related to cervical lymph node metastasis in group A, while less than 45 years in age (p = 0.010), male gender (p = 0.040), capsular invasion (p5 mm, including an irregular shape, a length/width ratio of ≥1, an unclear boundary, no peripheral halo ring, hypoechogenicity, no cystic change, calcification, no hypervascularity and no accompanying Hashimoto's thyroiditis. The clinical features of PTMC ≤5 mm were less aggressive than those of PTMC >5 mm.

Although point and line grading are widely utilized in garment CAD system, they have a common disadvantage: the increments of cardinal points or line on the to-be-graded patterns have to be calculated and inputted manually. In previous work, basic and fashion pattern are defined and the constant and proportional relation between them are considered to explore computerized grading. In the research, a dart pivotal-transfer relation between basic and fashion pattern is introduced. This paper proposes an automatic grading approach based on dart pivotal-transfers. This approach is illustrated with an example of the front panel of women’s jacket, the cardinal points concerning a dart are rotated around a pivotal-point, the increments of the cardinal points are transformed from that of original ones, and then the X and Y coordinates of the cardinal points in the to-be-graded pattern are gained. The experimental results show the approach is feasible.

Background: We aimed to provide a pooled analysis of controlled trials comparing long-term survival after primary laryngectomy and primary organ preservation methods in patients with T3-4 laryngeal cancer. Methods: We performed random-effects meta-analyses on overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), and locoregional control (LRC). Results: Fifteen studies met the selection criteria including 6288 patients (2696 patients who underwent primary laryngectomy and 3592 patients who underwent primary nonsurgical organ preservation therapy). There was a significant difference between the groups with respect to OS (HR 0.71, 95% CI 0.57–0.89, P = .003). However, a subgroup analysis found OS was not significantly worse for patients with T3 laryngeal cancer who received primary organ preservation compared with patients who underwent primary laryngectomy (HR 0.96, 95% CI 0.45–2.03, P = .91). There was no significant difference for DFS (HR 0.63, 95% CI 0.39–1.04, P = .07) in two groups. Patients with laryngeal cancer who underwent primary laryngectomy had a better DSS (HR 0.47, 95% CI 0.25–0.88, P = .02) and LRC (HR 0.56, 95% CI 0.390.80, P = .001) than patients who underwent primary nonsurgical organ preservation therapy. Conclusion: Our results support total laryngectomy for patients with T4 laryngeal cancer and show that primary organ preservation for laryngeal cancer has no advantage and also did not decrease the rate of OS in patients with T3 laryngeal cancer when compared with primary total laryngectomy.

RATIONALE We present a case of intrarenal vein thrombosis (IRVT) diagnosed by ultrasound (US). To the best of our knowledge, this is the first reported case in the imaging literature. PATIENT CONCERNS A 15-year-old boy with a 4-year history of thrombocytopenic purpura presented to the emergency room with a 2-day history of sudden-onset severe left flank pain associated with gross hematuria. DIAGNOSES Hypercholesterolemia, proteinuria, and elevated plasma creatinine level were present. The US examination showed obscurely structured, sparsely distributed arterial and venous flow signals, and an increased resistance index (RI) in a localized area. The diagnosis was acute renal failure and nephrotic syndrome accompanied by left IRVT. INTERVENTIONS The patient was treated with anticoagulation therapy for 1 month. OUTCOMES Clinical symptoms were relieved. The US re-examination revealed that the arterial flow spectra had returned to normal. Also, more venous flow signals were observed in the involved area, suggesting thrombolysis. LESSONS This previously unreported case should alert sonographers to include IRVT in the differential diagnosis of flank pain associated with hematuria. In such cases, both kidneys and different areas of the same kidney should be scanned and compared. Some features, including an obscure structure and an increased RI for the involved area indicate possible IRVT.

This paper presents an automatic pattern grading technique by obtaining point grading rules automatically in order to avoid the manual input of cardinal point increments in the traditional GCAD system. Based on the principles of the pattern grading and pattern structures, patterns are divided into two categories: basic patterns and fashion patterns that are derived from basic patterns. Since basic patterns and fashion patterns are the specific form of 2D garment structure of human body, the grading rule of the former has relationship with that of the latter quantitatively, thus the fashion patterns can be graded automatically by applying the grade rule data of basic patterns. This paper depicts the computer class design scheme of the technique, including the construction of the pattern data structure, the acquirement of the grading rules of basic patterns by parameterization, the algorithms on the automatic transformation from the grading point increment of basic patterns to the one of fashion patterns and the application of grading rule of basic pattern in fashion patterns. The experiment results show that the technique is feasible.

The association of prenatal signs of tuberous sclerosis complex (TSC) and renal cystic disease is very rare. We report the case of a male fetus with a cardiac mass and a renal cortical cyst detected in utero by sonography at 20 weeks' gestation. A postmortem examination showed polycystic kidney disease (PKD) and a cardiac rhabdomyoma, which is a prenatal marker of TSC. On the basis of the maternal history of TSC associated with radiographic features resembling autosomal dominant polycystic kidney disease (ADPKD), the early onset of the cardiac rhabdomyoma and renal cystic changes in the fetus strongly suggested TSC2/PKD1 contiguous gene syndrome or an impaired functional linkage between products of the 2 genes inherited from the mother.

High-end equipment manufacturing industry is one of the seven areas of the strategic new industry, according to The National Twelve-Five plan. The development of high-end equipment manufacturing industry not only affects the growth of China’s economy, but also affects the strengthening of comprehensive national strength. This paper briefly analyzes the current situation about the development of the high-end equipment manufacturing industry and the existing problems, then puts forward some related countermeasures and suggestions to the development of China’s high-end equipment manufacturing industry.

Since interactive pattern-making technique in Garment CAD has its inherent limitation, some advanced pattern-making ones are intensively studied. This paper reviews state-of-art pattern-making techniques, including pattern generation based on artificial neural network, pattern flattening technique from 3D human or garment model and parametric pattern-making technique. In each technique, basic principles, characteristic and application are systematically discussed and commented. In first technique, the model of artificial neural network is constructed to simulate a pattern-making process. Pattern flattening technique is one of the key techniques of 3D GCAD system, geometrical and physical pattern flattening approaches are presented in this technique. Variant programming, macro definition, parametric model based on sequence and dimensional constraints, parametric model based on dimensional and geometric constraints are included in parametric pattern-making technique, parametric model based on dimensional and geometric constraints is considered as a promising one.

Working position drive is one of the most important links among the nodes of modern manufacturing. Chinese medicine pharmaceutical manufacturing is a typical case of working position drive; working nodes and operation actions can be described into data structures by abstracting working position data effectively; the entire workflow can be formed with various working nodes structured in series by workflow control technologies. By applying the principle of working position drive and workflow control, the development of Chinese medicine pharmaceutical manufacturing simulation system become simpler and clearer, and it is more practical.

OBJECTIVES The purpose of this study was to investigate the influence of atherosclerosis and age on 4 representative Doppler parameters in the diagnosis of renal artery stenosis. METHODS The 4 parameters, renal peak systolic velocity (PSV), renal-aortic ratio, renal-interlobar ratio, and acceleration time, were measured in 208 patients before angiography. The 208 patients were divided into groups according to age and atherosclerosis stratification. The Student t test, 1-way analysis of variance, and the χ(2) test were used to compare all 4 parameters and clinical characteristics. The optimal cutoff values were determined by receiver operating characteristic curves. The diagnostic concordance between atherosclerosis and age strata was evaluated by the Cohen κ coefficient. RESULTS Of the 416 renal arteries shown on Doppler sonography, 204 had a diagnosis of renal artery stenosis and 19 as occlusion on angiography. The optimal cutoff values for the renal-aortic ratio and renal-interlobar ratio in the groups aged 46 years or older and younger than 46 years were much different (2.3 versus 1.4 and 5.1 versus 6.5, respectively), whereas those for the renal PSV and acceleration time were close to each other or the same (170 versus 180 cm/s and 51 versus 51 milliseconds). The κ coefficients for the renal PSV, renal-interlobar ratio, acceleration time, and renal-aortic ratio between the atherosclerosis and age strata were 0.93, 0.99, 1.00, and 0.71. CONCLUSIONS Atherosclerosis and age show comparable influences on Doppler parameters in the diagnosis of renal artery stenosis. For clinical convenience, cutoff values may be separately established on the basis of a 46-year-old borderline for the renal-aortic ratio and renal-interlobar ratio, although this process is not necessary for the renal PSV and acceleration time.

Point-to-point communication, as the base of wireless sensor network, is essential for wireless sensor network structure. This paper introduces a solution of point-to-point communication in wireless sensor network. A hardware platform is introduced in this paper. The authors design a low-level driver program of the platform, on the base of which the point-to-point communication is implemented. The successful test of the program verifies the viability of the solution. The solution can be easily transplanted and supports more complicated wireless sensor network system. Besides, it can configure serial baud rate, checking, encryption and communication channel. The communication distances can reach 63 meters.