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To compare the screening value of the Reflux Symptom Score (RSS) and the Reflux Symptom Index (RSI) for laryngopharyngeal reflux (LPR).All included patients attending the Department of Otolaryngology at the Sixth Medical Center of the PLA General Hospital from February 2022 to August 2022, completed the RSS and the RSI and underwent 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24 h HEMII-pH) monitoring. The results of 24 h HEMII-pH were used as a diagnostic criterion for LPR, consistency between two questionnaires (RSS, RSI) and 24 h HEMII-pH was compared by the weighted Cohen's kappa statistic and the screening value of RSS and RSI for LPR was compared by receiver operating characteristics analysis.A total of 77 patients, 58 males, and 19 females, were included. The Kappa values of between RSS, RSI, and 24 h HEMII-pH were 0.663 (p 0.001) and 0.213 (p 0.05), respectively. The sensitivity of RSS and RSI were 92.8% and 48.2%, respectively, the specificity was 71.4% and 80.9%. The negative predictive value and positive predictive value of RSI were 36.9%, 87.1%, and that of RSS were 78.9%, 89.6%. The area under curve of the RSS (0.783; 95% CI = 0.53, 0.75) is significantly higher than RSI (0.633; 95% CI = 0.72, 0.90).The RSS has a higher consistency and better screening value for LPR compared to RSI. In addition, the RSS includes more reflux symptoms, which may reduce the number of missed diagnoses in patients with LPR to some extent.3 Laryngoscope, 2022.

To investigate the mutually relationship between gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD).All included patients completed simultaneous 24-hour hypopharyngeal intraluminal multichannel impedance pH monitoring (24h-MII-pH), Reflux Symptom Index (RSI), and Reflux Finding Score (RFS). The LPRD diagnosis was based on the occurrence of ≥1 acid or non-acid hypopharyngeal proximal reflux episode(HRE), GERD was defined as a length of time4.0% of the 24-hour recording spent below pH 4.0 or a DeMeester score14.72. Patients with both positive LPRD and GERD were classified as LPRDGERD group, patients with positive LPRD and negative GERD were classified as ILPRD group, patients with negative LPRD and positive GERD were classified as IGERD group, and patients with both negative LPRD and GERD were classified as N group. The differences in clinical characteristics of reflux between the groups were statistically analyzed.A total of 437 patients were included, including 248 (56.75%) in the ILPRD group, 98 (22.43%) in the LPRDGERD group, 23 (5.26%) in the IGERD group, and 68 (15.56%) in the N group. There was no significant difference between the types of gastroesophageal reflux in patients with GERD. The number of weak acid/acid/gas/liquid HREs was significantly more in LPRDGERD patients than in ILPRD patients (P0.01), and the number of distal acid reflux events and Longest distal acid clearance time were significantly higher in LPRDGERD patients than in IGERD patients (P0.01).GERD and LPRD are not the same disease but can mutually influence. Combined GERD increased all types of laryngopharyngeal reflux events in patients with LPRD, whereas combined LPRD only increased acidic distal reflux events and acid clearance time in patients with GERD.

To evaluate the necessity of multiple salivary pepsin tests within a day when diagnosing laryngopharyngeal reflux.Prospective cohort study.Tertiary hospitals.A total of 138 patients with signs and/or symptoms associated with laryngopharyngeal reflux were included. Salivary pepsin was detected on the day of 24-hour pH monitoring, and the results of salivary pepsin detected once in the morning and multiple times in 1 day were compared with the results of pH monitoring.Among the 138 patients, pH monitoring results were positive in 112. Salivary pepsin was positive in 47 cases in the morning, which was not consistent with the results of pH monitoring (kappa value = 0.117). With the pH monitoring results as the standard, the salivary pepsin detected once in the morning had a sensitivity of 38.4% (43/112) and a specificity of 84.6% (22/26) for the diagnosis of laryngopharyngeal reflux. When salivary pepsin was detected multiple times per day, 102 patients tested positive. The consistency with pH monitoring was moderate (kappa value = 0.587). The sensitivity was 86.6% (97/112), and the specificity was 80.8% (21/26). Of the 97 patients with positive results from pH monitoring and salivary pepsin detected multiple times a day, 54 had negative findings for a single detection in the morning, indicating that 55.7% (54/97) of the true positive cases were missed.Although a single detection of salivary pepsin in the morning is more economical, the sensitivity is too low, and it is necessary to detect it multiple times a day.

To investigate the optimal time point for diagnosing laryngopharyngeal reflux (LPR) through combining 24-h hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24-h HEMII-pH) monitoring and the multi-time point salivary pepsin test (MTPSPT).Prospective uncontrolled trial.Patients with and without LPR symptoms were included as the test group and the control group, respectively. The patients in the test group underwent 24-h HEMII-pH and MTPSPT. The results of 24-h HEMII-pH were used as a diagnostic criterion for LPR, and the diagnostic value of salivary pepsin tests performed at different time points was compared by receiver operating characteristic (ROC) analysis.A total of 153 patients were included. Based on 24-h HEMII-pH, the positive rate of LPR in the test group of patients was 84.00%. In the control group, only one person (3.57%) had a positive salivary pepsin test result. The area under the curve (AUC) of the MTPSPT was 0.827. In addition, we separately calculated the AUC of the combined salivary pepsin test at different time points, and found good diagnostic value (AUC = 0.799) when the test was combined with the waking, 1 and 2 h after breakfast and lunch, and 1 h after dinner tests. However, when the number of tests were further increased, the diagnostic value did not improve significantly.Salivary pepsin testing combined with waking, 1 h and 2 h after breakfast and lunch, and 1 h after dinner has almost the same diagnostic value as MTPSPT, and testing at these time points can be an effective method for diagnosing LPR.3 Laryngoscope, 2022.

Deterministic networking for industrial manufacturing is a frontier technology with both theoretical innovativeness and technical practicability; it is significant for promoting technological innovations of the new-generation industrial Internet and for promoting the integrated development of industrial manufacturing and high-quality network, thereby providing opportunities for occupying the commanding height of network technology and seizing new economic growth points. This study investigates the development requirements for deterministic networking for industrial manufacturing from the aspects of manufacturing and communication enterprises, summarizes the development status and trends of the technology in detail, and further addresses development challenges. We classify the development stages of the technology into pilot demonstration, large-scale replication, and spontaneous innovation. Research reveals that the “deterministic network + industrial manufacturing” development in China needs to focus on the following aspects: establishing industry alliances to improve the industrial ecology, maximizing the existing public networks, carefully selecting industry development paths, increasing resource guarantee for application innovation, strengthening research on basic theories and key technologies, and training personnel through collaboration among industry, universities, and research institutes.

To investigate the profiles of laryngopharyngeal reflux (LPR) and the relationship between hypopharyngeal-proximal reflux episodes (HREs) and the positive rate of salivary pepsin testing in patients with vocal fold lesions (VFLs).The enrolled patients were divided into vocal fold cancer group (VFCG), vocal fold leukoplakia group (VFLG), benign vocal fold lesion group (BVFLG) and control group (CG). Patients benefited from multichannel intraluminal impedance-pH monitoring (MII-pH) and multi-time point salivary pepsin testing (MTPSPT). The LPR profiles of patients with VFLs were studied by analyzing the MII-pH findings. The relationship between HREs and positive rate of MTPSPT was investigated through the nonparametric test.177 patients were included. According to 24 h MII-pH, the occurrence of HREs tended to increase after meals. 55.75%, 63.98%, 66.82% and 55.77% of the HREs in the VFCG, VFLG, BVFLG and CG occurred within 3 h after meals, respectively. The overall positive rate of MTPSPT was higher in the VFCG than the remaining groups. In the VFCG, there was a significant correlation between overall positive results of MTPSPT and HREs occurring within 3 h after meals.In the Chinese population, the occurrence of HREs tend to more frequently after meals in patients with VFLs, and most HREs occur within 3 h after meals. By analyzing the 24h MII-pH findings, we can develop a more individualized anti-reflux therapeutic strategy for LPR patients.

To analyze the role of nonacid reflux in laryngopharyngeal reflux diseases (LPRD). From January 2014 to April 2019, 344 patients associated with LPRD underwent 24-h multichannel intraluminal impedance–pH monitoring, and their reflux symptom index (RSI) and reflux finding score (RFS) were recorded. The numbers of acid, weakly acidic and alkaline reflux events in the laryngopharynx were counted, and the consistency analysis of the results with the results of the RSI and RFS was conducted. Among the 344 patients, nonacid reflux events accounted for 74.1% (1367/1845) of the all reflux events. There were 111 patients with ≥ 3 acid reflux events, 218 patients with ≥ 3 any kinds of reflux events, and 257 patients with positive results of RSI or RFS. Taking the results of the RSI and or RFS as a reference, the sensitivity, specificity and consistency test Kappa value for the diagnosis of LPRD according to the existence of ≥ 3 acid reflux events were 41.2%, 94.2% and 0.228, respectively. With the existence of three or more all kinds of reflux events as the standard, the sensitivity, specificity and consistency test Kappa value were 76.7%, 74.7% and 0.449, respectively. The nonacid reflux events account for the highest proportion of laryngopharyngeal reflux events, and the consistency of the results of RSI and or RFS with all reflux events is higher than that with only acid reflux events, that indicates nonacid reflux may play an important role in LPRD.

This paper addresses task assignment (TA) for multivehicle systems. Multivehicle TA problems are formulated as a combinatorial optimization problem and further as a global optimization problem. To fulfill heterogeneous tasks, cooperation among heterogeneous vehicles is incorporated in the problem formulations. A collaborative neurodynamic optimization approach is developed for solving the TA problems. Experimental results on four types of TA problems are discussed to substantiate the efficacy of the approach.

The effect of impingement jet on heat transfer in a rotating wedge-shaped ribbed trailing edge was experimentally investigated in this study. The inlet Reynolds number varied from 10000 to 61000, a...

With the development of green agriculture, the demand of farmers for operation loans is increasing. Supply chain finance is becoming a new way to solve the problem of difficult credit in agricultural development. As the importance of sustainability issues continues to rise, there are growing numbers of practical examples of combining agricultural supply chain finance (ASCF) with sustainability, and the attendant risks are emerging. The objectives of this study are first to construct a risk indicator system for sustainable ASCF, then to propose a fuzzy decision method that considers the confidence of decision-makers, and finally to perform a risk assessment of a credit case in the coffee bean supply chain. A combination of the neutrosophic enhanced best–worst method (NE-BWM) and combined compromise solution (COCOSO) is used to evaluate risk problems. The practicality and effectiveness of this research method is verified by a numerical simulation and a comparison with the method. The results show that the credit rating of core companies is the most important indicator. In the context of green and sustainable development, this indicator system is more suitable for the current green transformation development of agriculture and can help decision-makers scientifically and reasonably assess the risk level of ASCF. When loans are needed to transform green agriculture, this study provides new ideas for credit models for various actors in the agricultural supply chain and offers a new entry point to the issue of sustainable agricultural development.

PURPOSE Laryngoscopy, the most common diagnostic method for vocal cord lesions (VCLs), is based mainly on the visual subjective inspection of otolaryngologists. This study aimed to establish a highly objective computer-aided VCLs diagnosis system based on deep convolutional neural network (DCNN) and transfer learning. METHODS To classify VCLs, our method combined DCNN backbone with transfer learning on a system specifically finetuned for a laryngoscopy image dataset. Laryngoscopy image database was collected to train the proposed system. The diagnostic performance was compared with other DCNN based model. Analysis of F1 score and receiver operating characteristic (ROC) curves were conducted to evaluate the performance of the system. RESULTS Beyond existing VCLs diagnosis method, the proposed system achieved an overall accuracy of 80.23%, an F1 score of 0.7836, and an AUC of 0.9557 for four fine-grained classes of VCLs, namely normal, polyp, keratinization, and carcinoma. It also demonstrated robust classification capacity for detecting urgent (keratinization, carcinoma) and non-urgent (normal, polyp), with an overall accuracy of 0.939, a sensitivity of 0.887, a specificity of 0.993, and an AUC of 0.9828. The proposed method also outperformed clinicians in the classification of normal, polyps, and carcinoma at an extremely low time cost. CONCLUSION The VCLs diagnosis system succeeded in using DCNN to distinguish the most common VCLs and normal cases, holding a practical potential for improving the overall diagnostic efficacy in VCLs examinations. The proposed VCLs diagnosis system could be appropriately integrated into the conventional work-flow of VCLs laryngoscopy as a highly objective auxiliary method. This article is protected by copyright. All rights reserved.

Kaposi sarcoma (KS) is a mesenchymal tumor characterized by angioproliferation in the setting of infection by human herpesvirus 8 (HHV-8), also known as KS–associated herpesvirus. The disease has several manifestations, the most common of which is a violaceous-to-dark brown macule, plaque, or nodule on the skin. Involvement of the gastrointestinal tract is less common, only affecting 10% of patients but is much more prevalent in the immunocompromised.1 Involvement of visceral organs outside the gastrointestinal tract such as the lungs, liver, and bone is extremely rare in immunocompetent patients. Clinically, most cases of KS fit into 1 of 5 reported subtypes: classical, African endemic, AIDS epidemic, iatrogenic, and nonepidemic. Very rarely do patients present who do not conform to 1 of the 5 subtypes. We present 3 such patients and discuss their fit in the current classification system.

In this paper, a method is presented for antidisturbance constrained control of autonomous underwater vehicles subject to uncertainties and constraints. The uncertainties stem from uncertain hydrodynamic parameters, modeling errors, and unknown forces due to the ocean currents in an underwater environment. An antidisturbance constrained controller is developed by designing a command governor and a disturbance observer. Specifically, the disturbance observer is developed to estimate the lumped disturbance composed of parametric model uncertainties, modeling errors, and unknown environmental forces. The command governor is designed for optimizing command signals in the receding horizon within the state and input constraints. The command governor is formulated as a quadratically constrained quadratic programming problem. To facilitate online implementations, a neurodynamic optimization method based on a one-layer recurrent neural network is employed for solving the quadratic optimization problem subject to inequality constraints with finite-time convergence. The efficacy of the proposed antidisturbance constrained control method for autonomous underwater vehicles is substantiated via simulations and comparisons.

This article presents a collaborative neurodynamic optimization (CNO) approach to multivehicle task assignments (TAs). The original combinatorial quadratic optimization problem for TA is reformulated as a quadratic unconstrained binary optimization (QUBO) problem with a quadratic utility function and a penalty function for handling load capacity and cooperation constraints. In the framework of CNO with a population of discrete Hopfield networks (DHNs), a TA algorithm is proposed for solving the formulated QUBO problem. Superior experimental results in four typical multivehicle operation scenarios are reported to substantiate the efficacy of the proposed neurodynamics-based TA approach.

This paper addresses the travelling salesman problem (TSP) based on collaborative neurodynamic optimization (CNO). In the CNO approach to TSP, a population of discrete Hopfield networks are employed for searching local optimal solutions and repeatedly reinitialized by using the particle swarm optimization rule towards a global optimal solution. Experimental results for solving four TSP benchmarks are reported to substantiate the efficacy of the CNO approach.

Flip chip technology has been rapidly developed and widely used in the field of microelectronic packaging, and defect detection has also received more and more attention. Aiming at the problem that noise affects the location and extraction of signal defects in ultrasonic testing, the sparse Bayesian learning based on generalized approximate message passing (GAMP-SBL) algorithm is used to extract signal defects, and the over-complete Gabor dictionary is used to reconstruct signal defects to effectively improve Sparse decomposition algorithm. The precision experiment tested the defect simulation signal and the actual ultrasonic signal respectively, and compared with the greedy algorithm. The experimental results show that the GAMP-SBL algorithm can more effectively extract the defect signal under the noise background.

This article presents a neurodynamic approach to nonlinear programming. Motivated by the idea of sequential quadratic programming, a class of two-timescale multilayer recurrent neural networks is presented with neuronal dynamics in their output layer operating at a bigger timescale than in their hidden layers. In the two-timescale multilayer recurrent neural networks, the transient states in the hidden layer(s) undergo faster dynamics than those in the output layer. Sufficient conditions are derived on the convergence of the two-timescale multilayer recurrent neural networks to local optima of nonlinear programming problems. Simulation results of collaborative neurodynamic optimization based on the two-timescale neurodynamic approach on global optimization problems with nonconvex objective functions or constraints are discussed to substantiate the efficacy of the two-timescale neurodynamic approach.