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Key point: Social determinants of health interactively influence sinonasal cancer care and prognosis.Housing‐transportation and socioeconomic status showed the largest associations with disparities.The social vulnerability index can reveal the social determinants of sinonasal cancers. [ABSTRACT FROM AUTHOR]

This article presents the discovery of an explicit 16-stage Runge–Kutta method that numerically satisfies the Runge–Kutta order conditions (in Butcher form) to 10th order, conjecturally improving the best-known number of stages in an explicit 10th-order Runge–Kutta method from 17 to 16. Unlike the vast majority of published Runge–Kutta methods, the method presented in this paper was not constructed via symbolic analysis or the use of simplifying assumptions, but instead by directly applying numerical optimization and root-finding algorithms to the order conditions. A naïve implementation of these algorithms would be made computationally infeasible by the considerable size and complex structure of the Butcher equations. However, we present a collection of software optimizations that greatly accelerate the evaluation of the Butcher equations and their derivatives while mitigating the effects of destructive cancellation, pushing these techniques within the realm of feasibility. While we do not have a formal proof of order, we present the results of numerical experiments to demonstrate that our method satisfies the Butcher equations to an accuracy of over 3000 decimal digits. [ABSTRACT FROM AUTHOR]

Purpose: With advances in orthopedic implants, the use of intramedullary lengthening devices has gained increasing popularity as an alternative technique compared to lengthening with external fixators, with alleged comparable or better outcomes. The aim of this study is to report our single-center technique and outcomes of combined ankle arthrodesis and proximal tibial lengthening using external fixator with a motorized intramedullary nail, respectively. Method: Fourteen patients with post-traumatic advanced ankle arthritis underwent staged ankle arthrodesis with external fixator and proximal tibial lengthening using the PRECICE® ILN. Amount of shortening, length achieved, bone healing index, infection rate, ankle fusion rate, and ASAMI score were evaluated. Results: The average age was 44 years old (range, 30–62). The mean follow up is 70 months (range, 43–121.4). The average amount of limb shortening for patients after ankle fusion was 36.7 mm (18–50) while lengthening was 35.9 mm (range, 18–50). Patients had the nail implanted for an average of 479 days (range, 248–730). Ankle fusions were healed in an average of 178.3 days. There were no surgical infections. All osteotomy-lengthening sites healed after an average 202 days (106–365). The mean bone healing index (BHI) was 56.0 days/cm (21.2–123.6) among the whole cohort. There were no cases of nonunion. ASAMI bone scores were excellent or good among all patients. Conclusion: Ankle arthrodesis with external fixation along with proximal tibial lengthening using motorized IMN yielded high rates of fusion and successful lengthening. This technique could be offered as a reasonable alternative to using external fixation for both purposes. Level of Evidence: Level IV, Retrospective cohort study. [ABSTRACT FROM AUTHOR]

Objectives: Online educational platforms with open access have seen a growing adoption in the field of medical education. However, the extent of their global usage is still unclear. To fill this knowledge gap, our objective is to examine the usage patterns of two renowned open‐access resources in Otolaryngology. This includes identifying the most sought‐after topics and understanding the demographics of their users. Methods: Retrospective study of web analytics data between 2016 and 2021 extracted from the Headmirror.com and Mayo Clinic Otolaryngology YouTube channel platforms analyzing demographic and education topic trends via descriptive, geospatial, time‐series, t‐tests, and ANOVA analyses. Results: Viewership spanned 124 countries in 7 different geographic regions, with 72 countries comprising low‐ to middle‐income countries, mostly represented ages of 25–34 years old, came from high‐income countries rather than low‐income (p <.001), and used mobile phones followed by computers for device access. Video‐educational material comprised of subspecialty topics on Rhinology and Sinus Surgery (25%) at the highest end and Facial Trauma (1%) at the lowest. Controlling for the age of the video content, the most‐accessed videos comprised of subspecialty topics on Head and Neck Surgery at the highest end and Laryngology at the lowest with significant differentiation across topics of interest (p <.044). Conclusions: This assessment of web‐analytics platforms from two widely used otolaryngology free, online‐access materials showed increasing global usage trends with significant differentiating factors along viewership demographics, as well as sought‐after subspecialty topics of interest. In turn, our results not only lay the groundwork for characterizing the global otolaryngology audience but also for future development of targeted educational materials and accessibility initiatives aimed at ameliorating global educational disparities in the field. [ABSTRACT FROM AUTHOR]

Background: As thyroid cancer incidence rises, it is increasingly valuable to recognize disparities in treatment and diagnosis. Prior investigations into social determinants of health (SDoH) are limited to pediatric populations or studies looking at single factors such as race or environmental influences. Utilizing the CDC-social vulnerability index and SEER-patient database to assess the amalgamated, real-world influence of varied SDoH and their quantifiable impact on thyroid cancer disparities across the United States. Methods: In a retrospective cohort study, 199,340 adult thyroid cancer patients from 1975 to 2017 were assessed for significant regression trends in months of follow-up/surveillance, survival, late staging, and treatment receipt across thyroid cancer-subtypes with increasing overall social vulnerability, as well as in 15 SDoH variables regarding socioeconomic status, minority-language status, household composition, and housing-transportation across all the U.S. counties while accounting for sociodemographic regional differences. Results: With increasing overall social vulnerability, decreases in months of follow-up were observed with patients with papillary, follicular, medullary, oncocytic, and anaplastic thyroid cancer (p = 0.001). Comparing lowest with highest vulnerability cohorts, relative decreases in months of surveillance ranged from 55.6% (14.5–6.5 months) with anaplastic to 17% (108.6–90.2) with oncocytic. Socioeconomic status vulnerabilities, followed by vulnerabilities in household composition and housing-transportation type, contributed to these overall trends. Similar survival decreases occurred across all thyroid cancer patients, ranging from 55.9% (9.6–4.2) with anaplastic to 28.3% (97–69.5) with oncocytic. Minority-language status vulnerabilities and housing-transportation types largely contributed to these trends. Increasing overall vulnerability was associated with increased odds of advanced staging for papillary (odds ratio [OR] = 1.07 [confidence interval, CI 1.03–1.12]) and decreased odds of indicated treatment via surgery (lowest, medullary: 0.91 [CI 0.84–0.99]), radiation therapy (lowest, anaplastic: 0.88 [CI 0.82–0.93]), and chemotherapy (lowest, oncocytic: 0.81 [CI 0.67–0.98]) were observed. Vulnerabilities in minority-language status and housing-transportation, followed by socioeconomic status vulnerabilities, were differential contributors to these overall vulnerability trends. Conclusions: Our results show significant detriments in thyroid cancer care and prognosis in the United States with increasing overall social vulnerability while identifying which SDoH quantifiably contribute more to disparities in inter-relational, real-world-like contexts. [ABSTRACT FROM AUTHOR]

Clip slippage and displacement during or after intracranial aneurysm surgery is associated with morbidity and can be detrimental. We report the usage of concomitant aneurysm clips and artery clips aiming to avoid this complication in a patient undergoing elective aneurysm surgical clipping. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aims to understand how unequal access to digital technology in the United States affects the care and outcomes of people with esophageal cancer. The researchers developed a Digital Inequity Index to measure this inequality in different areas. They found that as digital inequality increases, esophageal cancer patients have shorter follow-up times and lower survival rates. They are also less likely to receive important surgeries and chemotherapy. These findings show that unequal access to the internet and technology can significantly impact the care that cancer patients receive. This research emphasizes the need to address these disparities and provide equal access to technology for better healthcare outcomes in the future. Background: There is currently no comprehensive tool that quantifiably measures validated factors of modern technology access in the US for digital inequity impact on esophageal cancer care (EC). Objective: To assess the influence of digital inequities on esophageal cancer disparities while accounting for traditional social determinants. Methods: 15,656 EC patients from 2013–2017 in SEER were assessed for significant regression trends in long-term follow-up, survival, prognosis, and treatment with increasing overall digital inequity, as measured by the Digital Inequity Index (DII). The DII was calculated based on 17 census tract-level variables derived from the American Community Survey and Federal Communications Commission. Variables were categorized as infrastructure access or sociodemographic, ranked, and then averaged into a composite score. Results: With increasing overall digital inequity, significant decreases in the length of long-term follow-up (p < 0.001) and survival (p < 0.001) for EC patients were observed. EC patients showed decreased odds of receiving indicated surgical resection (OR 0.97, 95% CI 0.95–99) with increasing digital inequity. They also showed increased odds of advanced preliminary staging (OR 1.02, 95% CI 1.00–1.05) and decreased odds of receiving indicated chemotherapy (OR 0.97;95% CI 0.95–99). Conclusions: Digital inequities meaningfully contribute to detrimental trends in EC patient care in the US, allowing discourse for targeted means of alleviating disparities while contextualizing national, sociodemographic trends of the impact of online access on informed care. [ABSTRACT FROM AUTHOR]

AbstractIn this study, a design method is proposed for the stress adaptive porous structures with triply period minimal surface (TPMS). The method depends upon the modeling method of solving porous structures with complex contour and the mapping method achieved by mapping functions of mechanical properties for TPMS based porous structures. Additionally, the implementation framework is provided, and the proposed modeling method is evaluated by an example. The results show that the stress adaptive structures possess higher stiffness and peak stress, compared with uniform or graded type, which proved the promising potential in engineer applications, bone implants and efficient heat exchanger. [ABSTRACT FROM AUTHOR]

This paper aims to explore the influence of surface curvature distribution on the mechanical properties of lattice structures. In this study, a series of typical structure types were designed to obtain lattice structures with different surface Gaussian curvatures, including BCC (body center cubic) configuration, cross-cube configuration, and diamond lattice structure. Then, the above-mentioned porous structural sample was formed by SLM (selective laser melting), and the relevant mechanical properties were obtained by simulation and experiment. In addition, a characteristic method to describe the surface curvature of discrete triangular plaques is proposed and used to calculate the curvature distribution of the designed lattice structure. The results show that the lattice structure with concentrated Gaussian curvature distribution on the surface has good mechanical properties. Especially, for the cross-cube structure, the elastic modulus of the traditional configuration lattice structure increases by 79%, and the elastic modulus of the stretched structure increases by 70% when the volume fraction increased from 10 to 15%. Meanwhile, the elastic modulus for the traditional structure and the stretched structure increases by 41% and 14%, respectively, when the volume fraction of the structure increases from 15 to 20%. It is noted that the influence of surface curvature distribution on mechanical properties is slightly inferior to the volume fraction, which provides a new idea for the quantitative evaluation and design of porous structural properties. In addition, the BCC structure with concentrated curvature distribution provides a new scheme for the protection device after the stress climb stage after the elastic stage. Furthermore, the influence of surface curvature on the mechanical properties of lattice structures described in this paper will provide new inspiration for lattice structures in the fields of biocompatibility and heat exchange. [ABSTRACT FROM AUTHOR]

• A clear directionality of somatosensory evoked potentials recorded from segmented DBS leads in the sensory thalamus is observed. • This directional effect provides further evidence in support of the somatotopy of the sensory thalamus. • This may help identify the neurophysiological sweet spot in the possibly reorganized sensory thalamus in chronic pain patients. The aim of this feasibility study was to investigate the properties of median nerve somatosensory evoked potential (SEPs) recorded from segmented Deep Brain Stimulation (DBS) leads in the sensory thalamus (VP) and how they relate to clinical and anatomical findings. We analyzed four patients with central post-stroke pain and DBS electrodes placed in the VP. Median nerve SEPs were recorded with referential and bipolar montages. Electrode positions were correlated with thalamus anatomy and tractography-based medial lemniscus. Early postoperative clinical paresthesia mapping was performed by an independent pain nurse. Finally, we performed frequency and time–frequency analyses of the signals. We observed differences of SEP amplitudes recorded along different directions in the VP. SEP amplitudes did not clearly correlate to both atlas-based anatomical position and fiber-tracking results of the medial lemniscus. However, the contacts of highest SEP amplitude correlated with the contacts of lowest effect-threshold to induce paraesthesia. SEP recordings from directional DBS leads offer additional information about the neurophysiological (re)organization of the sensory thalamus. Directional recordings of thalamic SEPs bear the potential to assist clinical decision-making in DBS for pain. [ABSTRACT FROM AUTHOR]

Over the past few decades, there have been many important achievements on the design, research, and development of minimal surface lattice structures. In this work, we propose a modeling method for triply periodic minimal surfaces (TPMS) lattice structures with complex contours. This method is based on moving elements method (MEM) and mainly includes the following parts: dividing the model mesh, solving the iso-surface of the TPMS in the model, obtaining the TPMS lattice structure triangular surface of the model outline, integrating the interior of the model and the outline, and finally generating an STL file that can be used for additive manufacturing. Furthermore, the representative femur model, rabbit model, and gear model are provided as case studies to verify the validity and correctness of the proposed modeling method. Then, this approach is compared with the distance field-based method (DFBM) in terms of modeling speed and modeling accuracy. The research results show that the time required by the MEM method was reduced by 3055.56%, 2799.70% compared to the DFBM method, when filling the network primitive and network gyroid lattice structures in the femur model. Moreover, this method provides technical means and simulation data for designing TPMS lattice structures with complex contour, and offers the underlying design ideas for the development and application of the excellent physical properties of TPMS lattice structures in medicine and engineering. [ABSTRACT FROM AUTHOR]

Objectives To assess the ability of two risk prediction models in interstitial lung disease (ILD) to predict death or lung transplantation in a cohort of patients with interstitial pneumonia with autoimmune features (IPAF). Methods We performed a retrospective cohort study of adults with IPAF at an academic medical centre. The primary outcome was a composite of lung transplantation or death. We applied the patient data to the previously described Gender–Age–Physiology (GAP) and ILD-GAP models to determine the ability of these models to predict the composite outcome. Model discrimination was assessed using the c-index, and model calibration was determined by comparing the incidence ratios of observed vs expected deaths. Results Ninety-four patients with IPAF were included. Mean (s. d.) age was 58 (13.5) years and the majority were female (62%). The majority met serologic and morphologic criteria for IPAF (94% and 91%, respectively). The GAP model had a c-index of 0.664 (95% CI 0.547–0.781), while the ILD-GAP model had a c-index of 0.569 (95% CI 0.440–0.697). In those with GAP stage 1 or GAP stage 2 disease, calibration of the GAP model was satisfactory at 2 and 3 years for the cumulative end point of lung transplantation or death. Conclusion In patients with IPAF, the GAP model performed well as a predictor of lung transplantation or death at 2 years and 3 years from ILD diagnosis in patients with GAP stage 1 and GAP stage 2 disease. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the postnatal growth and neurodevelopment of infants with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB). Patients and Methods: This was a retrospective comparative study. A total of 262 infants were divided among three study groups: 22 treated with intravitreal bevacizumab, 55 treated with laser, and 185 with ROP that resolved without treatment. Infants with nonviable course or hydrocephalus, a source of non-physiologic weight gain, were excluded. Neurodevelopment was assessed with Bayley III scores at 17– 28 months if available and presence of hearing loss or cerebral palsy. Weekly weight, height, and head circumference from birth through 50 weeks postmenstrual age (PMA) were modeled to determine differences in growth trajectories following treatment. Results: Comparison of postnatal growth curves from the time of treatment to 50 weeks PMA showed no significant differences in growth trajectories between groups after adjusting for the corresponding growth parameters at birth. Comparison of Bayley scores in patients with available data (n = 120) showed no significant differences. There was an increased risk of cerebral palsy in the IVB group after logistic regression adjusting for baseline confounders, but this did not retain statistical significance after applying the false discovery rate correction for multiple testing. Conclusion: To our knowledge, this is the first large retrospective study to examine longitudinal growth in infants treated with IVB compared to controls. There were no significant differences in postnatal growth or neurodevelopmental outcomes between groups, which overall continue to support the safety of bevacizumab treatment for ROP. [ABSTRACT FROM AUTHOR]

Hypertension is a major risk factor for both stroke and cognitive impairment, but it is unclear whether it may specifically affect post-stroke cognitive impairment. We assessed the effect of hypertension and/or stroke on brain injury, cognitive outcome, and the brain transcriptomic profile. C57BL/6J mice (n = 117; 3–5 mo.) received s.c. infusion of either saline or angiotensin II followed by sham surgery or photothrombotic stroke targeting the prefrontal cortex seven days later. Cognitive function was assessed with the Barnes maze and RNA sequencing was used to quantify transcriptomic changes in the brain. Angiotensin II treatment produced spontaneous hemorrhaging after stroke. In the Barnes maze, hypertensive mice that received stroke surgery had an increased escape latency compared to other groups (day 3: hypertensive + stroke = 166.6 ± 6.0 s vs. hypertensive + sham = 122.8 ± 13.8 s vs. normotensive + stroke = 139.9 ± 10.1 s vs. normotensive + sham = 101.9 ± 16.7 s), consistent with impaired cognition. RNA sequencing revealed >1500 differentially expressed genes related to neuroinflammation in hypertensive + stroke vs. normotensive + stroke, which included genes associated with apoptosis, microRNAs, autophagy, anti-cognitive biomarkers and Wnt signaling. Overall, we show that the combination of hypertension and stroke resulted in greater learning impairment and brain injury. [ABSTRACT FROM AUTHOR]

The lattice structure based on minimal surface (also called the triply periodic minimal surfaces) is characterized by zero-value average curvature and high circulation, which leads to better mechanical performance than the CAD (computer aided design)-based structures. In this paper, the principle of least action was introduced to explain the extreme value phenomenon of minimal surface area, zero means curvature of the minimal surface, and the excellent mechanical properties. Firstly, a series of lattice structures with different configurations and the same volume fraction were fabricated by selective laser melting (SLM) with TC4 powder through changing the design method, including CAD design and minimal surface. Secondly, the solidworks software and the quasit-static compression are used to investigate the surface area of experimental samples, surface curvature, and compression responses. The results show that the zero-value mean curvature of the minimal surface follows the principle of least action. Also shown is that the minimal surface-based lattice structure has better mechanical properties than the CAD design method, which is attributed to the minimal surface that makes the nodes of the lattice structure smooth transition. The proposed concept is demonstrated through the comparison of the mechanical properties of representative specimens. The approach, which is generalized to the optimal design of lattice structures, provides a way toward functional gradient structures that need to simultaneously carry a load and achieve efficient heat dissipation or biocompatibility, such as load-bearing exchangers or bone implantation. [ABSTRACT FROM AUTHOR]

Reactive oxygen species (ROS) can be beneficial or harmful in health and disease. While low levels of ROS serve as signaling molecules to regulate vascular tone and the growth and proliferation of endothelial cells, elevated levels of ROS contribute to numerous pathologies, such as endothelial dysfunctions, colon cancer, and fibrosis. ROS and their cellular sources have been extensively studied as potential targets for clinical intervention. Whereas various ROS sources are important for different pathologies, four NADPH oxidases (NOX1, NOX2, NOX4, and NOX5) play a prominent role in homeostasis and disease. NOX1-generated ROS have been implicated in hypertension, suggesting that inhibition of NOX1 may be a promising therapeutic approach. NOX2 and NOX4 oxidases are of specific interest due to their role in producing extra- and intracellular hydrogen peroxide (H2O2). NOX4-released hydrogen peroxide activates NOX2, which in turn stimulates the release of mitochondrial ROS resulting in ROS-induced ROS release (RIRR) signaling. Increased ROS production from NOX5 contributes to atherosclerosis. This review aims to summarize recent findings on NOX enzymes and clinical trials inhibiting NADPH oxidases to target pathologies including diabetes, idiopathic pulmonary fibrosis (IPF), and primary biliary cholangitis (PBC). [ABSTRACT FROM AUTHOR]

Introduction: Early rooming triage increases patient throughput and satisfaction by rapidly assigning patients to a definitive care area, without using vital signs or detailed chart review. Despite these operational benefits, the clinical accuracy of early rooming triage is not well known. We sought to measure the accuracy of early rooming triage and uncover additional patient characteristics that can assist triage. Methods: We conducted a single-center, retrospective population study of walk-in emergency department (ED) patients presenting to the ED via an early rooming triage system, examining triage accuracy and demographic factor correlation with higher acuity ED outcomes. Results: Among all patients included from the three-year study period (N = 238,457), early rooming triage was highly sensitive (0.89) and less specific (0.61) for predicting which patients would have a severe outcome in the ED. Patients triaged to the lowest acuity area of the ED experienced severe outcomes in 4.39% of cases, while patients triaged to the highest acuity area of the ED experienced severe outcomes in 65.9% of cases. An age of greater than 43 years (odds ratio [OR] 3.48, 95% confidence interval: 3.40, 3.57) or patient's home address farther from the ED ([OR] 2.23 to 3.08) were highly correlated with severe outcomes. Multivariable models incorporating triage team judgment were robust for predicting severe outcomes at triage, with an area under the receiver operating characteristic of 0.82. Conclusion: Early rooming workflows are appropriately sensitive for ED triage. Consideration of demographic factors, automated or otherwise, can augment ED processes to provide optimal triage. [ABSTRACT FROM AUTHOR]

Compared with uniform structures, functionally graded lattice structures can control mechanical properties through varying structures and their volume fraction. In this study, a three-period minimal curved surface method was used to generate functional lattice structure with linear or quadratic function (LF or QF) gradient strategy in the forming direction, and the samples were fabricated by selective laser melting (SLM) using the Ti-6Al-4V metal powder. The mechanical properties, deformation behaviors, and energy absorption performance of graded lattice structures, LF, and QF I-Wrapped Package (IW-P) lattice structures were systematically investigated through experiment and finite element analysis (FEA). Based on the experimental and numerical simulation results, the LF lattice structure shows higher elastic modules and yield strength during small strain period. And the merits of performance increased layer-by-layer under large strain. Additionally, the simulation results based on Johnson-Cook and failure model show that this model can reflect structural compression deformation behavior and mechanical performance prediction. Furthermore, the elastic modulus of LF lattice structure is higher than uniform lattice structures by nearly 61.52% under the same lattice volume fraction. Compared to other lattice structures, the LF or QF lattice structures have better support performance under small strain and stronger energy absorption capacity under large strain with the same volume fraction, respectively, which shows superior potential to be applied to manufacture protective devices or vibration damping devices. [ABSTRACT FROM AUTHOR]

At Quesang on the Tibetan Plateau we report a series of hand and foot impressions that appear to have been intentionally placed on the surface of a unit of soft travertine. The travertine was deposited by water from a hot spring which is now inactive and as the travertine lithified it preserved the traces. On the basis of the sizes of the hand and foot traces, we suggest that two track-makers were involved and were likely children. We interpret this event as a deliberate artistic act that created a work of parietal art. The travertine unit on which the traces were imprinted dates to between ∼169 and 226 ka BP. This would make the site the earliest currently known example of parietal art in the world and would also provide the earliest evidence discovered to date for hominins on the High Tibetan Plateau (above 4000 m a.s.l.). This remarkable discovery adds to the body of research that identifies children as some of the earliest artists within the genus Homo. [ABSTRACT FROM AUTHOR]

Pulmonary fibrosis comprises a wide range of fibrotic lung diseases with unknown pathogenesis and poor prognosis. Familial pulmonary fibrosis (FPF) represents a unique subgroup of patients in which at least one other relative is also affected. Patients with FPF exhibit a wide range of pulmonary fibrosis phenotypes, although idiopathic pulmonary fibrosis is the most common subtype. Despite variable disease manifestations, patients with FPF experience worse survival compared with their counterparts with the sporadic disease form. Therefore, ascertaining a positive family history not only provides prognostic value but should also raise suspicion for the inheritance of an underlying causative genetic variant within kindreds. By focusing on FPF kindreds, rare variants within surfactant metabolism and telomere maintenance genes have been discovered. However, such genetic variation is not solely restricted to FPF, as similar rare variants are found in patients with seemingly sporadic pulmonary fibrosis, further supporting the idea of genetic susceptibility underlying pulmonary fibrosis as a whole. Researchers are beginning to show how the presence of rare variants may inform clinical management, such as informing predisposition risk for yet unaffected relatives as well as informing prognosis and therapeutic strategy for those already affected. Despite these advances, rare variants in surfactant and telomere-related genes only explain the genetic basis in about one-quarter of FPF kindreds. Therefore, research is needed to identify the missing genetic contributors of pulmonary fibrosis, which would not only improve our understanding of disease pathobiology but may offer additional opportunities to improve the health of patients. [ABSTRACT FROM AUTHOR]

Motivation The advent of long-read sequencing technologies has increased demand for the visualization and interpretation of transcripts. However, tools that perform such visualizations remain inflexible and lack the ability to easily identify differences between transcript structures. Here, we introduce ggtranscript , an R package that provides a fast and flexible method to visualize and compare transcripts. As a ggplot2 extension, ggtranscript inherits the functionality and familiarity of ggplot2 making it easy to use. Availability and implementation ggtranscript is an R package available at https://github.com/dzhang32/ggtranscript (DOI: https://doi.org/10.5281/zenodo.6374061) via an open-source MIT licence. Further documentation is available at https://dzhang32.github.io/ggtranscript/. [ABSTRACT FROM AUTHOR]

Aim: Clinical trials suggest that hyaluronate carboxymethylcellulose (HA/CMC) prevents adhesion‐related complications after intra‐abdominal surgery, but at a high upfront cost. This study evaluated the cost‐effectiveness of HA/CMC for patients undergoing curative‐intent open colorectal cancer surgery. Methods: Using a Markov Monte Carlo microsimulation model, we conducted a cost–utility analysis comparing the cost‐effectiveness of HA/CMC at curative‐intent open colorectal cancer surgery versus standard management. We considered a scenario where HA/CMC was used at the index operation only, as well as where it was used at the index operation and any subsequent operations. The perspective was that of the third‐party payer. Costs and utilities were discounted 1.5% annually, with a 1‐month cycle length and 5‐year time horizon. Model input data were obtained from a literature review. Outcomes included cost, quality‐adjusted life‐years (QALYs), small bowel obstructions (SBOs) and operations for SBO. Results: Using HA/CMC at the index operation results in an incremental cost increase of CA$316 and provides 0.001 additional QALYs, for an incremental cost‐effectiveness ratio of CA$310,000 per QALY compared to standard management. In our simulated cohort of 10,000 patients, HA/CMC prevented 460 SBOs and 293 surgeries for SBO. Probabilistic sensitivity analysis found that HA/CMC was cost‐effective in 18.5% of iterations, at a cost‐effectiveness threshold of CA$50,000 per QALY. Results of the scenario analysis where HA/CMC was used at the index operation and any subsequent operations were similar. Conclusions: Hyaluronate carboxymethylcellulose prevents adhesive bowel obstruction after open colorectal cancer surgery but is unlikely to be cost‐effective given minimal long‐term impact on healthcare costs and QALYs. [ABSTRACT FROM AUTHOR]

Due to the limitation of inherent ultra-high electron concentration, the electrical properties of In2O3 resemble those of conductors rather than semiconductors prior to special treatment. In this study, the effect of various annealing treatments on the microstructure, optical properties, and oxygen vacancies of the films and transistors is systematically investigated. Our finding reveals a progressive crystallization trend in the films with increasing annealing temperature. In addition, a higher annealing temperature is also associated with the reduction in the concentration of oxygen vacancies, as well as an elevation in both optical transmittance and optical bandgap. Furthermore, with the implementation of annealing process, the devices gradually transform from no pronounced gate control to exhibit with excellent gate control and electrical performances. The atomic layer deposited Hf-doped In2O3 thin film transistor annealed at 250 °C exhibits optimal electrical properties, with a field-effect mobility of 18.65 cm2 V−1 s−1, a subthreshold swing of 0.18 V/dec, and an Ion/Ioff ratio of 2.76 × 106. The results indicate that the impact of varying annealing temperatures can be attributed to the modulation of oxygen vacancies within the films. This work serves as a complementary study for the existing post-treatment of oxide films and provides a reliable reference for utilization of the annealing process in practical applications. [ABSTRACT FROM AUTHOR]

The relocation of peripheral transistors from the front-end-of-line (FEOL) to the back-end-of-line (BEOL) in fabrication processes is of significant interest, as it allows for the introduction of novel functionality in the BEOL while providing additional die area in the FEOL. Oxide semiconductor-based transistors serve as attractive candidates for BEOL. Within these categories, In2O3 material is particularly notable; nonetheless, the excessive intrinsic carrier concentration poses a limitation on its broader applicability. Herein, the deposition of Hf-doped In2O3 (IHO) films via atomic layer deposition for the first time demonstrates an effective method for tuning the intrinsic carrier concentration, where the doping concentration plays a critical role in determine the properties of IHO films and all-oxide structure transistors with Au-free process. The all-oxide transistors with In2O3: HfO2 ratio of 10:1 exhibited optimal electrical properties, including high on-current with 249 µA, field-effect mobility of 13.4 cm2 V−1 s−1, and on/off ratio exceeding 106, and also achieved excellent stability under long time positive bias stress and negative bias stress. These findings suggest that this study not only introduces a straightforward and efficient approach to improve the properties of In2O3 material and transistors, but as well paves the way for development of all-oxide transistors and their integration into BEOL technology. [ABSTRACT FROM AUTHOR]

Palm-related biometrics have been widely studied for a long time, as the palm contains many distinctive patterns. However, most of the existing systems are designed to work within an ideal environment, such as in front of a unicolor background or in a large enclosure. Those preconditions can avoid influences of ambient light and hand distance change, but at the same time, they also limit the applications of palm recognition. In the work reported in this paper, we designed a novel red-green-blue and depth-based four-camera system that can capture the palm-related images separately in real time. The techniques of region-of-interest (ROI) location, ROI alignment, and light-source intensity optimization were studied. The ROI location method is modified to increase the robustness of hand gesture variation. Based on the depth information, we proposed the coordinate mapping and inclination rectification methods to obtain aligned ROI pairs. Using this device, we collected a video-based multimodal palm image database. After the parameter optimization and information fusion, the equal-error-rate of our approach on this database is lower than 0.47%. The recognition rate obtained from the support-vector-machine-based fusion is higher than 99.8%. The experimental results prove that the proposed system achieves advantages of anti-spoofing, high speed, high accuracy, and small size. [ABSTRACT FROM AUTHOR]

Load, chamber stiffness, and relaxation are the three established determinants of global diastolic function (DF). Coupling of systolic stiffness and isovolumic relaxation has been hypothesized; however, diastolic stiffness-relaxation coupling (DSRC) remains unknown. The parametrized diastolic filling (PDF) formalism, a validated DF model incorporates DSRC. PDF model-predicted DSRC was validated by analysis of 159 Doppler E-waves from a published data set (22 healthy volunteers undergoing bicycle exercise). E-waves at varying (46-120 bpm) heart rates (HR) demonstrated variation in acceleration time (AT), deceleration time (DT), and E-wave peak velocity. AT, DT, and Epeak were converted into PDF parameters: stiffness (k), relaxation (c), and load (xo) using published numerical methods. Univariate linear regression showed that over a twofold increase in HR, AT, and DT decrease (r = -0.44; P < 0.001 and r = -0.42; P < 0.001, respectively), while, DT/AT remains constant (r = -0.04; P = 0.67). Similarly, k increases with HR (r = 0.55; P < 0.001), while c has no significant correlation with HR (r = 0.08; P = 0.32). However, the dimensionless DSRC parameter ϣ = c²/4k shows no significant correlation with HR (r = -0.03; P = 0.7). Furthermore, ϣ is uniquely determined by DT/AT rather than AT or DT independently. Constancy of w in spite of a twofold increase in HR establishes that stiffness (k) and relaxation (c) are coupled and manifest via a HR-invariant parameter of E-wave asymmetry and should not be considered independent of each other. The manifestation of DSRC through E-wave asymmetry via ϣ underscores the value of DT/AT as a physiological, mechanism-derived index of DF. NEW & NOTEWORTHY: Although diastolic stiffness and relaxation are considered independent chamber properties, the cardiohemic inertial oscillation that generates E-waves obeys Newton's law. E-waves vary with heart rate requiring simultaneous change in stiffness and relaxation. By retrospective analysis of human heart-rate varying transmitral Doppler-data, we show that diastolic stiffness and relaxation are coupled and that the coupling manifests through E-wave asymmetry, quantified through a parametrized diastolic filling model-derived dimensionless parameter, which only depends on deceleration time and acceleration time, readily obtainable via standard echocardiography. [ABSTRACT FROM AUTHOR]

Load, chamber stiffness, and relaxation are the three established determinants of global diastolic function (DF). Coupling of systolic stiffness and isovolumic relaxation has been hypothesized; however, diastolic stiffness-relaxation coupling (DSRC) remains unknown. The parametrized diastolic filling (PDF) formalism, a validated DF model incorporates DSRC. PDF model-predicted DSRC was validated by analysis of 159 Doppler E-waves from a published data set (22 healthy volunteers undergoing bicycle exercise). E-waves at varying (46-120 bpm) heart rates (HR) demonstrated variation in acceleration time (AT), deceleration time (DT), and E-wave peak velocity. AT, DT, and Epeak were converted into PDF parameters: stiffness (k), relaxation (c), and load (xo) using published numerical methods. Univariate linear regression showed that over a twofold increase in HR, AT, and DT decrease (r = -0.44; P < 0.001 and r = -0.42; P < 0.001, respectively), while, DT/AT remains constant (r = -0.04; P = 0.67). Similarly, k increases with HR (r = 0.55; P < 0.001), while c has no significant correlation with HR (r = 0.08; P = 0.32). However, the dimensionless DSRC parameter w = c²/4k shows no significant correlation with HR (r = -0.03; P = 0.7). Furthermore, w is uniquely determined by DT/AT rather than AT or DT independently. Constancy of w in spite of a twofold increase in HR establishes that stiffness (k) and relaxation (c) are coupled and manifest via a HR-invariant parameter of E-wave asymmetry and should not be considered independent of each other. The manifestation of DSRC through E-wave asymmetry via w underscores the value of DT/AT as a physiological, mechanism-derived index of DF. [ABSTRACT FROM AUTHOR]

Introduction: Isolated subtalar osteoarthritis (OA) is a debilitating condition usually occurring after trauma and particularly in the setting of an intraarticular calcaneal fracture. Currently, subtalar (talo-calcaneal joint) fusion surgery is the treatment of choice in managing subtalar OA after failure of conservative treatment. Unfortunately, subtalar fusion eliminates joint motion and increases the load over the adjacent midfoot and ankle joints, which affects the outcome of the surgery over time. Popular in the ankle, distraction arthroplasty offers another joint-preserving option, particularly important for active patients. In contrast to fusion as a salvage procedure, subtalar distraction arthroplasty allows the possibility of maintaining the function of the arthritic subtalar joint while reducing pain and improving the overall function of the foot and ankle.Methods: We performed subtalar distraction arthroplasty using a circular external fixator combined with BMAC on seven patients with symptomatic and refractory subtalar OA. All these patients were interested in an alternative to fusion. We obtained clinical and radiographic data before and after surgery. Ankle Osteoarthritis Score (AOS) and the Marijnissen Distraction Clinical Score (MDCS) were obtained before surgery, after one year, and at latest follow-up.Results: The average age was 56 years (range 45-69). The mean duration of post-operative follow-up was 35.4 months (range 15.2-53.5). The inversion of the ankle joint changed from 16.9° (10°-25°) pre-operatively to 14.3° (10°-20°) post-operatively (P = 0.28), and the eversion from 5.6° (0°-10°) to 10.0° (0°-20°) (P = 0.17). We found an increase in subtalar joint space from 1.4 mm (0-3) to 2.6 mm (2-4) before and after surgery (P = 0.01), respectively. Finally, Pixel Density Ratio (PDR) increased from 0.87 (0.66-1.30) to 1.01 (0.89-1.18) (P = 0.19). Compared to pre-operative conditions, we observed a decrease in subchondral sclerosis on X-ray in all cases post-operatively. The AOS score for ankle pain improved from 58.8 (47-74) to 15.1 (0-31) (p < 0.01). The AOS score for ankle disability improved from 68.2 (57-81) to 16.1 (0-43.5) (p < 0.001). We found improvement in the MDCS over time for all measured parameters. The clinical condition improved from 1.4 (0-2) to 0.8 (0-2) after one year and to 0.3 (0-2) at the latest follow-up (p < 0.001). Mobility was measured as ROM in the treated ankle relative to each patient's contralateral ankle. This increased from 35% (0-100) to 66% (15-120) to 76% (15-100) (p = 0.059). Function improved from 2.3 (0-3) to 1.3 (0-3) to 0.6 (0-3) (p < 0.001). Pain decreased from 7.4 (2-10) to 4.4 (2-8) to 2.1 (0-7) (p < 0.01). Complications include one patient with sensory neuralgia.Conclusions: Preliminarily, results of subtalar distraction arthroplasty as a new joint preservation technique are encouraging. Our research suggests the possibility of subtalar distraction arthroplasty as an effective treatment for symptomatic subtalar OA. Furthermore, this new operation does not eliminate the possibility of a future surgery like fusion. Subtalar distraction arthroplasty can be helpful in the management of subtalar OA in active patients who desire preservation of foot and ankle motion. [ABSTRACT FROM AUTHOR]

The ongoing outbreak of COVID-19 has quickly become a daunting challenge to global health. In the absence of targeted therapy and a reported 5.5% case fatality rate in the United States, treatments preventing rapid cardiopulmonary failure are urgently needed. Clinical features, pathology and homology to better understood pathogens suggest that uncontrolled inflammation and a cytokine storm likely drive COVID-19's unrelenting disease process. Interventions that are protective against acute lung injury and ARDS can play a critical role for patients and health systems during this pandemic. Nitric oxide is an antimicrobial and anti-inflammatory molecule with key roles in pulmonary vascular function in the context of viral infections and other pulmonary disease states. This article reviews the rationale for exogenous nitric oxide use for the pathogenesis of COVID-19 and highlights its potential for contributing to better clinical outcomes and alleviating the rapidly rising strain on healthcare capacity. • SARS-CoV-2's pathophysiology is increasingly understood, from entry through ACE2 to the cytokine storm of severe disease. • The rapidly growing body of literature identifies several mechanisms that may be targeted with nitric oxide. • Reported proofs of concept for inhaled nitric oxide treating COVID-19 demonstrate the need for randomized control trials. [ABSTRACT FROM AUTHOR]

This research empirically analyzes the association between climate change, population size, and demographic crises as indicated by what we term "population checks," or major wars, epidemics, and famines from AD 1000 to AD 1900 in the Northern Hemisphere based on historical records and climate reconstructions. We conducted this study at two temporal scales: (1) the entire study period of 900 years and (2) three climate phases according to temperature (cold, mild, and warm) of 300 years each. By adopting linear and nonlinear statistical methods, we found climate change and population size to have significant roles in driving the demographic crisis at the temporal scale of the entire study period. In terms of the three climate phases of 300 years each, we find that war is more closely correlated to climate change than to population size for all three phases. However, population size itself is more likely to trigger epidemics during mild and warm phases and is more important in relation to famines than climate change during all three climate phases. This study emphasizes the importance of scale in reviewing the social past in terms of climate change and population size. Empirical evidence of large-scale demographic crises within the three climate phases could also provide a timely reference for scientists or policymakers in addressing the potential effects of global warming. [ABSTRACT FROM AUTHOR]

The cold and hypoxic environment of the Tibetan Plateau was a major challenge for its prehistoric human occupants. The earliest known hominin occupation (or visitation) of the Tibetan Plateau was at ~200 ka, in the middle Pleistocene, and these hominins must have had survival strategies for this harsh environment. We report the discovery of 5 handprints and 17 footprints on the travertine near the outlet of the Quesang hot spring, a well-documented archeological site with well-studied hominin hand and footprints on the Tibetan Plateau. Based on ichnological analysis and U-Th dating, we found that these intentional and unintentional traces were impressed during the early to middle Holocene. Combined with the 19 previously-dated hand and footprints from around the hot spring, we conclude that this site was attractive to ancient humans who made repeated visits over a long period. The strengthened monsoon in the early and middle Holocene may have promoted the expansion of prehistoric human activity onto the central Tibetan Plateau. The frequent human activities near the Quesang hot spring imply that the widespread hot springs on the Tibetan Plateau provided resources that facilitated human survival in this cold and dry plateau region. [ABSTRACT FROM AUTHOR]

The article explores the genetics of the incomplete annotation which has a disproportionate impact on our understanding of Mendelian and complex neurogenetic disorders. It discusses the study in which the researchers detect previously unannotated transcription from Genotype-Tissue Expression RNA sequencing data from several human tissues.

Studies about climate change and the variation of the spatial pattern of war are extremely scarce in academia at present. Therefore, the temperature series and battle coordinates in imperial China from AD 5 to 1911 are integrated in this research, and their long-term quantitative relationship is examined by employing mathematical statistics such as one-way ANOVA, as well as the spatial analytical tool, standard deviational ellipse (SDE) in ArcGIS. Meanwhile, the temperature sequence is divided into three multicentennial warm–cold cycles, which are combined with different types of war (all war, agri-nomadic conflict, and rebellion) to reveal the spatial disparity of war under the influence of secular and periodic temperature change. Results show that (1) battle longitude and battle latitude are significantly different between warm and cold phases. (2) SDEs stretch toward the north/west/northwest in warm intervals but retreat south-/east-/southeastward in cold stages. (3) SDEs generally shift southeastward over time, and the variation of latitude is more evident than that of longitude, which corresponds to the overall cooling trend throughout the past 2000 years. Based on these research findings, we conclude that temperature fundamentally regulates the spatial difference of war in imperial China via controlling agricultural and pastoral productivity. This innovative study provides a robust climatological explanation of the historical conundrum why wars in ancient China distribute with specific directions, and it also lays a foundation for spatiotemporal investigations of climate change and human responses at long-term scales in the future. [ABSTRACT FROM AUTHOR]

Kinetic, potential and overlap matrix elements of one dimensional correlated Gaussians multiplied by polynomial factors are presented. These matrix elements can be used to calculate energies of one dimensional cold atom systems, or to construct a tensorial product to calculate energies in 2 or 3 dimensional systems with a nonspherical potential. [ABSTRACT FROM AUTHOR]

Additive manufacturing (AM), also known as 3D printing, has been called a disruptive technology as it enables the direct production of physical objects from digital designs and allows private and industrial users to design and produce their own goods enhancing the idea of the rise of the "prosumer". It has been predicted that, by 2030, a significant number of small and medium enterprises will share industry-specific AM production resources to achieve higher machine utilization. The decision-making on the order acceptance and scheduling (OAS) in AM production, particularly with powder bed fusion (PBF) systems, will play a crucial role in dealing with on-demand production orders. This paper introduces the dynamic OAS problem in on-demand production with PBF systems and aims to provide an approach for manufacturers to make decisions simultaneously on the acceptance and scheduling of dynamic incoming orders to maximize the average profit-per-unit-time during the whole makespan. This problem is strongly NP hard and extremely complicated where multiple interactional subproblems, including bin packing, batch processing, dynamic scheduling, and decision-making, need to be taken into account simultaneously. Therefore, a strategy-based metaheuristic decision-making approach is proposed to solve the problem and the performance of different strategy sets is investigated through a comprehensive experimental study. The experimental results indicated that it is practicable to obtain promising profitability with the proposed metaheuristic approach by applying a properly designed decision-making strategy. [ABSTRACT FROM AUTHOR]

The pulse sensed over radial artery on the wrist is regarded as an important physiological index in traditional Chinese medicine and Ayurvedic medicine. The computerized pulse diagnosis has been obtaining more and more attentions for its noninvasive character and its convenience in judging the health status of people. To acquire more accurate signals of pulse wave and contact pressure, several acquisition devices have been proposed. But most of them use a single type of sensor that cannot obtain both accurate dynamic pulse wave and static contact pressure. In this paper, we design a pressure sensor array comprising two different transducers to collect wrist pulse signal and contact pressure, synchronously. What is more, we propose a signal quality assessment frame by analyzing the types of abnormal signals and their causes. It can be used to improve the level of automatic collection and the performance of data analysis. The experimental results show that the proposed system can record more abundant information of the pulse signal, and the frame can identify different qualities of the signal as well. For computerized pulse diagnosis, the multichannel signals can achieve higher performance than single channel in distinguishing diseases from health after removing the abnormal signals. [ABSTRACT FROM AUTHOR]

Introduction: Blood cultures are of limited utility in nonsevere community-acquired pneumonia, though routinely recommended for severe community-acquired pneumonia or health care-associated pneumonia due to perceived greater bacteremia risk, particularly with multidrug-resistant organisms. The utility of this practice is unknown.Methods: In this observational cohort study, we abstracted data from medical records for consecutive hospitalizations for pneumonia by adults to an academic medical center from 2014-2015. The primary outcomes included bacteremia, multidrug-resistant organism bacteremia, and appropriate management changes attributed to culture results, stratified by pneumonia classification (nonsevere community-acquired pneumonia, severe community-acquired pneumonia, or health care-associated pneumonia) and likelihood the bacteremia was due to pneumonia vs another infection. We assessed the diagnostic test performance of one or more guideline-defined risk factors for bacteremia in nonsevere community-acquired pneumonia, for whom cultures are routinely recommended.Results: Of 456 pneumonia hospitalizations, 30 (6.6%) had bacteremia, with a greater incidence in severe community-acquired pneumonia (14.7%) than nonsevere community-acquired pneumonia (7.8%) and health care-associated pneumonia (6.6%; P = .12). Seventeen bacteremia cases were likely due to pneumonia (3.7%). Only 2 (0.4%) had multidrug-resistant organisms (both health care-associated pneumonia), one of whom was due to pneumonia. Appropriate management changes occurred in 8 cases (1.8%; 7 de-escalation and 1 escalation of antibiotics); only 1 with bacteremia likely due to pneumonia (de-escalation). The one case of appropriate antibiotic escalation occurred in a patient with vancomycin-resistant Enterococcus unrelated to pneumonia. Having one or more guideline-defined risk factors did not identify bacteremia in nonsevere community-acquired pneumonia (positive likelihood ratio, 1.10; 95% confidence interval, 0.61-1.99).Conclusion: Routine blood cultures in pneumonia have extremely low yield and utility irrespective of severity and risk. [ABSTRACT FROM AUTHOR]

Background: Septo-optic dysplasia, also known as de Morsier syndrome, is a disorder of brain development characterized by optic nerve hypoplasia, hypopituitarism, and midline brain defects. Materials and Methods: Single retrospective case report. Results: An infant born at 38 5/7 weeks gestation age weighing 3125 g developed respiratory distress shortly after birth. Systemic findings included myocardial dysfunction, hypopituitarism, feeding intolerance, microphallus, and dysmorphic features. Eye examination revealed tractional retinal detachments and optic nerve hypoplasia. In addition, peripheral non-perfusion and peripheral neovascularization were consistent with Familial Exudative Vitreoretinopathy (FEVR) phenotype. MRI showed hypoplastic optic nerves, ectopic posterior pituitary with hypoplastic pituitary infundibulum, and slightly thin corpus callosum, diagnostic of septo-optic dysplasia. Genetic testing revealed no pathogenic variants and two variants of uncertain significance. Conclusion: FEVR findings can be associated with septo-optic dysplasia and may point to an etiologic connection between neural development and subsequent vascular development. [ABSTRACT FROM AUTHOR]

Copper-promoted azide-alkyne cycloadditions were attempted to synthesize a series of variedly functionalized 1 H -1,2,3-triazole-linked isatin-ferrocene, ferrocenylmethoxy-isatin and isatin-ferrocenyl-chalcone conjugates. The synthesized scaffolds were assayed for their inhibitory activity against T. vaginalis as well as several common normal human flora bacteria. The observed inhibitory activities against T. vaginalis and undetectable inhibition of microflora bacteria suggest that these compounds may be specific against trichomonad protozoa and could serve as a new scaffold for synthesis of novel compounds against this important human pathogen. Image 1 • Synthesis and anti trichomonad evaluation of isatin-ferrocene conjugates. • The presence of halogen at C-5 position proved to be essential for good activities. • The conjugate 11f displayed an IC 50 value of 27 μM and was non-cytotoxic. [ABSTRACT FROM AUTHOR]

Synapses in biology provide a variety of functions for the neural system. Artificial synaptic electronics that mimic the biological neuron functions are basic building blocks and developing novel artificial synapses is essential for neuromorphic computation. Inspired by the unique features of biological synapses that the basic connection components of the nervous system and the parallelism, low power consumption, fault tolerance, self-learning and robustness of biological neural systems, artificial synaptic electronics and neuromorphic systems have the potential to overcome the traditional von Neumann bottleneck and create a new paradigm for dealing with complex problems such as pattern recognition, image classification, decision making and associative learning. Nowadays, two-dimensional (2D) materials have drawn great attention in simulating synaptic dynamic plasticity and neuromorphic computing with their unique properties. Here we describe the basic concepts of bio-synaptic plasticity and learning, the 2D materials library and its preparation. We review recent advances in synaptic electronics and artificial neuromorphic systems based on 2D materials and provide our perspective in utilizing 2D materials to implement synaptic electronics and neuromorphic systems in hardware. [ABSTRACT FROM AUTHOR]

[Display omitted] • A novel design method of composite lattice structure is proposed based on triply periodic minimal surface lattice cells. • The tunable anisotropy of elastic modulus is achieved by adjusting the design parameters of composite lattice structure. • The unique optimization method can significantly improve the global stiffness of composite lattice infill structure. • The multiple deformations of bending and compression are observed in composite lattice infill structures. Compared with the single-morphology lattice structures, multi-morphology composite lattice structure shows the potential to achieve a broad spectrum of customizable mechanical properties by modify the architectural feature of substructures. Inspired by Sigmoid mathematical function, a new parametrical design method for composite lattice structure was presented by combining the two cell lattice structs with complementary spatial distribution of elastic modulus based on previous studies. The results indicate that the unique anisotropy control strategy of elastic modulus is achieved by changing the design variables. Moreover, instead of altering the volume fraction of single-morphology lattice structure, the elastic constants of new composite lattice structure can be modified under a constant volume fraction by adjusting the design parameters. To further enhance the structural stiffness of composite lattice infilling structures, we propose a novel stiffness optimization approach based on the principal stress direction. This anisotropy control strategy enables the optimal distribution of design variables in the lattice-infill structures. Finally, the numerical results show that the proposed approach improves global stiffness compared to traditional approaches. [ABSTRACT FROM AUTHOR]

• Novel mathematical design method of hybrid-dimensional gyroid lattice structure. • Deformation responses are different among hybrid lattice samples. • Significant reinforcement of stress at plateau stage was observed. • Compressive properties can be modified by adjusting the proportion of substructure. This work proposed a novel hybrid method based on the three-dimensional gyroid lattice structure and two-dimensional honeycomb lattice structure. We choose a commercial stereolithography (SLA) printer to fabricate the lattice samples with 405 nm photosensitive resin material. Axial quasi-static compression is selected to test the mechanical properties. According to the experimental results, the multiple deformation behaviors and reinforcement of stress response at the post-plateau stage are observed in hybrid lattice samples. By the proportion of substructure, the compressive strength and energy absorption of the hybrid-dimensional lattice can be tailored, which is suitable to act as an effective energy absorber for various applications. [ABSTRACT FROM AUTHOR]

Researchers mostly ascribe contemporary natural disaster and the concomitant social crisis to anomalous climate change or global warming. However, whether such a relationship is still valid in long-term historical settings remains doubtful. In this study, data obtained from historical records about natural calamities (flood and drought) and their social impacts (famine, cannibalism, and war) at provincial and decadal scales during AD1–1910 are applied to mathematical statistics such as correlation and regression analysis as well as spatial visualization. Also, the role of population in the nexus of meteorological catastrophes and human miseries is investigated. Results show that at the provincial scale, generally there is high consistency among different variables and most of them are clustered in eastern part of China, especially in the north. More in-depth examinations indicate regional disparities that variables account for higher proportion in the south during the later imperial era, which may be attributed to the southward movement of population center. At the decadal scale, drought is the primary contributor to famine and cannibalism, while severe or even out-of-control famine i.e. cannibalism is more likely to incur war than ordinary famine per se. Besides, population growth rate exerts its positive effect on natural hazards and food crises, whereas more wars bring population loss and relieve population stress despite the weak negative association. These findings supplement previous views and confirm that the distributions of disasters in ancient China are affected by population rather than climatic variability, which only determines the occurrence of disaster. [ABSTRACT FROM AUTHOR]

Domain adaptation aims to generalize the classification model from a source domain to a different but related target domain. Recent studies have revealed the benefit of deep convolutional features trained on a large dataset (e.g. ImageNet) in alleviating domain discrepancy. However, literatures show that the transferability of features decreases as (i) the difference between the source and target domains increases, or (ii) the layers are toward the top layers. Therefore, even with deep features, domain adaptation remains necessary. In this paper, we propose a novel unsupervised domain adaptation (UDA) model for deep neural networks, which is learned with the labeled source samples and the unlabeled target ones simultaneously. For target samples without labels, pseudo labels are assigned to them according to their maximum classification scores during training of the UDA model. However, due to the domain discrepancy, label noise generally is inevitable, which degrades the performance of the domain adaptation model. Thus, to effectively utilize the target samples, three specific robust deep softmax regression (RDSR) functions are performed for them with high, medium and low classification confidence respectively. Extensive experiments show that our method yields the state-of-the-art results, demonstrating the effectiveness of the robust deep softmax regression classifier in UDA. [ABSTRACT FROM AUTHOR]

The temperature variation in China is closely related to the dynamics of global climate change. In order to reveal its possible connections with global climate during the Holocene, we present a nationwide temperature reconstruction in China for the past 12,000 years, based on multiple proxies with three statistical methods, including empirical orthogonal function, composite-plus-scale, and simple arithmetic average. Our reconstruction shows that the late 20th-century temperature in China is the highest at least over the past millennium. Although the low temperature in the period of 10,000–12,000 yr BP was mainly related to the North Atlantic cool conditions, the reconstructed China's temperature followed solar forcing variations more closely than climatic influence from the North Atlantic. The Asian Monsoon was also closely connected to temperature change in China over the Holocene. [ABSTRACT FROM AUTHOR]

• We propose a fitting method to model the pressure pulse waveform. • We extract the coefficients of the proposed model as feature. • The fitting residuals of proposed method are smaller than the traditional methods. • The classification performance of the proposed feature is higher than the previous features. Background and objectives: Radial artery pulse diagnosis has been playing an important role in traditional Chinese medicine (TCM). For its non-invasion and convenience, the pulse diagnosis has great significance in diseases analysis of modern medicine. The practitioners sense the pulse waveforms in patients' wrist to make diagnoses based on their non-objective personal experience. With the researches of pulse acquisition platforms and computerized analysis methods, the objective study on pulse diagnosis can help the TCM to keep up with the development of modern medicine. Methods: In this paper, we propose a new method to extract feature from pulse waveform based on discrete Fourier series (DFS). It regards the waveform as one kind of signal that consists of a series of sub-components represented by sine and cosine (SC) signals with different frequencies and amplitudes. After the pulse signals are collected and preprocessed, we fit the average waveform for each sample using discrete Fourier series by least squares. The feature vector is comprised by the coefficients of discrete Fourier series function. Results: Compared with the fitting method using Gaussian mixture function, the fitting errors of proposed method are smaller, which indicate that our method can represent the original signal better. The classification performance of proposed feature is superior to the other features extracted from waveform, liking auto-regression model and Gaussian mixture model. Conclusions: The coefficients of optimized DFS function, who is used to fit the arterial pressure waveforms, can obtain better performance in modeling the waveforms and holds more potential information for distinguishing different psychological states. [ABSTRACT FROM AUTHOR]

Highlights • A model based on losses coupling is proposed for voice based disease detection. • Regression targets are relaxed to obtain more discriminant representation. • Low-rank constraints are imposed to make the representation more compact. • Key factors for the methods are separately analyzed by experiment. Abstract Voice analysis provides a non-invasive way for disease detection, in which most methods only consider a single audio, although different audios contain complementary information and a fusion of them is beneficial. In this paper, a novel model JOLL4R (JOint Learning based on Label Relaxed low-Rank Ridge Regression) is proposed to fuse audios for voice based disease detection. First, the model couples the regression losses from two audios together to jointly learn a transformation matrix for each audio. Secondly, the conventional zero-one regression targets are relaxed by the ϵ-dragging technique so that the margins between different classes are enlarged. Third, low-rank constraint is imposed to exploit the correlation structure among different classes. The proposed algorithm not only enables to consider multiple audios, but also adjusts the weight of each audio adaptively. Due to the design of losses coupling, ϵ-dragging technique, and low rank constraint, high performance is achieved. Experiments conducted on two disease detection tasks, each with six types of fusion, show that our fusion approach outperforms the case of using a single audio and another two fusion methods. Finally, key factors in JOLL4R are analyzed. [ABSTRACT FROM AUTHOR]

Abstract Detecting Parkinson's disease (PD) based on voice analysis is meaningful due to its non-invasion and convenience. Traditional features adopted for PD detection are often hand-crafted, in which special expertise is needed. In this paper, we propose to employ feature learning technique to learn features automatically, where special expertise is unnecessary. First, calculate the first derivative of Mel-spectrogram with respect to time for pre-processed audio signals. Then, we use spherical K-means to train two dictionaries using samples of PD patients and healthy controls, respectively. Third, frames in an audio signal are encoded with the two dictionaries, followed by a pooling method to summarize over frames to obtain the learned features. Experiments show the superiority of the proposed method after comparison with two baseline algorithms. Additionally, issues like clustering number in spherical K-means and pooling method are discussed. Finally, by analyzing the similarities between the hand-crafted and learned features, some knowledge is obtained, which can guide future learning and design of features in PD detection. [ABSTRACT FROM AUTHOR]