Search

BackgroundOxygen saturation (Spo2) screening has not led to earlier detection of critical congenital heart disease (CCHD). Adding pulse oximetry features (ie, perfusion data and radiofemoral pulse delay) may improve CCHD detection, especially coarctation of the aorta (CoA). We developed and tested a machine learning (ML) pulse oximetry algorithm to enhance CCHD detection.Methods and resultsSix sites prospectively enrolled newborns with and without CCHD and recorded simultaneous pre- and postductal pulse oximetry. We focused on models at 1 versus 2 time points and with/without pulse delay for our ML algorithms. The sensitivity, specificity, and area under the receiver operating characteristic curve were compared between the Spo2-alone and ML algorithms. A total of 523 newborns were enrolled (no CHD, 317; CHD, 74; CCHD, 132, of whom 21 had isolated CoA). When applying the Spo2-alone algorithm to all patients, 26.2% of CCHD would be missed. We narrowed the sample to patients with both 2 time point measurements and pulse-delay data (no CHD, 65; CCHD, 14) to compare ML performance. Among these patients, sensitivity for CCHD detection increased with both the addition of pulse delay and a second time point. All ML models had 100% specificity. With a 2-time-points+pulse-delay model, CCHD sensitivity increased to 92.86% (P=0.25) compared with Spo2 alone (71.43%), and CoA increased to 66.67% (P=0.5) from 0. The area under the receiver operating characteristic curve for CCHD and CoA detection significantly improved (0.96 versus 0.83 for CCHD, 0.83 versus 0.48 for CoA; both P=0.03) using the 2-time-points+pulse-delay model compared with Spo2 alone.ConclusionsML pulse oximetry that combines oxygenation, perfusion data, and pulse delay at 2 time points may improve detection of CCHD and CoA within 48 hours after birth.RegistrationURL: https://www.clinicaltrials.gov/study/NCT04056104?term=NCT04056104&rank=1; Unique identifier: NCT04056104.

The efficacy of supervised deep learning in medical image analyses, particularly in pathology, is hindered by the necessity for extensive manual annotations. Annotating images at the gigapixel level manually proves to be a highly labor-intensive and time-consuming task. Semi-supervised learning (SSL) has emerged as a promising approach that leverages unlabeled data to reduce labeling efforts. In this work, we introduce Semi-Path, a practical SSL framework enhanced with active learning (AL) for gigapixel pathology tasks. Unlike existing methods that treat SSL and AL as independent components where AL incurs significant computational complexity to SSL, we propose a deep fusion of SSL and AL into a unified framework. Our framework introduces Informative Active Annotation (IAA) that employs a SSL-AL iterative structure to effectively extract knowledge from unlabeled pathology data. This structure significantly minimizes labeling efforts and computational complexity. Then, we propose Adaptive Pseudo-Labeling (APL) to address heterogeneity in class distribution, and prediction difficulty that are often observed in real-world pathology tasks. We evaluate Semi-Path on pathology image classification and segmentation tasks over three datasets that include WSIs from breast, colorectal, and brain tissues. The experimental results demonstrate the consistent superiority of Semi-Path over state-of-the-art methods.

Estimation of temporospatial clinical features of gait (CFs), such as step count and length, step duration, step frequency, gait speed, and distance traveled, is an important component of community-based mobility evaluation using wearable accelerometers. However, accurate unsupervised computerized measurement of CFs of individuals with Duchenne muscular dystrophy (DMD) who have progressive loss of ambulatory mobility is difficult due to differences in patterns and magnitudes of acceleration across their range of attainable gait velocities. This paper proposes a novel calibration method. It aims to detect steps, estimate stride lengths, and determine travel distance. The approach involves a combination of clinical observation, machine-learning-based step detection, and regression-based stride length prediction. The method demonstrates high accuracy in children with DMD and typically developing controls (TDs) regardless of the participants level of ability. Fifteen children with DMD and fifteen TDs underwent supervised clinical testing across a range of gait speeds using 10 m or 25 m run/walk (10 MRW, 25 MRW), 100 m run/walk (100 MRW), 6-min walk (6 MWT), and free-walk (FW) evaluations while wearing a mobile-phone-based accelerometer at the waist near the bodys center of mass. Following calibration by a trained clinical evaluator, CFs were extracted from the accelerometer data using a multi-step machine-learning-based process and the results were compared to ground-truth observation data. Model predictions vs. observed values for step counts, distance traveled, and step length showed a strong correlation (Pearsons r = -0.9929 to 0.9986, p < 0.0001). The estimates demonstrated a mean (SD) percentage error of 1.49% (7.04%) for step counts, 1.18% (9.91%) for distance traveled, and 0.37% (7.52%) for step length compared to ground-truth observations for the combined 6 MWT, 100 MRW, and FW tasks. Our study findings indicate that a single waist-worn accelerometer calibrated to an individuals stride characteristics using our methods accurately measures CFs and estimates travel distances across a common range of gait speeds in both DMD and TD peers.

Fluid bolus therapy (FBT) is fundamental to the management of circulatory shock in critical care but balancing the benefits and toxicities of FBT has proven challenging in individual patients. Improved predictors of the hemodynamic response to a fluid bolus, commonly referred to as a fluid challenge, are needed to limit non-beneficial fluid administration and to enable automated clinical decision support and patient-specific precision critical care management. In this study we retrospectively analyzed data from 394 fluid boluses from 58 pigs subjected to either hemorrhagic or distributive shock. All animals had continuous blood pressure and cardiac output monitored throughout the study. Using this data, we developed a machine learning (ML) model to predict the hemodynamic response to a fluid challenge using only arterial blood pressure waveform data as the input. A Random Forest binary classifier referred to as the ML fluid responsiveness algorithm (MLFRA) was trained to detect fluid responsiveness (FR), defined as a ≥ 15% change in cardiac stroke volume after a fluid challenge. We then compared its performance to pulse pressure variation, a commonly used metric of FR. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC), confusion matrix metrics, and calibration curves plotting predicted probabilities against observed outcomes. Across multiple train/test splits and feature selection methods designed to assess performance in the setting of small sample size conditions typical of large animal experiments, the MLFRA achieved an average AUROC, recall (sensitivity), specificity, and precision of 0.82, 0.86, 0.62. and 0.76, respectively. In the same datasets, pulse pressure variation had an AUROC, recall, specificity, and precision of 0.73, 0.91, 0.49, and 0.71, respectively. The MLFRA was generally well-calibrated across its range of predicted probabilities and appeared to perform equally well across physiologic conditions. These results suggest that ML, using only inputs from arterial blood pressure monitoring, may substantially improve the accuracy of predicting FR compared to the use of pulse pressure variation. If generalizable, these methods may enable more effective, automated precision management of critically ill patients with circulatory shock.

Accurate and scalable quantification of amyloid-β (Aβ) pathology is crucial for deeper disease phenotyping and furthering research in Alzheimer Disease (AD). This multidisciplinary study addresses the current limitations on neuropathology by leveraging a machine learning (ML) pipeline to perform a granular quantification of Aβ deposits and assess their distribution in the temporal lobe. Utilizing 131 whole-slide-images from consecutive autopsied cases at the University of California Davis Alzheimer Disease Research Center, our objectives were threefold: (1) Validate an automatic workflow for Aβ deposit quantification in white matter (WM) and gray matter (GM); (2) define the distributions of different Aβ deposit types in GM and WM, and (3) investigate correlates of Aβ deposits with dementia status and the presence of mixed pathology. Our methodology highlights the robustness and efficacy of the ML pipeline, demonstrating proficiency akin to experts' evaluations. We provide comprehensive insights into the quantification and distribution of Aβ deposits in the temporal GM and WM revealing a progressive increase in tandem with the severity of established diagnostic criteria (NIA-AA). We also present correlations of Aβ load with clinical diagnosis as well as presence/absence of mixed pathology. This study introduces a reproducible workflow, showcasing the practical use of ML approaches in the field of neuropathology, and use of the output data for correlative analyses. Acknowledging limitations, such as potential biases in the ML model and current ML classifications, we propose avenues for future research to refine and expand the methodology. We hope to contribute to the broader landscape of neuropathology advancements, ML applications, and precision medicine, paving the way for deep phenotyping of AD brain cases and establishing a foundation for further advancements in neuropathological research.

Cardiovascular disease (CVD) is largely preventable, and the leading cause of death for men and women. Though women have increased life expectancy compared to men, there are marked sex disparities in prevalence and risk of CVD-associated mortality and dementia. Yet, the basis for these and female-male differences is not completely understood. It is increasingly recognized that heart and brain health represent a lifetime of exposures to shared risk factors (including obesity, hyperlipidemia, diabetes, and hypertension) that compromise cerebrovascular health. We describe the process and resources for establishing a new research Center for Women's Cardiovascular and Brain Health at the University of California, Davis as a model for: (1) use of the cy pres principle for funding science to improve health; (2) transdisciplinary collaboration to leapfrog progress in a convergence science approach that acknowledges and addresses social determinants of health; and (3) training the next generation of diverse researchers. This may serve as a blueprint for future Centers in academic health institutions, as the cy pres mechanism for funding research is a unique mechanism to leverage residual legal settlement funds to catalyze the pace of scientific discovery, maximize innovation, and promote health equity in addressing society's most vexing health problems.

Triple-negative breast cancer (TNBC) is highly aggressive with limited available treatments. Stromal cells in the tumor microenvironment (TME) are crucial in TNBC progression; however, understanding the molecular basis of stromal cell activation and tumor-stromal crosstalk in TNBC is limited. To investigate therapeutic targets in the TNBC stromal niche, we used an advanced human in vitro microphysiological system called the vascularized micro-tumor (VMT). Using single-cell RNA sequencing, we revealed that normal breast tissue stromal cells activate neoplastic signaling pathways in the TNBC TME. By comparing interactions in VMTs with clinical data, we identified therapeutic targets at the tumor-stromal interface with potential clinical significance. Combining treatments targeting Tie2 signaling with paclitaxel resulted in vessel normalization and increased efficacy of paclitaxel in the TNBC VMT. Dual inhibition of HER3 and Akt also showed efficacy against TNBC. These data demonstrate the potential of inducing a favorable TME as a targeted therapeutic approach in TNBC.

BACKGROUND & AIMS: Practice guidelines promote a routine noninvasive, non-endoscopic initial approach to investigating dyspepsia without alarm features in young patients, yet many patients undergo prompt upper endoscopy. We aimed to assess tradeoffs among costs, patient satisfaction, and clinical outcomes to inform discrepancy between guidelines and practice. METHODS: We constructed a decision-analytic model and performed cost-effectiveness/cost-satisfaction analysis over a 1-year time horizon on patients with uninvestigated dyspepsia without alarm features referred to gastroenterology. A RAND/UCLA expert panel informed model design. Four competing diagnostic/management strategies were evaluated: prompt endoscopy, testing for Helicobacter pylori and eradicating if present (test-and-treat), testing for H pylori and performing endoscopy if present (test-and-scope), and empiric acid suppression. Outcomes were derived from systematic reviews of clinical trials. Costs were informed by prospective observational cohort studies and national commercial/federal cost databases. Health gains were represented using quality-adjusted life years. RESULTS: From the patient perspective, costs and outcomes were similar for all strategies (maximum out-of-pocket difference of $30 and

Background: The association between cancer and venous thromboembolism (VTE) is well-established with cancer patients accounting for approximately 20% of all VTE incidents. In this paper, we have performed a comparison of machine learning (ML) methods to traditional clinical scoring models for predicting the occurrence of VTE in a cancer patient population, identified important features (clinical biomarkers) for ML model predictions, and examined how different approaches to reducing the number of features used in the model impact model performance. Methods: We have developed an ML pipeline including three separate feature selection processes and applied it to routine patient care data from the electronic health records of 1910 cancer patients at the University of California Davis Medical Center. Results: Our ML-based prediction model achieved an area under the receiver operating characteristic curve of 0.778 ± 0.006 (mean ± SD) when trained on a set of 15 features. This result is comparable with the model performance when trained on all features in our feature pool [0.779 ± 0.006 (mean ± SD) with 29 features]. Our result surpasses the most validated clinical scoring system for VTE risk assessment in cancer patients by 16.1%. We additionally found cancer stage information to be a useful predictor after all performed feature selection processes despite not being used in existing score-based approaches. Conclusion: From these findings, we observe that ML can offer new insights and a significant improvement over the most validated clinical VTE risk scoring systems in cancer patients. The results of this study also allowed us to draw insight into our feature pool and identify the features that could have the most utility in the context of developing an efficient ML classifier. While a model trained on our entire feature pool of 29 features significantly outperformed the traditionally used clinical scoring system, we were able to achieve an equivalent performance using a subset of only 15 features through strategic feature selection methods. These results are encouraging for potential applications of ML to predicting cancer-associated VTE in clinical settings such as in bedside decision support systems where feature availability may be limited.

Dicrotic Notch (DN), one of the most significant and indicative features of the arterial blood pressure (ABP) waveform, becomes less pronounced and thus harder to identify as a matter of aging and pathological vascular stiffness. Generalizable and automatic DN identification for such edge cases is even more challenging in the presence of unexpected ABP waveform deformations that happen due to internal and external noise sources or pathological conditions that cause hemodynamic instability. We propose a physics-aware approach, named Physiowise (PW), that first employs a cardiovascular model to augment the original ABP waveform and reduce unexpected deformations, then apply a set of predefined rules on the augmented signal to find DN locations. We have tested the proposed method on in-vivo data gathered from 14 pigs under hemorrhage and sepsis study. Our result indicates 52% overall mean error improvement with 16% higher detection accuracy within the lowest permitted error range of 30ms. An additional hybrid methodology is also proposed to allow combining augmentation with any application-specific user-defined rule set.

Women with germline BRCA1 mutations (BRCA1+/mut) have increased risk for hereditary breast cancer. Cancer initiation in BRCA1+/mut is associated with premalignant changes in breast epithelium; however, the role of the epithelium-associated stromal niche during BRCA1-driven tumor initiation remains unclear. Here we show that the premalignant stromal niche promotes epithelial proliferation and mutant BRCA1-driven tumorigenesis in trans. Using single-cell RNA sequencing analysis of human preneoplastic BRCA1+/mut and noncarrier breast tissues, we show distinct changes in epithelial homeostasis including increased proliferation and expansion of basal-luminal intermediate progenitor cells. Additionally, BRCA1+/mut stromal cells show increased expression of pro-proliferative paracrine signals. In particular, we identify pre-cancer-associated fibroblasts (pre-CAFs) that produce protumorigenic factors including matrix metalloproteinase 3 (MMP3), which promotes BRCA1-driven tumorigenesis in vivo. Together, our findings demonstrate that precancerous stroma in BRCA1+/mut may elevate breast cancer risk through the promotion of epithelial proliferation and an accumulation of luminal progenitor cells with altered differentiation.

Computational machine learning (ML)-based frameworks could be advantageous for scalable analyses in neuropathology. A recent deep learning (DL) framework has shown promise in automating the processes of visualizing and quantifying different types of amyloid-β deposits as well as segmenting white matter (WM) from gray matter (GM) on digitized immunohistochemically stained slides. However, this framework has only been trained and evaluated on amyloid-β-stained slides with minimal changes in preanalytic variables. In this study, we evaluated select preanalytical variables including magnification, compression rate, and storage format using three digital slides scanners (Zeiss Axioscan Z1, Leica Aperio AT2, and Leica Aperio GT 450), on over 60 whole slide images, in a cohort of 14 cases having a spectrum of amyloid-β deposits. We conducted statistical comparisons of preanalytic variables with repeated measures analysis of variance evaluating the outputs of two DL frameworks for segmentation and object classification tasks. For both WM/GM segmentation and amyloid-β plaque classification tasks, there were statistical differences with respect to scanner types (p

In this paper, we study the L 1 /L 2 minimization on the gradient for imaging applications. Several recent works have demonstrated that L 1 /L 2 is better than the L 1 norm when approximating the L 0 norm to promote sparsity. Consequently, we postulate that applying L 1 /L 2 on the gradient is better than the classic total variation (the L 1 norm on the gradient) to enforce the sparsity of the image gradient. Numerically, we design a specific splitting scheme, under which we can prove subsequential and global convergence for the alternating direction method of multipliers (ADMM) under certain conditions. Experimentally, we demonstrate visible improvements of L 1 /L 2 over L 1 and other nonconvex regularizations for image recovery from low-frequency measurements and two medical applications of MRI and CT reconstruction. Finally, we reveal some empirical evidence on the superiority of L 1 /L 2 over L 1 when recovering piecewise constant signals from low-frequency measurements to shed light on future works.

Since the discovery of neutrino oscillations, we know that neutrinos have non-zero mass. However, the absolute neutrino-mass scale remains unknown. Here we report the upper limits on effective electron anti-neutrino mass, mν, from the second physics run of the Karlsruhe Tritium Neutrino experiment. In this experiment, mν is probed via a high-precision measurement of the tritium β-decay spectrum close to its endpoint. This method is independent of any cosmological model and does not rely on assumptions whether the neutrino is a Dirac or Majorana particle. By increasing the source activity and reducing the background with respect to the first physics campaign, we reached a sensitivity on mν of 0.7 eV c–2 at a 90% confidence level (CL). The best fit to the spectral data yields mν2 = (0.26 ± 0.34) eV2 c–4, resulting in an upper limit of mν < 0.9 eV c–2 at 90% CL. By combining this result with the first neutrino-mass campaign, we find an upper limit of mν < 0.8 eV c–2 at 90% CL.

IntroductionMortality is an important long-term indicator of the public health impact of chronic kidney disease (CKD). We investigated the role of individual comorbidities and multimorbidity on age-specific mortality risk among US veterans with new-onset CKD.MethodsThe cohort included 892,005 veterans aged ≥18 years with incident CKD stage 3 between January 2004 and April 2018 in the US Veterans Health Administration (VHA) system and followed until death, December 2018, or up to 10 years. Incident CKD was defined as the first-time estimated glomerular filtration rate (eGFR) was 3 months. Comorbidities were ascertained using inpatient and outpatient clinical records in the VHA system and Medicare claims. We estimated death rates for any cardiovascular disease (CVD, a composite of 6 CVD conditions) and 15 non-CVD comorbidities, and adjusted risks of death (hazard ratio [HR], 95% confidence interval [CI]) overall and by age group at CKD incidence.ResultsAt CKD incidence, the mean age was 72 years, and 97% were male; the mean eGFR was 52 mL/min/1.73 m2, and 95% had ≥2 comorbidities (median, 4) in addition to CKD. During a median follow-up of 4.5 years, among the 16 comorbidities, CVD was associated with the highest relative risk of death in younger veterans (HR 1.96 [95% CI: 1.61-2.37] in ages 18-44 years and HR 1.66 [1.63-1.70] in ages 45-64 years). Dementia was associated with the highest relative risk of death among older veterans (HR 1.71 [1.68-1.74] in ages 65-84 years and HR 1.69 [1.65-1.73] in ages 85-100 years). The additive effect of multimorbidity on risk of death was stronger in younger than older veterans. Compared to having 1 or no comorbidity at CKD onset, the risk of death with ≥5 comorbidities was >7-fold higher among veterans aged 18-44 years and >2-fold higher among veterans aged 85-100 years.ConclusionThe large burden of comorbidities in US veterans with newly identified CKD places them at the risk of premature death. Compared with older veterans, younger veterans with multiple comorbidities, particularly with CVD, at CKD onset are at an even higher relative risk of death.

As neurodegenerative disease pathological hallmarks have been reported in both grey matter (GM) and white matter (WM) with different density distributions, automating the segmentation process of GM/WM would be extremely advantageous for aiding in neuropathologic deep phenotyping. Standard segmentation methods typically involve manual annotations, where a trained researcher traces the delineation of GM/WM in ultra-high-resolution Whole Slide Images (WSIs). This method can be time-consuming and subjective, preventing a scalable analysis on pathology images. This paper proposes an automated segmentation pipeline (BrainSec) combining a Convolutional Neural Network (CNN) module for segmenting GM/WM regions and a post-processing module to remove artifacts/residues of tissues. The final output generates XML annotations that can be visualized via Aperio ImageScope. First, we investigate two baseline models for medical image segmentation: FCN, and U-Net. Then we propose a patch-based approach, BrainSec, to classify the GM/WM/background regions. We demonstrate BrainSec is robust and has reliable performance by testing it on over 180 WSIs that incorporate numerous unique cases as well as distinct neuroanatomic brain regions. We also apply gradient-weighted class activation mapping (Grad-CAM) to interpret the segmentation masks and provide relevant explanations and insights. In addition, we have integrated BrainSec with an existing Amyloid-β pathology classification model into a unified framework (without incurring significant computation complexity) to identify pathologies, visualize their distributions, and quantify each type of pathologies in segmented GM/WM regions, respectively.

Fibrotic tissues share many common features with neoplasms where there is an increased stiffness of the extracellular matrix (ECM). In this review, we present recent discoveries related to the role of the mechanosensitive ion channel Piezo1 in several diseases, especially in regulating tumor progression, and how this can be compared with cardiac mechanobiology. Based on recent findings, Piezo1 could be upregulated in cardiac fibroblasts as a consequence of the mechanical stress and pro-inflammatory stimuli that occurs after myocardial injury, and its increased activity could be responsible for a positive feedback loop that leads to fibrosis progression. The increased Piezo1-mediated calcium flow may play an important role in cytoskeleton reorganization since it induces actin stress fibers formation, a well-known characteristic of fibroblast transdifferentiation into the activated myofibroblast. Moreover, Piezo1 activity stimulates ECM and cytokines production, which in turn promotes the phenoconversion of adjacent fibroblasts into new myofibroblasts, enhancing the invasive character. Thus, by assuming the Piezo1 involvement in the activation of intrinsic fibroblasts, recruitment of new myofibroblasts, and uncontrolled excessive ECM production, a new approach to blocking the fibrotic progression can be predicted. Therefore, targeted therapies against Piezo1 could also be beneficial for cardiac fibrosis.

Dual-functional aggregation-induced photosensitizers (AIE-PSs) with singlet oxygen generation (SOG) ability and bright fluorescence in aggregated state have received much attention in image-guided photodynamic therapy (PDT). However, designing an AIE-PS with both high SOG and intense fluorescence via molecular design is still challenging. In this work, we report a new nanohybrid consisting of gold nanostar (AuNS) and AIE-PS dots with enhanced fluorescence and photosensitization for theranostic applications. The spectral overlap between the extinction of AuNS and fluorescence emission of AIE-PS dots (665 nm) is carefully selected using five different AuNSs with distinct localized surface plasmon (LSPR) peaks. Results show that all the AuNSs can enhance the 1O2 production of AIE-PS dots, among which the AuNS with LSPR peak at 585 nm exhibited the highest 1O2 enhancement factor of 15-fold with increased fluorescence brightness. To the best of our knowledge, this is the highest enhancement factor reported for the metal-enhanced singlet oxygen generation systems. The Au585@AIE-PS nanodots were applied for simultaneous fluorescence imaging and photodynamic ablation of HeLa cancer cells with strongly enhanced PDT efficiency in vitro. This study provides a better understanding of the metal-enhanced AIE-PS nanohybrid systems, opening up new avenue towards advanced image-guided PDT with greatly improved efficacy.

Critical Congenital Heart Disease (CCHD) screening that only uses oxygen saturation (SpO2), measured by pulse oximetry, fails to detect an estimated 900 US newborns annually. The addition of other pulse oximetry features such as perfusion index (PIx), heart rate, pulse delay and photoplethysmography characteristics may improve detection of CCHD, especially those with systemic blood flow obstruction such as Coarctation of the Aorta (CoA). To comprehensively study the most relevant features associated with CCHD, we investigated interpretable machine learning (ML) algorithms by using Recursive Feature Elimination (RFE) to identify an optimal subset of features. We then incorporated the trained ML models into the current SpO2-alone screening algorithm. Our proposed enhanced CCHD screening system, which adds the ML model, improved sensitivity by approximately 10 percentage points compared to the current standard SpO2-alone method with minimal to no impact on specificity.Clinical relevance- This establishes proof of concept for a ML algorithm that combines pulse oximetry features to improve detection of CCHD with little impact on false positive rate.

As early intervention is highly effective for young children with autism spectrum disorder (ASD), it is imperative to make accurate diagnosis as early as possible. ASD has often been associated with atypical visual attention and eye gaze data can be collected at a very early age. An automatic screening tool based on eye gaze data that could identify ASD risk offers the opportunity for intervention before the full set of symptoms is present. In this paper, we propose two machine learning methods, synthetic saccade approach and image based approach, to automatically classify ASD given children's eye gaze data collected from free-viewing tasks of natural images. The first approach uses a generative model of synthetic saccade patterns to represent the baseline scan-path from a typical non-ASD individual and combines it with the real scan-path as well as other auxiliary data as inputs to a deep learning classifier. The second approach adopts a more holistic image-based approach by feeding the input image and a sequence of fixation maps into a convolutional or recurrent neural network. Using a publicly-accessible collection of children's gaze data, our experiments indicate that the ASD prediction accuracy reaches 67.23% accuracy on the validation dataset and 62.13% accuracy on the test dataset.

BackgroundThe global epidemiology of end-stage kidney disease (ESKD) reflects each nation's unique genetic, environmental, lifestyle, and sociodemographic characteristics. The response to ESKD, particularly regarding kidney replacement therapy (KRT), depends on local disease burden, culture, and socioeconomics. Here, we explore geographic variation and global trends in ESKD incidence and prevalence and examine variations in KRT modality, practice patterns, and mortality. We conclude with a discussion on disparities in access to KRT and strategies to reduce ESKD global burden and to improve access to treatment in low- and middle-income countries (LMICs).SummaryFrom 2003 to 2016, incidence rates of treated ESKD were relatively stable in many higher income countries but rose substantially predominantly in East and Southeast Asia. The prevalence of treated ESKD has increased worldwide, likely due to improving ESKD survival, population demographic shifts, higher prevalence of ESKD risk factors, and increasing KRT access in countries with growing economies. Unadjusted 5-year survival of ESKD patients on KRT was 41% in the USA, 48% in Europe, and 60% in Japan. Dialysis is the predominant KRT in most countries, with hemodialysis being the most common modality. Variations in dialysis practice patterns account for some of the differences in survival outcomes globally. Worldwide, there is a greater prevalence of KRT at higher income levels, and the number of people who die prematurely because of lack of KRT access is estimated at up to 3 times higher than the number who receive treatment. Key Messages: Many people worldwide in need of KRT as a life-sustaining treatment do not receive it, mostly in LMICs where health care resources are severely limited. This large treatment gap demands a focus on population-based prevention strategies and development of affordable and cost-effective KRT. Achieving global equity in KRT access will require concerted efforts in advocating effective public policy, health care delivery, workforce capacity, education, research, and support from the government, private sector, nongovernmental, and professional organizations.

To develop and characterize a machine learning algorithm to discriminate acute respiratory distress syndrome from other causes of respiratory failure using only ventilator waveform data.DesignRetrospective, observational cohort study.SettingAcademic medical center ICU.PatientsAdults admitted to the ICU requiring invasive mechanical ventilation, including 50 patients with acute respiratory distress syndrome and 50 patients with primary indications for mechanical ventilation other than hypoxemic respiratory failure.InterventionsNone.Measurements and main resultsPressure and flow time series data from mechanical ventilation during the first 24-hours after meeting acute respiratory distress syndrome criteria (or first 24-hr of mechanical ventilation for non-acute respiratory distress syndrome patients) were processed to extract nine physiologic features. A random forest machine learning algorithm was trained to discriminate between the patients with and without acute respiratory distress syndrome. Model performance was assessed using the area under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value. Analyses examined performance when the model was trained using data from the first 24 hours and tested using withheld data from either the first 24 hours (24/24 model) or 6 hours (24/6 model). Area under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, and negative predictive value were 0.88, 0.90, 0.71, 0.77, and 0.90 (24/24); and 0.89, 0.90, 0.75, 0.83, and 0.83 (24/6).ConclusionsUse of machine learning and physiologic information derived from raw ventilator waveform data may enable acute respiratory distress syndrome screening at early time points after intubation. This approach, combined with traditional diagnostic criteria, could improve timely acute respiratory distress syndrome recognition and enable automated clinical decision support, especially in settings with limited availability of conventional diagnostic tests and electronic health records.

IntroductionAccess to patient medical data is critical to building a real-time data analytic pipeline for improving care providers' ability to detect, diagnose, and prognosticate diseases. Critical congenital heart disease (CCHD) is a common group of neonatal life-threatening defects that must be promptly diagnosed to minimize morbidity and mortality. CCHD can be diagnosed both prenatally and postnatally. However, despite current screening practices involving oxygen saturation analysis, timely diagnosis is missed in approximately 900 infants with CCHD annually in the USA and can benefit from increased data processing capabilities. Adding non-invasive perfusion measurements to oxygen saturation data can improve the timeliness and fidelity of CCHD diagnostics. However, real-time monitoring and interpretation of non-invasive perfusion data are currently limited.MethodsTo address this challenge, we created a hardware and software architecture utilizing a Pi-top™ for collecting, visualizing, and storing dual oxygen saturation, perfusion indices, and photoplethysmography data. Data aggregation in our system is automated and all data files are coded with unique study identifiers to facilitate research purposes.ResultsUsing this system, we have collected data from 190 neonates, 130 presumably without and 60 with congenital heart disease, in total comprising 1665 min of information. From these data, we are able to extract non-invasive perfusion features such as perfusion index, radiofemoral delay, and slope of systolic rise or diastolic fall.ConclusionThis data collection and waveform analysis is relatively inexpensive and can be used to enhance future CCHD screening algorithms.

Photosensitizers with aggregation-induced emission (AIE-PS) are attractive for image-guided photodynamic therapy due to their dual functional role in generating singlet oxygen and producing high fluorescent signal in the aggregated state. However, their brightness and treatment efficiency maybe limited in current practice. Herein we report the first systematic investigation on the metal-enhanced fluorescence (MEF) and singlet oxygen generation (ME-SOG) ability of our newly synthesized AIE-photosensitizers. The Ag@AIE-PS of varied sizes were prepared via layer-by-layer assembly with controlled distance between silver nanoparticles (AgNPs) and AIE-PS. A maximum of 6-fold enhancement in fluorescence and 2-fold increment in SOG were observed for the 85nmAg@AIE-PS. Comprehensive characterization and simulation were conducted to unravel the plasmon-enhancement mechanisms of Ag@AIE-PS. Results show that MEF of AIE-PS is determined by the enhanced electric field around AgNPs, while ME-SOG is dictated by the scattering efficiency of the metal core, where bigger AgNPs would result in larger enhancement factor. Furthermore, the optimum distance between AgNPs and AIE-PS to achieve maximum SOG enhancement is shorter than that required for the highest MEF. The correlation of MEF and ME-SOG found in this study is useful for designing new a generation of AIE-photosensitizers with high brightness and treatment efficiency towards practical theranostic application in the future.

Future healthcare systems will rely heavily on clinical decision support systems (CDSS) to improve the decision-making processes of clinicians. To explore the design of future CDSS, we developed a research-focused CDSS for the management of patients in the intensive care unit that leverages Internet of Things (IoT) devices capable of collecting streaming physiologic data from ventilators and other medical devices. We then created machine learning (ML) models that could analyze the collected physiologic data to determine if the ventilator was delivering potentially harmful therapy and if a deadly respiratory condition, acute respiratory distress syndrome (ARDS), was present. We also present work to aggregate these models into a mobile application that can provide responsive, real-time alerts of changes in ventilation to providers. As illustrated in the recent COVID-19 pandemic, being able to accurately predict ARDS in newly infected patients can assist in prioritizing care. We show that CDSS may be used to analyze physiologic data for clinical event recognition and automated diagnosis, and we also highlight future research avenues for hospital CDSS.

Future healthcare systems will rely heavily on clinical decision support systems (CDSS) to improve the decision-making processes of clinicians. To explore the design of future CDSS, we developed a research-focused CDSS for the management of patients in the intensive care unit that leverages Internet of Things (IoT) devices capable of collecting streaming physiologic data from ventilators and other medical devices. We then created machine learning (ML) models that could analyze the collected physiologic data to determine if the ventilator was delivering potentially harmful therapy and if a deadly respiratory condition, acute respiratory distress syndrome (ARDS), was present. We also present work to aggregate these models into a mobile application that can provide responsive, real-time alerts of changes in ventilation to providers. As illustrated in the recent COVID-19 pandemic, being able to accurately predict ARDS in newly infected patients can assist in prioritizing care. We show that CDSS may be used to analyze physiologic data for clinical event recognition and automated diagnosis, and we also highlight future research avenues for hospital CDSS.

Myeloid-derived suppressor cells (MDSCs) are innate immune cells that acquire the capacity to suppress adaptive immune responses during cancer. It remains elusive how MDSCs differ from their normal myeloid counterparts, which limits our ability to specifically detect and therapeutically target MDSCs during cancer. Here, we sought to determine the molecular features of breast cancer-associated MDSCs using the widely studied mouse model based on the mouse mammary tumor virus (MMTV) promoter-driven expression of the polyomavirus middle T oncoprotein (MMTV-PyMT). To identify MDSCs in an unbiased manner, we used single-cell RNA sequencing to compare MDSC-containing splenic myeloid cells from breast tumor-bearing mice with wild-type controls. Our computational analysis of 14,646 single-cell transcriptomes revealed that MDSCs emerge through an aberrant neutrophil maturation trajectory in the spleen that confers them an immunosuppressive cell state. We establish the MDSC-specific gene signature and identify CD84 as a surface marker for improved detection and enrichment of MDSCs in breast cancers.

Given the clinical effect of laminopathies, understanding lamin mechanical properties will benefit the treatment of heart failure. Here we report a mechano-dynamic study of LMNA mutations in neonatal rat ventricular myocytes (NRVM) using single cell spectroscopy with Atomic Force Microscopy (AFM) and measured changes in beating force, frequency and contractile amplitude of selected mutant-expressing cells within cell clusters. Furthermore, since beat-to-beat variations can provide clues on the origin of arrhythmias, we analyzed the beating rate variability using a time-domain method which provides a Poincaré plot. Data were further correlated to cell phenotypes. Immunofluorescence and calcium imaging analysis showed that mutant lamin changed NRVMs beating force and frequency. Additionally, we noted an altered microtubule network organization with shorter filament length, and defective hemichannel membrane localization (Connexin 43). These data highlight the interconnection between nucleoskeleton, cytoskeleton and sarcolemmal structures, and the transcellular consequences of mutant lamin protein in the pathogenesis of the cardiac laminopathies.

In daily life, we use visual working memory (WM) to guide our actions. While attending to currently-relevant information, we must simultaneously maintain future-relevant information, and discard information that is no longer relevant. However, the neural mechanisms by which unattended, but future-relevant, information is maintained in working memory, and future-irrelevant information is discarded, are not well understood. Here, we investigated representations of these different information types, using functional magnetic resonance imaging in combination with multivoxel pattern analysis and computational modeling based on inverted encoding model simulations. We found that currently-relevant WM information in the focus of attention was maintained through representations in visual, parietal and posterior frontal brain regions, whereas deliberate forgetting led to suppression of the discarded representations in early visual cortex. In contrast, future-relevant information was neither inhibited nor actively maintained in these areas. These findings suggest that different neural mechanisms underlie the WM representation of currently- and future-relevant information, as compared to information that is discarded from WM.

Given the clinical effect of laminopathies, understanding lamin mechanical properties will benefit the treatment of heart failure. Here we report a mechano-dynamic study of LMNA mutations in neonatal rat ventricular myocytes (NRVM) using single cell spectroscopy with Atomic Force Microscopy (AFM) and measured changes in beating force, frequency and contractile amplitude of selected mutant-expressing cells within cell clusters. Furthermore, since beat-to-beat variations can provide clues on the origin of arrhythmias, we analyzed the beating rate variability using a time-domain method which provides a Poincaré plot. Data were further correlated to cell phenotypes. Immunofluorescence and calcium imaging analysis showed that mutant lamin changed NRVMs beating force and frequency. Additionally, we noted an altered microtubule network organization with shorter filament length, and defective hemichannel membrane localization (Connexin 43). These data highlight the interconnection between nucleoskeleton, cytoskeleton and sarcolemmal structures, and the transcellular consequences of mutant lamin protein in the pathogenesis of the cardiac laminopathies.

In this paper, I examine the development, implementation, and results of utilizing three types of storybooks in a language revitalization classroom for students ages 5-12 learning Teotitlán del Valle Zapotec, an indigenous language of southern Mexico. Although each method used for creating books in Zapotec generated a positive reaction from students and parents, I consider the ways in which each method facilitates student learning while also problematizing the cultural authenticity of the classroom. Based on classroom observations, a parent focus group, and student interviews, I conclude that the most effective method for storybook creation involved students creating their own book modeled on a pre-existing book written in the non-indigenous language. This student-created book generated sustained interest in the language and allowed for students to shape the materials into something that was culturally relevant for them personally.

Clinical decision support systems (CDSS) will play increasing role in improving quality of medical care for critically ill patients. However, due to limitations in current informatics infrastructure, CDSS do not always have complete information on state of supporting physiologic monitoring devices, which can limit input data available to CDSS. This is especially true in use case of mechanical ventilation (MV), where current CDSS have no knowledge of critical ventilation settings, such as ventilation mode. To enable MV CDSS make accurate recommendations related to ventilator mode, we developed a highly performant machine learning model that is able to perform per-breath classification of five of most widely used ventilation modes in USA with average F1-score of 97.52%. We also show how our approach makes methodologic improvements over previous work and is highly robust to missing data caused by software/sensor error.

Clinical decision support systems (CDSS) will play increasing role in improving quality of medical care for critically ill patients. However, due to limitations in current informatics infrastructure, CDSS do not always have complete information on state of supporting physiologic monitoring devices, which can limit input data available to CDSS. This is especially true in use case of mechanical ventilation (MV), where current CDSS have no knowledge of critical ventilation settings, such as ventilation mode. To enable MV CDSS make accurate recommendations related to ventilator mode, we developed a highly performant machine learning model that is able to perform per-breath classification of five of most widely used ventilation modes in USA with average F1-score of 97.52%. We also show how our approach makes methodologic improvements over previous work and is highly robust to missing data caused by software/sensor error.

As the majority of Internet traffic today is attributed to content-centric applications, there has been ever-increasing demand for highly scalable and efficient content delivery. An accurate prediction on future content consumption is essential for such demand. To address such an issue, this paper introduces a new computational approach, Content Network (CN) that can capture the relations among contents, and its potential applications. We conduct a measurement study to investigate how contents are inter-related from the viewpoint of content spreading on one of the popular BitTorrent portals: The Pirate Bay. Based on the large-scale dataset that contains 18 K torrents and 9 M users, we construct the CN and investigate its structural properties. Our key finding is that contents in the same community in the CN (i) belong to the same content category with 94% probability, (ii) are uploaded by the same content publisher with 76% probability, and (iii) have the similar titles with 51% probability, which implies that contents in the same community collectively contain common (shared) interests of users. Our trace-driven study demonstrates that the proposed CN model is useful in (i) content recommendation for increasing sales and (ii) content caching for networking efficiency. We believe our work can provide an important insight for content stakeholders, e.g., content providers for efficient publishing strategies, network engineers for networking efficiency, or content marketers for accurate recommendation.

Learning and exploring the connectivity of unknown networks represent an important problem in practical applications of communication networks and social-media networks. Modeling large-scale networks as connected graphs is highly desirable to extract their connectivity information among nodes to visualize network topology, disseminate data, and improve routing efficiency. This paper investigates a simple measurement model in which a small subset of source nodes collect hop distance information from networked nodes in order to generate a virtual coordinate system (VCS) for networks of unknown topology. We establish the VCS to define logical distance among nodes based on principal component analysis and to determine connectivity relationship and effective routing methods. More importantly, we present a robust analytical algorithm to derive the VCS against practical issues of missing and corrupted measurements. We also develop a connectivity inference method which classifies nodes into layers based on the hop distances and derives partial information on network connectivity.

The hippocampus plays a critical role in episodic memory, among other cognitive functions. However, few tools exist to causally manipulate hippocampal function in healthy human participants. Recent work has targeted hippocampal-cortical networks by performing TMS to a region interconnected with the hippocampus, posterior inferior parietal cortex (pIPC). Such hippocampal-targeted TMS enhances associative memory and influences hippocampal functional connectivity. However, it is currently unknown which stages of mnemonic processing (encoding or retrieval) are affected by hippocampal-targeted TMS. Here, we examined whether hippocampal-targeted TMS influences the initial encoding of associations (vs. items) into memory. To selectively influence encoding and not retrieval, we performed continuous theta-burst TMS before participants encoded object-location associations and assessed memory after the direct effect of stimulation dissipated. Relative to control TMS and baseline memory, pIPC TMS enhanced associative memory success and confidence. Item memory was unaffected, demonstrating a selective influence on associative versus item memory. The strength of hippocampal-pIPC functional connectivity predicted TMS-related memory benefits, which was mediated by parahippocampal and retrosplenial cortices. Our findings indicate that hippocampal-targeted TMS can specifically modulate the encoding of new associations into memory without directly influencing retrieval processes and suggest that the ability to influence associative memory may be related to the fidelity of hippocampal TMS targeting. These results support the notion that pIPC TMS may serve as a potential tool for manipulating hippocampal function in healthy participants. Nonetheless, future work combining hippocampal-targeted continuous theta-burst TMS with neuroimaging is needed to better understand the neural basis of TMS-induced memory changes.

In this paper, we propose the Programmable LInk Metric Identification (ProgLIMI) infrastructure for software-defined networking (SDN) networks. ProgLIMI identifies round-trip link metrics (RTLMs) from accumulated end-to-end metrics of selected measurement paths by leveraging the flexible routing control capability of SDN networks. ProgLIMI mainly solves three sub-problems: 1) monitor placement; 2) linearly independent measurement path construction; and 3) flow rule design. To reduce measurement cost, ProgLIMI tries to minimize the number of required monitors and flow rules. In this paper, we address the three sub-problems for both full and hybrid SDN networks. For full SDN networks, ProgLIMI can achieve full RTLM identification using only one monitor and two flow rules in each SDN switch. In contrast, the RTLM identification in hybrid SDN networks is more complicated due to the routing constraint of hybrid SDN networks. We first prove that the monitor placement problem in hybrid SDN networks is NP-hard. We then formulate the monitor placement and measurement path selection problem in hybrid SDN networks and propose a greedy heuristic algorithm to solve the problem efficiently. Our evaluations on both physical testbed and simulation platform reveal that ProgLIMI can accurately identify the RTLMs (delay and loss rate). Besides, ProgLIMI is also resource efficient, i.e., it only requires two flow rules in each SDN switch and a small number of monitors, and the extra probing traffic load incurred by ProgLIMI is also low.

The hippocampus plays a critical role in episodic memory, among other cognitive functions. However, few tools exist to causally manipulate hippocampal function in healthy human participants. Recent work has targeted hippocampal-cortical networks by performing TMS to a region interconnected with the hippocampus, posterior inferior parietal cortex (pIPC). Such hippocampal-targeted TMS enhances associative memory and influences hippocampal functional connectivity. However, it is currently unknown which stages of mnemonic processing (encoding or retrieval) are affected by hippocampal-targeted TMS. Here, we examined whether hippocampal-targeted TMS influences the initial encoding of associations (vs. items) into memory. To selectively influence encoding and not retrieval, we performed continuous theta-burst TMS before participants encoded object-location associations and assessed memory after the direct effect of stimulation dissipated. Relative to control TMS and baseline memory, pIPC TMS enhanced associative memory success and confidence. Item memory was unaffected, demonstrating a selective influence on associative versus item memory. The strength of hippocampal-pIPC functional connectivity predicted TMS-related memory benefits, which was mediated by parahippocampal and retrosplenial cortices. Our findings indicate that hippocampal-targeted TMS can specifically modulate the encoding of new associations into memory without directly influencing retrieval processes and suggest that the ability to influence associative memory may be related to the fidelity of hippocampal TMS targeting. These results support the notion that pIPC TMS may serve as a potential tool for manipulating hippocampal function in healthy participants. Nonetheless, future work combining hippocampal-targeted continuous theta-burst TMS with neuroimaging is needed to better understand the neural basis of TMS-induced memory changes.

BACKGROUND:As healthcare increasingly digitizes, streaming waveform data is being made available from an variety of sources, but there still remains a paucity of performant clinical decision support systems. For example, in the intensive care unit (ICU) existing automated alarm systems typically rely on simple thresholding that result in frequent false positives. Recurrent false positive alerts create distrust of alarm mechanisms that can be directly detrimental to patient health. To improve patient care in the ICU, we need alert systems that are both pervasive, and accurate so as to be informative and trusted by providers. OBJECTIVE:We aimed to develop a machine learning-based classifier to detect abnormal waveform events using the use case of mechanical ventilation waveform analysis, and the detection of harmful forms of ventilation delivery to patients. We specifically focused on detecting injurious subtypes of patient-ventilator asynchrony (PVA). METHODS:Using a dataset of breaths recorded from 35 different patients, we used machine learning to create computational models to automatically detect, and classify two types of injurious PVA, double trigger asynchrony (DTA), breath stacking asynchrony (BSA). We examined the use of synthetic minority over-sampling technique (SMOTE) to overcome class imbalance problems, varied methods for feature selection, and use of ensemble methods to optimize the performance of our model. RESULTS:We created an ensemble classifier that is able to accurately detect DTA at a sensitivity/specificity of 0.960/0.975, BSA at sensitivity/specificity of 0.944/0.987, and non-PVA events at sensitivity/specificity of .967/.980. CONCLUSIONS:Our results suggest that it is possible to create a high-performing machine learning-based model for detecting PVA in mechanical ventilator waveform data in spite of both intra-patient, and inter-patient variability in waveform patterns, and the presence of clinical artifacts like cough and suction procedures. Our work highlights the importance of addressing class imbalance in clinical data sets, and the combined use of statistical methods and expert knowledge in feature selection.

BackgroundAs healthcare increasingly digitizes, streaming waveform data is being made available from an variety of sources, but there still remains a paucity of performant clinical decision support systems. For example, in the intensive care unit (ICU) existing automated alarm systems typically rely on simple thresholding that result in frequent false positives. Recurrent false positive alerts create distrust of alarm mechanisms that can be directly detrimental to patient health. To improve patient care in the ICU, we need alert systems that are both pervasive, and accurate so as to be informative and trusted by providers.ObjectiveWe aimed to develop a machine learning-based classifier to detect abnormal waveform events using the use case of mechanical ventilation waveform analysis, and the detection of harmful forms of ventilation delivery to patients. We specifically focused on detecting injurious subtypes of patient-ventilator asynchrony (PVA).MethodsUsing a dataset of breaths recorded from 35 different patients, we used machine learning to create computational models to automatically detect, and classify two types of injurious PVA, double trigger asynchrony (DTA), breath stacking asynchrony (BSA). We examined the use of synthetic minority over-sampling technique (SMOTE) to overcome class imbalance problems, varied methods for feature selection, and use of ensemble methods to optimize the performance of our model.ResultsWe created an ensemble classifier that is able to accurately detect DTA at a sensitivity/specificity of 0.960/0.975, BSA at sensitivity/specificity of 0.944/0.987, and non-PVA events at sensitivity/specificity of .967/.980.ConclusionsOur results suggest that it is possible to create a high-performing machine learning-based model for detecting PVA in mechanical ventilator waveform data in spite of both intra-patient, and inter-patient variability in waveform patterns, and the presence of clinical artifacts like cough and suction procedures. Our work highlights the importance of addressing class imbalance in clinical data sets, and the combined use of statistical methods and expert knowledge in feature selection.

Visual working memory (VWM) recruits a broad network of brain regions, including prefrontal, parietal, and visual cortices. Recent evidence supports a "sensory recruitment" model of VWM, whereby precise visual details are maintained in the same stimulus-selective regions responsible for perception. A key question in evaluating the sensory recruitment model is how VWM representations persist through distracting visual input, given that the early visual areas that putatively represent VWM content are susceptible to interference from visual stimulation.To address this question, we used a functional magnetic resonance imaging inverted encoding model approach to quantitatively assess the effect of distractors on VWM representations in early visual cortex and the intraparietal sulcus (IPS), another region previously implicated in the storage of VWM information. This approach allowed us to reconstruct VWM representations for orientation, both before and after visual interference, and to examine whether oriented distractors systematically biased these representations. In our human participants (both male and female), we found that orientation information was maintained simultaneously in early visual areas and IPS in anticipation of possible distraction, and these representations persisted in the absence of distraction. Importantly, early visual representations were susceptible to interference; VWM orientations reconstructed from visual cortex were significantly biased toward distractors, corresponding to a small attractive bias in behavior. In contrast, IPS representations did not show such a bias. These results provide quantitative insight into the effect of interference on VWM representations, and they suggest a dynamic tradeoff between visual and parietal regions that allows flexible adaptation to task demands in service of VWM.SIGNIFICANCE STATEMENT Despite considerable evidence that stimulus-selective visual regions maintain precise visual information in working memory, it remains unclear how these representations persist through subsequent input. Here, we used quantitative model-based fMRI analyses to reconstruct the contents of working memory and examine the effects of distracting input. Although representations in the early visual areas were systematically biased by distractors, those in the intraparietal sulcus appeared distractor-resistant. In contrast, early visual representations were most reliable in the absence of distraction. These results demonstrate the dynamic, adaptive nature of visual working memory processes, and provide quantitative insight into the ways in which representations can be affected by interference. Further, they suggest that current models of working memory should be revised to incorporate this flexibility.

AimsGiven the clinical impact of LMNA cardiomyopathies, understanding lamin function will fulfill a clinical need and will lead to advancement in the treatment of heart failure. A multidisciplinary approach combining cell biology, atomic force microscopy (AFM), and molecular modeling was used to analyse the biomechanical properties of human lamin A/C gene (LMNA) mutations (E161K, D192G, N195K) using an in vitro neonatal rat ventricular myocyte model.Methods and resultsThe severity of biomechanical defects due to the three LMNA mutations correlated with the severity of the clinical phenotype. AFM and molecular modeling identified distinctive biomechanical and structural changes, with increasing severity from E161K to N195K and D192G, respectively. Additionally, the biomechanical defects were rescued with a p38 MAPK inhibitor.ConclusionsAFM and molecular modeling were able to quantify distinct biomechanical and structural defects in LMNA mutations E161K, D192G, and N195K and correlate the defects with clinical phenotypic severity. Improvements in cellular biomechanical phenotype was demonstrated and may represent a mechanism of action for p38 MAPK inhibition therapy that is now being used in human clinical trials to treat laminopathies.

In this paper, we propose an intelligent framework for Traffic Matrix (TM) inference in Software Defined Networks (SDN) where the Ternary Content Addressable Memory (TCAM) entries of switches are partitioned into two parts to: 1) effectively aggregate part of incoming flows for aggregate measurements, and 2) de-aggregate and directly measure the most informative flows for per-flow measurements. These measurements are then processed to effectively estimate the size of network flows. Under hard resource constraints of limited TCAM sizes, we show how to design the optimal and efficient-compressed flow aggregation matrices. We propose an optimal Multi-Armed Bandit (MAB) based algorithm to adaptively measure the most rewarding flows. We evaluate the performance of our framework using real traffic traces from different network environments and by considering two main applications: TM estimation and Heavy Hitter (HH) detection. Moreover, we have implemented a prototype of our framework in Mininet to demonstrate its effectiveness.

With the attractive feature of guaranteeing maximum network throughput, backpressure routing has been widely used in wireless communication networks. Motivated by the backpressure routing, in this paper, we propose a delay-based traffic signal control algorithm in transportation networks. We prove that this delay-based control achieves optimal throughput performance, same as the queue-based traffic signal control in the literature. However, a vehicle at a lane whose queue length remains very small may be excessively delayed under the queue-based signal control. Our delay-based backpressure control can deal with the excessive delays and achieve better fairness with respect to delay while still guaranteeing throughput optimality. Moreover, a general weighted control scheme combining the queue-based and delay-based schemes is also investigated, to provide a more flexible control according to the quality of service requirements. Numerical results explore their performance under both homogeneous and heterogeneous traffic scenarios.

Single-cell transcriptomic technologies have emerged as powerful tools to explore cellular heterogeneity at the resolution of individual cells. Previous scientific knowledge in cell biology is largely limited to data generated by bulk profiling methods, which only provide averaged read-outs that generally mask cellular heterogeneity. This averaged approach is particularly problematic when the biological effect of interest is limited to only a subpopulation of cells such as stem/progenitor cells within a given tissue, or immune cell subsets infiltrating a tumor. Great advances in single-cell RNA sequencing (scRNAseq) enabled scientists to overcome this limitation and allow for in depth interrogation of previously unexplored rare cell types. Due to the high sensitivity of scRNAseq, adequate attention must be put into experimental setup and execution. Careful handling and processing of cells for scRNAseq is critical to preserve the native expression profile that will ensure meaningful analysis and conclusions. Here, we delineate the individual steps of a typical single-cell analysis workflow from tissue procurement, cell preparation, to platform selection and data analysis, and we discuss critical challenges in each of these steps, which will serve as a helpful guide to navigate the complex field of single-cell sequencing.

We consider the quantitative group testing problem where the objective is to identify defective items in a given population based on results of tests performed on subsets of the population. Under the quantitative group testing model, the result of each test reveals the number of defective items in the tested group. The minimum number of tests achievable by nested test plans was established by Aigner and Schughart in 1985 within a minimax framework. The optimal nested test plan offering this performance, however, was not obtained. In this paper, we establish the optimal nested test plan in a closed form. This optimal nested test plan is also order optimal among all test plans as the population size approaches infinity. Using heavy-hitter detection as a case study, we show via simulation examples orders of magnitude improvement of the group testing approach over two prevailing sampling-based approaches in detection accuracy and counter consumption. Other applications include anomaly detection and wideband spectrum sensing in cognitive radio systems.

Single-cell transcriptomic technologies have emerged as powerful tools to explore cellular heterogeneity at the resolution of individual cells. Previous scientific knowledge in cell biology is largely limited to data generated by bulk profiling methods, which only provide averaged read-outs that generally mask cellular heterogeneity. This averaged approach is particularly problematic when the biological effect of interest is limited to only a subpopulation of cells such as stem/progenitor cells within a given tissue, or immune cell subsets infiltrating a tumor. Great advances in single-cell RNA sequencing (scRNAseq) enabled scientists to overcome this limitation and allow for in depth interrogation of previously unexplored rare cell types. Due to the high sensitivity of scRNAseq, adequate attention must be put into experimental setup and execution. Careful handling and processing of cells for scRNAseq is critical to preserve the native expression profile that will ensure meaningful analysis and conclusions. Here, we delineate the individual steps of a typical single-cell analysis workflow from tissue procurement, cell preparation, to platform selection and data analysis, and we discuss critical challenges in each of these steps, which will serve as a helpful guide to navigate the complex field of single-cell sequencing.