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Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): This study was supported by unrestricted grants from the Korean Society of Interventional Cardiology. Aims Despite the benefit of culprit-only percutaneous coronary intervention (PCI) in the CULPRIT-SHOCK trial, the optimal revascularization strategy for a refractory cardiogenic shock (CS) requiring mechanical circulatory support devices remains controversial. This study aimed to compare clinical outcomes between the culprit-only and immediate multi-vessel PCI strategies in patients with acute myocardial infarction (AMI) complicated by CS who underwent venoarterial-extracorporeal membrane oxygenation (VA-ECMO). Methods and Results This study was patient-pooled data from the RESCUE and SMC-ECMO registries. A total of 408 AMI patients with multi-vessel disease who underwent VA-ECMO due to refractory CS were included in this analysis. The study population was classified into culprit-only versus immediate multi-vessel PCI according to non-culprit lesion (NCL) treatment strategies. The co-primary endpoints were 30-day mortality or renal-replacement therapy and 12-month follow-up mortality. Among the study population, 241 (59.1%) underwent culprit-only PCI and 167 (40.9%) underwent immediate multi-vessel PCI. Compared with culprit-only PCI, immediate multi-vessel PCI was associated with significantly lower risks of 30-day mortality or renal-replacement therapy (66.8% vs. 54.5%, p=0.02) and all-cause mortality during 12 months of follow-up (59.5% vs. 47.8%, hazard ratio [HR] 0.70; 95% confidence interval [CI] 0.53–0.92, p=0.01) in patients with AMI and CS who underwent VA-ECMO. These results were also consistent in the 290 pairs of propensity score-matched population (55.6% vs. 46.1%, HR 0.71; 95% CI 0.51–0.98, p=0.04). Conclusion Among AMI patients with multi-vessel disease complicated by advanced CS, immediate multi-vessel PCI might be associated with improved clinical outcomes in those undergoing VA-ECMO.

Funding Acknowledgements Type of funding sources: None. Introduction Despite the introduction of mechanical circulatory support (MCS), short-term mortality rates in cardiogenic shock (CS) remain high. Prior CS risk scores have limited reliability because of selected derivation cohorts or inadequate validation. Purpose The aim of this study is to develop and validate externally the risk prediction model for in-hospital mortality in CS patients using machine learning (ML) algorithms. Methods 1247 patients of all-cause CS from the RESCUE registry (Retrospective and Prospective Observational Study to Investigate Clinical Outcomes and Efficacy of Left Ventricular Assist Device for Korean Patients with CS) between January 2014 and December 2018 were analyzed. Patients were randomly divided into two groups for training and testing at a ratio of 7 to 3. Risk prediction models were estimated with the logistic regression analysis and four ML algorithms: Least absolute shrinkage and selection operator analysis (LASSO), Support vector machine (SVM), Extreme Gradient Boosting (XGB), and Random Forest classifier. Internal validation with the RESCUE registry and external validation with the single center CS registry including 678 patients were performed. Results All four ML models made an agreement with the seven important variables associated with mortality as follows; age, vasoactive inotropic score, left ventricular ejection fraction, lactic acid, cardiac arrest at presentation, requiring continuous renal replacement therapy, and mechanical ventilator. The logistic regression analysis was performed with the risk factors which were derived by ML models. The logistic regression model named RESCUE score showed the predictive performance with an area under the curve (AUC) of 0.86 [95% CI 0.83-0.88] for in-hospital mortality. External validation showed excellent discrimination with an AUC of 0.80 [95% CI 0.76-0.84]. Decision curve analysis indicated that the nomogram conferred high clinical net benefit. Conclusion The RESCUE score using advanced machine learning techniques has excellent predictive performance for the in-hospital mortality of CS regardless of the underlying cause. This model may be useful as a tool to estimate the risk stratification of CS patients.

A high-speed infrared small-angle infrared thermography system (SATS) has been developed and installed on the Experimental Advanced Superconducting Tokamak (EAST) for measuring the surface temperature of the divertor target to calculate the high heat flux induced by Edge Localized Modes (ELMs) and providing observation means for the further physical study of some key parameters, such as power decay length λq and the characteristic time of different types of ELMs. An endoscopic optical system is applied to realize the SATS for clear imaging of the divertor plate area and protection from the harm of impurity deposition and latent tungsten ablation during discharge. The field of view (FOV) of the endoscopic optical system is designed to be 13° in the horizontal direction and 9° in the vertical direction. As a consequence, ∼35° of coverage of the lower-outer divertor and a small part of the lower-inner divertor in toroidal are covered by the FOV with a spatial resolution of around 2 mm/pixel. This paper presents a detailed description of the new SATS and the preliminary experimental diagnostic results. The radial distribution of heat flux induced by an ELM crash was demonstrated.

Background In a few studies, obesity was associated with better outcomes in patients with cardiogenic shock (CS). Although this phenomenon, the “obesity paradox”, reportedly manifests differently based on sex in other disease entities, it has not yet been investigated in CS patients. Methods and results 1,227 patients with CS from The REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock (RESCUE) registry in Korea were analyzed. The study population was classified into obese and non-obese groups according to Asian-Pacific criteria (BMI >25.0 kg/m2 for obese). Clinical impact of obesity on in-hospital mortality according to sex was analyzed using logistic regression analysis and restricted cubic spline curves. In-hospital mortality rate was significantly lower in obese men than non-obese men (34.2% vs. 24.1%, p=0.004) while the difference was not significant in women (37.3% vs. 35.8%, p=0.884). As a continuous variable, higher BMI showed a protective effect in men conversely, BMI was not associated with clinical outcomes in women. Comparing to normal-weight patients, obesity was associated with a decreased risk of in-hospital death in men (multivariable-adjusted OR 0.63, CI 0.43–0.92, p=0.016), not in women (multivariable-adjusted OR 0.94, 95% CI 0.55–1.61, p=0.828). Interaction P value for the association between BMI and sex was 0.023. Conclusions Obesity paradox exists and apparently occurs in men among CS patients. The differential effect of BMI on in-hospital mortality was observed according to sex. Funding Acknowledgement Type of funding sources: None.

Background p.Arg4810Lys variant of the ring finger protein 213 (RNF213) vasculopathy is a nonsyndromatic vasculopathy involving multisystemic organs including pulmonary arteries. Peripheral pulmonary arterial stenosis (PPAS) with diffuse stenosis and beaded appearance is a unique feature of this disease and no treatment option has been tried before. Methods We performed BPA for PPAS in RNF213 patients (n=7). Severity of pulmonary hypertension was assessed by echocardiography and right heart catheterization at the baseline. Several clinical and hemodynamic parameters were followed up after each BPA sessions. Results All of the patients had dyspnea on exertion. Right ventricular dysfunction was observed in six patients and NT-proBNP was elevated (949.2±1148.1 pg/mL). Baseline echocardiography showed severe pulmonary hypertension (70.1±19.2 mmHg). Pulmonary arterial ballooning was performed to all patients, but stenting (n=6) and cutting balloon (n=1) was necessary due to elastic recoil. Improvement of clinical and hemodynamic parameters was achieved in six patients after 5.3 sessions of BPA in average. Reperfusion edema was seen in four patients, eventually leading to death in one patient. Conclusions Pulmonary arterial angioplasty, when coupled with stenting, is an effective treatment for PPAS with RNF213 vasculopathy. Although reperfusion injury was common and fatal in a few cases, it is the only modality to improve the patient's symptom and hemodynamics till now. Careful selection of the target population should be preceded to perform the intervention. Funding Acknowledgement Type of funding sources: None.

Background Even though the presence of hyperglycemia has shown to affect the clinical outcome of cardiogenic shock patients, the extent of hyperglycemia and its association with prognosis have not been fully addressed in large population Purpose Investigate the clinical relationship between hyperglycemic status and in-hospital mortality in cardiogenic shock patients Method A total of 1,177 consecutive cardiogenic shock patients were enrolled from January 2014 to December of 2018 at 12 hospitals in South Korea. The primary outcome was in-hospital mortality. Patients were divided into four groups according to their initial plasma glucose level in each of diabetes patients (n=752) and non-diabetes patients (n=425); group 1 (≤8 mmol/L), group 2 (8–12 mmol/L), group 3 (12–16 mmol/L) and group 4 (≥16 mmol/L). Results The groups with higher admission plasma glucose were associated with lower systolic blood pressure and higher lactic acid level in both diabetic and non-diabetic patients. In-hospital mortality increased in groups with higher admission plasma glucose level in non-diabetic patients (group-1:24.2%, group-2: 28.6%, group-3: 38.1%, group-4: 49.0%, p Conclusion In cardiogenic shock patients, plasma glucose obtained at admission was associated with in-hospital mortality in non-diabetic patients Funding Acknowledgement Type of funding sources: Private hospital(s). Main funding source(s): Inha University hospital

Background Chronic thromboembolic pulmonary disease (CTEPD) without pulmonary hypertension could cause significant exercise limitations. However, interventional or surgical treatments for CTEPD with mild pulmonary hypertension or normal pressure are on controversy. Purpose We aimed to evaluate cardiopulmonary function through cardiopulmonary exercise test (CPET) with stress echocardiography and to determine whether exercise pulmonary hypertension can explain exercise limitations in CTEPD patients with mPAP Methods Patients diagnosed as CTEPD with mPAP less than 30mmHg was derived from our pulmonary hypertension center registry from April 2014 to October 2021.Transthoracic echocardiography (TTE) was performed at baseline (resting state) and immediately after CPET. TTE derived parameters and CPET parameters were compared with hemodynamic parameters measured by right catheterization. Results Total 37 patients were enrolled. Of these, Thirty-five patients had previously been diagnosed with CTEPH and had undergone PEA, BPA, or both. Most of the patients complained dyspnea of WHO functional class II or III. Pulmonary vascular resistance (PVR) was slightly higher than normal (185.0±102.2 dyne sec cm–5). Also VO2max was decreased in CPET (23.1±6.5 mL/kg/min). In correlation analysis, the higher the mPAP and PVR at rest, the lower VO2max during exercise. Meanwhile basal right ventricular (RV) function was normal, an increase in RVSP was notably observed during exercise (RVSP: pre-exercise 36.2±11.9, post-exercise 60.7±19.3, p value Conclusions CTEPD patients with mild or normal PAP showed limited exercise capacity with exercise induced hypertension. Even in the mPAP less than 30mmHg, PVR and mPAP was significantly associated with exercise capacity. CPET with stress echocardiography could help to identify the main cause of exercise limitation in CTEPD patients and possibly provide the guideline for treatment plan. Funding Acknowledgement Type of funding sources: None.

To screen differentially expressed genes (DEGs) associated with chronic schistosomiasis japonica-induced hepatic fibrosis and analyze their functions.The dataset of gene expression profiles of patients with chronic schistosomiasis japonica-induced hepatic fibrosis was downloaded from the Gene Expression Omnibus (GEO) database, and DEGs were screened using R package. The biological functions of DEGs were characterized using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. In addition, the protein-protein interaction (PPI) network of DEGs was created to screen the hub genes.A total of 62 DEGs were identified, including 12 down-regulated genes and 50 up-regulated genes. GO enrichment analysis showed that DEGs were mainly enriched in 116 biological processes, including fatty acid, sulfur compound, acyl-coenzyme A and thioester metabolism; 19 cellular components, including mitochondrial matrix, outer mitochondrial membrane and organelle outer membrane; and 7 molecular functions, including insulin-like growth factor binding and oxidoreductase activity. KEGG pathway enrichment analysis that the DEGs were significantly enriched in phosphatidylinositol-3-kinase/serine/threonine protein kinase (PI3K/Akt), mitogen-activated protein kinase (MAPK), calcium metabolism and cyclic adenosine monophosphate (cAMP) signaling. PPI network analysis identified six hub genes involved in the development of chronic schistosomiasis japonica-induced hepatic fibrosis, including

Preliminary evidence has demonstrated a link between anxiety and memory impairment in Parkinson’s disease (PD). This study further investigated this association using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for anxiety disorders and a standardized cognitive test battery. A convenience sample of 89 PD patients without dementia was recruited from neurology outpatient clinics. A cross-sectional design was applied. Participants completed two semi-structured interviews. The first interview diagnosed DSM-5 anxiety disorders, unspecified anxiety disorder, and no anxiety. The second interview applied a neurocognitive test battery comprising two tests for each domain. Logistic regression models compared cognitive characteristics associated with anxiety disorders to no anxiety. Clinically significant anxiety was associated with immediate verbal memory impairment compared to the no anxiety group (OR, 95% CI 0.52, 0.30–0.89; p = 0.018), controlling for sex and age. The anxiety disorders group demonstrated immediate (OR, 95% CI 0.46, 0.26–0.83; p = 0.010) and delayed (OR, 95% CI 0.63, 0.40–0.99; p = 0.047) verbal memory impairments compared to those without anxiety, controlling for sex and age. This association remained for immediate (OR, 95% CI 0.43, 0.22–0.84; p = 0.013), but not delayed verbal memory impairment (OR, 95% CI 0.65, 0.39–1.06; p = 0.081) when additionally controlling for disease severity, education and levodopa dose. These findings present first evidence that anxiety disorders are associated with verbal memory impairment in PD and have implications for the management and treatment of anxiety in PD.

High-quality gallium nitride etching is highly desirable in electronic device fabrications. For the GaN base devices, the electronic properties largely depended on the etching induced surface damages. To overcome this, a controllable GaN etching method was developed using inductively coupled plasma reactive ion etching (ICP-RIE) by controlling radio frequency (RF) power, and DC bias. The etching rate, DC bias, and root-mean-square surface roughness were measured as a function of bias power under different RF, 40 and 13.56 MHz. The effects of ICP power and chlorine to argon percentage were systematically studied. An extremely slow etching rate and low-damage surface were achieved by reducing DC bias power to 25 W under RF 40 MHz. Ni|Au Schottky diodes were fabricated and characterized. The diode fabricated on the 40-MHz RF etching GaN surface has a much lower ideality factor and higher barrier height than non-etched GaN and RF 13.56 MHz etching GaN.

It is of great significance in the design and evaluation of anti-impact protective structures to investigate the dynamic mechanical properties of lightweight concrete structures. The present work aims to address this challenging task by the development of an improved large-diameter split Hopkinson pressure bar that can accurately predict the dynamic compressive strength and impact failure characteristics of lightweight concrete under different stress states. Our findings exposed that the impact resistance of lightweight concrete is substantially improved and the failure modes of it have altered under the 3D coupled static–dynamic loads. When the confining pressure remains at the same level and the loading strain rate is low, the unloading curve of lightweight concrete shows a significant hysteresis phenomenon. We have further found that for a higher strain rate the stress–strain curve can be divided into five stages: (i) the inertial-effect-enhanced stage, (ii) the nonlinear elastic deformation stage, (iii) the elastoplastic deformation stage, (iv) the strain-softening stage, and (v) the plastic flow stage. Based on the linear relationships among the logarithm of the strain rate, the dynamic increase factor (DIF), and the confining pressure conditions, we have constructed a two-factor equation for the DIF of lightweight concrete that depends on the confining pressure and the strain rate.

The concept of Mild Cognitive Impairment (MCI) in Parkinson’s disease (PD) has shown the potential for identifying at-risk dementia patients. Identifying subtypes of MCI is likely to assist therapeutic discoveries and better clinical management of patients with PD (PWP). Recent cluster-based approaches have demonstrated dominance in memory and executive impairment in PD. The present study will further explore the role of memory and executive impairment and associated clinical features in non-demented PWP. A K-means cluster analysis was performed on ten “frontal” and “posterior” cognitive variables derived from a dataset of 85 non-demented PWP. The resulting cluster structure was chosen based on quantitative, qualitative, theoretical, and clinical validity. Cluster profiles were then created through statistical analysis of cognitive and clinical/demographic variables. A descriptive analysis of each cluster’s performance on a comprehensive PD-MCI diagnostic battery was also explored. The resulting cluster structure revealed four distinct cognitive phenotypes: (1) frontal-dominant impairment; (2) posterior-cortical-dominant impairment; (3) global impairment, and (4) cognitively intact. Demographic profiling revealed significant differences in the age, gender split, global cognitive ability, and motor symptoms between these clusters. However, there were no significant differences between the clusters on measures of depression, apathy, and anxiety. These results validate the existence of distinct cognitive phenotypes within PD-MCI and encourage future research into their clinical trajectory and neuroimaging correlates.

Although studies have identified risk factors for adolescent handgun carrying, previous research on risk factors for carrying a handgun to school specifically is sparse. This study examines self-re...

A conversational chatbot or dialogue system is a computer program designed to simulate conversation with human users, especially over the Internet. These chatbots can be integrated into messaging apps, mobile apps, or websites, and are designed to engage in natural language conversations with users. There are also many applications in which chatbots are used for educational support to improve students’ performance during the learning cycle. The recent success of ChatGPT also encourages researchers to explore more possibilities in the field of chatbot applications. One of the main benefits of conversational chatbots is their ability to provide an instant and automated response, which can be leveraged in many application areas. Chatbots can handle a wide range of inquiries and tasks, such as answering frequently asked questions, booking appointments, or making recommendations. Modern conversational chatbots use artificial intelligence (AI) techniques, such as natural language processing (NLP) and artificial neural networks, to understand and respond to users’ input. In this study, we will explore the objectives of why chatbot systems were built and what key methodologies and datasets were leveraged to build a chatbot. Finally, the achievement of the objectives will be discussed, as well as the associated challenges and future chatbot development trends.

Gastric varices are one of the serious complications of liver cirrhotic portal hypertension. Balloon-occluded retrograde transvenous obliteration (BRTO), as an interventional treatment method, can effectively prevent and control gastroesophagel variceal bleeding. Simultaneously, it has an obvious effect in the treatment of hepatic encephalopathy and liver function improvement. This article reviews the clinical application and research progress of BRTO at home and abroad in recent years, with a view to provide reference for clinical treatment.胃静脉曲张是肝硬化门脉高压症的严重并发症之一,球囊阻断逆行经静脉闭塞术（BRTO）作为一种介入治疗手段，能有效预防和控制胃静脉曲张出血，同时在治疗肝性脑病和改善肝功能上有明显的效果。就近年来国内外对BRTO的临床应用、研究进展作一综述，期望为临床治疗提供参考。.

Background Hidradenitis suppurativa (HS) is a devastating chronic inflammatory skin disease with frequent recurrences. Various systemic treatments and procedures have been used but the efficacy of fractional microneedling radiofrequency (FMR) has not been reported. Aim To evaluate the clinical and histological efficacy of FMR in the treatment of HS lesions. Methods An 8-week, prospective, split-body, unblinded study was conducted, which enrolled 10 adult patients with mild to moderate HS to receive 3 sessions of FMR treatment biweekly. HS severity was assessed using the number and type of lesions, HS Physician Global Assessment (HS-PGA) and the modified Sartorius score (mSS). Skin biopsies were performed on participants to assess change in inflammation before and after FMR. Results Severity of HS was significantly reduced on the FMR-treated side of the body, but not on the control side. Inflammatory HS lesions were significantly reduced after 4 weeks, while HS-PGA and mSS were significantly decreased after 6 weeks. Immunohistochemistry staining showed decreased expression of inflammatory markers including neutrophil elastases, interleukin (IL)-8 and IL-17, tumour necrosis factor-α, transforming growth factor-β1 and matrix metalloproteinases. Conclusion FMR may be a viable treatment option for mild to moderate HS.

心脏建模仿真技术基于心肌纤维化、心脏电学重构、心脏自主神经系统等恶性心律失常机制，可以预测心脏性猝死的风险。本文报道1例置入了心律转复除颤器（ICD）的扩张型心肌病患者，针对该例患者的心脏核磁心肌纤维化信息进行了计算机心脏建模仿真，并诱发出与心肌纤维化相关的室性心动过速，验证了计算机心脏建模仿真技术应用于指导心肌病患者置入ICD的可行性。.

We projected incident surface solar radiation (SSR) over China in the middle (2040–2059) and end (2080–2099) of the 21st century in the Representative Concentration Pathway (RCP) 8.5 scenario using a multi-model ensemble derived from the weighted average of seven global climate models (GCMs). The multi-model ensemble captured the contemporary (1979–2005) spatial and temporal characteristics of SSR and reproduced the long-term temporal evolution of the mean annual SSR in China. However, it tended to overestimate values compared to observations due to the absence of aerosol effects in the simulations. The future changes in SSR showed increases over eastern and southern China, and decreases over the Tibetan Plateau (TP) and northwest China relative to the present day. At the end of the 21st century, there were SSR increases of 9–21 W m−2 over northwest, central, and south China, and decreases of 18–30 W m−2 over the TP in June–July–August (JJA). In northeast China, SSR showed seasonal variation with increases in JJA and decreases in December–January–February. The time series of annual SSR had a decreased linear trend for the TP, and a slightly increased trend for China during 2006–2099. The results of our study suggest that solar energy resources will likely decrease in the TP under future climate change scenarios.

Although previous research has established a link between early interpersonal callousness (IC) from childhood to adolescence and later antisocial behavior and psychopathic features, the majority of these studies assess more proximal outcomes (e.g., assessed in adolescence). Thus, it is unclear whether youth with early-onset chronic levels of IC will continue to have negative outcomes into adulthood (i.e., roughly 14 years after IC was assessed). The current study used data from the youngest cohort (N = 503) of the Pittsburgh Youth Study to examine how latent classes of youth with different developmental patterns of IC across a 7-year period (∼ages 8 to 15) differed in their official records of juvenile (∼ages 16-17) and young adult (∼ages 18-31) offending, as well as self-reported psychopathic features and aggression in young adulthood (∼age 29). Results indicated that after adjusting for race, early offending, and externalizing behaviors in adolescence, youth with an early-onset chronic pattern of IC had substantially elevated risk for a serious and persistent pattern of offending, particularly violent offending. However, once these covariates were included, IC class no longer significantly predicted psychopathic features in adulthood. Thus, it is possible that the stability from early patterns of IC to adult psychopathic features may have previously been overstated. Future work could examine whether interventions to reduce IC in childhood and adolescence could successfully result in improved outcomes into adulthood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The present review asks whether magnetic resonance imaging (MRI) studies are able to define neural correlates of episodic memory within the hippocampus in Parkinson's disease (PD). Systematic searches were performed in PubMed, Web of Science, Medline, CINAHL, and EMBASE using search terms related to structural and functional MRI (fMRI), the hippocampus, episodic memory, and PD. Risk of bias was assessed for each study using the Newtown-Ottawa Scale. Thirty-nine studies met inclusion criteria; eight fMRI, seven diffusion MRI (dMRI), and 24 structural MRI (14 exploring whole hippocampus and 10 exploring hippocampal subfields). Critical analysis of the literature revealed mixed evidence from functional and dMRI, but stronger evidence from sMRI of the hippocampus as a biomarker for episodic memory impairment in PD. Hippocampal subfield studies most often implicated CA1, CA3/4, and subiculum volume in episodic memory and cognitive decline in PD. Despite differences in imaging methodology, study design, and sample characteristics, MRI studies have helped elucidate an important neural correlate of episodic memory impairment in PD with both clinical and theoretical implications. Natural progression of this work encourages future research on hippocampal subfield function as a potential biomarker of, or therapeutic target for, episodic memory dysfunction in PD.

A huge amount of data is available almost every second nowadays due to fast development of technology. This provides a perfect opportunity to improve mathematical modeling using measured data for understanding and predicting behaviors of dynamic systems, but at the same time it also poses a challenge on how to effectively and efficiently extract information from a large amount of data, because it means that a large computational power is required. This paper addresses the problem of identifying mathematical models of large-scale complex dynamic systems in civil engineering based on measured data. This problem is especially challenging in practice because identifying a mathematical model in high-dimensional parameter space is time-consuming (sometimes the model is unidentifiable), and the information contained in data is always incomplete and there are uncertainties. The identification problem is formulated as a Bayesian learning problem where the plausible models and the associated uncertainties are learned by identifying the posterior PDF of the model of a dynamic system. Bayesian model class selection is also discussed, i.e., how to select an appropriate model class that is not too simple and not too complicated based on the same set of data. Because conventional methods are not applicable in the current case, an efficient Markov chain Monte Carlo method is proposed to sample from the posterior PDF in a complex high-dimensional parameter space. The proposed Bayesian method is applied on a full-scale building.

We discuss the new challenges and directions facing the use of big data and artificial intelligence (AI) in education research, policy-making, and industry. In recent years, applications of big data and AI in education have made significant headways. This highlights a novel trend in leading-edge educational research. The convenience and embeddedness of data collection within educational technologies, paired with computational techniques have made the analyses of big data a reality. We are moving beyond proof-of-concept demonstrations and applications of techniques, and are beginning to see substantial adoption in many areas of education. The key research trends in the domains of big data and AI are associated with assessment, individualized learning, and precision education. Model-driven data analytics approaches will grow quickly to guide the development, interpretation, and validation of the algorithms. However, conclusions from educational analytics should, of course, be applied with caution. At the education policy level, the government should be devoted to supporting lifelong learning, offering teacher education programs, and protecting personal data. With regard to the education industry, reciprocal and mutually beneficial relationships should be developed in order to enhance academia-industry collaboration. Furthermore, it is important to make sure that technologies are guided by relevant theoretical frameworks and are empirically tested. Lastly, in this paper we advocate an in-depth dialog between supporters of “cold” technology and “warm” humanity so that it can lead to greater understanding among teachers and students about how technology, and specifically, the big data explosion and AI revolution can bring new opportunities (and challenges) that can be best leveraged for pedagogical practices and learning.

Artificial liver support system is an important method of treating liver failure, but after artificial liver treatment, secondary infections are usually amalgamated. Additionally, infection is a risk factor that aggravates liver failure, leading to an increased mortality and poor prognosis. Therefore, how to prevent and treat occurrence of infection in patients with liver failure is a key factor to improve the efficacy of artificial liver treatment.人工肝支持系统是肝衰竭治疗的重要手段，但人工肝治疗后常合并继发性感染。而感染是肝衰竭患者病情加重的危险因素，导致患者病死率增加，预后不佳。如何防治肝衰竭人工肝治疗患者发生感染，是提高人工肝治疗效果的关键因素。.

To examine the effect of schistosomiasis on the development of gastric cancer and colorectal cancer.The clinical data of patients with gastric cancer and colorectal cancer with and without schistosomiasis japonica that were admitted to the Yijishan Hospital Affiliated to Wannan Medical College from January 2014 to December 2018 were collected. All cases were divided into schistosomal gastric cancer group and non - schistosomal gastric cancer group, schistosomal colorectal cancer group and non-schistosomal colorectal cancer group. The risk factors of gastric cancer and colorectal cancer were identified using univariate analysis and multivariate logistic regression analysis, and the effects of schistosomiasis on the development and progression of gastric cancer and colorectal cancer were evaluated. In addition, the survival of 32 patients with schistosomal colorectal cancer and 68 cases with non-schistosomal colorectal were estimated using telephone follow-up, and compared.There were 113 patients with schistosomal gastric cancer and 3 741 cases with non-schistosomal gastric cancer enrolled in this study, and there were significant differences between them in terms of sex ratio, age and prevalence ofSchistosomiasis may alter the pathogenesis of colorectal cancer, resulting in the differences in the epidemiology, clinical characteristics and 5-year survival rate between patients with schistosomal and non-schistosomal colorectal cancer. Periodical gastrointestinal endoscopy and other examinations are recommended to exclude the likelihood of gastrointestinal cancers in men with anemia of unknown causes and at ages of 60 years living in schistosomiasis-endemic areas.

This study was aimed to observe the significance of the left atrium (LA) functional index combined with B-type natriuretic peptide (BNP) level in predicting recurrence in patients with paroxysmal atrial fibrillation (PAF) after circumferential pulmonary vein ablation (CPVA). Real-time three-dimensional echocardiography (RT-3DE) was used to observe the structural and functional changes of LA in patients with PAF after CPVA. BNP is a hemodynamic indicator of myocardial stretching increase in atrial fibrillation (AF) patients.243 patients with PAF who intended to undergo CPVA were selected in the study, and the following clinical data of the patients were collected. Firstly, the blood BNP levels measured before CPVA. Secondly, the measurements of routine echocardiography before CPVA. RT-3DE was used to obtain the time-volume curve of LA. Then, multivariate logistic regression analysis was used to analyze the factors affecting PAF recurrence after CPVA. Finally, we obtained the receiver operating characteristic (ROC) curve of PAF recurrence predicted by the independent risk factors.A total of 233 AF patients with an average age of 63.1 ± 9.3 years (range, 39-75 years; male: female =195: 38) underwent CPVA. 42 patients had AF recurrence (18.0%) during 3-6months follow-up after an operation blanking period of 3 months, BNP in the Recurrence Group was higher than that in Sinus Rhythm Group (p≤0.001). The preoperative left minimum volume index (LAVImin), left atrial volume index before contraction (LAVIpre-a) were higher in Recurrence Group than in Sinus Rhythm Group (p≤0.001). Expansion index, Diastolic emptying index (DEI), Passive emptying index (PEI), Active emptying index (AEI) were lower in the Recurrence Group than in the Sinus Rhythm Group (p≤0.001). Logistic regression analyses showed that BNP and DEI were independent predictors for PAF recurrence (OR=1.004, 95% CI: 1.01-1.07, p=0.001; OR=0.655, 95% CI: 0.57-0.75, p=0.001). The AUC of BNP, DEI and combined index for recurrence of CPVA were higher than LAVImax (p range: 0.001-0.013).In patients with PAF treated with CPVA, the impaired DEI of LA reservoir function and increased BNP may be useful predictors of PAF recurrence.

The mortality risk showed a positive correlation as the number of subsequent fractures increased. Hip fracture showed the greatest association with mortality risk, followed by vertebral fracture. For the combination of hip and vertebral fracture, a hip fracture after a vertebral fracture showed the highest mortality risk.It is unclear whether subsequent fractures or a certain location and sequence of subsequent fractures are associated with mortality risk in the elderly. We aimed to investigate the relationship between subsequent fractures and mortality risk.Using the Korean National Health Insurance Research Database, we analyzed the cohort data of 24,756 patients aged 60 years who sustained fractures between 2002 and 2013. Cox regression was used to assess the mortality risk associated with the number, locations, and sequences of subsequent fractures.Mortality hazard ratios (HRs) for women and men were shown to be associated with the number of subsequent fractures (one, 1.63 (95% confidence interval [CI], 1.48-1.80) and 1.42 (95% CI, 1.28-1.58); two, 1.75 (95% CI, 1.47-2.08) and 2.03 (95% CI, 1.69-2.43); three or more, 2.46(95% CI, 1.92-3.15) and 1.92 (95% CI, 1.34-2.74), respectively). For women, the mortality risk was high when hip (HR, 2.49; 95% CI, 1.80-3.44) or vertebral (HR, 1.40; 95% CI, 1.03-1.90) fracture occurred as a second fracture. Compared with a single hip fracture, there was a high mortality risk in the group with hip fracture after the first vertebral fracture (HR, 2.90; 95% CI, 1.86-4.54), followed by vertebral fracture after the first hip fracture (HR, 1.90; 95% CI, 1.12-3.22).The mortality risk showed a positive correlation as the number of subsequent fractures increased. Hip fracture showed the greatest association with mortality risk, followed by vertebral fracture. For the combination of hip and vertebral fracture, a hip fracture after a vertebral fracture showed the highest mortality risk.

Blazars show extreme observational properties that are due to the beaming effect with the jet being close to the line of sight. It was found that the observed luminosity is anticorrelated with the synchrotron peak frequency but the debeamed luminosity and the frequency is positively correlated. In this work, we revisit this correlation for a large sample of 255 blazars from the fourth Fermi catalog with available Doppler factors. Our analysis comes to the following conclusions. (1) The observed radio, X-ray, γ-ray, and synchrotron peak luminosity are all anticorrelated with the peak frequency, but the debeamed luminosity is positively correlated with the debeamed peak frequency. The anticorrelation is due to a selection effect or a beaming effect. (2) The Compton dominance parameter is correlated with both the bolometric luminosity and Doppler factor, implying that the more highly Compton-dominated sources are more luminous. (3) The bolometric luminosity can be represented by the γ-ray luminosity for Fermi blazars.

A new method for measuring the position and displacement of the last closed flux surface (LCFS) with visible imaging diagnostics has been developed in EAST. By measuring the relative intensity profiles of the green visible Li-II emission in the tangential planes of the optical systems, it is possible to infer the positions of certain points on the LCFS. This emission line is readily available in discharges with Li-coating wall routinely employed to improve the plasma performance. We describe the measuring method, giving results which are compared with those obtained by EFIT, and showing this as an effective and convenient approach to determine the position of the LCFS. This method is further applied to measure the displacements of the LCFS during application of resonant magnetic perturbation fields in the EAST tokamak.

Considering the large heat capacity of the surrounding soil, the influence of cable load on the transient temperature rise of the soil can be neglected within short periods of time. A simplified transient thermal circuit model based on the monitoring ambient temperature in the trench is proposed. The thermal resistance and thermal capacity of the model are calculated by using the empirical formula. Considering the strong thermal interaction between multiple loops of the cables, the external thermal resistance is modified by the load and air temperature. By comparing the result of the calculation of the model with that of the finite element method, the accuracy of the thermal circuit model is verified. Based on the method of the transient thermal circuit model, the maximum permissible current-carrying can be predicted.

Background Multidisciplinary team approach is necessary for the management of critically-ill patients. However, limited data are available on the impact of specialized extracorporeal membrane oxygenation (ECMO) team on clinical outcomes in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. Objectives This study aimed to identify whether specialized ECMO team is associated with improved in-hospital mortality in AMI patients underwent venoarterial ECMO. Methods A total of 255 AMI patients underwent venoarterial ECMO from May 2004 to July 2018 were enrolled. In January 2014, multidisciplinary ECMO team was founded at our institution. Eligible patients were classified into pre-ECMO team group (n=131) and post-ECMO team group (n=124). The primary outcome was in-hospital mortality. Results In-hospital mortality (54.2% vs. 33.9%, p=0.002) and cardiac intensive care unit mortality (45.0% vs. 25.0%, p=0.001) were significantly lower after the implantation of multidisciplinary ECMO team (pre ECMO team vs. post-ECMO team). On binary logistic regression model, the multidisciplinary ECMO team approach was associated with lower risk of in-hospital mortality (odds ratio 0.36, 95% confidence interval 0.19–0.67, p=0.001). Incidence of all-cause mortality (58.3% vs. 35.2%, p Clinical outcomes Variables Total (N=255) Pre-ECMO team (N=131) Post-ECMO team (N=124) P value In-hospital mortality 113 (44.3) 71 (54.2) 42 (33.9) 0.002 Cardiovascular death 90 (35.3) 59 (45.0) 31 (25.0) 0.001 Noncardiovascular death 23 (9.0) 12 (9.2) 11 (8.9) >0.99 Cardiac intensive care unit mortality 106 (41.6) 68 (51.9) 38 (30.6) 0.001 Successful weaning of ECMO 169 (66.3) 75 (57.3) 94 (75.8) 0.002 Data are presented as n (%). Abbreviations: ECMO, extracorporeal membrane oxygenation. Incidence of death, readmission for HF Conclusions The multidisciplinary ECMO team approach was associated with improved clinical outcomes in AMI patients complicated by cardiogenic shock. Our data support that specialized ECMO team is indispensable to improve outcomes in patients with AMI with refractory cardiogenic shock.

Aims Transfusion long after percutaneous coronary intervention (PCI) may pose a significant risk but is not sufficiently understood. We investigated the long-term patterns and impact of transfusion on the clinical outcome of patients undergoing PCI. Methods and results Five-year clinical outcomes of all Korean undergoing PCI using stent in year 2011 (n=48786) were investigated. Primary outcome was the incidence density of transfusion. The association of transfusion with major adverse clinical event (MACE) consisting all-cause death, revascularization, critically ill cardiovascular status, or stroke was assessed after reflecting the propensity of each patient for transfusion and adjusting transfusion frequency and intervals. The 5-year incidence density of transfusion was 4.74 (95% confidence interval [CI] = 4.70–4.79) per 100 person-year. Patients who received transfusion were older, were more often women, and had overall higher frequency of clinical risk factors (p Year of transfusion and outcome Conclusions One out of every 4 Koreans undergoing PCI received transfusion within 5 years, and had 3-fold higher risk of MACE compared to patients without transfusion. These observational findings may warrant the establishment of transfusion strategies for patients undergoing PCI.

Long non-coding ribonucleic acids (lncRNAs) play a vital role in bone development, but the function of lncRNA taurine up-regulated gene 1 (TUG1) in osteoblast proliferation and differentiation is still unknown.The expression of TUG1 and the messenger RNA (mRNA) expressions of the Wnt/β-catenin signaling pathway markers [Runt-related transcription factor 2 (Runx2), Frizzled-2, axis inhibition protein 2 (Axin 2) and β-catenin] at 0 d, 1 d, 7 d and 14 d after in vitro culture of osteoblasts were detected, respectively, by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). The effects of TUG1 on the Wnt/β-catenin signaling pathway markers and osteoblast proliferation and differentiation were studied through the silencing of TUG1 by short hairpin TUG1 (shTUG1). Furthermore, the effects of the Wnt/β-catenin signal on osteoblast proliferation and differentiation was verified by Wnt/β-catenin signal inhibitors.With the continuous differentiation of osteoblasts, the level of TUG1 was significantly increased. The mRNA levels of the Wnt/β-catenin signaling pathway markers (Runx2, Frizzled-2, Axin 2 and β-catenin) also showed the same increasing trend. ShTUG1 notably reduced the activity of alkaline phosphatases (ALPs), the levels of osteocalcin and osteopontin and osteoblast proliferation activity. In addition, the silencing of TUG1 by shTUG1 resulted in significant reductions in the proteins of the Wnt/β-catenin signaling pathway markers (Runx2, Frizzled-2, Axin 2 and β-catenin), and Wnt/β-catenin inhibitors markedly reduced osteoblast proliferation and differentiation activity.LncRNA TUG1 inhibition can suppress the Wnt/β-catenin signaling pathway and reduce osteoblast proliferation and differentiation.

OBJECTIVES: To examine the association between parental disengagement in childhood and adolescent gun carrying and determine whether this association is accounted for by externalizing problems and affiliation with delinquent peers during early adolescence. METHODS: The sample included 503 boys (55.7% African American, 40.6% white, 3.7% other) recruited from first-grade classrooms in Pittsburgh public schools. Multi-informant assessments were conducted regularly (semiannually then annually) from approximately ages 7.5 to 20 years. Latent factors were constructed by using parent-reported parental disengagement (ie, poor parental involvement, poor parent-son communication, poor parent-son relationship quality) collected from ages 7.5 to 10 years, youth-reported peer delinquency from ages 10.5 to 13 years, and teacher-reported externalizing problems from ages 10.5 to 13 years. The outcome was youth-reported gun carrying from ages 14 to 20 years. RESULTS: Twenty percent of individuals sampled reported carrying a gun during adolescence. Childhood parental disengagement was significantly associated with adolescent gun carrying (β = .22; 95% confidence interval: 0.08 to 0.36). Furthermore, the association between parental disengagement and gun carrying was partially mediated through peer delinquency and externalizing problems during early adolescence. The 2 indirect paths accounted for ∼29% of the total effect of parental disengagement. CONCLUSIONS: Boys exposed to poorer parental engagement during childhood are more likely to affiliate with delinquent peers and exhibit externalizing problems during early adolescence, which (in turn) increases their risk of carrying a firearm in later adolescence. This suggests that gun violence prevention efforts with children should work to enhance aspects of parental engagement.

Alternaria rot, caused by Alternaria alternata, was observed in commercial peach orchards in South Carolina. Single-spore isolates formed two phenotypically different culture morphologies on two artificial media. Isolates highly resistant (HR) to boscalid were also HR to penthiopyrad. Among isolates HR and medium resistant (MR) to boscalid and penthiopyrad, we detected isolates that were MR to fluopyram and HR to fluxapyroxad. Sequence analysis of succinate dehydrogenase (sdh) genes sdhB, sdhC, and sdhD revealed that resistant phenotypes were associated with point mutations leading to amino acid substitutions. In particular, H277Y/R in the SDHB and H134R in SDHC were consistently associated with the boscalid HR phenotype. The highest effective concentration that inhibits growth by 50% (EC50) values to penthiopyrad were conferred by H134R and D123E, whereas H134R conferred low resistance and MR to fluxapyroxad. A previously undescribed mutation, G79R, was identified in our collection conferring HR to both boscalid and penthiopyrad. The point mutations associated with highest EC50 values to all four FRAC 7 fungicides were H277L and H134R. The outbreak of Alternaria rot demonstrates that fungicide programs containing “medium to high-risk fungicides” may promote disease outbreaks by secondary pathogens that typically are outcompeted or controlled effectively, while still controlling the primary target disease.