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To describe the burden and causes of disease in Mexican women in 1990 and 2019, based on the data disaggregation by age groups and states. Also, to evaluate the relationship of years of healthy life lost with the Socio-demographic Index (SDI) and with the Healthcare Access and Quality (HAQ) Index. This was an ecological descriptive study. Based on the Global Burden of Disease, Injuries, and Risk Factors Study study, the age-standardized and age-specific rates for mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) were reported. At the national level, the all-cause age-standardized rates for Mexican women decreased in mortality −28.8%; YLLs -39.8%; YLDs −1.3%; and DALYs −26.2%. For 2019, the indicators analyzed had the worst performances in Chiapas and Chihuahua, while women in Sinaloa had the lowest age-standardized rates. In 1990, it is worth noting that there was a remarkable presence of CDs, mainly in YLLs. In all age groups, diabetes mellitus was the leading cause of DALYs in Mexico's 32 states, followed by CKD (in 24 states), and ischemic heart disease (in 18 states). In both 1990 and 2019, a negative and statistically significant correlation between DALYs and the HAQ Index was evident. The correlation between DALYs and the SDI was only significant in 1990. In the last 30 years, the burden of disease on Mexican women has undergone substantial changes that reflect progress in the improvement of their health conditions. However, the current scenario is complex because the convergence of communicable diseases, non-communicable diseases, and injuries is evident, which implies important challenges that must be addressed as soon as possible. [ABSTRACT FROM AUTHOR]

Rising length of stay and inpatient boarding in emergency departments have directly affected patient satisfaction and nearly all provider-to-patient care metrics. Prior studies suggest that ED observation has significant clinical and financial benefits including decreasing hospitalization and length of stay. ED observation is one method long employed to shorten ED length of stay and to free up inpatient beds, yet many patients continue to be admitted to the hospital with an average hospital length of stay of only one day. The objectives of this study were to evaluate whether vigorous tracking and provider reviews of one day hospital admits affected the utilization of ED observation and whether this correlated with significant change in rates of admission from observation status. Between September 2020 and May 2021, in a tertiary care hospital with an annual ED volume of 55,0000, chart reviews of 24-h inpatient discharges were initiated by two senior EM faculty to determine perceived suitability for ED observation. Non-punitive email reviews were then initiated with ED attending providers in order to encourage evaluation of whether these patients would have benefitted from being placed into observation. We then analyzed ED observation patient volumes and subsequent admission rates to the hospital from ED observation and compared these numbers to baseline ED observation volume and admission rates between September 2018 and May 2019. A total of 1448 reviews were conducted on 24-h discharges which correlated with an increase in utilization of ED observation from 11.77% (95% CI [11.62, 12.31]) of total ED volume in our control period to 14.21% (95% CI [13.84, 14.58]) during the study period. We found that the overall admission rate from ED observation increased from 20.12% (95% CI [18.97, 21.26]) baseline to 23.80% (95% CI [22.60, 25.00]) during the same time periods. Our data suggest that increasing the total number of patients placed into observation by 21% correlated with a relative increase in admission rates from ED observation by 18%. This would suggest that our efforts to potentially include more patients into our observation program led to a significant increase in subsequent admission rates. There is likely a balance that must be struck between under- and over-utilization of ED observation, and expanding ED observation may be an effective solution to hospital boarding and ED overcrowding. [ABSTRACT FROM AUTHOR]

Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in 235 ICUs in 8 Asian countries: India, Malaysia, Mongolia, Nepal, Pakistan, the Philippines, Thailand, and Vietnam. From January 1, 2014, to February 12, 2022, we conducted a prospective cohort study. To estimate CAUTI incidence, the number of UC days was the denominator, and CAUTI was the numerator. To estimate CAUTI RFs, we analyzed 11 variables using multiple logistic regression. 84,920 patients hospitalized for 499,272 patient days acquired 869 CAUTIs. The pooled CAUTI rate per 1,000 UC-days was 3.08; for those using suprapubic-catheters (4.11); indwelling-catheters (2.65); trauma-ICU (10.55), neurologic-ICU (7.17), neurosurgical-ICU (5.28); in lower-middle-income countries (3.05); in upper-middle-income countries (1.71); at public-hospitals (5.98), at private-hospitals (3.09), at teaching-hospitals (2.04). The following variables were identified as CAUTI RFs: Age (adjusted odds ratio [aOR] = 1.01; 95% CI = 1.01-1.02; P <.0001); female sex (aOR = 1.39; 95% CI = 1.21-1.59; P <.0001); using suprapubic-catheter (aOR = 4.72; 95% CI = 1.69-13.21; P <.0001); length of stay before CAUTI acquisition (aOR = 1.04; 95% CI = 1.04-1.05; P <.0001); UC and device utilization-ratio (aOR = 1.07; 95% CI = 1.01-1.13; P =.02); hospitalized at trauma-ICU (aOR = 14.12; 95% CI = 4.68-42.67; P <.0001), neurologic-ICU (aOR = 14.13; 95% CI = 6.63-30.11; P <.0001), neurosurgical-ICU (aOR = 13.79; 95% CI = 6.88-27.64; P <.0001); public-facilities (aOR = 3.23; 95% CI = 2.34-4.46; P <.0001). CAUTI rate and risk are higher for older patients, women, hospitalized at trauma-ICU, neurologic-ICU, neurosurgical-ICU, and public facilities. All of them are unlikely to change. It is suggested to focus on reducing the length of stay and the Urinary catheter device utilization ratio, avoiding suprapubic catheters, and implementing evidence-based CAUTI prevention recommendations. • Identify rates and risk factors for CAUTI in ICUs of 8 Asian Countries. • A cohort study over 8 years with data on 84,920 patients from 8 Countries. • Length of stay increase the risk of CAUTI by 4% per day. • The urinary catheter and device utilization ratio increases the risk of CAUTI. • Age, female sex, suprapubic catheter, and public facilities increase CAUTI risk. [ABSTRACT FROM AUTHOR]

Mexico is among the countries with the highest estimated excess mortality rates due to the COVID–19 pandemic, with more than half of reported deaths occurring in adults younger than 65 years old. Although this behavior is presumably influenced by the young demographics and the high prevalence of metabolic diseases, the underlying mechanisms have not been determined. The age–stratified case fatality rate (CFR) was estimated in a prospective cohort with 245 hospitalized COVID–19 cases, followed through time, for the period October 2020–September 2021. Cellular and inflammatory parameters were exhaustively investigated in blood samples by laboratory test, multiparametric flow cytometry and multiplex immunoassays. The CFR was 35.51%, with 55.2% of deaths recorded in middle–aged adults. On admission, hematological cell differentiation, physiological stress and inflammation parameters, showed distinctive profiles of potential prognostic value in patients under 65 at 7 days follow–up. Pre–existing metabolic conditions were identified as risk factors of poor outcomes. Chronic kidney disease (CKD), as single comorbidity or in combination with diabetes, had the highest risk for COVID–19 fatality. Of note, fatal outcomes in middle–aged patients were marked from admission by an inflammatory landscape and emergency myeloid hematopoiesis at the expense of functional lymphoid innate cells for antiviral immunosurveillance, including NK and dendritic cell subsets. Comorbidities increased the development of imbalanced myeloid phenotype, rendering middle–aged individuals unable to effectively control SARS–CoV–2. A predictive signature of high–risk outcomes at day 7 of disease evolution as a tool for their early stratification in vulnerable populations is proposed. [Display omitted] [ABSTRACT FROM AUTHOR]

Medication errors (MEs) are a huge burden on any healthcare system and have been associated with significant morbidity and mortality. The medical literature reported heavily on MEs but lacked focus on analyzing high-risk medications such as antimicrobials. This was a retrospective analysis of the MEs database reported by the eastern region's medical centers in Saudi Arabia from January 1, 2019 to December 31, 2019. We used descriptive analysis to identify most common antimicrobials with errors, the stage of antimicrobial errors, type of the errors, contributing factors to the errors, and categories of errors based on the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification of errors. A total of 1422 (22.1%) antimicrobial errors were identified out of 6412 MEs. Amoxicillin/Clavulanate (18%) was the most common antimicrobial reported in the database. Most errors occurred in the prescribing phase (87.6%) and included mainly incorrect doses (32.1%) and duplicate therapy (20.5%). In addition, most errors were identified as category B (72.5%). Finally, inexperienced personnel (57.9%) was the most cited contributing factor. This study revealed that antimicrobial errors occur primarily during prescription and that policy gaps and inexperienced staff were contributory factors. To improve, the focus should shift to physician education, clear dosing guidelines, efficient workload management, and implementing antimicrobial stewardship programs to promote appropriate antimicrobial use. [ABSTRACT FROM AUTHOR]

As one of the malignant tumors with rising incidence, early diagnosis and accurate treatment of liver cancer play a crucial role in improving the cure rate of patients. Alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) are two important tumor markers in the diagnosis of liver cancer. Although antibody analysis methods such as immunoassay have been developed, they are still challenging considering the sensitivity and operating cost. Here, we describe a fluorescent RNA aptamer-based rolling circle transcription (FRA-RCT) test, which can ultra-sensitively and accurately detect the presence of both AFP and CEA target proteins at the same time. The dual-targets sensor integrating the aptamers of AFP and CEA can be protectively bound to the target proteins in advance, while the remaining complements are bound by the trigger chains. Through the in vitro transcription process of FRA-RCT, the amount of the targets is successfully converted to the amount of the remaining triggers and thus amplified into two fluorescent RNA aptamer products. This collection of modular components greatly improves the signal gain and specificity of the FRA-RCT technology. In addition, we have successfully distinguished the positive serum samples of liver cancer patients from the negative healthy controls, and realized the point of care testing (POCT) of different targets by using portable chips. The differential fluorescence output proved its effectiveness and practicability. Therefore, this dual-targets aptamer sensor has a promising prospect in simultaneous cancer diagnosis at low cost and high efficiency. [Display omitted] • A dual-aptamer biosensor was used for ultrasensitive and simultaneous detection of AFP and CEA. • Quantitative analysis of AFP and CEA was achieved by rolling circle transcription amplification based on fluorescent RNA aptamer. • The chip-based FRA-RCT owns advantages of portability, label-free and low-cost. • The assay can effectively meet the requirements of point-of-care diagnosis of AFP and CEA. [ABSTRACT FROM AUTHOR]

• We study the effect of emergency department crowding due to low severity patients. • We unpack welfare implications for high severity patients along their pathway in ED. • We show the slack in capacity by looking at the distribution of unplanned demand. • Emergency departments efficiently prioritise high severity patients. • Care rationing at very high levels of demand explains crowding effects on outcomes. Unexpected peaks in volumes of attendances at hospital emergency departments (EDs) have been found to affect waiting times, intensity of care and outcomes. We ask whether these effects of ED crowding on patients are caused by poor clinical prioritisation or a quality-quantity trade-off generated by a binding capacity constraint. We study the effects of crowding created by lower-severity patients on the outcomes of approximately 13 million higher-severity patients attending the 140 public EDs in England between April 2016 and March 2017. Our identification approach relies on high-dimensional fixed effects to account for planned capacity. Unexpected demand from low-severity patients has very limited effects on the care provided to higher-severity patients throughout their entire pathway in ED. Detrimental effects of crowding caused by low-severity patients materialise only at very high levels of unexpected demand, suggesting that binding resource constraints impact patient care only when demand greatly exceeds the ED's expectations. These effects are smaller than those caused by crowding induced by higher-severity patients, suggesting an efficient prioritisation of incoming patients in EDs. [ABSTRACT FROM AUTHOR]

In many well-resourced countries, rising rates of intervention are being observed during pregnancy, labour and childbirth with induction of labour (IOL) fast becoming one of the most common. In Australia, the rate of induction of labour has increased by over 30% since 2007, and today one in three women have their labours induced. We do not however have a good understanding of the contribution of specific obstetric populations to this trend. We examine the contribution of specific obstetric populations to induction of labour over a six-year period at one tertiary maternity service, using the Nippita classification system. Average Annual Percentage Changes (AAPC) were calculated along with 95% confidence intervals and P values set at 0.05. The overall rate of induction of labour increased from 21.3% in 2012 to 30.9% in 2017, representing an Average Annual Percent Change of 8.1, P < 0.0001 (95% CI 7–9.6). The greatest AAPC was seen in group 5 (parous, no previous caesarean section, 39–40 weeks, single cephalic), followed by group 2 (nulliparous, 39–40 weeks, single cephalic) and 1 (nulliparous, 37–38 weeks, single cephalic). The use of the Nippita classification system allowed for standardised comparison across timepoints, facilitating identification of the subpopulations driving changes in rates of induction of labour. Rates of induction of labour saw a year on year increase which in this maternity service, it is not being driven by post-dates pregnancies. Further work is required to understand the role of other potential contributors such as diabetes. [ABSTRACT FROM AUTHOR]

• First time we identified three unique heterozygous nonsynonymous variations at exon 8 in the ABCB6 gene. • One synonymous SNV at exon8 of ABCB6 gene was observed. • One homozygous stop-gain SNV at exon5 position in GRN gene was found. Protease inhibitors (PIs) are associated with an incidence of lipodystrophy among people living with HIV (PLHIV). Lipodystrophies are characterised by the loss of adipose tissue. Evidence suggests that a patient's lipodystrophy phenotype is influenced by genetic mutation, age, gender, and environmental and genetic factors, such as single-nucleotide variants (SNVs). Pathogenic variants are considered to cause a more significant loss of adipose tissue compared to non-pathogenic. Lipid metabolising enzymes and transporter genes have a role in regulating lipoprotein metabolism and have been associated with lipodystrophy in HIV-infected patients (LDHIV). The long-term effect of the lipodystrophy syndrome is related to cardiovascular diseases (CVDs). Hence, we determined the SNVs of lipid metabolising enzymes and transporter genes in a total of 48 patient samples, of which 24 were with and 24 were without HIV-associated lipodystrophy (HIVLD) using next-generation sequencing. A panel of lipid metabolism, transport and elimination genes were sequenced. Three novel heterozygous non-synonymous variants at exon 8 (c.C1400A:p.S467Y, c.G1385A:p.G462E, and c.T1339C:p.S447P) in the ABCB6 gene were identified in patients with lipodystrophy. One homozygous non-synonymous SNV (exon5:c.T358C:p.S120P) in the GRN gene was identified in patients with lipodystrophy. One novel stop-gain SNV (exon5:c.C373T:p.Q125X) was found in the GRN gene among patients without lipodystrophy. Patients without lipodystrophy had one homozygous non-synonymous SNV (exon9:c.G1462T:p.G488C) in the ABCB6 gene. Our findings suggest that novel heterozygous non-synonymous variants in the ABCB6 gene may contribute to defective protein production, potentially intensifying the severity of lipodystrophy. Additionally, identifying a stop-gain SNV in the GRN gene among patients without lipodystrophy implies a potential role in the development of HIVLD. [ABSTRACT FROM AUTHOR]

• Fewer Latin American and Caribbean nations achieving 90% coverage for some vaccines. • Caribbean sub-region accounts for much of the decline in vaccine coverage. • Moderate association between gross national income per capita and vaccine coverage. • Weak to moderate associations between immunization expenditures and coverage rates. • Latin America and Caribbean countries self-reliant in funding vaccine expenditures. From 2006 to 2011 nearly 174,000 deaths were prevented in Latin America and the Caribbean through vaccination of children under five, which is widely attributed to the Expanded Program on Immunization (EPI). Despite near global adoption of EPI recommendations, vaccination coverage shows substantial variation across world regions. Causes for low immunizations within regions are multifaceted and include vaccination program costs. To date, publications regarding vaccine coverage across Latin America and the Caribbean are not readily available. This study aimed to: (1) compare vaccine coverage trends across nations within the region; and (2) assess whether national immunization program expenditures are correlated with vaccine coverage. Coverage for nine vaccines were collected by nation using publicly available data from WHO. National immunization program expenditures for each country were collected from the World Bank Index. The proportion of countries achieving 90% coverage in the years 2013 and 2017 for each vaccine were compared. Pearson correlation coefficients were calculated to measure the relationship between financing variables and DTP3 coverage for 2017. In 2017, fewer Latin American and Caribbean nations were able to achieve 90% vaccine coverage for five vaccines compared to 2013. Mostly weak to moderate positive relationships were found between national immunization program expenditures and DTP3 coverage for 2017. Excluding Haiti, a weak negative relationship was found between total government expenditure on vaccines per infant and DTP3 coverage for 2017. Countries across Latin America and the Caribbean were largely self-reliant in funding vaccine expenditures. Fewer countries across Latin America and the Caribbean are currently achieving optimum national vaccine coverage and weak to moderate relationships between routine immunization and vaccine expenditures and coverage were observed. Additional factors contributing to national vaccine coverage should be concomitantly examined to implement strategies which optimize delivery of childhood immunizations. [ABSTRACT FROM AUTHOR]

In this paper we prove an estimate for the total variation distance, in the framework of the Breuer–Major theorem, using the Malliavin–Stein method, assuming the underlying function g to be once weakly differentiable with g and g ′ having finite moments of order four with respect to the standard Gaussian density. This result is proved by a combination of Gebelein's inequality and some novel estimates involving Malliavin operators. [ABSTRACT FROM AUTHOR]

Sluggish cognitive tempo (SCT) is associated with—but distinct from—attention-deficit/hyperactivity disorder (ADHD). This study examined SCT rates in adult outpatients seeking an ADHD assessment, differences in rates based on ADHD status, impact of assessment method (i.e., reporting source, symptom count, and functional impairment), and age of SCT symptom onset. Outpatients (n = 124) completed an SCT measure (n = 120 other-reporters). SCT was based on reporting source (i.e., self-report, other-report, either reporting source ["or" rule], and both reporting sources ["and" rule]), symptom count (i.e., age-based norms at or near the 93rd percentile, and a higher symptom count threshold of five), and functional impairment (i.e., 0, 1, and ≥2 domains). SCT rates varied based on assessment method for the full sample (26%–82%) and among those with (32%–91%) and without (16%–66%) ADHD. Rates decreased with stricter functional impairment and symptom count criteria. SCT was higher in the ADHD group than the non-ADHD group based on other-reporters and the "or" rule, but not the "and" rule. Functional impairment and symptom count criteria did not impact these comparisons. For self-reported SCT rates, ADHD/non-ADHD group comparisons did not differ based on age-based symptom count threshold, but did with a symptom count threshold of five. Self-reported SCT symptom onset was 13.36 years-old and was significantly younger for the ADHD group (11.69 years) than the non-ADHD group (16.36 years). Elevated SCT symptoms and related impairment are common among adults seeking an ADHD evaluation. These rates and ADHD/non-ADHD group differences vary substantially based on diagnostic methods. [ABSTRACT FROM AUTHOR]

Service disengagement is a frequent problem in early intervention in psychosis. The goal of this study was to evaluate the rate and variables associated with service disengagement in a three year specialized program that allows treatment intensification on a case to case basis. 328 early psychosis patients were assessed at baseline on a large set of socio-demographic and clinical variables and were followed-up over 36 months. Patients who left the program for reasons related to engagement with care were compared to patients who completed the program. Rates of disengagement were low (6.3%). Patients with lower socio-economic status, who committed offences during the program or with a diagnosis of Schizophreniform/brief psychotic disorder were more likely to disengage from the program. The engagement strategies implemented in the context of our early intervention programs have allowed to keep disengagements to a relatively low level. In this context, only 3 variables emerged to guide adaptation of the intervention in order to improve this already good engagement rate. [ABSTRACT FROM AUTHOR]

• The effect of DO on nitritation-anammox was investigated in IFAS under different HRTs. • The overall nitrogen removal rate was significantly increased with elevated DO concentrations. • Anammox activity inhibition was observed at DO of 0.28−0.35 mg/L in the bulk liquid at HRT of 1.2 day. • This study confirms the use of intermitted aeration as a strategy to effectively avoid NOB growth. Dissolved oxygen (DO) is an important parameter for partial nitritation-anammox process but previously not evaluated for the treatment of digested biosolid thickening lagoon supernatant. Using intermittent aeration we investigated nitrogen removal from such supernatant in an integrated fixed film activated sludge (IFAS) process operated under a variety of hydraulic retention times (1.2–2.5 days). The overall nitrogen removal rate (NRR) was significantly increased (P < 0.01) from 0.26 ± 0.01 kg N m−3 d-1 at HRT of 2.5 days to 0.50 ± 0.01 kg N m-3 d-1 at HRT of 1.2 day. Higher nitrogen loading rates needed higher DO concentrations in order to cope with the increased oxygen demand by ammonium-oxidizing bacteria (AOB). Enhancing the DO concentration from 0.18 mg L-1 to 0.35 mg L-1 improved AOB activity. However, when the bulk liquid DO was in the range of 0.28−0.35 mg L-1, anammox activity inhibition was observed associated with a significant free nitrous acid (FNA) accumulation (21.70 ± 4.10 μg L-1). Batch studies confirmed the inhibition of anammox activity under high DO conditions (0.28−0.35 mg L-1). Aeration strategies, other than increasing the DO set points, should be investigated in order to be able to work at high nitrogen loading rates without compromising anammox activity. [ABSTRACT FROM AUTHOR]

• A new GAN-based framework is proposed for robust adversarial examples generation. • Our method can achieve high attack success rate under semi-whitebox and black-box attacks. • Adversarial examples generated by our method preserve higher perceptual quality than that generated by AdvGAN. To improve the attack success rate and image perceptual quality of adversarial examples against deep neural networks(DNNs), we propose a new Generative Adversarial Network (GAN) based attacker, named Elastic-net Regularized Boundary Equilibrium Generative Adversarial Network(ERBEGAN). Recent studies have shown that DNNs are easy to attack by adversarial examples(AEs) where benign images with small-magnitude perturbations mislead DNNs to incorrect results. A number of methods are proposed to generate AEs, but how to generate them with high attack success rate and perceptual quality needs more effort. Most attackers generate AEs by restricting L 2 -norm and L ∞ -norm of adversarial perturbations. However, very few works have been developed on L 1 distortion matrix which encourages sparsity in the perturbation. In this paper, we penalize both L 2 -norm and L 1 -norm of perturbation as Elastic-Net regularization to improve the diversity and robustness of AEs. We further improve GAN by minimizing the additional pixel-wise loss derived from the Wasserstein distance between benign and adversarial auto-encoder loss distributions. Extensive experiments and visualizations on several datasets show that the proposed ERBEGAN can yield higher attack success rates than the state-of-the-art GAN-based attacker AdvGAN under the semi-whitebox and black-box attack settings. Besides, our method efficiently generates diverse adversarial examples that are more perceptually realistic. [ABSTRACT FROM AUTHOR]

We study a mutation–selection model with a fluctuating environment. More precisely, individuals in a large population are assumed to have a modifier locus determining the mutation rate u ∈ [ 0 , ϑ ] at a second locus with types v ∈ [ 0 , 1 ]. In addition, the environment fluctuates, meaning that individual types change their fitness at some high rate. Fitness only depends on the type of the second locus. We obtain general limit results for the evolution of the allele frequency distribution for rapidly fluctuating environments. As an application, we make use of the resulting Fleming–Viot process and compute the fixation probabilities for higher mutation rates in the special case of two bi-allelic loci in the limit of small fitness differences at the second locus. [ABSTRACT FROM AUTHOR]

Background: Lateral lumbar interbody fusion (LLIF) is used to treat multiple conditions, including spondylolisthesis, degenerative disc disorders, adjacent segment disease, and degenerative scoliosis. Although many advocate for posterior fixation with LLIF, stand-alone LLIF is increasingly being performed. Yet the fusion rate for stand-alone LLIF is unknown.Purpose: Determine the fusion rate for stand-alone LLIF.Study Design: Systematic review.Methods: We queried Cochrane, EMBASE, and MEDLINE for literature on stand-alone LLIF fusion rate with a publication cutoff of April 2020. LLIF surgery was considered stand-alone when not paired with supplemental posterior fixation. Cohort fusion rate differences were calculated and tested for significance (p<0.05). All reported means were pooled.Results: A total of 2,735 publications were assessed. Twenty-two studies met inclusion criteria, including 736 patients and 1,103 vertebral levels. Mean age was 61.7 years with BMI 26.5 kg/m2. Mean fusion rate was 85.6% (range, 53.0%-100.0%), which did not differ significantly by number of levels fused (1-level, 2-level, and ≥3-level). Use of rhBMP-2 was reported in 39.3% of subjects, with no difference in fusion rates between studies using rhBMP-2 (87.7%) and those in which rhBMP-2 was not used (83.9%, odds ratio=1.37, p=0.448). Fusion rate did not differ with the addition of a lateral plate, or by underlying diagnosis. All-complication rate was 42.2% and mean reoperation rate was 11.1%, with 2.3% reoperation due to pseudarthrosis. Of the studies comparing stand-alone to circumferential fusion, pooled fusion rate was found to be 80.4% versus 91.0% (p=0.637).Conclusions: Stand-alone LLIF yields high fusion rates overall. The wide range of reported fusion rates and lower fusion rates in studies involving subsequent surgical reoperation highlights the importance of proper training in this technique and employing a rigorous algorithm when indicating patients for stand-alone LLIF. Future research should focus on examining risk factors and patient-reported outcomes in stand-alone LLIF. [ABSTRACT FROM AUTHOR]

• Educating physicians not to send urine tests in patients with extraurinary tract reasons for hospitalization lowers the urine culture rate. • Reflex urine culture cancellation in hospitalized patients with a negative dipstick decreases the urine culture rate by around 30%. • The combined intervention decreases urine culture rates by approximately 50%. • The decrease in urine cultures occurred in males and females, and in patients with various chief complaints. • The interventions were accepted by the physicians. There are no previous studies on decreasing urine cultures in hospitalized internal medicine patients by a combination of physician education and reflex cancellation of urine cultures in those with a negative dipstick urinalysis. We compared urine culture rates in all hospitalized internal medicine patients 18 years or older before intervening (2016), during medical education efforts (2017), and after reflex cancellation of urine cultures in patients with a negative dipstick (negative leukocyte esterase and nitrites) (2018, 2019). Compared to the preintervention period (2016), urine cultures decreased from a baseline of 32.7% (95% confidence intervals [95%CI]—31.7-33.6) to 26.6% (95%CI—25.8%-27.4%) after medical education efforts, and to 18.2% (95%CI—17.4%-19.0%) and to 15.2 (95%CI—14.5%-15.9%) during the 2 years after reflex cancellation of the urine cultures. There were no physician complaints and there were no urine cultures orders after reflex cancellation. We conclude that physician education and cancellation of urine cultures in those with negative dipsticks resulted in a persistent decrease in urine cultures of around 50%. Extrapolation to other settings requires caution since the results are dependent on patient selection, physician behavior, and methods of urine testing. [ABSTRACT FROM AUTHOR]

The control performance can be worsened by actuator rate limit, which can result in amplitude attenuation and phase delay in process control. In some extreme situations, actuator rate limit may bring about the system non-convergence. This paper focuses on the control difficulties and solutions of first-order plus time-delay (FOPTD) systems caused by rate limit. The influence of rate limit on stability regions of proportional–integral (PI) controller is analysed. Results show that a small rate limit value can reduce stability regions of PI parameters greatly. The negative correlation between the integral gain and the onset frequency, and the positive correlation between the proportional gain and the onset frequency are conducted. Moreover, the control performance of different PI tuning rules such as Skogestad internal model control, integral gain maximization, delay robustness-constrained optimization and Tyreus–Luyben​ tuning rules is evidently affected by rate limit. Simulation and experiment results verify that the PI controller tuned by Skogestad internal model control (SIMC) method is less sensitive to the rate limit variation and is more suitable for processes (the normalized dead-time is from 0.03 to 1) which have severe actuator rate limit. Tyreus–Luyben tuning rule is another optional method. In addition, the reasons why SIMC is not sensitive to rate limit variation are analysed. These analytical results can offer a guideline for practical applications. • Influence of different parameters on the onset frequency is analysed. • Influence of different PI tuning rules on the closed-loop system is analysed. • SIMC method is less sensitive to the rate limit variation for processes (0. 03 ≤ L ∕ T ≤ 1). • The conclusions are verified by comparative experiments. [ABSTRACT FROM AUTHOR]

We prove some new results concerning the approximation rate of neural networks with general activation functions. Our first result concerns the rate of approximation of a two layer neural network with a polynomially-decaying non-sigmoidal activation function. We extend the dimension independent approximation rates previously obtained to this new class of activation functions. Our second result gives a weaker, but still dimension independent, approximation rate for a larger class of activation functions, removing the polynomial decay assumption. This result applies to any bounded, integrable activation function. Finally, we show that a stratified sampling approach can be used to improve the approximation rate for polynomially decaying activation functions under mild additional assumptions. [ABSTRACT FROM AUTHOR]

Neural networks implemented with traditional hardware face inherent limitation of memory latency. Specifically, the processing units like GPUs, FPGAs, and customized ASICs, must wait for inputs to read from memory and outputs to write back. This motivates memristor-based neuromorphic computing in which the memory units (i.e., memristors) have computing capabilities. However, training a memristor-based neural network is difficult since memristors work differently from CMOS hardware. This paper proposes a new training approach that enables prevailing neural network training techniques to be applied for memristor-based neuromorphic networks. Particularly, we introduce momentum and adaptive learning rate to the circuit training, both of which are proven methods that significantly accelerate the convergence of neural network parameters. Furthermore, we show that this circuit can be used for neural networks with arbitrary numbers of layers, neurons, and parameters. Simulation results on four classification tasks demonstrate that the proposed circuit achieves both high accuracy and fast speed. Compared with the SGD-based training circuit, on the WBC data set, the training speed of our circuit is increased by 37.2% while the accuracy is only reduced by 0.77%. On the MNIST data set, the new circuit even leads to improved accuracy. [ABSTRACT FROM AUTHOR]

This paper studies proofs of strong convergence of various iterative algorithms for computing the unique zeros of set-valued accretive operators that also satisfy some weak form of uniform accretivity at zero. More precisely, we extract explicit rates of convergence from these proofs which depend on a modulus of uniform accretivity at zero, a concept first introduced by A. Koutsoukou-Argyraki and the first author in 2015. Our highly modular approach, which is inspired by the logic-based proof mining paradigm, also establishes that a number of seemingly unrelated convergence proofs in the literature are actually instances of a common pattern. [ABSTRACT FROM AUTHOR]

The National Cancer Institute's Radiation Research Program, in collaboration with the Radiosurgery Society, hosted a workshop called Understanding High-Dose, Ultra-High Dose Rate and Spatially Fractionated Radiotherapy on August 20 and 21, 2018 to bring together experts in experimental and clinical experience in these and related fields. Critically, the overall aims were to understand the biological underpinning of these emerging techniques and the technical/physical parameters that must be further defined to drive clinical practice through innovative biologically based clinical trials. [ABSTRACT FROM AUTHOR]

Mechanical thrombectomy (MT) is the standard of care for the treatment of acute ischemic stroke (AIS) caused by anterior circulation large-vessel occlusion. However, the true safety and efficacy of MT in medium-size vessel occlusions such as the M2 segment of the middle cerebral artery have yet to be completely defined. In this study, we analyze the safety and efficacy of MT in M2 occlusions compared with M1 occlusions. A retrospective analysis was performed of patients with AIS secondary to M1 and M2 occlusions between 2011 and 2018. The inclusion criteria were 1) AIS secondary to M1 or M2 occlusion, 2) MT performed by stentrieval technique alone, aspiration technique, or combined stentrieval–aspiration techniques. Basic patient characteristics, number of passages, first passage recanalization success (≥TICI [Thrombolysis in Cerebral Ischemia] grade 2b), total recanalization success, hemorrhagic complications (including intracerebral hemorrhage [ICH] and subarachnoid hemorrhage), and clinical outcomes were compared between both groups. Two hundred and sixty patients met the inclusion criteria; 171 patients had M1 occlusion versus 89 with M2 occlusion. First passage recanalization success rate was significantly higher in the M2 group (55.1% vs. 39.2%; P = 0.015). Total recanalization success rate was higher in the M2 group but did not reach significance (83% vs. 75%; P = 0.128). Subarachnoid hemorrhage rate was significantly higher in the M2 group (25% vs. 12%; P = 0.010) but there was no difference for ICH complications (14.6% vs. 16.4%; P = 0.711). MT for M2 occlusions has similar overall efficacy to that for M1 occlusions, but with higher first-pass successful recanalization rates. MT for M2 occlusions has a higher risk of associated subarachnoid hemorrhage. [ABSTRACT FROM AUTHOR]

Ventriculopleural shunting (VPLS) is recognized as an alternative method when the standard ventriculoperitoneal shunting (VPS) is not applicable. Nevertheless, there is limited clinical evidence of its effectiveness including long-term patency. Data on 35 consecutive patients who underwent VPLS at a single institution were retrospectively analyzed. The rates of shunt survival and incidence of symptomatic pleural effusion were calculated, and risk factors were evaluated. Mean follow-up after VPLS was 64.1 months. The cumulative overall shunt survival rates were 70%, 44%, and 28% at 1, 3, and 5 years, respectively. Among patients with shunt failure, 3 (8.6%) with overdrainage underwent simple valve replacement (from fixed to programmable valve) and retained a VPLS. If these patients are excluded, shunt survival rates were 76%, 51%, and 34% at 1, 3, and 5 years, respectively, and the median shunt survival time was 3.0 years. No factor was significantly associated with shunt survival. Cumulative rates of symptomatic pleural effusion were 18%, 23%, and 46% at 1, 2, and 3 years, respectively. Median time from VPLS placement to symptomatic pleural effusion was 1.1 years. It seems that VPLS survival has improved with more modern shunt technology. VPLS is a reasonable second-line option when VPS is not feasible. The possibility of pleural effusion is not negligible, but asymptomatic/mild effusions may be managed conservatively. [ABSTRACT FROM AUTHOR]

Heating rate is crucial to the pyrolysis process of charring materials in the thermal protection system (TPS) of spacecraft. In order to study the influence of heating rate on the thermal response of charring materials, a novel formula for pyrolysis rate of charring materials is presented on the basis of experimental results of charring materials under different heating rates and the Levenberg-Marquardt algorithm. Then combined with the pyrolysis layer model, from the numerical simulation we find an interesting result that the traditional method to determine pyrolysis rate without considering the heating rate is conservative for the design of TPS, but the novel method in this study contributes to optimization design of TPS in spacecraft. • Novel formula for pyrolysis rate under different heating rates is given. • Presented formula is combined with the pyrolysis layer model. • Charring materials encounter a more severe pyrolysis process as heating rate rises. • Bondline temperature of thermal protection system decreases as heating rate rises. [ABSTRACT FROM AUTHOR]

Germline mutations are the source of all heritable variation. In the past few years, whole genome sequencing has allowed direct and comprehensive surveys of mutation patterns in humans and other species. These studies have documented substantial variation in both mutation rates and spectra across primates, the causes of which remain unclear. Here, we review what is currently known about mutation rates in primates, highlight the factors proposed to explain the variation across species, and discuss some implications of these findings on our understanding of the chronology of primate evolution and the process of mutagenesis. [ABSTRACT FROM AUTHOR]

Dietary betaine improves egg-laying rate in hens through hypomethylation and glucocorticoid receptor-mediated activation of hepatic lipogenesis-related genes. [Extracted from the article]

In this paper, a polynomial decay rate of Kirchhoff's nonlinear viscoelastic viscoelastic equation solution related with Balakrishnan-Taylor dissipation solution and logarithmic source terms is obtained, where we obtain the result of energy decay of solutions without impose the usual relationship between certain relaxation functions and their derivatives. This result generalizes the previous results to an arbitrary decay rate, that is not necessarily of the polynomial or exponential decay. [ABSTRACT FROM AUTHOR]

FTY720 and IMMH002, prodrugs for sphingosine-1-phosphate receptor 1 (S1P 1) agonists, show inadequate and inconsistent levels of phosphorylation in humans compared to that in rats. In this study, FTY720 or IMMH002 analogues (21 – 24) were designed and synthesized with modified head pieces to improve the biotransformation of the prodrugs to the active phosphorylated forms. Target compounds were synthesized via a convergent route using the key and optically pure building block 9 , which was first synthesized via asymmetrically catalyzed amination. The phosphorylation rates of these analogues in rat or human blood were compared. The new methyl-substituted analogue compound 21 showed higher phosphorylation rates in both rats and humans than the parent compound, whereas compound 23 showed improvements in rats, but not in humans. In pharmacokinetics studies of rats, compounds 21 and 23 both had higher levels of phosphorylation than FTY720 and IMMH002. Thus, our study not only yielded new compounds with therapeutic potential, but also showed species differences between rats and humans in response to the structural modifications, which might be useful for predicting the biotransformation behavior and efficacy of this class of prodrugs in the clinic. In this work, FTY720 and IMMH002 analogues (21 – 24) were designed and synthesized with modified head pieces to improve the biotransformation of the prodrugs to the active phosphorylated forms. New methyl-substituted analogue, compounds 21 and 23 , showed higher phosphorylation rates in vivo or in vitro. Image 1 [ABSTRACT FROM AUTHOR]

This article describes a new method of estimating the absorption rate constant (k a) of a 2-compartment model with extravascular administration, which is called an alternative method. The method was based on approximating the distribution and elimination phases of a 2-compartment model to the elimination phase of a one-compartment model. By using the model equation t max = ln k a − ln ( k 10 + k 12 ) k a − ( k 10 + k 12 ) , first, we obtained the peak time (t max) and the sum value of the first-order elimination rate constant (k 10) and the distribution rate constant (k 12), then the iterative method was used to obtain estimated value. And the estimation results were compared with the results obtained by the Loo-Riegelman and statistical moment methods and the factors affecting the estimation results of alternative method were explored. Finally, verification experiments were carried out with actual data in the literature. In general, a good estimation effect on the value of k a in the extravascular administration of the 2-compartment model was obtained by this method, with less errors compared with the commonly used 2 other methods (p < 0.05). Changes in k 12 , k 10 , k a , and another distribution rate constant (k 21) all influenced the estimation results. The alternative method also showed good results in estimating k a of compounds in the literature. [ABSTRACT FROM AUTHOR]

Formins direct the elongation of unbranched actin filaments by binding their barbed ends and processively stepping onto incoming actin monomers to incorporate them into the filament. Binding of profilin to actin monomers creates profilin-actin complexes, which then bind polyproline tracts located in formin homology 1 (FH1) domains. Diffusion of these natively disordered domains enables direct delivery of profilin-actin to the barbed end, speeding the rate of filament elongation. In this study, we investigated the mechanism of coordinated actin delivery from the multiple polyproline tracts in formin FH1 domains. We found that each polyproline tract can efficiently mediate polymerization, but that all tracts do not generate the same rate of elongation. InWTFH1 domains, the multiple polyproline tracts compete to deliver profilin-actin to the barbed end. This competition ultimately limits the rate of formin-mediated elongation. We propose that intrinsic properties of the filament-binding FH2 domain tune the efficiency of FH1-mediated elongation by directly regulating the rate of monomer incorporation at the barbed end. A strong correlation between competitive FH1-mediated profilin-actin delivery and FH2- regulated gating of the barbed end effectively limits the elongation rate, thereby obviating the need for evolutionary optimization of FH1 domain sequences. [ABSTRACT FROM AUTHOR]

Aim: The mathematical method used to calculate chest compression (CC) rate during cardiopulmonary resuscitation varies in the literature and across device manufacturers. The objective of this study was to determine the variability in calculated CC rates by applying four published methods to the same dataset.Methods: This study was a secondary investigation of the first 200 pediatric cardiac arrest events with invasive arterial line waveform data in the ICU-RESUScitation Project (NCT02837497). Instantaneous CC rates were calculated during periods of uninterrupted CCs. The defined minimum interruption length affects rate calculation (e.g., if an interruption is defined as a break in CCs ≥ 2 s, the lowest possible calculated rate is 30 CCs/min). Average rates were calculated by four methods: 1) rate with an interruption defined as ≥ 1 s; 2) interruption ≥ 2 s; 3) interruption ≥ 3 s; 4) method #3 excluding top and bottom quartiles of calculated rates. American Heart Association Guideline-compliant rate was defined as 100-120 CCs/min. A clinically important change was defined as ±5 CCs/min. The percentage of events and epochs (30 s periods) that changed Guideline-compliant status was calculated.Results: Across calculation methods, mean CC rates (118.7-119.5/min) were similar. Comparing all methods, 14 events (7%) and 114 epochs (6%) changed Guideline-compliant status.Conclusion: Using four published methods for calculating CC rate, average rates were similar, but 7% of events changed Guideline-compliant status. These data suggest that a uniform calculation method (interruption ≥ 1 s) should be adopted to decrease variability in resuscitation science. [ABSTRACT FROM AUTHOR]

To provide descriptive data on rates of total hip replacement (THR) and total knee replacement (TKR) within a large RA cohort and describe variation in risk. Incident RA patients (1995 to 2014) were identified from the Clinical Practice Research Datalink (CPRD). First subsequent occurrence of THR and TKR were identified (analysed separately) and incidence rates calculated, stratified by sex, age, BMI, geographic region, and quintiles of the index of multiple deprivation (IMD) score. There were 27,607 RA patients included, with a total of 1,028 THRs (mean age at surgery: 68.4 years) and 1,366 TKRs (mean age at surgery: 67.6 years), at an overall incidence rate per 1,000 person-years (PYs) [95% CI] of 6.38 [6.00–6.78] and 8.57 [8.12–9.04], respectively. TKR incidence was similar by gender but THR rates were higher in females than males. Rates of TKR but not THR rose according to BMI. An increasing trend was observed in rates of both outcomes according to age (although not ≥75) but of decreasing rates according to socio-economic deprivation. There was some evidence for regional variation in TKR. The 10-year cumulative incidence was 5.2% [4.9, 5.6] and 7.0% [6.6, 7.4] for THR and TKR, respectively. We provide generalizable estimates of THR and TKR incidence in the UK RA patient population and note variation across several key variables. Increased BMI was associated with a large increase in TKR but not THR incidence. Increased deprivation was associated with a downward trend in rates of THR and TKR. [ABSTRACT FROM AUTHOR]

Shock-to-detonation transition profiles of PBX 9502 explosive are analyzed to develop a rate law for shock acceleration. The shock motion profiles are seen to follow a common trend in the shock acceleration–velocity frame, aside from an early time transient that is dependent on the initiating shock strength. The duration of the early time transient is seen to correlate with the initial shock strength. The common shock acceleration profile is seen to be Arrhenius-like with respect to the local particle velocity or pressure. A dual-rate pressure-dependent Arrhenius-type rate law is developed with the duration of the early rate set by the initial shock strength. The rate law is able to predict the shock motion for all tests well in both particle velocity and pressure space. In addition to directly measuring commonalities in the acceleration profiles of the experimental shock motion, this work provides insight into the functional form of the reaction rate laws for this TATB-based high explosive. The rate law also supports the concept that shock-driven reaction in heterogenous high explosives is driven by localized ignition and growth of hotspots. [ABSTRACT FROM AUTHOR]

We sought to assess whether controlled, intraoperative lumbar drainage (LD) of cerebrospinal fluid (CSF) could facilitate resection of pituitary macroadenomas and reduce the rate of CSF leak. A retrospective cohort study from a prospective database was conducted on 189 patients with pituitary macroadenoma who received endoscopic transsphenoidal surgery between 2013 and 2017. Patients were classified into 2 groups: 119 patients received an intraoperative LD (LD group) and 70 patients underwent routine endoscopic surgery without LD (control group). In the LD group, lumbar catheters were placed preoperatively and CSF was drained intermittently during tumor resection. The rates of gross total resection (GTR) and CSF leaks were assessed both intraoperatively and postoperatively. Intraoperative LD was associated with a higher rate of GTR (92.4% in the LD group vs. 78.6% in the control group, P = 0.006), especially in macroadenomas with suprasellar extension (90.3% vs. 75.0%, P = 0.012). Both intraoperative and postoperative CSF leak rates were significantly decreased in the LD group (intraoperative: 10.1% vs. 31.4%, P < 0.001; postoperative: 3.4% vs. 11.4%, P = 0.035). In functioning adenomas, a better remission rate of excess-hormone secretion was observed in the LD group compared with the controls (89.1% vs. 60.6%, P = 0.001). Patients in the LD group also had an enhanced recovery with a shorter postoperative length of stay (7 days vs. 5 days, P = 0.020). Intraoperative LD may assist surgeons during endoscopic transsphenoidal resection of pituitary macroadenomas by achieving a higher rate of GTR and a lower rate of perioperative CSF leaks. Validation in prospective randomized controlled studies is needed. [ABSTRACT FROM AUTHOR]

• Near-ridge sedimentary 230ThXS deposition rates constrained using 3HeET. • Surplus 230ThXS deposition rates occur in close proximity to vent sites. • Diffusive seawater 230Th transport drives deficit 230ThXS deposition off-axis. • Spatial extent of hydrothermal influence on 230ThXS varies by ridge and over time. • 230ThXS deposition approaches seawater production rate within ∼10 km of most ridges. Mid-ocean ridges are valuable archives of sedimentary flux records used to investigate atmospheric, oceanographic, and solid Earth responses to climate variability. Constant flux proxies, such as extraterrestrial helium-3 (3He ET) and excess thorium-230 (230Th XS), constrain vertical mass accumulation rates independent of the biases associated with lateral sediment transport and age model resolution. However, thorium scavenging by hydrothermal particles can perturb local 230Th XS deposition and complicate its application as a constant flux proxy in near-ridge environments. We characterize the footprint of hydrothermal scavenging on sedimentary 230Th XS using coupled 3He ET -230Th XS analyses in cores from the Mid-Atlantic Ridge and the Juan de Fuca Ridge. Samples deposited >10 km from the Juan de Fuca Ridge indicate reliable off-axis behavior of both constant flux proxies. In contrast, samples deposited <10 km from the Juan de Fuca Ridge axis and within the axial valley of the Mid-Atlantic Ridge suggest 50–80% deficits in sedimentary 230Th XS relative to its production rate. These deficits contrast with sedimentary 230Th XS surpluses recently observed on the East Pacific Rise. The spatial footprint of hydrothermal scavenging varies globally and temporally, likely as a function of the intensity of local hydrothermal activity. The combined ridge data suggest that near-vent sediments (typically within ∼5 km, but variable by ridge) receive relatively high 230Th XS deposition rates as a direct result of hydrothermal particle scavenging, while more distal sediments receive relatively low 230Th XS deposition rates due to diffusive loss of overlying seawater 230Th XS towards the vent. Aside from the East Pacific Rise, far-field sediments are likely to exhibit typical 230Th XS deposition rates at distances greater than ∼10 km of the ridge axis. However, 230Th XS systematics within the axial valleys of slow-spreading ridges may be complicated by other factors. Combined 3He ET -230Th XS studies at multiple ridges are needed to further characterize the nature of hydrothermal scavenging and to evaluate the potential of sedimentary 230Th XS anomalies to record large-scale variability in past hydrothermal activity. [ABSTRACT FROM AUTHOR]

The progression rate for clinical manifestations in hemifacial spasm (HFS) varies; however, little is known about the factors contributing to this. The purpose of this study was to identify independent factors affecting the rate of symptom progression and to evaluate clinical outcomes according to progression rates. The study enrolled 1335 patients who underwent microvascular decompression for HFS between July 2004 and January 2015. We assessed detailed history, clinical manifestations, and outcomes. Based on the duration and severity of symptoms, patients were classified into rapidly progressive and slowly progressive groups. We identified predisposing factors affecting the differences between the 2 groups and evaluated the clinical outcome in each group. Of 1335 patients with HFS, 825 (61.8%) were classified as rapidly progressive, and 510 (38.2%) were classified as slowly progressive. In univariable and multivariable analyses, younger age at surgery, older age at symptom onset, and absence of intraoperative facial nerve indentation were significant predisposing factors for rapid progression. The rapidly progressive group had worse outcomes than the slowly progressive group following microvascular decompression. In this study, patients with rapidly progressive HFS had worse clinical outcomes. Therefore, patients with rapidly progressive symptoms should be warned in advance that the prognosis may be worse after microvascular decompression. This study is also useful to understand the differences in symptom progression rates in HFS in order to inform patients about symptom progression. [ABSTRACT FROM AUTHOR]

The aims of the present study were to evaluate the effect of cooling of the dromedary camel embryos on the pregnancy and pregnancy loss rates, and to investigate the factors which might affect the outcomes of the transfer of cooled embryos. After the donors (n = 56) had been super-ovulated and mated, they were flushed at Day 8 or 9 post-mating. Of 487 collected embryos, 110 were refrigerated at 4 ° C for up to 5 days in holding medium (HM), flushing medium supplemented with 10% fetal calf serum (FM + FCS) or TCM199 supplemented with 50% FCS and HEPES (TCM + FCS + HEPES). Both fresh (n = 377) and cooled embryos were transferred individually into synchronized recipients. Pregnancy diagnoses were carried out at Days 18–19, 30 and 60 post-mating of the donors. Transferring of fresh embryos into the recipients resulted in significantly higher pregnancy rates at Days 18–19 (53.1% vs. 38.2%, P < 0.01), Day 30 (46.4% vs. 31.8%, P < 0.01) and Day 60 (42.4% vs. 26.4%, P < 0.005) compared with those of cooled embryos, respectively. Pregnancy rates after transferring cooled embryos progressively decreased with the prolongation of the storage period. A significant difference in the pregnancy rate (56% vs. 13%, respectively, P < 0.05) was recorded only at Days 18–19 between cooled embryos held for one day and those held for 5 days. The pregnancy rates at Days 18–19, Day 30 and Day 60 were non-significantly higher when TCM + HEPES and FCS medium used for cooling of embryos compared to those of FM + FCS or HM medium. Cooling of spherical embryos resulted in significantly higher pregnancy rates at Days 30 (45.6% vs. 17.0%, respectively, P < 0.005) and 60 (42.1 vs. 9.4%, respectively, P < 0.005) and a significantly lower pregnancy loss rate (11.1% vs. 66.6%, respectively, P < 0.005) compared to those resulting from cooling of folded embryos. Neither the size of embryo nor the day of flushing had a significant effect on the pregnancy and pregnancy loss rates after the transfer of cooled embryos. In conclusion, pregnancy could be obtained after the transfer of camel embryos refrigerated for up to 5 days. In addition, higher pregnancy rates could be obtained if only spherical embryos are selected for cooling. • Acceptable pregnancy rates obtained after ET of cooled embryos kept for up to 5 days. • Higher pregnancy rates obtained after ET of cooled spherical embryos. • Neither size nor day of flushing affected the outcomes of ET of cooled embryos. • Significant decrease in the pregnancy rate observed at Day 5 of cooled embryo storage. [ABSTRACT FROM AUTHOR]

Background: In first episode psychosis (FEP) baseline negative symptoms (BNS) and relapse both predict less favorable functional outcome. Relapse-prevention is one of the most important goals of treatment. Apart from discontinuation of antipsychotics, natural causes of relapse are unexplained. We hypothesized that BNS, apart from predicting worse functional outcome, might also increase relapse risk.Methods: We performed a post-hoc analysis of 7-year follow-up data of a FEP cohort (n = 103) involved in a dose-reduction/discontinuation (DR) vs. maintenance treatment (MT) trial. We examined: 1) what predicted relapse, 2) what predicted functional outcome, and 3) if BNS predicted relapse, whether MT reduced relapse rates compared to DR. After remission patients were randomly assigned to DR or MT for 18 months. Thereafter, treatment was uncontrolled.Outcomes: BNS and duration of untreated psychosis (DUP) predicted relapse. Number of relapses, BNS, and treatment strategy predicted functional outcome. BNS was the strongest predictor of relapse, while number of relapses was the strongest predictor of functional outcome above BNS and treatment strategy. Overall and within MT, but not within DR, more severe BNS predicted significantly higher relapse rates. Treatment strategies did not make a difference in relapse rates, regardless of BNS severity.Interpretation: BNS not only predicted worse functional outcome, but also relapses during follow-up. Since current low dose maintenance treatment strategies did not prevent relapse proneness in patients with more severe BNS, resources should be deployed to find optimal treatment strategies for this particular group of patients. [ABSTRACT FROM AUTHOR]

Anxiety and depression symptoms are frequently experienced by individuals with psychosis, although prevalence rates have not been reviewed in first-episode psychosis (FEP). The aim of this systematic review was to focus on the prevalence rates for both anxiety and depression, comparing the rates within the same study population. A systematic review and meta-analysis was completed for all studies measuring both anxiety and depression in FEP at baseline. The search identified 6040 citations, of which n = 10 met inclusion criteria. These reported 1265 patients (age 28.3 ± 9.1, females: 39.9%) with diagnosed FEP. Studies which used diagnosis to define comorbidity count were included in separate meta-analyses for anxiety and depression, although the heterogeneity was high limiting interpretation of separate prevalence rates. A random-effects meta-analysis also compared the mean difference between anxiety and depression within the same studies. We show that anxiety and depression co-occur at a similar rate within FEP, although the exact rates are not reliable due to the heterogeneity between the small number of studies. Future research in FEP should consider routinely measuring anxiety and depression using continuous self-report measures of symptoms. Clinically we recommend that both anxiety and depression are equally targeted during psychological intervention in FEP, together with the psychotic symptoms. [ABSTRACT FROM AUTHOR]

Rating-based methods (e.g., collaborative filtering) in recommendation can explicitly model users and items from their rating patterns, nevertheless suffer from the natural data sparsity problem. In other hand, user-generated reviews can provide rich semantic information of user preference and item features, and can alleviate the sparsity problems of rating data. In fact, ratings and reviews are complementary and can be viewed as two different sides of users and items, hence fusing rating patterns and text reviews effectively has the potential to learn more accurate representations of users and items for recommendation. In this paper, we propose a hybrid neural recommendation model to learn the deep representations for users and items from both ratings and reviews. Our model contains three major components, i.e., a rating-based encoder to learn deep and explicit features from rating patterns of users and items, a review-based encoder to model users and items from text reviews, and the prediction module for recommendation according to the rating- and review-based representations of users and items. In addition, considering that different reviews have different informativeness for modelling users and items, we introduce a novel review-level attention mechanism incorporating with rating-based representation as query vector to select useful reviews. We conduct extensive experiments on several benchmark datasets and the experimental results demonstrate that our model can outperform the existing competitive baseline methods in recommendations. [ABSTRACT FROM AUTHOR]

We study the qualitative properties of the unique global viscosity solution of the superquadratic diffusive Hamilton-Jacobi equation with (generalized) homogeneous Dirichlet conditions. We are interested in the phenomena of gradient blow-up (GBU), loss of boundary conditions (LBC), recovery of boundary conditions and eventual regularization, and in their mutual connections. In any space dimension, we establish the sharp minimal rate of GBU. Only partial results were previously known except in one space dimension. We also obtain the corresponding minimal regularization rate. In one space dimension, under suitable conditions on the initial data, we give a quite detailed description of the behavior of solutions for all t > 0. In particular, we show that nonminimal GBU solutions immediately lose the boundary conditions after the blow-up time and are immediately regularized after recovering the boundary data. Moreover, both GBU and regularization occur with the minimal rates, while loss and recovery of boundary data occur with linear rate. We describe further the intermediate singular life of those solutions in the time interval between GBU and regularization. We also study minimal GBU solutions, for which GBU occurs without LBC: those solutions are immediately regularized, but their blow-up and regularization rates are more singular. Most of our one-dimensional results crucially depend on zero-number arguments, which do not seem to have been used so far in the context of viscosity solutions of Hamilton-Jacobi equations. [ABSTRACT FROM AUTHOR]

Previous studies have reported significant variation in prostate cancer rates and trends mainly due to differences in detection practices, availability of treatment, and underlying genetic susceptibility. To assess recent worldwide prostate cancer incidence, mortality rates, and trends using up-to-date incidence and mortality data. We present estimated age-standardized prostate cancer incidence and mortality rates by country and world regions for 2018 based on the GLOBOCAN database. We also examined rates and temporal trends for incidence (44 countries) and mortality (76 countries) based on data series from population-based registries. The highest estimated incidence rates were found in Australia/New Zealand, Northern America, Western and Northern Europe, and the Caribbean, and the lowest rates were found in South-Central Asia, Northern Africa, and South-Eastern and Eastern Asia. The highest estimated mortality rates were found in the Caribbean (Barbados, Trinidad and Tobago, and Cuba), sub-Saharan Africa (South Africa), parts of former Soviet Union (Lithuania, Estonia, and Latvia), whereas the lowest rates were found in Asia (Thailand and Turkmenistan). Prostate cancer incidence rates during the most recent 5 yr declined (five countries) or stabilized (35 countries), after increasing for many years; in contrast, rates continued to increase for four countries in Eastern Europe and Asia. During the most recent 5 data years, mortality rates among the 76 countries examined increased (three countries), remained stable (59 countries), or decreased (14 countries). As evident from available data, prostate cancer incidence and mortality rates have been on the decline or have stabilized recently in many countries, with decreases more pronounced in high-income countries. These trends may reflect a decline in prostate-specific antigen testing (incidence) and improvements in treatment (mortality). We examined recent trends in prostate cancer incidence and mortality rates in 44 and 76 countries, respectively, and found that rates in most countries stabilized or decreased. We examined recent trends in prostate cancer incidence and mortality rates in 44 and 76 countries, respectively, and found that rates mostly stabilized or decreased. These trends may reflect declines in prostate-specific antigen testing (incidence) and improvements in treatment (mortality). [ABSTRACT FROM AUTHOR]

This paper studies the decay estimate of solutions to the 3D generalized magnetohydrodynamic system in the critical space χ 1 − 2 α (R 3) with 1 2 ≤ α ≤ 1. We obtain the temporal decay rate (1 + t) − (5 4 α − 1) for a small initial data global solution which was established by Ye (2016) and improve the temporal decay rate. [ABSTRACT FROM AUTHOR]

Learning classifiers with false positive rate control have drawn intensive attention in applications over past years. While various supervised algorithms have been developed for obtaining low false positive rates, they commonly require the coexistence of both positive and negative samples in data. However, the scenario studied in positive unlabeled (PU) learning is more pervasive in practice. Namely, at inception, most of the data may not have known labels, and the data with known labels may only represent one type of samples. To tackle this challenge, in this paper we propose a new positive unlabeled learning classifier with false positive rate control. In particular, we first prove that in this context employing oft-adopted convex surrogate loss functions, such as the hinge loss function, begets a redundant penalty for false positive rates. Then, we present that the non-convex ramp loss surrogate function can overcome this barrier and show a concave-convex procedure can solve the associated non-convex optimization problem. Finally, we demonstrate the effectiveness of the proposed method through extensive experiments on multiple datasets. [ABSTRACT FROM AUTHOR]

We propose a symbol rate estimation technique by using absolute value of correlation of received signal for single-carrier polarization division multiplexed (PDM) systems in coherent detection system. We analytically show that spectrum of absolute value of correlation contains a peak indicating the symbol rate and has a robust performance which is insensitive to accumulated chromatic dispersion (CD) and first-order polarization-mode dispersion (PMD), amplified spontaneous emission (ASE) noise and laser frequency offset. Simulation result shows that this technique is applicable to long-haul application. [ABSTRACT FROM AUTHOR]

In this paper, we prove new convergence results improving the ones by Chassagneux et al. (2012) for the discrete-time approximation of multidimensional obliquely reflected BSDEs. These BSDEs, arising in the study of switching problems, were considered by Hu and Tang (2010) and generalized by Hamadène and Zhang (2010) and Chassagneux et al. (2011). Our main result is a rate of convergence obtained in the Lipschitz setting and under the same structural conditions on the generator as the one required for the existence and uniqueness of a solution to the obliquely reflected BSDE. [ABSTRACT FROM AUTHOR]

• The watershed algorithm and concave point detection algorithm were used for touching particles. • The effect of the flow rate of aggregates on the accuracy of the sieve test was evaluated. • The effect of the layer thickness for aggregates on the accuracy of the sieve test was estimated. • There is an appropriate layer thickness combination for various specifications of aggregates. • The image segmentation based on machine vision was verified by the road construction projects. The objective of this study was to determine the effects of flow rates and layer thicknesses for the aggregates on the estimation of the aggregate gradation of an asphalt mixture based on machine vision. The watershed algorithm based on distance transform and concave point detection algorithm were synthetically used to split the touching particles. Increasing the flow rate overall decreased the prediction accuracy of aggregate gradation by image segmentation; the prediction accuracy decreased with the increase of the layer thickness. The prediction accuracy of the segmentation was better than that of the online detection of the asphalt mixture plant. [ABSTRACT FROM AUTHOR]