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Stereotactic ablative radiotherapy (SABR) may improve survival in patients with inoperable pulmonary oligometastases. However, the impact of pulmonary oligometastatic status after systemic therapy on SABR outcomes remains unclear. Hence, we investigated the outcomes of SABR in 45 patients with 77 lung tumors and the prognostic value of pulmonary oligoprogression. Eligibility criteria were pulmonary oligometastases (defined as ≤5 metastatic lung tumors), controlled extrapulmonary disease (EPD) after front-line systemic therapy, SABR as primary local treatment for inoperable pulmonary metastases, and consecutive imaging follow-up. Oligometastatic lung tumor was classified into controlled or oligoprogressive status. Overall survival (OS), in-field progression-free survival (IFPFS), out-field progression-free survival (OFPFS), and prognostic variables were evaluated. With 21.8 months median follow-up, the median OS, IFPFS, and OFPFS were 28.3, not reached, and 6.5 months, respectively. Two-year OS, IFPFS, and OFPFS rates were 56.0%, 74.2%, and 17.3%, respectively. Oligoprogressive status (p = 0.003), disease-free interval < 24 months (p = 0.041), and biologically effective dose (BED10) < 100 Gy (p = 0.006) were independently associated with inferior OS. BED10 ≥ 100 Gy (p = 0.029) was independently correlated with longer IFPFS. Oligoprogressive status (p = 0.017) and EPD (p = 0.019) were significantly associated with inferior OFPFS. Grade ≥ 2 radiation pneumonitis occurred in four (8.9%) patients. Conclusively, SABR with BED10 ≥ 100 Gy could provide substantial in-field tumor control and longer OS for systemic therapy respondents with inoperable pulmonary oligometastases. Oligoprogressive lung tumors exhibited a higher risk of out-field treatment failure and shorter OS. Hence, systemic therapy should be tailored for patients with oligoprogression to reduce the risk of out-field treatment failure. However, in the absence of effective systemic therapy, SABR is a reasonable alternative to reduce resistant tumor burden.

A high-pressure (HP) GaN nucleation layer (NL) was inserted between AlGaN buffer and an unintentionally doped (UID) GaN layer of an AlGaN/GaN HEMT on Si. The XRD and TEM showed that when the V/III ratio was optimized during the HP-GaN NL growth, the edge dislocation density in the HP-GaN NL layer could be reduced significantly. Experimental results exhibited a lower off-state leakage current, higher maximum ID and Gm (corresponding to 22.5% and 21.7% improvement, respectively), and lower on-state resistance. These results demonstrate that the electrical properties of the AlGaN/GaN HEMT can be improved through the insertion of a HP-GaN NL.

Many studies have shown that urban workers may have a higher acceptance rate of coronavirus disease (COVID-19) vaccine uptake compared to their rural counterparts. As Omicron spreads globally, the COVID-19 booster vaccination has been acknowledged as the primary strategy against this variant. In this study, we identify factors related to the willingness of workers in megacities to take the vaccine booster shots and their main reasons accounting for their booster willingness. This research survey was conducted in megacity H in eastern China, and a total of 1227 employees from different industries were interviewed. The study at hand examines the relationship between various characteristics (including both economic and non-economic factors) of urban employees and their intention/desire to accept the COVID-19 booster shoots. The survey results show that some characteristics, namely work organization, vaccine knowledge, and social network, affect their intention to take COVID-19 vaccine booster shots. Urban employees with a strong work organization, a high degree of vaccine knowledge, and a dense social capital are more likely to receive booster injections than other employees. Therefore, work organization, vaccine knowledge, and social networks provide fundamental entry points for designing enhanced injection strategies to increase the acceptance of COVID-19 vaccines among employees in megacities.

In this study, nondominated sorting genetic algorithm II (NSGA-II) was used to minimize the cost and carbon emissions of a liquefied natural gas (LNG) dual-fuel ship for a given route. This study considered the regulations of emission control areas (ECA) and the European Union (EU) Emissions Trading System (ETS) to determine the optimal speed and LNG/oil ratio for the ship. NSGA-II used the arrival time at each port and the LNG usage ratio for each voyage leg as its genes. The time window for arrival, the fuel cost, and potential EU carbon emission regulations were used to estimate the cost of the considered voyage. Moreover, fuel consumption was determined using historical data that were divided by period, machinery, and voyage leg. The results indicated that the optimal speed and fuel ratio could be determined under any given fuel and carbon price profile by using NSGA-II. Finally, the effects of regulations and carbon price differences on the optimal speed and fuel ratio were investigated. The cost minimization solution was susceptible to being affected by the regulations of ECAs and the EU ETS. The speed profile of the cost minimization solution was found to have a tendency to travel at faster-than-average speeds outside ECAs and non-EU regions, and travel slower in ECAs and EU regions. Meanwhile, the selection of fuel type showed that 100% traditional fuel oil in all regions, but with sufficiently high EU carbon permit cost, tends to use 100% LNG in EU regions.

To overcome the ongoing coronavirus disease 2019 (COVID-19) pandemic, transmission routes, such as healthcare worker infection, must be effectively prevented. Ultraviolet C (UVC) (254 nm) has recently been demonstrated to prevent environmental contamination by infected patients; however, studies on its application in contaminated hospital settings are limited. Herein, we explored the clinical application of UVC and determined its optimal dose. Environmental samples (n = 267) collected in 2021 were analyzed by a reverse transcription-polymerase chain reaction and subjected to UVC irradiation for different durations (minutes). We found that washbasins had a high contamination rate (45.5%). SARS-CoV-2 was inactivated after 15 min (estimated dose: 126 mJ/cm2) of UVC irradiation, and the contamination decreased from 41.7% before irradiation to 16.7%, 8.3%, and 0% after 5, 10, and 15 min of irradiation, respectively (p = 0.005). However, SARS-CoV-2 was still detected in washbasins after irradiation for 20 min but not after 30 min (252 mJ/cm2). Thus, 15 min of 254-nm UVC irradiation was effective in cleaning plastic, steel, and wood surfaces in the isolation ward. For silicon items, such as washbasins, 30 min was suggested; however, further studies using hospital environmental samples are needed to confirm the effective UVC inactivation of SARS-CoV-2.

Drought is a key factor affecting plant growth and development. Heat shock transcription factors (Hsfs) have been reported to respond to diverse abiotic stresses, including drought stress. In the present study, functional characterization of maize heat shock transcription factor 05 (ZmHsf05) gene was conducted. Homologous analysis showed that ZmHsf05 belongs to Class A2 Hsfs. The mRNA expression level of ZmHsf05 can be affected by drought, high temperature, salt, and abscisic acid (ABA) treatment. Ectopic overexpression of ZmHsf05 in rice (Oryza sativa) could significantly enhance the drought tolerance. Faced with drought stress, transgenic rice exhibited better phenotypic performance, higher survival rate, higher proline content, and lower leaf water loss rate, compared with wild-type plant Zhonghua11. Additionally, we assessed the agronomic traits of seven transgenic rice lines overexpressing ZmHsf05 and found that ZmHsf05 altered agronomical traits in the field trials. Moreover, rice overexpressing ZmHsf05 was more sensitive to ABA and had either a lower germination rate or shorter shoot length under ABA treatment. The transcription level of key genes in the ABA synthesis and drought-related pathway were significantly improved in transgenic rice after drought stress. Collectively, our results showed that ZmHsf05 could improve drought tolerance in rice, likely in an ABA-dependent manner.

The increasing demand for precious timber resources promotes immediate efforts to develop high-valuable hardwood resources in afforestation. However, the lack of valuable tree species seedlings for afforestation and their ecological adaptability must primarily be addressed. To explore a valuable tree species for precious timber resourcing in afforestation, a comparative analysis of the characteristics of photosynthetic physiology and leaf anatomy in three different Quercus L. Section Cyclobalanopsis seedlings of Quercus chungii,Quercus gilva, and Quercus glauca was performed during three growth stages (July, September, and November) in South China. The results showed that there are significant differences in photosynthetic physiological characteristic parameters, chlorophyll content, and leaf anatomical structure among the three seedlings in each growth stage (p < 0.05). The photosynthetic parameters, i.e., Pn, Gs, Tr,WUE and Ci in each tree species all had the same trend of increase from July to September and decrease from September to November, and with a pick point in September during the three stages. The Pn in Q. chungii was higher than that in the other two species in each stage, and the highest Pn with an average value of 8.26 μmol·m−2·s−1 was obtained in September in Q. chungii, which was 13.77% and 20.06% higher than that of in Q. gilva and Q. glauca at the same time, respectively. Significant differences were also detected in the chlorophyll fluorescence of Fo, Fm, Fv/Fm, Y, ETR, qP, and NPQ among three seedlings within each growth stage from July to November (p < 0.05). The thickness of the mature leaf was decreased in order as Q. chungii, Q. glauca, and Q. gilva. From July to September, more notable changes were observed in Q. chungii in September, with a drop of 3.49% in leaf thickness, and a drop of 3.34% and 10.06% in the volume of palisade tissue and sponge tissue, respectively. Consequently, increasing tightness and deducing looseness were observed in Q. chungii. The principal component analysis (PCA) on photosynthesis and leaf anatomy showed that Q. chungii displayed a stronger photosynthetic physiology with a positive coordination on water, air, light, and heat. These findings facilitate the evaluation of ecological adaptability among the three Quercus seedlings and provide compelling evidence for the application of Q. chungii for precious timber resources in afforestation.

Substrate voltage (VSUB) effects on GaN-on-Si high electron mobility transistors (HEMTs) power application performance with superlattice transition layer structure was investigated. The 2DEG conductivity and buffer stack charge redistribution can be affected by neutral/ionized donor and acceptor traps. As the donor/acceptor traps are excessively ionized or de-ionized by applying VSUB, the depletion region between the unintentionally doped (UID)/Carbon-doped (C-doped) GaN layer may exhibit a behavior similar to the p–n junction. An applied negative VSUB increases the concentration of both the ionized donor and acceptor traps, which increases the breakdown voltage (BV) by alleviating the non-uniform distribution of the vertical electric field. On the other hand, an applied positive VSUB causes the energy band bending flattener to refill the ionized traps and slightly improves the dynamic Ron degradation. Moreover, the amount of electrons injected into the buffer stack layer from the front side (2DEG channel/Ohmic contact) and the back side (AlN nucleation layer/superlattice transition layer) are asymmetric. Therefore, different VSUB can affect the conductivity of 2DEG through the field effect, buffer trapping effect, and charge redistribution, which can change the electrical performance of the device.

Visceral pain (VP) is the organ-derived nociception in which increased inflammatory reaction and exaggerated activation of the central nucleus of the amygdala (CeA) may contribute to this deficiency. Considering the amygdala also serves as the integration center for olfaction, the present study aimed to determine whether olfactory stimulation (OS) would effectively depress over-activation and inflammatory reaction in CeA, and successfully relieve VP-induced abnormalities. Adult rats subjected to intraperitoneal injection of acetic acid inhaled lavender essential oil for 2 or 4 h. The potential benefits of OS were determined by measuring the pro-inflammatory cytokine level, intracellular potassium and the upstream small-conductance calcium-activated potassium (SK) channel expression, together with detecting the stress transmitters that participated in the modulation of CeA activity. Results indicated that in VP rats, strong potassium intensity, reduced SK channel protein level, and increased corticotropin-releasing factor, c-fos, and substance P immuno-reactivities were detected in CeA. Enhanced CeA activation corresponded well with increased inflammatory reaction and decreased locomotion, respectively. However, in rats subjected to VP and received OS, all above parameters were significantly returned to normal levels with higher change detected in treating OS of 4h. As OS successfully depresses inflammation and CeA over-activation, application of OS may serve as an alternative and effective strategy to efficiently relieve VP-induced deficiency.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is still an ongoing global health crisis. Immediately after the inhalation of SARS-CoV-2 viral particles, alveolar type II epithelial cells harbor and initiate local innate immunity. These particles can infect circulating macrophages, which then present the coronavirus antigens to T cells. Subsequently, the activation and differentiation of various types of T cells, as well as uncontrollable cytokine release (also known as cytokine storms), result in tissue destruction and amplification of the immune response. Vitamin D enhances the innate immunity required for combating COVID-19 by activating toll-like receptor 2. It also enhances antimicrobial peptide synthesis, such as through the promotion of the expression and secretion of cathelicidin and β-defensin; promotes autophagy through autophagosome formation; and increases the synthesis of lysosomal degradation enzymes within macrophages. Regarding adaptive immunity, vitamin D enhances CD4+ T cells, suppresses T helper 17 cells, and promotes the production of virus-specific antibodies by activating T cell-dependent B cells. Moreover, vitamin D attenuates the release of pro-inflammatory cytokines by CD4+ T cells through nuclear factor κB signaling, thereby inhibiting the development of a cytokine storm. SARS-CoV-2 enters cells after its spike proteins are bound to angiotensin-converting enzyme 2 (ACE2) receptors. Vitamin D increases the bioavailability and expression of ACE2, which may be responsible for trapping and inactivating the virus. Activation of the renin–angiotensin–aldosterone system (RAS) is responsible for tissue destruction, inflammation, and organ failure related to SARS-CoV-2. Vitamin D inhibits renin expression and serves as a negative RAS regulator. In conclusion, vitamin D defends the body against SARS-CoV-2 through a novel complex mechanism that operates through interactions between the activation of both innate and adaptive immunity, ACE2 expression, and inhibition of the RAS system. Multiple observation studies have shown that serum concentrations of 25 hydroxyvitamin D are inversely correlated with the incidence or severity of COVID-19. The evidence gathered thus far, generally meets Hill’s causality criteria in a biological system, although experimental verification is not sufficient. We speculated that adequate vitamin D supplementation may be essential for mitigating the progression and severity of COVID-19. Future studies are warranted to determine the dosage and effectiveness of vitamin D supplementation among different populations of individuals with COVID-19.

The amount of wasted polylactic acid (PLA) is increasing because 3D printing services are an increasingly popular offering in many fields. The PLA is widely employed in the fused deposition modeling (FDM) since it is an environmentally friendly polymer. However, failed prototypes or physical models can generate substantial waste. In this study, the feasibility of recycling PLA waste plastic and re-extruded it into new PLA filaments was investigated. An automatic PLA filament extruder was first developed for fabricating new PLA filaments. This paper also discusses the process, challenges, and benefits of recycling PLA waste plastic in an effort to fabricate new PLA filaments more sustainable. It was found that&nbsp, it was possible to fabricate PLA filament using recycled PLA waste plastic. The production cost is only 60% of the commercially available PLA filament. The tensile strength of the developed PLA filament is approximately 1.1 times that of the commercially available PLA filament. The design of experiments approach was employed to investigate the optimal process parameters for fabricating PLA filaments. The most important control factor affecting the diameter of PLA filament is the barrel temperature, followed by recycled material addition ratio, extrusion speed, and cooling distance. The optimal process parameters for fabricating PLA filament with a diameter of 1.7 mm include the barrel temperature of 184 °C, extrusion speed of 490 mm/min, cooling distance of 57.5 mm, and recycled material addition ratio of 40%.

In this study, white organic light-emitting diodes (OLEDs) consisting of red quantum dots (RQD) and green quantum dots (GQD) were investigated. These are the most exciting new lighting technologies that have grown rapidly in recent years. The white OLED development processes used consisted of the following methods: (a) fabrication of a blue single-emitting layer OLED, (b) nanoimprinting into QD photoresists, and (c) green and red QD photoresists as color conversion layers (CCL) excited by blue OLEDs. To fabricate the blue OLED, the HATCN/TAPC pair was selected for the hole injection/transport layer on ITO and TPBi for the electron transport layer. For blue-emitting material, we used a novel polycyclic framework of thermally activated delayed fluorescence (TADF) material, ν-DABNA, which does not utilize any heavy metals and has a sharp and narrow (FWHM 28 nm) electroluminescence spectrum. The device structure was ITO/HATCN (20 nm)/TAPC (30 nm)/MADN: ν-DABNA (40 nm)/TPBi (30 nm)/LiF (0.8 nm)/Al (150 nm) with an emitting area of 1 cm × 1 cm. The current density, luminance, and efficiency of blue OLEDs at 8 V are 87.68 mA/cm2, 963.9 cd/m2, and 1.10 cd/A, respectively. Next, the bottom emission side of the blue OLED was attached to nanoimprinted RQD and GQD photoresists, which were excited by the blue OLED in order to generate an orange and a green color, respectively, and combined with blue light to achieve a nearly white light. In this study, two different excitation architectures were tested: BOLED→GQD→RQD and BOLED→RQD→GQD. The EL spectra showed that the BOLED→GQD→RQD architecture had stronger green emissions than BOLED→RQD→GQD because the blue OLED excited the GQD PR first then RQD PR. Due to the energy gap architectures in BOLED-GQD-RQD, the green QD absorbed part of the blue light emitted from the BOLED, and the remaining blue light penetrated the GQD to reach the RQD. These excited spectra were very close to the white light, which resulted in three peaks emitting at 460, 530, and 620 nm. The original blue CIE coordinates were (0.15, 0.07). After the excitation combination, the CIE coordinates were (0.42, 0.33), which was close to the white light position.

This study proposes an oscillatory water tunnel (O/U-tube) equipped with two impellers to drive flows. The O/U-tube consists of two modes: U-tube mode and O-tube mode. The former can generate oscillatory flow, while the latter can produce both oscillatory and unidirectional flows with velocities up to 1.6 m/s. The hydrodynamics of the U-tube and O-tube modes were examined analytically. For the U-tube mode, a sine-varying rotational speed for the impeller caused higher harmonic components for the velocity, owing to the local inertia and gravity forces. In the steady state of the O-tube mode, owing to the resistance force, the flow velocity was proportional to the rotational speed. To generate the target flow conditions, two open-loop control schemes were proposed according to the analytic approach for the U-tube mode and a genetic algorithm for the O-tube mode. The analytic approach was based on a hydrodynamic model with a given flow condition. In the genetic algorithm, the rotational speed was represented by a square root of the Fourier series. The optimal coefficients of the Fourier series to generate the target flow were determined by using the genetic algorithm and the hydrodynamic model. Both approaches were experimentally validated. Consequently, the O/U-tube with the open-loop schemes can be used to generate the desired oscillatory and unidirectional flows.

In recent years, chip design technology and AI (artificial intelligence) have made significant progress. This forces all of fields to investigate how to increase the competitiveness of products with machine learning technology. In this work, we mainly use deep learning coupled with motor control to realize the real-time interactive system of air hockey, and to verify the feasibility of machine learning in the real-time interactive system. In particular, we use the convolutional neural network YOLO (&ldquo, you only look once&rdquo, ) to capture the hockey current position. At the same time, the law of reflection and neural networking are applied to predict the end position of the puck Based on the predicted location, the system will control the stepping motor to move the linear slide to realize the real-time interactive air hockey system. Finally, we discuss and verify the accuracy of the prediction of the puck end position and improve the system response time to meet the system requirements.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly evolved into a global pandemic. The hyperglycemia in patients with diabetes mellitus (DM) substantially compromises their innate immune system. SARS-CoV-2 uses human angiotensin-converting enzyme 2 (ACE2) receptors to enter the affected cell. Uncontrolled hyperglycemia-induced glycosylation of ACE2 and the S protein of SARS-CoV-2 could facilitate the binding of S protein to ACE2, enabling viral entry. Downregulation of ACE2 activity secondary to SARS-CoV-2 infection, with consequent accumulation of angiotensin II and metabolites, eventually leads to poor outcomes. The altered binding of ACE2 with SARS-CoV-2 and the compromised innate immunity of patients with DM increase their susceptibility to COVID-19; COVID-19 induces pancreatic β-cell injury and poor glycemic control, which further compromises the immune response and aggravates hyperglycemia and COVID-19 progression, forming a vicious cycle. Sequential cleavage of viral S protein by furin and transmembrane serine protease 2 (TMPRSS2) triggers viral entry to release the viral genome into the target cell. Hence, TMPRSS2 and furin are possible drug targets. As type 1 DM exhibits a Th1-driven autoimmune process, the relatively lower mortality of COVID-19 in type 1 DM compared to type 2 DM might be attributed to an imbalance between Th1 and Th2 immunity. The anti-inflammatory effects of dipeptidyl peptidase-4 inhibitor may benefit patients with DM and COVID-19. The potential protective effects of sodium–glucose cotransporter-2 inhibitor (SGLT2i), including reduction in lactate level, prevention of lowering of cytosolic pH and reduction in pro-inflammatory cytokine levels may justify the provision of SGLT2i to patients with DM and mild or asymptomatic COVID-19. For patients with DM and COVID-19 who require hospitalization, insulin-based treatment is recommended with cessation of metformin and SGLT2i. Further evidence from randomized or case–control clinical trials is necessary to elucidate the effectiveness and pitfalls of different types of medication for DM.

Long-term poor glycemic control negatively affects macrovascular and microvascular diseases, as well as wound restoration. Buckwheat is a good source of rutin (quercetin-3-O-rutoside) and has benefits in regulating blood sugar. This study was to evaluate the antioxidant and anti-inflammatory effects of rutin on wound healing in streptozotocin-induced hyperglycemic rats. Eighteen male Wistar rats were randomly divided into three groups: normal (NDM), hyperglycemic (DM), and hyperglycemic with rutin (DMR). After induction of hyperglycemia for 2 days, a 15 &times, 15 mm wound was induced on the back of each rat. Intraperitoneal injection of rutin significantly ameliorated diabetes-induced body weight loss and improved metabolic dysfunctions of hyperglycemic rats. Based on appearance and histopathological staining, rutin promotes wound healing and inhibits production of inflammatory cells. The immunoblotting data indicated that rutin promotes production of antioxidant enzymes induced by nuclear factor erythroid 2-related factor 2 (NRF2), inhibits the expression of matrix metalloproteinases (MMPs) regulated by NF-&kappa, B, and decreases the expression of vascular endothelial growth factor (VEGF). It also promotes the expression of neurogenic-related protein (UCH-L1). The aforementioned results indicated that rutin reduces oxidative stress and inflammatory response in hyperglycemic rats, promoting wound healing and subsequently reducing the risk of wound ulcers.

In this study, the effects of different fruit parts and extraction conditions on the antioxidant properties of jujube (Ziziphus jujuba Mill.) fruit were investigated. Five in vitro antioxidant models and statistical analyses were performed. The results revealed that jujube peel with pulp (peel pulp) exhibited better antioxidant capacity than did seeds. Overall, jujube peel pulp extracted using 50% ethanol at 60 &deg, C exhibited the best antioxidant capacity in terms of 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity (0.3 &plusmn, 0 mg/mL), 2,2-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid) radical scavenging activity (0.5 &plusmn, 0 mg/mL), total phenolic content (38.3 &plusmn, 0.4 mg gallic acid equivalent per gram dry weight), total flavonoid content (43.8 &plusmn, 0.2 mg quercetin equivalent per gram dry weight), and reducing power (41.9 &plusmn, 2.2 mg ascorbic acid equivalent per gram dry weight). The results indicated that jujube peel pulp is a more potential natural antioxidant than seeds.

A position observer and a predictive controller for sensorless synchronous-reluctance-motor (SynRM) drive systems are investigated in this paper. The rotor position observer, based on motor parameters, and stator currents and voltages, was designed and implemented to compute the rotor position. A pole-assignment technique was used to provide similar converging rates of the position observer, even when operated at different speeds. Furthermore, a predictive controller was designed to enhance performance. A digital-signal processor (DSP), TMS-320F-28335, was used as a computation tool. Several simulated results are provided and compared with the measured results. The measured results showed that the implemented predictive controller sensorless SynRM drive system could be adjusted from 30 to 1800 rpm with satisfactory performance, including quicker and better tracking responses, and a lower speed drop than that of a proportional-integral (PI) controller.

Radar Warning Receiver (RWR) is one of the basic pieces of combat equipment necessary for the electromagnetic situational awareness of aircraft in modern operations and requires good rapid performance and accuracy. This paper proposes a data processing flow for radar warning devices based on a hierarchical processing mechanism to address the issue of existing algorithms’ inability to balance real-time and accuracy. In the front-level information processing module, multi-attribute decision-making under intuitionistic fuzzy information (IFS) is used to process radar signals with certain prior knowledge to achieve rapid performance. In the post-level information processing module, an improved tri-training method is used to ensure accurate recognition of signals with low pre-level recognition accuracy. To improve the performance of tri-training in identifying radar emitters, the original algorithm is combined with the modified Hyperbolic Tangent Weight (MHTW) to address the problem of data imbalance in the radar identification problem. Simultaneously, cross entropy is employed to enhance the sample selection mechanism, allowing the algorithm to converge rapidly.

Adipokines are a growing group of peptide or protein hormones that play important roles in whole body metabolism and metabolic diseases. Sleep is an integral component of energy metabolism, and sleep disturbance has been implicated in a wide range of metabolic disorders. Accumulating evidence suggests that adipokines may play a role in mediating the close association between sleep disorders and systemic metabolic derangements. In this review, we briefly summarize a group of selected adipokines and their identified function in metabolism. Moreover, we provide a balanced overview of these adipokines and their roles in sleep physiology and sleep disorders from recent human and animal studies. These studies collectively demonstrate that the functions of adipokine in sleep physiology and disorders could be largely twofold: (1) adipokines have multifaceted roles in sleep physiology and sleep disorders, and (2) sleep disturbance can in turn affect adipokine functions that likely contribute to systemic metabolic derangements.

Alert dwell time, defined as the time elapsed from the generation of an interruptive alert to its closure, has rarely been used to describe the time required by clinicians to respond to interruptive alerts. Our study aimed to develop a tool to retrieve alert dwell times from a homegrown CPOE (computerized physician order entry) system, and to conduct exploratory analysis on the impact of various alert characteristics on alert dwell time. Additionally, we compared this impact between various professional groups. With these aims, a dominant window detector was developed using the Golang programming language and was implemented to collect all alert dwell times from the homegrown CPOE system of a 726-bed, Taiwanese academic medical center from December 2019 to February 2021. Overall, 3,737,697 interruptive alerts were collected. Correlation analysis was performed for alerts corresponding to the 100 most frequent alert categories. Our results showed that there was a negative correlation (ρ = −0.244, p = 0.015) between the number of alerts and alert dwell times. Alert dwell times were strongly correlated between different professional groups (physician vs. nurse, ρ = 0.739, p < 0.001). A tool that retrieves alert dwell times can provide important insights to hospitals attempting to improve clinical workflows.