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To evaluate system task availability under the condition of real-time fault feature parameter input, a method of assessing task availability capability based on characteristic parameters was proposed. By introducing the neuro-fuzzy system(NFS), a vulnerability model of the aviation insurance system was established, and fuzzy rules were integrated into the framework of neural networks to establish an assessment model for system task availability capability. This method combined the reasoning ability of fuzzy logic and the infinite approximation function ability of neural networks to create an alternative model of the real system, which was more universal. Moreover, an intelligent optimization algorithm was used to make the alternative model approach to the real model, getting rid of the influence of unknown weight coefficients in the system that relied on experts or experience and endowing the fuzzy neural network(FNN) with learning capabilities. The experimental results and analysis show that the assessment model is comprehensive and reasonable and can be extended to the underwater field to assess the mission capabilities of navigation support systems and naval ship systems.

Abstract Choroidal neovascularization (CNV) underlies the crux of many angiogenic eye disorders. Although medications that target vascular endothelial growth factor (VEGF) are approved for treating CNV, their effectiveness in destroying new blood vessels is limited, and invasive intravitreal administration is required. Additionally, other drugs that destroy established neovessels, such as combretastatin A‐4, may have systemic side effects that limit their therapeutic benefits. To overcome these shortcomings, a two‐pronged anti‐vascular approach is presented for CNV treatment using a photoactivatable nanoparticle system that can release a VEGF receptor inhibitor and a vascular disrupting agent when irradiated with 690 nm light. The nanoparticles can be injected intravenously to enable anti‐angiogenic and vascular disrupting combination therapy for CNV through light irradiation to the eyes. This approach can potentiate therapeutic effects while maintaining a favorable biosafety profile for choroidal vascular diseases.

Summary: Fundus fluorescein angiography (FFA) examinations are widely used in the evaluation of fundus disease conditions to facilitate further treatment suggestions. Here, we present a protocol for performing deep learning-based FFA image analytics with classification and segmentation tasks. We describe steps for data preparation, model implementation, statistical analysis, and heatmap visualization. The protocol is applicable in Python using customized data and can achieve the whole process from diagnosis to treatment suggestion of ischemic retinal diseases.For complete details on the use and execution of this protocol, please refer to Zhao et al.1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Abstract Background The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active. Methods Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis. Results Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) ‘unpredictable’ troubles: they tended to favor the ‘optimal’ solution of keeping their lives in order rather than the best medical treatment options. Conclusion This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the ‘inaccessibility’ of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education.

Abstract Introduction This trial aimed to compare the efficacy and safety between biosimilar QL1207 and the reference aflibercept for the treatment of neovascular age-related macular degeneration (nAMD). Methods This randomized, double-blind, phase 3 trial was conducted at 35 centers in China. Patients aged ≥ 50 years old with untreated subfoveal choroidal neovascularization secondary to nAMD and best-corrected visual acuity (BCVA) letter score of 73–34 were eligible. Patients were randomly assigned to receive intravitreous injections of QL1207 or aflibercept 2 mg (0.05 ml) in the study eye every 4 weeks for the first 3 months, followed by 2 mg every 8 weeks until week 48, stratified by baseline BCVA ≥ or

In this paper, a new command filter-based adaptive NN control strategy is developed to address the prescribed tracking performance issue for a class of nonstrict-feedback nonlinear systems. Compared with the existing performance functions, a new performance function, the fixed-time performance function, which does not depend on the accurate initial value of the error signal and has the ability of fixed-time convergence, is proposed for the first time. A radial basis function neural network is introduced to identify unknown nonlinear functions, and the characteristic of Gaussian basis functions is utilized to overcome the difficulties of the nonstrict-feedback structure. Moreover, in contrast to the traditional Backstepping technique, a command filter-based adaptive control algorithm is constructed, which solves the “explosion of complexity” problem and relaxes the assumption on the reference signal. Additionally, it is guaranteed that the tracking error falls within a prescribed small neighborhood by the designed performance functions in fixed time, and the closed-loop system is semi-globally uniformly ultimately bounded (SGUUB). The effectiveness of the proposed control scheme is verified by numerical simulation.

Abstract Female infertility is a worldwide concern that impacts the quality of life and well-being of affected couples. Failure of embryo implantation is a major cause of early pregnancy loss and is precisely regulated by a programmed molecular mechanism. Recent studies have shown that proper trophoblast adhesion and invasion are essential for embryo implantation. However, the potential regulatory mechanism involved in trophoblast adhesion and invasion has yet to be fully elucidated. KRT18 has been reported to play a critical role in early embryonic development, but its physiological function in embryo implantation remains unclear. In the present study, we revealed that KRT18 was highly expressed in trophoblast cells and that knockdown of KRT18 in mouse embryos inhibited embryo adhesion and implantation. In vitro experiments further showed that silencing KRT18 disturbed trophoblast migration and invasion. More importantly, we provide evidence that KRT18 directly binds to and stabilizes cell surface E-cadherin in trophoblast cells through microscale thermophoresis (MST) analysis and molecular biology experiments. In brief, our data reveal that KRT18, which is highly expressed in trophoblast cells, plays an important role in the regulation of trophoblast invasion and adhesion during embryo implantation by directly binding to E-cadherin.

BackgroundThe development of prenatal diagnosis technology allows prompt detection of severe fetal diseases. To address adverse factors that threaten fetal survival, fetal therapy came into existence, which aims to preserve the function after birth to a higher degree and improve the quality of life.ObjectiveTo conduct a comprehensive bibliometric analysis of studies on fetal therapy in the past decade and explore the research trends and hotspots in this field.MethodsWe conducted a systematic search on the Web of Science Core Collection to retrieve studies related to fetal therapy published from 2012 to 2022. VOSviewer and CiteSpace were used to analyze the key features of studies, including annual output, countries/regions, institutions, authors, references, research hotspots, and frontiers.ResultsA total of 9,715 articles were included after eliminating duplicates. The annual distribution of the number of articles showed that the number of articles published in fetal therapy had increased in the past decade. Countries and institutions showed that fetal therapy is more mature in the United States. Author analysis showed the core investigators in the field. Keyword analysis showed the clustering and emergence frequency, which helped summarize the research results and frontier hotspots in this field. The cocited references were sorted out to determine the literature with a high ranking of fetal therapy in recent years, and the research trend in recent years was analyzed.ConclusionsThis study reveals that countries, institutions, and researchers should promote wider cooperation and establish multicenter research cooperation in fetal therapy research. Moreover, fetal therapy has been gradually explored from traditional surgical treatment to gene therapy and stem cell therapy. In recent years, fetoscopic laser surgery, guideline, and magnetic resonance imaging have become the research hotspots in the field.

Objective: To assess the relationship between optic disc microvasculature and renal function in subjects with diabetes mellitus without diabetic retinopathy (DR). Design: Prospective, cross-sectional study. Participants: A total 1629 patients with type 2 diabetes mellitus without DR were recruited from the community of Guangzhou, China. Methods: All subjects underwent 6 mm × 6 mm OCT angiography (OCTA) centered on the optic nerve head. Four state-of-the-art microcirculation parameters, including peripapillary vessel density (PVD) in the radial peripapillary capillaries (RPC), superficial capillary plexus, deep capillary plexus (DCP), and a choriocapillaris flow void density percentage (CC FVD%) were assessed via swept-source OCTA. Primary Outcomes: Renal function was assessed by levels of microalbuminuria (MAU) and estimated glomerular filtration rate (eGFR). Results: Compared with non-chronic kidney disease (CKD) participants, PVD was significantly lower in subjects in the CKD group and worsened as eGFR declined. After adjustment for covariates, higher eGFR was significantly associated with higher PVD in the RPC (β = 0.01; 95% confidence interval [CI], 0.01–0.02; P < 0.001), in the superficial capillary plexus (β = 0.010; 95% CI, 0.002–0.019; P = 0.020), in the DCP (β = 0.02; 95% CI, 0.01–0.03; P < 0.001), and lower CC FVD% (β = −0.01; 95% CI, −0.03 to −0.001; P = 0.040) in the entire images. After they were fully adjusted, the parameters in the inner ring of the RPC, DCP, and CC FVD% were significantly associated with MAU (P < 0.05). Conclusion: Decrease in retinal and choroidal microcirculation in the optic nerve head was independently associated with renal dysfunction. Further longitudinal studies are needed to clarify the peripapillary vessel changes during CKD progression. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Abstract Choroidal neovascularization (CNV) is the key pathological event of wet age‐related macular degeneration (wAMD) leading to irreversible vision loss. Currently, anti‐angiogenic therapy with anti‐vascular endothelial growth factor (VEGF) agents has become the standard treatment for wAMD, while it is still subject to several limitations, including the safety concerns of monthly intravitreal administration and insufficient efficacy for neovascular occlusion. Combined therapy with photodynamic therapy (PDT) and anti‐angiogenic agents has emerged as a novel treatment paradigm. Herein, a novel and less‐invasive approach is reported to achieve anti‐angiogenic and photodynamic combination therapy of wAMD by intravenous administration of a photoactivatable nanosystem (Di‐DAS‐VER NPs). The nanosystem is self‐assembled by reactive oxygen species (ROS)‐sensitive dasatinib (DAS) prodrug and photosensitizer verteporfin (VER). After red‐light irradiation to the diseased eyes, intraocular release of anti‐angiogenic DAS is observed, together with selective neo‐vessels occlusion by VER‐generated ROS. Notably, Di‐DAS‐VER NPs demonstrates promising therapeutic efficacy against CNV with minimized systemic toxicity. The study enables an efficient intravenous wAMD therapy by integrating a photoactivation process with combinational therapeutics into one simple nanosystem.

Objective We aimed to construct and validate a prognostic nomogram to predict cancer-specific survival (CSS) after surgery in patients with advanced endometrial carcinoma (EC).Design Retrospective cohort study.Setting and participants The Surveillance, Epidemiology, and End Results (SEER) Database contains cancer incidence and survival data from population-based cancer registries in the USA. A total of 5445 patients from the SEER Database diagnosed with advanced EC between 2004 and 2015 were included and randomised 7:3 into a training cohort (n=3812) and a validation cohort (n=1633).Outcome measure CSS.Results The nomograms for CSS included 10 variables (positive regional nodes, age, tumour size, International Federation of Gynecology and Obstetrics (FIGO) stage, grade, ethnicity, income, radiation, chemotherapy and historical stage) based on the forward stepwise regression results. They revealed discrimination and calibration using the concordance index (C-index) and area under the time-dependent receiver operating characteristic curve, with a C-index value of 0.7324 (95% CI=0.7181 to 0.7468) and 0.7511 (95% CI=0.7301 to 0.7722) for the training and validation cohorts, respectively. Using calibration plots, a high degree of conformance was shown between the predicted and observed results. Additionally, a comparison of the nomogram and FIGO staging based on changes in the C-index, net reclassification index and integrated discrimination improvement demonstrated that the nomogram had better accuracy and efficacy.Conclusions We successfully constructed an accurate and effective nomogram to predict CSS in patients with advanced EC, which may help clinicians determine optimal individualised treatment strategies for patients with advanced EC. The predictive performance of the nomogram was evaluated thoroughly, but only internally. Therefore, further validation using different data sources is warranted in future related studies.

Recent studies have revealed that the Kerivoula depressa complex should be divided into two species, K. depressa distributed mainly in Myanmar, Vietnam, Laos and Cambodia, and K. dongduongana found only in the Annamite Mountains of Vietnam, Laos and Cambodia. In November 2018 and April 2019, 24 woolly bats were collected by two-band harp traps in Xishuangbanna, Yunnan, China. Based on morphological, morphometric, and phylogenetic (COI, Cytb, and RAG2 gene sequences) analyses, these bats were identified as K. depressa and K. dongduongana, representing two new species records for the country. Including the new records, six Kerivoula species have been recorded in China, namely K. depressa, K. dongduongana, K. furva, K. kachinensis, K. picta and K. titania. To facilitate their identification and biological research in the future, we have provided an up-to-date key to all Kerivoula species occurring in China.

Abstract Background Plenty of studies explored the most optimal treatment protocol for infertile women with adenomyosis in in-vitro fertilization (IVF) /intracytoplasmic sperm injection (ICSI), however, there is still no consensus on which treatment protocol is ideal for these women at present. So, we conducted this study comparing the pregnancy outcomes in infertile women with ultrasound-diagnosed adenomyosis who underwent GnRH antagonist protocol with freeze-all strategy or long-acting GnRH agonist protocol. Methods This was a retrospective cohort study and a propensity-score matching (PSM) analysis including 282 women diagnosed with adenomyosis undergoing their first IVF/ICSI cycle from January 2016 to July 2021 at the Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, China. The patients were divided into two groups: the GnRH antagonist protocol with freeze-all strategy (n = 168) and the long-acting GnRH agonist protocol with fresh embryo transfer (n = 114) according their treatment protocols. The primary outcome was live birth rate. Cumulative live birth rate was also calculated. Results After adjusting for confounders, clinical pregnancy rate (49.40% vs 64.04%; odds ratio (OR) 1.33; 95% confidence interval (CI) 0.70 to 2.37; P = 0.358), live birth rate (36.90% vs 45.61%; OR 1.10; 95% CI 0.61 to 2.00, P = 0.753) and cumulative live birth rate (51.79% vs 64.04%; OR 1.01; 95% CI 0.49 to 1.74, P = 0.796) were not significantly different between the GnRH antagonist protocol with freeze-all strategy and long-acting GnRH agonist protocol. Similar results were conducted in PSM analysis with clinical pregnancy rate (46.48% vs 60.56%; OR 1.33; 95% CI 0.76 to 2.34; P = 0.321), live birth rate (32.39% vs 45.07%; OR 1.31; 95% CI 0.63 to 2.72, P = 0.463) and cumulative live birth rate (54.90% vs 60.60%; OR 1.01; 95% CI 0.59 to 1.74, P = 0.958). Conclusions For infertile women with adenomyosis, these two treatment protocols resulted in similar pregnancy outcomes. Larger, prospective studies are needed in the future.

Abstract This paper addresses constrained robust control for dynamic positioning of the Liquefied Natural Gas (LNG) Carrier in side‐by‐side offloading operations subject to input time delay. During the LNG offloading operation, the relative motions of the multibody system are connected by the LNG offloading arm. To ensure the operation safety, robust control with asymmetric Barrier Lyapunov Function is proposed considering predefined output constraints under the unknown dynamics and external disturbances. In offshore engineering, due to the mechanical effects, the thrusters of the LNG carrier in the presence of time‐delay should be investigated to guide the design practice. The predictor‐based method is employed to deal with the time delay induced by the control inputs. It is proven that the proposed scheme can guarantee semi‐global uniform ultimate boundedness. The performance and feasibility of the proposed control are further verified by simulation studies.

Preeclampsia (PE) is a severe placenta-related pregnancy disease that has been associated with maternal systemic inflammation and immune system disorders. However, the distribution and functional changes in immune cells of the maternal–placental interface have not been well characterized. Herein, cytometry by time-of-flight mass spectrometry (CyTOF) was used to investigate the immune atlas at the decidua, which was obtained from four PE patients and four healthy controls. Six superclusters were identified, namely, T cells, B cells, natural killer (NK) cells, monocytes, granulocytes, and others. B cells were significantly decreased in the PE group, among which the reduction in CD27+CD38+ regulatory B cell (Breg)-like cells may stimulate immune activation in PE. The significantly increased migration of B cells could be linked to the significantly overexpressed chemokine C-X-C receptor 5 (CXCR5) in the PE group, which may result in the production of excessive autoantibodies and the pathogenesis of PE. A subset of T cells, CD11c+CD8+ T cells, was significantly decreased in PE and might lead to sustained immune activation in PE patients. NK cells were ultimately separated into four subsets. The significant reduction in a novel subset of NK cells (CD56-CD49a-CD38+) in PE might have led to the failure to suppress inflammation at the maternal–fetal interface during PE progression. Moreover, the expression levels of functional markers were significantly altered in the PE group, which also inferred that shifts in the decidual immune state contributed to the development of PE and might serve as potential treatment targets. This is a worthy attempt to elaborate the differences in the phenotype and function of CD45+ immune cells in the decidua between PE and healthy pregnancies by CyTOF, which contributes to understand the pathogenesis of PE, and the altered cell subsets and markers may inspire the immune modulatory therapy for PE.

Background: Evidence on environmental exposure to perchlorate, nitrate, and thiocyanate, three thyroidal sodium iodine symporter (NIS) inhibitors, and thyroid function in the Chinese population remains limited. Objective: To investigate the associations of environmental exposure to perchlorate, nitrate, and thiocyanate with markers of thyroid function in Chinese adults. Methods: A total of 2441 non-pregnant adults (mean age 50.4 years and 39.1% male) with a median urinary iodine of 180.1 μg/L from four communities in Shenzhen were included in this cross-sectional study. Urinary perchlorate, nitrate, thiocyanate, and thyroid profiles, including serum free thyroxine (FT4), total thyroxine (TT4), free triiodothyronine (FT3), total triiodothyronine (TT3), and thyroid stimulating hormone (TSH), were measured. Generalized linear model was applied to investigate the single-analyte associations. Weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were used to examine the association between the co-occurrence of three anions and thyroid profile. Results: The median levels of urinary perchlorate, nitrate, and thiocyanate were 5.8 μg/g, 76.4 mg/g, and 274.1 μg/g, respectively. After adjusting for confounders, higher urinary perchlorate was associated with lower serum FT4, TT4, and TT3, and higher serum FT3 and TSH (all P

As a common feature of tumors, chromosomal instability (CIN) not only forces carcinomatous evolution, but also loads cancer cells with extra pressure through a robust imbalance of genome patterning that may be used for cancer treatment. Errors in cytokinesis increase CIN, so cytokinesis components are valuable targets for treating cancer. However, due to the short time span and confined space of cytokinesis bridges, profiling cytokinesis factors is challenging. Taking advantage of engineered ascorbate peroxidase (APEX2), we established a cytokinesis bridge-APEX reaction in living cells. A total of 218 cytokinesis bridge proteins were identified with high reliability. Knockdown of cytokinesis bridge genes generated micronuclei that activate the cGAS-pathway and cause apoptosis in cancer cells bearing high CIN rather than low CIN. Thus, our study proposes a strategy for killing high-CIN tumors regardless of tumor type, and provides a proteome resource of cytokinetic bridges for future research.

Abstract Vessel train formation as a new trend has been raised in cooperative control for multiple vessels. This paper addresses formation control design for a group of unmanned surface vehicles platoon considering input delay. To account for connectivity-preserving and collision-avoiding, Barrier Lyapunov function is incorporated into the constraints design of line-of-sight range and bearing. To alleviate the computational burden, neural dynamic model is employed to simplify the control design and smooth the input signals. Besides, input control arising from time delay due to mechanisms and communication is considered in the marine vessels. Within the framework of the backstepping technique, distributed coordination is accomplished in finite time and the uniformly ultimately boundness of overall system is guaranteed via rigorous stability analysis. Finally, the simulation is performed to verify the effectiveness of the proposed control method.

Introduction Although obesity is one of the established risk factors of diabetes mellitus, the relationship between obesity and diabetic retinopathy (DR) remains unclear in different studies. This study aimed to investigate the association of DR with four obesity-related indexes, including body mass index (BMI), waist to hip ratio (WHR), waist to height ratio (WHtR) and body adiposity index (BAI) in patients with diabetes.Research design and methods We prospectively enrolled 2305 patients with diabetes (2305 eyes) in the Guangzhou Diabetic Eye Study between November 2017 and December 2019 to investigate the prevalence and the association of different types of obesity with DR using BMI, WHR, WHtR and BAI. DR, diabetic macular oedema (DME) and vision-threatening DR (VTDR) were selected as primary outcomes. BMI was categorised as normal (18.5–22.9 kg/m2), overweight (23.0–25.0 kg/m2) and obese (>25.0 kg/m2); WHR, WHtR and BAI were categorised into quarters.Results A total of 336 (14.58%), 93 (4.03%) and 98 (4.25%) developed DR, DME and VTDR, respectively. The prevalence of DR, DME and VTDR was higher in patients with higher BMI/WHR or lower WHtR/BAI. In the univariate regression model, WHR correlated positively with DR, while WHtR and BAI correlated negatively with DR, DME and VTDR. The association remained independent of age, sex and lipid metabolism parameters. In the multivariate model, obese presented as a protective factor for DME and VTDR, while the second quarter of WHtR(Q2-WHtR) presented as a risk factor.Conclusions As high as 67.8% of patients with diabetes were overweight or obese. Obese presented as a significant protective factor of VTDR, while Q2-WHtR presented as a significant risk factor. Therefore, more attention should be paid to centripetal obesity as well as general obesity. Further research is also needed to focus on the improvement of sex-specific weight management in patients with diabetes.

BackgroundThe relationship between obesity and diabetic retinopathy (DR) remains controversial. The aim of this study was to assess the association of generalized obesity [assessed by body mass index (BMI)] and abdominal obesity [assessed by waist to hip ratio (WHR)] with incident DR, and vision-threatening DR (VTDR), and DR progression among Chinese adults with type 2 diabetic mellitus (T2DM).MethodThis prospective cohort study was conducted at the Zhongshan Ophthalmic Center, from November 2017 to December 2020. DR was assessed based on the 7-filed fundus photographs using the modified Airlie House Classification. Multivariable logistic regression models were used to evaluate the associations of BMI and WHR with the development and progression of DR after adjusting for age, sex, traditional risk factors, and mutually for BMI and WHR.ResultsAmong the 1,370 eligible participants, 1,195 (87.2%) had no sign of any DR and 175 (12.8%) had DR at baseline examination. During the 2 years follow-up visit, 342 (28.6%) participants had incident DR, 11 (0.8%) participants developed VTDR, 15 (8.6%) demonstrated DR progression. After adjusting for confounders, the BMI was negatively associated with incident DR [relative risk (RR) =0.31; 95% confidence interval (CI), 0.26–0.38; P < 0.001] and incident VTDR (RR = 0.22; 95%CI, 0.11–0.43; P < 0.001), while WHR was positively associated with incident DR (RR = 1.47; 95% CI, 1.27–1.71; P < 0.001). BMI and WHR level were not significantly associated with 2-year DR progression in multivariate models (all P > 0.05).ConclusionsThis study provides longitudinal evidence that generalized obesity confer a protective effect on DR, while abdominal obesity increased the risk of DR onset in Chinese patients, indicating that abdominal obesity is a more clinically relevant risk marker of DR than generalized obesity.

Offshore operations have been moving towards ultra-deep waters where rich resources are detected and mined in a challenging environment. Dynamic Positioning (DP) control remains a challenge due to time delay in the input control and unknown wave or wind disturbance. In this paper, robust control is proposed for the DP of an accommodation vessel in the presence of the input time delay. In order to overcome the unknown dynamics and external disturbances, a robust controller with predefined tracking constraints is developed to guarantee a safe operation. Time delay caused by the control input is also considered on the predictor-based method. The boundedness of all closed-loop signals is demonstrated via rigorous Lyapunov analysis. Simulation studies help demonstrate outstanding performance and feasibility of the proposed control structure.

This paper addresses the decentralized problem for marine surface vessels (MSVs) in the presence of unknown unmodeled nonlinear dynamics, time-varying external disturbances and input saturations. First, platoon formation is proceeded by using line-of-sight (LOS) guidance. Since each marine vehicle can only acquire information from its immediate predecessor, a symmetric barrier Lyapunov function (BLF) is employed to guarantee the formation errors constrained within a certain range such that leaders and followers can preserve the predefined information structure and ensure the correct steady-state regime. Next, due to the superior approximation capability of an adaptive neural network (NN), we propose a BLF-based controller to deal with the model uncertainties. Further, an auxiliary design system is introduced to compensate for the effect of input saturation. Finally, the uniform ultimate boundedness of all the state errors can be proved and simulation examples are presented to illustrate the effectiveness of the proposed method.

Background: Excess selenium has been related with adverse lipid levels in previous epidemiological studies. Meanwhile, a functional variant in SEPP1 (encodes selenoprotein P), namely rs7579, has been suggested to modulate lipid metabolism. However, the interactions between selenium status and rs7579 polymorphism on lipid changes remain unclear.Objective: To examine whether the associations between plasma selenium and 3-year lipid changes is modified by rs7579 polymorphism.Methods: A prospective cohort study was conducted among 1,621 individuals to examine the associations between baseline plasma selenium and 3-year lipid changes, as well as the interactions between plasma selenium and rs7579 polymorphism on lipid changes.Results: The median (interquartile range) concentration of plasma selenium was 91.68 (81.55–104.92) μg/L. Higher plasma selenium was associated with adverse 3-year lipid changes. Comparing the highest to the lowest quartiles of plasma selenium concentrations, 3-year lipid changes were elevated by 8.25% (95% CI: 1.54–14.96%) for triglycerides (P = 0.016), 5.88% (3.13–8.63%) for total cholesterol (P < 0.001), 7.37% (3.07–11.67%) for low-density lipoprotein cholesterol (P = 0.0008), 6.44% (2.66–10.21%) for non-high-density lipoprotein cholesterol (P = 0.0009), 4.99% (0.62–9.36%) for total cholesterol/high-density lipoprotein cholesterol ratio (P = 0.025), and 7.00% (1.55–12.46%) for low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio (P = 0.012). In analyses stratified by rs7579 genotypes, positive associations between plasma selenium concentrations and 3-year changes in triglycerides, TC, LDL-C, non-HDL-C, TC/HDL-C ratio, and LDL-C/HDL-C ratio were observed among CC genotype carriers, but negative associations between plasma selenium and TC/HDL-C ratio, and LDL-C/HDL-C ratio were observed among TT genotype carriers.Conclusions: Our findings suggested that plasma selenium was associated with 3-year lipid changes differentially by rs7579 genotypes, and higher plasma selenium was associated with adverse lipid changes among rs7579 CC genotype carriers, but not among T allele carriers.

Purpose: To investigate the error rate of segmentation in the automatic measurement of anterior chamber volume (ACV) and iris volume (IV) by swept-source anterior segment optical coherence tomography (SS-ASOCT) in narrow-angle and wide-angle eyes.Methods: In this study, fifty eyes from 25 narrow-angle subjects and fifty eyes from 25 wide-angle subjects were enrolled. SS-ASOCT examinations were performed and each SS-ASOCT scan was reviewed, and segmentation errors in the automatic measurement of ACV and IV were classified and manually corrected. Error rates were compared between the narrow-angle and the wide-angle groups, and ACV and IV before and after manual correction were compared.Results: A total of 12,800 SS-ASOCT scans were reviewed. Segmentation error rates of angle recess, iris root, posterior surface of the iris, pupil margin, and anterior surface of the lens were 84.06, 93.30, 13.15, 59.21, and 25.27%, respectively. Segmentation errors of angle recess, iris root, posterior surface of the iris, and pupil margin occurred more frequently in narrow-angle eyes, while more segmentation errors of the anterior surface of the lens were found in wide-angle eyes (all P < 0.001). ACV decreased and IV increased significantly after manual correction of segmentation errors in both groups (all P < 0.01).Conclusion: Segmentation errors were prevalent in the volumetric measurement by SS-ASOCT, particularly in narrow-angle eyes, leading to mismeasurement of ACV and IV.

Introduction Myopia is the common cause of reduced uncorrected visual acuity among school-age children. It is more prevalent in urban than in rural areas. Although many myopia studies have focused on the effect of urbanisation, it remains unclear how visual experience in urban regions could affect childhood myopia. This study aims to investigate the incidence and prevalence of myopia among school-age children in urban and rural settings, thereby identifying the environmental factors that affect the onset and progression of myopia.Methods and analysis A school-based cohort study will be conducted. We will enroll all first-grade students from an urban (10 primary schools) and a rural (10 primary schools) regions of Zhaoqing city, China. Over 3-year follow-up period, students will receive detailed eye examinations annually and complete questionnaires about living habits and environment. In a 5% random subsample of the cohort, physical activity, light intensity and eye-tracking data will be obtained using wearable devices, and high-resolution macular images will be obtained by optical coherence tomography (OCT). The primary outcome is incident myopia, defined as myopia (spherical equivalent refractive of at least −0.5D) detected during follow-up among those without myopia at baseline.Ethics and dissemination Ethics approval was obtained from the ethics committee of the Zhongshan Ophthalmic Center (number: 2019KYPJ171). Study findings will be published in a peer-reviewed journal.Trial registration number NCT04219228.

The formation control of unmanned surface vehicles (USVs) while considering communication topology, dynamic model uncertainties, environmental disturbances, and a fast convergence rate is addressed in this paper. First, graph theory is introduced to describe the connective relationships and establish generalized formation errors among USVs. Then, a second-order fast nonsingular terminal sliding-mode control (SOFNTSMC) is designed to guarantee that the system converges quickly and without chatter. An adaptive update law is designed in order to estimate the model uncertainties and external disturbances without the requirement of the boundary information of the system uncertainties. With the application of the adaptive SOFNTSMC (ASOFNTSMC) and graph theory, a distributed control is developed for every USV to perform the desired formation pattern. Finally, the results of simulations and comparisons demonstrate the effectiveness of the proposed method.

Previous behavioral studies on aesthetics demonstrated that there was a close association between perceived action and aesthetic appreciation. However, few studies explored whether motor imagery would influence aesthetic experience and its neural substrates. In the current study, Chinese calligraphy was used as the stimuli to explore the relationship between the motor imagery and the aesthetic judgments of a participant using functional magnetic resonance imaging. The imaging results showed that, compared with the baseline, the activation of the brain regions [e.g., anterior cingulate cortex (ACC), putamen, and insula] involved in perceptual processing, cognitive judgments, aesthetic emotional, and reward processing was observed after the participants performed motor imagery tasks. The contrast analyses within aesthetic judgments showed that the kinesthetic imagery significantly activated the middle frontal gyrus, postcentral gyrus, ACC, and thalamus. Generally, these areas were considered to be closely related to positive aesthetic experience and suggested that motor imagery, especially kinesthetic imagery, might be specifically associated with the aesthetic appreciation of Chinese calligraphy.

Abstract Background Acinetobacter baumannii is a nosocomial pathogen which is reported as a major cause of morbidity and mortality in intensive care units (ICUs). However, there is a lack of analysis focused on multidrug-resistant Acinetobacter baumannii (MDRAB) infection among patients from pediatric intensive care unit (PICU) in China. The aim of this study was to investigate the molecular characterization of MDRAB isolated from PICU. Methods In this study, 86 isolates of MDRAB were collected from PICU patients, from the First Affiliated Hospital of Sun Yat-sen University. The minimal inhibitory concentrations (MICs) of the isolates against common antibiotics were determined. The carbapenemase-encoding resistance genes and AdeABC-AdeRS efflux system genes of these isolates were detected by PCR. Real-time PCR was performed to determine the relative expression of the relevant efflux pumps. Results Among 86 strains of MDRAB, 76.7% (66/86) were carbapenem-resistant A. baumannii (CRAB). All 86 clinical isolates possessed the bla OXA-51 gene. Bla OXA-23 was detected as the second most frequent (90.7%) carbapenemase. Harboring AdeABC efflux pump genes was prevalent among the majority of the MDR isolates. Specially, the distributions of AdeABC-AdeRS efflux system genes in CRAB strains reached up to 90.0%. Compared with those of the CSAB strains, there was a statistically significant increasing distribution of the regulator AdeR and AdeS genes(p

The complete mitochondrial genome of Tylonycteris fulvida (Peters, 1872) was obtained using high-throughput sequencing technology. The genome is a circular molecule of 16,621 bp length, containing 13 protein-coding genes, 2 rRNA genes, 22 tRNA genes, and a control region. A phylogenetic tree of 13 protein-coding genes was constructed using IQ-TREE. Our result suggests that T. fulvida cluster within Chiroptera and Fereuungulata. The complete mitochondrial genome sequence of T. fulvida will be helpful for future taxonomic and phylogenetic studies on Chiroptera.

A three-dimensional (3D) deep learning method is proposed, which enables the rapid diagnosis of coronavirus disease 2019 (COVID-19) and thus significantly reduces the burden on radiologists and physicians. Inspired by the fact that the current chest computed tomography (CT) datasets are diversified in equipment types, we propose a COVID-19 graph in a graph convolutional network (GCN) to incorporate multiple datasets that differentiate the COVID-19 infected cases from normal controls. Specifically, we first apply a 3D convolutional neural network (3D-CNN) to extract image features from the initial 3D-CT images. In this part, a transfer learning method is proposed to improve the performance, which uses the task of predicting equipment type to initialize the parameters of the 3D-CNN structure. Second, we design a COVID-19 graph in GCN based on the extracted features. The graph divides all samples into several clusters, and samples with the same equipment type compose a cluster. Then we establish edge connections between samples in the same cluster. To compute accurate edge weights, we propose to combine the correlation distance of the extracted features and the score differences of subjects from the 3D-CNN structure. Lastly, by inputting the COVID-19 graph into GCN, we obtain the final diagnosis results. In experiments, the dataset contains 399 COVID-19 infected cases, and 400 normal controls from six equipment types. Experimental results show that the accuracy, sensitivity, and specificity of our method reach 98.5%, 99.9%, and 97%, respectively.

Purpose. To investigate the choroidal vascularity index (CVI) as a prognostic factor for the visual efficacy of antivascular endothelial growth factor (VEGF) treatment in diabetic macular edema (DME). Methods. We retrospectively reviewed 92 DME eyes receiving anti-VEGF treatment, which were stratified as responders (≥5 letters gained) and nonresponders (5 letters in visual acuity after anti-VEGF treatment. CVI may serve as a novel biomarker for visual response to anti-VEGF treatment in DME.

Background: We investigated whether specific appointments for quality-assured care could increase referral uptake, often low in China, in children's vision screening. Methods: We randomized children aged 4–7 years in Yudu, Jiangxi, China, by school to Control (free school-based eye screening, parents of children failing screening recommended for further examination [usual practice]) or Intervention (identical examinations, with parents additionally provided with specific appointments for further examinations by quality-assured doctors at a designated local hospital). Both groups could select any hospital for referral exams, which were not free. Six months after screening, parents were interviewed on referral compliance at any hospital (primary outcome) and potential determinants. This trial is registered at the ClinicalTrials.gov, number NCT 03251456. Findings: Among 9936 children at 63 schools randomized to Intervention (32 schools, 5053 [50·9%] children) or Control (31 schools, 4883 [49·1%] children), 1114 children (11·2%) failed screening. Among 513 referred Intervention children (46·1%, 32 schools, mean age 5·36 years, 53·0% boys) and 601 referred Control children (53·9%, 31 schools, mean age 5·30 years, 57·7% boys), 104 (20·3%) and 135 (22·5%) were lost to follow-up respectively. Under Intention to Treat analysis, assuming children lost to follow-up were non-compliant, Intervention children had significantly higher compliance than Controls (308/513 = 60·0% vs. 225/601 = 37·4%, P

This paper presents the platoon formation control design for unmanned surface vehicles with input and output constraints. First, Barrier Lyapunov Function (BLF) is employed to ensure the desired line-of-sight (LOS) range. The LOS range should be maintained within the predefined regions between each marine vehicle and its predecessor while the connected platoons track the trajectory. Next, to handle the model uncertainties and unknown external disturbance, we propose an adaptive neural network controller that approximates the unknown nonlinearities. Furthermore, the Nussbaum function is applied to compensate for input saturations. In addition, formation errors can be guaranteed by stability analysis. The distance between two consecutive agents does not violate collision avoidance and connectivity in the presence of input saturation. Finally, the feasibility of the theoretical results is illustrated through the simulation results.

This study aims to evaluate the efficacy of ketorolac with local anesthesia compared to local anesthesia alone for perioperative pain control in day care retinal detachment surgery. The randomized controlled trial included 59 eyes of 59 participants for retinal detachment surgery who were randomly assigned (1 : 1) into the ketorolac (K) group and control (C) group. All participants underwent conventional local anesthesia while patients in the K group received an extra administration of preoperative ketorolac. Participants in the K group had a statistically significantly lower intraoperative NRS score (median 1.0 versus 3.0, P=0.003), lower postoperative NRS score (median 0 versus 1.0, P=0.035), fewer proportion of rescue analgesic requirement (10% versus 34.5%, P=0.023), and lower incidence of postoperative nausea and vomiting (13.3% versus 41.4%, P=0.015) compared to the C group. Intraocular pressure (IOP) changes (△IOP) were significantly reduced in the K group (median 1.9 versus 3.0, P=0.038) compared to the C group 24 hours postoperatively. In conclusion, the combination of local anesthesia with ketorolac provides better pain control in retinal detachment surgery compared to local anesthesia alone. The beneficial effect of ketorolac with local anesthesia may contribute to a wider-spread adoption of day care retinal detachment surgery. This trial is registered with ClinicalTrials.gov NCT02729285.