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Atrial fibrosis is an essential contributor to atrial fibrillation (AF). It remains unclear whether atrial endocardial endothelial cells (AEECs) that undergo endothelial-mesenchymal transition (EndMT) are among the sources of atrial fibroblasts. We studied human atria, TGF-[beta]-treated human AEECs, cardiac-specific TGF-[beta]-transgenic mice, and heart failure rabbits to identify the underlying mechanism of EndMT in atrial fibrosis. Using isolated AEECs, we found that miR-181b was induced in TGF-[beta]-treated AEECs, which decreased semaphorin 3A (Sema3A) and increased EndMT markers, and these effects could be reversed by a miR-181b antagomir. Experiments in which Sema3A was increased by a peptide or decreased by a siRNA in AEECs revealed a mechanistic link between Sema3A and LIM-kinase 1/phosphorylated cofilin (LIMK/p-cofilin) signaling and suggested that Sema3A is upstream of LIMK in regulating actin remodeling through p-cofilin. Administration of the miR181b antagomir or recombinant Sema3A to TGF-[beta]-transgenic mice evoked increased Sema3A, reduced EndMT markers, and significantly decreased atrial fibrosis and AF vulnerability. Our study provides a mechanistic link between the induction of EndMT by TGF-[beta] via miR-181b/Sema3A/LIMK/p-cofilin signaling to atrial fibrosis. Blocking miR-181b and increasing Sema3A are potential strategies for AF therapeutic intervention., Introduction Atrial fibrillation (AF) is the most common sustained arrhythmia and results in increased morbidity and mortality. Rhythm control in persistent long-term AF, which is characterized by severe atrial myocyte [...]

Byline: Yi-Fei. Hsin, Shu-Hsin. Chen, Teng-Jen. Yu, Chung-Chi. Huang, Yen-Huey. Chen PURPOSE: Muscle atrophy and diaphragm dysfunction are common with prolonged mechanical ventilation (PMV). Electrical stimulation on peripheral muscles has [...]

Formulaic language is important to language acquisition; however, English language learners are often reported to have problems with formulaic expressions. Several lists of formulaic sequences have been proposed, mainly for developing teaching and testing materials. However, their limited numbers and insufficient usage information seem unable to benefit formulaic language use. To address these issues we have developed GRASP, a reference aid for formulaic expressions, to promote learners' productive competence. Users are allowed multi-word inputs to target their desired phrases or collocations. Utilizing natural language processing techniques, our system categorizes and displays the structures and sequences in a hierarchical way. The corresponding example sentences are also provided. The formulaic structures serve as a quick access index. The formulaic sequences and corpus examples illustrate the real world language use. Importantly, automatic summarization from language data lends support to the idea of data-driven learning. A single-group pre-posttest design was adopted to assess the effectiveness of GRASP on 150 Chinese-speaking college freshmen. The results indicated that our reference aid made a substantial contribution to students' performance on formulaic expression use in a sentence completion task, compared with the existing tools. Notably, the less proficient students showed marked improvement.

Background/Objective: Bereaved family surrogates from intensive care units (ICU) are at risk of comorbid anxiety, depression, and post-traumatic stress disorder (PTSD), but the temporal reciprocal relationships among them have only been examined once among veterans. This study aimed to longitudinally investigate these never-before-examined temporal reciprocal relationships for ICU family members over their first two bereavement years. Methods: In this prospective, longitudinal, observational study, symptoms of anxiety, depression, and PTSD were assessed among 321 family surrogates of ICU decedents from 2 academically affiliated hospitals in Taiwan by the anxiety and depression subscales of the Hospital Anxiety and Depression Scale, and the Impact of Event Scale-Revised, respectively at 1, 3, 6, 13, 18, and 24 months postloss. Cross-lagged panel modeling was conducted to longitudinally examine the temporal reciprocal relationships among anxiety, depression, and PTSD. Results: Examined psychological-distress levels were markedly stable over the first 2 bereavement years: autoregressive coefficients for symptoms of anxiety, depression, and PTSD were 0.585–0.770, 0.546–0.780, and 0.440–0.780, respectively. Cross-lag coefficients showed depressive symptoms predicted PTSD symptoms in the first bereavement year, whereas PTSD symptoms predicted depressive symptoms in the second bereavement year. Anxiety symptoms predicted symptoms of depression and PTSD at 13 and 24 months postloss, whereas depressive symptoms predicted anxiety symptoms at 3 and 6 months postloss while PTSD symptoms predicted anxiety symptoms during the second bereavement year. Conclusions: Different patterns of temporal relationships among symptoms of anxiety, depression, and PTSD over the first 2 bereavement years present important opportunities to target symptoms of specific psychological distress at different points during bereavement to prevent the onset, exacerbation, or maintenance of subsequent psychological distress. [ABSTRACT FROM AUTHOR]

Driving pressure (ΔP) and mechanical power (MP) are associated with increased mortality in patients with acute respiratory distress syndrome (ARDS). We aimed to investigate which was better to predict mortality between changes in ΔP and MP. We reanalyzed data from a prospective observational cohort study of patients with ARDS in our hospital. Serial ΔP and MP values were calculated. The factors associated with survival were analyzed. Binary logistic regression showed that age (odds ratio (OR), 1.012; 95% confidence interval (CI), 1.003–1.022), Sequential Organ Failure assessment (SOFA) score (OR, 1.144; 95% CI, 1.086–1.206), trauma (OR, 0.172; 95% CI, 0.035–0.838), ΔP (OR, 1.077; 95% CI, 1.044–1.111), change in ΔP (OR, 1.087; 95% CI, 1.054–1.120), and change in MP (OR, 1.018; 95% CI, 1.006–1.029) were independently associated with 30-day mortality. Change in MP, change in ΔP, and SOFA scores were superior to ΔP in terms of the accuracy of predicting 30-day mortality. In conclusion, calculating change in ΔP is easy for respiratory therapists in clinical practice and may be used to predict mortality in patients with ARDS. [ABSTRACT FROM AUTHOR]

Obesity has negative impacts on cardiovascular function and may increase cerebrovascular complications during exercise. We compared hemodynamic and cerebral oxygen changes during high-intensity exercise between overweight (OW) and normal-weight (NW) individuals. Eighteen NW and fourteen OW male individuals performed high-intensity (70% of peak oxygen uptake, VO2peak) cycling exercises for 30 min. Hemodynamics were measured using a bioelectrical impedance device, and cerebral oxygenation status was measured using a near-infrared spectrophotometer during and after exercise. The VO2peak of NW individuals was significantly higher than that of OW individuals (41.3 ± 5.7 vs. 30.0 ± 5.0 mL/min/kg, respectively; p < 0.05). During the 30 min exercise, both groups exhibited an increase in oxygenated hemoglobin (O2Hb) (p < 0.001), deoxygenated hemoglobin (p < 0.001), and cardiac output with increasing time. Post-exercise, cardiac output and systemic vascular resistance were significantly higher in the OW group than in the NW group (p < 0.05). The O2Hb in the NW group was significantly higher at post-exercise times of 20 min (13.9 ± 7.0 μmol/L) and 30 min (12.3 ± 8.7 μmol/L) than that in the OW group (1.0 ± 13.1 μmol/L and 0.6 ± 10.0 μmol/L, respectively; p = 0.024 vs. 0.023, respectively). OW participants demonstrated lower cerebral oxygenation and higher vascular resistance in the post-exercise phase than non-OW subjects. These physiological responses should be considered while engaging OW and obese individuals in vigorous exercise. [ABSTRACT FROM AUTHOR]

In the paper, it is proposed to develop a machine learning based intelligent defect detection system for metal products. The common machine vision system has the surface (stain, shallow pit, shallow tumor, scratches, Edge defects, pattern defects) detection, or for the processing of the size, diameter, diameter, eccentricity, height, thickness and other parts of the non-contact numerical parameters of detection. Considering the quality of the work piece and the defects of the standard, so for the quality of customized testing requirements, the study is the development of machine vision and machine learning metal products defect detection system, mainly composed of three procedures: Image preprocessing, training procedures and testing procedures. The system architecture consists of three parts: (1) Image preprocessing: we first use the machine vision. OPENCV to carry out the image pre-processing part of the product before the detection. (2) Training procedures: The algorithm of the machine learning includes the convolution neural network (CNN), chunk-max pooling is used to train the program, and the generative adversarial network (GAN) based architecture is used to solve the problem of small datasets for surface defects. (3) Testing procedures：The Python language is used to write the program and implement the testing procedures with the GPU-Based embedded hardware In industries, collecting training dataset is usually costly and related methods are highly dataset-dependent. So most companies cannot provide Big-data to be analyzed or applied. By the experimental results, the recognition accuracy can be obviously improved as increasing data augmentation by GAN-Based samples maker. Manual inspection is labor intensive, costly and less in efficiency. Therefore, this study will contribute to technological innovation, industry, national development and other applications. (1) The use of intelligent machine learning technology will make the industry 4.0 technology more sophisticated. (2) It will make the development of equipment industry be better by the machine learning applications. (3) It will increase the economics and productivity of countries for the aging of the population by machine learning.

Background: Acute hypoxemic respiratory failure is common in intensive care units (ICUs). Lung biopsies may be required to make a definitive diagnosis in patients with unknown etiologies. The feasibility of transbronchial lung cryobiopsy is undetermined in patients with respiratory failure in the ICU. Methods: Patients who underwent bronchoscopy examinations with transbronchial lung cryobiopsy (TBLC) between July 2018 and December 2019 were retrospectively analyzed through medical chart review. The procedures were performed by well-experienced interventional pulmonologists. Results: Ten patients underwent bronchoscopy examinations with TBLC in the ICU at Chang Gung Memorial Hospital during the study period. In all patients, the diagnosis was made via pathological analysis. One patient developed pneumothorax and required chest tube placement after the procedure. None of the patients had bleeding requiring blood transfusion, and no deaths were directly related to the procedure. Conclusions: TBLC is a feasible technique to obtain lung pathology in patients with acute respiratory diseases of unknown etiologies. While the complication rate may be acceptable, the procedure should be performed by experienced interventional pulmonologists. However, airway blockers and fluoroscopy are highly recommended when used according to the current guideline. We do not encourage TBLC to be performed without having airway blockers available at the bedside. [ABSTRACT FROM AUTHOR]

Prolonged mechanical ventilation (PMV) is associated with poor outcomes and a high economic cost. The association between protein intake and PMV has rarely been investigated in previous studies. This study aimed to investigate the impact of protein intake on weaning from mechanical ventilation. Patients with the PMV (mechanical ventilation ≥6 h/day for ≥21 days) at our hospital between December 2020 and April 2022 were included in this study. Demographic data, nutrition records, laboratory data, weaning conditions, and survival data were retrieved from the patient's electronic medical records. A total of 172 patients were eligible for analysis. The patients were divided into two groups: weaning success (n = 109) and weaning failure (n = 63). Patients with daily protein intake greater than 1.2 g/kg/day had significant shorter median days of ventilator use than those with less daily protein intake (36.5 vs. 114 days, respectively, p < 0.0001). Daily protein intake ≥1.065 g/kg/day (odds ratio: 4.97, p = 0.033), daily protein intake ≥1.2 g/kg/day (odds ratio: 89.07, p = 0.001), improvement of serum albumin (odds ratio: 3.68, p = 0.027), and BMI (odds ratio: 1.235, p = 0.014) were independent predictor for successful weaning. The serum creatinine level in the 4th week remained similar in patients with daily protein intake either >1.065 g/kg/day or >1.2 g/kg/day (p = 0.5219 and p = 0.7796, respectively). Higher protein intake may have benefits in weaning in patients with PMV and had no negative impact on renal function. [ABSTRACT FROM AUTHOR]

With the advent of global high-tech industry and commerce era, the sedentary reduces opportunities of physical activity. And physical fitness and health of people is getting worse and worse. At present, the shortage of physical fitness instructors greatly affected the effectiveness of health promotion. Therefore, it is necessary to develop an auxiliary system which can reduce the workload of instructors and enhance physical fitness and health for people. But current general physical fitness and healthcare system is hard to meet individualized needs. The main purpose of this research is to develop an intelligent auxiliary system for customized physical fitness and healthcare. It records all processes of physical fitness and healthcare system by wireless sensors network. The results of intelligent auxiliary systems for customized physical fitness and healthcare will be generated by fuzzy logic Inference. It will improve individualized physical fitness and healthcare. Finally, we will demonstrate the advantages of the intelligent auxiliary system for customized physical fitness and healthcare.

In the use of the time-domain integral equation (TDIE) method for the analysis of layered media, it is important to have the time-domain layered medium Green's function computed for many source-to-field distances [rho] and time instants t. In this paper, a numerical method is used that computes the mixed potential Green's functions [G.sub.v]([rho], t) and [G.sub.A] ([rho], t) for a multilayered medium for many [rho]'s and t's simultaneously. The method is applicable to multilayered media and for lossless or lossy dispersive media. Salient features of the method are: 1) the use of complex [omega] so that the surface wave poles are lifted off the real [k.sub.[rho]] axis such that pole extractions are not required; 2) the use of half-space extraction so that the integrand for the Sommerfeld integral decays exponentially along the [k.sub.[rho]] axis to obtain fast convergence of the integral; and 3) the use of the fast Hankel transform so that the Green's function is calculated for many values of [rho] simultaneously. For a four-layer medium, we illustrate the numerical results by a three-dimensional plot of [rho][G.sub.v]([rho], t) versus [rho] and t and demonstrate the space-time evolution of these Green's functions. For a maximum frequency range of 8 GHz, the method requires only a few CPU minutes to compute a table of 100 (points in [rho]) x 168 (points in t) uniformly spaced values of [G.sub.v]([rho], t) on an 867-MHz Pentium PC. Index Terms--Discrete transforms, Green function, nonhomogenous media, time-domain analysis.

A method is presented for full-wave modeling of vertical vias in multilayered integrated circuits. The analysis of the interior problem is based upon the cylindrical wave expansion of the magnetic field Green's function. The multiple interaction among vertical vias is modeled by the Foldy-Lax scattering formula. Multilayered effects are included by using cascaded network of the single-layer components. The exterior problem of the via and the transmission line is analyzed using the method of moments approach. The exterior and interior problems are combined into a system of equations to facilitate the solution of a large number of vias. Using this approach, the scattering matrix of problems of several thousand vias can be calculated with moderate CPU and memory requirement. Numerical results have been obtained for different via configurations and for a large range of frequency. Also illustrated are results for common and differential mode in differential signaling with surrounding idle and shorting vias. Index Terms--Differential signaling, scattering parameter, via-coupling.

Diffuse alveolar damage (DAD) is the pathological hallmark of acute respiratory distress syndrome (ARDS). DAD is independently correlated with higher mortality compared with the absence of DAD. Traction bronchiectasis in areas of ground-glass opacity or consolidation is associated with the late fibroproliferative or fibrotic phase of DAD. This study examined whether the 60-day mortality related to DAD could be predicted using high-resolution computed tomography (HRCT) findings and HRCT scores. A total of 34 patients with DAD who received HRCT within 7 days of ARDS diagnosis were enrolled; they were divided into a 60-day survival group and a nonsurvival group, with 17 patients in each group. Univariate and multivariate binary regression analyses and the receiver operating characteristic curve revealed that only the total percentage of the area with traction bronchiectasis or bronchiolectasis was an independent predictor of 60-day mortality (odds ratio, 1.067; 95% confidence interval (CI), 1.011–1.126) and had favorable predictive performance (area under the curve (AUC): 0.784; 95% CI, 0.621–0.946; cutoff, 21.7). Physiological variables, including age, days from ARDS to HRCT, the sequential organ failure assessment (SOFA) score, the PaO2/fraction of inspired oxygen (FiO2) ratio, dynamic driving pressure, and dynamic mechanical power, were not discriminative between 60-day survival and nonsurvival. In conclusion, the extent of fibroproliferation on HRCT in early ARDS, presented as the total percentage of area with bronchiectasis or bronchiolectasis, is an independent positive predictor with a favorable predictive ability for the 60-day mortality of DAD. [ABSTRACT FROM AUTHOR]