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Understanding building area in agricultural land is important since arable land area in Taiwan is limited. One of the practical ways is manual digitization on high resolution satellite imagery, which can avoid field investigation and achieve satisfying results. However, such practice is tedious and labor intensive. Past researches have shown that deep learning methods are useful to segment buildings in different cities using satellite imagery. In this study, ENVINet5 model was trained and used to segment buildings from high resolution Pleiades pansharpened imagery. The training images (with the size of 2500 pixels × 2500 pixels) were randomly selected from 9 counties/cities to increase diversity since each county/city has different building patterns. The performance of ENVINet5 model reached 0.977, 0.814, 0.847, and 0.829 respectively on accuracy, precision, recall, and F1 score. Since evaluation by pixels can be difficult to show geometry of buildings, we evaluated the model by counting the number of inference building segments, which was post-processed from inference result of ENVINet5 trained model. Further analysis by counting the inference building segments is discussed in this study.

Objectives To explore the causes of cochlear implantation and reference function of old electrical stimulation electrode in cochlear reimplantation in children. Methods The causes, surgical methods and problems found during the operations of 24 cases of cochlear reimplantation in Henan Children's Hospital from June 2016 to April 2018 were analyzed. Results Twenty-three cases successfully completed the surgery of cochlear-reimplantation, and the remaining one case had approximately 1/3 of the anterior end of the residual cochlear electrode due to high resistance at the time of withdrawal of the electrodes. The causes of re-implantation were implant equipment failure (eleven cases), elevated impedance values of all electrodes after head trauma (two cases), and implant prolapse together with the electrode caused by a traffic accident (one case). Conclusion The old stimulus electrode can provide an important reference to reduce the risk of operation and ensure the success of the reoperation.

We apply a U-Net-based convolutional neural network (NN) architecture to the problem of predictive adaptive optics (AO) for tracking and imaging fast-moving targets, such as satellites in low Earth orbit (LEO). We show that the fine-tuned NN is able to achieve an approximately 50% reduction in mean-squared wavefront error over non-predictive approaches while predicting up to eight frames into the future. These results were obtained when the NN, trained mostly on simulated data, tested its performance on 1 kHz Shack–Hartmann wavefront sensor data collected in open-loop at the Advanced Electro-Optical System facility at Haleakala Observatory while the telescope tracked a naturally illuminated piece of LEO space debris. We report, to our knowledge, the first successful test of a NN for the predictive AO application using on-sky data, as well as the first time such a network has been developed for the more stressing space tracking application.

Hybrid light-emitting diodes (LEDs) were fabricated by spin coating poly(9,9-dioctylfluorene-alt-benzothiadiazole) (F8BT) on blue InGaN/GaN multiple-quantum-well (MQW) LED chips as a downconverter. As the F8BT film thickness was in the range of 235–290 nm, the hybrid LEDs emitted cool white light with a downconversion efficiency of 28.8%. The F8BT film quality was markedly improved by postannealing at 200 °C, raising the downconversion efficiency to 82.6%. To obtain more efficient white light emission, we proposed to insert Ag nanoparticles (NPs) with a diameter of 13 nm at the inorganic–organic interface to form an MQWs/NPs/F8BT structure. Simulations showed that nonradiative energy transfer from the MQWs to F8BT can be mediated by localized surface plasmons, leading to more efficient downconversion and overall white light emission. The proof of concept of such a hybrid LED will pave the way toward high-performance phosphor-free white LED sources for microdisplay and general lighting applications.

This paper uses the instruments independently developed by Hunan Meteorological Station to carry out automatic observation experiments for cloud amounts and cloud forms in Changsha and Xilinhot. By comparing the manual and automatic observation results at 270 observation times from June to July in 2019, the feasibility of the automatic observation for cloud amounts and cloud forms based on image recognition is discussed. Meanwhile, suggestions and the basis for instrument improvement are provided in this paper. The main conclusions are as follows. During the test, the instrument runs stably; compared with those in manual observations, the consistency rates of the automatic observation results for cloud amounts and cloud forms are 70.8% and 77.1%, respectively; the consistency rates are over 90% when precipitation occurs. Most automatic observation deviations of the cloud form are concentrated in recognizing cloud genera. Being able to provide favorable supports for weather forecasts and services, the automatic observation results are highly applicable. The simple datasource and imbalanced classification of training samples are the main reasons for the low consistency rates of automatic observation results in some cases, and the image distortion of the fish-eye camera also has a great influence on the cloud-amount recognition results. The automatic observation results could be improved by enriching training sample sets, as well as optimizing the image processing and recognition algorithm in the future.

We conducted accelerated reliability tests of electron-only devices (EODs) and organic light-emitting diodes (OLEDs) differing only in their electron-transport material (ETM). High current stressing of EODs at 50 mA/cm2 showed that Bphen ~ Alq3 > TPBi > TAZ in terms of intrinsic material stability. In addition, the lowest unoccupied molecular orbital (LUMO) level and electron mobility have been identified as two other key material factors affecting the degradation rate of OLEDs. TAZ has a low electron mobility, a LUMO level misaligned with the Fermi level of the cathode, and poor material stability, leading to extremely poor reliability of devices with a TAZ electron-transport layer (ETL). In contrast, the OLED with a Bphen ETL exhibited more stable operation and a 76 × longer luminance lifetime. Due to its relatively high electron mobility and good stability as well as perfect energy level alignment with the cathode, Bphen has proven to be the most desirable ETM from the standpoint of OLED reliability.

The effects of delta doping in organic materials were investigated by incorporating periodic 0.5-nm MoO3 layers into a Tris(4-carbazoyl-9-ylphenyl)amine (TCTA) thin film. Secondary ion mass spectrometry revealed the transient diffusion of MoO3 into the underlying TCTA, resulting in a stable delta doping profile. Delta-doped hole-only devices exhibited greatly enhanced current conduction along and perpendicular to the film plane compared with a uniformly doped device, and had a turn-on voltage as low as 1 V. The enhanced conductivity is attributed to free hole accumulation in potential wells formed in the delta-doped regions as a result of doping-induced energy level shifts. This unique doping strategy may open new perspectives for developing high-transconductance organic transport devices.

Natural causes and high-speed train load will result in the structural deformation of long-span bridges, which greatly influence the safety operation of high-speed railway. Hence it is necessary to conduct the deformation monitoring and regular status assessment for long-span bridges. However for some traditional surveying technique, e.g. control-point-based surveying techniques, a lot of human and material resources are needed to perform the long-term monitoring for the whole bridge. In this study we detected the long-term bridge deformation time-series by persistent scatterer interferometric synthetic aperture radar (PSInSAR) technique using the high-resolution SAR images and external digital elevation model. A test area in Nanjing city in China is chosen and TerraSAR-X images and Tandem-X for this area have been used. There is the Dashengguan bridge in high speed railway in this area as study object to evaluate this method. Experiment results indicate that the proposed method can effectively extract the long-term deformation of long-span high-speed railway bridge with higher accuracy.

The ultra-high pressure piezoresistive sensor works with the Wheatstone half bridge theory. Because of the electric resistance temperature coefficient difference and the four electric resistances value of bridge arm are different in the manufacturing, zero drift and zero temperature drift generally exist in practical application of the ultra-high pressure piezoresistive sensor, which leads to loss of measuring accuracy of sensor. It requires a normalized polynomial fitting algorithm to achieve null balance and compensate zero drift simultaneously. According to model analysis and deduction as well as experiments, statistics obtained through normalized polynomial fitting algorithm is the same as experiments and shows higher accuracy, better compensation effect. The ultra-high pressure piezoresistive sensor compensated by the software method can be widely used in pressure testing and research on interior ballistics, especially the high pressure gun under the high temperature, high pressure, and high impact environment.

Objective. This study was designed to compare the effects of metformin and repaglinide on the fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) in newly diagnosed type 2 diabetes in China.Methods. A total of 107 newly diagnosed type 2 diabetic patients (46 women and 61 men) participated in the study. All patients received 3-month treatment of metformin or repaglinide. Fasting blood glucose and HbA1c were determined at baseline and at the end of the 3-month of treatment.Results. FPG and HbA1c decreased in both metformin and repaglinide groups after 3 months treatment (P<0.01). The reduction of HbA1c was significantly greater in the repaglinide group(P<0.01). Metformin decreases fasting insulin concentration and HOMA-IR(P<0.01), and repaglinide improves HOMA-β (P<0.01). Triglycerides (TG) were reduced in both groups(P<0.01in metformin group;P<0.05in repaglinide group), but total cholesterol (TC) and low-density lipoprotein (LDL) were decreased only after metformin treatment(P<0.05).Conclusions. Both repaglinide and metformin were effective in glycaemic control in new onset patients with type 2 diabetes in China. Repaglinide had no effect on insulin sensitivity, but it improvedβ-cell function.

The effects of Sheng Hua Tang (SHT) on uterine involution and ovarian activity were investigated in postpartum dairy cows. SHT (70 g) was given to dairy cows (n = 10) to evaluate its effects for five days from the first postpartum day. Postpartum cows fed with a basal diet without SHT were used as the control group (n = 10). Ultrasounds and blood tests were recorded for four weeks from postpartum day seven with a 3-d interval. The results showed that the areas and diameters of endometria were significantly (p0.01) reduced in the group that received SHT compared to the control group on the seventh postpartum day. The group that received SHT had an intrauterine fluid volume mean of 1.2±0.6 cm(3), which was significantly lower than that of the control group, 2.3±0.8 cm(3) (p0.01) on the 13th postpartum day. In addition, the uterine tension score was a mean of 1.0±0.0 in the group that received SHT, which was also significantly lower than that of the control group, 1.5±0.5 (p0.01) on the 19th postpartum day. Taken together, the Chinese herbal medicine remedy, SHT, promoted uterine involution and ovarian activity in postpartum dairy cows.

Background Systematic reviews or randomised-controlled trials usually help to establish the effectiveness of drugs and other health technologies, but are rarely sufficient by themselves to ensure actual clinical use of the technology. The process from innovation to routine clinical use is complex. Numerous computerised decision support systems (DSS) have been developed, but many fail to be taken up into actual use. Some developers construct technologically advanced systems with little relevance to the real world. Others did not determine whether a clinical need exists. With NHS investing £5 billion in computer systems, also occurring in other countries, there is an urgent need to shift from a technology-driven approach to one that identifies and employs the most cost-effective method to manage knowledge, regardless of the technology. The generic term, 'decision tool' (DT), is therefore suggested to demonstrate that these aids, which seem different technically, are conceptually the same from a clinical viewpoint. Discussion Many computerised DSSs failed for various reasons, for example, they were not based on best available knowledge; there was insufficient emphasis on their need for high quality clinical data; their development was technology-led; or evaluation methods were misapplied. We argue that DSSs and other computer-based, paper-based and even mechanical decision aids are members of a wider family of decision tools. A DT is an active knowledge resource that uses patient data to generate case specific advice, which supports decision making about individual patients by health professionals, the patients themselves or others concerned about them. The identification of DTs as a consistent and important category of health technology should encourage the sharing of lessons between DT developers and users and reduce the frequency of decision tool projects focusing only on technology. The focus of evaluation should become more clinical, with the impact of computer-based DTs being evaluated against other computer, paper- or mechanical tools, to identify the most cost effective tool for each clinical problem. Summary We suggested the generic term 'decision tool' to demonstrate that decision-making aids, such as computerised DSSs, paper algorithms, and reminders are conceptually the same, so the methods to evaluate them should be the same.

Background A computer-assisted history-taking system (CAHTS) is a tool that aids clinicians in gathering data from patients to inform a diagnosis or treatment plan. Despite the many possible applications and even though CAHTS have been available for nearly three decades, these remain underused in routine clinical practice. Objective Through an interpretative review of the literature, we provide an overview of the field of CAHTS, which also offers an understanding of the impact of these systems on policy, practice and research. Methods We conducted a search and critique of the literature on CAHTS. Using a comprehensive set of terms, we searched: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, Health Technology Assessment Database and the NHS Economic Evaluation Database over a ten-year period (January 1997 to May 2007) to identify systematic reviews, technical reports and health technology assessments, and randomised controlled trials. Results The systematic review of the literature suggests that CAHTS can save professionals' time, improve delivery of care to those with special needs and also facilitate the collection of information, especially potentially sensitive information (e.g. sexual history, alcohol consumption). The use of CAHTS also has disadvantages that impede the process of history taking and may pose risks to patients. CAHTS are inherently limited when detecting non-verbal communication, may pose irrelevant questions and frustrate the users with technical problems. Our review suggests that barriers such as a preference for pen-and-paper methods and concerns about data loss and security still exist and affect the adoption of CAHTS. In terms of policy and practice, CAHTS make input of data from disparate sites possible, which facilitates work from disparate sites and the collection of data for nationwide screening programmes such as the vascular risk assessment programme for people aged 40_74, now starting in England. Conclusions Our review shows that for CAHTS to be adopted in mainstream health care, important changes should take place in how we conceive, plan and conduct primary and secondary research on the topic so that we provide the framework for a comprehensive evaluation that will lead to an evidence base to inform policy and practice.

There is a persistent view of a significant minority in the medical informatics community that the randomized controlled trial (RCT) has a limited role to play in evaluating clinical information systems. A common reason voiced by skeptics is that these systems are fundamentally different from drug interventions, so the RCT is irrelevant. There is an urgent need to promote the use of RCTs, given the shift to evidence-based policy and the need to demonstrate cost-effectiveness of these systems. The authors suggest returning to first principles and argue that what is required is clarity about how to match methods to evaluation questions. The authors address common concerns about RCTs, and the extent to which they are fallacious, and also discuss the challenges of conducting RCTs in informatics and alternative study designs when randomized trials are infeasible. While neither a perfect nor universal evaluation method, RCTs form an important part of an evaluator's toolkit.

This paper surveys the current state of information technology (IT) availability on the IBM System p5® server platform, then describes how selected hardware and software features of the next-generation IBM Power™ Systems platform (by which we specifically mean IBM POWER6™ processor-based systems running the IBM AIX® 6 operating system) will enable client IT organizations to more closely approach true continuous availability. Also presented is information on several IT management disciplines that are critical to achieving high levels of availability. The objective is to enable accelerated adoption and success with the new Power Systems platform by explaining how the technologies can be used to improve IT availability. We define the underlying dependencies required to implement the new live partition mobility and the live application mobility features and show how the environment can be best designed for planned maintenance. Until now, the concept of server virtualization in the UNIX® environment has been limited to a single server, but the Power Systems platform extends the virtualization realm. A brief discussion is given comparing software clustering with the new mobility features and illustrating how they are complementary.

Summary Aim and methods: Data were collected from 3814 patients in this postmarketing surveillance study to assess the efficacy and tolerability of moxifloxacin. Results: Improvement was observed in 69.1% of the patients after 3 days of moxifloxacin treatment and in 90.4% after 5 days. Full recovery had occurred in 71.3% by 7 days and in 86.8% by 10 days. A total of 129 adverse events occurred in 74 (1.9%) patients and mainly involved either the gastrointestinal or nervous system. All events were mild or moderate, and most resolved or improved after stopping treatment. Physicians rated moxifloxacin as ‘good’ or ‘very good’ in 92% of patients for efficacy and in 90.8% of the patients for tolerability. Of the 936 patients who completed a questionnaire, 94.7% stated that moxifloxacin had helped them, 95.5% reported an improvement in symptoms after 5 days and 97.7% reported symptom improvement after 10 days. Conclusions: Moxifloxacin performs well in the ‘real world’, and is acceptable to both patients and physicians.

Background: Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015. Objectives: Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions. Secondary objective: to estimate the relative accuracy of the different index tests. Search methods: Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references. Selection criteria: We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva). Data collection and analysis: Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity. Main results: This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence. Authors' conclusions: At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted.

We report on the research work at Peking University on optimizing high-temperature superconductor (HTS) rf superconducting quantum interference device (SQUID) systems and applying them in geophysical survey and magnetocardiography (MCG). Emphasis is placed on the design of comb-shape resonators for HTS rf SQUID systems and the experimental results of two applications: transient electromagnetics and MCG. The magnetic-field sensitivity of HTS magnetometers is now adequate for MCG applications. However, in order to be commercially used, the system still needs some improvements: development of suitable gradiometers and multi-channel systems.

Although Hong Kong's infant mortality is among the lowest in the world, there may still be subgroups in the population with unusually high and possibly avoidable mortality rates. We conducted an ecological study on the relationship between socioeconomic deprivation and infant mortality in Hong Kong by using government data from three periods: 1979-83, 1984-88 and 1989-93. The study population comprised all infant births in 65 modified districts in Hong Kong in the period 1979-93. Infant, neonatal and post-neonatal mortality rates (IMRs, NMRs and PNMRs) were used as the health indicators. An F score was derived from highly correlated socioeconomic variables by factor analysis and used as a summary index of socioeconomic status. In 1979-83, socioeconomic deprivation was found to be significantly associated with high IMRs and high NMRs in both sexes, while in 1984-88 this association was observed only in baby girls. None of the observed associations were significant in 1989-93. Overall, the territory's infant mortality rates fell from 10.2 per thousand live births in 1979-83 to 5.6 per thousand live births in 1989-93. Individual-based studies are needed to ascertain whether this apparent disappearance of the socioeconomic relationship with infant and neonatal mortality is real.This study determined the relationship between socioeconomic deprivation and infant mortality in Hong Kong by using government data from three periods: 1979-83; 1984-88; 1989-93. The study population comprised all infant births in 65 modified districts in Hong Kong. Infant mortality rates (IMR), neonatal mortality rates (NMR) and postneonatal mortality rates were used as the health indicators. A factor score for each modified district was calculated using factor analysis to provide a summary indicator of the socioeconomic variables. Findings demonstrated that in 1979-83 socioeconomic deprivation was significantly associated with high IMR and high NMR in both sexes, while in 1984-88 this association was observed only for baby girls. None of the observed associations were significant in 1989-93. Overall, the territory's infant mortality rates fell from 10.2/1000 live births in 1979-83 to 5.6/1000 live births in 1989-93. Further studies based on individuals are needed to confirm that the link between socioeconomic factors and infant mortality no longer exists, since a group-based study such as this is potentially vulnerable to the usual problems of confounding and ecologic fallacies.

Reason for Withdrawal Protocol withdrawn due to lack of progress on review. To view the published versions of this article, please click the 'Other versions' tab.

Optical waveguides of zinc and nickel co-diffused on lithium niobate substrates were measured with secondary-ion-mass spectrometry for metal ion concentrations and differential optical-fields for refractive index profiles. Correlation between compositional and optical properties was studied.

Pb(Zr0.5Ti0.5)O3 films with thickness of about 1.5 and 3.7 μm have been deposited on single-crystal SrTiO3 substrate by a sol-gel process from nonhydrolyzed metal alkoxide precursor. X-ray diffraction shows that the films exhibit a single perovskite phase with (001)-preferred orientation. Atomic force microscopy study indicates that the PZT film possesses a crack-free and smooth surface. The optical waveguide property has been examined by the prism-film coupling experiment. Four and 12 TE modes are observed for 1.5 and 3.7 μm PZT films, respectively.

3 μm thick ferroelectric PbZrxTi1−xO3 films with x=0.4 and 0.5 have been fabricated on LaNiO3 coated silicon substrates by a modified sol-gel process. X-ray diffraction analysis shows that the films exhibit highly (100)-preferred orientation (α100>99%) and a single perovskite phase. Atomic force microscopy study shows that specimens possess smooth surfaces. The prism-film coupling measurement indicates that the system with the configuration of PbZr0.5Ti0.5O3/PbZr0.4Ti0.6O3/air can be used for a planar optical waveguide.

We report all solid-state, continuous-wave, high-power, deep ultraviolet generation. An intracavity frequency doubled Nd:YAG laser pumped by fiber-coupled diodes is used to generate the high-power green output. The significance of nonlinear coupling and spatial hole burning of the two-mode oscillations in the laser is discussed. When the incident 532 mn power on an external resonant doubler was 2.9 W, we generated 1.5 W of continuous-wave 266-nm radiation using a Czochralski-grown /spl beta/-BaB/sub 2/O/sub 4/. To achieve stable external resonance, a novel voice coil motor actuator is employed with servo bandwidth as large as 50 kHz. >

Background Chronic obstructive pulmonary disease (COPD) is common. Telehealthcare, involving personalised health care over a distance, is seen as having the potential to improve care for people with COPD. Aim To systematically review the effectiveness of telehealthcare interventions in COPD to improve clinical and process outcomes. Design and setting Cochrane Systematic Review of randomised controlled trials. Methods The study involved searching the Cochrane Airways Group Register of Trials, which is derived from the Cochrane Central Register of Controlled Trials, MEDLINE®, embase™, and CINAHL®, as well as searching registers of ongoing and unpublished trials. Randomised controlled trials comparing a telehealthcare intervention with a control intervention in people with a clinical diagnosis of COPD were identified. The main outcomes of interest were quality of life and risk of emergency department visit, hospitalisation, and death. Two authors independently selected trials for inclusion and extracted data. Study quality was assessed using the Cochrane Collaboration’s risk of bias method. Meta-analysis was undertaken using fixed effect and/or random effects modelling. Results Ten randomised controlled trials were included. Telehealthcare did not improve COPD quality of life: mean difference –6.57 (95% confidence interval [CI] = –13.62 to 0.48). However, there was a significant reduction in the odds ratios (ORs) of emergency department attendance (OR = 0.27; 95% CI = 0.11 to 0.66) and hospitalisation (OR = 0.46; 95% CI = 0.33 to 0.65). There was a non-significant change in the OR of death (OR = 1.05; 95% CI = 0.63 to 1.75). Conclusion In COPD, telehealthcare interventions can significantly reduce the risk of emergency department attendance and hospitalisation, but has little effect on the risk of death.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a disease of irreversible airways obstruction in which patients often suffer exacerbations. Sometimes these exacerbations need hospital care: telehealthcare has the potential to reduce admission to hospital when used to administer care to the pateint from within their own home. OBJECTIVES: To review the effectiveness of telehealthcare for COPD compared with usual face‐to‐face care. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register, which is derived from systematic searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; last searched January 2010. SELECTION CRITERIA: We selected randomised controlled trials which assessed telehealthcare, defined as follows: healthcare at a distance, involving the communication of data from the patient to the health carer, usually a doctor or nurse, who then processes the information and responds with feedback regarding the management of the illness. The primary outcomes considered were: number of exacerbations, quality of life as recorded by the St George's Respiratory Questionnaire, hospitalisations, emergency department visits and deaths. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion and extracted data. We combined data into forest plots using fixed‐effects modelling as heterogeneity was low (I(2) < 40%). MAIN RESULTS: Ten trials met the inclusion criteria. Telehealthcare was assessed as part of a complex intervention, including nurse case management and other interventions. Telehealthcare was associated with a clinically significant increase in quality of life in two trials with 253 participants (mean difference ‐6.57 (95% confidence interval (CI) ‐13.62 to 0.48); minimum clinically significant difference is a change of ‐4.0), but the confidence interval was wide. Telehealthcare showed a significant reduction in the number of patients with one or more emergency department attendances over 12 months; odds ratio (OR) 0.27 (95% CI 0.11 to 0.66) in three trials with 449 participants, and the OR of having one or more admissions to hospital over 12 months was 0.46 (95% CI 0.33 to 0.65) in six trials with 604 participants. There was no significant difference in the OR for deaths over 12 months for the telehealthcare group as compared to the usual care group in three trials with 503 participants; OR 1.05 (95% CI 0.63 to 1.75). AUTHORS' CONCLUSIONS: Telehealthcare in COPD appears to have a possible impact on the quality of life of patients and the number of times patients attend the emergency department and the hospital. However, further research is needed to clarify precisely its role since the trials included telehealthcare as part of more complex packages.

Background: Telehealthcare has the potential to provide care for long-term conditions that are increasingly prevalent, such as asthma. We conducted a systematic review of studies of telehealthcare interventions used for the treatment of asthma to determine whether such approaches to care are effective. Methods: We searched the Cochrane Airways Group Specialised Register of Trials, which is derived from systematic searches of bibliographic databases including CENTRAL (the Cochrane Central Register of Controlled Trials), MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and PsycINFO, as well as other electronic resources. We also searched registers of ongoing and unpublished trials. We were interested in studies that measured the following outcomes: quality of life, number of visits to the emergency department and number of admissions to hospital. Two reviewers identified studies for inclusion in our meta-analysis. We extracted data and used fixedeffect modelling for the meta-analyses. Results: We identified 21 randomized controlled trials for inclusion in our analysis. The methods of telehealthcare intervention these studies investigated were the telephone and video- and Internet-based models of care. Meta-analysis did not show a clinically important improvement in patients’ quality of life, and there was no significant change in the number of visits to the emergency department over 12 months. There was a significant reduction in the number of patients admitted to hospital once or more over 12 months (risk ratio 0.25 [95% confidence interval 0.09 to 0.66]). Interpretation: We found no evidence of a clinically important impact on patients’ quality of life, but telehealthcare interventions do appear to have the potential to reduce the risk of admission to hospital, particularly for patients with severe asthma. Further research is required to clarify the cost-effectiveness of models of care based on telehealthcare.

BackgroundHealthcare systems internationally need to consider new models of care to cater for the increasing numbers of people with asthma. Telehealthcare interventions are increasingly being seen by policymakers as a potential means of delivering asthma care. We defined telehealthcare as being healthcare delivered from a distance, facilitated electronically and involving the exchange of information through the personalised interaction between a healthcare professional using their skills and judgement and the patient providing information.ObjectivesTo assess the effectiveness of telehealthcare interventions in people with asthma.Search strategyWe searched in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO; this was supplemented by handsearching of respiratory journals. We also searched registers of ongoing and unpublished trials.Selection criteriaWe selected completed randomised controlled trials of telehealthcare initiatives aiming to improve asthma care.Data collection and analysisTwo review authors independently appraised studies for inclusion and extracted data and performed meta-analyses. We analysed dichotomous variables to produce an odds ratio (OR) and continuous variables to produce a mean difference.Main resultsWe included 21 trials in this review. The 21 included studies investigated a range of technologies aiming to support the provision of care from a distance. These included: telephone (n = 9); video-conferencing (n = 2); Internet (n = 2); other networked communications (n = 6); text Short Messaging Service (n = 1); or a combination of text and Internet (n = 1). Meta-analysis showed that these interventions did not result in clinically important improvements in asthma quality of life (minimum clinically important difference = 0.5): mean difference in Juniper's Asthma Quality of Life Questionnaire (AQLQ) 0.08 (95% CI 0.01 to 0.16). Telehealthcare for asthma resulted in a non-significant increase in the odds of emergency department visits over a 12-month period: OR 1.16 (95% CI 0.52 to 2.58). There was, however, a significant reduction in hospitalisations over a 12-month period: OR 0.21 (95% CI 0.07 to 0.61), the effect being most marked in people with more severe asthma managed predominantly in secondary care settings.Authors' conclusionsTelehealthcare interventions are unlikely to result in clinically relevant improvements in health outcomes in those with relatively mild asthma, but they may have a role in those with more severe disease who are at high risk of hospital admission. Further trials evaluating the effectiveness and cost-effectiveness of a range of telehealthcare interventions are needed.

We have obtained 3.5 W of TEM00 output at 532 nm from a longitudinally diode-pumped intracavity-doubled Nd:YAG laser with a diode-to-green conversion efficiency of 14%. Using this laser, we obtained 0.8 W of UV radiation at 266 nm through resonant doubling.

We analyze self-starting in additive-pulse mode-locked lasers and find that dynamic gain saturation can play a determining role. A simple condition for self-starting is presented for comparison with experiments on different laser systems.

A simple model is presented to describe mode locking in a laser coupled to a nonlinear resonator. It reveals a new mechanism for pulse shortening and shows that shortening does not rely on dispersion in the auxiliary cavity. Experimental results are given to support the basic predictions of the model.

In order to characterize the atmospheric optical turbulence at Ali observatory, we have deployed multi-instruments, which are able to continuously monitor the optical turbulence for site evaluation. These instruments include the DIMM, MASS, Single Star SCIDAR and Polaris seeing monitor, and we also plan to install SNODAR and Micro-thermal sensors for the turbulence on surface layer by the end of this year. This configuration allows us to collect a substantial database and make cross-comparison of the results. We have successfully obtained the profiles of optical turbulence and wind speed with Single Star SCIDAR, as well as the key parameters for adaptive optics application, such as seeing, coherence time, and isoplanatic angle. The DIMM seeing measurements are also carried out simultaneously. The median seeing measured by the DIMM and SSS in 2013 is 0.69 and 0.79 arcsec, respectively.

Objectives: To review for acute abdominal pain (AAP), the diagnostic accuracies of combining decision tools (DTs) and doctors aided by DTs compared with those of unaided doctors. Also to evaluate the impact of providing doctors with an AAP DT on patient outcomes, clinical decisions and actions, what factors are likely to determine the usage rates and usability of a DT and the associated costs and likely cost-effectiveness of these DTs in routine use in the UK. Design: Electronic databases were searched up to 1 July 2003. Review methods: Data from each eligible study were extracted. Potential sources of heterogeneity were extracted for both questions. For the accuracy review, meta-analysis was conducted. Among studies comparing diagnostic accuracies of DTs with unaided doctors, error rate ratios provided estimates of the differences between the false-negative and false-positive rates of the DT and unaided doctors' performance. Pooled error rate ratios and 95% confidence intervals (CIs) for false-negative rates and false-positive rates were computed. Metaregression was used to explore heterogeneity. Results: Thirty-two studies from 27 articles, all based in secondary care, were eligible for the review of DT accuracies, while two were eligible for the review of the accuracy of hospital doctors aided by DTs. Sensitivities and specificities for DTs ranged from 53 to 99% and from 30 to 99%, respectively. Those for unaided doctors ranged from 64 to 93% and from 39 to 91%, respectively. Thirteen studies reported false-positive and false-negative rates for both DTs and unaided doctors, enabling a direct comparison of their performance. In random effects meta-analyses, DTs had significantly lower false-positive rates (error rate ratio 0.62, 95% CI 0.46 to 0.83) than unaided doctors. DTs may have higher false-negative rates than unaided doctors (error rate ratio 1.34, 95% CI 0.93 to 1.93). Significant heterogeneity was present. Two studies compared the diagnostic accuracies of doctors aided by DTs to unaided doctors. In a multiarm cluster randomised controlled trial (n = 5193), the diagnostic accuracy of doctors not given access to DTs was not significantly worse (sensitivity 28.4% and specificity 96.0%) than that of three groups of aided doctors (sensitivities of 42.4-47.9%, and specificities of 95.5-96.5%, respectively). In an uncontrolled before-and-after study (n = 1484), the sensitivities and specificities of aided and unaided doctors were 95.5% and 91.5% (p = 0.24) and 78.1% and 86.4% (p < 0.001), respectively. The metaregression of DTs showed that prospective test-set validation at the site of the tool's development was associated with considerably higher diagnostic accuracy than prospective test-set validation at an independent centre [relative diagnostic odds ratio (RDOR) 8.2; 95% CI 3.1 to 14.7]. It also showed that the earlier in the year the study was performed the higher the performance (RDOR 0.88, 0.83 to 0.92), that when developers evaluated their own DT there was better performance than when independent evaluators carried out the study (RDOR = 3.0, 1.3 to 6.8), and that there was no evidence of association between other quality indicators and DT accuracy. The one eligible study of the impact study review, a four-arm cluster randomised trial (n = 5193), showed that hospital admission rates of patients by doctors not allocated to a DT (42.8%) were significantly higher than those by doctors allocated to three combinations of decision support (34.2-38.5%) (p < 0.001). There was no evidence of a difference between perforation rates (p = 0.19) and negative laparotomy rates in the four trial arms (p = 0.46). Usage rates of DTs by doctors in accident and emergency departments ranged from 10 to 77% in the six studies that reported them. Possible determinants of usability include the reasoning method used, the number of items used and the output format. A deterministic cost-effectiveness comparison demonstrated that a paper checklist is likely to be 100-900 times more cost-effective than a computer-based DT under stated assumptions. Conclusions: With their significantly greater specificity and lower false-positive rates than doctors, DTs are potentially useful in confirming a diagnosis of acute appendicitis, but not in ruling it out. The clinical use of well-designed, condition-specific paper or computer-based structured checklists is promising as a way to improve impact on patient outcomes, subject to further research. © Queen's Printer and Controller of HMSO 2006. All rights reserved.

A novel laser tracking measuring system based on the principle of multi-lateration is developed. The system consists of a four-quadrant silicon photoelectric cell measuring the position of reflected beam from the target with sensitivity of 200mv/mm, a rotational tracking mirrror with a solid angle of 35 degrees driven by two motors and a new type of closed-loop control with digital PID and analog PID. The experiment shows that it works reliably with tracking speed 0.7m/s, and the standard deviation of measurement is 1.2μm.

A compact, reliable high power deep ultraviolet (UV) source should encounter much use in areas such as next generation ultra high density optical disk mastering, photo-lithography and material processing. To achieve this goal, an all solid-state approach is imperative. Commercial UV lasers are currently all gas lasers and therefore tend to be bulky and not very efficient. Recently, much work has been reported on UV sources using nonlinear frequency conversion. Previous approaches however were either not all solid-state [1-2] or were characterized by lower UV power [3-5].

OBJECTIVE: To estimate the economic burden of coronary heart disease in the UK using both direct and indirect costs. DESIGN AND SETTING: A prevalence based approach was used to assess coronary heart disease related costs from the societal perspective. PATIENTS: All UK residents in 1999 with coronary heart disease (ICD 9 codes 410-414 and ICD10 codes I20-I25). MAIN OUTCOME MEASURES: Direct health care costs were estimated from spending on prevention, accident and emergency care, hospital care, rehabilitation, and drug treatment. Direct non-health service costs were estimated from data on informal care. "Friction period" adjusted productivity costs were estimated using the human capital approach from lost earnings attributable to coronary heart disease related mortality and morbidity. The friction period is the period of employees' absence from work before the employer replaces them with other workers. Failure to adjust for this factor would overstate production loss. RESULTS: Coronary heart disease cost pound 1.73 billion to the UK health care system in 1999: pound 2.42 billion in informal care and pound 2.91 billion in friction period adjusted productivity loss; 24.1% of production losses were attributable to mortality and 75.9% to morbidity. The total annual cost of all coronary heart disease related burdens was pound 7.06 billion, the highest of all diseases in the UK for which comparable analyses have been done. CONCLUSIONS: Coronary heart disease is a leading public health problem in the UK in terms of the economic burden from disease. Cost estimates would be substantially understated if informal care/productivity costs were excluded.

Initial experiments of a passive polymeric TE-to-TM polarization converter that utilizes laterally offset upper and lower poling electrodes to induce a 45/spl deg/ optical axis in the core of a nonlinear optical polymer waveguide are reported. By optimizing the device length, we have demonstrated polarization conversion efficiencies greater than 95% in devices as short as 240 /spl mu/m with negligible insertion loss.

This glossary defines terms used in the comparatively young science of medical informatics. It is hoped that it will be of interest to both novices and professionals in the field.

We propose a novel field‐effect semiconductor laser whose wavelength can be tuned by an electric field parallel to the growth direction of two tightly coupled quantum wells in the active region. We have demonstrated the concept by optically pumping a laser heterostructure whose active region consisted of two 50 A GaAs wells separated by a 20 A Ga0.77Al0.23As potential barrier, in which, at 5 K, we have achieved tuning of the stimulated emission by more than 7 nm.

Nicotine replacement therapy is probably the most effective of the many methods available to help people to stop smoking (Law & Tang, 1995). Four major forms of nicotine preparations are now available: chewing-gum, patch, inhaler and nasal spray. Chewing-gum and patch have been the most extensively studied in randomized controlled trials, but the four preparations probably have very similar effectiveness: 10–15% of people give up smoking as a result of the treatment (Tang et al., 1994). The effectiveness is highly dependent on the provision of instructions for use and the choice of smokers. Nicotine replacement therapy is also recommend for patients with coronary heart disease and pregnant women since the benefits of treatment well outweigh any harm it may induce. We review the evidence from randomized controlled trials and systematic reviews, raise some issues with regard to the use of nicotine replacement therapy and point out potential ways of increasing the benefit—harm ratio of this therapy.

Objective: The objectives were to estimate the prevalence and correlates of physical abuse-related outcomes in the family setting in Hong Kong’s adolescent population. Method: A cross-sectional study design was used. A randomly selected sample of 3,355 secondary school students in Kwai Tsing District of Hong Kong was surveyed. The response rate was 98%. Results: The prevalence rates of corporal punishment, being beaten by parents for no apparent reason, being beaten to injury by family members in the past 3 months and any one of the above three were 4.9% (95% CI , 4.2% to 5.6%), 2.0% (95% CI , 1.5% to 2.5%), 1.1% (95% CI , .98% to 1.2%) and 6.6% (95% CI , 5.7% to 7.5%), respectively. Students who had experienced the above physical abuse-related outcomes were at a significant disadvantage for a wide range of morbidity indicators, including self-perceived bad health, anxiety and stress, somatic illnesses (such as asthma and epigastric pain), injuries and accidents, and hospitalization. They were more likely to have poor familial relations and coping skills, and to take up habits which potentially put their health at risk, such as smoking, alcohol consumption, and fighting with others. Conclusions: Our prevalence estimates of physical abuse in the family setting for a student population in Hong Kong is an improvement over previous local estimates of physical abuse occurrence, which were mainly based on case notifications and clinical samples. The results also show that the abused adolescents are growing up in an environment filled with physical, psychological, and familial adversities.

The practice of Traditional Chinese Medicine (TCM) is largely unregulated in Hong Kong. Yet, as previous studies have shown, a sizable segment of the population consults TCM practitioners for health problems. This paper uses health care utilization data from a telephone health survey of 847 adult subjects in Tai Po District who had suffered from acute illness in the past month, to examine the profile of TCM users in the District. Women, older residents, unemployed workers, low skill laborers, current smokers and subjects dissatisfied with the quality of private sector clinics were significantly more likely to consult TCM practitioners.

Initial experiments of a passive polymeric TE-to-TM polarization converter that utilizes laterally offset upper and lower poling electrodes to induce a 45° optical axis in the core of a nonlinear optical polymer waveguide are reported. By optimizing the device length, we have demonstrated polarization conversion efficiencies greater than 95% in devices as short as 240 um with negligible insertion loss.

We describe a 0.4W average power at maximum, frequency-quintupled Q-switched Nd:YAG laser at a repetition rate of 7 kHz, which is a potential light source for next generation microlithography. Calculated results for the conversion efficiencies considering pump depletion will be discussed. Our results allow to foresee further scaling up 213 nm power up to the 1W level by increasing the fundamental power.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

High power deep ultraviolet (UV) radiation has attracted much attention in areas such as photo-lithography, micro fabrication, material processing and ultra high density optical disk mastering. We report progress in improving the quality of Czochralski-grown (beta) -BaB2O4 (BBO) which is essential for generating high average output power in the deep ultraviolet regime. We obtained 1.5 W of cw 266 nm output using an external resonant doubler, 1.3 W of 213 nm output from a flashlamp pumped Q-switched Nd:YAG laser and more than 0.4 W of 213 nm radiation from a commercial 6 W diode-pumped high repetition rate Q-switched Nd:YAG laser using our melt-grown BBO crystals for the nonlinear frequency conversion. Using the cw 266 nm output speckle-free 0.25 micrometers photolithography and micro-fabrication was demonstrated.© (1996) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

Thin films with ultrafine Si nanocrystals and ultraviolet (UV) light emission were prepared by using reactive sputtering of SiO2 and Al targets. The reaction of Al and SiO2 leads to the formation of ultrafine Si nanocrystals with compact Al2O3 shell. Al2O3 shell retards the growth of Si nanocrystals and provides ideal passivation on Si nanocrystals. Intrinsic UV photoluminescence is ascribed to the quantum-confinement effect of Si nanocrystals.