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This protocol aimed to describe data transformation procedure of medical histories from electronic health records (EHRs) to historical rates by Kaplan-Meier (KM) estimation. The applicability is to extract features from real-world, time-varying data of EHRs, for developing but not limited to a machine learning prediction model. By this extraction technique, machine can learn medical history of a condition in each healthcare provider, as a differential quantity through time in term of affecting a future health state, without a need to access EHRs of other healthcare providers. However, this protocol needs a sufficient amount of longitudinal data from the most subjects in EHRs. The key stages consisted of time interval computation, historical rate derivation, and data transformation into historical rates.

We proposed a learning algorithm for human to conduct literature and data mining for causal factor discovery. The applicability is to select features for a machine learning prediction model, including but not limited to that using real-world, time-varying data from electronic health records. This protocol is relatively quick to find potentially actionable predictors for a clinical prediction while dealing with high dimensionality in big data. However, this protocol might not find a potentially novel cause, since this only exhaustively examines the existing evidences in a single study. The key stages consisted of systematic human learning, causal diagram construction, data preprocessing, causal inference modeling, and development and validation of a prediction model to describe the explainability.

We aimed to provide a resampling protocol for dimensional reduction resulting a few latent variables. The applicability focuses on but not limited for developing a machine learning prediction model in order to improve the number of sample size in relative to the number of candidate predictors. By this feature representation technique, one can improve generalization by preventing latent variables to overfit data used to conduct the dimensional reduction. However, this technique may warrant more computational capacity and time to conduct the procedure. The key stages consisted of derivation of latent variables from multiple resampling subsets, parameter estimation of latent variables in population, and selection of latent variables transformed by the estimated parameters.

This protocol aims to develop, validate, and deploy a prediction model using high dimensional data by both human and machine learning. The applicability is intended for clinical prediction in healthcare providers, including but not limited to those using medical histories from electronic health records. This protocol applies diverse approaches to improve both predictive performance and interpretability while maintaining the generalizability of model evaluation. However, some steps require expensive computational capacity; otherwise, these will take longer time. The key stages consist of designs of data collection and analysis, feature discovery and quality control, and model development, validation, and deployment.

Backgrounds Trigeminal neuralgia (TGN) is a common pain syndrome of nervous system, despite about 90% patients who were refectory to medications could free from pain after microvascular decompression (MVD), some patients did experience recurrence. Objectives The study aimed to analyze clinical characteristics of patients with recurrent TN, recurrence factors of TN, and prognosis after re-do MVD. Methods Clinical data and at least 12 months follow-up of patients with recurrent TN who underwent re-do MVD in our hospital from 2005 to 2020 were collected and analyzed. Results 14 patients with recurrent TN were enrolled eventually, adhesive arachnoid membranes were found in all patients. Teflon granuloma was found in 10 patients, new neurovascular compression (NVC) in 3 patients, and Teflon displacement in 1 patient. Pain disappeared in 12 patients and relieved in 2 patients, but 4 patients experienced facial numbness and 1 patient suffered from incision infection after re-do MVC. No serious surgery-related complications and pain recurrences were recorded. Conclusions Teflon granuloma was the most common cause of TN recurrence in current study, new NVC was also a common cause, patients with recurrent TN could get satisfactory results from re-do MVD.

Imatinib is a crucial therapeutic strategy against chronic myeloid leukemia. Though superficial edema is a common adverse effect of imatinib, massive fluid retention is rarely reported. Here, we report the case of an adolescent who had tolerated imatinib for a long time, and then presented with massive pleural/pericardial effusion during an episode of Campylobacter jejuni bacteremia. A stepwise and comprehensive survey excluded all other plausible causes of disease. The Naranjo scale was used to assess the probability of an adverse effect of medication, and the score turned out to be 9, indicating severe fluid retention to be a definite reaction to imatinib. Drug discontinuation, antibiotic administration, and invasive procedures improved this condition. After this episode, the patient could tolerate imatinib again, illustrating the transient and reversible nature of this reaction. Since prolonged imatinib usage is crucial for chronic myeloid leukemia control, alertness to drug-related adverse effects is recommended, even if the subject has previously shown a good tolerance to the drug due to various physical conditions, especially physiological stressors, like infection or inflammation.

Background Overweight and obesity rates have increased rapidly in Chinese school-age children, and previous studies have indicated that poor dietary literacy can lead to unhealthy eating behaviours. However, few studies have investigated the association between the dietary literacy of daily diet providers and the eating behaviours and nutritional status of school-age children raised by the providers. Thus, we aimed to explore this association. Methods We collected data on the eating behaviours and nutritional status of children in two primary schools in Anhui Province, as well as the dietary literacy of their daily diet providers. T-tests, one-way ANOVA, chi-square tests, and multiple linear regression were used to analyse the association. Results We found significant differences in the scores on the Questionnaire of Children's Daily Diet Providers' Dietary Literacy (QCDDPDL) by region, relationship with the child, age, and educational level of the daily diet provider (all p p p = .006). Conclusions Our study showed that the dietary literacy of diet providers may influence children's health and eating behaviours. Improving the dietary literacy of diet providers may promote the health status and eating behaviours of school-age children.

Background/purpose: Burning mouth syndrome (BMS) is defined as a chronic burning pain of the oral mucosa with no associated clinical signs or apparent extraneous cause. Limited epidemiologic data have been published. In this study, we probed the nationwide registered database to assess the prevalence of BMS in Taiwan. Materials and methods: A retrospective study was conducted to analyze the dental dataset compiled by the Taiwan's National Health Insurance Research Database from 2004 to 2013. The diagnosis of BMS was identified in accordance with the International Classification of Disease, Ninth revision. In addition, sex and age were analyzed by multivariate Poisson regression. Results: The prevalence of BMS revealed from 2.24 (per 104) to 3.11 (per 104) over past 10 year period. Female has higher risk of BMS than male (RR: 1.39; 95% CI: 1.37–1.41). The 50–59 years old group, 60–69 years old group, and >70 years old group had 1.55-, 2.06-, and 2.58-fold risk than 40–49 years old group for BMS (p

Background The global pandemic of COVID-19 has brought huge changes to people's lifestyles, college students have also been affected seriously. Evidence about these significant changes indicated that college students were more prone to feel anxious and depressed. To derive a precise assessment of the prevalence of anxiety symptom and depressive symptom among college students worldwide, we conducted this meta-analysis. Methods Based on the guidance of PRISMA, literature was searched in Pubmed, Web of Science, Embase, and PsycArticles (last search November 6, 2020). These articles after the screening were analyzed by a random-effects model to estimate the pooled prevalence of anxiety symptom and depressive symptom. Also, subgroup analysis, sensitivity analysis, and publication bias were performed in this meta-analysis. Results The results showed that the pooled anxiety symptom prevalence was 31% (95% CI: 23-39%), pooled depressive symptom prevalence was 34% (95% CI: 27-41%). Subgroup analysis showed that the prevalence of anxiety symptom and depressive symptom among different countries’ college students were different, and the pooled depressive symptom prevalence of females was higher compared with males. Limitations The prevalence of anxiety symptom and depressive symptom in worldwide college students could be better assessed by a standard and reliable questionnaire. Conclusions The results suggest that the prevalence of anxiety symptom and depressive symptom during the COVID-19 pandemic is relatively high. Except for interventions that should be taken to control the pandemic urgently, mental health services are also needed to decrease the risk of anxiety and depression among college students.

With the continuous development of high-spatial-resolution ground observation technology, it is now becoming possible to obtain more and more high-resolution images, which provide us with the possibility to understand remote sensing images at the semantic level. Compared with traditional pixel- and object-oriented methods of change detection, scene-change detection can provide us with land use change information at the semantic level, and can thus provide reliable information for urban land use change detection, urban planning, and government management. Most of the current scene-change detection methods are based on the visual-words expression of the bag-of-visual-words model and the single-feature-based latent Dirichlet allocation model. In this article, a scene-change detection method for high-spatial-resolution imagery is proposed based on a multi-feature-fusion latent Dirich- let allocation model. This method combines the spectral, textural, and spatial features of the high-spatial-resolution images, and the final scene expression is realized through the topic features extracted from the more abstract latent Dirichlet allocation model. Post-classification comparison is then used to detect changes in the scene images at different times. A series of experiments demonstrates that, compared with the traditional bag-of-words and topic models, the proposed method can obtain superior scene-change detection results.

Case‐control design based high‐throughput pharmacoinformatics study using large‐scale longitudinal health data is able to detect new adverse drug event (ADEs) signals. Existing control selection approaches for case‐control design included the dynamic/super control selection approach. The dynamic/super control selection approach requires all individuals to be evaluated at all ADE case index dates, as the individuals’ eligibilities as control depend on ADE/enrollment history. Thus, using large‐scale longitudinal health data, the dynamic/super control selection approach requires extraordinarily high computational time. We proposed a random control selection approach in which ADE case index dates were matched by randomly generated control index dates. The random control selection approach does not depend on ADE/enrollment history. It is able to significantly reduce computational time to prepare case‐control data sets, as it requires all individuals to be evaluated only once. We compared the performance metrics of all control selection approaches using two large‐scale longitudinal health data and a drug‐ADE gold standard including 399 drug‐ADE pairs. The F‐scores for the random control selection approach were between 0.586 and 0.600 compared to between 0.545 and 0.562 for dynamic/super control selection approaches. The random control selection approach was ~ 1000 times faster than dynamic/super control selection approach on preparing case‐control data sets. With large‐scale longitudinal health data, a case‐control design‐based pharmacoinformatics study using random control selection is able to generate comparable ADE signals than the existing control selection approaches. The random control selection approach also significantly reduces computational time to prepare the case‐control data sets.

This paper addresses a multiobjective Unmanned Aerial Vehicle (UAV) and Unmanned Ground Vehicle (UGVs) collaboration scheduling problem in which UAVs must be recharged periodically during a persistent task, such as wireless communication and making aerial panoramic VR video by UAV. The proposal is to introduce a UGV/UAV cooperative system in which UAVs should be recharged by UGVs periodically, and also, the UGVs have to visit their task points expect for the recharge points. The objective of the problem is to schedule and plan paths with the tradeoff of path length and makespan for UAVs and UGVs. The mathematical model which can be considered a combinatorial multiobjective optimization problem is presented firstly, and the solution of the problem is composed of presubsolution and postsubsolution. The multiobjective adaptive large neighborhood is hybrid with the Pareto local search (MOALP) to resolve the problem. The experimental result shows that the proposed algorithm outperforms the compared algorithms on the rendezvous planning problem for UAVs and UGVs working collaboratively in intelligent tasks.

Well-crystallized perovskite ferroelectric films usually display a bulk-like polarization response (P) under an external electric field (E), i.e., a large P-E hysteresis loop featuring a sizable remnant polarization and an early polarization saturation. Such characteristics are undesirable for capacitive energy storage applications. In this work, we demonstrate an optimal P-E behavior, i.e., a small remnant polarization and a delayed polarization saturation, in perovskite BaTiO3 films consisting of superfine columnar nanograins. In a low-temperature, nucleation-dominated sputtering deposition, an in-situ grown conductive buffer layer promotes the formation of these nanograins, which display a controllable diameter down to ~10 nm and extend throughout the film thickness. The deterioration of the remnant polarization and its delayed saturation under an electric field, can be attributed to a strong polarization-constraining effect from the densely-packed, non-ferroelectric grain boundaries, which is supported by a phase field modeling simulation. The resulted BaTiO3 film capacitors integrated on Si at 350°C display a high recyclable energy density (Wrec~135±10 J/cm3) and efficiency (η~80%±4%) which are thickness-scalable. An intrinsically high power density, a simple and stable chemical composition, and good thermal (-150°C ~ 170°C) and cycling stabilities (up to ~ 2 × 108 charge-discharge cycles) warrant a broad range of applications for these film capacitors.

To optimize the high-speed modulation package of the TO-can mounted violet laser diode (VLD) for optical wireless communication, three different impedance matching methods with adding or removing resistor/inductor/capacitor (R/L/C) elements are employed to discuss their effects on the direct encoding bandwidth of the VLD. With reducing the parasitic inductance by shortening the cathode/anode pin length of the TO-can VLD, the 2.5-mm-long pin acts as a series inductance to 1.74 nH to enormously improve the modulation bandwidth of the VLD for encoding the 16 quadrature amplitude modulation orthogonal frequency division multiplexing data as high as 20.4 GB/s. Neither the surface mounted device (SMD) resistor nor the SMD inductor in series connection can further improve the modulation bandwidth of the VLD. In contrast, a parallel connection of the VLD with Teflon ring capacitor can somewhat broaden its encodable bandwidth at low biased conditions, whereas the allowable bandwidth still degrades when increasing the VLD bias to enlarge its modulation throughput. Numerical simulations also verify that the shortening pin length (with reducing the inductance) of TO-can VLD is the best selection for bandwidth enlargement. With optimized impedance matching design, the comparison on data transmission characteristics for several 2.5-mm-pin VLDs with different rated powers is presented.

This study investigated the effect and mechanism of electroacupuncture (EA) on the contralesional hemisphere in rats with ischemic stroke. EA of 2 Hz was applied on the contralesionally Luoque (BL8) and Tongtian (BL7) acupoints of the scalp to investigate the neurological status and mechanism in ischemia–reperfusion injury rats. The differences in the neurological deficit score and Rotarod test time between days 3 and 15 after reperfusion were significantly lower in the sham group (0.00 (−1.00, 0.00) and 3.53 (−0.39, 7.48) second, respectively) than in the EA group (−4.00 (−4.00, −3.00) and 44.80 (41.69, 54.13) second, respectively, both p < 0.001 ). The ratio of infarction volume was 0.19 ± 0.04 in the sham group greater than 0.07 ± 0.04 in the EA group ( p < 0.001 ). On day 15, in the cerebral cortex of the lesioned hemisphere, the gamma-aminobutyric acid (GABA)-A/actin ratio in the normal group (1.11 ± 0.36) was higher than that in the sham group (0.38 ± 0.07, p < 0.05 ) and similar to that in the EA group (0.69 ± 0.18, p > 0.05 ); the difference between the EA and sham groups was significant ( p < 0.05 ). EA of 2 Hz on the BL8 and BL7 acupoints on the contralesional scalp can improve motor function and also can reduce infarction volume, and this effect of EA, and that GABA-A, plays at least a partial role in ischemia–reperfusion injury rats.

Background An early indicator for monitoring the effect of adjuvant treatment after lung cancer surgery is urgently needed. The study was to explore the effects of epithelial cell adhesion molecule (EpCAM) of circulating tumor cells (CTCs) in NSCLC patients with postoperative adjuvant chemotherapy. Methods Two drugs (platinum-containing chemotherapeutics + platinum-free chemotherapeutics) first-line chemotherapy regimen were given after surgery. MRNA of EpCAM was detected. Chest computed tomography, head computed tomography and abdominal B-ultrasound were reviewed before the first and third chemotherapy. Results EpCAM in CTCs from peripheral blood between the recurrent group and the non-recurrent group at 1 day before surgery, first, second and third adjuvant chemotherapy were no significant differences (P>0.05). Only one day before the fourth adjuvant chemotherapy treatment, it showed significant difference between the recurrent group and the non-recurrent group (P=0.008). There was a significant difference between the time of imaging diagnosis of recurrence or metastasis and the time of monitoring the expression level of EpCAM in CTCs from peripheral blood (P

BACKGROUND There have been few reports on level 3 difficult removal of peripherally inserted central catheter (PICC) in neonates. Here, we reported a case of an extremely preterm infant who underwent level 3 difficult removal of a PICC. CASE SUMMARY Female baby A, weighing 1070 g at 27+1 wk of gestational age, was diagnosed with extremely preterm infant and neonatal respiratory distress syndrome. She underwent PICC insertion twice. The first PICC insertion went well; the second PICC was inserted in the right lower extremity, however, phlebitis occurred on the second day after the placement. On the third day of catheterization, phlebitis was aggravated, while the right leg circumference increased by 2.5 cm. On the fourth day of catheterization, more red swelling was found in the popliteal part, covering an area of about 1.5 cm × 4 cm, which was diagnosed as phlebitis level 3; thus, we decided to remove the PICC. During tube removal, the catheter rebounded and could not be pulled out (several conventional methods were performed). Finally, we successfully removed the PICC using a new approach termed “AFGP”. On the 36th day of admission, the baby fully recovered and was discharged. CONCLUSION The “AFGP” bundle approach was effective for an extremely preterm infant, who underwent level 3 difficult removal of a PICC.

Considering the uncertainties of the behaviour of electric vehicles (EVs) and the bidding of other participants in the market, the light robustness bidding model for the EV aggregator in the day‐ahead market is constructed. The model is a bilevel model, with the upper‐level model representing cost minimisation of the EV aggregator, whereas the lower‐level model represents market clearing providing market price and bidding energy for the upper‐level model. Bids of other market participants and EV driving pattern were not known to the EV aggregator in advance. They were seen as uncertain variables. A numerical example was used to illustrate the feasibility of the proposed method. Through the example analysis, the costs of the EV aggregator under different circumstances are compared and, under the same uncertainties, the results of the method proposed herein are also compared with the traditional robust optimisation method and stochastic fuzzy programming method.

In this work, we, for the first time, observed the remarkable thermoelectric properties of a few high-quality PtSe2 layered films fabricated by a post selenization of Pt thin films. An excellent po...

The declining cost of solar Photovoltaics (PV) generation is driving its worldwide deployment. As conventional generation with large rotating masses is being replaced by renewable energy such as PV, the power system’s inertia will be affected. As a result, the system’s frequency may vary more dramatically in the case of a disturbance, and the frequency nadir may be low enough to trigger protection relays such as under-frequency load shedding. The existing frequency-watt function mandated in power inverters cannot provide grid frequency support in a loss-of-generation event, as PV plants usually do not have power reserves. In this article, a novel adaptive PV frequency control strategy is proposed to reserve the minimum power required for grid frequency support. A machine learning model is trained to predict system frequency response under varying system conditions, and an adaptive allocation of PV headroom reserves is made based on the machine learning model as well as real-time system conditions including inertia. Case studies show the proposed control method meets the frequency nadir requirements using minimal power reserves compared to a fixed headroom control approach.

Background Understanding the specific characteristics of the patients with dementia is essential in developing services required to meet their needs. The purpose of this study was to investigate the patterns of use of home- and community-based services (HCBS) by patients with dementia and the factors influencing the utilisation of these services. Methods We analysed a dataset of patients with dementia receiving long-term care at a medical centre. All participating patients were required to complete a structured interview form every 6 months to assess their need for service utilisation. Between 2015 and 2018, a total of 822 patients fulfilled the criteria for dementia, and 737 people had assessment records, of whom 244 had used social services. Robust Poisson regression analyses were performed to estimate HCBS usage and the factors influencing service utilisation. Results The overall service utilisation rate was 33 %. Most patients used only one service, and assistive devices were used as the main service. Regarding the factors influencing service use, dementia concomitant with dependency increased the use of HCBS. These results suggest that patients with mild dependency might prefer to use community support services, whereas those with moderate to severe dependency being more likely to utilise in-home care services. Conclusions This study provides empirical evidence regarding the use of long-term care resources by patients with dementia in the community. Providing customised HCBS, rather than a non-specialised service assumed to be suitable for every patient, is essential for ensuring good patient care. In addition, attention needs to be paid to patients with care needs who do not use HCBS.

In this study, we focused on the influencing factors of renal anaemia in patients with IgA nephropathy and constructed a nomogram model. We divided 462 patients with IgA nephropathy diagnosed by renal biopsy into anaemic and non-anaemic groups. Then, the influencing factors of renal anaemia in patients with IgA nephropathy were analysed by least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression, and a nomogram model for predicting renal anaemia was established. Eventually, nine variables were obtained, which are easy to apply clinically. The areas under the receiver operating characteristic (ROC) curve and precision-recall (PR) curve reached 0.835 and 0.676, respectively, and the C-index reached 0.848. The calibration plot showed that the model had good discrimination, accuracy, and diagnostic efficacy. In addition, the C-index of the model following internal validation reached 0.823. Decision curve analysis suggested that the model had a certain degree of clinical significance. This new nomogram model of renal anaemia combines the basic information, laboratory findings, and renal biopsy results of patients with IgA nephropathy, providing important guidance for predicting and clinically intervening in renal anaemia.

To retrospectively analyze the pulmonary computed tomography (CT) characteristics and dynamic changes in the lungs of cured coronavirus disease 2019 (COVID-19) patients at discharge and reexamination.A total of 155 cured COVID-19 patients admitted to designated hospitals in Yunnan Province, China, from February 1, 2020, to March 20, 2020, were included. All patients underwent pulmonary CT at discharge and at 2 weeks after discharge (during reexamination at hospital). A retrospective analysis was performed using these two pulmonary CT scans of the cured patients to observe changes in the number, distribution, morphology, and density of lesions.At discharge, the lung CT images of 15 cured patients showed no obvious lesions, while those of the remaining 140 patients showed different degrees of residual lesions. Patients with moderate disease mostly had multiple pulmonary lesions, mainly in the lower lobes of both lungs. At reexamination, the lung lesions in the patients with moderate disease had significantly improved (P0.05), and the lung lesions in the patients with severe disease had partially improved, especially in patients with multi-lobe involvement (χ 2 =3.956, P0.05). At reexamination, the lung lesions of patients with severe disease did not show significant changes (P0.05).The pulmonary CT manifestations of cured COVID-19 patients had certain characteristics and variation patterns, providing a reference for the clinical evaluation of treatment efficacy and prognosis of patients.

Zhenyu Ji,1 Jinyuan Luo,1 Ting Su,2 Changzheng Chen,1 Yu Su1 1Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of China; 2Eye Institute of Xiamen University, Xiamen University, Xiamen, Fujian, 361102, People’s Republic of ChinaCorrespondence: Yu SuDepartment of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, People’s Republic of ChinaTel/Fax +86-2788041911Email sy_daisy1206@163.comIntroduction: Diabetic retinopathy (DR) is one of the major leading causes for vision loss globally. Current study illustrates the role of miR-7a in DR.Material and Methods: Retinal pericytes (RPs) and Endothelial cells (ECs) were isolated from mouse model of DR. qRT-PCR was done for expression of miR-7a and target gene mRNA, Western blot for protein expression. Identification of miR-7a target gene was done by TargetScan and Luciferase assay. Cell viability and invasion was done by MTT and Transwell chamber assay.Results: The expression of miR-7a was down-regulated whereas level of IRS-2 was unregulated in isolated RPs and ECs. Luciferase assay suggested correlation between miR-7a and IRS-2, over-expression of miR-7a using a mimic resulted in suppression in viability and invasion capacity of RPs and ECs and inhibited the protein levels of PI3K/Akt cascade and IRS-2, and however the inhibitor reversed them respectively. Transfection of siRNA targeting IRS-2 caused alteration in miR-7a mediated changes in ECs suggesting that miR-7a may decrease angiogenesis in DR by inhibiting the levels of IRS-2.Conclusion: miR-7a suppresses PI3K/Akt cascade via targeting IRS-2, thus decreasing the viability and invasion capacity of RPs and ECs, suggesting an interesting treatment target for DR.Keywords: miR-7a, diabetic retinopathy; DR, IRS-2, PI3K/Akt, endothelial cells; ECs, retinal pericytes; RPs

Cochlear implantation (CI) is a safe and beneficial surgery for children with congenital inner ear malformations, with the exception of cochlear nerve aplasia. The combination of microtia with middle and inner ear abnormalities is extremely uncommon and sufficiently severe to make a surgical approach to the cochlea difficult. We report herein the case of a 2-year-old girl who presented with profound bilateral sensorineural hearing loss, congenital aural atresia, microtia, and inner ear malformations. High-resolution computed tomography revealed poor development of the bilateral middle ear spaces, absence of the incus and stapes, aberrant courses of facial nerves, aplastic lateral semicircular canals, and covered round windows. With intraoperative imaging assistance, sequential bilateral CI was performed using a transmastoid approach with no complication. We propose that CI is feasible in patients with severe external and middle ear malformations. However, major malformations increase the risk of complications. As the facial nerve and cochlea are difficult to locate due to the lack of important anatomical landmarks, detailed planning and adequate preparation, including review of the preoperative imaging data, and the use of facial nerve monitoring and intraoperative imaging are very important. In addition, experienced surgeons should perform CI to ensure the success of the operation.

Luna Liu,1,2 Shuang Liu,1,2 Qianmei Song,1,2 Dandan Luo,1,2 Yu Su,1,2 Xiangyu Qi,1,2 Qian Wang,3 Jing Ning,1,2 Youyuan Lv,1,2 Qingbo Guan1,2,4 1Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, People’s Republic of China; 2Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, People’s Republic of China; 3Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People’s Republic of China; 4Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, People’s Republic of ChinaCorrespondence: Qingbo Guan Tel +86-531-68776375Fax +86-531-87068707Email doctorguanqingbo@163.comObjective: Obesity and metabolic syndrome have been reported to exert an impact on the male reproductive system with decreasing levels of serum total testosterone (TT); however, the effect of different metabolic obesity phenotypes on testosterone has been poorly studied. We aimed to evaluate the association of metabolic obesity phenotypes and total testosterone levels in a Chinese male population.Methods: We performed a retrospective study based on an epidemiological investigation, a total of 4,081 male individuals aged from 40– 75 years old were recruited. The population was classified as metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO) according to normal weight (BMI< 25.0) and overweight/obesity (BMI≥ 25.0) with or without metabolic syndrome.Results: We collected 563 hypotestosteronemia among 4,081 male individuals. The odds ratios (ORs) (95% CIs) of hypotestosteronemia in obesity and metabolic syndrome were 3.072 (2.414– 3.911) and 3.294 (2.631– 4.125), respectively, after adjusting for age, luteinizing hormone, smoking status, and alcohol consumption. Compared to the MHNW group, male subjects in MHO, MUNW, and MUO groups had decreased serum TT levels. Additionally, the MUO group had a lowest concentration of serum TT and a highest proportion of hypotestosteronemia. There was no significant difference of TT levels between the MHO and MUNW groups.Conclusion: Obesity and metabolic syndrome are independent risk factors of hypotestosteronemia in Chinese male populations. Our study also suggested that individuals with MHO, MUNW, and MUO have a higher risk of developing hypotestosteronemia.Keywords: metabolic obesity phenotypes, testosterone, metabolically healthy overweight/obese, metabolically unhealthy normal weight, hypotestosteronemia

Objective To observe the clinical effect of acupoint catgut embedding combined with auricular plaster therapy in the treatment of children with vocal tic disorders. Methods Catgut embedding was performed at the acupoints Bǎihui (百会GV20), Shenting (神庭GV24), Dazhuī (大椎GV14), Shēnzhu (身柱GV12), Feishū (肺俞BL13), and Weishū (胃俞BL21), and then auricular plaster sticking was applied to the acupoints Yānhou(咽喉TG3), Fei(肺CO14), Wei (胃CO4), Jiāogan(交感AH6a), Pizhixia(皮质下AT4). Results After treatment, the Yale Global Tic Severity Scale (YGTSS) scores of the patients were significantly reduced (P Conclusion Acupoint catgut embedding combined with auricular plaster therapy for vocal tic disorders was effective, being worthy of clinical popularization.

For offering proactive services to students in intelligent education, one of the fundamental tasks is predicting their performance (e.g., scores) on future exercises, where it is necessary to track each student's knowledge acquisition during her exercising activities. However, existing approaches can only exploit the exercising records of students, and the problem of extracting rich information existed in the exercise's materials (e.g., knowledge concepts, exercise content) to achieve both precise predictions of student performance and interpretable analysis of knowledge acquisition remains underexplored. In this paper, we present a holistic study of student performance prediction. To directly achieve the primary goal of prediction, we first propose a general Exercise-Enhanced Recurrent Neural Network (EERNN) framework by exploring both student's records and the exercise contents. In EERNN, we simply summarize each student's state into an integrated vector and trace it with a recurrent neural network, where we design a bidirectional LSTM to learn the encoding of each exercise's content. For making predictions, we propose two implementations under EERNN with different strategies, i.e., EERNNM with Markov property and EERNNA with Attention mechanism. Then, to explicitly track student's knowledge acquisition on multiple knowledge concepts, we extend EERNN to an explainable Exercise-aware Knowledge Tracing (EKT) by incorporating the knowledge concept effects, where the student's integrated state vector is extended to a knowledge state matrix. In EKT, we further develop a memory network for quantifying how much each exercise can affect the mastery of students on concepts during the exercising process. Finally, we conduct extensive experiments on large-scale real-world data. The results demonstrate the prediction effectiveness of two frameworks as well as the superior interpretability of EKT., Accepted by IEEE Transactions on Knowledge and Data Engineering (IEEE TKDE)

Planned islanding is one of the fundamental functions of microgrid (MG) controllers. However, existing planned islanding functions cannot be directly utilized in MGs that have the capability to have both dynamic boundary and multiple sub-MGs. To optimize the smart switch operation and distributed energy resource (DER) output power, a planned islanding algorithm is designed to minimize the battery energy storage systems’ power difference before and after a planned islanding. To verify the performance of the proposed algorithm, a hardware-in-the-loop (HIL) test has been conducted by implementing the algorithm in a general purpose MG controller system. The results demonstrate that the difference in active power before and after the planned islanding decreases significantly with the proposed algorithm.

The specific energy consumption of machine tools and surface roughness are important indicators for evaluating energy consumption and surface quality in processing. Accurate prediction of them is the basis for realizing processing optimization. Although tool wear is inevitable, the effect of tool wear was seldom considered in the previous prediction models for specific energy consumption of machine tools and surface roughness. In this paper, the prediction models for specific energy consumption of machine tools and surface roughness considering tool wear evolution were developed. The cutting depth, feed rate, spindle speed, and tool flank wear were featured as input variables, and the orthogonal experimental results were used as training points to establish the prediction models based on support vector regression (SVR) algorithm. The proposed models were verified with wet turning AISI 1045 steel experiments. The experimental results indicated that the improved models based on cutting parameters and tool wear have higher prediction accuracy than the prediction models only considering cutting parameters. As such, the proposed models can be significant supplements to the existing specific energy consumption of machine tools and surface roughness modeling, and may provide useful guides on the formulation of cutting parameters.

In-home monitoring has the potential to track health changes for older adults with chronic health conditions, thereby making early treatment possible when exacerbations arise. A recliner chair is often used by older adults for sleeping at night, especially by those with breathing difficulty, neck and back problems. Here, we present a sensor system for recliner chairs that can be used to monitor heart and respiration rates. The system uses two accelerometers placed strategically to capture these vital signs noninvasively and without direct contact with the body, while at the same time, being hidden from view. The system was tested with 45 subjects, having an average age of 78.8 (S.D. = 12.5) years, for both upright and reclined configurations of the chair. We also tested the system on 6 different types of recliner models. The ground truth signal for the heart and respiratory rates were obtained using a piezoelectric finger transducer and thorax chest belt respectively. The mean heartbeat error for 45 subjects was 0.6 ms with an average error rate of 3.6% (p value = 0.00081, significance level = 0.05). Similarly, the mean respiratory breath error was 4.2 ms with an average detection error rate of 6.25% (p value = 0.032, significance level = 0.05). An analysis of the error rates are considered and possible explanations are suggested. This new system has the potential to help in identifying health changes very early, thereby facilitating early treatment and improved health outcomes for older adults.

Older adults with hyperkyphosis might have a high risk of falls since their whole body center of mass may shift to the boundary of the base of support. Body composition changes, such as low bone mineral content (BMC), decreased muscle mass, high body mass index (BMI), and increased fat mass are common in older adults with hyperkyphosis. This study aimed to investigate the relationship between body composition and balance performance using a biomechanical analysis in older adults with hyperkyphosis. Thirty older adults with hyperkyphosis were recruited. BMC, muscle mass, BMI, and fat mass were measured for body composition. Balance performances were determined with walking, quiet standing, and forward reach. Gait speed, step length, center of mass–center of pressure inclination angle of heel strike (Inc-HS) and toe off (Inc-TO) during walking, center of mass–center of pressure inclination angle during quiet standing (Inc-QS), and reaching distance were calculated. BMC had a moderately positive correlation with gait speed (r = 0.48, p

OBJECTIVE This study aimed to examine the developmental pattern of diurnal cortisol rhythm during pubertal transition and its prospective association with psychopathological symptoms. METHODS A cohort of 1158 children consisting of 608 boys and 550 girls aged 7 to 9 years (mean [standard deviation] age = 8.04 [0.61] years) were recruited in the Anhui Province of China in 2015 (wave 1). A single awakening sample was collected at baseline, and three additional samples were collected at one weekday in wave 2 to wave 4. Four indices of cortisol activity were evaluated and calculated across the day: awakening cortisol level, cortisol awakening response, the area under the curve with respect to ground (AUC), and the diurnal cortisol slope. In each wave, pubertal development was assessed by testicular size in boys and Tanner scales in girls. Psychopathological symptoms were ascertained in waves 2 to 4. RESULTS Multilevel mixed models revealed no significant pubertal changes in diurnal cortisol activity in girls. In boys, awakening cortisol (β = -0.005, p = .004) and total cortisol output (lnAUC, β = -0.005, p = .040) significantly decreased across pubertal transition. Higher awakening cortisol and total cortisol output (lnAUC) were associated with higher scores on internalizing symptoms in girls (β = 0.82, p < .001; β = 0.62, p = .012) and externalizing symptoms in boys (β = 0.73, p = .001; β = 0.55, p = .019) during the 3-year follow-up. In contrast, no associations were found between cortisol awakening response and diurnal cortisol slope with psychopathological symptom scores in boys or girls. CONCLUSIONS Development of diurnal cortisol activity during pubertal transition occurs in a sex-specific manner. Awakening cortisol level and daily total cortisol output may serve as markers for psychopathology during pubertal transition.

Purpose Our research aimed to investigate the expression level of circ_0002232, which is transcribed from PTEN, and find out the association of circ_0002232/miR-92a-3p/PTEN network in acute myeloid leukemia (AML). Methods Circ_0002232 expression in 115 AML patients and 48 controls was detected by using real-time quantitative PCR. The diagnostic value of circ_0002232 expression was evaluated by receiver operating characteristic curve. Kaplan-Meier curves were used to analyse the impact of circ_0002232 for overall survival. Associated network of circ_0002232 was predicted by using interaction prediction websites. Results Compared with controls, circ_0002232 was notably low-expressed in AML (P

To investigate the function and mechanism of Alpinetin on chronic obstructive pulmonary disease (COPD) in rat model. The markers of lung injury (body weight/pulmonary function) were measured, and the protein levels of inflammatory‐, apoptosis‐, and fibrotic‐related were determined by Western blot. HE/TUNEL/Masson staining was performed to investigate the mechanisms involved. The levels of inflammatory factors lung injury were detected by ELISA. The in vivo activities of all molecules were determined using a rat model. Alpinetin suppressed the injury of alveolus pulmonis cells occurred in vivo due to the decrease in inflammatory factors and biochemical markers by reduced the expression of TGF‐β1, α‐SMA, and TNF‐α (p, This work was to evaluate Alpinetin to COPD treatment by vivo study.

Cyclocryotherapy and transscleral cyclophotocoagulation are commonly used procedures for the treatment of refractory glaucoma, but still with many complications. Ultrasound cyclo plasty (UCP) is a novel technique that determines a selective and more precise coagulation necrosis of the ciliary body to reduce intraocular pressure (IOP), but its efficacy and safety have been less investigated in Chinese population. This study aimed to evaluate the clinical efficacy and safety of UCP in Chinese patients with refractory glaucoma. We designed a prospective, before–after study involving 36 eyes of 36 patients with refractory glaucoma that underwent uneventful UCP. Mean IOP, mean IOP reduction and subjective pain scale scores before and after UCP were compared to evaluate the efficacy of UCP in these patients. Procedural success defined as no abnormality of the treatment sites, and complications were recorded, along with confirmation of the safety of UCP. The 36 UCP patients had a mean IOP of 53.61 ± 12.4 mmHg and a mean VAS score of 5.69 ± 3.02 preoperatively. Successful operation was achieved in 28 patients, with a success rate of 77.8%. In the follow-up observation at day 1, day 7, and month 1, 2, 3 and 6 postoperatively, both mean IOP and mean VAS score were significantly lower than those before operation (both P

An eye-safe white-lighting source configured with violet laser diode (VLD) and an ultrafast color convertor using the BEHP-PPV + MEH-PPV polymer blend is demonstrated for optical wireless communica...

BackgroundGermline variants inPTPN11are the primary cause of Noonan syndrome with multiple lentigines (NSML) and Noonan syndrome (NS), which share common skin and facial symptoms, cardiac anomalies and retardation of growth. Hearing loss is considered an infrequent feature in patients with NSML/NS. However, in our cohort, we identified a group of patients withPTPN11pathogenic variants that were primarily manifested in congenital sensorineural hearing loss (SNHL). This study evaluated the incidence ofPTPN11-related NSML or NS in patients with congenital SNHL and explored the expression ofPTPN11and the underlying mechanisms in the auditory system.MethodsA total of 1502 patients with congenital SNHL were enrolled. Detailed phenotype-genotype correlations were analysed in patients withPTPN11variants. Immunolabelling of Ptpn11 was performed in P35 mice. Zebrafish withPtpn11knockdown/mutant overexpression were constructed to further explore mechanism underlying the phenotypes.ResultsTen NSML/NS probands were diagnosed via the identification of pathogenic variants ofPTPN11, which accounted for ~0.67% of the congenital SNHL cases. In mice cochlea, Shp2, which is encoded byPtpn11, is distributed in the spiral ganglion neurons, hair cells and supporting cells of the inner ear. In zebrafish, knockdown ofptpn11aand overexpression of mutantPTPN11were associated with a significant decrease in hair cells and supporting cells. We concluded that congenital SNHL could be a major symptom inPTPN11-associated NSML or NS. Other features may be mild, especially in children.ConclusionScreening forPTPN11in patients with congenital hearing loss and variant-based diagnoses are recommended.

In order to diminish the impacts brought by high penetration of renewable energy on the reliability of distribution systems, some distribution networks (e.g. Chattanooga electric power board system) have deployed smart switches (SSs) to island some areas to mitigate outage losses. However, due to intermittency and sharply changing rate of renewable energy, it is likely to experience insufficient or excessive power for islanded areas. Therefore, a microgrid controller featured with flexible boundaries is proposed. With proposed microgrid controller, the microgrid can not only shrink or expand its boundaries according to current renewable energy supply, but also disconnect/connect to the main grid with a designated SS. Moreover, to ensure the microgrid controller could obtain suitable boundaries on the time scale of seconds, a real-time power management technique with alternative generating algorithm is designed to generate all possible alternative boundaries and choose the optimal one, which is scalable to any topology. In addition, in order to maintain state of charge of batteries within a desirable range, anti-overcharge/discharge strategies are designed. Four comprehensive experiments verify that the implementation of the microgrid controllers can realise flexible boundaries and deal with sharply changing rate of renewable generation or load on the time scale of seconds.

Objective To observe the clinical therapeutic effect on refractory peripheral facial paralysis treated with the combination of warming-needle moxibustion and stuck-needle-pulling therapy. Methods A total of 33 patients with refractory peripheral facial paralysis were treated with the combination of warming-needle moxibustion and stuck-needle-pulling technique. The treatment was given once daily and there were 2 days at interval after consecutive 5 treatments. A total of 10 treatments made one course and consecutive 2 courses of treatment were required. Before and after treatment, House-Brackmann (H-B) facial nerve grading scale score was adopted to evaluate the degree of facial paralysis in the patients and the clinical effect was assessed. Results After treatment, the mean H-B score was higher than that before treatment in the patients, indicating a statistical significance (P Conclusion The combination treatment of warming-needle moxibustion and stuck-needle-pulling technique achieves a definite effect on refractory peripheral facial paralysis.

Exhaustive exercise may damage muscles due to oxidative stress and inflammation and cause muscle fatigue and soreness. The study investigated the effects of Chinese herbal supplements (CHS) B307 on muscle endurance after exhaustive swimming (ES). Thirty‐two male ICR mice were randomly divided into 4 groups: Sham + ES, pretreatment of CHS B307 + ES (Pre + ES), post‐treatment of CHS B307 + ES (Post + ES), and dual treatment of CHS B307 + ES (Dual + ES). All mice were subjected to ES in the form of a forced swimming test. Then, we compared ES time (EST) as the index of muscular endurance. Also, we examined the fatigue, oxidative stress, inflammation, and damage in the muscle tissue among these groups by using immunohistochemistry (IHC), chemiluminescence, and biochemical analysis. Our results revealed that those mice of Pre + ES and Dual + ES groups had remarkably better EST than those mice of Sham + ES and Post + ES groups. Those mice with oral treatment of CHS B307(Pre + ES, Post + ES, and Dual + ES groups) showed significantly reduced leukocyte counts in the urine, and reduced levels of reactive oxygen species (ROS), neutrophils, and lactic acid in the blood than those mice of Sham + ES. In addition, those mice with oral treatment of CHS B307 (Pre + ES, Post + ES, and Dual + ES groups) showed significant alleviation of oxidative stress, inflammation, and damage in the muscle tissue than those mice of Sham + ES. Thus, we suggested that CHS B307 can be a functional sports supplement because it can enhance muscle endurance after exhaustive swimming via suppressing fatigue, oxidative stress, and inflammation., The study reported that Chinese herbal supplements B307 can be a functional sports supplement against exhaustive exercise.

Deep vein thrombosis (DVT) is a common complication after trauma. The development of markers to predict DVT in trauma patients is needed, and circulating microparticles (MPs) and their contents are possible candidates. In this study, we aimed to identify platelet factor 4 (PF4) and β-thromboglobulin (β-TG) mRNAs in circulating MPs as potential markers for DVT diagnosis in trauma patients. Fifteen trauma patients diagnosed with DVT and fifteen matched patients without DVT were included in this study. Fifteen healthy volunteers also were included as controls. Circulating MPs were obtained from the plasma of all study subjects. Annexin V+ MPs and platelet-derived MPs (PMPs) were quantified using flow cytometry. PF4 and β-TG mRNAs in MPs were determined by qPCR, and the common logarithm of relative quantitation (RQ) was calculated using the comparative Ct method. Receiver-operating characteristic (ROC) curves were performed to analyze the diagnostic value of PF4 and β-TG mRNAs. No significant differences were found in Annexin V+ MPs and PMPs levels between trauma patients with and without DVT. However, both PF4 and β-TG mRNAs in MPs from the DVT group were significantly higher than the non-DVT group and healthy controls (P = 0.014 for PF4, P = 0.010 for β-TG). The ROC curve analysis showed that both the PF4 mRNA (area-under curve (AUC) 0.756, P = 0.017) and the β-TG mRNA (AUC 0.751, P = 0.019) had a positive predictive value for DVT. This finding indicates that the PF4 and β-TG mRNAs in MPs may be used as potential biomarkers for DVT diagnosis in trauma patients.

Most of the existing energy-consumption models of machine tools are related to specific machine components and hence cannot be applied to other machine tools with different specifications. In order to help operators optimize machining parameters for improving energy efficiency, the tool tip cutting specific energy prediction model based on machining parameters and tool wear in milling is developed, which is independent of the standby power of machine tools and the spindle no-load power. Then, the prediction accuracy of the proposed model is verified with dry milling AISI 1045 steel experiments. Finally, the influence of machining parameters and tool wear on tool tip cutting specific energy is studied. The developed model is independent of machine components, so it can reveal the influence of machining parameters and tool wear on tool tip cutting specific energy. The tool tip cutting specific energy reduces with the increase in the cutting depth, side cutting depth, feed rate, and cutting speed, while increases linearly as the tool wears gradually. The research results are helpful to formulate efficient and energy-saving processing schemes on various milling machines.

Objective Understanding patients' acceptance of and satisfaction with telehealth use is important for workplace health promotion. In this study, we used a questionnaire to measure patients' usage behavior and satisfaction with cloud-based telehealth services in the workplace. We empirically investigated the factors that influence patients' usage and satisfaction based on data collected from 101 participants. Methods As its main research framework, this study utilized a revised version of the technology acceptance model 2 that was based on the telehealth services provided for chronic disease management. Through integrating a cross-sectional research design with an author-developed structured questionnaire that was assessed using reliability and validity tests, an anonymous survey was conducted on selected participants. The proposed research model and hypotheses were validated through path analysis using SPSS. Results We found that users believe telehealth services can promote their workplace health management; that job relevance, result demonstrability, and perceived ease of use (PEOU) positively affect the perceived usefulness (PU), which implies that cognitive instrumental processes have the most significant impact on the PU of cloud-based telehealth; and that both PEOU and PU positively affect the intention to use (IU), but PU has a bigger influence than PEOU on users' intentions to continue using telehealth. In particular, the IU and actual usage behavior were critical to the patients' satisfaction with telehealth services. Conclusion This research contributes to the rapid developing field of technology acceptance research by examining workplace telemedicine engagement. Our results will provide researchers with useful advice and a user-centered strategy for promoting workplace health management, which benefits both health care providers and corporate managers.

Co-delivery nanoparticles with characteristics of intracellular precision release drug have been generally accepted as an effective therapeutic strategy for eye diseases. In this study, we designed a new co-delivery system (miRNA/NP-BRZ) as a lasting therapeutic approach to prevent the neuro-destructive after the long-term treatment of glaucoma. Neuroprotective and intraocular pressure (IOP) response were assessed in in vivo and in vitro models of glaucoma. At the meaning time, we describe the preparation of miRNA/NP-BRZ, drug release characteristics, intraocular tracing, pharmacokinetic and pharmacodynamics study and toxicity test. We found that miRNA/NP-BRZ could remarkably decrease IOP and significantly prevent retinal ganglion cell (RGC) damages. The new formula of miRNA-124 encapsulated in PEG-PSA-BRZ nanoparticles exhibits high encapsulation efficiency (EE), drug-loading capacity (DC), and stable controlled-release efficacy (EC). Moreover, we also verified that the miRNA/NP-BRZ system is significantly neuroprotective and nontoxic as well as lowering IOP. This study shows our co-delivery drug system would have a wide potential on social and economic benefits for glaucoma.

Most studies focusing on only one directional effect among cognitive health, physical function, and incontinence may miss potential paths. This study aimed to determine the pathway by analyzing the bidirectional effects of exposure (X) on outcome (Y) and explore the mediating effect (M) between X and Y. Secondary data analyses were performed in this study. The original data were collected from August to October 2013 in one VH in Tainan, Taiwan, and the final sample size was 144 older male veterans. Path analysis was performed to test the pathway sequence X → M → Y among the three outcome variables. Approximately 80% of the veterans were aged 81 or older, approximately 42% had a functional disability, 26% had cognitive impairment, and 20% had incontinence. The relationships between functional disability and incontinence and between functional disability and cognition impairment were bidirectional, and functional disability played a key mediating role in the relationship between cognitive impairment and incontinence. Physical more than cognitive training in order to improve or at least stabilize functional performance could be a way to prevent or reduce the process of developing incontinence.