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BACKGROUND The anti-M antibody can lead to hemolytic disease of the fetus and newborn (HDFN) and adverse fetal outcomes, especially in the Asian population. However, fetal erythropoiesis resulting from M alloimmunization needs further investigation. STUDY DESIGN AND METHODS We analyzed erythropoiesis in eight fetuses with M alloimmunization and compared them with the fetuses affected by anti-D. They were matched as pairs according to the gestational age of diagnosis and the hematocrit before treatment. Paired t-tests or paired Wilcoxon rank-sum tests were conducted to compare the difference in the cord blood indexes. Pearson correlation analysis was used to evaluate the correlativity between hematocrit and the reticulocyte percentage in the two groups. RESULTS The fetuses in the MN group had lower reticulocyte count and percentage than those in the RhD group (p

In order to explore the postoperative complications of laparoscopic adhesive release in the treatment of intestinal obstruction, 70 patients with adhesive intestinal obstruction (IO) who visited Banan District People’s Hospital on March 1, 2017 and received surgical treatment on June 30, 2019 were selected as the research objects. The patients were divided into an experimental group (EG) and control group (CG) using random number table, 35 cases in each group. The EG accepted laparoscopic adhesion release, while the CG accepted laparotomy. The time spent during the operation, intraoperative blood loss (IBL), intestinal injury rate and intestinal resection rate, postoperative anal exhaust (PAE) time, hospital stay, feeding time and concurrent symptoms were recorded and compared between the two groups. Multivariate Logistic regression (MLR) model was adopted for the correlation analysis between symptoms after laparoscopic surgery (LS) and basic characteristics of patients and intraoperative information. It was found that the time of LS, IBL, PAE time, hospital stay and feeding time of the EG are greatly lower than that of the CG (P < 0.05). The number of cases of intestinal injury and intestinal resection in the EG was lower than that in the CG. The incidence of intestinal fistula, pulmonary infection, intestinal paralysis, incision infection, renal dysfunction and malnutrition in the EG was also lower than that in the CG. The regression coefficients of concurrent symptoms of LS and operative time and IBL were 0.376 and 0.343, respectively, showing a significant positive correlation (P < 0.05), which indicated that compared with traditional laparotomy, laparoscopic technique can effectively reduce the occurrence of complicated intestinal fistula, pulmonary infection, intestinal paralysis, incision infection, renal dysfunction, malnutrition, and so on. At the same time, ligation and frequent replacement of surgical instruments should be avoided as far as possible during the operation, and the occurrence of concurrent symptoms can be effectively decreased by reducing the operation time, IBL, and postoperative recovery time of patients with IO.

Objectives To evaluate the incidence and types of chromosomal abnormalities detected in twins with structural anomalies and compare their distribution according to chorionicity and amnionicity and by structural-anomaly type. The added value of chromosomal microarray analysis (CMA) over conventional karyotyping in twins was also estimated. Methods This was a single-center, retrospective analysis of 534 twin pregnancies seen over an 11-year period, in which one or both fetuses were diagnosed with congenital structural anomalies on ultrasound. The ultrasound findings and invasive prenatal diagnostic results were reviewed. Twin pregnancies were categorized as monochorionic monoamniotic (MCMA), monochorionic diamniotic (MCDA) or dichorionic diamniotic (DCDA). Chromosomal abnormalities detected by G-banding karyotyping and/or CMA were analyzed by chorionicity and amnionicity and by structural-anomaly type. Results The 534 twin pairs analyzed comprised 25 pairs of MCMA, 112 pairs of MCDA and 397 pairs of DCDA twins. Of the 549 fetuses affected by structural anomalies, 432 (78.7%) underwent invasive prenatal testing and cytogenetic results were obtained. The incidence of overall chromosomal abnormalities in the DCDA fetuses (25.4%) was higher than that in the MCMA (3.7%) and MCDA (15.3%) fetuses. The incidence of aneuploidy was significantly higher in the DCDA group (22.8%) than in the MCMA (0.0%) and MCDA (12.4%) groups. The incidence of chromosomal abnormalities detected in fetuses, with anomalies of the cardiovascular, faciocervical, musculoskeletal, genitourinary and gastrointestinal systems, was higher in the DCDA group than in the MCDA group. In both the DCDA and MCDA groups, hydrops fetalis was associated with the highest incidence of chromosomal abnormality; of these fetuses, 67.6% had Turner syndrome (45,X). Pathogenic copy-number variations (CNVs) undetectable by karyotyping were identified by CMA in five (2.0%; 95% CI, 0.3-3.7%) DCDA fetuses. No pathogenic CNVs were found in MCMA and MCDA twins. Conclusions Dichorionic twins with structural anomalies have a higher risk of chromosomal abnormalities, especially aneuploidies, than do monochorionic twins. The incremental diagnostic yield of CMA over karyotyping seems to be lower (2.0%) in twins than that reported in singleton pregnancy. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

The incoming 5G technology is expected to proliferate tremendous internet-of-thing (IoT) services with real-time and mobility requirements, which are quite different from the legacy cloud services. Due to the centralized management relying on distant datacenters, cloud computing is short of satisfying the stringent IoT requirements, such as ultra-low latency, mobility, etc. Instead, distributed edge computing, such as fog computing has been coined as a promising approach and has received enormous attention in recent years. In this paper, to optimally provision the huge volume of IoT services with significant diversity, we propose to efficiently organize the leisure network devices in the network edge to form fog networks (fogs), which are then integrated with the cloud to provide storage and computing resources. Specifically, we propose two Integer Linear Programming (ILP) models to solve the fog planning issue under the integrated Cloud-Fog (iCloudFog) framework. In the first ILP model, the objective is to minimize the CAPEX cost caused by planning fogs and the OPEX cost caused by utilizing the planned fogs. In the second ILP model, the objective is to minimize the power consumption while maximizing the number of successfully provisioned IoT tasks on the planned fogs. The proposed ILP models are numerically evaluated by considering different IoT task requirements, such as real-time and mobility. The numerical results show that efficiently planned fogs can help to reduce the planning overhead while satisfying diverse IoT task requirements.

Background Hydatidiform moles exhibit a distinctive gross appearance of multiple vesicles in the placenta. The advances in cytogenetic technologies have helped uncover novel entities of hydatidiform moles and enabled elaborate diagnoses. However, management of a vesicular placenta with a coexistent live fetus poses a bigger challenge beyond hydatidiform moles. Case presentation A 33-year-old woman was referred to our department for suspected hydatidiform mole coexistent with a live fetus at 24 weeks’ gestation. The patient had conceived through double embryo transplantation, and first-trimester ultrasonography displayed a single sac. Mid-trimester imaging findings of normal placenta parenchyma admixed with multiple vesicles and a single amniotic cavity with a fetus led to suspicion of a singleton partial molar pregnancy. After confirmation of a normal diploid by amniocentesis and close surveillance, the patient delivered a healthy neonate. Preliminary microscopic examination of the placenta failed to clarify the diagnosis until fluorescence in situ hybridization showed a majority of XXY sex chromosomes. The patient developed suspected choriocarcinoma and achieved remission for 5 months after chemotherapy, but relapsed with suspected intermediate trophoblastic tumor. Conclusion We report a rare case of twin pregnancy comprising a partial mole and a normal fetus that resembled a singleton partial molar pregnancy. Individualized care is important in conditions where a vesicular placenta coexists with a fetus. We strongly recommend ancillary examinations in addition to traditional morphologic assessment in such cases.

The huge volume of IoT data generated by emerging IoT end devices have triggered the prosperous development of Fog computing in the past years, mainly due to their real-time requirements. Fog computing aims at forming the idle edge devices that are in the vicinity of IoT end devices as instantaneous small-scale Fog networks (Fogs), so as to provide one-hop services to satisfy the real-time requirement. Since Fogs may consist of only wireless nodes, only wired nodes or both of them, it is significant to map IoT tasks with diverse QoS requirements to appropriate types of Fogs, in order to optimize the overall Fog performance in terms of the OPEX cost and transmission latency. Regarding this, we propose an integer linear programming (ILP) model to optimally map the IoT tasks to different Fogs and/or Cloud, taking into consideration of the task mobility and real-time requirements. Numerical results show that the real-time and mobility requirements have significant impact on the OPEX cost of the integrated Cloud-Fog (iCloudFog) framework.

Aiming at the shortages of basic flower pollination algorithm (FPA) with slow convergence speed, low search precision, and easy to fall into local optimum, a new adaptive FPA based on opposition-based learning and t-distribution (OTAFPA) was proposed and be applied to the social networks. First, the opposition-based learning strategy is utilized to increase the diversity and quality of the initial population. Then, the adaptive dynamic switching probability is introduced, which can effectively balance the global and local search according to the current number of iterations. Finally, the t-distribution variation is used to increase the population diversity and to help the algorithm jump out of the local optimum. The simulation experiments on eight classical test functions show that OTAFPA has better global optimization ability, which improves the convergence speed and the solution accuracy of the algorithm. The OTAFPA also shows superior performance in practical applications of user identification across social networks.

Background Haemolytic disease of the foetus and newborn (HDFN) is the most common aetiology of haemolytic anaemia and hyperbilirubinaemia in foetuses and neonates. Studies on the distribution of antibodies that cause haemolytic disease of the foetus (HDF) in China are limited, and the effects of multiple antibodies on the severity of HDF need further evaluation. Methods An observational cohort study from January 2005 to December 2019 was conducted in two hospitals affiliated with Sun Yat-sen University. Maternal red cell alloimmunization was identified by the Guangzhou Blood Centre. In total, 268 pregnant woman-foetus pairs were divided into four groups according to the type of maternal alloantibodies: anti-D, anti-D combined with other antibodies, other single-antibody and other multiple antibodies. The obstetric history, antibody characteristics, incidence of severe HDF and foetal outcomes were collected and compared. Logistic regression analysis of the risk factors for HDF and survival analysis of the severe HDF-free interval were conducted. Results Anti-D was the most common cause of HDF, followed by anti-M. No anti-K- or isolated anti-c-associated HDF was found. The incidence of severe HDF was higher in the group with anti-D combined with other antibodies than in the group with anti-D alone (P = 0.025), but no significant difference was found in haemoglobin level and reticulocyte count in the anaemic foetuses between these two groups. Foetuses in the other single-antibody group had a lower reticulocyte count (P = 0.007), more IUTs (P = 0.007) and an earlier onset of severe HDF (P = 0.012). The maximum antibody titre was significantly lower in the other single-antibody group than in the anti-D group (P P P P = 0.042) were independent risk factors for HDF. A higher reticulocyte count (P = 0.041) was an independent risk factor for severe HDF in anaemia foetuses affected by Rh(D) alloimmunization. Conclusions The distribution of HDF-associated antibodies in China is different from that in Western countries. Other single non-Rh(D) antibodies could increase the risk of HDF, and anti-D combined with other antibodies would not influence the severity of foetal anaemia compared with anti-D alone.

Key Clinical Message Pallister‐Killian syndrome (PKS) is often incidentally diagnosed prenatally due to ultrasound abnormalities or advanced maternal age. Severely shortened limbs could be the most outstanding abnormal observation in a fetus with PKS. PKS can be detected with the highest mosaic ratio by chromosomal microarray analysis (CMA) on uncultured amniocytes prenatally.

Objective To investigate the types of cardiovascular anomalies and the results of invasive prenatal diagnosis in twin fetuses. Methods A total of 298 fetuses in 149 twin pairs were enrolled, in which 1 or 2 fetuses of a twin pair had cardiovascular anomalies. Prenatal diagnosis was performed on 290 fetuses of 149 twin pairs, including 150 monochorionic diamniotic (MCDA) fetuses (79 pairs) and 140 dichorionic diamniotic (DCDA) fetuses (70 pairs). G-Banding karyotyping and/or chromosomal microarray analysis were performed. The types of cardiovascular anomalies and the results of prenatal diagnosis were analyzed. Results Fifty percent (79/158) fetuses in MCDA group and 52.1% (73/140) fetuses in DCDA group were diagnosed with cardiovascular anomalies by ultrasound. Primary cardiac structural defects such as septal defects and tetralogy of Fallot were more common in DCDA group than in MCDA group, while acardiac anomaly was the most common in MCDA group. Chromosomal aberrations were identified in 7.7% fetuses (11/142) of MCDA group and in 18.3% fetuses (22/120) of DCDA group by G-banding karyotyping. Except benign copy number variations (CNVs), 37 CNVs (pathogenic, likely pathogenic, and variant of uncertain significance) and chromosomal aberrations were detected in 21.3% (32/150) fetuses of MCDA group and 47 CNVs (pathogenic, likely pathogenic, and variant of uncertain significance) and chromosomal aberrations were detected in 32.1% (45/140) fetuses of DCDA group by chromosomal microarray analysis. Conclusions Most of cardiovascular anomalies were identified in one fetus of a twin pair no matter in MCDA or DCDA twin. Primary cardiac structural defects were more common in DCDA group. Monozygotic twins may have discordant phenotypes, karyotypes, and CNVs between 2 fetuses of each pair.

Objective To elucidate the relationship between copy number variations (CNVs) detected by high-resolution chromosomal microarray analysis (CMA) and the type of prenatal posterior fossa anomalies (PFAs), especially cerebellar hypoplasia (CH). Methods This study involved 77 pregnancies with PFAs who underwent CMA. Results Chromosomal aberrations including pathogenic CNVs and variants of unknown significance were detected in 31.2% (24/77) of all cases by CMA and in 18.5% (12/65) in fetuses with normal karyotypes. The high detection rate of clinically significant CNVs was evident in fetuses with cerebellar hypoplasia (54.6%, 6/11), vermis hypoplasia (33.3%, 1/3), and Dandy-Walker malformation (25.0%, 3/12). Compare with fetuses without other anomalies, cases with CH and additional malformations had the higher CMA detection rate (33.3% vs 88.9%). Three cases of isolated unilateral CH with intact vermis and normal CMA result had normal outcomes. The deletion of 5p15, 6q terminal deletion, and X chromosome aberrations were the most frequent genetic defects associated with cerebellar hypoplasia. Conclusion Among fetuses with PFA, those with cerebellar hypoplasia, vermis hypoplasia, or Dandy-Walker malformation are at the highest risk of clinically significant CNVs. Chromosomal microarray analysis revealed the most frequent chromosomal aberrations associated with CH.

Underground structures can be vulnerable due to seismic-induced deformation. A resilient underground structure is preferable for seismic response mitigation and quick recovery. In this study, a resilient central column with angular friction damper (RC-AFD) was constructed for the seismic performance upgrading of underground structures, and a practical design procedure was developed for the RC-AFD to enable the two-state control for underground structures subject to seismic excitations with multi-intensity. The RC-AFD consists of a self-centering column characterized by relaxed constraints at the top and bottom column that is restricted by unbounded prestressed tendons, whereas a pair of angular friction dampers are placed at the top of the central column. The mechanical model and its physical realization are detailed, whereas the two-state control mechanism is proposed by following the enhanced demand of seismic performance upgrading. The effectiveness and robustness of the proposed RC-AFD for structural seismic response mitigation of typical underground structures were investigated in terms of structural displacement, shear force, bending moments, and energy-based responses. The obtained results show that the two flexible connection joints concentrated at the top and bottom of the RC-AFD produce a significant isolation effect, through which the multiple responses of the central column can be reduced significantly. Benefiting from the two-state design and the employed angular friction damper with a large radius plate, the RC-AFD exhibits an enhanced energy dissipation capacity, which robustly dissipates the intense plastic energy for multi-intensity excitations. As a consequence, the plastic energy dissipation burden of the primary structures can be significantly relieved and residual deformation can be avoided due to the excellent self-centering ability.

Cases of CD36 deficiency are not rare in Asian populations, foetal and neonatal alloimmune thrombocytopenia (FNAIT) caused by anti-CD36 isoantibodies appears more frequent than other HPA alloantibodies. However, little is known about the treatment of anti-CD36 mediated FNAIT in this region. A Chinese male foetus, whose mother had a history of multiple intrauterine foetal demise and/or hydrops, was diagnosed with severe FNAIT at 27 weeks of gestational age. Immunological analysis revealed total absence of CD36 on platelets and monocytes from mother, caused by a 329–330delAC mutation of the CD36 gene. Anti-CD36 and anti-HLA class I antibodies were detected in the maternal serum, whereas only anti-CD36 isoantibodies were detectable in the foetal blood sample. Serial intrauterine transfusions with red blood cells (RBC) and platelets from a CD36null donor were performed to improve the severe anaemia and thrombocytopenia. The baby (2250 g; Apgar scores 10) was delivered vaginally at 32 weeks of gestation with normal haemoglobin (186 g/L) but low platelet count (48 × 109/L). After 2 days the platelet count rose to 121 × 109/L. This report suggests that intrauterine transfusions with compatible RBC and CD36null platelets are useful in preventing the deleterious clinical effects of anti-CD36-mediated severe FNAIT.

Background Fetal femur length (FL) is an important biometric index in prenatal screening. The etiology of short femur is diverse, with some pathogenic causes leading to adverse outcomes. To improve the accuracy and practicability of diagnosis, we investigated the value of genetic analysis in prenatal diagnosis of short femur. Methods We examined chromosomal microarray analysis (CMA) (64 fetuses) and karyotyping (59 fetuses) data retrospectively for short femur without fetal growth restriction (FGR). Genetic testing was conducted for 15 fetuses. Results Karyotyping and CMA detected chromosomal aberrations at rates of 13.6% and 27.2%, respectively. Among fetuses with other abnormalities, detection rates were 21.0% higher with CMA than karyotyping. CMA identified chromosomal abnormalities in 36.4% of cases with a FL 2–4 standard deviations (SDs) below the gestational age (GA) mean. Abnormality detection by CMA reached 38.5% in the second trimester. Duplication of 12p, 16p13.1 deletion, and uniparental disomy 16 were identified by CMA in three cases of short femur. Gene sequencing detected clinically notable mutations in 12/15 fetuses, among which 9/12 fetuses had FLs >4 SDs below the GA mean. Conclusions CMA yielded a higher detection value than karyotyping in fetuses with other abnormalities or a FL 2–4 SDs below the GA mean during the second trimester. Gene sequencing should be performed when FL is >4 SDs below the mean.

OBJECTIVES To investigate the general occurrence and clinical significance of absence of heterozygosity (AOH), detected by single-nucleotide polymorphism (SNP) array on prenatal diagnosis. METHODS We recruited pregnancies undergoing invasive prenatal diagnosis at our fetal medicine center over a 6-year period. All fetuses underwent SNP array using the Affymetrix CytoScan HD array platform. AOH was defined as a chromosomal homozygosity segment with neutral copy number. Cases with AOH over 10 Mb in size or with suspected pathogenicity were further analyzed, and the clinical features and outcome were reviewed. RESULTS Of 10 294 recruited fetuses, 100 (0.97%) with AOH were identified; in 81 (81.0%) of these, AOH occurred in a single chromosome, while 19 (19.0%) patients had multiple AOHs in different chromosomes. AOH was observed in all chromosomes, chromosomes X, 2 and 16 being the most frequently involved. The length of AOH ranged from partial chromosome (9.002-80.222 Mb) to the entire chromosome. Similar AOH regions displayed varied clinical manifestations. In total, 55 patients presented with concomitant ultrasound abnormalities, the most common being multiple abnormalities (14/55 (25.5%)), genitourinary malformations (8/55 (14.5%)), skeletal malformations (5/55 (9.1%)) and small-for-gestational age (5/55 (9.1%)). Notably, the rate of adverse perinatal outcome (including termination of pregnancy, neonatal death, fetal death, selective reduction and miscarriage) in fetuses with AOH and ultrasound abnormalities (30/48 (62.5%)) was higher than in those without ultrasound abnormalities (6/40 (15.0%)) (P

In this paper, the formulation of Stolt migration is modified for impulse borehole radar imaging in large nonuniform subsurface scenarios. By applying the nonuniform fast Fourier transform (FFT) to the acquisition of the frequency–wavenumber spectrum (FWS), the efficiency of Stolt migration for nonuniform surveys is improved. First, each nonuniform exponent basis in Fourier transform is approximated with a weighted summation of several uniform exponent bases. Then, the nonuniform samples with the same uniform exponent basis are accumulated to generate a larger virtual uniform sample set. The FWS of nonuniform samples is approximated with the virtual sample set by FFT. Finally, angular frequency interpolation and inverse FFT are performed over a sample FWS to reconstruct the reflectivity map of the imaging area. The selection of approximation parameters is discussed to make a tradeoff between approximation error and computational cost. The improved Stolt migration technique is compared with the conventional backprojection method and the Kirchhoff migration method on synthetic data and validated by a single borehole radar experiment in a subsurface scenario. The results show that the developed Stolt migration is superior to the conventional methods in terms of computational cost, cross-range resolution, and the ability to reconstruct the targets.

Central-column failure can cause large underground structures to collapse during strong earthquakes. The use of lead-filled steel-tube dampers (LFSTDs) in the seismic design of such structures is proposed to mitigate or prevent such an eventuality. Three-dimensional nonlinear dynamic analyses of the Daikai subway station with and without LFSTDs under the action of the Hyogoken–Nambu earthquake has been performed, considering soil-structure interaction. The feasibility of the proposed method was verified from four aspects—force, deformation, damage, and energy dissipation. The effects of variability in seismic inputs, strength ratio, and arrangement mode of dampers on the structural dynamic response characteristics have been discussed. Results reveal that the application of LFSTDs to large underground structures remarkably reduces the force, deformation, and damage associated with the central column under seismic loading. Additionally, a strength ratio of 0.4 is recommended when using LFSTDs, whereas in cases without LFTSTDs, the strength of the central column must be appropriately enhanced.

In the view of the lack of user’s property information and low utilization rate of the user’s dynamic behavior data in the networks, a new identification method that incorporate user’s dynamic preferences (DPUI) is proposed. First, we analyze nickname’s naming features on massive real data sets and constructed a nickname similarity calculation approach. Then, we use time sliding window and LDA model to mine user’s long-term dynamic preferences from their behavior data. Finally, integrated user’s preference to identify users. Experimental results show that the proposed algorithm can effectively identify user’s identity with high precision and recall rate.

Fetal ECG can provide fetal health information to determine whether the fetal development is good. Before the birth of the fetus, indirect methods are usually used to obtain the abdomen electrocardiogram of pregnant women. However, due to the influence of maternal ECG and noise, blind source separation of fetal ECG is still challenging. The paper proposed a fetal electrocardiogram extraction method based on fast fixed-point algorithm. Here we are focusing on the independent component analysis based on negentropy. The ECG signals are picked up at the thoracic and abdominal region of the pregnant women. The paper analyses all abdominal ECG and one pectoral ECG to get fetal ECG. Then, the separated signal is reconstructed by principal component analysis. Finally, the reconstructed fetal ECG signal is further denoised by wavelet transform to improve the performance of the algorithm. The results show that the algorithm can effectively separate the fetal ECG from the ECG in pregnant women. The improved algorithm reduces the complexity of blind source separation, improves the robustness, and the signal separated is clear.

Background The sustainability of the rural health-care system is under pressure in Gongcheng county, Guangxi, China, mainly owing to disparities between rural and urban medical resources, and preference of local patients to seek health care in urban tertiary hospitals. Our aim is to reform the county's primary care model to improve rural health-care services and increase its use, a critical component of the current national health-care reform plan. In this study, we primarily test the feasibility of implementing artificial intelligence (AI) powered bidirectional referral between rural clinics and the county hospitals on a new internet-based platform. We focused on developing the new web platform and primary care model and implementing it throughout the whole county health system, which serves over 300 000 residents. Methods Our reform adopts the University of California, San Francisco primary care model augmented with AI on a cloud platform. The main county hospital of Gongcheng county, Guangxi, China, and its associated rural clinics used the AI-powered Internet+ Primary Care Model (AiPCM) platform to provide patient education, patient engagement, bidirectional referral, panel management, and health coaching. The aim was for the three-level county health-care system to operate seamlessly and cost-effectively. In conjunction, the second key innovation required to make AiPCM work in rural China was deployed; an online health-care team from Guilin Medical University provided support to rural doctors in the form of professional training, online support, and a chatbot to assist village doctors in making referrals and managing the health care of rural residents. Findings We developed a new web platform to smoothly integrate AiPCM into existing clinical workflows at county, town and village levels. The main county people's hospital, two town health centres, and 17 village clinics joined the web platform in the first phase of the pilot study. The internet-based hub and spokes model allows the main county hospital (hub), and town health centres and village clinics (spokes) to care collaboratively for patients through bidirectional referral mechanisms. County hospital teams focus on diagnosis and treatment of patients referred from town health centres. Town health centre teams provide panel management for patients at risk and refer patients to county hospitals when needed. Village clinic doctors engage villagers and refer patients to town health centres when needed. County hospital specialists provide feedback to the referring doctors for them to continue caring for the patient locally. As care data are collected, a chatbot can be trained to further assist village and town doctors to make referrals and provide initial primary care. The AiPCM cloud platform can allow Guilin Medical University teams to add more capabilities to the county health system, including doctor training, patient coaching, referral assistance, chatbot training, and patient education. Thus, it is feasible to use AiPCM on a web platform to effectively implement bidirectional referrals, which should encourage more patients to see local doctors. Interpretation With AiPCM and technical support from academic institutions, the new primary care model can be implemented in rural China. Next, we will evaluate the effectiveness of AiPCM, its effect on the number of rural residents receiving the health care that they require, and patient clinical outcomes. Funding None.

The aim of this study is to analyze the influence of neglecting compound Gaussian clutter texture on wideband radar targets detection. The texture of compound-Gaussian clutter is researched, the Probability Density Function (PDF) expression of G0 distributed clutter is proposed. The optimal detection statistics treats the texture of G0 distributed clutter as a certain function is derived. As contrast, another detector neglects the clutter texture is derived. The numerical results are presented by means of Monte Carlo simulation strategy. Assume that cells of signal components are available. Those secondary data are supposed to possess either the same covariance matrix or the same structure of the covariance matrix of the cells under test. The simulation results highlight that the performance loss of the two detectors in different roughness parameter, the result shows the loss less than 2dB due to the texture is neglected and adaptively estimating the covariance matrix.

The aim of this study is to analyze the influence of neglecting K distributed clutter texture on wideband radar distributed targets detection. At first, the texture and the speckle of K clutter are researched and the Probability Density Function (PDF) of K clutter and its texture are derived, then the optimal detector by Neyman-Pearson (NP) is proposed, by contrast, another detector-Suboptimum Generalized Likelihood Ratio Test (GLRT) neglecting the clutter texture is given. Next, the estimation of covariance matrix is introduced. Finally, the numerical results are presented by means of Monte Carlo simulation strategy and the simulation results highlight that the performance loss of the 2 detectors in different shaping parameter, the result shows that the performance loss of the detector in K distributed clutter less than 1 db due to the texture is neglected and adaptively estimating the covariance matrix and the K clutter texture can be neglected on wideband radar targets detection.

An improved reverse time migration (RTM) method is proposed for borehole radar imaging in the subsurface scenarios with layered media. The time gating function is designed and applied to the incident wave field and scattering wave field for each imaging point, which strengthens the correlation between the wave fields in time domain. A normalized zero-offset cross-correlation with gated samples is conducted and used to weight the result of RTM. The improved approach is compared with the conventional RTM, back projection method, and Stolt migration algorithm with synthetic data. The results demonstrate the developed approach is superior to the conventional methods in locating targets and robust in complex subsurface environments.

Frequency diverse array (FDA) has its unique advantage in realizing low probability of intercept (LPI) technology for its dependent beam pattern. In this paper, we proposed a cognitive radar based on the frequency diverse array multiple-input multiple-output (MIMO). To implement LPI of FDA MIMO transmit signals, a scheme for array weighting design is proposed, which is to minimize the energy of the target location and maximize the energy of the receiver. This is based on the range dependent characteristics of the frequency diverse array transmit beam pattern. To realize the objective problem, the algorithm is proposed as follows: the second-order nonconvex optimization problem is converted into a convex problem and solved by the bisection method and convex optimization. To get the information of target, the FDA MIMO radar is proposed to estimate the target parameters. Simulation results show that the proposed approach is effective in decreasing the detection probability of radar with lossless detection performance of the receive signal.

To identify the association between preeclampsia (PE) and selective intrauterine growth restriction (sIUGR) in twin pregnancies.This was a retrospective cohort study of 1004 twin pregnancies from 2008 to 2014. We specifically compared the incidence, clinical characteristics and outcomes of PE between sIUGR and normal-growth twin pregnancies.PE occurred more frequently in sIUGR pregnancies [29.0% (51/176)] than in normal-growth twin pregnancies [13.1% (99/756), p 0.001, adjusted odds ratio 3.29]. Among sIUGR, the incidence of PE was significantly higher in dichorionic (DC) pregnancies (37.5%, 30/80) than in monochorionic (MC) pregnancies (21.9%, 21/96). The rates of onset at32 weeks (p = 0.045) and of severe PE (p = 0.025) were higher in sIUGR pregnancies with PE. The systolic blood pressure was also higher in sIUGR pregnancies with PE (152.6 ± 11.8 mmHg) than in normal-growth pregnancies with PE (148.0 ± 8.2 mmHg) (p = 0.042). Additionally, more sIUGR pregnancies were delivered at 32-36 weeks (p = 0.001), and fewer were delivered at ≥36 weeks (p 0.001). Moreover, the prevalence of severe neonatal asphyxia was higher in sIUGR pregnancies with PE than in normal-growth pregnancies with PE (8.8% versus 2.5%, p = 0.020).sIUGR is associated with increased odds of developing severe PE in twin pregnancies, leading to poorer perinatal outcomes.

In this paper, a novel data acquisition and imaging method based on compressive sensing (CS) is utilized for impulse borehole radar (IBR). With the sparse transform we present for the IBR systems, only 50% or even less samples are demanded to be collected and transmitted to reconstruct the target space. It reduces the required sampling rate and data transmission rate of IBR systems. Moreover, the simulation and experiment results show that the target spaces reconstructed by CS-based imaging method are less cluttered, comparing with the solutions of traditional Stolt migration method.

the problem of adaptive detection of spatially distributed targets or targets embedded in no homogeneous clutter with unknown covariance matrix is studied. At first, assume the clutter is complex circular zero-mean Gaussian clutter with an unknown positive definite covariance matrix, and it is independent of the covariance matrix vector under test, the secondary data are assumed to be random, then the properties of complex Wish art distributed is researched. Next, the Generalized Likelihood Ratio Test (GLRT) decision statistic based on Bayesian methods is derived, and then the numerical results are presented by means of Monte Carlo simulation strategy. Assume that cells of signal components are available, in this context, the simulation results highlight that the influence of different numbers of secondary data on detection performance, finally the influence of dispersion exponent on detection performance is studied.

In this paper, the problem of clutter interference caused by leak energy from signal source in cross-borehole radar is presented. This kind of clutter interference reduces the quality of Stolt migration result. A method based on the frequency difference between signal and clutter is put forward to improve signal-to-noise-ratio (SNR) and the corresponding infinite impulse response (IIR) band-pass filter is designed before Stolt migration. It is proved with field data that the filter improves the migration result and makes the signal energy more focused. (4 pages)

With its outstanding advantages in the antijamming communications, the frequency hopping technology is used in radar receivers. Based on the theoretical analysis of poly-phase structure in digital channelized receiver, a simple and reliable method technology for channel decision on frequency hopping (FH) signal is proposed. Simulation results certificate the design scheme is easy for hardware to realize.

To evaluate the high-risk factors and perinatal outcome in selective intrauterine growth restriction (sIUGR) and non-selective IUGR (non-sIUGR) in twins.In total, 336 pairs of twins were enrolled from December 2003 to 2009. According to the birth weight, 295 pairs of twins were divided into sIUGR, non-sIUGR and normal growth groups. Maternal characteristics, complications, chorionicity, zygosity and perinatal outcomes were analyzed among the three groups.The overall IUGR incidence (including sIUGR and non-sIUGR) in twin pregnancies was 23.2%. The sIUGR incidence was ten times greater than that of non-sIUGR. Monochorionicity and monozygosity were risk factors for overall IUGR, especially for the sIUGR (P0.01). Pre-eclampsia was more common in sIUGR than in the normal growth group (P0.05). Both the sIUGR and non-sIUGR groups had more intrauterine fetal death and neonatal death than the normal growth group (P0.01). The sIUGR group had more brain injury than the normal growth group (P0.01).Monochorionicity, monozygosity, pre-eclampsia were high-risk factors for IUGR in twins. Perinatal death was more prevalent in the non-sIUGR group, and neonatal brain damage was more prevalent in the sIUGR group.

According to the shortage that only historical data are made use of in the previous researches on stock forecast, a new idea of multi-input stock forecasting integrating various outer impact factors such as Dow Jones Index, Nikkei Index and Hang Seng Index etc. was presented. To avoid the local convergence of BP Neural Network, Radial Basis Function Neural Network (RBF) was selected and Genetic Algorithm (GA) was adopted for parameter optimization of RBF, and then forecasting was carried out by making use of the GA-RBF network obtained after optimization. This approach has good generalization capability and learning speed, which overcomes the shortages in BP network and solves the problem that a unified standard is lacked for RBF network parameter selection. The experiment results indicate that the approach of this paper can reflect the impact factors more complete and thus works better.

A prospective, randomized, controlled study was performed in 100 patients suffering from migraine without aura, assessed according to the TCM classification to evaluate the efficacies and impact factors of acupuncture and oral medicine in the treatment of primary headaches. The patients were divided into the 3 groups. In the majority of the trials, it was concluded that acupuncture offers benefits in the treatment of headaches. Conversely, the evaluation of physical forms of treatment, including acupuncture, has special difficulties that the studies till now are lack of meaningful quantitative analysis on mechanism. This note show an opposite conclusion to Prof. Andrew J Vickers that age is related to Migraine. Chronicity and headache degree will also affect the treatment result.

To acquire a comprehensive evaluation on image segmentation, this paper suggests an evaluation method based on Grey Clustering Analysis. In the method, several single-performance measures of segmentation results are discussed first, and then they are used to construct some whitenization weight functions and a clustering coefficient matrix. Next, on the basis of the matrix, the segmented images and their corresponding algorithms are clustered to three grades. Finally, according to the membership degree of the best grade, an overall evaluation result is gained. Our experiments show that the proposed method not only can cluster image segmentation algorithms or segmented images correctly, but also is efficient in automatic performance evaluation.

In this paper, we compare the performance of two classes of adaptive beamformers for wideband and coherent signals. It is well known that when the desired signal and interferences are partially or completely correlated, performance of conventional beamformer degrades severely. Therefore, spatial smoothing method and frequency focusing method have been proposed to tackle coherent sources. In this paper, we first discuss a frequency focusing method which is based on time-domain and can be applied to real time systems. And then, a new wideband beamformer was proposed by introducing spatial smoothing method into Frost beamformer. Result of simulations shows that the new beamformer has better frequency response than the time-domain based frequency focusing beamformer. (4 pages)

A cohort study.To clarify the risk factors for the subsidence of the titanium mesh cage (TMC) after anterior cervical corpectomy and fusion, and to discuss their clinical correlations.Fusion with TMC after anterior cervical corpectomy has become popular as an established treatment for cervical degenerative diseases, but postoperative TMC subsidence has often been reported in the literature.A total of 300 patients with anterior cervical corpectomy and TMC fusion were included in the study, including 1-level corpectomy in 236 patients and 2-level corpectomy in 64. TMC subsidence, radiologic findings, and clinical results were evaluated in the 12-month follow-up period.TMC subsidence occurred in 239 (79.7%) cases, including mild subsidence (1 to 3 mm) in 182 (60.7%) and severe subsidence (3 mm) in 57 (19.0%). Two-level corpectomy was more susceptible to severe subsidence, when compared with 1-level corpectomy (P0.001). Japanese Orthopedic Association recovery rate for severe subsidence was significantly lower than that for no subsidence (P=0.010). Severe subsidence was correlated with subsidence-related complications, including neck pain, neurologic deterioration, and instrument failure.TMC subsidence was a common phenomenon after anterior cervical corpectomy and fusion with TMC. Level of corpectomy was a unique risk factor for severe subsidence in this study, which might have led to bad clinical results and subsidence-related complications.

A high-speed general-purpose radar signal processing system is designed on the parallel processing platform combining four ADSP-21160s. In a typical example of digital pulse compression in the frequency domain, a highly efficient algorithm is presented after comparing different parallel processing algorithms. The validity of this algorithm is proved through experiments.