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With the rapid development of the Internet, readers tend to share their views and emotions about news events. Predicting these emotions provides a vital role in social media applications (e.g., sentiment retrieval, opinion summary, and election prediction). However, news articles usually consist of objective texts that lack emotion words, making emotion prediction challenging. From prior studies, we know that comments that come directly from readers are full of emotions. Therefore, in this article, we propose a deep learning framework that first merges article and comment information to predict readers' emotions. At the same time, in the prediction process, we design a pseudo comment representation for unpublished news articles by the comments of published news. In addition, a better model is required to encode articles that contain implicit emotions. To solve this problem, we propose a block emotion attention network (BEAN) to encode news articles better. It includes an emotion attention mechanism and a hierarchical structure to capture emotion words and generate structural information during encoding. Experiments performed on three public datasets show that BEAN achieves the state-of-the-art average Pearson (AP) and accuracy (Acc@1). Moreover, results on four self-collected datasets show that both the introduction of emotional comments and BEAN in our framework improve the ability to predict readers' emotions.

In this article, a semisupervised weighting method for feature dimension based on entropy is proposed for classification, dimension reduction, and correlation analysis. For real-world data, different feature dimensions usually show different importance. Generally, data in the same class are supposed to be similar, so their entropy should be small; and those in different classes are supposed to be dissimilar, so their entropy should be large. According to this, we propose a way to construct the weights of feature dimensions with the whole entropy and the innerclass entropies. The weights indicate the contribution of their corresponding feature dimensions in classification. They can be used to improve the performance of classification by giving a weighted distance metric and can be applied to dimension reduction and correlation analysis as well. Some numerical experiments are given to test the proposed method by comparing it with some other representative methods. They demonstrate that the proposed method is feasible and efficient in classification, dimension reduction, and correlation analysis.

Periodontitis is an oral chronic inflammatory disease. Inhibiting tissue destruction and promoting tissue regeneration are important means for the treatment of periodontitis. Metformin not only has hypoglycemic effect but also has anti-inflammatory effect. Metformin has been shown to inhibit oxidative stress and activate autophagy through AMPK/mTOR pathway. High mobility group box 1 (HMGB1) has been implicated in the pathogenesis of many inflammatory diseases including periodontitis, it can participate in the induction of oxidative stress. HMGB1 is an autophagy regulator under oxidative stress, which can activate mTOR pathway. However, it is not clear whether metformin is related to HMGB1 and its mechanism in the process of periodontitis. Cell viability and expression of inflammatory cytokines were clarified by Cell Counting Kit-8, real-time PCR and enzyme-linked immunosorbent assay. Western blot and immunofluorescence were conducted to determine HMGB1 intracellular localization and expression of autophagy-associated proteins in vitro. Experimental periodontitis mice model was induced by administering a ligature. Immunohistochemistry was performed to detect the expression and localization of HMGB1 in vivo. The results of CCK-8, real-time PCR, enzyme-linked immunosorbent assay, Western blot and immunofluorescence showed lipopolysaccharide (LPS) treatment inhibited cell viability, and increased HMGB1 expression at a dose-independent manner. Metformin can reduce the effect of LPS. It also improves autophagy pathway inhibited by LPS and down-regulates mTOR expression. In addition, metformin attenuated alveolar bone resorption induced by ligation. This study provides new evidence for that metformin is a potential drug for the treatment of periodontitis and HMGB1 may be a potential target for periodontal intervention.

To investigate the overall damage characteristics and failure modes of a warship subjected to an underwater non-contact near-field explosion, a hull girder with a trapezoidal cross-section was designed, manufactured, and tested. The design criteria and parameters were determined according to the similarity criterion. Dynamic responses of the girder freely floating on water were obtained under varying conditions, including stand-off distance, charge mass, and position of attack. Damage morphologies of the girder model were obtained. Based on our analysis, basic conditions for sagging damage of the hull girder are proposed. The aim of this study was to determine an efficient method of attack resulting in the most severe damage to the ship hull. The experimental results show that the girder mainly exhibits a first-order response when the first wet frequency of the girder is close to the frequency of the explosion bubble pulsation. The largest deformation was observed when the underwater explosion occurred directly below the midspan of the girder compared to other explosions of the same intensity at different attack positions. When the ratio of stand-off to maximum bubble radius (λ) satisfies 0.7 ≤ λ＜2, the bubble mainly causes sagging damage instead of hogging. As λ decreases (1≤ λ＜2), the sagging damage increases under the same charge mass. However, as λ decreases further (0.7≤ λ＜1), the sagging deformation decreases. This is likely due to the impact of the liquid jet formed by the collapsing bubble, which causes the girder deformation to shift from sagging back to hogging deformation. The initial shock wave excites the high-frequency response of the girder structure but contributes very little to the overall velocity and displacement. However, bubble pulsation typically causes a low-frequency response, which will affect the velocity and displacement of the girder. The low-pressure region of the flow field formed by bubble pulsation and resonant coupling between the girder and the bubble are the predominant causes of damage to the overall girder structure.

Background Growing evidence has revealed abnormalities in the retinal structure of patients with alopecia areata (AA). However, the relationship between AA and retinopathy remains unclear. Objective To investigate the association between AA and retinal diseases. Method The study participants were recruited from the National Health Insurance Research Database in Taiwan. We included 9,909 patients with AA and 99,090 matched controls to assess the risk of retinal diseases. A Cox regression model was used for all analyses. Results Compared with the controls, patients with AA had an adjusted hazard ratio (aHR) of 2.96 (95% confidence interval [CI], 2.20–3.98) for retinal diseases. With respect to individual retinal disease, AA patients had a significantly higher risk of developing retinal detachment (aHR, 3.80; 95% CI, 1.97–7.31), retinal vascular occlusion (aHR, 2.14; 95% CI, 1.09–4.19), and retinopathy (aHR 3.18; 95% CI 2.21–4.57) than controls. Limitations This is a retrospective cohort study. Meanwhile, almost all the participating individuals were residents of Taiwan; therefore, the validity of our findings in other demographics remains unclear. Conclusion Patients with AA had a significantly higher risk of retinal disease than the controls. Further studies are needed to clarify the pathophysiology of AA and retinal diseases.

Indoxyl sulfate (IS) and p-cresyl sulfate (pCS) are two important gut microbiota-generated protein-bound uremic toxins. The present study aims to explore the alterations of serum IS and pCS concentrations, their production, and daily removal in end-stage renal disease (ESRD).A case-controlled study was conducted based on 11 patients with ESRD and 11 healthy volunteers. The metabolic processes for IS and pCS were compared in these two groups, including gut microbiome, fecal indole and p-cresol, indole-producing bacteria and p-cresol-producing bacteria, serum total IS and pCS concentrations, and their daily removal by urine and spent dialyzate.Compared with healthy controls, patients with ESRD exhibited higher relative abundance of the indole-producing bacteria Escherichia coli (P .001) and Bacteroides fragilis (P = .010) and p-cresol-producing bacteria Bacteroides fragilis (P = .010) and Bacteroides caccae (P = .047). The predicted functional profiles of gut microbiome based on 16S rRNA gene PhyloChip analysis showed that the microbial tryptophan metabolism pathway (map00380, P = .0006) was significantly enriched in patients with ESRD. However, the fecal precursors indole (P = .332) and p-cresol concentrations (P = .699) were comparable between the two groups. The serum IS (P .001) and pCS (P .001) concentrations were far higher in patients with ESRD than those in healthy controls, whereas the daily total removal by urine and dialyzate was much lower for the former than that for the latter (P = .019 for IS, P = .016 for pCS).The present study showed serious IS and pCS accumulation in patients with ESRD, with significant expansion of indole-producing bacteria and p-cresol-producing bacteria, upregulation of the bacterial tryptophan metabolism pathway, and greatly increased serum IS and pCS concentrations, whereas significant decline of daily IS and pCS removal.

Making public health data easier to access, understand, and use makes it more likely that the data will be influential. Throughout the COVID-19 pandemic, the New York City (NYC) Department of Health and Mental Hygiene’s Web-based data communication became a cornerstone of NYC’s response and allowed the public, journalists, and researchers to access and understand the data in a way that supported the pandemic response and brought attention to the deeply unequal patterns of COVID-19’s morbidity and mortality in NYC. (Am J Public Health. 2021;111(S3):S193–S196. https://doi.org/10.2105/AJPH.2021.306446 )

Danon disease (DD) is an X-linked multisystem disorder with clinical features characterized by the triad of hypertrophic cardiomyopathy, skeletal muscle weakness, and mental retardation. Cardiac involvement can be fatal in the absence of an effective treatment option such as heart transplantation. Molecular studies have proved that LAMP-2 protein deficiency, mainly LAMP-2B isoform, resulting from LAMP2 gene mutation, is the culprit for DD. Autophagy impairment due to LAMP-2 deficiency mediated the accumulation of abnormal autophagic vacuoles in cells. While it is not ideal for mimicking DD phenotypes in humans, the emergence of LAMP-2-deficient animal models and induced pluripotent stem cells from DD patients provided powerful tools for exploring DD mechanism. In both in vitro and in vivo studies, much evidence has demonstrated that mitochondria dysfunction and fragmentation can result in DD pathology. Fundamental research contributes to the therapeutic transformation. By targeting the molecular core, several potential therapies have demonstrated promising results in partial phenotypes improvement. Among them, gene therapies anticipate inaugurate a class of symptom control and prevention drugs as their in vivo effects are promising, and one clinical trial is currently underway.

Federated learning allows a large number of resource-constrained clients to train a globally-shared model together without sharing local data. These clients usually have only a few classes (categories) of data for training, where the data distribution is non-iid (not independent identically distributed). In this paper, we put forward the concept of category privacy for the first time to indicate which classes of data a client has, which is an important but ignored privacy goal in the federated learning with non-iid data. Although secure aggregation protocols are designed for federated learning to protect the input privacy of clients, we perform the first systematic study on category inference attack and demonstrate that these protocols cannot fully protect category privacy. We design a differential selection strategy and two de-noising approaches to achieve the attack goal successfully. In our evaluation, we apply the attack to non-iid federated learning settings with various datasets. On MNIST, CIFAR-10, AG\_news, and DBPedia datasets, our attack achieves >90% accuracy measured in F1-score in most cases. We further consider a possible detection method and propose two strategies to make the attack more inconspicuous.

This study aims to find out the possible optimal therapy and assess the prognosis properly for patient with spontaneous rupture of hepatocellular carcinoma (HCC).Propensity score matching (PSM) analysis was used to study the data from 325 patients with ruptured HCC (RHCC) and 2,291 patients with non-RHCC.The incidence and hospital mortality of RHCC were 5.1% and 0.8% respectively, with a median overall survival (OS) time of 17 months. There was no difference between ruptured and non-RHCC patients undergoing conservation treatment in terms of OS. Trans-arterial embolization (TAE) was carried out in 69 (21.2%) cases with RHCC, with a median OS of 7 months, which was no difference from that of non-RHCC (pre- and post-PSM). One hundred and sixty-nine (52.0%) RHCC cases underwent one-stage hepatectomy, with a median OS and disease-free survival (DFS) of 30 and 6 months respectively, which were shorter than that of non-RHCC (post-PSM). TAE plus two-stage hepatectomy was performed in 30 RHCC cases, with a median OS and DFS of 28 and 10 months respectively; these outcomes were better than that from RHCC patients undergoing TAE alone or one-stage hepatectomy (post-PSM), which were no difference from that of non-RHCC patients undergoing hepatectomy. The risk of death for RHCC patient undergoing one-stage hepatectomy is 1.545 times higher than that of one undergoing TAE + two-stage hepatectomy.TAE plus two-stage hepatectomy might be the optimal treatment for RHCC patient. Under the premise of the same pathological properties, there is no difference in prognosis between ruptured and non-RHCC patients if the therapy is appropriate.

Background/aimsFuchs’ uveitis syndrome (FUS) is one of the frequently misdiagnosed uveitis entities, which is partly due to the absence of internationally recognised diagnostic criteria. This study was performed to develop and evaluate a set of revised diagnostic criteria for FUS.MethodsThe clinical data of Chinese patients with FUS and patients with non-FUS were collected and analysed from a tertiary referral centre between April 2008 and December 2020. A total of 593 patients with FUS and 625 patients with non-FUS from northern China were enrolled for the development of diagnostic criteria for FUS. Three hundred and seventy-seven patients with FUS and 503 patients with non-FUS from southern China were used to validate the criteria. Clinical symptoms and ocular signs were collected from all patients with FUS and patients with non-FUS. Multivariate two-step cluster analysis, logistic regression and decision tree algorithms in combination with the clinical judgement of uveitis experts were used to revise diagnostic criteria for FUS.ResultsThree essential findings including diffuse iris depigmentation, absence of posterior synechiae, mild inflammation in the anterior chamber at presentation and five associated findings including mostly unilateral involvement, cataract, vitreous opacities, absence of acute symptoms and characteristic iris nodules were used in the development of FUS diagnostic criteria. All essential findings were required for the diagnosis of FUS, and the diagnosis was further strengthened by the presence of associated findings.ConclusionRevised diagnostic criteria for FUS were developed and validated by analysing data from Chinese patients and showed a high sensitivity (96.55%) and specificity (97.42%).

Despite much research on the interdisciplinarity of the publications across subject categories, few studies analyze the interdisciplinarity of the technological knowledge flow among research entities (i.e., patent assignees, inventors, and countries). In this article, we propose a framework to identify the roles of the research entities by measuring the interdisciplinarity of the technological knowledge flow. Research entities are positioned on the two-dimensional maps based on the integration index, diffusion index, and specialization index, which are used to measure the degree of the interdisciplinarity of different research entities in knowledge flow. In order to explore the role of the research entities in knowledge flow, we put forward four kinds of research entities: diverse knowledge provider, active mediator of diverse knowledge flow, diverse knowledge consumer, and negative mediator of diverse knowledge flow. The case study related to synthetic biology indicates that this method is valid and could explore effectively, the roles of the research entities to further guide the creation of new inventions by converging prominent technologies beyond technology field boundaries in facilitating active technology flow and support technological competitive evaluation and policy decision-making.

Purpose This study examined the efficacy of prescribing antibiotics, specifically a single dose of vancomycin, in reducing the incidence of culture-positive and culture-negative sepsis prior to the removal of peripherally inserted central catheters (PICCs). Materials and methods We retrospectively reviewed charts of infants who had PICCs in a tertiary level hospital during the period from 2010 to 2019. The incidence of post-catheter removal clinical sepsis between the groups with or without antibiotics was compared. The antibiotic group was defined by receiving a single dose of vancomycin or any other antibiotic prior to line removal. Results We enrolled 585 PICC removal episodes in 546 infants for analysis. Antibiotics were given prior to removal in 257 cases (43.9%) and not given prior to removal in 328 cases (56.1%). There were 13 episodes of post-catheter removal clinical sepsis detected within 72 h (2.2%), 2 of which were culture-positive (0.3%). A 9.3-fold decrease in the odds for clinical sepsis was observed in the antibiotic group (p = 0.01). The incidence of post-catheter removal sepsis was decreased by a single prophylactic dose of vancomycin (p = 0.02), whereas the use of other antibiotics showed no effect (p = 0.35). Logistic regression analysis demonstrated that comorbidities with gastrointestinal diseases (p = 0.01), PICC insertion sites in the scalp and neck (p = 0.04), and no vancomycin administration prior to line removal (p = 0.02) were independent risk factors for subsequent clinical sepsis. Conclusion A single prophylactic dose of vancomycin prior to PICC line removal might reduce clinical sepsis events in infants.

Background: Since the increasing use of asbestos occurred in China and the long latency period after asbestos exposure, predicting the incidence of malignant mesothelioma played an important role in attracting the attention of clinicians. The Bayesian age-period-cohort prediction model was fitted to predict the development trend from 2016 to 2030 based on the publicly available data of the national cancer registration network. Methods: Malignant mesothelioma incidence data were retrieved from the national cancer registration annual reports from 2005 to 2015. The Bayesian Age-Period-Cohort (APC) Modeling and Prediction package (Institute of Biomedical Engineering, Imperial College, London, UK) was used to describe the trend of malignant mesothelioma incidence and to predict the incidence rate and number of cases until the year of 2030. Findings: The crude incidence rates of malignant mesothelioma decreased from 0.22 per 100 000 in 2005 to 0.16 per 100000 in 2015. After age standardization, the incidence rates remained stable over the 11-year period. The trends were mainly caused by aging. The Bayesian APC model showed that increased from 0.14 per 100 000 in 2016 to 0.19 per 100000 in 2030 and the estimated number of new incident cases was predicted to increase to 2775 in 2030. The age-standardized incidence rate would remain steady. Interpretation: The incidence of malignant mesothelioma would remain stable in the next ten years, but due to its high degree of malignancy, the cancer still needs to be taken more attention at. Funding: Ministry of Science and Technology of the People's Republic of China; Beijing Hope Run Special Fund; Chinese Academy of Medical Sciences; Beijing Municipal Health Commission. Conflict of Interest: All authors declare no competing interests.

Objective Defects in the human solute carrier family 26 member 4 (SLC26A4) gene are reported to be one of the causes of congenital hypothyroidism (CH). We aimed to identify SLC26A4 mutations in Chinese patients with CH and analyze the function of the mutations. Methods 273 patients with primary CH were screened for 21 CH candidate genes mutations by targeted next-generation sequencing. All the exons and exon-intron boundaries of SLC26A4 were found and analyzed. The function of 6 missense mutation in SLC26A4 were further investigated in vitro. Results Among 273 patients with CH, 7 distinct SLC26A4 heterozygous mutations (p.S49R, p.I363L, p.R409H, p.T485M, p.D661E, p.H723R, c.919-2A>G) were identified in 10 patients (3.66%, 10/273). In vitro experiments showed that mutation p.I363L, p.R409H,p.H723R affect the membrane location and ion transport of SLC26A4, ,while p.S49R did not.Mutation p.T485M and p.D661E only affect the ion transport, but has no effect on the membrane location. Conclusion Our study indicated that the prevalence of SLC26A4 mutations was 3.66% in the Chinese patients with CH. Five mutations (p.I363L, p.R409H, p.T485M, p.D661E and p.H723R) impaired the membrane location or ion transport function of SLC26A4，which revealed important role of the Ile363,Arg409, Thr485, Asp661, His723 residues in function of SLC26A4. Because these mutations are heterozygous mutations, the pathogenesis of these patients cannot be explained, and the pathogenesis of these patients needs further study.

Background: This study investigated the efficacy and complications of microwave ablation in combination with chemotherapy in treating peripheral IIIB-IV nonsmall cell lung cancer (NSCLC). Materials...

Introduction Gut microbiota has been implicated in the pharmacological activities of many natural products. As an effective hypolipidemic agent, berberine (BBR)’s clinical application is greatly impeded by the obvious inter-individual response variation. To date, little evidence exists on the causality between gut microbes and its therapeutic effects, and the linkage of bacteria alterations to the inter-individual response variation. Objectives This study aims to confirm the causal role of the gut microbiota in BBR’s anti-hyperlipidemic effect and identify key bacteria that can predict its effectiveness. Methods The correlation between gut microbiota and BBR’s inter-individual response variation was studied in hyperlipidemic patients. The causal role of gut microbes in BBR’s anti-hyperlipidemic effects was subsequently assessed by altered administration routes, co-treatment with antibiotics, fecal microbiota transplantation, and metagenomic analysis. Results Three-month clinical study showed that BBR was effectively to decrease serum lipids but displayed an obvious response variation. The cholesterol-lowering but not triglyceride-decreasing effect of BBR was closely related to its modulation on gut microbiota. Interestingly, the baseline levels of Alistipes and Blautia could accurately predict its anti-hypercholesterolemic efficiency in the following treatment. Causality experiments in mice further confirmed that the gut microbiome is both necessary and sufficient to mediate the lipid-lowering effect of BBR. The absence of Blautia substantially abolished BBR's cholesterol-decreasing efficacy. Conclusion The gut microbiota is necessary and sufficient for BBR’s hyperlipidemia-ameliorating effect. The baseline composition of gut microbes can be an effective predictor for its pharmacotherapeutic efficacy, providing a novel way to achieve personalized therapy.

BACKGROUND Rapid developments in medical care-such as monitoring devices, medications, and working hours restrictions for intensive care personnel-have dramatically increased the demand for intensive care physicians. Therefore, nurse practitioner (NP)-staffed care is becoming increasingly important. This study was aimed to compare the outcomes of daytime NP-staffed and daytime resident-staffed nonsurgical intensive care units (ICU). METHODS We retrospectively assessed patients admitted to a nonsurgical ICU from March 2017 to December 2017. We collected basic patient data, including age, sex, admission diagnosis, transferring unit, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Primary endpoints were ICU mortality, hospital mortality, and 30-day mortality. Secondary endpoints were 48-h readmission, discharge to nonhome locations, and lengths of ICU and hospital stay. RESULTS A total of 838 subjects were analysed: 334 subjects in the NP-staffed group and 504 in the resident-staffed group. The NP-staffed group was more likely to come from inpatient units (38.3% vs 16.5% for resident-staffed group; p

Ciphertext-Policy Attribute-Based Encryption (CP-ABE) is one of the potent encryption paradigms in protecting data confidentiality in the cloud data sharing scenario. However, the access policy of the traditional CP-ABE is in plaintext form that reveals significant sensitive information of data owners and data visitors. To mitigate this problem, two approaches have been proposed in the literature. One is partially hidden, where the attributes in the access policy are divided into two parts: the plaintext attribute names and the hidden attribute values. The other approach fully hides the attributes in the access policy which, unfortunately, hinders efficient and correct decryption as well as dynamic policy-updating. In this paper, we design a security-enhanced Attribute Cuckoo Filter (se-ACF) to hide the access policy and propose a new CP-ABE system, called Privacy-Preserving Policy Updating ABE (3PU-ABE), which effectively integrates policy hiding and policy updating. We conduct rigorous security analysis and performance evaluation of 3PU-ABE. The results indicate that 3PU-ABE completely hides the access policy without affecting the decryption, and entails better policy-updating efficiency than similar works.

In this paper, we report our discovery on named entity distribution in general word embedding space, which helps an open definition on multilingual named entity definition rather than previous closed and constraint definition on named entities through a named entity dictionary, which is usually derived from human labor and replies on schedule update. Our initial visualization of monolingual word embeddings indicates named entities tend to gather together despite of named entity types and language difference, which enable us to model all named entities using a specific geometric structure inside embedding space, namely, the named entity hypersphere. For monolingual case, the proposed named entity model gives an open description on diverse named entity types and different languages. For cross-lingual case, mapping the proposed named entity model provides a novel way to build named entity dataset for resource-poor languages. At last, the proposed named entity model may be shown as a very useful clue to significantly enhance state-of-the-art named entity recognition systems generally.

Ground military target recognition plays a crucial role in unmanned equipment and grasping the battlefield dynamics for military applications, but is disturbed by low-resolution and noisy-representation. In this paper, a recognition method, involving a novel visual attention mechanism-based Gabor region proposal sub-network (Gabor RPN) and improved refinement generative adversarial sub-network (GAN), is proposed. Novel central–peripheral rivalry 3D color Gabor filters are proposed to simulate retinal structures and taken as feature extraction convolutional kernels in low-level layer to improve the recognition accuracy and framework training efficiency in Gabor RPN. Improved refinement GAN is used to solve the problem of blurry target classification, involving a generator to directly generate large high-resolution images from small blurry ones and a discriminator to distinguish not only real images vs. fake images but also the class of targets. A special recognition dataset for ground military target, named Ground Military Target Dataset (GMTD), is constructed. Experiments performed on the GMTD dataset effectively demonstrate that our method can achieve better energy-saving and recognition results when low-resolution and noisy-representation targets are involved, thus ensuring this algorithm a good engineering application prospect.

Traditional data sharing systems are facing new challenges when implementing access control with more and more complex data sharing requirements. Flexibility of user revocation in completely decentralized environments needs to be taken into account. In this paper, we propose a Key-Policy Attribute-Based Encryption scheme with Multiple Authorities and Flexible Revocation (MAFR-KP-ABE) to achieve the features of decentralized authorization and flexible revocation. We prove the security of our MAFR-KP-ABE scheme in the standard model and provide the comparison with relevant schemes to demonstrate its efficiency. Then we propose a fine-grained access control system based on MAFR-KP-ABE scheme and blockchain that matches the need of paid data sharing services with several security properties enhanced. Security analysis and system implementation are given subsequently to demonstrate our system efficient and secure.

BACKGROUND We conducted a longitudinal survey for methicillin-resistant Staphylococcus aureus (MRSA) carriage in nursing homes and long-term care facilities (LTCFs) in northern Taiwan. METHODS From July 2016 to February 2017, healthcare workers and residents in four institutions were enrolled. One swab sample from nares and another swab sample from umbilicus were obtained from each participant for detection of MRSA at enrolment and then follow-up samples were collected every two months for additional three times if feasible. RESULTS We enrolled a total of 194 participants, including 127 residents and 67 healthcare workers. MRSA colonization rates were 23.2%, 22.8%, 20.7% and 18.6% at enrolment, the 2-, 4-, and 6-month follow-up survey, respectively, and the cumulative colonization rate was 40.2%. The MRSA detection rate was significantly higher at Institution 2 (70.7%) than that at other three institutions (25.7% ∼ 35%) (p

In this paper, we explore the mask representation in instance segmentation with Point-of-Interest (PoI) features. Differentiating multiple potential instances within a single PoI feature is challenging because learning a high-dimensional mask feature for each instance using vanilla convolution demands a heavy computing burden. To address this challenge, we propose an instance-aware convolution. It decomposes this mask representation learning task into two tractable modules as instance-aware weights and instance-agnostic features. The former is to parametrize convolution for producing mask features corresponding to different instances, improving mask learning efficiency by avoiding employing several independent convolutions. Meanwhile, the latter serves as mask templates in a single point. Together, instance-aware mask features are computed by convolving the template with dynamic weights, used for the mask prediction. Along with instance-aware convolution, we propose PointINS, a simple and practical instance segmentation approach, building upon dense one-stage detectors. Through extensive experiments, we evaluated the effectiveness of our framework built upon RetinaNet and FCOS. PointINS in ResNet101 backbone achieves a 38.3 mask mean average precision (mAP) on COCO dataset, outperforming existing point-based methods by a large margin. It gives a comparable performance to the region-based Mask R-CNN with faster inference., Comment: Accepted by IEEE Transactions on Pattern Analysis and Machine Intelligence

Text is a new way to guide human image manipulation. Albeit natural and flexible, text usually suffers from inaccuracy in spatial description, ambiguity in the description of appearance, and incompleteness. We in this paper address these issues. To overcome inaccuracy, we use structured information (e.g., poses) to help identify correct location to manipulate, by disentangling the control of appearance and spatial structure. Moreover, we learn the image-text shared space with derived disentanglement to improve accuracy and quality of manipulation, by separating relevant and irrelevant editing directions for the textual instructions in this space. Our model generates a series of manipulation results by moving source images in this space with different degrees of editing strength. Thus, to reduce the ambiguity in text, our model generates sequential output for manual selection. In addition, we propose an efficient pseudo-label loss to enhance editing performance when the text is incomplete. We evaluate our method on various datasets and show its precision and interactiveness to manipulate human images.

Motivation: The prediction of drug-target interaction (DTI) from heterogeneous biological data is critical to predict drugs and therapeutic targets for known diseases such as tumor and bowel disease. The study of DTI based on drug representation learning can strengthen or integrate our knowledge of pharmacological and chemical phenomena. Therefore, there is a strong motivation to develop effective methods that can detect these potential drug-target interactions. Results: We have developed a novel Knowledge-Enhanced Multi-View framework (KEMV) to predict unknown DTIs from pharmacological data and chemical data on a large scale. The proposed method consists of two steps: (i) learning more comprehensive drug representations via the proposed multi-view attention mechanism, which bridges pharmacological and chemical information, and interactively summarizes the attention values depending on varying interactions between different pairs of drug features. (ii) predicting unknown drug-target interactions based on the drug and target representations. The method is tested on real-world dataset KEGG with three classes of important drug–target interactions involving enzymes, ion channels, and G-protein-coupled receptors. Our framework is proven to uncover potential DTIs with scientific evidences explaining the mechanism of the interactions through the processing of high-dimensional, heterogeneous, and sparse drug data. Availability: Our code is available at: https://github.com/YuanKQ/DTI-Prediction

Multiview fuzzy systems aim to deal with fuzzy modeling in multiview scenarios effectively and to obtain the interpretable model through multiview learning. However, current studies of multiview fuzzy systems still face several challenges, one of which is how to achieve efficient collaboration between multiple views when there are few labeled data. To address this challenge, this article explores a novel transductive multiview fuzzy modeling method. The dependency on labeled data is reduced by integrating transductive learning into the fuzzy model to simultaneously learn both the model and the labels using a novel learning criterion. Matrix factorization is incorporated to further improve the performance of the fuzzy model. In addition, collaborative learning between multiple views is used to enhance the robustness of the model. The experimental results indicate that the proposed method is highly competitive with other multiview learning methods.

In the inductive charging scenario of an electric vehicle (EV), the charger should have the capability to flexibly regulate the output power regardless of the misalignment and EV battery voltage. This paper proposes a hybrid voltage and frequency tuning strategy for a series-series (SS) inductive power transfer (IPT) system to regulate power through 0 to 3.3kW at any battery voltages and misalignment conditions without using additional converters. A voltage tuning is used to achieve full-power of 3.3kW and partly contribute to reducing the power. When the input voltage achieves the lower limit, a frequency tuning is used to further decrease the power to 0W, achieving the regulation through 0 to full power. The practical charging region is specified by 110mm airgap, 100mm misalignment in both x and y directions, and 180V-240V battery voltage range. Experiments are carried out at various conditions, and it shows that with an input voltage range of 180V-380V and a frequency of 82.5kHz~87.9kHz, the charging power can be regulated between 100W and 3.3kW at any case in the specified working region. In addition, a peak dc-dc efficiency of 95.7% is achieved at 3.29 kW.

High-Altitude Long-Endurance (HALE) solar-powered Unmanned Aircraft Vehicles (UAVs) can utilize solar energy as power source and maintain extremely long cruise endurance, which has attracted extensive attentions from researchers. Trajectory optimization is a promising way to achieve superior flight time because of the finite solar energy absorbed in a day. In this work, a method of trajectory optimization and guidance for HALE solar-powered aircraft based on a Reinforcement Learning (RL) framework is introduced. According to flight and environment information, a neural network controller outputs commands of thrust, attack angle, and bank angle to realize an autonomous flight based on energy maximization. The validity of the proposed method was evaluated in a 5-km radius area in simulation, and results have shown that after one day-night cycle, the battery energy of the RL-controller was improved by 31% and 17% compared with those of a steady-state strategy with a constant speed and a constant altitude and a kind of state-machine strategy, respectively. In addition, results of an uninterrupted flight test have shown that the endurance of the RL controller was longer than those of the control cases.

Background Oxidative stress and memory impairment have been implicated, a common functional brain disease. Nuclear factor E2-related factor 2 (Nrf2) is highly induced in oxidative stress, indicating that Nrf2 is an emerging target of memory therapy. This study aimed to investigate the effect of Noni on brain memory impairment induced by hydrocortisone and its protection mechanism in mice. Methods Male Kuming mice were (n = 8/group) given hydrocortisone by gastric gavage for 14 consecutive days to establish the memory impairment model except for those in the control group. At the same day, the corresponding drugs were given by gastric gavage. The changes in ethology were examined. Brains were extracted and subjected to western blot analysis and biochemical analyses to assess the activities of oxidative stress. Results The middle and high-dose Noni groups ameliorated the ethology and the high-dose Noni group increased cerebral protein expressions of Nrf2, kelch-like ECH-associated protein 1 (KEAP1) and heme oxygenase-1 (HO-1), as compared to the model group. The arrangement of CA3 vertebral cells in hippocampus of mice was slightly compact and hyperchromatic and pyknosis were alleviated. Furthermore, the biochemical analyses showed the activities of related enzymes of oxidative stress in high-dose Noni group were increased. Conclusions Noni might be a powerful antioxidant that can protect nerve cell and may possess as a potential benefit for the treatment of memory impairment.

AIMS Culprit-plaque morphology [plaque rupture (PR) and plaque erosion (PE)] and high-risk plaques (HRP) identified by optical coherence tomography (OCT) and residual SYNTAX score (rSS) have been reported to influence clinical outcomes. Thus, in this study, we aimed to investigate the prognostic implication of culprit-plaque morphology and rSS for major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS Based on plaque morphology and rSS, 274 STEMI patients were divided into 4 groups: PE/low-rSS (n=61), PE/high-rSS (n=58), PR/low-rSS (n=55), and PR/high-rSS (n=100). According to HRP and rSS, patients were stratified to non-HRP/low-rSS (n=97), non-HRP/high-rSS (n=109), HRP/low-rSS (n=19), and HRP/high-rSS (n=49). MACE was defined as the composite of all-cause death, recurrence of myocardial infarction, stroke, and unplanned revascularization of any coronary artery. RESULTS During the follow-up of 2.2 years, 47 (17.2%) MACE were observed. Patients with PR/high-rSS and HRP/high-rSS presented lower survival probability on revascularization and MACE. In fully adjusted analyses, PR/high-rSS group presented higher MACE risk than PE/low-rSS (HR: 4.80, 95% CI: 1.43-16.11, P=0.025). Patients with non-HRP/high-rSS (HR: 2.90, 95% CI: 1.01-8.38, P=0.049) and HRP/high-rSS (HR: 8.67, 95% CI: 2.67-28.21, P＜0.001) presented higher risk of cardiac events than non-HRP/low-rSS. Adding rSS and HRP to the risk prediction model increased the C-statistic to 0.797 (95% CI: 0.737-0.857), with ΔC-statistic of 0.066 (P=0.002) and the NRI (46.0%, 95% CI: 20.5-56.8%, P＜0.001) and IDI (8.7%, 95% CI: 3.6-18.2%, P＜0.001). CONCLUSION High-risk plaques in combination with rSS enhanced the predictive ability for MACE, indicating culprit-plaque features and residual atherosclerosis burden should be taken into account in risk stratification of STEMI patients.

Background: Colorectal peritoneal carcinomatosis (CRPC) is a primary cause of death in colorectal cancer (CRC) patients. In the past, computed tomography (CT) has been the primary method used to ev...

Background: Nanowires (NWs) have received extensive attention as the candidate materials for transparent conductive films (TCFs) in recent years. To date, the aligned nanowire (NW)- based TCFs with the same arrangement direction have shown superior characteristics to their random counterparts in applications. Objective: To fully develop the potential of NW TCFs in devices and provide inspiration for the development of subsequent NW alignment processes, this review summarizes state-of-the-art alignment techniques and emphasizes their mechanisms in detail from multiple perspectives. Methods: According to the mechanism of NW alignment, this review divides these techniques into seven categories, i.e., the assisted assembly of fluid flow, meniscus, pressure, template, electromagnetic field, contact and strain, and analyzes the characteristics of these techniques. Moreover, by briefly enumerating the applications of aligned NW films in solar cells, organic light-emitting diodes, and touch screens, the superiority of aligned NW films over random NW films is also addressed. Results: Contact-assisted assembly exhibits the best arrangement effect, reaching a 98.6% alignment degree within ±1°. Under the same conditions, shorter NWs show better alignment in several cases. The combination of various assembly techniques is also an effective means to improve the alignment effect. Conclusion: There is still room for improvement in the precise control of NW position, density, and orientation in a simple, efficient and compatible process. Therefore, follow-up research work is needed to conquer these problems. Moreover, a process that can realize NWs’ alignment and film patterning simultaneously is also a desirable scheme for fabricating personalized devices.

Sinomenine (SIN) is commonly used as part of rheumatoid arthritis (RA) therapy in China, but there is still no published evidence of the efficacy of SIN monotherapy. This work investigates the efficacy and safety of SIN in treating RA patients and analyzes the correlation between ornithine level and the alleviation of disease activity in RA patients. In this 24 week, randomized, placebo-controlled, double-blind clinical trial, people with mild to moderate RA were randomly assigned (1:1:1, stratified by hospital) to receive SIN (120 mg, twice daily), methotrexate (MTX) (10 mg per week), or SIN + MTX therapy. The primary outcome was the proportion of patients who achieved a 50% improvement in the American College of Rheumatology (ACR) criteria at week 24 and who showed improvement according to the clinical disease activity index (CDAI). In this prospective subgroup analysis, we also assessed whether the 24 week alterations of disease activity in the treatment group were significantly correlated to the levels of blood ornithine. Of the 135 enrolled participants, 38, 39, and 36 patients were treated with SIN, MTX, and SIN + MTX, respectively. In the SIN-treated group, 52.63% of patients achieved ACR50 after 24 weeks of treatment, which was comparable to the results in the MTX-treated and SIN + MTX-treated groups. Hepatic and gastrointestinal disorders were the main adverse events; however, the ratio of patients suffering from hepatic disorder in the SIN group (1/38) was much lower than that in the MTX (10/39) and SIN + MTX (8/36) groups. A total of 221 serum samples were collected at the four follow-up time points in the three treatments, and the levels of ornithine, citrulline, and arginine were obtained through ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). The serum ornithine level decreased after the 24 week treatment along with a decrease in disease activity, and may reflect therapeutic responses with a sensitivity value of 80%. In conclusion, SIN revealed a comparable efficacy to MTX for treating RA patients, but with fewer side effects. In addition, the serum ornithine level was found for the first time to have a close correlation with the alleviation of RA, which shows the value of this measure as an assessment indicator of drugs in treating RA.

Background/Purpose The long-term disease course and efficacy of maintenance therapies have rarely been investigated in Asian patients with neuromyelitis optica spectrum disorder (NMOSD). Methods Medical records of patients fulfilling the 2015 International Consensus Diagnostic Criteria for NMOSD at three medical centers in Taiwan were systematically analyzed. Linear regression analysis was performed to investigate factors related to annualized relapse rate (ARR); survival analysis was used to estimate the relapse-free intervals among therapies. Results A total of 557 relapses affecting 648 regions (202 optic neuritis, 352 acute myelitis, and 94 brain syndromes) in 204 patients were analyzed during a follow-up period of 69.5 months (range, 1–420). Up to 36.1% of myelitis-onset patients and 24.0% of optic neuritis-onset patients exhibited a limited form disease, defined as having one or more relapses confined to the same region. The median ARR was significantly lower in patients with limited form disease than those with relapses involving multiple regions (0.30 vs. 0.47, respectively). An older age at disease onset was associated with a lower ARR (p = 0.023). Kaplan–Meier analysis showed that the estimated time (months) to next relapse was longest in rituximab-treatment group (58.0 ± 13.2), followed by immunosuppressant (48.5 ± 4.8) or prednisone (29.6 ± 4.6) groups, and shortest in those without maintenance therapy (27.6 ± 4.2) (p = 8.1 × 10−7). Conclusion Limited form disease and older age at disease onset are associated with a lower relapse rate in NMOSD. Compared to no maintenance therapy, rituximab and immunosuppressant significantly reduce the relapse risks.

Previous neural network accelerators tailored to video analysis only accept data of RGB/YUV domain, requiring decompressing the video that are often compressed before transmitted from the edge sensors. A compressed video processing accelerator can alleviate the decoding overhead, and gain performance speedup by operating on more compact input data. This work proposes a novel deep learning accelerator architecture, Alchemist, which is able to predict results directly from the compressed video bitstream instead of reconstructing the full RGB images. By utilizing the metadata of motion vector and critical blocks extracted from bitstreams, Alchemist contributes to remarkable performance speedup of 5x with negligible accuracy loss. Nevertheless, we still find that the original compressed video coded by standard algorithms such as H.264 is not suitable to be directly manipulated, due to diverse compressed structures. Although obviating the requirement to recover all RGB frames, the accelerator must parse the entire compressed video bitstream to locate reference frames and extract useful metadata. If we combine the video codec with the proposed compressed video analysis, additional optimizations can be obtained. Therefore, to cope with the mismatch between current video coding algorithms such as H.264 and neural network-based video analysis, we propose a specialized coding strategy to generate compressed video bitstreams more suitable for transmission and analysis, which further simplifies the decoding stage of video analysis and is capable of achieving significant storage reduction.

Vogt-Koyanagi-Harada disease (VKH) is a rare autoimmune disease characterized by diffuse and bilateral uveitis, alopecia, tinnitus, hearing loss, vitiligo and headache. The transcriptional expression pattern of peripheral blood mononuclear cells (PBMC) in VKH remains largely unknown. In this study, mRNA sequencing was conducted in PBMC from VKH patients with active uveitis before treatment (n = 7), the same patients after prednisone combined with cyclosporine treatment (n = 7) and healthy control subjects strictly matched with gender and age (n = 7). We found 118 differentially expressed genes (DEGs) between VKH patients and healthy control subjects, and 21 DEGs between VKH patients before and after treatment. TRIB1 was selected as a potential biomarker to monitor the development of VKH according to the mRNA sequencing. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to predict the possible biological functions and signaling pathways of DEGs. Neutrophil degranulation, peptidase regulator activity, secretory granule membrane, cellular response to peptide, growth factor binding and cell projection membrane were enriched as GO annotations of DEGs. Arachidonic acid metabolism and mitogen-activated protein kinase (MAPK) signaling pathway were potential signaling pathways involved in pathogenesis and drug response of VKH. A protein–protein interaction (PPI) network was constructed by STRING, and colony stimulating factor 1 receptor (CSF1R) was identified as the hubgene of all DEGs by Cytoscape. The cell type presumed to contribute to the aberrant expression of DEGs was analyzed with the use of publicly available single-cell sequencing data of PBMC from a healthy donor and single-cell sequencing dataset of monocytes from VKH patients. Our findings may help to decipher the underlying cellular and molecular pathogenesis of VKH and may lead novel therapeutic applications.

Aims Despite the recent prosperity of shrimp cultivation in China, very little is known about how different shrimp farming models influence the dynamics of Vibrio parahaemolyticus populations and the antibiotic resistance of this bacterium. Methods and Results To this end, we conducted continuous surveillance of V. parahaemolyticus on four farms over 3 years: two traditional shrimp farms with daily water exchange and two farms operated in the recirculating aquaculture systems (RAS). No antibiotics were used in these farms to exclude the potential impacts of antibiotics on the emergence of antibacterial resistance. Multilocus sequence typing was utilized to characterize the dynamics of V. parahaemolyticus populations. Whole-genome sequencing (WGS) was conducted to determine the representative sequence types (STs) at each farm. Results revealed that the population structure of V. parahaemolyticus remained stable over time in both RAS farms, with only nine and four STs observed at each. In contrast, annual replacement of V. parahaemolyticus populations was observed in traditional farms with 26 and 28 STs identified in rearing water. WGS of 50 isolates divided them into five clusters, of which ST917a isolates harboured a genomic island that disrupted the gene recA. Pair-wised genomic comparison of isolates from the same STs showed that they were genetically related but belonged to different clones associated with geographical distribution. Conclusions These results suggested that RAS presented a specific ecological niche by minimizing the water exchanges with the external environment. In contrast, traditional farming might pose a food safety issue by introducing new V. parahaemolyticus populations with antibiotic resistance genes. Significance and Impact of the Study Our results expose the potential food safety issue associated with conventional agriculture and should encourage the development of preventive strategies to reduce the emergence of resistant V. parahaemolyticus populations.

Objectives. To evaluate the effectiveness of a novel health care access program (ActionHealthNYC) for uninsured immigrants. Methods. The evaluation was conducted as a randomized controlled trial in New York City from May 2016 through June 2017. Using baseline and follow-up survey data, we assessed health care access, patient experience, and health status. Results. At baseline, 25% of participants had a regular source of care; two thirds had visited a doctor in the past year and reported 2.5 visits in the past 12 months, on average. Nine to 12 months later, intervention participants were 1.2 times more likely to report having a primary care provider (58% vs 46%), were 1.2 times more likely to have seen a doctor in the past 9 months (91% vs 77%), and had 1.5 times more health care visits (4.1 vs 2.9) compared with control participants. Conclusions. ActionHealthNYC increased health care access among program participants. Public Health Implications. State and local policymakers should build on the progress that has been made over the last decade to expand and improve access to health care for uninsured immigrants.

Parkinson's disease (PD) is an incapacitating neurodegenerative disease. Patients with PD and their caregivers may have interactive effects on each other’s psychological well-being. This study aimed to assess the dyadic dynamics of resilience, fatigue, and suicidal ideation on the depression severity of PD patients and their caregivers. In total, 175 PD patients and 175 caregivers were recruited at a medical center from August 2018 to May 2020. Structural equation modeling (SEM) was used to examine the actor/partner effects on the psychological well-being of both the PD patients and their caregivers. The most common psychiatric diagnoses of both the PD patients (28.6%) and their caregivers (11.4%) were depressive disorders. The PD patients’ and their caregivers’ fatigue, suicidal ideation, and lack of resilience were significantly associated with the severity of their depression, respectively. Interactive effects existed between psychological well-being of individuals with PD and their caregivers. Clinicians must be aware of, and manage, these contributing factors between PD patients and their caregivers in order to prevent them from worsening each other’s depression.

BACKGROUND Although endoscopy is the gold standard to assess disease activity and infliximab efficacy in inflammatory bowel disease (IBD), the invasive, costly, and time-consuming procedure limits its routine applications. We aimed to investigate the clinical value of serum oncostatin M (OSM) as a surrogate biomarker. METHODS Fifty healthy controls, 34 non-IBD patients, and 189 IBD patients who were pre-infliximab treatment (n = 122) or in infliximab maintenance (n = 67) were enrolled. A chemiluminescence immunoassay (CLIA) was constructed to quantify serum OSM concentrations. Receiver operator characteristic (ROC) curve analysis was used to evaluate the performance of blood biomarkers for IBD management. RESULTS The methodology of CLIA exhibited great analytical performance with a wide linear range of 31.25-25000 pg/mL, a low detection limit of 23.2 pg/mL, acceptable precision, and applicable accuracy. Patients with IBD (121.5 [43.3-249.4] pg/mL, p

Nondipping heart rate (HR), defined as a night/day HR ratio0.90, has been associated with increased mortality in epidemiologic studies. However, its prognostic value in stage 5 chronic kidney disease (CKD5) patients and the effects of parathyroidectomy (PTX) on nondipping HR remain unknown.This case-control study of 162 healthy controls and 502 CKD5 patients was performed between 2011 and 2018, in which CKD5 patients were further divided into non-PTX (n = 186) and severe secondary hyperparathyroidism (SHPT) with PTX (n = 316) subgroups. Each participant underwent 24-hour Holter monitoring for HR ratio. Mortality was followed up in CKD5 patients (median time: 46.0 months).The HR ratio in CKD5 patients was higher than in controls (0.92 ± 0.08 vs 0.81 ± 0.08, P.001), associated with a 44% increase in mortality risk per 0.1 increment (hazard ratio, 1.44; 95% CI: 1.02-2.03; P =.04), and was positively related to serum intact parathyroid hormone levels (P.001). PTX reversed nondipping HR in SHPT patients (n = 50, median time: 6.3 months, P.001). Survival probabilities for PTX (n = 294) were better than non-PTX (n = 47) (hazard ratio, 0.31; 95% CI: 0.14-0.67; P.01) in SHPT patients (serum intact parathyroid hormone500.0 pg/mL).CKD5 patients displayed a nondipping HR pattern, which is a prognostic marker of all-cause mortality. PTX for SHPT patients was associated with a reversal in nondipping HR ratio, which may mediate a better outcome.

Background/purpose: To the best of our knowledge, no studies have examined longitudinal changes in the accessibility of suicide-related content on Chinese-language websites. We investigated changes between 2016 and 2019 in suicide-related materials likely to be accessed by individuals through websites in Taiwan. Methods: In March 2019, we searched the Taiwanese versions of Google and Yahoo! using six suicide-related terms and compared the results to a search performed in 2016. Website characteristics (e.g., pro- or anti-suicide) generated by various keywords were calculated and compared in 2016 and 2019. Results: The number of anti-suicide websites exceeded that of pro-suicide websites in 2016 and 2019. Between 2016 and 2019, the proportion of pro-suicide sites decreased slightly from 16.3% (61 out of 375 sites) to 12.3% (51 out of 417 sites) (p = 0.10). User-generated webpages constituted the primary source of pro-suicide content at both time points. Over the same period, the proportion of pro-suicide information on internet forums decreased from 59.1% to 17.8% (p

Purpose To evaluate the diagnostic performance of swept-source anterior segment optical coherence tomography (SS-OCT) in differentiating eyes with primary angle closure disease (PACD) from eyes of control subjects, as well as eyes with PAC and PAC glaucoma (PACG) from eyes with PAC suspect (PACS) disease. Design Multicenter cross-sectional study. Methods Chinese patients were classified into control, PACS, and PAC/PACG groups. The area under the receiving operating characteristic curve (AUC) from logistic regression models was used to evaluate discriminating ability. Sensitivity and specificity were calculated, and performance of the models was validated using an independent dataset. Results A total of 2928 SS-OCT images from 366 eyes of 260 patients were recruited to develop diagnostic models. The validation dataset included 1176 SS-OCT images from 147 eyes of 143 patients. For distinguishing PACD from control eyes, average anterior chamber depth had the highest AUC (0.94). With a cutoff of 2.2 mm for average anterior chamber depth, the sensitivity and specificity were 90.2% and 85.2% in the training set. For distinguishing PAC/PACG from PACS, a multivariate model had an AUC of 0.83, with sensitivity and specificity of 82.0% and 62.8% in the training set. The validation set confirmed the findings. Conclusions SS-OCT of the anterior segment showed excellent diagnostic performance distinguishing PACD from normal eyes and moderate diagnostic ability distinguishing eyes with PAC/PACG from eyes with PACS. ACD alone may provide a simple and effective way to diagnose PACD from control subjects. As ACD can be obtained using other more available modalities, this has implications for the early diagnosis of PACD.

Hepatitis B virus (HBV) represents the commonest etiologic agent of acute-on-chronic liver failure (ACLF) in most Asian countries. Nucleos(t)ide analogs (NAs) are effective in the treatment of chronic HBV infections, but may also exacerbate the disease and stimulate its development into HBV-associated ACLF if not used appropriately. The current study aimed to assess the prevalence and severity of HBV-associated ACLF as a result from irregular medication of NAs (IMNA). A total of 1134 individuals with HBV-associated ACLF in nine hospitals in Heilongjiang Province were enrolled in this study between 2005 and 2015. Among these, 777 chronic hepatitis B (CHB) and 357 HBV-associated liver cirrhosis cases were classified based on various predisposing factors, including IMNA, HBV reactivation (HBVR), infections, treatment drugs, alcohol use and others (hepatitis C virus, hepatitis E virus, gastrointestinal bleeding and unknown reasons). The percentage and improvement rate were examined. Among individuals with HBV-associated ACLF and CHB, IMNA was found in 9.01%, HBVR in 46.20%, infections in 9.52%, treatment drugs in 14.67%, alcohol in 11.71%, and others in 24.58% as predisposing factors. Improvement rates in cases with IMNA, HBVR, infections, treatment drugs, alcohol and others were 41.43%, 58.50%, 58.11%, 56.14%, 53.85%, and 65.97%, respectively. Multivariable analysis showed that IMNA, others, infections, hepatic encephalopathy and hepatorenal syndrome were associated with prognosis. Only IMNA independently predicted HBV-associated ACLF prognosis. Overall, our study demonstrated that the percentage of IMNA-induced HBV-associated ACLF was 12.61%, and worse disease conditions resulted from IMNA compared with other factors. Thus, the suitability of treatment with NAs should be thoroughly evaluated.

PURPOSE Using novel Bayesian adaptive designs has great potential to improve the efficiency of early-phase clinical trials. A major barrier for clinical researchers to adopt novel designs is the lack of easy-to-use software. Our purpose is to develop a user-friendly software platform to implement novel clinical trial designs that address various challenges in early-phase dose-finding trials. METHODS We used R Shiny to develop a web-based software platform to facilitate the use of recent novel adaptive designs. RESULTS We developed a web-based software suite, called Bayesian optimal interval (BOIN) suite, which includes R Shiny applications to handle various clinical settings, including single-agent phase I trials with and without prior information, trials with late-onset toxicity, trials to find the optimal biological dose based on risk-benefit trade-off, and drug combination trials to find a single maximum tolerated dose (MTD) or the MTD contour. The applications are built using the same software architecture to ensure the best and a uniform user experience, and they are developed using a proven software development standard operating procedure to ensure accuracy, robustness, and reproducibility. The suite is freely available with internet access and a web browser without the need of installing any other software. CONCLUSION The BOIN suite allows clinical researchers to design various types of early-phase clinical trials under a unified framework. This work is extremely important because it not only advances the clinical research and drug development by facilitating the use of novel trial designs with optimal performance but also enhances collaborations between biostatisticians and clinicians by disseminating novel statistical methodology to broader scientific communities through user-friendly software. The BOIN suite establishes a KISS principle: keep it simple, but smart.

BACKGROUND Geographic isolation and travel distance to specialist care is a known social determinant of health and contributes to poorer oncology survival outcomes. AIMS Our objective was to compare survival and toxicity outcomes for patients travelling long distances (>50 km) for treatment on clinical trials with local patients (

Background: Propagated sensation along channels occurs because of stimulations during acupuncture therapies and tends to transmit the stimulating signals along the meridians. From the Western medicine aspect, researchers consider the phenomena as neurotransmissions initiated by nerves, and various ions regulate the physiological functions of the nervous systems. Objective: This research investigates the critical characteristics of ions at acupoints and the mechanism of propagated sensation along channels, crossing meridians in traditional Chinese medicine (TCM). Methods: This research first conducts experiments by applying intense pulse light beams, which replace the traditional acupuncture treatments, on designated acupoints of studied human subjects, and employs a thermal infrared imager to monitor the temperature responses, which are induced by post sensation, in adjacent regions of the acupoints. Meanwhile, the research applies a synchrotron radiation technique on adult SD (Sprague Dawley) rats. The study analyzes the output responses with an X-ray Absorption Fine Spectroscopy (XAFS) to investigate the ion distributions in the relevant acupoints, which trigger the propagated sensation crossing meridians. Results: Experimental results demonstrate significant temperature increases simultaneously at the stimulated acupoints and specific other acupoints, whether in the same meridians. Moreover, XAFS experimental results indicate significantly high calcium, potassium, and sulfide ions at the stimulated acupoint regions. On the contrary, the measured chloride ions level at the regions is correspondingly lower. Conclusions: The thermal infrared imager monitoring shows significant temperature variations of crossing-meridian acupoints after implementing the intense pulse light beams on designated acupoints, and it implies the occurring of prolonged sensation along channels using acupuncture therapies. The X-ray absorption spectrum demonstrates significant differences in ion amounts and distributions between the acupoints and non-acupoints, and acupuncture therapies result in ion concentrations in the correlated regions inducing propagated sensation crossing meridians in TCM. Hence, the stimulated acupoints operate as ion reservoirs to provide high-concentration of specific ions to trigger the crossing-meridian post sensation.