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Multimodal emotion recognition has gained much traction in the field of affective computing, human–computer interaction (HCI), artificial intelligence (AI), and user experience (UX). There is growing demand to automate analysis of user emotion towards HCI, AI, and UX evaluation applications for providing affective services. Emotions are increasingly being used, obtained through the videos, audio, text or physiological signals. This has led to process emotions from multiple modalities, usually combined through ensemble-based systems with static weights. Due to numerous limitations like missing modality data, inter-class variations, and intra-class similarities, an effective weighting scheme is thus required to improve the aforementioned discrimination between modalities. This article takes into account the importance of difference between multiple modalities and assigns dynamic weights to them by adapting a more efficient combination process with the application of generalized mixture (GM) functions. Therefore, we present a hybrid multimodal emotion recognition (H-MMER) framework using multi-view learning approach for unimodal emotion recognition and introducing multimodal feature fusion level, and decision level fusion using GM functions. In an experimental study, we evaluated the ability of our proposed framework to model a set of four different emotional states (Happiness, Neutral, Sadness, and Anger) and found that most of them can be modeled well with significantly high accuracy using GM functions. The experiment shows that the proposed framework can model emotional states with an average accuracy of 98.19% and indicates significant gain in terms of performance in contrast to traditional approaches. The overall evaluation results indicate that we can identify emotional states with high accuracy and increase the robustness of an emotion classification system required for UX measurement.

BACKGROUND: The EQ-5D is a standardised instrument that measures health-related quality-of-life and explores cost-effectiveness of treatments. Malawi is a low-resource country that would benefit from assessment of quality-of-life among individuals living with chronic conditions. Chichewa is the official native language of Malawi. The Chichewa version of the EQ-5D-3L developed by EuroQoL group has not been validated with Chichewa speakers. The purpose of this study was to evaluate the clinimetric properties of the Chichewa EQ-5D-3L. METHODS: Patients with orthopaedic conditions were recruited in the outpatient orthopaedic clinics and wards at Queen Elizabeth Central Hospital, Blantyre, Malawi. Fifty-three patients with various musculoskeletal problems were administered the Chichewa EQ-5D-3L and World Health Organization quality of life (WHO-QOL) questionnaires. To assess repeatability, a separate test-retest population of 20 patients were also selected from orthopaedic clinics and wards to fill out the questionnaire twice. RESULTS: Convergence validity was determined, with each of the WHO-QOL domains and the EQ-5D descriptive index and visual analogue scale (VAS) having good to moderate correlation (r = 0.3-0.7). Internal consistency was measured for the descriptive index, and the Cronbachs alpha was 0.7. The ceiling effect for the descriptive index and the VAS were 9.4% and 0%, respectively. No respondents reached floor effect for the descriptive index or the VAS. The test-retest intraclass correlation coefficient reliability at 14 days was 0.984 for the VAS and 1 for the descriptive index, with all 20 respondents providing the same responses. CONCLUSIONS: The EuroQoL translated version of the Chichewa EQ-5D-3L was found to demonstrate adequate validity, internal consistency, floor/ceiling effects, and reliability.

Background: For the surgical treatment of single-level degenerative spondylolisthesis (DS), patients can be treated with either an anterior or posterior interbody fusion. Prior studies have shown that patients with symptomatic degenerative spondylolisthesis treated surgically maintain substantially greater pain relief and improvement in function when compared to those treated non-operatively, but no consensus has emerged between which approach results in the best outcomes. Methods: The PearlDiver MARINER database was queried for patients with single-level DS who underwent either an anterior or posterior lumbar interbody fusion. Both populations were compared on multiple outcomes, including reoperation, post-operative complications, and readmission rates at 90 days, as well as rates of reoperation and cauda equina syndrome two-years postoperatively. Results: At 90 days patients who underwent anterior interbody were found to have higher rates of DVT (OR 2.53, 95% CI 1.74 – 3.70, p

Abstract Background Open tibia fractures are a major source of disability in low- and middle-income countries (LMICs) due to the high incidence of complications, particularly infection and chronic osteomyelitis. One proposed adjunctive measure to reduce infection is prophylactic local antibiotic delivery, which can achieve much higher concentrations at the surgical site than can safely be achieved with systemic administration. Animal studies and retrospective clinical studies support the use of gentamicin for this purpose, but no high-quality clinical trials have been conducted to date in high- or low-income settings. Methods We describe a protocol for a pilot study conducted in Dar es Salaam, Tanzania, to assess the feasibility of a single-center masked randomized controlled trial to compare the efficacy of locally applied gentamicin to placebo for the prevention of fracture-related infection in open tibial shaft fractures. Discussion The results of this study will inform the design and feasibility of a definitive trial to address the use of local gentamicin in open tibial fractures. If proven effective, local gentamicin would be a low-cost strategy to reduce complications and disability from open tibial fractures that could impact care in both high- and low-income countries. Trial registration ClinicalTrials.gov, Registration # NCT03559400 ; Registered June 18, 2018.

Abstract The Erdős-Rényi (ER) random graph G(n, p) analytically characterizes the behaviors in complex networks. However, attempts to fit real-world observations need more sophisticated structures (e.g., multilayer networks), rules (e.g., Achlioptas processes), and projections onto geometric, social, or geographic spaces. The p-adic number system offers a natural representation of hierarchical organization of complex networks. The p-adic random graph interprets n as the cardinality of a set of p-adic numbers. Constructing a vast space of hierarchical structures is equivalent for combining number sequences. Although the giant component is vital in dynamic evolution of networks, the structure of multiple big components is also essential. Fitting the sizes of the few largest components to empirical data was rarely demonstrated. The p-adic ultrametric enables the ER model to simulate multiple big components from the observations of genetic interaction networks, social networks, and epidemics. Community structures lead to multimodal distributions of the big component sizes in networks, which have important implications in intervention of spreading processes.

A machine learning (ML)-based random forest (RF) classification model algorithm was employed to investigate the main factors affecting the formation of the core-shell structure of BaTiO3-based ceramics and their interpretability was analyzed by using Shapley additive explanations (SHAP). An F1-score changed from 0.879 5 to 0.931 0, accuracy from 0.845 0 to 0.907 0, precision from 0.871 4 to 0.900 0, recall from 0.892 9 to 0.964 3, and ROC/AUC value of 0.97±0.03 was achieved by the RF classification with the optimal set of features containing only 5 features, demonstrating the high accuracy of our model and its high robustness. During the interpretability analysis of the model, it was found that the electronegativity, melting point, and sintering temperature of the dopant contribute highly to the formation of the core-shell structure, and based on these characteristics, specific ranges were delineated and twelve elements were finally obtained that metall the requirements, namely Si, Sc, Mn, Fe, Co, Ni, Pd, Er, Tm, Lu, Pa, and Cm. In the process of exploring the structure of the core-shell, the doping elements can be effectively localized to be selected by choosing the range of features. [ABSTRACT FROM AUTHOR]

Background and purpose — Intramedullary nailing (IMN) is underutilized in low-income countries (LICs) where skeletal traction (ST) remains the standard of care for femoral shaft fractures. This prospective study compared patient-reported quality of life and functional status after femoral shaft fractures treated with IMN or ST in Malawi. Patients and methods — Adult patients with femoral shaft fractures managed by IMN or ST were enrolled prospectively from 6 hospitals. Quality of life and functional status were assessed using EQ-5D-3L, and the Short Musculoskeletal Function Assessment (SMFA) respectively. Patients were followed up at 6 weeks, 3, 6, and 12 months post-injury. Results — Of 248 patients enrolled (85 IMN, 163 ST), 187 (75%) completed 1-year follow-up (55 IMN, 132 ST). 1 of 55 IMN cases had nonunion compared with 40 of 132 ST cases that failed treatment and converted to IMN (p < 0.001). Quality of life and SMFA Functional Index Scores were better for IMN than ST at 6 weeks, 3 and 6 months, but not at 1 year. At 6 months, 24 of 51 patients in the ST group had returned to work, compared with 26 of 37 in the IMN group (p = 0.02). Interpretation — Treatment with IMN improved early quality of life and function and allowed patients to return to work earlier compared with treatment with ST. Approximately one-third of patients treated with ST failed treatment and were converted to IMN.

Leaf color has been considered an important agronomic trait in rice (Oryza sativa L.) for a long time. The changes in leaf color affect the yield of rice. In this study, a green-revertible albino (graS) mutant was isolated from a 60Co-gamma-irradiated mutant pool of indica cultivar Guangzhan 63-4S. The fine mapping indicated that graS mutant was mapped to chromosome 1, and was located in a confined region between markers ab134 and InDel 8 with genetic distances of 0.11 and 0.06 cM, respectively. Based on the annotation results, four open reading frames (ORFs) were predicted in this region. Sequence analysis revealed that LOC_Os01g55974 had a 2-bp nucleotide insertion (AA) in the coding region that led to premature termination at the 324th base. Sequence analysis and expression analysis of related genes indicated that LOC_Os01g55974 is the candidate gene of GraS. We studied the genome and protein sequences of LOC_Os01g55974, and the data showed that GraS contains a deoxycytidine deaminase domain, which was expressed ubiquitously in all tissues. Further investigation indicated that GraS plays an essential role in the regulation of chloroplast biosynthesis, photosynthetic capacity and yield. Moreover, leaf color mutant can be used as an effective marker for the purity of breeding and hybridization.

Abstract. Immunotherapy has become the mainstay for lung cancer treatment, providing sustained therapeutic responses and improved prognosis compared with those obtained with surgery, chemotherapy, radiotherapy, and targeted therapy. It has the potential for anti-tumor treatment and killing tumor cells by activating human immunity and has moved the targets of anti-cancer therapy from malignant tumor cells to immune cell subsets. Two kinds of immune checkpoints, cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1), are the main targets of current immunotherapy in lung cancer. Despite the successful outcomes achieved by immune checkpoint inhibitors, a small portion of lung cancer patients remain unresponsive to checkpoint immunotherapy or may ultimately become resistant to these agents as a result of the complex immune modulatory network in the tumor microenvironment. Therefore, it is imperative to exploit novel immunotherapy targets to further expand the proportion of patients benefiting from immunotherapy. This review summarizes the molecular features, biological function, and clinical significance of several novel checkpoints that have important roles in lung cancer immune responses beyond the CTLA-4 and PD-1/PD-L1 axes, including the markers of co-inhibitory and co-stimulatory T lymphocyte pathways and inhibitory markers of macrophages and natural killer cells.