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Abstract Traffic Signal Control (TSC) is a fundamental task in modern intelligent transport systems. TSC is often formulated as a bi‐level optimization problem, comprised by the signal timing at the upper level and the Dynamic User Equilibrium (DUE) traffic assignment at the lower level. Since DUE is non‐convex, existing methods either formulate approximation models or adopt traffic simulators. However, approximation models may oversimplify the practical situations, while traffic simulators are usually time‐consuming. This paper formulates a vehicle‐based DUE (vDUE) model and proposes an agile method that can simultaneously maintain the computational simplicity and the traffic dynamics for the traffic assignment. Further, an agile TSC system is built by combining the vDUE at the lower level for the traffic assignment with an adaptive differential evolution algorithm at the upper level for the signal timing optimization. To enhance the effectiveness of optimization, the TSC problem formulation is also improved to make it better characterize the practical requirements. In the experiments undertaken, comparisons of different TSC methods are carried out on both real‐world and synthetic transportation networks. The experimental results validate the effectiveness of the proposed agile TSC system in various traffic situations.

Liou et al. report a 4.6 Å resolution structure of the human p53/ RNA polymerase II assembly, using single particle cryoelectron microscopy. This study suggests that p53’s functional domains regulate the DNA binding activity of RNA polymerase II, providing insights into p53-regulated gene expression.

Importance: Acupuncture is used to induce ovulation in some women with polycystic ovary syndrome, without supporting clinical evidence.Objective: To assess whether active acupuncture, either alone or combined with clomiphene, increases the likelihood of live births among women with polycystic ovary syndrome.Design, Setting, and Participants: A double-blind (clomiphene vs placebo), single-blind (active vs control acupuncture) factorial trial was conducted at 21 sites (27 hospitals) in mainland China between July 6, 2012, and November 18, 2014, with 10 months of pregnancy follow-up until October 7, 2015. Chinese women with polycystic ovary syndrome were randomized in a 1:1:1:1 ratio to 4 groups.Interventions: Active or control acupuncture administered twice a week for 30 minutes per treatment and clomiphene or placebo administered for 5 days per cycle, for up to 4 cycles. The active acupuncture group received deep needle insertion with combined manual and low-frequency electrical stimulation; the control acupuncture group received superficial needle insertion, no manual stimulation, and mock electricity.Main Outcomes and Measures: The primary outcome was live birth. Secondary outcomes included adverse events.Results: Among the 1000 randomized women (mean [SD] age, 27.9 [3.3] years; mean [SD] body mass index, 24.2 [4.3]), 250 were randomized to each group; a total of 926 women (92.6%) completed the trial. Live births occurred in 69 of 235 women (29.4%) in the active acupuncture plus clomiphene group, 66 of 236 (28.0%) in the control acupuncture plus clomiphene group, 31 of 223 (13.9%) in the active acupuncture plus placebo group, and 39 of 232 (16.8%) in the control acupuncture plus placebo group. There was no significant interaction between active acupuncture and clomiphene (P = .39), so main effects were evaluated. The live birth rate was significantly higher in the women treated with clomiphene than with placebo (135 of 471 [28.7%] vs 70 of 455 [15.4%], respectively; difference, 13.3%; 95% CI, 8.0% to 18.5%) and not significantly different between women treated with active vs control acupuncture (100 of 458 [21.8%] vs 105 of 468 [22.4%], respectively; difference, -0.6%; 95% CI, -5.9% to 4.7%). Diarrhea and bruising were more common in patients receiving active acupuncture than control acupuncture (diarrhea: 25 of 500 [5.0%] vs 8 of 500 [1.6%], respectively; difference, 3.4%; 95% CI, 1.2% to 5.6%; bruising: 37 of 500 [7.4%] vs 9 of 500 [1.8%], respectively; difference, 5.6%; 95% CI, 3.0% to 8.2%).Conclusions and Relevance: Among Chinese women with polycystic ovary syndrome, the use of acupuncture with or without clomiphene, compared with control acupuncture and placebo, did not increase live births. This finding does not support acupuncture as an infertility treatment in such women.Trial Registration: clinicaltrials.gov Identifier: NCT01573858. [ABSTRACT FROM AUTHOR]

Atmospheric compositions and acid rain are closely related to atmospheric environment, weather, and climate change. In this study, the concentration levels and long-term trends of CO2, CH4, O3, PM2.5, PM10, and acid rain were presented at the Mt. Waliguan global baseline station in Qinghai, Shangdianzi and Lin'an regional background stations in the North China Plain (NCP) and the Yangtze River Delta region (YRD) of China based on the data observed until 2018. Significant increasing trends of CO2 were found at all of these stations. At Mt. Waliguan, the concentration levels and growth rate were consistent with the average values in the Northern Hemisphere (NH) and those observed at the Mauna Loa station in Hawaii. The CH4 also showed a upward tendency similar to that observed in NH. Compared with the observations at Mt. Waliguan global baseline station, the CO2 and CH4 mole fractions were higher at Shangdianzi and Lin'an regional background stations, indicating the important contributions of anthropogenic activities to the regional background level of CO2 and CH4. The annual averaged surface ozone showed increasing trends at Mt. Waliguan and Shangdianzi stations, whereas no clear trend was found at Lin'an station. Similar variations in the patterns of aerosol concentrations at Shangdianzi and Lin'an were found according to the PM2.5 or PM10 observations. Overall, the aerosol concentrations at both stations shown declining trends since the observations. However, two periods of high particle concentrations occurred in 2006–2007 and 2013–2014. The annual mean aerosol concentrations have continuously decreased after 2013–2014, indicating the effectiveness of pollution control in the NCP and YRD, especially since the implementation of the ‘Action Plan for Prevention and Control of Air Pollution’ in September 2013. Comparative analysis of aerosol with acid rain showed that the period with high concentrations of aerosols in the early years was consistent with that of severe acid rain pollution, suggesting that both aerosol pollution and severe acid rain are closely related to coal combustion emissions in China. As a result of the control of coal combustion emissions for acid and SO2, NOx emissions have contributed more substantially to aerosols due to the rapid growth of vehicle ownership. A comparison of the trends of aerosols with the maximum daily 8-h average of surface ozone (MDA8) at Shangdianzi and Lin'an stations revealed the complicated relationship between aerosol reduction and ozone production, i.e., together with the continuous improvement of particulate pollution in the NCP and YRD, the MDA8 at both stations showed a decreasing trend at first but subsequently increased after 2014 with aerosols remaining reduced. Such different variation patterns of the MDA8 with PM2.5 (or PM10) indicated the high challenge of synergic control of aerosol and ozone pollution in China.

BackgroundEmerging evidence shows allergic diseases, such as atopic dermatitis and asthma, are risk factors of heart failure. However, the causal relationship between allergic diseases and heart failure is not clear.MethodsWe performed a two-sample Mendelian randomization analysis between allergic diseases and heart failure using summary statistics of genome-wide association studies from large GWAS consortia, with total sample size of 1.2 million. Independent instrumental variables for asthma and atopic dermatitis (PResultsWe have identified 55 independent single nucleotide polymorphisms (SNPs) for asthma 54 independent SNPs for atopic dermatitis as our instrumental variables. The inverse variance-weighted (IVW) analysis showed asthma was significantly associated with increased risk of heart failure (ORIVW = 1.04, 95% CI, 1.01-1.07, P = 0.03). The Mendelian randomization analysis using the other four models also showed consistent results with the IVW analysis. Similarly, atopic dermatitis was also significantly associated with an increased risk of heart failure (ORIVW = 1.03, 95% CI, 1.01-1.06, P = 0.01), consistent with the other four models. The sensitivity analysis showed no evidence of horizontal pleiotropy or results were driven by single SNPs.ConclusionOur study identified asthma and atopic dermatitis as a causal risk factor for heart failure and suggest inflammatory pathogenesis as a key factor contributing to the underlying mechanism. These findings emphasize the importance of asthma and allergy control in the prevention and management of heart failure.

Background. Sexual dimorphism with critical diseases has been documented. However, the role of serum sex hormones for the presence of acute kidney injury (AKI) in moderately or severe acute pancreatitis (MSAP and SAP) patients remains controversial. Here we set out to evaluate whether early (first 48 h) serum estradiol level is associated with AKI in patients with MSAP and SAP. Patients and Methods. We retrospectively collected data from patients with preliminary diagnosis of MSAP and SAP from the Affiliated Hospital of Yangzhou University between January 2014 and June 2018. Serum sex hormones were extracted for further assessment within first 48 h following admission. Logistic regression analysis and the receiving operating characteristic (ROC) curve were applied to evaluate the association and correlation between serum sex hormones and AKI. Results. Data from a total of 122 patients with MSAP or SAP were enrolled in this study. There were no differences in the incidence of AKI between males and females. However, comparing with patients without AKI, those with AKI saw higher estradiol level (p≤0.01) and slight higher progesterone level (p=0.014) but similar testosterone level (p=0.668). Interestingly, during both the manual selection and the stepwise backward logistic regression analysis, serum estradiol level was independently associated with AKI in patients with MSAP and SAP (OR 4.699, CI 1.783-12.386, and p=0.002). Additionally, area under the curve of ROC (AUCROC) showed that serum estradiol level was a proper predictor for AKI (area under the curve 0.875). Specifically, the serum estradiol level of 223.15 pg/mL demonstrated a 92.3% sensitive and a 79.3% specificity in predicting AKI of MSAP and SAP patients, respectively. Conclusions. High baseline serum estradiol level appears to be an independent risk factor for AKI in patients with MSAP and SAP. It also tends to be an appropriate indicator for AKI.

Background. Quinolones are commonly used for reducing the duration of diarrhea, infection severity, and limiting further transmission of disease related to Vibrio cholerae, but V. cholerae susceptibility to quinolone decreases over time. In addition to mutations in the quinolone-resistance determining regions (QRDRs), the presence of qnr and other acquired genes also contributes to quinolone resistance. Results. We determined the prevalence of quinolone resistance related genes among V. cholerae O139 strains isolated in China. We determined that eight strains carried qnrVC, which encodes a pentapeptide repeat protein of the Qnr subfamily, the members of which protect topoisomerases from quinolone action. Four qnrVC alleles were detected: qnrVC1, qnrVC5, qnrVC12, and qnrVC9. However, the strains carrying qnrVC1, qnrVC5, and qnrVC12 were ciprofloxacin (CIP)-sensitive. Contrastingly, the strain carrying qnrVC9 demonstrated high CIP resistance. qnrVC9 was carried by a small plasmid, which was conjugative and contributed to the high CIP resistance to the receptor V. cholerae strain. The same plasmid was also detected in V. vulnificus. The qnrVC1, qnrVC5, and qnrVC12 were cloned into expression plasmids and conferred CIP resistance on the host V. cholerae O139 strain. Conclusions. Our results revealed the contribution of quinolone resistance mediated by the qnrVC9 carried on the small plasmid and its active horizontal transfer among Vibrio species. The results also suggested the different effects of qnrVC alleles in different V. cholerae strains, which is possibly due to differences in sequences of qnrVC alleles and even the genetic characteristics of the host strains.

A grasp planning method based on the volume and flattening of a generalized force ellipsoid is proposed to improve the grasping ability of a dexterous robotic hand. First, according to the general solution of joint torques for a dexterous robotic hand, a grasping indicator for the dexterous hand -- the maximum volume of a generalized external force ellipsoid and the minimum volume of a generalized contact internal force ellipsoid during accepted flattening -- is proposed. Second, an optimal grasp planning method based on a task is established using the grasping indicator as an objective function. Finally, a simulation analysis and grasping experiment are performed. Results show that when the grasping experiment is conducted with the grasping configuration and positions of contact points optimized using the proposed grasping indicator, the root-mean-square values of the joint torques and contact internal forces of the dexterous hand are at a minimum. The effectiveness of the proposed grasping planning method is thus demonstrated. [ABSTRACT FROM AUTHOR]

Objective This study aimed to develop a blood test for the prediction of pre-eclampsia (PE) early in gestation. We hypothesised that the longitudinal measurements of circulating adipokines and sphingolipids in maternal serum over the course of pregnancy could identify novel prognostic biomarkers that are predictive of impending event of PE early in gestation.Study design Retrospective discovery and longitudinal confirmation.Setting Maternity units from two US hospitals.Participants Six previously published studies of placental tissue (78 PE and 95 non-PE) were compiled for genomic discovery, maternal sera from 15 women (7 non-PE and 8 PE) enrolled at ProMedDx were used for sphingolipidomic discovery, and maternal sera from 40 women (20 non-PE and 20 PE) enrolled at Stanford University were used for longitudinal observation.Outcome measures Biomarker candidates from discovery were longitudinally confirmed and compared in parallel to the ratio of placental growth factor (PlGF) and soluble fms-like tyrosine kinase (sFlt-1) using the same cohort. The datasets were generated by enzyme-linked immunosorbent and liquid chromatography-tandem mass spectrometric assays.Results Our discovery integrating genomic and sphingolipidomic analysis identified leptin (Lep) and ceramide (Cer) (d18:1/25:0) as novel biomarkers for early gestational assessment of PE. Our longitudinal observation revealed a marked elevation of Lep/Cer (d18:1/25:0) ratio in maternal serum at a median of 23 weeks’ gestation among women with impending PE as compared with women with uncomplicated pregnancy. The Lep/Cer (d18:1/25:0) ratio significantly outperformed the established sFlt-1/PlGF ratio in predicting impending event of PE with superior sensitivity (85% vs 20%) and area under curve (0.92 vs 0.52) from 5 to 25 weeks of gestation.Conclusions Our study demonstrated the longitudinal measurement of maternal Lep/Cer (d18:1/25:0) ratio allows the non-invasive assessment of PE to identify pregnancy at high risk in early gestation, outperforming the established sFlt-1/PlGF ratio test.

Background: Very-low-birth-weight (VLBW) infants have a high risk of postdischarge growth retardation (GR). Continued GR might exert negative long-term effects on their health. This study examined the prevalence and the risk factors for postdischarge GR among VLBW infants in Taiwan. Methods: Nationwide data from the Taiwan Premature Infant Follow-up Network between 2007 and 2011 were analyzed. Infants with a gestational age (GA)

Abstract. Background:. Sepsis-3 definitions have been published recently; however, their diagnostic value remains controversial. This study was to assess the accuracy of Sepsis-3 definitions compared to Sepsis-1 definitions by stratifying mortality among adult critically ill patients with suspected infection. Methods:. A multicenter, prospective cohort study was conducted from November 10, 2017 to October 10, 2018, in five Intensive Care Units (ICUs) at four teaching hospitals. Thirty-day mortality was compared across categories for both Sepsis-3 definitions and Sepsis-1 definitions, which were evaluated by logistic regression analysis followed by measurement of the area under the receiver operating characteristic curve (AUROC) for predicting 30-day mortality rates. Results:. Of the 749 enrolled patients, 644 (85.9%) were diagnosed with sepsis according to the Sepsis-1 definitions. Among those patients, 362 were diagnosed with septic shock (362/749, 48.3%). However, according to the Sepsis-3 definitions, there were 483 patients with a diagnosis of sepsis (483/749, 64.5%), among whom 299 patients were diagnosed with septic shock (299/749, 39.9%). According to the Sepsis-3 definitions, sepsis (sepsis and septic shock) patients had higher 30-day mortality (41.8%) than sepsis patients according to the Sepsis-1 definitions (31.8%, χ2 = 5.552, P = 0.020). The AUROC of systemic inflammatory response syndrome (SIRS) and quick sequential organ failure assessment (qSOFA) scores with regard to 30-day mortality rates were 0.609 (0.566–0.652) and 0.694 (0.654–0.733), respectively. However, the AUROC of SOFA scores (0.828 [0.795–0.862]) were significantly higher than that of SIRS or qSOFA scores (P