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This article presents a hierarchical control framework for autonomous vehicle trajectory planning and tracking, addressing the challenge of accurately following high-speed, at-limit maneuvers. The proposed time-optimal trajectory planning and tracking (TOTPT) framework utilizes a hierarchical control structure, with an offline trajectory optimization (TRO) module and an online nonlinear model predictive control (NMPC) module. The TRO layer generates minimum-lap-time trajectories using a direct collocation method, which optimizes the vehicle’s path, velocity, and control inputs to achieve the fastest possible lap time, while respecting the vehicle dynamics and track constraints. The NMPC layer is responsible for precisely tracking the reference trajectories generated by the TRO in real time. The NMPC also incorporates a preview algorithm that utilizes the predicted future travel distance to estimate the optimal reference speed and curvature for the next time step, thereby improving the overall tracking performance. Simulation results on the Catalunya circuit demonstrated the framework’s capability to accurately follow the time-optimal raceline at an average speed of 116 km/h, with a maximum lateral error of 0.32 m. The NMPC module uses an acados solver with a real-time iteration (RTI) scheme, to achieve a millisecond-level computation time, making it possible to implement it in real time in autonomous vehicles.

Background As the burden and distribution of calcification within chronic total occlusion (CTO) lesions can be diverse, its effect on CTO recanalization using multiple devices and techniques is debatable. This study investigated the role of calcification in wiring-based intraplaque tracking techniques for CTO recanalization.Methods A modified J-CTO score without counting calcification was used to analyze the procedures of 458 consecutive patients who underwent CTO interventions. Failed guidewire crossing and intraplaque tracking were considered procedural failures. Recanalization time details were analyzed for successful procedures.Results In patients with calcified CTO, the rate of procedural success only significantly declined to be lower than that of noncalcified CTO when the modified J-CTO score was ≥3 (77% vs. 94%, p = 0.008). In 422 patients with successful procedures, the presence of calcification was irrelevant to guidewire crossing time, but was accompanied with longer time from guidewire cross to final angiogram when the modified J-CTO score was 1–2 (53 ± 35 vs. 35 ± 17 [noncalcified] min, p 60 min (OR = 4.8, 95% CI = 2.2–10.2) in successfully recanalized lesions with modified J-CTO score 1–2.Conclusions Using intraplaque guidewire tracking, calcification was unfavorable for very difficult CTO lesions, and caused prolongation of angioplasty time for lesions with moderate complexity. This suggested that the role of calcification in the J-CTO score could be altered when different recanalization techniques were applied for CTO interventions.

ObjectiveThis study aimed to analyze the growth patterns of height and foot length (FL) among Chinese children aged 3–18 and examine their associations with puberty development.MethodsA cross-sectional survey was conducted in September 2022 in Beijing. Data were collected through questionnaires and on-site physical examinations. The growth patterns and velocity of height and FL in different age groups were described, and their associations with puberty development were analyzed.ResultsFrom an age perspective, the peak FL growth occurred between 9 and 11 years (boys were 11 years and girls were 9 years), while the peak height growth occurred at 11 ~ 13 years for boys and 9 ~ 11 years for girls. Additionally, boys and girls reached 99.0% of their final FL at the ages of 14 and 13, respectively, while they reached 99.0% of their final height at the ages of 16 and 15, respectively. From the perspective of Tanner stage, the age of peak FL growth in boys coincided with the age of the G2 stage, while in girls it occurred slightly earlier than the mean age of the B2 stage. The peak height growth for both boys and girls occurred between Tanner stages 2 and 3.ConclusionBoys and girls reach their peak FL growth at 11 and 9 years old, respectively, which were both 2 years earlier than their peak height growth. The peak FL growth occurred around the onset of puberty, while the peak height growth occurred between Tanner stages 2 and 3.

Concurrently with the maser flare observed in W51-North during the 3 month monitoring of H _2 O, NH _3 , and CH _3 OH maser variability from 2020 January to April using the Tianma 65 m Radio Telescope, we conducted Very Large Array mappings for these three maser species across the entirety of W51A region. After finding the ring-shaped H _2 O maser which might trace the disk surrounding the protostar residing in W51-North, the NH _3 (9,6) maser delineated a jet which might be illuminated in the luminosity outburst possibly caused by the infalling streamer’s interaction with the protostar’s disk. An analysis of the comprehensive distribution of maser spots allowed us to affirm that W51N4 or ALMAmm31 serves as the primary source of the Lacy jet. Furthermore, we observed that class I methanol maser spots may extend beyond the locations of the H _2 O and NH _3 (9,6) masers within the outflow. Additionally, emissions from other NH _3 maser transitions coincided with specific 1.3 mm continuum sources. The arrangement of H _2 O maser spots in the vicinity of W51e2-E potentially indicates episodic accretions in this source. Combining the data from the Atacama Large Millimeter/submillimeter Array data archive for W51-North, W51e2, and W51e8, we have discovered that the H _2 O, NH _3 , and CH _3 OH masers, as well as the HC _3 N and SiO emissions are found to be good tools for tracing outflow in this work for W51A.

This study focuses on the analysis of mid-infrared variability in a sample of high-mass young stellar objects (YSOs) associated with the cataloged sources from the APEX Telescope Large Area Survey of the Galaxy (ATLASGAL). The Near-Earth Object Wide-field Infrared Survey Explorer Reactivation Mission (NEOWISE) database was used to explore the long-term mid-infrared variability of these high-mass YSOs at a half-year scale. After matching with NEOWISE photometric measurements, a total of 2230 ATLASGAL sources were selected for the variability analysis, out of which 717 were identified as variables. The derived proportions of variables at different evolutionary stages show that the variability rate of high-mass YSOs is highest during the YSO stage and decreases with evolution toward the H ii region stage, resembling the behavior of low-mass YSOs. The variables can be classified into six types based on their light curves, divided into two categories: secular (linear, sin, sin+linear) and stochastic variables (burst, drop, and irregular). The magnitude–color variations observed in ∼160 secular variables can be mainly divided into “bluer when brighter/redder when dimming” and “redder when brighter/bluer when dimming,” likely originating from changes in accretion rate or the effect of extinction due to obscuration. Moreover, several episodic accretion candidates were selected for further observational studies.

We present observations of the 6.7 GHz methanol and 4.8 GHz formaldehyde masers toward the high-mass young stellar object G24.33+0.14 (hereafter G24). Our observations were conducted from 2019 to 2021 using the Shanghai Tianma 65 m Radio Telescope and the Very Large Array in response to the luminosity outburst event traced by these two species masers in 2019. Our results indicate that the provenance of the maser flares is unlikely to be ascribed to the protostar of G24 itself. Through analyzing NEOWISE infrared monitoring data, we identified two light curves of G24 with long-term (3083 days, ∼8.5 yr) and short-term (424 days) periods. Intriguingly, 11 periodic variable sources located in the same bubble as G24 exhibiting periods comparable to the short-term period of G24 were also detected. The analysis of the spectral energy distributions of these periodic variables revealed a possible correlation between their temperature fluctuations and the surrounding radiation field that possibly emanates from the driving source of the bubble. This source could be an individual supergiant protostar of a few hundred solar masses with periodic pulsation potentially accounting for the observed short-term period in the G24 region.

Abstract Background The vital signs of trauma patients are complex and changeable, and the prediction of blood transfusion demand mainly depends on doctors’ experience and trauma scoring system; therefore, it cannot be accurately predicted. In this study, a machine learning decision tree algorithm [classification and regression tree (CRT) and eXtreme gradient boosting (XGBoost)] was proposed for the demand prediction of traumatic blood transfusion to provide technical support for doctors. Methods A total of 1371 trauma patients who were diverted to the Emergency Department of the First Medical Center of Chinese PLA General Hospital from January 2014 to January 2018 were collected from an emergency trauma database. The vital signs, laboratory examination parameters and blood transfusion volume were used as variables, and the non-invasive parameters and all (non-invasive + invasive) parameters were used to construct an intelligent prediction model for red blood cell (RBC) demand by logistic regression (LR), CRT and XGBoost. The prediction accuracy of the model was compared with the area under the curve (AUC). Results For non-invasive parameters, the LR method was the best, with an AUC of 0.72 [95% confidence interval (CI) 0.657–0.775], which was higher than the CRT (AUC 0.69, 95% CI 0.633–0.751) and the XGBoost (AUC 0.71, 95% CI 0.654–0.756, P

Stress-induced myocardial perfusion defects found in dipyridamole–thallium-201 single-photon emission computed tomography imaging may indicate vascular perfusion abnormalities and risk of obstructive or nonobstructive coronary heart disease. Besides nuclear imaging and subsequent coronary angiography (CAG), no blood test can indicate whether dysregulated homeostasis is associated with stress-induced myocardial perfusion defects. This study investigated the expression signature of long noncoding RNAs (lncRNAs) and genes involved in vascular inflammation and stress response in the blood of patients with stress-induced myocardial perfusion abnormalities (n = 27). The results revealed an expression signature consisting of the upregulation of RMRP (p < 0.01) and downregulations of THRIL (p < 0.01) and HIF1A (p < 0.01) among patients with a positive thallium stress test and no significant coronary artery stenosis within 6 months after baseline treatment. We developed a scoring system based on the expression signatures of RMRP, MIAT, NTT, MALAT1, HSPA1A, and NLRP3 to predict the need for further CAG among patients with moderate-to-significant stress-induced myocardial perfusion defects (area under the receiver operating characteristic curve = 0.963). Therefore, we identified a dysregulated expression profile of lncRNA-based genes in the blood that could be valuable for the early detection of vascular homeostasis imbalance and personalized therapy.

BackgroundLesion characteristics were shown to predict procedural success and outcomes in chronic total occlusion (CTO) recanalization. However, diverse techniques involved in these studies might cause potential heterogeneity.ObjectiveThe study aimed to test the impacts of lesion characteristics on CTO intervention with a pure antegrade wiring-based technique.Methods and ResultsWe studied consecutive 325 patients (64.5 ± 11.1 years, 285 men) with native CTO lesions intervened by a single operator with an antegrade-based technique between August 2014 and July 2020. Forty-seven patients with antegrade procedural failure (20 with pure antegrade wiring failure and 27 with back-up retrograde techniques) were compared to 278 patients with antegrade-only procedural success. With a median follow-up of 30.8 (16.1–48.6) months, 278 patients with procedural success were further assessed for target vessel failure (TVF: cardiac death, target vessel myocardial infarction [MI], and target lesion revascularization [TLR]). Patients with antegrade procedural success had a lower percentage of history with bypass graft (4 vs. 15%, p = 0.004) and lower Multicenter Chronic Total Occlusion Registry of Japan (J-CTO) score (2.1±1.3 vs. 3.4 ± 1.0, p < 0.001), when compared to those with antegrade failure. The J-CTO score was independently associated with procedural failure (odds ratio = 2.5, 95% CI = 1.8–3.4) in multivariate analysis. However, only clinical features, such as female gender (hazard ratio [HR] = 4.3, 95% CI = 1.4–13.1), estimated glomerular filtration rate

We present a statistical study of infrared variability using the Near-Earth Object Wide-field Infrared Survey Explorer (NEOWISE) database for a sample consisting of 1085 high-mass young stellar objects (YSOs) related to 6.7 GHz methanol masers. A total of 383 maser sources were identified as NEOWISE variables and classified in two variability behavior classifications: 204 secular (linear, curved, and periodic) and 179 stochastic (burst, drop, and irregular) variables. Statistical analysis of the properties of these variables (e.g., the dust temperature, bolometric luminosity, hydrogen column density, W4 luminosity, and W1−W2 color) has revealed a potential evolutionary sequence among different light-curve types of variables. There is a possible general evolutionary (from less to more evolved) trend between the three variable types from secular to stochastic to nonvariable. For the specific classifications, the evolutionary trend for secular variables is linear to sin to sin+linear, and for stochastic variables it is burst to irregular to drop. These sequences may reflect the evolution of the envelope or accretion disk of high-mass YSOs, from large to small radii due to gravitational collapse. Although no significant variability correlation was established between the 6.7 GHz methanol maser and the W2-band emission based on the data collected so far, a number of candidates were found for further investigating the accretion burst events via future variability monitoring programs of both mid-infrared emission and masers.

Light variability is an essential attribute of young stellar objects (YSOs) at the pre-main-sequence (PMS) stage, which can be treated as an indicator to trace star formation. We present a statistical study on the infrared NEOWISE variability of new and large-sized PMS stars as well as Herbig Ae/Be (HAeBe) and classical Be (CBe) stars identified from Gaia Data Release 2. A total of 3792 (including 714 HAeBe), 417, and 473 NEOWISE variable sources were detected from the catalog of 8470 PMS (including 1361 HAeBe), 693 CBe, and 1309 uncertain (possibly belonging to either HAeBe or CBe) stars, respectively. We found that 80% of the PMS variables are dominated by irregular infrared variability, whereas variables in the CBe and uncertain categories exhibit comparable contributions from secular (linear, curved, and periodic) and stochastic (burst, drop, and irregular) variables. This, in combination with infrared W1–W2 colors, W4 luminosities, and the spectral energy distribution slope at near- and mid-infrared wavelengths, suggests different evolutionary stages of the PMS (including HAeBe), uncertain, and CBe stars, from less to more evolved. A statistical analysis of variable source properties (e.g., period and fractional amplitude) further reveals a potential sequence possibly associated with disk evolution for different types of light curves (from linear, to curved, periodic, stochastic, and nonvariable stars). Possible mechanisms for the variable sources are suggested to be related to either extinction via circumstellar matter, or contribution of multiple systems surrounding the YSOs, as opposed to variable accretion (e.g., episodic accretion or accretion burst).

Background: In the era of drug-eluting stents, although bare-metal stent (BMS) remains an option for percutaneous coronary intervention (PCI), restenosis remains the Achilles' heel of BMS implantation. A recent study demonstrated several pleiotropic anti-inflammatory effects of dextromethorphan (DXM). This study aims to evaluate the effects of DXM on the outcome of PCI with BMS implantation.Methods: In this prospective, double-blind, randomized trial, we enrolled 55 patients who underwent PCI with BMS implantation from May 2006 to February 2009. The patients were divided into DXM (60 mg once daily) and placebo groups. We compared mortality rates, myocardial infarction (MI), target lesion revascularization (TLR), restenosis, stent thrombosis, and plasma levels of high-sensitivity C-reactive protein (hs-CRP) with repeated coronary angiography 6 months after the initial procedure.Results: During the 6-month follow-up period, no events of death, MI and stent thrombosis were reported in both groups. The TLR rate was 16.7% in patients receiving DXM compared to 24% receiving a placebo (P = 0.521). The restenosis rate was 30% in patients receiving DXM as compared to 40% receiving the placebo (P = 0.571). Although nonsignificant, the percentage of hs-CRP elevation was lower in the DXM group (20%) compared to the placebo group 32%; P = 0.363).Conclusions: DXM is safe to use in patients who underwent PCI. Although DXM therapy following BMS implantation did not significantly reduce the TLR and restenosis rates, it implied a trend toward a lower TLR and restenosis and reduced inflammation in the DXM group compared to the placebo group. Nonetheless, further extensive studies are warranted to elucidate the anti-restenosis effects of DXM.

Statins constitute the mainstay treatment for atherosclerotic cardiovascular disease, which is associated with the risk of new-onset diabetes mellitus (NODM). However, the effects of individual statins on the risk of NODM remain unclear. We recruited 48,941 patients taking one of the three interested statins in a tertiary hospital between 2006 and 2018. Among them, 8337 non-diabetic patients taking moderate-intensity statins (2 mg/day pitavastatin, 10 mg/day atorvastatin, and 10 mg/day rosuvastatin) were included. The pitavastatin group had a higher probability of being NODM-free than the atorvastatin and rosuvastatin groups during the 4-year follow-up (log-rank test: p = 0.038). A subgroup analysis revealed that rosuvastatin had a significantly higher risk of NODM than pitavastatin among patients with coronary artery disease (CAD) (adjusted HR [aHR], 1.47, 95% confidence interval [CI], 1.05–2.05, p = 0.025), hypertension (aHR, 1.26, 95% CI, 1.00–1.59, p = 0.047), or chronic obstructive pulmonary disease (COPD) (aHR, 1.74, 95% CI, 1.02–2.94, p = 0.04). We concluded that compared with rosuvastatin, reduced diabetogenic effects of pitavastatin were observed among patients treated with moderate-intensity statin who had hypertension, COPD, or CAD. Additional studies are required to prove the effects of different statins on the risk of NODM.

Background: Concerns regarding stroke safety associated with the use of atypical antipsychotics among dementia patients have been raised. Although observational studies have found conflicting associations of stroke risk with the use of typical or atypical antipsychotics among the elderly with or without dementia, patients with cardiovascular diseases (CVDs), a high-risk for the stroke population, have not been examined. Little evidence has been provided regarding comparison of the stroke risk between the two antipsychotic classes. This study aimed to evaluate the comparative stroke risk with atypical versus typical antipsychotic use among CVD patients. Materials and Methods: We conducted a population-based nested case-control study analyzing the Taiwan National Health Insurance Research Database from January 1, 1996 to December 31, 2007. A total of 7,460 CVD patients was followed-up, among which 580 hospitalized cases with stroke were identified and matched to 5,398 randomly selected controls. Conditional logistic regressions were employed to quantify the difference in stroke risk associated with atypical versus typical antipsychotics. Results: Any use and current use of atypical antipsychotics were associated with a 1.67-fold (95% confidence interval [CI], 1.21-2.30) and a 2.30-fold (95% CI, 1.56-3.40) increased risk of stroke relative to any typical antipsychotic use, respectively. The stroke risk associated with current use of atypical antipsychotics persisted even compared with current use of typical antipsychotics (adjusted odds ratio, 1.53; 95% CI, 1.02-2.33). Conclusions: Use of atypical antipsychotics is associated with an increased risk of stroke requiring hospitalization compared to typical antipsychotic use among CVD patients. Healthcare professionals should take this risk into account when choosing between typical and atypical antipsychotic treatments among CVD patients.

Background: Revascularization within a 90-min door-to-balloon time is a strict policy enacted in Taiwan. Prompt diagnosis is critical to avoid an unnecessary procedure and catheterization laboratory activation. This study was aimed to investigate the clinical and prognostic characteristics of the patients with ST-elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention (PCI) and normal coronary arteries found following coronary angiography (CAG). Materials and Methods: From October 2009 to December 2012, 216 consecutive patients with STEMI referred for primary PCI were enrolled. The data of clinical history, physical examination, laboratory results, electrocardiography, echocardiography, CAG findings, diagnosis, and outcomes were collected and analyzed. Results: A total of 17 patients were proved normal coronaries angiographically. The incidence of the conditions mimicking as STEMI is 7.9%. Alternative diagnosis was coronary spasm (n = 7), peri-myocarditis (n = 6), apical ballooning syndrome (n = 3), anaphylactic shock (n = 1). Compared with STEMI group, patients in normal coronaries group were younger, with a less premature family history of coronary artery disease (CAD), and reported angina. The 30-day mortality rate in the normal coronaries group was 5.9%. Conclusions: Cautiously evaluating CAD risk factors and symptoms of angina and awareness of alternative diagnosis are important to make a prompt diagnosis without compromising accuracy in the patients presenting as suspected STEMI.

The objective of this paper is to propose a multi-input DC-DC converter with bidirectional power flow control capability. Compared to the traditional power converter, the multi-input converter (MIC) can save on the number of components and the circuit cost. Under normal conditions, the MIC is able to transfer energy from different input sources to the load. However, if the battery module is adopted, both the charging or discharging features should be considered. Therefore, the bidirectional power flow control of the MIC is necessary. On the other hand, because of the inconsistency characteristics of batteries, unbalanced circuit operation might occur whereby the circuit and the battery might be damaged. Therefore, dynamic current regulation strategies are developed for the MIC. Consequently, the proposed MIC circuit is able to achieve the bidirectional power flow control capability as well as control the input currents independently. Detailed circuit analysis and comprehensive mathematical derivation and of the proposed MIC will be presented in this paper. Finally, both simulation and experimental results obtained from a 500 W prototype circuit verify the performance and feasibility of the proposed bidirectional multi-input converter.