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Visual question answering(VQA) is a multi-modal task that combines computer vision and natural language proces-sing,which is extremely challenging.However,the current VQA model is often misled by the apparent correlation in the data,and the output of the model is directly guided by language bias.Many previous researches focus on solving language bias and assisting the model via counterfactual sample methods.These studies,however,ignore the prediction information and the difference between key features and non-key features in counterfactual samples.The proposed model can distinguish the difference between the original sample,the factual sample and the counterfactual sample.In view of this,this paper proposes a paradigm of contrastive learning based on counterfactual samples.By comparing these three samples in terms of feature gaps and prediction gaps,the VQA model has been significantly improved in its robustness.Compared with CL-VQA method,the overall precision,average precision and Num index of this method improves by 0.19%,0.89% and 2.6% respectively.Compared with the CSSVQA method,the Gap of the proposed method decrease to 0.45 from 0.96.

Background: Diffusion magnetic resonance imaging (dMRI) has revealed microstructural changes in white matter (WM) in Huntington's disease (HD). Objective: To compare the validities of different dMRI, i.e., diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in HD. Methods: 22 mutant huntingtin (mHTT) carriers and 14 controls were enrolled. Clinical assessments and dMRI were conducted. Based on CAG-Age Product (CAP) score, mHTT carriers were categorized into high CAP (hCAP) and medium and low CAP (m& lCAP) groups. Spearman analyses were used to explore correlations between imaging parameters in brain regions and clinical assessments. Receiver operating characteristic (ROC) was used to distinguish mHTT carriers from control, and define the HD patients at advanced stage. Results: Compared to controls, mHTT carriers exhibited WM changes in DKI and DTI. There were 22 more regions showing significant differences in HD detected by MK than FA. Only MK in five brain regions showed significantly difference between any two group, and negatively correlated with the disease burden (r = –0.80 to –0.71). ROC analysis revealed that MK was more sensitive and FA was more specific, while Youden index showed that the integration of FA and MK gave rise to higher authenticities, in distinguishing m& lCAP from controls (Youden Index = 0.786), and discerning different phase of HD (Youden Index = 0.804). Conclusions: Microstructural changes in WM occur at early stage of HD and deteriorate over the disease progression. Integrating DKI and DTI would provide the best accuracies for differentiating early HD from control and identifying advanced HD. [ABSTRACT FROM AUTHOR]

BackgroundDelirium is a postoperative complication that occurs frequently in patients older than 65 years, and presages adverse outcomes. We investigated whether prophylactic low-dose dexmedetomidine, a highly selective α2 adrenoceptor agonist, could safely decrease the incidence of delirium in elderly patients after non-cardiac surgery.MethodsWe did this randomised, double-blind, placebo-controlled trial in two tertiary-care hospitals in Beijing, China. We enrolled patients aged 65 years or older, who were admitted to intensive care units after non-cardiac surgery, with informed consent. We used a computer-generated randomisation sequence (in a 1:1 ratio) to randomly assign patients to receive either intravenous dexmedetomidine (0·1 μg/kg per h, from intensive care unit admission on the day of surgery until 0800 h on postoperative day 1), or placebo (intravenous normal saline). Participants, care providers, and investigators were all masked to group assignment. The primary endpoint was the incidence of delirium, assessed twice daily with the Confusion Assessment Method for intensive care units during the first 7 postoperative days. Analyses were done by intention-to-treat and safety populations. This study is registered with Chinese Clinical Trial Registry, www.chictr.org.cn, number ChiCTR-TRC-10000802.FindingsBetween Aug 17, 2011, and Nov 20, 2013, of 2016 patients assessed, 700 were randomly assigned to receive either placebo (n=350) or dexmedetomidine (n=350). The incidence of postoperative delirium was significantly lower in the dexmedetomidine group (32 [9%] of 350 patients) than in the placebo group (79 [23%] of 350 patients; odds ratio [OR] 0·35, 95% CI 0·22-0·54; p

The effect of temperature (T) on stability of squeezed soybean oil (SSO) were studied by four characterization parameters (CPs, conductivity, peroxide value, isovolumetric combustion heat and acid value)similarities and differences of CPs characterization results were further compared.Under the fixed conditions of relative humidity was 40%, partial pressure of oxygen was 21 kPa, illumination was 800 lx and initial headspace rate was 50%, regulated and controled T to 30 ℃, 40 ℃, 50 ℃, 60 ℃ and 70 ℃ respectively,SSO test samples were oxidized continuously in airtight container for a long time, four CPs at different oxidation time (t) were multiple measured in the same time, curve of CP～t was plotted, kinetic equation was regressed, rate constant (k) and apparent activation energy were calculated, the prediction model of metamorphic time was established and coincidence rate was verified.The results show that CP changed significantly with the increase of T and the extension of t, the oxidative rancidity of SSO has characteristic of simple series reaction,the prediction model of metamorphic time has a good coincidence, CP was different, and there was a big difference in k.The stability of squeezed soybean oil of SSO should be described by multiple CPs.

Purpose: The purpose of this study was to measure the diffusion spectrum imaging (DSI) parameters of corticospinal tracts (CSTs) and evaluate diffusional changes in CSTs in patients with idiopathic normal pressure hydrocephalus (iNPH) by DSI.Methods: Twenty-three iNPH patients and twenty-one healthy controls (HCs) were involved in this study. Brain DSI data for all participants were collected through the same MR scanning procedure. The diffusion parameters measured and analyzed included quantitative anisotropy (QA), the isotropic diffusion component (ISO), general fractional anisotropy (GFA), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of corticospinal tracts.Results: The QA and ISO values of corticospinal tracts in iNPH patients were significantly lower than those in HCs (PLQA = 0.008, PRQA = 0.016, PLISO = 0.024, PRISO = 0.016). The mean MD, AD, and RD values in iNPH patients were significantly higher than those in HCs (PMD = 0.032, PAD = 0.032, PRD = 0.048,). No significant differences in GFA and FA values were noted between iNPH patients and HCs.Conclusion: Decreased QA and ISO values of corticospinal tracts were found in iNPH patients. Quantitative CST evaluation using DSI may lead to information that can improve the present understanding of the disease mechanism.

In patients undergoing major surgery, complete handover of intraoperative anesthesia care is associated with adverse postoperative outcomes including high mortality and more major complications. The purpose of this study was to explore the association between the intraoperative complete handover between anesthesiologists and the occurrence of postoperative delirium. This was a secondary analysis of the database of a previously published clinical trial. Seven hundred patients aged 65 years or older, who were admitted to the intensive care unit after noncardiac surgery, were included. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit twice daily during the first 7 postoperative days. Other postoperative outcomes were also monitored. The association between the intraoperative complete handover of anesthesia care and the development of postoperative delirium was analyzed with a logistic regression model. Of the 700 enrolled patients, 111 (15.9%) developed postoperative delirium within 7 days. After correction for confounding factors, intraoperative complete handover between anesthesiologists was associated with an increased risk of postoperative delirium (OR 1.787, 95% CI 1.012-3.155, P = 0.046). Patients with intraoperative complete handover also had higher incidence of non-delirium complications (P = 0.003) and stayed longer in hospital after surgery (P = 0.002). For elderly patients admitted to the intensive care unit after noncardiac surgery, intraoperative complete handover of anesthesia care was associated with an increased risk of postoperative delirium. Chinese Clinical Trial Registry (http://www.chictr.org.cn http://www.chictr.org.cn ): ChiCTR-TRC-10000802., Author(s): Guang-Yu Liu [sup.1] , Xian Su [sup.1] , Zhao-Ting Meng [sup.1] , Fan Cui [sup.1] , Hong-Liang Li [sup.2] , Sai-Nan Zhu [sup.3] , Dong-Xin Wang [sup.1] Author Affiliations: [...]