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As the foundation of human survival, the development of agriculture has always played an important role in social development. The quality of agricultural development determines the speed of social progress. With the development of computer science, using computer technology to solve problems related to agricultural development has become an important research direction in current computer development. In recent years, remote sensing detection has received widespread attention, and the application of remote sensing detection technology in agriculture can provide great convenience for the development of agriculture. Benefit from the development of deep learning, remote sensing detection has made gigantic achievements. However, we have to face some challenges. First, deep learning depends on large scale of data with annotations, which expends inestimable human resources. In addition, as the depth of detection network increases, the amount of parameters explosively extends. In this work, we carry out the research based on the two problems. At the beginning, an active learning method considering classification and localization task is proposed. Our method can choose some few but valuable images. It uses 34.48% amount of training set, up to 97.4% baseline performance, and realize the compression of the scale of dataset, which reduces the trouble of manual labeling. Due to imaging and other factors, there exists many small objects in remote sensing images. So we add the mixed convolution, dilated convolution, and mosaic data augmentation modules into HRDNet network. Experiments on the agriculture dataset indicate that the improved algorithm can obtain about 2% higher than HRDNet. To reduce the number of parameters, we adjust the weighted sum ratio of importance scores dynamically. With the pruning ratio of 80%, the model volume has only 184 MB, degrading 70%. Model compression accelerates the detection speed for seven times on NVIDIA AGX Xavier, with a speed of 6 FPS. Our work will lay a foundation for remote sensing detection.

Purpose: The purpose of this study is to investigate the efficacy and safety of immune checkpoint inhibitors (ICIs) or plus with chemotherapy in older patients. Methods: We enrolled 110 older patients with non-small cell lung cancer (NSCLC ≥75 years) who received either chemotherapy alone (chemo), ICI plus chemotherapy (ICI + chemo), or ICI alone and ICI plus other therapies, which included anti-angiogenesis drugs or other novel ICI (ICIs). Patient characteristics, treatment response, survival, and toxicity were evaluated. Results: In total population, the ICIs group has the highest disease control rate (DCR 75%). There were no significant differences in progression-free survival (PFS) and overall survival (OS) among older patients between ICI + chemo and ICIs groups (PFS: 5.3 months vs. 5.5 months, p = 0.70, OS: 10.7 months vs. 20.3 months, p = 0.995). Meanwhile, we observed ICIs had a longer PFS and OS than chemo group (PFS: 3.9 months vs. 5.5 months, p = 0.01, OS: 10.9 months vs. 20.3 months, p = 0.05). Subgroup analysis showed that patients with programmed death ligand-1 (PD-L1) ≥ 1% had a distinct longer trend toward OS in ICIs group compared to ICI + chemo group (22.4 months vs. 10.7 months, p = 0.605), even though there was no significant difference. In terms of safety, ICIs was more tolerable and had a lower discontinuation rate than ICI + chemo group. Conclusion: In the real world, ICI + chemo is more likely to be discontinued due to adverse effects and does not significantly improve patient survival compared with ICIs treatment in total population and subgroup. Therefore, ICI alone or ICIs plus other therapies, such as anti-angiogenesis drugs or other novel ICI (ICIs) could be recommended for older cases with PD-L1 positive NSCLC.

Abstract Background Lung Adenocarcinoma (LUAD) is a major component of lung cancer. Endoplasmic reticulum stress (ERS) has emerged as a new target for some tumor treatments. Methods The expression and clinical data of LUAD samples were downloaded from The Cancer Genome Atlas (TCGA) and The Gene Expression Omnibus (GEO) database, followed by acquiring ERS-related genes (ERSGs) from the GeneCards database. Differentially expressed endoplasmic reticulum stress-related genes (DE-ERSGs) were screened and used to construct a risk model by Cox regression analysis. Kaplan–Meier (K-M) curves and receiver operating characteristic (ROC) curves were plotted to determine the risk validity of the model. Moreover, enrichment analysis of differentially expressed genes (DEGs) between the high- and low- risk groups was conducted to investigate the functions related to the risk model. Furthermore, the differences in ERS status, vascular-related genes, tumor mutation burden (TMB), immunotherapy response, chemotherapy drug sensitivity and other indicators between the high- and low- risk groups were studied. Finally, quantitative real-time polymerase chain reaction (qRT-PCR) was used to validate the mRNA expression levels of prognostic model genes. Results A total of 81 DE-ERSGs were identified in the TCGA-LUAD dataset, and a risk model, including HSPD1, PCSK9, GRIA1, MAOB, COL1A1, and CAV1, was constructed by Cox regression analysis. K-M and ROC analyses showed that the high-risk group had a low survival, and the Area Under Curve (AUC) of ROC curves of 1-, 3- and 5-years overall survival was all greater than 0.6. In addition, functional enrichment analysis suggested that the risk model was related to collagen and extracellular matrix. Furthermore, differential analysis showed vascular-related genes FLT1, TMB, neoantigen, PD-L1 protein (CD274), Tumor Immune Dysfunction and Exclusion (TIDE), and T cell exclusion score were significantly different between the high- and low-risk groups. Finally, qRT-PCR results showed that the mRNA expression levels of 6 prognostic genes were consistent with the analysis. Conclusion A novel ERS-related risk model, including HSPD1, PCSK9, GRIA1, MAOB, COL1A1, and CAV1, was developed and validated, which provided a theoretical basis and reference value for ERS-related fields in the study and treatment of LUAD.

Water inrush disaster of karst tunnel often lead to significant economic losses and serious casualties, which is an urgent engineering roadblock to be solved in the construction of tunnel in karst area. In this paper, three-dimensional discrete element method considering fluid-solid coupling effect and structural characteristics of water-mud resistant rock mass is adopted to systematically study the evolution law of displacement field and seepage field of intermittent joint type water-mud resistant rock mass of tunnel face and its water inrush critical characteristics during the process of sequential excavation of karst tunnel close to the frontal high-pressure water-rich karst cavity. The results show that: With the tunnel face gradually approaching the front-concealed high-pressure water-rich karst cavity, the stability of water-mud resistant rock mass is increasingly affected by high-pressure karst water, and karst water pressure gradually becomes the main control factor. The closer the tunnel face is to the front-concealed high-pressure water-rich karst cavity, the greater the extrusion displacement of karst tunnel face and its increase amplitude, the higher damage degree of water-mud resistant rock mass of face. With the advance of tunnel excavation, the intermittent cracks in the water-mud resistant rock mass of face gradually connect and form a stable hydraulic connection. The flow velocity and seepage pressure of karst water rise significantly at the moment of overall instability of face and the formation of water inrush channel, showing obvious precursor characteristics. The research achievements provide a reference for early warning and prevention and control of water inrush disaster of karst tunnel face.

Abstract Background Currently there is no standard therapy recommended for second‐line treatment for thymic carcinoma. Our study compared multidrug chemotherapy, single‐agent chemotherapy, and PD‐1 inhibitors in patients diagnosed with advanced thymic carcinoma who had previous platinum‐based chemotherapy at the clinic. Methods The study included patients with thymic carcinoma who failed first‐line platinum‐based chemotherapy. Kaplan–Meier methods were applied in the study for estimating the progression‐free survival (PFS) and overall survival (OS) curves. Pearson chi‐square or Fisher's exact chi‐square test was adopted to make comparisons of the objective response rate (ORR) between treatment groups. Cox regression was used for the multivariate analyses in PFS and OS. Results Among the 92 patients enrolled, multidrug chemotherapy was used in 51 (55.4%) patients for second‐line therapy. Thirty‐six patients (35.9%) received single‐agent chemotherapy, and eight patients (8.7%) underwent PD‐1 inhibitors. The multidrug chemotherapy group showed better efficacy than the other two groups, with an ORR of 35.3% (p = 0.006). The median PFS of multidrug chemotherapy, single‐agent chemotherapy and PD‐1 inhibitors were 5.0 months, 3.0 months, and 4.0 months, respectively (p = 0.008). Patients in the multidrug chemotherapy group also showed an advantage in OS in comparison with the other two treatment groups (p = 0.045), with a median OS of 30.4 months. Multivariate analysis showed that second‐line treatment was independent factor for both PFS (p = 0.035) and OS (p = 0.037). Grade 3–4 AEs were mostly detected in patients receiving multidrug chemotherapy and were primarily hematologic. Treatment‐related mortality was not found in any of the groups. Conclusions Multidrug chemotherapy had a trend toward a more positive response rate and outcomes in longer survival time than single‐agent chemotherapy and PD‐1 inhibitors. Multidrug chemotherapy is a choice worth considering for second‐line therapy in patients with thymic carcinoma if tolerable.

ObjectiveThis study aimed to detect circulating tumor cells (CTCs) and circulating tumor-derived endothelial cells (CTECs) in patients with advanced lung cancer, for describing the distribution characteristics of CTC and CTEC subtypes, exploring the correlation between CTC/CTEC subtypes and novel prognostic biomarkers.MethodsA total of 52 patients with advanced lung cancer were enrolled in this study. Using the subtraction enrichment-immunofluorescence in situ hybridization (SE-iFISH) system, CTCs and CTECs derived from these patients were identified.ResultsBased on cell size, there were 49.3% small and 50.7% large CTCs, and 23.0% small and 77.0% large CTECs. Triploidy, tetraploidy, and multiploidy varied in the small and large CTCs/CTECs. Besides these three aneuploid subtypes, monoploidy was found in the small and large CTECs. Triploid and multiploid small CTCs and tetraploid large CTCs were associated with shorter overall survival (OS) in patients with advanced lung cancer. However, none of the CTECs subtypes showed a significant correlation with patient prognosis. In addition, we found strong positive correlations (P

BackgroundThe progress of Moyamoya disease (MMD) is often accompanied by the occurrence of new ischemia or hemorrhagic events, which was difficult to predict. This systematic review and meta-analysis aimed to identify predictors for progression in MMD patients.MethodsWe searched PubMed, Web of Science, Cochrane Library, and Embase databases up to December 10th, 2022 for randomized controlled trials, case-control studies, or cohort studies reporting predictors of disease progression in MMD patients. The results of each predictor were pooled by meta-analysis and further analyzed by subgroup analysis for predictors of unilateral to bilateral progression of MMD.ResultsA total of 842 patients from 12 studies were included. The estimated pooled means indicated lower age (standard mean difference [SMD]: −0.29, 95% confidence interval [CI]: −0.55 to −0.03; P = 0.03), family history (odds ratio [OR] 3.97, 95% CI: 1.96 to 8.03; P < 0.001) and contralateral abnormality (OR 3.95, 95% CI: 1.10 to 14.20; P = 0.04) were associated with progression in MMD patients. Subgroup analyses indicated that the same three factors were associated with the progression of unilateral to bilateral MMD.ConclusionsThis meta-analysis revealed that lower age, family history and contralateral abnormality were associated with progression in MMD patients. The same three factors are associated with the progression of unilateral to bilateral MMD. Further studies are needed to validate our results.

BackgroundThe present study aimed to evaluate the prognostic value of the 24-h National Institute of Health Stroke Scale (NIHSS) for short- and long-term outcomes of patients with basilar artery occlusion (BAO) after endovascular treatment (EVT) in daily clinical routine.MethodsPatients with EVT for acute basilar artery occlusion study registry with the 24-h NIHSS, and clinical outcomes documented at 90 days and 1 year were included. The NIHSS admission, 24-h NIHSS, NIHSS delta, and NIHSS percentage change, binary definitions of early neurological improvement [ENI; improvement of 4/(common ENI)/8 (major ENI)/10 (dramatic ENI)] NIHSS points were compared to predict the favorable outcomes and mortality at 90 days and 1 year. The primary outcome was defined as favorable if the modified Rankin Scale (mRS) score was 0–3 at 90 days.ResultsOf the 644 patients treated with EVT, the 24-h NIHSS had the highest discriminative ability for favorable outcome prediction [receiver operator characteristic (ROC)NIHSS 24 h area under the curve (AUC): 0.92 (0.90–0.94)] at 90 days and 1 year [(ROCNIHSS 24 h AUC: 0.91 (0.89–0.94)] in comparison to the NIHSS score at admission [ROCNIHSS admission AUC at 90 days: 0.73 (0.69–0.77); 1 year: 0.74 (0.70–0.78)], NIHSS delta [ROCΔ NIHSS AUC at 90 days: 0.84 (0.81–0.87); 1 year: 0.81 (0.77–0.84)], and NIHSS percentage change [ROC%change AUC at 90 days: 0.85 (0.82–0.89); 1 year: 0.82 (0.78–0.86)].ConclusionThe 24-h NIHSS with a threshold of ≤23 points was the best surrogate for short- and long-term outcomes after EVT for BAO in the clinical routine.

As the leading cause of vision loss in working-age adults, diabetic retinopathy requires routinely retinal screening. Here the authors develop a deep learning system that can facilitate the screening by providing real-time image quality assessment, lesions detection, and grades across the disease spectrum.

Summary: We described a challenge named “Diabetic Retinopathy (DR)—Grading and Image Quality Estimation Challenge” in conjunction with ISBI 2020 to hold three sub-challenges and develop deep learning models for DR image assessment and grading. The scientific community responded positively to the challenge, with 34 submissions from 574 registrations. In the challenge, we provided the DeepDRiD dataset containing 2,000 regular DR images (500 patients) and 256 ultra-widefield images (128 patients), both having DR quality and grading annotations. We discussed details of the top 3 algorithms in each sub-challenges. The weighted kappa for DR grading ranged from 0.93 to 0.82, and the accuracy for image quality evaluation ranged from 0.70 to 0.65. The results showed that image quality assessment can be used as a further target for exploration. We also have released the DeepDRiD dataset on GitHub to help develop automatic systems and improve human judgment in DR screening and diagnosis. The bigger picture: Diabetic retinopathy (DR) is the most common disease caused by diabetes. Challenges are held to address real-world issues encountered in the design of DR automated screening systems to advance the technology in this area. Thus, we described a challenge named ''Diabetic Retinopathy (DR)—Grading and Image Quality Estimation Challenge'' in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI 2020) for fundus image assessment and DR grading. The scientific community responded positively to the challenge. In the challenge, we provided a deep DR image dataset (DeepDRiD) containing regular DR images and ultra-widefield (UWF) DR images, both having image quality and DR grading diagnosis. We discussed details of the three best algorithms in each sub-challenges. The results by the top algorithms showed that image quality assessment can be used as a target for further exploration.

Abstract Background The psychological birth trauma is a universal phenomenon in childbearing women. The influences could extend in a wide range, which includes the mothers’ health, mother-infant relationship, partner relationship. The medical staff could even choose to quit playing their part in the birthing process. The phenomenon has gradually garnered attention around the world. However, it has rarely been discussed under Chinese special conditions. The study was to explore Chinese women’s lived experiences of psychological birth trauma during labor and birth. Methods A descriptive phenomenological approach was adopted in this study. Twenty-four women were recruited, who reported having experienced psychological birth trauma. In-depth interviews were conducted within 1 week after birth. Colaizzi’s method was used to analyze the data. Results Twenty-four women participated in the study. Four themes emerged to describe the women’s experience of psychological birth trauma: “How am I supposed to relieve the endless pain?” “ Can’t I be weak?” “Am I not important?” “What uncertainties are waiting for me?” Conclusions The findings provide deep insight into Chinese women’s unique experience of psychological birth trauma. The social and health system could prevent psychological harm during birth and promote maternal health by measures of pain management, thoughtful attention, adequate caring, and prenatal preparation.

ObjectiveCurrent advances in immunotherapy requires accurate tumor sub-classification due to the heterogeneity of lung adenocarcinoma (LUAD). This study aimed to develop a LUAD sub-classification system based on immune cell signatures and identified prognostic gene markers.MethodsSignatures related to the prognosis of TCGA-LUAD and 4 GSE cohorts were screened and intersected from 184 previously published immune cell signatures. The LUAD samples in the TCGA were clustered by ConsensusClusterPlus. Molecular characteristics, immune characteristics and sensitivity to immunotherapies/chemotherapies were compared. LDA score was established through Linear Discriminant Analysis (LDA). Co-expression module was constructed by Weighted Gene Co-Expression Network Analysis (WGCNA).ResultsFour LUAD subtypes with different molecular and immune characteristics were identified. Significant differences in prognosis among the four subtypes were observed. The IS1 subtype with the worst prognosis showed the highest number of TMB, mutant genes, IFN γ score, angiogenesis score and immune score. Twenty co-expression modules were generated by WGCNA. Blue module, sky blue module and light yellow module were significantly correlated with LUAD prognosis. The hub genes (CCDC90B, ARNTL2, RIPK2, SMCO2 and ADA and NBN) showing great prognostic significance were identified from the blue module. A total of 8 hub genes (NLRC3, CLEC2D, GIMAP5, CXorf65, PARP15, AKNA, ZC3H12D, and ARRDC5) were found in the light yellow module. Except for CXorf65, the expression of the other seven genes were significantly correlated with LUAD prognosis.ConclusionThis study determined four LUAD subtypes with different molecular and immune characteristics and 13 genes closely related to the prognosis of LUAD. The current findings could help understand the heterogeneity of LUAD immune classes.

Purpose: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives. Methods: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews. Results: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations). Conclusion: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased. Keywords: labor pain, midwifery, natural childbirth, psychological trauma, social support

Abstract Multireservoir joint flood control operation is an important nonstructural measure for flood control in some basins. Owing to the existence of uncertainties in flood control operation, various degrees of risk can be shown in flood control operation systems. Examining these uncertainties and the resulting risk of failure in multireservoir operation systems is extremely beneficial and indispensable for basin flood mitigation. In this study, different stochastic simulation methods were employed to generate streamflow series at multiple stations and other uncertainties such as the flood forecast errors, discharge capacity, and reservoir storage. Then, the Monte Carlo framework was established based on the simulation sequence to estimate the risk of a failure of each flood control unit in the flood control system. Furthermore, a comprehensive risk assessment indicator was proposed to consider the failure probability and failure consequences at the same time. The Xiluodu‐Xiangjiaba‐Three Gorges cascade reservoirs were selected as a case study. Results show that the applied probabilistic simulation methods could simulate various uncertainties in a multireservoir flood control system effectively, and the proposed risk analysis method could comprehensively evaluate the risks of reservoir overtopping, flood flows exceeding a standard, and flood diversion from the perspective of overall watershed security.

Objective: Pembrolizumab and bevacizumab both have antitumor activity. According to NCCN updated guideline the benefit of pembrolizumab or bevacizumab as a first line in management of advanced nonsmall cell lung cancer (NSCLC) is documented in randomized controlled studies. The study aimed to evaluate the response and complications of patients with advanced NSCLC treated with pembrolizumab or bevacizumab plus chemotherapy. Methods: This study was a retrospective cohort study of patients with advanced nonsquamous NSCLC who received cisplatin with pemetrexed combined with pembrolizumab (A group) or bevacizumab (B group) from 07/02/2018 to 07/03/2021 at Peking University Cancer Hospital. Progression-free survival (PFS) was the primary outcome. The secondary outcomes included overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DoR), and adverse events (AEs). Results: This study included 66 patients, 34 in A group and 32 in B group. There were no differences in median PFS (7.6 vs 9.9 months, P = .601). There were no differences in median OS (23.1 vs 24.2 months, P = .782). There were no differences in ORR (57.6 % vs 41.9 % , P = .211) and DCR (93.9 % vs 100.0 % , P = .164) between 2 groups. The occurrence of AEs was similar. No new safety signals were observed. Grade 3 to 4 treatment-related AEs occurred in 17 (50.0 % ) patients of A group and in 12 (37.5 % ) of B group ( P > .05). Conclusion: The addition of pembrolizumab or bevacizumab to pemetrexed plus cisplatin was well tolerated and resulted in a clinically meaningful treatment benefit in advanced nonsquamous NSCLC. When pembrolizumab is not suitable, bevacizumab plus chemotherapy may be an option.

Background This real‐world study assessed the efficacy and toxicity of anlotinib as salvage treatment in Chinese patients with advanced non‐small cell lung cancer (NSCLC). Methods The medical records of 81 patients with advanced NSCLC who had failed at least two lines of chemotherapy were retrospectively collected. All patients were administered anlotinib treatment until disease progression or intolerance as a result of adverse events. Survival curves were created using the Kaplan–Meier method. The log‐rank test was used for univariate analysis of progression‐free survival (PFS) between groups. Cox regression was used to estimate the statistically significant factors based on univariate analysis. Results The median PFS was five months (95% confidence interval [CI] 3.5–6.5). The objective response rate (ORR) was 7% and the disease control rate (DCR) was 84%. The following subgroups of patients had longer PFS (P

Background Thymoma and thymic carcinoma are rare thymic epithelial tumors. We investigated the efficacy of first‐line gemcitabine and cisplatin (GP) chemotherapy versus gemcitabine and cisplatin chemotherapy combined with the anti‐angiogenic drug endostar (GP + E) in advanced thymoma and thymic carcinoma. Methods The records of 45 patients with invasive metastatic thymomas or thymic carcinomas treated with GP as first‐line therapy between August 2008 and July 2017 at the Department of Respiratory Medicine, Peking University Cancer Hospital and Institute were retrospectively reviewed. Results Eighteen patients (75%) in the GP + E group achieved a partial response and six (25%) had stable disease. In GP only group, nine (42.8%) patients achieved a partial response, 11 (52.4%) had stable disease, and one (4.8%) had progressive disease. The GP + E group had a significantly higher overall response rate (75% vs. 42.9%; P = 0.028), and median progression‐free survival (PFS) and overall survival (OS) of 19 and 76 months, respectively. In the GP only group, median PFS and OS were 16 and 29 months, respectively. PFS and OS were not significantly different between the groups. Conclusions GP has moderate efficacy and could represent a suitable first‐line therapy for thymic carcinoma and thymoma. Chemotherapy combined with endostar could improve the overall response rate, but did not prolong PFS or OS.

BackgroundProgrammed cell death-1/programmed cell death ligand-1 (PD-1/PD-L1) inhibitors are increasingly used in China, but no real-world data are available about the immune-related adverse events (irAEs). This real-world retrospective study aimed to assess the safety and effectiveness of PD-1/PD-L1 inhibitors in patients with non-small cell lung cancer (NSCLC) and to analyze the association between irAEs and effectiveness.MethodsThis was a retrospective study of the clinical data of patients with NSCLC treated with PD-1/PD-L1 inhibitors from August 2016 to November 2019 at Beijing Cancer Hospital. The patients were divided into the irAE or non-irAE groups. Overall adverse events, the impact of irAE on tumor response, and the association of irAEs with effectiveness were evaluated.ResultsOne hundred and ninety-one patients were included, including 70 (36.6%) patients in the irAE group and 121 (63.4%) patients in the non-irAE group. AE, grades 3–5 AEs, and irAE occurred in 107 (56.0%), 24 (12.6%), and 70 (36.6%) of the patients, respectively. The objective response rate (ORR) and disease control rate (DCR) were higher in the irAE group compared with the non-irAE group (42.0% vs. 25.8%, P=0.038; 91.9% vs. 70.8%, P=0.002). Multivariable analyses identified that irAE were associated with progression-free survival (HR=0.62, 95%CI: 0.43–0.91; P=0.015), but not with overall survival (HR=0.76, 95%CI: 0.44–1.28; P=0.299).ConclusionIn NSCLC treated with PD-1/PD-L1 inhibitors, patients with irAEs showed improved effectiveness over patients without irAEs. Future studies of anti-PD-1/PD-L1 immunotherapy should explore this association and the underlying biological mechanisms of efficacy.

In the field of remote sensing, most of the feature indexes are obtained based on expert knowledge or domain analysis. With the rapid development of machine learning and artificial intelligence, this method is time-consuming and lacks flexibility, and the indexes obtained cannot be applied to all areas. In order to not rely on expert knowledge and find the effective feature index with regard to a certain material automatically, this paper proposes a data-driven method to learn interactive features for hyperspectral remotely sensed data based on a sparse multiclass logistic regression model. The key point explicitly expresses the interaction relationship between original features as new features by multiplication or division operation in the logistic regression. Through the strong constraint of the L1 norm, the learned features are sparse. The coefficient value of the corresponding features after sparse represents the basis for judging the importance of the features, and the optimal interactive features among the original features. This expression is inspired by the phenomenon that usually the famous indexes we used in remote sensing, like NDVI, NDWI, are the ratio between different spectral bands, and also in statistical regression, the relationship between features is captured by feature value multiplication. Experiments were conducted on three hyperspectral data sets of Pavia Center, Washington DC Mall, and Pavia University. The results for binary classification show that the method can extract the NDVI and NDWI autonomously, and a new type of metal index is proposed in the Pavia University data set. This framework is more flexible and creative than the traditional method based on laboratory research to obtain the key feature and feature interaction index for hyperspectral remotely sensed data.

Flood disasters are the most frequent and most severe natural disasters in most countries around the world. Reservoir flood operation is an important method to reduce flood losses. When there are multiple reservoirs and flood control points in the basin, it is difficult to use reservoirs separately to fully realize their flood control potential. However, the multi-reservoir joint flood control operation is a multi-objective, multi-constrained, multi-dimensional, nonlinear, and strong-transition feature decision-making problem, and these characteristics make modeling and solving very difficult. Therefore, a large-scale reservoirs flood control operation modeling method is innovatively proposed, and Dynamic Programming (DP) combined with the Progressive Optimality Algorithm (POA) and Particle Swarm Optimization (PSO) methods, DP-POA-PSO, are designed to efficiently solve the optimal operation model. The middle and upper Yangtze River was chosen as a case study. Six key reservoirs in the basin were considered, including Xiluodu (XLD), Xiangjiaba (XJB), Pubugou (PBG), Tingzikou (TZK), Goupitan (GPT), and Three Gorges (TG). Studies have shown that DP-POA-PSO can effectively solve the optimal operation model. Compared with the current operation method, the joint flood control optimal operation makes the flood control point reach the flood control standard, moreover, in the event of the flood with a return period of 1000 years, Jingjiang, the most critical flood control point of the Yangtze River, does not require flood diversion, and the volume of flood diversion in Chenglingji is also greatly reduced.

Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified. The rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no significant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease specific-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group. Results Median overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 months vs 12.6 months; P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 months vs 3.0 months; P

Background and objective Chemotherapy is a highly efficient primary treatment for extensive-stage small cell lung cancer (ES-SCLC). However, patients receiving such treatment are prone to develop drug resistance. Local treatment is palliative and thus can alleviate the local symptoms and improve quality of life, but limited evidence is available for prolonging survival. Hence, this study evaluated the role of local treatment in chemotherapy of patients with ES-SCLC. Methods A total of 302 ES-SCLC cases were enrolled in this retrospective study. Prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results Median progression-free survival (PFS) and median survival time (MST) of the patients were 4.4 and 10.4 months, respectively. 1-, 2-, and 3-year survival rates were 37.8%, 10.2% and 4.4%, correspondingly. The MST of the primary tumor radiotherapy plus chemotherapy group was 14.3 months, whereas that of the chemotherapy group was 8.2 months (P

Background and objective Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about 15%-20% of all lung cancer. The objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients. Methods A retrospective study has enrolled 160 cases of lung cancer aged over 65. The prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results ① The median follow-up time was 12 (2-109) months. 1-, 3-, and 5-year survival rate was 47.1%, 13.0%, 9.6% respectively, and 74.4%, 25.0%, 19.7% for limited-stage (LD), and 36.8%, 8.7%, 5.8% for extensive-stage (ED). Median survival time (MST) of all the patients was 12 months, 24 months for LD and 11 months for ED, respectively. ② Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS after treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients. ③ For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic factors. The model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemoradiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show significant difference. ④ For ED-SCLC patients, sex, the change of PS after treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors. Conclusion The survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.

The risk inevitably exists in the process of flood control operation and decision-making of reservoir group, due to the hydrologic and hydraulic uncertain factors. In this study different stochastic simulation methods were applied to simulate these uncertainties in multi-reservoir flood control operation, and the risk caused by different uncertainties was evaluated from the mean value, extreme value and discrete degree of reservoir occupied storage capacity under uncertain conditions. In order to solve the conflict between risk assessment indexes and evaluate the comprehensive risk of different reservoirs in flood control operation schemes, the subjective weight and objective weight were used to construct the comprehensive risk assessment index, and the improved Mahalanobis distance TOPSIS method was used to select the optimal flood control operation scheme. The proposed method was applied to the flood control operation system in the mainstream and its tributaries of upper reaches of the Yangtze River basin, and 14 cascade reservoirs were selected as a case study. The results indicate that proposed method can evaluate the risk of multi-reservoir flood control operation from all perspectives and provide a new method for multi-criteria decision-making of reservoir flood control operation, and it breaks the limitation of the traditional risk analysis method which only evaluated by risk rate and cannot evaluate the risk of the multi-reservoir flood control operation system.

Background and objective Some clinical predictors can be used to evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy for non-small cell lung cancer (NSCLC), including female, East-Asian, non-smoker, adenocarcinoma, skin rash, etc. The aim of this study is to explore the prognosis of advanced NSCLC patients treated with gefitinib for more than 6 months. Methods Eighty advanced NSCLC patients treated with gefitinib for more than 6 months were collected from January, 2005 to March, 2010. The association of their clinical characteristics with median progression-free survival time (PFS) was analysed. Results Significantly longer median PFS were found in patients with > 70 years old, earlier clinical stage (IIIb), non-bone metastasis (27 months vs 12 months; 32 months vs 12 months; 16 months vs 10 months, P < 0.05). There was no significant difference in median PFS between ECOG performance status 0-1 group and 2-4 group, between more than 4 cycles of chemotherapy and 1-4 cycles, between PFS of chemotherapy > 6 months group and ≤6 months group, however, ECOG 0-1 group and more than 4 cycles of chemotherapy or PFS of chemotherapy > 6 months group seemed to have longer median PFS (15 months vs 10 months; 16 months vs 12 months; 14months vs 12 months). Compared with no skin rash and grade 0-I rash group, the patients with rash or grade ≥II rash had longer median PFS (16 months vs 13 months, P=0.171; 19 months vs 11 months, P=0.085). The median PFS was not related with sex, smoking index, pathological types, metastatic sites except bone, treatment strategy, etc (P > 0.05). Conclusion For gefitinib treatment, longer median PFS is likely to be obtained in patients with > 70 years old, earlier clinical stage (IIIb), non-bone metastasis.

The purpose of a flood control reservoir operation is to prevent flood damage downstream of the reservoir and the safety of the reservoir itself. When a single reservoir cannot provide enough storage capacity for certain flood control points downstream, cascade reservoirs should be operated together to protect these areas from flooding. In this study, for efficient use of the reservoir storage, an optimal flood control operation model of cascade reservoirs for certain flood control points downstream was proposed. In the proposed model, the upstream reservoirs with the optimal operation strategy were considered to reduce the inflow of the reservoir downstream. For a large river basin, the flood routing and time-lag cannot be neglected. So, dynamic programming (DP) combined with the progressive optimality algorithm (POA) method, DP-POA, was proposed. Thus, the innovation of this study is to propose a two-stage optimal reservoir operation model with a DP-POA algorithm to solve the problem of optimal co-operation of cascade reservoirs for multiple flood control points downstream during the flood season. The upper Yangtze River was selected as a case study. Three reservoirs from upstream to downstream, Xiluodu, Xiangjiaba and the Three Gorges reservoirs (TGR) in the upper Yangtze River, were taken into account. Results demonstrate that the two-stage optimization algorithm has a good performance in solving the cascade reservoirs optimization problem, because the inflow of reservoir downstream and the division volumes were largely reduced. After the optimal operation of Xiluodu and Xiangjiaba reservoirs, the average reduction of flood peak for all these 13 typical flood hydrographs (TFHs) is 13.6%. Meanwhile, the cascade reservoirs can also store much more storm water during a flood event, and the maximum volumes stored in those two reservoirs upstream in this study can reach 25.2 billion m3 during a flood event. Comprising the proposed method with the current operation method, results demonstrate that the flood diversion volumes at the flood control points along the river decrease significantly.

This study aims to assess the motivational factors influencing the participation of older adults in various exercise interventions during depressive episodes and to identify which types of exercise are most effective in alleviating depressive symptoms in this population. Therefore, randomized controlled trials (RCTs) focusing on exercise interventions and their impact on depression in older adult patients, identified by the terms “exercise” AND “depression” AND “elderly” OR “geriatric”, were selected from primary electronic databases to conduct this network meta-analysis (NMA). The primary outcome was the effect on depressive symptoms, while the secondary outcome was the comparison of dropout rates between the intervention groups and the usual care control groups, as a measure of sustained motivation and engagement. Standardized mean difference (SMD) values and the corresponding 95% confidence intervals (CIs) were computed for effect evaluation. This study protocol has been registered in IPLASY (INPLASY 202460035). The results of 31 RCTs with 3238 participants indicated that qigong (SMD −1.17, −2.28 to −0.06), Otago Exercise (SMD −1.15, −2.29 to −0.01), and yoga (SMD −0.88, −1.55 to −0.21) significantly alleviate depressive symptoms in older adults. Walking (SMD −0.82, −1.34 to −0.31) and strength training (SMD −0.67, −1.05 to −0.30) also showed significant effects. Aerobic, physical training, and tai chi had moderate effects, while multisport showed a weaker impact with no significant improvement. In summary, our research findings demonstrate that exercise can effectively alleviate depressive symptoms in older adults, with low dropout rates likely due to interconnected physiological, psychological, and social mechanisms. This is crucial for enhancing treatment strategies for older adults’ depression.

Introduction: Natural hybridization is common and plays a crucial role in driving biodiversity in nature. Despite its significance, the understanding of hybridization in ferns remains inadequate. Therefore, it is imperative to study fern hybridization to gain a more comprehensive understanding of fern biodiversity. Our study delves into the role of hybridization in shaping fern species, employing Microlepia matthewii as a case study to investigate its origins of hybridization. Methods: We performed double digest Genotyping-by-sequencing (dd-GBS) on M. matthewii and its potential parent species, identifying nuclear and chloroplast SNPs. Initially, nuclear SNPs were employed to construct the three cluster analysis: phylogenetic tree, principal component analysis, and population structure analysis. Subsequently, to confirm whether the observed genetic mixture pattern resulted from hybridization, we utilized two methods: ABBABABA statistical values in the D-suite program and gene frequency covariance in the Treemix software to detect gene flow. Finally, we employed chloroplast SNPs to construct a phylogenetic tree, tracing the maternal origin. Results and discussion: The analysis of the nuclear SNP cluster revealed that M. matthewii possesses a genetic composition that is a combination of M. hancei and M. calvescens. Furthermore, the analysis provided strong evidence of significant gene flow signatures from the parental species to the hybrid, as indicated by the two gene flow analyses. The samples of M. matthewii cluster separately with M. hancei or M. calvescens on the chloroplast systematic tree. However, the parentage ratio significantly differs from 1:1, suggesting that M. matthewii is a bidirectional and asymmetrical hybrid offspring of M. hancei and M. calvescens. [ABSTRACT FROM AUTHOR]

The cytological diagnosis of atypical squamous cells that cannot exclude high-grade squamous intraepithelial lesions (ASC-H) is subjective and entails great variation in the risk of HSIL+. Therefore, we retrospectively analyzed the clinicopathological outcomes of patients with ASC-H cytology from January 2018 to June 2021 to determine associated predictors for diagnosing HSIL+ and explore their appropriate clinical management. Overall, 279 patients with ASC-H cytology were enrolled, 64.9% (181/279) of whom were histopathologically confirmed as HSIL+. Further analysis showed that only human papillomavirus (HPV) positivity was an independent risk factor for HSIL+ in ASCH patients. Additionally, no significant difference was observed in the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the three HPV testing methods (hybrid capture (HC) II, HPV E6E7 mRNA and HPV genotyping testing) for detecting HSIL+ (p > 0.05). The perfect agreement between colposcopy and final histology was 40.5%, with a κ value of 0.145. The sensitivity, specificity, PPV and NPV of colposcopy for detecting HSIL+ were 32.6%, 91.8%, 87.9% and 42.3%, respectively. After cervical conization, none of the patients diagnosed with normal/benign histopathology by cervical biopsy was reclassified to HSIL+, while 39.5% (17/43) of the low-grade squamous intraepithelial lesion (LSIL) patients were reclassified as HSIL. During follow-up, ASC-H patients diagnosed with LSIL had a high rate of normalization (70%) and a low rates of persistence (20%) and progression (10%). In four ASC-H patients younger than 30 years old with HSIL (cervical intraepithelial neoplasia (CIN) 2), two normalized and two persisted during followup. In conclusion, ASC-H patients should be directly referred for colposcopy and undergo biopsy irrespective of their age, menopausal status and HPV status. Relatively conservative management might be more suitable for ASC-H patients with LSIL- or ASC-H patients younger than 30 years with HSIL (CIN2). [ABSTRACT FROM AUTHOR]