Deep learning solutions for smart city challenges in urban development.

In the realm of urban planning, the integration of deep learning technologies has emerged as a transformative force, promising to revolutionize the way cities are designed, managed, and optimized. This research embarks on a multifaceted exploration that combines the power of deep learning with Bayesian regularization techniques to enhance the performance and reliability of neural networks tailored for urban planning applications. Deep learning, characterized by its ability to extract complex patterns from vast urban datasets, has the potential to offer unprecedented insights into urban dynamics, transportation networks, and environmental sustainability. However, the complexity of these models often leads to challenges such as overfitting and limited interpretability. To address these issues, Bayesian regularization methods are employed to imbue neural networks with a principled framework that enhances generalization while quantifying predictive uncertainty. This research unfolds with the practical implementation of Bayesian regularization within neural networks, focusing on applications ranging from traffic prediction, urban infrastructure, data privacy, safety and security. By integrating Bayesian regularization, the aim is to, not only improve model performance in terms of accuracy and reliability but also to provide planners and decision-makers with probabilistic insights into the outcomes of various urban interventions. In tandem with quantitative assessments, graphical analysis is wielded as a crucial tool to visualize the inner workings of deep learning models in the context of urban planning. Through graphical representations, network visualizations, and decision boundary analysis, we uncover how Bayesian regularization influences neural network architecture and enhances interpretability.

Effects of Glucomannan Supplementation on Type II Diabetes Mellitus in Humans: A Meta-Analysis.

The hypoglycemic and lipid-lowering effects of glucomannan are widely known, and it is a potential effective treatment for type II diabetes. In this study, we evaluated the effects of glucomannan supplementation on blood-lipid-related indicators, blood-glucose-related indicators, blood pressure (BP), and body weight (BW) in patients suffering from type II diabetes. We searched databases including PubMed, Cochrane, the comprehensive biomedical research database (Embase), Web of Science, and China National Knowledge Infrastructure (CNKI) for literature on glucomannan and type II diabetes. Six randomized controlled trials (RCTs) were eligible (n = 440 participants) to be included in our analysis. Glucomannan not only reduced the total cholesterol (TC) (MD -0.38 [95% CI: -0.61, -0.15], p = 0.001) and low-density lipoprotein (LDL) levels (MD -0.35 [95% CI: -0.52, -0.17], p < 0.0001) compared with the control group, but also reduced the fasting blood glucose (FBG) (MD -1.08 [95% CI: -1.65, -0.50], p = 0.0002), 2 h postprandial blood glucose (P2hBG) (MD -1.92 [95% CI: -3.19, -0.65], p = 0.003), fasting insulin (FINS) (MD -1.59 [95% CI: -2.69, -0.50], p = 0.004), and serum fructosamine (SFRA) levels (SMD -1.19 [95% CI: -1.74, -0.64], p < 0.0001). Our analysis indicates that glucomannan is an effective nutritional intervention for type II diabetes.

Association of differential body water composition by sex, measured using BIA, with survival in a real­world lung cancer cohort.

OBJECTIVE: The aim of this study was to evaluate the association of differential body water composition with survival in patients with lung cancer. METHODS: This retrospective cohort study included 1314 patients diagnosed with lung cancer in 80 Chinese institutions from May 2013 to August 2020. We calculated hazard ratios (HRs) to evaluate the associations of all-cause mortality with extracellular water (ECW) and intracellular water (ICW). Cox proportional risk regression models were adjusted for sociodemographic characteristics, tumor characteristics, treatment, body mass index (BMI), and body composition measures. We also evaluated cross-classification of the dichotomy of ECW and ICW with outcomes. The association among ECW, ICW, and survival was evaluated via Cox regression and the restricted cubic-spline model using a two-sided P value. RESULTS: The study included 819 (62%) men and 495 (28%) women. The HR of lung cancer mortality significantly decreased as ECW increased (HR, 0.96; 95% confidence interval [CI], 0.93-1.00) and ICW (HR, 0.97; 95% CI, 0.95-1.00) with cutoff values of 10.5 and 16.3 L, respectively. When patients were cross-classified into categories of sex, age, BMI, visceral fat index, pathology, tumor stage, tumor burden, total bilirubin, and neutrophil count, ICW and ECW were protective factors. Only sex interacted significantly with ICW or ECW. High ICW and ECW had significant protective effects, and women had a greater risk for death than men in the case of either poor ICW or poor ECW. Sensitivity analysis showed the protective effect of the higher dichotomy of ICW (HR, 0.52; 95% CI, 0.35-0.78) and ECW (HR, 0.45; 95% CI, 0.31-0.66) on female lung cancer patients by removing patients who died within 12 mo of diagnosis. CONCLUSION: Greater ICW and ECW, especially ICW, were independent predictors for better survival in patients with lung cancer. Female patients were more vulnerable to dehydration than male patients.

The effects of taurine supplementation on diabetes mellitus in humans: A systematic review and meta-analysis.

Objective: The ameliorative effect of taurine on diabetes has received extensive attention in recent years. Despite promising data from animal studies, the efficacy of taurine supplementation in human studies has been inconsistent. We thus did a meta-analysis of randomized controlled trials to assess the effect of taurine supplement on glycemic indices, serum lipids, blood pressure, body composition in patients with diabetes. Methods: We systematically searched PubMed, Embase, Cochrane, Web of Science, FDA.gov, and ClinicalTrials.gov for randomized controlled trials (published from inception to January 15, 2022; no language restrictions) about the effect of taurine supplement on diabetes. Values of Standardized Mean Differences (SMD) were determined for continuous outcomes. Results: Of 2206 identified studies, 5 randomized controlled trials were eligible and were included in our analysis (N = 209 participants). Compared with the control group, taurine could significantly reduce HbA1c (SMD -0.41[95% CI: -0.74, -0.09], p = 0.01), Fasting Blood Sugar (SMD - 1.28[95% CI: -2.42, -0.14], p = 0.03) and HOMA-IR (SMD - 0.64[95% CI: -1.22, -0.06], p = 0.03). In addition, taurine also reduced Insulin (SMD -0.48 [95% CI: -0.99, 0.03], p = 0.06) and TG (SMD -0.26 [95% CI: -0.55, 0.02], p = 0.07), but did not reach statistical significance. Conclusions: Taurine supplementation is beneficial in reducing glycemic indices, such as HbA1c, Fasting Blood Sugar, HOMA-IR in diabetic patients, but has no significant effect on serum lipids, blood pressure and body composition in diabetic patients. Taurine emerges as a new option for the management of patients with diabetes. Further studies are needed to understand the potential effect of taurine in diabetic patients.

Evaluation of exposure risk for healthcare personnel performing the open technique HIPEC procedure using cisplatin.

OBJECTIVE: To perform an evaluation of the risk to healthcare personnel of exposure to cisplatin during a Hyperthermic Intraperitoneal Chemotherapy (HIPEC) procedure in an operating room environment. METHODS: Breathing zone air samples were taken from the operating room (OR) before, during and after the procedure of HIPEC filter membrane adsorption and the liquid impact method was applied to collect air samples. The samples of surface wipe from the floor of the OR were taken after the procedure. Inductively coupled plasma mass spectrometry(ICP-MS) was used to detect the content of cisplatin in all the samples. RESULTS: Thirty-six air samples and three surface wipes were collected from three different locations of healthcare personnel breathing zones. All the breathing zone air samples were negative for cisplatin; however, cisplatin contamination was detected on three surface wipes from the floor, but in a lowconcentration(≤ 2.25 ng). CONCLUSION: The results suggest that the risk of inhalation of cisplatin was extremely low for the healthcare personnel during the procedure of HIPEC, but the contamination of the OR floor should be taken into consideration.

Surgical and Conservative Management of Malignant Bowel Obstruction: Outcome and Prognostic Factors.

PURPOSE: Malignant bowel obstruction (MBO) is a common problem in late-stage cancer patients. Many factors are suggested to be associated with the prognosis of MBO. The current investigation was designed to explore the factors associated with the prognosis of conservative and surgery treatment in one single institution. PATIENTS AND METHODS: Sixty-four patients of MBO were recruited into the study. Demographic and clinical data including gender, age, primary cancer, radiological and laboratory examinations, and nutritional and pain index scaling were extracted for further analysis. Kaplan-Meier analysis and logistic regression analysis were used to compare the prognosis and detect significant factors. RESULTS: Of the 64 patients, there is no statistical difference in baseline features between conservative and surgical group. However, the length of stay, total medical costs, re-admission interval, and re-admission rate are statistically significant. There is no significance in Kaplan-Meier log rank test for median survival time, though the overall survival time in the conservative group is longer than that of the surgery group. Logistic regression analysis has found that prior chemotherapy is a significant predictor for final survival outcome. CONCLUSION: The election of surgery might not improve the overall survival time. Non-surgical procedures, especially chemotherapy, might be preferable for MBO patients.

Comparison of perioperative clinicopathologic outcome and postoperative survival of laparoscopic and open sphincter-sparing surgery in patients with rectal cancer: a retrospective study.

PURPOSE: To investigate the perioperative clinicopathologic outcome and postoperative survival of sphincter-sparing surgery by laparoscopic and open approach for patients with rectal cancer. Μethods: From January 1, 2008 to December 31, 2011, laparoscopic sphincter-sparing surgery and open sphincter-sparing surgery was performed in 228 patients with rectal cancer who were included in this study as open group (N=112) and laparoscopic group (N=116), respectively. The average follow-up time was approximately 5 years. RESULTS: Spearman's test showed that there was a slight negative correlation in overall survival and American Society of Anesthesiologists (ASA) grade (Spearman's r=-0.146, p=0.028), History of abdominal surgery (Spearman's r=-0.134, p=0.044) of all patients was statistically significant. There was no significant difference in survival between laparoscopic and open group (p=0.988). Kaplan-Meier curves showed that the total overall survival rates after laparoscopic and open sphincter-sparing surgery were similar in both groups. Log rank test showed that there were significant differences in overall survival among different ypTNM stages (pathological TNM after neoadjuvant chemotherapy) (p=0.002) and Charlson comorbidity index (p=0.03). CONCLUSIONS: Compared with open approach, laparoscopic sphincter-sparing surgery of rectal cancer had less intraoperative bleeding, less postoperative complications and faster recovery of intestinal function after operation. Survival of open surgery and laparoscopic rectal sphincter preservation surgery was similar in both groups. ypTNM stage and Charlson comorbidity index are the risk factors affecting the survival of patients with rectal cancer.

Association of FPGS genetic polymorphisms with primary retroperitoneal liposarcoma.

Primary retroperitoneal liposarcoma is generally regarded as a genetic disorder. We have retrospectively genotyped 8 single nucleotide polymorphisms (SNPs) in 6 candidate genes (MDM2, CDK4, CDC27, FPGS, IGFN1, and PRAMEF13) in 138 patients and 131 healthy control subjects to evaluate the effects of genetic factors on individual susceptibility to primary retroperitoneal liposarcoma in Chinese population. Three SNPs (rs2870820, rs1695147, rs3730536) of MDM2 showed significant differences in single-loci genotypes and allele frequencies between case and control groups (p < 0.05). The minor allele G of SNP rs10760502 in FPGS (folylpolyglutamate synthase) gene was significantly associated with increased risk for primary retroperitoneal liposarcoma, compared with major allele A. Our data suggest that FPGS variant in Chinese population may affect individual susceptibility to primary retroperitoneal liposarcoma.

[Prospective study of gracilis muscle repair of complex rectovaginal fistula and rectourethral fistula].

OBJECTIVE: To assess the efficacy and experience of gracilis muscle transposition for complex rectovaginal fistula (RVF) and rectourethral fistula (RUF). METHODS: Nineteen patients underwent gracilis muscle transposition for complex RVF and RUF from May 2009 to November 2011 in the Beijing Shijitan Hospital and the clinical data were prospectively collected. The success rate and complications were recorded. SF-36 quality of life score, Wexner fecal incontinence score, and female sexual function score before surgery and 6 months after surgery were recorded. RESULTS: In 19 patients, there were 8 males (RUF) and 11 females (RUF). The times of failed attempt repair preoperatively ranged from 0-3 (mean, 1.0). The diameter of the fistula ranged from 0.5-3.0 cm (mean, 1.6), and all fistulas located above the sphincter. The operative time ranged from 145-400 minutes (median, 240). The postoperative hospital stay ranged from 10-39 days (median 21). Early postoperative complications included thigh pain and numbness in 2 cases, leg numbness in 2 cases. No long-term complications were noticed. The follow-up period ranged from 6-35 months (median, 18). The gracilis muscle transposition had a healing rate of 94.7% (18/19). As compared with the preoperative level, Wexner score decreased from 10.0±8.8 to 2.9±5.8, and the continence function improved significantly (P=0.002). Sexual function score of 11 female patients increased from 1.0±1.8 to 4.0±4.0, and the sexual function had a significant improvement after surgery (P=0.022). SF-36 quality of life scores improved significantly (P<0.001). CONCLUSIONS: Gracilis muscle transposition for complex rectovaginal fistula and rectourethral fistula has high success rate with mild and rare complications.

Comparison of laparoscopic cholecystectomy for acute cholecystitis within and beyond 72 h of symptom onset during emergency admissions.

BACKGROUND: Laparoscopic cholecystectomy (LC) performed for acute cholecystitis (AC) is usually advised within 72 h of symptom onset. It can be difficult to accommodate all these patients within 72 h. LC beyond this early phase potentially increases the chances of LC-related complications. The aim of this study was to evaluate the outcomes of LC both within and beyond 72 h of presentation during the emergency admission. METHODS: A retrospective clinical study was performed from February 2004 to December 2009. A total of 133 patients underwent LC for AC during the emergency admission according to the protocol: 34 patients underwent early LC (ELC) (i.e., operation within 72 h of symptom onset) and 99 underwent late LC (LLC) (i.e., operation beyond 72 h of symptom onset). Pathologic type of cholecystitis, duration of the procedure, conversion rate, complications, length of hospital stay (LOS), and total charges were compared between the two groups. RESULTS: Patients undergoing ELC experienced a significantly shorter operating time (44.1 ± 5.32 vs. 66.4 ± 3.05 min, p < 0.01). Most of the AC (95/133, 71 %) was pathologically simple cholecystitis. There was no significant difference regarding wound infection rates [1/34 (2.94 %) vs. 2/99 (2.02 %), p > 0.05] or postoperative hospital stay (6.50 ± 1.31 vs. 6.67 ± 0.73, p > 0.05) between groups. There were no conversions to open cholecystectomy, no biliary tract injury or biliary leak, no other complications, and no 30-day readmission rates in either group. ELC was less costly than LLC (6,692 ± 794 vs. 8,378 ± 802 RMB, p < 0.05). CONCLUSIONS: Both ELC and LLC are safe for treating of AC, but the operative difficulty of LLC is greater. ELC is superior to LLC as it tends to shorten the total LOS and is less expensive.

Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial.

BACKGROUND: The open tension-free mesh-plug hernia technique, transabdominal preperitoneal (TAPP) technique, and totally extraperitoneal (TEP) laparoscopic technique all are common surgical procedures for primary unilateral inguinal hernia repair. However, the choice of the right surgical procedure still is controversial in China. This study aimed to compare open tension-free hernioplasty with two laparoscopic hernia repairs. METHODS: In this study, 164 male patients with primary unilateral inguinal hernia were randomized to undergo an open operation with mesh-plug and patch, TAPP, or TEP. RESULTS: Completion of the study required 3 years, from February 2006 to February 2009. Of the 164 patients, 62 underwent open repair, 50 had TAPP, and 52 had TEP. The patients then were followed up for 15.6 ± 8.5 months. The average operating time for the open repair group was significantly shorter than for the other two groups (p < 0.001). The cost for the open repair group also was significantly less than for the other two groups (p < 0.001). By contrast, the pain scores in the open mesh group were significantly higher than in the other two groups (p < 0.001). The hospital stay and the recovery time both were significantly longer in open repair group than in the other two groups (p < 0.001). No major complications or recurrence was found in any of the groups. CONCLUSIONS: The findings show that open tension-free mesh-plug hernia repair, TAPP, and TEP are safe and effective for patients with primary unilateral inguinal hernia. Both TAPP and TEP are superior to open repair in terms of less postoperative pain and faster recovery time. The authors therefore recommend laparoscopic repair techniques as the preferable choice of surgical procedure. However, they think open repair will remain a practical solution in China because of its lower cost, short learning period, and need for no special equipment.