Automatic Recognition of High-Density Epileptic EEG Using Support Vector Machine and Gradient-Boosting Decision Tree.

BACKGROUND: Epilepsy (Ep) is a chronic neural disease. The diagnosis of epilepsy depends on detailed seizure history and scalp electroencephalogram (EEG) examinations. The automatic recognition of epileptic EEG is an artificial intelligence application developed from machine learning (ML). PURPOSE: This study compares the classification effects of two kinds of classifiers by controlling the EEG data source and characteristic values. METHOD: All EEG data were collected by GSN HydroCel 256 leads and high-density EEG from Xiangya Third Hospital. This study used time-domain features (mean, kurtosis and skewness processed by empirical mode decomposition (EMD) and three IMFs), a frequency-domain feature (power spectrum density, PSD) and a non-linear feature (Shannon entropy). Support vector machine (SVM) and gradient-boosting decision tree (GBDT) classifiers were used to recognize epileptic EEG. RESULT: The result of the SVM classifier showed an accuracy of 72.00%, precision of 73.98%, and an F1_score of 82.28%. Meanwhile, the result of the GBDT classifier showed a sensitivity of 98.57%, precision of 89.13%, F1_score of 93.40%, and an AUC of 0.9119. CONCLUSION: The comparison of GBDT and SVM by controlling the variables of the feature values and parameters of a classifier is presented. GBDT obtained the better classification accuracy (90.00%) and F1_score (93.40%).

[History and application of foreign medicinal resources serving healthcare industry].

Foreign medicinal resources have always been an important part of Chinese medicine and have made great contributions to the development of the Chinese medical and health industry. Since the opening of the Silk Road in the Han Dynasty, foreign medicinal resources have been introduced for different purposes, some of which have become Chinese medicine in clinical practice and are still in use today.Today, foreign medicinal resources also serve the Big Health industry in China. They are introduced and applied to the fields in the Big Health industry, such as food, cosmetics, health products, decoction pieces, and daily chemical products. With the integration and development of the "Healthy China" initiative, more foreign resources will enter the Big Health industry. This paper retrospectedthe history of foreign medicinal resources serving the ancient medical and health industry, reviewedits current development under the Big Health industry, summarizedthe experience of foreign medicinal resources serving the ancient medical and health industry, as well as the development and problems of new foreign medicinal resources, and put forward some suggestions to provide ideas for the development and application of foreign medicinal resources under the Big Health industry.

[Analysis of status quo of outcome indicators of randomized controlled trials in treatment of acute ischemic stroke with acupuncture in recent three years].

To analyze the use of outcome indicators of randomized controlled trial(RCT) of acupuncture in the treatment of acute ischemic stroke in recent three years, so as to provide a basis for building a study on the core outcome indicators for the treatment of acute ischemic stroke with acupuncture. The RCTs of acupuncture treatment for acute ischemic stroke in recent three years were collec-ted through computer retrieval of eight Chinese and English databases and two clinical trial registries at home and abroad. Literature was screened out, and data was extracted. Risk of assessment bias tool Cochrane 6.1 was used for bias risk assessment, outcome indicators were summarized and analyzed. A total of 47 RCTs were included, and 3 studies were trials registration scheme. Outcome indicators were divided into 6 categories according to functional attributes, namely physical symptoms/signs, physical and chemical examination, quality of life, traditional Chinese medicine symptoms/syndromes, safety events and long-term prognosis. The study found that in addition to the common problems in previous studies covered by the status quo of outcome indicators selection of RCT of acupuncture in the treatment of acute ischemic stroke, there were also the other problems as follows: emphasis on macroscopic efficacy indicators but neglect of acupuncture specific indicators, lack of characteristic indicators and economic indicators of traditional Chinese medicine therapy, and unification of indicators measurement tool and measurement time point. In the future, the outcome indicators set for the treatment of acute ischemic stroke with acupuncture shall be established, and the core outcome indicators set shall be in line with the characteristics of traditional Chinese medicine treatment.

Similarities and Dissimilarities of COVID-19 and Other Coronavirus Diseases.

In less than two decades, three deadly zoonotic coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and SARS-CoV-2, have emerged in humans, causing SARS, MERS, and coronavirus disease 2019 (COVID-19), respectively. The current COVID-19 pandemic poses an unprecedented crisis in health care and social and economic development. It reinforces the cruel fact that CoVs are constantly evolving, possessing the genetic malleability to become highly pathogenic in humans. In this review, we start with an overview of CoV diseases and the molecular virology of CoVs, focusing on similarities and differences between SARS-CoV-2 and its highly pathogenic as well as low-pathogenic counterparts. We then discuss mechanisms underlying pathogenesis and virus-host interactions of SARS-CoV-2 and other CoVs, emphasizing the host immune response. Finally, we summarize strategies adopted for the prevention and treatment of CoV diseases and discuss approaches to develop effective antivirals and vaccines.

Risk assessment for COVID-19 pandemic in Taiwan.

BACKGROUND AND OBJECTIVES: Event-based surveillance and rapid risk assessment for acute public health events are essential in emerging infectious disease control. Since detecting the unusual signal in Wuhan in December 2019, Taiwan has been aligning risk management to policy planning via conducting regular risk assessments to combat the coronavirus disease 2019 (COVID-19). This article aims to provide some insights into Taiwan's experiences and corresponding actions for the outbreak. RESULTS: The COVID-19 risk level in Taiwan was raised to "moderate-to-high" in mid-January 2020 when neighboring countries had reported cases and the human-to-human transmission became obvious. The risk level became "high" on 24 January due to China's escalating epidemic situation and imposed a lockdown in Wuhan. We learned that the commander recognized the importance of risk assessments and considered advice from the experts was crucial in making the correct decision at the early stage of the crisis. CONCLUSIONS: Given the surge of COVID-19 cases globally, understanding the evidence-driven mobilizations via detailed risk assessments in Taiwan may be an example worth considering for other countries. We believe that strengthening a global epidemic intelligence network and sharing information in a timely and transparent manner are essential for confronting new challenges of COVID-19 and other emerging infectious diseases.

Infrared Thermography Measurement for Vibration-Based Structural Health Monitoring in Low-Visibility Harsh Environments.

In this study, infrared thermography is used for vibration-based structural health monitoring (SHM). Heat sources are employed as sensors. An acrylic frame structure was experimentally investigated using the heat sources as structural marker points to record the vibration response. The effectiveness of the infrared thermography measurement system was verified by comparing the results obtained using an infrared thermal imager with those obtained using accelerometers. The average error in natural frequency was between only 0.64% and 3.84%. To guarantee the applicability of the system, this study employed the mode shape curvature method to locate damage on a structure under harsh environments, for instance, in dark, hindered, and hazy conditions. Moreover, we propose the mode shape recombination method (MSRM) to realize large-scale structural measurement. The partial mode shapes of the 3D frame structure are combined using the MSRM to obtain the entire mode shape with a satisfactory model assurance criterion. Experimental results confirmed the feasibility of using heat sources as sensors and indicated that the proposed methods are suitable for overcoming the numerous inherent limitations associated with SHM in harsh or remote environments as well as the limitations associated with the SHM of large-scale structures.

Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset.

Importance: The dynamics of coronavirus disease 2019 (COVID-19) transmissibility are yet to be fully understood. Better understanding of the transmission dynamics is important for the development and evaluation of effective control policies. Objective: To delineate the transmission dynamics of COVID-19 and evaluate the transmission risk at different exposure window periods before and after symptom onset. Design, Setting, and Participants: This prospective case-ascertained study in Taiwan included laboratory-confirmed cases of COVID-19 and their contacts. The study period was from January 15 to March 18, 2020. All close contacts were quarantined at home for 14 days after their last exposure to the index case. During the quarantine period, any relevant symptoms (fever, cough, or other respiratory symptoms) of contacts triggered a COVID-19 test. The final follow-up date was April 2, 2020. Main Outcomes and Measures: Secondary clinical attack rate (considering symptomatic cases only) for different exposure time windows of the index cases and for different exposure settings (such as household, family, and health care). Results: We enrolled 100 confirmed patients, with a median age of 44 years (range, 11-88 years), including 44 men and 56 women. Among their 2761 close contacts, there were 22 paired index-secondary cases. The overall secondary clinical attack rate was 0.7% (95% CI, 0.4%-1.0%). The attack rate was higher among the 1818 contacts whose exposure to index cases started within 5 days of symptom onset (1.0% [95% CI, 0.6%-1.6%]) compared with those who were exposed later (0 cases from 852 contacts; 95% CI, 0%-0.4%). The 299 contacts with exclusive presymptomatic exposures were also at risk (attack rate, 0.7% [95% CI, 0.2%-2.4%]). The attack rate was higher among household (4.6% [95% CI, 2.3%-9.3%]) and nonhousehold (5.3% [95% CI, 2.1%-12.8%]) family contacts than that in health care or other settings. The attack rates were higher among those aged 40 to 59 years (1.1% [95% CI, 0.6%-2.1%]) and those aged 60 years and older (0.9% [95% CI, 0.3%-2.6%]). Conclusions and Relevance: In this study, high transmissibility of COVID-19 before and immediately after symptom onset suggests that finding and isolating symptomatic patients alone may not suffice to contain the epidemic, and more generalized measures may be required, such as social distancing.

Assessment of Expert-Level Automated Detection of Plasmodium falciparum in Digitized Thin Blood Smear Images.

Importance: Decades of effort have been devoted to establishing an automated microscopic diagnosis of malaria, but there are challenges in achieving expert-level performance in real-world clinical settings because publicly available annotated data for benchmark and validation are required. Objective: To assess an expert-level malaria detection algorithm using a publicly available benchmark image data set. Design, Setting, and Participants: In this diagnostic study, clinically validated malaria image data sets, the Taiwan Images for Malaria Eradication (TIME), were created by digitizing thin blood smears acquired from patients with malaria selected from the biobank of the Taiwan Centers for Disease Control from January 1, 2003, to December 31, 2018. These smear images were annotated by 4 clinical laboratory scientists who worked in medical centers in Taiwan and trained for malaria microscopic diagnosis at the national reference laboratory of the Taiwan Centers for Disease Control. With TIME, a convolutional neural network-based object detection algorithm was developed for identification of malaria-infected red blood cells. A diagnostic challenge using another independent data set within TIME was performed to compare the algorithm performance against that of human experts as clinical validation. Main Outcomes and Measures: Performance on detecting Plasmodium falciparum-infected blood cells was measured by average precision, and performance on detecting P falciparum infection at the image level was measured using sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Results: The TIME data sets contained 8145 images of 36 blood smears from patients with suspected malaria (30 P falciparum-positive and 6 P falciparum-negative smears) that had reliable annotations. For clinical validation, the average precision was 0.885 for detecting P falciparum-infected blood cells and 0.838 for ring form. For detecting P falciparum infection on blood smear images, the algorithm had expert-level performance (sensitivity, 0.995; specificity, 0.900; AUC, 0.997 [95% CI, 0.993-0.999]), especially in detecting ring form (sensitivity, 0.968; specificity, 0.960; AUC, 0.995 [95% CI, 0.990-0.998]) compared with experienced microscopists (mean sensitivity, 0.995 [95% CI, 0.993-0.998]; mean specificity, 0.955 [95% CI, 0.885-1.000]). Conclusions and Relevance: The findings suggest that a clinically validated expert-level malaria detection algorithm can be developed by using reliable data sets.

Optimizing a desirable fare structure for a bus-subway corridor.

This paper aims to optimize a desirable fare structure for the public transit service along a bus-subway corridor with the consideration of those factors related to equity in trip, including travel distance and comfort level. The travel distance factor is represented by the distance-based fare strategy, which is an existing differential strategy. The comfort level one is considered in the area-based fare strategy which is a new differential strategy defined in this paper. Both factors are referred to by the combined fare strategy which is composed of distance-based and area-based fare strategies. The flat fare strategy is applied to determine a reference level of social welfare and obtain the general passenger flow along transit lines, which is used to divide areas or zones along the corridor. This problem is formulated as a bi-level program, of which the upper level maximizes the social welfare and the lower level capturing traveler choice behavior is a variable-demand stochastic user equilibrium assignment model. A genetic algorithm is applied to solve the bi-level program while the method of successive averages is adopted to solve the lower-level model. A series of numerical experiments are carried out to illustrate the performance of the models and solution methods. Numerical results indicate that all three differential fare strategies play a better role in enhancing the social welfare than the flat fare strategy and that the fare structure under the combined fare strategy generates the highest social welfare and the largest resulting passenger demand, which implies that the more equity factors a differential fare strategy involves the more desirable fare structure the strategy has.

Disease burden of enterovirus infection in Taiwan: Implications for vaccination policy.

OBJECTIVES: This study aimed to assess the disease burden and economic impacts of human nonpolio enteroviruses (NPEV) and enterovirus A71 (EV-A71) infection in Taiwan. MATERIALS AND METHODS: We included children under five years old (n=983,127-1,118,649) with ICD-9-CM codes 0740 (herpangina) or 0743 (hand-foot-and-mouth disease) from the 2006 to 2010 National Health Insurance Database. Severity of enterovirus infection was assessed from outpatient/emergency visits, hospitalization (with/without intensive care unit [ICU] admission), infection with severe complications, and death. We estimated medical costs and indirect costs from the societal perspective. RESULTS: The annual rates of NPEV events for children under five years old ranged from 13.9% to 38.4%, of which 5.1-8.8% were hospitalized. EV-A71 accounted for 7.8% of all NPEV medical costs, but 79.1% of NPEV ICU costs. Travel costs and productivity loss of caregivers were $37.1 (range: $24.5-$64.7) million per year. These costs were not higher in the EV-A71 dominant year ($34.4 million) compared with those in the other years. Productivity losses resulting from premature mortality by NPEV infection were $0.8 (range: $0.0-$2.9) million per year, of which 96.3% were caused by EV-A71. CONCLUSIONS: Diseases associated with NPEV other than EV-A71 were responsible for most of the medical expenses. In addition, caregiver productivity loss by high rates of NPEV infection impacted the society much more than medical costs. A multi-valent vaccine that includes EV-A71 and other serotypes, for example coxsackievirus A16, may be beneficial to the health of children in Taiwan.

[Distribution Characteristics of Heavy Metals in the Street Dusts in Xuanwei and Their Health Risk Assessment].

Relationship between high lung cancer incidence in Xuanwei residents and environmental pollution has been a hot topic in the field of environmental sciences. Street dusts in Xuanwei power plant area as well as its upwind area (Banqiao town) and downwind area (Laibin town, Tangtang town) were collected. Chemical elements in the street dust samples were investigated using ICP-MS. Health risk assessment of heavy metals in the street dusts was carried out using the US EPA Health Risk Assessment Model. Our results showed that the mass level of Al, V, Ni, Co, Zn and Cd in street dusts followed the order of Xuanwei power plant > Laibin town > Tangtang town. The mean concentrations of V, Cd, Cr, Cu, Mn, Co, Ni, Pb, As and Zn were all higher than the background values in Yunnan soil, indicating that the street dusts of Xuanwei city have been heavily polluted by those metals. The health risk assessment results showed that the non-cancer hazard risks induced by the 10 heavy metals were higher to children compared to adults. The heavy metals in street dust were mainly ingested by human bodies through hand-mouth ingestion. The 5 carcinogenic metals, including Cd, Cr, Ni, Cr and As, had a potential risk of carcinogenicity in human after exposed to the dusts. Cr was the major toxic element to the local children's health.