Integrating visual large language model and reasoning chain for driver behavior analysis and risk assessment.

Driver behavior is a critical factor in driving safety, making the development of sophisticated distraction classification methods essential. Our study presents a Distracted Driving Classification (DDC) approach utilizing a visual Large Language Model (LLM), named the Distracted Driving Language Model (DDLM). The DDLM introduces whole-body human pose estimation to isolate and analyze key postural features-head, right hand, and left hand-for precise behavior classification and better interpretability. Recognizing the inherent limitations of LLMs, particularly their lack of logical reasoning abilities, we have integrated a reasoning chain framework within the DDLM, allowing it to generate clear, reasoned explanations for its assessments. Tailored specifically with relevant data, the DDLM demonstrates enhanced performance, providing detailed, context-aware evaluations of driver behaviors and corresponding risk levels. Notably outperforming standard models in both zero-shot and few-shot learning scenarios, as evidenced by tests on the 100-Driver dataset, the DDLM stands out as an advanced tool that promises significant contributions to driving safety by accurately detecting and analyzing driving distractions.

Economic effects of command-and-control abatement policies under China's 2030 carbon emission goal.

To mitigate greenhouse gas emissions, China has committed to reducing its national carbon emission intensity, which is a measure of carbon dioxide produced per unit of gross domestic product (GDP), by 65% by 2030 compared with the level in 2005. The government is pursuing corresponding abatement initiatives to achieve this goal. Coupling the physical data of sectoral energy inputs and emissions with a mixed exogenous/endogenous input-output model, this study first projected the carbon emissions in 2030 under a business-as-usual baseline and then investigated the potential economic effects of the "command-and-control" approach for reducing carbon emissions by limiting production capacity and strengthening forest carbon sink management. Three carbon abatement scenarios were evaluated from the perspectives of social equity, abatement efficiency, and forest carbon sinks. Our results indicated that, under the 2030 carbon emission goal, the GDP in China would decline by 17.17-41.26 trillion yuan (equivalent to a marginal abatement cost of 2315-5387 yuan per ton of carbon dioxide reduction), depending on different policy initiatives. The policy of carbon reduction for high-emission sectors only is more cost-effective and economically efficient and has resulted in fewer negative economic impacts than the policy of requiring all economic sectors to do so. Asking high-carbon emission industries to undertake carbon abatement can further reduce national carbon emission intensity. Additionally, promoting forest carbon sinks as an abatement initiative also demonstrates substantial economic benefits for society.

Successful Urgent TAVI for Critical Aortic Valve Stenosis after ECMO Implantation.

Transcatheter aortic valve implantation (TAVI) has evolved to be the treatment of choice for patients with severe aortic stenosis and high perioperative risk. Cardiogenic shock is one of the most severe complications during the TAVI procedure, especially as the prognosis of cardiogenic shock secondary to aortic stenosis is very poor. This situation can be challenging, while extracorporeal membranous oxygenation (ECMO) can be a treatment option. Here, we reported on an 88-year-old female patient who had been diagnosed as non-ST-elevation myocardial infarction (NSTEMI) and critical aortic valve stenosis (AS) with a logistic Euroscore of 25%. Percutaneous coronary angioplasty (PCI) was performed smoothly and developed tachy-brady arrhythmia of atrial fibrillation then cardiac arrest at the beginning of the TAVI procedure. A v-a ECMO was installed at her left femoral side. Afterward, the TAVI procedure was completed accordingly; her consciousness recovered and Levosimendan therapy enhanced her left-ventricular ejection fraction (LVEF) from 22% to 40%. Five days after TAVI, ECMO was replaced by intra-aortic balloon pumping (IABP) and it was removed 3 days later. A minor complication of this therapy, e.g., muscular weakness in her left leg, was noted. The patient underwent rehabilitation for about 2 months, and was discharged from hospital with a wheel chair and clear consciousness. At the 24 month follow-up she was in good recovery and was able to walk upstairs to the second floor again. Our experience suggests that one indication of prophylactic use of ECMO is for patients with an unstable hemodynamic condition.

A splay tree-based approach for efficient resource location in P2P networks.

Resource location in structured P2P system has a critical influence on the system performance. Existing analytical studies of Chord protocol have shown some potential improvements in performance. In this paper a splay tree-based new Chord structure called SChord is proposed to improve the efficiency of locating resources. We consider a novel implementation of the Chord finger table (routing table) based on the splay tree. This approach extends the Chord finger table with additional routing entries. Adaptive routing algorithm is proposed for implementation, and it can be shown that hop count is significantly minimized without introducing any other protocol overheads. We analyze the hop count of the adaptive routing algorithm, as compared to Chord variants, and demonstrate sharp upper and lower bounds for both worst-case and average case settings. In addition, we theoretically analyze the hop reducing in SChord and derive the fact that SChord can significantly reduce the routing hops as compared to Chord. Several simulations are presented to evaluate the performance of the algorithm and support our analytical findings. The simulation results show the efficiency of SChord.

Clinical and angiographic determinants of adverse cardiac events in patients with stent restenosis.

Patients with angiographically proven stent restenoses do not necessarily develop adverse cardiac events. Which clinical, procedural, or angiographic parameters relate to the development of adverse cardiac events among these patients has not been determined. This study included 155 patients (167 stented lesions) with angiographically proven restenosis (> or = 50% diameter stenosis) within the stent or at its margins in routine follow-up angiograms that was obtained at 6.5 +/- 3.6 months after successful stenting. Thirty-six patients (22%) had adverse cardiac events (including unstable angina necessitating target lesion revascularization, acute myocardial infarction, or cardiac death) during follow-up and 119 patients (78%) were event-free. These two groups of patients were compared to determine the parameters related to adverse cardiac events. Univariate determinants of adverse events included hypertension (P = 0.023), unstable angina at initial presentation (P = 0.002), target lesion in proximal left anterior descending artery (P = 0.041), TIMI grade 0-2 flow in follow-up angiograms (p < 0.001), impaired left ventricular function at follow-up (P = 0.002), follow-up minimal lumen diameter < or = 0.6 mm (P = 0.003), follow-up diameter stenosis > 75% (P = 0.005), late loss > 2 mm (P = 0.01), and loss index > 1.127 (P < 0.001). Multivariate analysis demonstrated hypertension (odds ratio, OR, = 3.6; P = 0.019), unstable angina at initial presentation (OR = 2.6; P = 0.007), TIMI grade 0-2 flow at follow-up (OR = 2.8; P = 0.05), impaired LV function at follow-up (OR = 4.2; P = 0.004), and loss index > 1.127 (OR = 3.6; P = 0.017) as independent risk factors for adverse cardiac events. Classification and regression tree analysis identified loss index > 1.127 and impaired LV function as the two strongest determinant of adverse cardiac event. Therefore, hypertensive patients whose initial clinical presentation were unstable angina should be managed carefully to optimize the angiographic results and, most importantly, followed up more closely for development of impaired LV function after coronary stenting in order to prevent the occurrence of adverse cardiac event at follow-up.