Buoyancy-Driven Dissolution Instability in a Horizontal Hele-Shaw Cell.

The dissolution of minerals within rock fractures is fundamental to many geological processes. Previous research on fracture dissolution has highlighted the significant role of buoyancy-driven convection leading to dissolution instability. Yet, the pore-scale mechanisms underlying this instability are poorly understood primarily due to the challenges in experimentally determining flow velocity and concentration fields. Here, we integrate pore-scale simulations with theoretical analysis to delve into the dissolution instability prompted by buoyancy-driven convection in a radial horizontal geometry. Initially, we develop a pore-scale modeling approach incorporating gravitational effects, subsequently validating it through experiments. We then employ pore-scale numerical simulations to elucidate the 3D intricacies of flow-dissolution dynamics. Our findings reveal that a simple criterion can delineate the condition for the onset of buoyancy-driven dissolution instability. If the characteristic length falls below a critical threshold, dissolution remains stable. Conversely, exceeding this threshold leads to two distinct regimes: the unstable regime of the confined domain affected by the initial aperture and the unstable regime of the semi-infinite domain independent of the initial aperture where the instability is no longer influenced by the lower boundary. We demonstrate that the pore-scale mechanism for this instability is due to the concentration boundary layer attaining a gravitationally unstable critical thickness. Through theoretical analysis of this layer and the time scales of diffusion and advection, we establish a theoretical model to predict where the dissolution instability occurs. This model aligns closely with our numerical simulations and experimental data across diverse conditions. Our work improves the understanding of buoyancy-driven dissolution instability in radial horizontal geometry. It is also of practical significance in understanding cavity formation in karst hydrology and preventing leaks in geological CO2 storage.

Awake Unilateral Biportal Endoscopic Decompression Under Local Anesthesia for Degenerative Lumbar Spinal Stenosis in the Elderly: A Feasibility Study with Technique Note.

Purpose: Here, we introduce a novel strategy of awake unilateral biportal endoscopic (UBE) decompression, which applies conscious sedation combined with stepwise local anesthesia (LA) as an alternative to general anesthesia (GA). The study aims to evaluate the feasibility of awake UBE decompression for degenerative lumbar spinal stenosis (DLSS) in elderly patients. Patients and Methods: This retrospective study included 31 consecutive patients who received awake UBE decompression for DLSS in our institution from January 2021 to March 2022. Clinical results were evaluated using patient-reported outcomes measures (PROM) including visual analog scale for leg pain (VAS-LP), Oswestry Disability Index (ODI), and modified MacNab criteria. The anesthesia effectiveness and intraoperative experience were evaluated by intraoperative VAS and satisfaction rating system. Results: UBE decompression was successfully performed in all patients under LA combined with conscious sedation. 26 (83.9%) patients rated the intraoperative experience as satisfactory (excellent or good) and 5 (16.1%) as fair. The mean intraoperative VAS was 3.41±1.26. The VAS and ODI at each follow-up stage after surgery were significantly improved compared to preoperative scores (p < 0.01). At the last follow-up, 28 patients (90.3%) classified the surgical outcome as good or excellent, and 3 (9.7%) as fair. There were no serious complications or adverse reactions observed in the study. Conclusion: Our preliminary results suggest that awake UBE decompression is a feasible and promising alternative for elderly patients with DLSS.

Cost-Effectiveness of Dapagliflozin in Heart Failure with Preserved or Mildly Reduced Ejection Fraction: the DELIVER Trial.

PURPOSE: The DELIVER trial demonstrated the efficacy of dapagliflozin in reducing primary endpoint (cardiovascular (CV) mortality or worsening heart failure) for heart failure with mid-range ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF). This study assessed the economic and clinical effects of incorporating dapagliflozin into a standard treatment regimen for HFpEF and HFmrEF cases in China. METHODS: A multistate Markov model was used to assess the clinical and economic effects of adding dapagliflozin to the usual treatment regimen for HFpEF and HFmrEF. A log-logistic formula was used to represent the cumulative incidence of hospitalization, readmission, and CV mortality. A 5% annual discount was applied to all costs. The health outcome was the incremental cost-effectiveness ratio (ICER), measured using quality-adjusted life years (QALYs) and life years (LYs). The findings were examined using sensitivity and scenario analyses to assess robustness. RESULTS: In the HFpEF or HFmrEF population, the 11.2-year incremental QALYs was 0.15 and LYs was 0.2, yielding an ICER of $10,615.87 per QALY and $7,763.08 per LY. These ICER values are lower than China's per capita gross domestic product (GDP) of $12,752 in 2022. The one-way sensitivity analysis revealed that non-hospital CV death was the most influential parameter. Furthermore, there was a 68% chance that dapagliflozin was cost-effective as an additional treatment, given a willingness-to-pay limit of three times the GDP ($38,256). CONCLUSIONS: Dapagliflozin adjunctive therapy was cost-effective in patients with HFpEF or HFmrEF from the perspective of Chinese national insurance.

[Clinicopathological Features and Prognosis of Patients Newly Diagnosed With Lung Adenocarcinoma With Both EGFR Mutation and C-MET Amplification].

Objective To explore the clinicopathological features and prognosis of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification.Methods The pathological sections were reviewed.EGFR mutation was detected by amplification refractory mutation system-quantitative real-time polymerase chain reaction,and C-MET amplification by fluorescence in situ hybridization.The clinicopathological features and survival data of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification were analyzed retrospectively.Results In 11 cases of EGFR mutation combined with C-MET amplification,complex glands and solid high-grade components were observed under a microscope in 10 cases except for one case with a cell block,the tissue structure of which was difficult to be evaluated.The incidence of lung adenocarcinoma in the patients with EGFR mutation combined with C-MET amplification at clinical stage Ⅳ was higher than that in the EGFR mutation or C-MET amplification group (all P<0.001),whereas the difference was not statistically significant between the EGFR mutation group and C-MET amplification group at each clinical stage (all P>0.05).There was no significant difference in the trend of survival rate between EGFR gene group and C-MET amplification group (χ2=0.042,P=0.838),while the survival of the patients with EGFR mutation combined with C-MET amplification was worse than that of the patients with EGFR mutation (χ2=246.72,P<0.001) or C-MET amplification (χ2=236.41,P<0.001).Conclusions The patients newly diagnosed with lung adenocarcinoma with EGFR mutation plus C-MET amplification demonstrate poor histological differentiation,rapid progress,and poor prognosis.The patients are often in the advanced stage when being diagnosed with cancer.Attention should be paid to this concurrent adverse driving molecular event in clinical work.With increasing availability,the inhibitors targeting C-MET may serve as an option to benefit these patients in the near future.

Pore-scale investigation of surfactant-enhanced DNAPL mobilization and solubilization.

Surfactant-enhanced aquifer remediation has been proved successful to remove dense non-aqueous phase liquids (DNAPLs) from contaminated sites. However, the underlying mechanisms of the DNAPL mobilization and solubilization at the pore scale remains to be addressed for efficient application to the field remediation system. In this work, the emerging microfluidic and imaging technologies are applied to investigate the dynamics of DNAPL remediation. Visualized experiments of the evolution of DNAPL remediation are performed to study the role of surfactant type, concentration and injection rate. The DNAPL remediation is dominated by mobilization followed by solubilization for most surfactants. Mobilization occurs as soon as surfactants and DNAPL are in contact until forming a new stable phase structure, and the solubilization continues until the end of injection. We observe the breakup behavior of long droplets and ganglia during the mobilization, which is attributed to the surfactant-reduced interfacial tension and thus expedites DNAPL mobilization and redistribution. During the solubilization, the formation of micelles incorporating DNAPL fractions increases the DNAPL concentration gradient and thus enhances the mass transfer, but the rate-limited diffusion of micelles reduces the mass transfer rate coefficient. Increasing the surfactant content and decreasing the injection rate can promote mobilization and solubilization. The DNAPL mobilization ability of the surfactants SDS and SDBS is stronger than SAOS and Tween 80 regardless of the injection rates. Tween 80 may be considered an ideal surfactant of only solubilization but not mobilization is desired. This work elucidates the pore-scale mechanisms during surfactant-enhanced DNAPL remediation, which are beneficial for upscaling studies, predictive modeling, and operation optimization of DNAPL remediation in the field.

A New Compound-Limbs Paradigm: Integrating Upper-Limb Swing Improves Lower-Limb Stepping Intention Decoding From EEG.

Brain-computer interface (BCI) systems based on spontaneous electroencephalography (EEG) hold the promise to implement human voluntary control of lower-extremity powered exoskeletons. However, current EEG-BCI paradigms do not consider the cooperation of upper and lower limbs during walking, which is inconsistent with natural human stepping patterns. To deal with this problem, this study proposed a stepping-matched human EEG-BCI paradigm that involved actions of both unilateral lower and contralateral upper limbs (also referred to as compound-limbs movement). Experiments were conducted in motor execution (ME) and motor imagery (MI) conditions to validate the feasibility. Common spatial pattern (CSP) proposed subject-specific CSP (SSCSP), and filter-bank CSP (FBCSP) methods were applied for feature extraction, respectively. The best average classification results based on SSCSP indicated that the accuracies of compound-limbs paradigms in ME and MI conditions achieved 89.02% ± 12.84% and 73.70% ± 12.47%, respectively. Although they were 2.03% and 5.68% lower than those of the single-upper-limb mode that does not match human stepping patterns, they were 24.30% and 11.02% higher than those of the single-lower-limb mode. These findings indicated that the proposed compound-limbs EEG-BCI paradigm is feasible for decoding human stepping intention and thus provides a potential way for natural human control of walking assistance devices.

Improving the Enantioselectivity of CHMOBrevi1 for Asymmetric Synthesis of Podophyllotoxin Precursor.

(R)-ß-piperonyl-γ-butyrolactones are key building blocks for the synthesis of podophyllotoxin, which have demonstrated remarkable potential in cancer treatment. Baeyer-Villiger monooxygenases (BVMOs)-mediated asymmetric oxidation is a green approach to produce chiral lactones. While several BVMOs were able to oxidize the corresponding cyclobutanone, most BVMOs gave the (S) enantiomer while Cyclohexanone monooxygenase (CHMO) from Brevibacterium sp. HCU1 gave (R) enantiomer, but with a low enantioselectivity (75 % ee). In this study, we use a strategy called "focused rational iterative site-specific mutagenesis" (FRISM) at residues ranging from 6 Šfrom substrate. The mutations by using a restricted set of rationally chosen amino acids allow the formation of a small mutant library. By generating and screening less than 60 variants, we achieved a high ee of 96.8 %. Coupled with the cofactor regeneration system, 9.3 mM substrate was converted completely in a 100-mL scale reaction. Therefore, our work reveals a promising synthetic method for (R)-ß-piperonyl-γ-butyrolactone with the highest enantioselectivity, and provides a new opportunity for the chem-enzymatic synthesis of podophyllotoxin.

Ultrasound-guided Jamshidi needle puncture to reduce radiation exposure during percutaneous pedicle screw placement: study protocol for a randomised controlled trial.

INTRODUCTION: Percutaneous pedicle screw placement (PPSP) is a minimally invasive procedure highly dependent on fluoroscopic guidance, which results in increased radiation exposure and prolonged operative time. Ultrasound can image the lumbar paravertebral anatomy and the needle trajectory in real time, which may help reduce the use of fluoroscopy and radiation dose in PPSP. We will conduct a parallel randomised controlled trial to mainly investigate the effect of ultrasound guidance in radiation reduction during PPSP. METHODS AND ANALYSIS: A total of 42 patients will be recruited and randomly assigned to the intervention group and the control group at a 1:1 ratio. In the intervention group, we will use ultrasound in combination with fluoroscopy to guide the insertion of the Jamshidi needles. In the control group, PPSP will be performed under conventional fluoroscopic guidance. The primary outcomes are the cumulative fluoroscopy time (s), radiation dose (mGy) and exposure times of screw placement. The secondary outcomes are insertion time of guidewire, rate of pedicle perforation, rate of facet joint violation, visual analogue scale for back pain, Oswestry Disability Index and complications. The participants, outcome assessors and data analysts will be blinded to allocation. ETHICS AND DISSEMINATION: The trial was approved by the research ethics committee of Shengjing Hospital, China Medical University. The results will be presented at academic seminars and submitted for publication in peer-reviewed journals.This study involves human participants and was approved by Research Ethics Committee of Shengjing Hospital, China Medical University reference number：2022PS704K. Participants gave informed consent to participate in the study before taking part. TRIAL REGISTRATION NUMBER: ChiCTR2200057131.

Molecular Origin of Wetting Characteristics on Mineral Surfaces.

Accurate determination of the wetting characteristics on mineral surfaces is critical for many natural processes and industrial applications where multiphase flow in porous media is involved. The wetting behaviors on mineral surfaces are controlled by water-mineral interactions, giving rise to various wetting characteristics, including contact line advancement, formation of precursor films, etc. However, a fundamental understanding of wetting characteristics on different mineral surfaces is still lacking at the molecular level. Here, utilizing a comprehensive set of molecular dynamics simulations, we investigate the wetting characteristics of water on various mineral surfaces and obtain the corresponding water-mineral interaction properties (including the areal density of water-mineral interaction energy and the work of adhesion of the water-mineral interface), mineral wettability, and structural and diffusion properties of water molecules near the surface. We show that the diffusion properties of water molecules on mineral surfaces play an important role in wetting characteristics. We find that the contact line tends to advance forward in the jumping mode or the rolling mode during the wetting process, which depends on the diffusion capacity of the water molecules on mineral surfaces. The corresponding evolution of the solid-liquid friction coefficient during dynamic spreading is also analyzed. We further demonstrate the strong impact of isomorphic substitution and charge-balancing counterions on wetting characteristics on the surfaces of clay minerals. It is shown that the introduction of charge-balancing counterions can shift the mineral surface from strongly hydrophilic to strongly hydrophobic and lead to completely different wetting characteristics. Our results provide a clearer picture of the molecular underpinnings in mineral wetting phenomena and deepen the understanding of the control of water-mineral interactions on the wetting properties.

Three-Dimensional Visualization Reveals Pore-Scale Mechanisms of Colloid Transport and Retention in Two-Phase Flow.

Colloids are ubiquitous in the natural environment, playing an important role in facilitating the transport of absorbed contaminants. However, due to the complexities arising from two-phase flow and difficulties in three-dimensional observations, the detailed mechanisms of colloid transport and retention under two-phase flow are still not well understood. In this work, we visualize the colloid transport and retention during immiscible two-phase flow based on confocal microscopy. We find that the colloid transport and retention behaviors depend strongly on the flow rate and pore/grain size. At low levels of saturation (high flow rate) with the wetting liquid mainly present as pendular rings, the colloids can aggregate at the liquid filaments in small-grain packings and are uniformly distributed in large-grain packings. Through theoretical analysis of the pendular ring geometry, we elucidate the mechanism responsible for the strong dependence of colloid clogging behavior on solid grain size. Our results further demonstrate that even at dilute concentrations, colloids can alter the flow paths and the wetting fluid topology, suggesting a strong two-way coupling dynamics between immiscible two-phase flow and colloid transport and calling for improved predictive models to incorporate the overlooked clogging behavior.

A pore-scale investigation of microplastics migration and deposition during unsaturated flow in porous media.

Microplastics are ubiquitous in the natural environment and have the potential to endanger the natural environment, ecology and even human health. A series of microfluidic experiments by using soft lithography technology were carried out to investigate the effect of flow rate, particle volume fraction, particle size and pore/throat ratio on microplastics migration and deposition at the pore scale. We discovered a range of deposition patterns of the spherical microplastics from no particle deposition, to discontinuous particle layer, and to continuous particle layers in the retained liquid in the pores, depending on the particle size and volume fraction. Several metrics, including air saturation, probability of particle detainment, expansion ratio and thickness of residual liquid, were quantified to examine the role of various parameters on particle migration and retention of microplastics. At low flow rate (Q = 0.05 µL/min), microplastics migration and deposition were sensitive to changes in particle volume fraction, particle size and pore/throat ratio. In contrast, at high flow rates (Q > 5 µL/min), the migration and retention of particles were mainly controlled by strongly channelized air invasion pattern, while the particle volume fraction, particle size and pore/throat size ratio have only secondary influence. At intermediate range of flow rates, microplastics migration and deposition were dramatically impacted by flow rate, particle volume fraction, particle size and pore/throat ratio. This work improves the understanding of the mechanisms of particle migration and retention in porous media and can provide a reference for more accurate assessment of the exposure levels and times of microplastics in soil and groundwater systems.

Decoding Coordinated Directions of Bimanual Movements From EEG Signals.

Bimanual coordination is common in human daily life, whereas current research focused mainly on decoding unimanual movement from electroencephalogram (EEG) signals. Here we developed a brain-computer interface (BCI) paradigm of task-oriented bimanual movements to decode coordinated directions from movement-related cortical potentials (MRCPs) of EEG. Eight healthy subjects participated in the target-reaching task, including (1) performing leftward, midward, and rightward bimanual movements, and (2) performing leftward and rightward unimanual movements. A combined deep learning model of convolution neural network and bidirectional long short-term memory network was proposed to classify movement directions from EEG. Results showed that the average peak classification accuracy for three coordinated directions of bimanual movements reached 73.39 ± 6.35 %. The binary classification accuracies achieved 80.24 ± 6.25 , 82.62 ± 7.82 , and 86.28 ± 5.50 % for leftward versus midward, rightward versus midward and leftward versus rightward, respectively. We also compared the binary classification (leftward versus rightward) of bimanual, left-hand, and right-hand movements, and accuracies achieved 86.28 ± 5.50 %, 75.67 ± 7.18 %, and 77.79 ± 5.65 %, respectively. The results indicated the feasibility of decoding human coordinated directions of task-oriented bimanual movements from EEG.

Continuous Bimanual Trajectory Decoding of Coordinated Movement From EEG Signals.

While many voluntary movements involve bimanual coordination, few attempts have been made to simultaneously decode the trajectory of bimanual movements from electroencephalogram (EEG) signals. In this study, we proposed a novel bimanual brain-computer interface (BCI) paradigm to reconstruct the continuous trajectory of both hands during coordinated movements from EEG. The protocol required human subjects to complete a bimanual reaching task to the left, middle, or right target while EEG data were collected. A multi-task deep learning model combining the EEGNet and long short-term memory network (LSTM) was proposed to decode bimanual trajectories, including position and velocity. Decoding performance was evaluated in terms of the correlation coefficient (CC) and normalized root mean square error (NRMSE) between decoded and real trajectories. Experimental results from 13 human subjects showed that the grand-averaged combined CC values achieved 0.54 and 0.42 for position and velocity decoding, respectively. The corresponding combined NRMSE values were 0.22 and 0.23. Both CC and NRMSE were significantly superior to the chance level (p<0.05). Comparative experiments also indicated that the proposed model significantly outperformed some other commonly-used methods in terms of CC and NRMSE for continuous trajectory decoding. These findings demonstrated the feasibility of simultaneously decoding bimanual trajectory from EEG, indicating the potential of bimanual control for coordinated tasks.

[Clinicopathological Characteristics of Lymphadenitis Caused by Talaromyces marneffei Diagnosed by Core Needle Biopsy].

Objective To analyze the clinicopathological characteristics of lymphadenitis caused by Talaromyces marneffei (TM).Method s The clinical data,pathological features,pathogen examination,and treatment of 15 cases of TM-caused lymphadenitis were analyzed retrospectively.Results The 15 cases included 14 males and 1 females,who were aged 26-67 years,with an average age of (49.1±11.87) years.The 15 cases,including 13 cases of acquired immunodeficiency syndrome and 2 cases of diabetes mellitus,were accompanied by superficial lymph node enlargement in the neck and supraclavicular,axillary,and inguinal regions.The structure of cord-like lymph node tissue punctured by thick needle was completely or partially replaced by inflammatory lesions. Under microscope,8 cases showed mainly diffuse infiltration of phagocytes with pathogens;5 cases presented mainly extensive coagulation necrosis with a small amount of pathogens and nuclear debris;2 cases were characterized by small nodular hyperplasia of fibroblasts,formation of granulomatous structure,and scattered distribution of a few multinucleated giant cells.The pathogens were relatively consistent in size and shape,which were round,oval or sausage-shaped and clustered like mulberry.Diastase periodic acid-Schiff staining and hexamine silver staining highlighted the bacterial structure with transverse septum.TM growth was detected in the blood,alveolar lavage fluid,sputum or lymph node extract fungal culture of the 15 patients.Owing to the adequate antifungal treatment in time,these 15 patients were discharged after their conditions were improved.Conclusion Lymphadenitis is one of the major manifestations of the systemic invasion of TM at the late stage,which is tended to be misdiagnosed.Through core needle biopsy of lymph node,it can be diagnosed as soon as possible to avoid delayed treatment and improve the cure rate.

Pore-Scale Mechanisms of Solid Phase Emergence During DNAPL Remediation by Chemical Oxidation.

In situ chemical oxidation (ISCO) has proven successful in the remediation of aquifers contaminated with dense nonaqueous phase liquids (DNAPLs). However, the treatment efficiency can often be hampered by the formation of solids or gas, reducing the contact between remediation agents and residual DNAPLs. To further improve the efficiency of ISCO, fundamental knowledge is needed about the complex multiphase flow and reactive transport processes as new solid and fluid phases emerge at the microscale. Here, via microfluidic experiments, we study the pore-scale dynamics of trichloroethylene degradation by permanganate. We visualize how the remediation evolves under the influence of solid phase emergence and explore the roles of injection rate, oxidant concentration, and stabilization supplement. Combining image processing, pressure analysis, and stoichiometry calculations, we provide comprehensive descriptions of the oxidant concentration-dependent growth patterns of the solid phase and their impact on the remediation efficiency. We further corroborate the stabilization mechanism provided by phosphate supplement, which is effective in inhibiting solid phase generation and thus highly beneficial for the oxidation remediation. This work elucidates the pore-scale mechanisms during remediation of chlorinated solvents with a particular context in the solid phase production and the associated effects, which is of general significance to understanding various processes in natural and engineered systems involving solid phase emergence or aggregation phenomena, such as groundwater and soil remediation.

Radioactive Iodine Treatment for Thyroid Cancer Patients Increases the Risk of Long-Term Gastrointestinal Disorders: A Nationwide Population-Based Cohort Analysis.

(1) Background: The study aimed to investigate the association between radioactive iodine (RAI) treatment and long-term gastrointestinal disorders including ulcers, atrophic gastritis, and secondary malignant neoplasm of the stomach in patients with thyroid cancer. (2) Methods: The data of the study were extracted from the National Health Insurance Database (NHIRD) of Taiwan between 2000 to 2015. Patients of ages older than 20 with thyroid cancer after thyroidectomy were included and divided into groups with RAI (study cohort) and without RAI (comparison cohort). Multivariate Cox proportional hazards regression analysis and the Kaplan-Meier method were used for statistical analysis. (3) Results: A total of 7250 (with RAI: 5800, without RAI: 1450) patients were included. The Kaplan-Meier analysis revealed a significantly higher cumulative risk for overall gastrointestinal disorders in the group with RAI (log-rank p = 0.034). The risk for gastrointestinal disorders was higher when receiving a cumulative RAI dose higher than 1.11 GBq in the Cox regression analysis. In the subgroup analysis, the risks of gastric and duodenal ulcers are significantly higher in the group with RAI treatment. (4) Conclusions: This study revealed that RAI was associated with an increased risk for long-term gastrointestinal disorders, specifically gastric and duodenal ulcers, in thyroid cancer, especially when the cumulative dose exceeds 1.11 GBq.

Symmetric Convolutional and Adversarial Neural Network Enables Improved Mental Stress Classification From EEG.

Electroencephalography (EEG) is widely used for mental stress classification, but effective feature extraction and transfer across subjects remain challenging due to its variability. In this paper, a novel deep neural network combining convolutional neural network (CNN) and adversarial theory, named symmetric deep convolutional adversarial network (SDCAN), is proposed for stress classification based on EEG. The adversarial inference is introduced to automatically capture invariant and discriminative features from raw EEG, which aims to improve the classification accuracy and generalization ability across subjects. Experiments were conducted with 22 human subjects, where each participant's stress was induced by the Trier Social Stress Test paradigm while EEG was collected. Stress states were then calibrated into four or five stages according to the changing trend of salivary cortisol concentration. The results show that the proposed network achieves improved accuracies of 87.62% and 81.45% on the classification of four and five stages, respectively, compared to conventional CNN methods. Euclidean space data alignment approach (EA) was applied and the improved generalization ability of EA-SDCAN across subjects was also validated via the leave-one-subject-out-cross-validation, with the accuracies of four and five stages being 60.52% and 48.17%, respectively. These findings indicate that the proposed SDCAN network is more feasible and effective for classifying the stages of mental stress based on EEG compared with other conventional methods.

Non-vitamin K oral anticoagulants versus vitamin K antagonists in post transcatheter aortic valve replacement patients with clinical indication for oral anticoagulation: A meta-analysis.

BACKGROUND: Current guidelines recommend oral anticoagulation (OAC) following transcatheter aortic valve replacement (TAVR) in patients with clinical indication, but the optimal antithrombotic regimen remains uncertain. We aimed to compare the efficacy and safety of non-vitamin K oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in patients undergoing TAVR with concomitant indication of OAC. HYPOTHESIS: Comparing with VKAs therapy, NOACs are similar in reducing the all-cause mortality and major bleeding in post-TAVR patients requiring OAC medication. METHODS: We searched the databases of PubMed, Embase, and Cochrane library databases to identify studies that investigated NOACs versus VKAs after TAVR in patients with another indication of OAC, which were published before 28th September 28, 2021. The effectiveness of outcomes was all-cause mortality and stroke or systemic embolism, while the main safety outcome was major and/or life-threatening bleeding. The hazard ratio (HR) with 95% confidence interval (CI) was used as a measure of treatment effect. RESULTS: Our search identified eight studies. We included 4947 post-TAVR patients with another indication of OAC allocated to the NOAC (n = 2146) or VKA groups (n = 2801). There were no significant differences in the all-cause mortality (HR: 0.91, 95% CI: 0.77-1.08, p = .29, I2 = 47%), stroke or systemic embolism (HR: 0.96, 95% CI: 0.68-1.37, p = .84, I2 = 0%), and major and/or life-threatening bleeding (HR: 1.09, 95% CI: 0.89-1.32, p = .40, I2 = 30%) in both groups. CONCLUSION: Among post-TAVR patients who required OAC therapy, NOACs therapy compared to VKAs is similar in reducing the all-cause mortality, stroke or systemic embolism, and major and/or life-threatening bleeding events.

Roles of energy dissipation and asymmetric wettability in spontaneous imbibition dynamics in a nanochannel.

HYPOTHESIS: The imbibition dynamics is controlled by energy dissipation mechanisms and influenced by asymmetric wettability in a nanochannel. We hypothesize that the imbibition dynamics can be described by a combined model of the Lucas-Washburn equation and the Cox-Voinov law considering velocity-dependent contact angles. METHODS: Molecular dynamics simulations are utilized to investigate the imbibition dynamics. A wide range of wetting conditions is achieved via adjusting the liquid-solid interaction parameters, and the spontaneous imbibition processes are quantified and compared. FINDINGS: The critical condition for the occurrence of spontaneous imbibition is analyzed from a surface energy perspective. The analyses of energy conversion and dissipation indicate that the viscous dissipation is dominant during spontaneous imbibition. The classical Lucas-Washburn equation is modified with the Cox-Voinov law considering the effect of the dynamic contact angle and an effective equilibrium contact angle. We show that the proposed theory well captures the imbibition dynamics embodied in the growth of imbibition length as well as the transient interface shape and velocity for both the symmetric and asymmetric wetting conditions. In nanochannels with asymmetric wettability, the imbibition length difference between the sidewalls and interface oscillations increases with wetting disparity. Our findings deepen the understanding of imbibition dynamics on the nanoscale, and provide a theoretical reference for relevant applications.

Structural break-aware pairs trading strategy using deep reinforcement learning.

Pairs trading is an effective statistical arbitrage strategy considering the spread of paired stocks in a stable cointegration relationship. Nevertheless, rapid market changes may break the relationship (namely structural break), which further leads to tremendous loss in intraday trading. In this paper, we design a two-phase pairs trading strategy optimization framework, namely structural break-aware pairs trading strategy (SAPT), by leveraging machine learning techniques. Phase one is a hybrid model extracting frequency- and time-domain features to detect structural breaks. Phase two optimizes pairs trading strategy by sensing important risks, including structural breaks and market-closing risks, with a novel reinforcement learning model. In addition, the transaction cost is factored in a cost-aware objective to avoid significant reduction of profitability. Through large-scale experiments in real Taiwan stock market datasets, SAPT outperforms the state-of-the-art strategies by at least 456% and 934% in terms of profit and Sortino ratio, respectively.