Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.250
Filtrar
1.
IEEE Trans Cybern ; 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32224475

RESUMO

Recently, learning-based representation techniques have been well exploited for grayscale face image hallucination. For color images, the previous methods only handle the luminance component or each color channel individually, without considering the abundant correlations among different channels as well as the inherent geometrical structure of data manifold. In this article, we propose a learning-based model in quaternion space with graph representation for color face hallucination. Instead of the spatial domain, the color image is represented in the quaternion domain to preserve correlations among different color channels. Moreover, a quaternion graph is learned to smooth the quaternion feature space, which helps to not only stabilize the linear system but also enclose the inherent topology structure of quaternion patch manifold. Besides, considering that single low-resolution (LR) image patch can just provide limited informative information in representation, we propose to simultaneously encode the query smaller LR patch as well as a larger patch containing the surrounding pixels seated at the same position in the objective. The larger patch with rich patterns is used to compensate the lost information in the query LR patch, which further enhances the manifold consistency assumption between the LR and HR patch spaces. The experimental results demonstrated the efficiency of the proposed method in hallucinating color face images.

2.
Zhonghua Wai Ke Za Zhi ; 58(4): 295-302, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32241060

RESUMO

Objective: To examine the value of number of metastatic lymph nodes(NMLN), lymph node ratio(LNR) and log odds of metastatic lymph nodes(LODDS) in assessing the prognosis of patients with intrahepatic cholangiocarcinoma(ICC). Methods: The clinical and pathological data of 440 ICC patients who underwent curative-intent resection in 10 of Chinese hepatobiliary surgery centers from January 2010 to December 2018 were collected, and the deadline of follow-up was April 30th, 2019. Among them, 205 were males and 235 were females, with age of (57.0±9.9) years (range:23-83 years).Eighty-five cases (19.3%) had intrahepatic bile duct stones, and 98 cases (22.3%) had chronic viral hepatitis.The Kaplan-Meier method was used for survival analysis. The univariate and multivariate analysis were implemented respectively using the Log-rank test and Cox proportional hazard model. Results: A total of 440 patients underwent curative-intent resection and lymphadenectomy.R0 resection were achieved in 424 cases (96.4%) and R1 resection were in 16 cases (3.6%). The results of postoperative pathological examination showed that high, moderate and poor differentiation was 4.2%(18/426), 60.6%(258/426) and 35.2%(150/426), respectively.Adenocarcinoma was seen in 90.2%(397/440) and non-adenocarcinoma was seen in 9.8%(43/440), respectively. T stage: 2 cases (0.5%) with Tis, 83 cases(18.9%) with T1a, 97 cases(22.0%) with T1b, 95 cases(21.6%) with T2, 122 cases (27.7%) with T3 and 41 cases(9.3%) with T4.The overall median survival time was 24.0 months, and the 1-,3-, and 5-year survival rate was 74.3%, 37.7% and 18.3%, respectively. Lymphatic metastasis occurred in 175 patients(39.8%), the median total number of TNLE(M(Q(R))) was 6(5), the median number of NMLN was 0(1), the median number of LNR was 0 (0.33) and the median number of LODDS was -0.70(-0.92). Rerults of univariate analysis showed that combined stones, pathological differentiation, vascular invasion, LODDS, margin and T staging affected the prognosis (all P<0.05). Rerults of multivariate analysis showed that pathological differentiation, LODDS, margin, and T staging were independent risk factors affecting the prognosis of ICC patients (all P<0.05). Conclusion: LODDS could be used as an optimal prognostic lymph node staging index for ICC, and it is also an independent risk factor for survival after curative intent resection.

3.
Zhonghua Wai Ke Za Zhi ; 58(4): 303-309, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32241061

RESUMO

Objective: To examine the role of the number of lymph nodes examined(NLNE) on the prognosis of patients with curatively resected gallbladder carcinoma(GBC). Methods: The clinicopathological data and prognosis of 401 patients with GBC who underwent radical surgery from six institutions of China from January 2013 to December 2017 were analyzed retrospectively. There were 153 males(38.2%) and 248 females(61.8%), with age of (62.0±10.5) years (range: 30-88 years). Fifty-three patients(22.2%) were accompanied by jaundice. All patients underwent radical resection+regional lymphadenectomy.R0 or R1 resection was confirmed by postoperative pathological examination.The different cut-off values of NLNE were determined by the X-tile software, the optimal cut-off values were identified by analyzing the relationship between different cut-off values of NLNE with survival rate. Kaplan-Meier method was used for survival analysis. Univariate and multivariate analysis were implemented respectively using the Log-rank test and Cox proportional hazard model. Results: Among the 401 patients enrolled, 135 cases (33.6%) had lymphatic metastasis, of which 98 cases were in N1 stage(24.4%) and 37 cases were in N2 stage(9.2%).A total of 2 794 NLNE were retrieved, with a median count of 6 (5).The median positive lymph nodes count was 0 (1), and the median positive lymph nodes ratio was 0 (IQR, 0-0.2). Since the 12 and 15 were determined as the cut-off values by X-tile, all patients were divided into three groups of 1-11, 12-15 and ≥16.The 3-year survival rate of the three groups was 45.2%, 74.5%, 12.0% respectively, with statistically significant difference between three groups (χ(2)=10.94, P<0.01). The results of multivariate analysis showed that NLNE was an independent prognostic factor for overall survival (P<0.05). Further analysis was performed specifically for subgroup of T stages. For T1b patients, the prognosis of the NLNE with 1-7 group was significantly better than that of the ≥8 group(χ(2)=4.610, P<0.05). For T2 patients, the prognosis of the TLNE ≥7 group was significantly better than that of 1 -6 group (χ(2)=4.287, P<0.05). For T3 and T4 patients, the prognosis of the TLNE with 12 - 15 group was significantly better than that of 1 -11 group (χ(2)=5.007, P<0.01) and ≥16 group (χ(2)=10.158, P<0.01). Conclusions: The NLNE is an independent factor affecting the prognosis of patients with GBC.For patients with stage T1b,8 lymph nodes should be retrieved; for patients with stage T2,extensive dissection of more than 6 lymph nodes can significantly improve the prognosis.For advanced patients (stages T3 and T4), extensive dissection with 12-15 lymph nodes is recommended. However, it fails to get more survival benefits by dissecting more than 16 lymph nodes.

4.
Zhonghua Yi Xue Za Zhi ; 100(11): 828-832, 2020 Mar 24.
Artigo em Chinês | MEDLINE | ID: mdl-32234153

RESUMO

Objective: To explore the feasibility of short-term efficacy prognosis prediction model for HCC patients undergoing transcatheter arterial chemoembolization (TACE) based on MRI-based radiomics technique. Methods: A total of 123 patients with liver cancer who received TACE treatment in Lishui Central Hospital from June 2016 to July 2018 were retrospectively collected, including 90 males and 33 females, with an average age of 24-83 (58±10) years. All the patients were pathologically confirmed as hepatocellular carcinoma and underwent MRI scan before surgery.All patients were followed up 3-4 months after TACE, and further divided into training group (n=85, 42 of which were effective and 43 cases were ineffective) and the validation group (n=38, 19 of which were effective and 19 were ineffective) according to the modified response evaluation criteria in solid tumors (mRECIST). There was no statistical difference in the general information between the two groups of patients, which was comparable. Then, preoperative T(2)WI images were used for radiomics analysis, texture parameters were screened based on R language, and short-term efficacy prediction model of TACE for training group and verification group was constructed. Results: T(2)WI image analysis of each patient received 396 different texture parameters, and further used Lasso dimensionality reduction and 10 times cross-validation screening to obtain 5 characteristic texture parameters, specifically stdDeviation, ClusterProminence_angle135_offset4, Correlation_angle135_offset4, Inertia_angle135_offset4, InverseDifferenceMoment_angle45_offset4. According to the above five texture parameters and their corresponding coefficient values, the corresponding radiomics scores (Radscore) were calculated, and the prediction models of the training group and the verification group were further constructed.It was found that the area under the ROC curve of the training group was 0.812 (95%CI: 0.722-0.901), the sensitivity and specificity were 83.7% and 69.0%, respectively. The area under the ROC curve of the validation group was 0.801 (95%CI:0.654-0.947), and the sensitivity and specificity were 89.5% and 63.2%, respectively. Conclusion: The constructed TACE prediction model in the present study has high prediction accuracy, sensitivity and specificity.The short-term efficacy prognosis prediction model for HCC based on MRI is constructed, stable and reliable.

5.
Zhonghua Yi Xue Za Zhi ; 100(11): 853-858, 2020 Mar 24.
Artigo em Chinês | MEDLINE | ID: mdl-32234158

RESUMO

Objective: To detect gene mutation sassociated with deafness in four Waardenburg syndrome (WS) type Ⅱ patients, and to explore the possible mechanism of molecular genetics. Methods: All patients with WS were identified at the genetic and prenatal diagnosis center of the First Affiliated Hospital of Zhengzhou University from August 2015 to December 2018.Clinical materials and peripheral blood were collected from patients and family members. The genes associated with deafness of the patients were tested by next generation sequencing(NGS). And suspected mutations were verified by Sanger sequencing. Results: All patients carried heterozygous mutations in SOX10, they were c.355_356insTCAGGCAGCGC, c.1106_1107insTGGGGCCCCCCACACTA, c.511T>C (p.Y171H), c.91_100del. According to the guidelines for genetic variation of the Amercian College of Medical Genetics and Genomics (ACMG), three frameshift mutations were pathogenic mutations, one missense mutation was likely pathogenic mutation. Conclusion: Application of next generation sequencing technologies make gene diagnosis of Waardenburg syndrome efficiently and accurately.

6.
Zhonghua Er Ke Za Zhi ; 58(4): 301-307, 2020 Apr 02.
Artigo em Chinês | MEDLINE | ID: mdl-32234137

RESUMO

Objective: To investigate the availability, prices and affordability of essential medicines in pediatric population across China, in the hope of improving rational use of medicines. Methods: A multicenter cross-sectional survey of medicine prices, availability and affordability was conducted in 17 provinces, municipalities and autonomous region across east, south-central part, west and north of China. Data on 42 medicines used in pediatric population, both original and generic, were collected in 55 public hospitals from May 26 to June 2, 2017. Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio (MPR) was the ratio of price upon investigation to international reference. Based on national minimum daily wage, affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine. Statistical software SPSS 13.0 was applied for descriptive analysis of availability, MPR and affordability. Results: Mean Availability of original and generic medicine was 33% and 32%, with median MPR being 5.43 and 1.55. Among the 19 medicines with price information for both original and generic product, the median MPR was 7.73 and 2.04 respectively. Regarding the five medicines used to treat four common pediatric diseases (pneumonia,peptic ulcer, congenital hypothyroidism, refractory nephrotic syndrome), the affordability was 0.63 (0.16-6.17) d for generic medicine, and 1.03 (0.16-11.53) d for its original counterpart. Conclusions: The availability to both original and generic products of the 42 medicines used in pediatric population was low in China. The prices of generic medicines seem to be lower and affordability higher than those of original medicines. There is an urgent need to improve the availability and affordability of pediatric medicines.


Assuntos
Preparações Farmacêuticas/economia , Preparações Farmacêuticas/provisão & distribução , Criança , China , Estudos Transversais , Custos de Medicamentos , Medicamentos Genéricos/economia , Medicamentos Genéricos/provisão & distribução , Humanos , Pediatria
7.
Public Health ; 182: 102-109, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32247105

RESUMO

OBJECTIVE: In the context of universal health insurance coverage, this study aimed to determine whether urban-rural inequality still exists in preventive health care (PHC) amongst children in Taiwan. STUDY DESIGN: Prospective cohort study. METHODS: A total of 184,117 mothers and their children born in 2009 were identified as the study cohort. The number of children born in urban, satellite and rural areas was 40,176, 57,565 and 86,805, respectively. All children were followed for 7 years, before which a total of seven times PHC were provided by Taiwan's National Health Insurance (NHI) programme. Ordinal logistic regression models were used to associate urbanisation level with the frequency of PHC utilisation. Stratified analyses were further performed in accordance with the children's birth weight and the mothers' birthplace. RESULTS: Children from satellite areas had higher utilisation for the first four scheduled PHC visits. Children living in urban areas received more PHC for the fifth and sixth scheduled visits. Compared with those from rural areas, children in satellite areas exhibited a small but significant increase in odds in PHC utilisation, with a covariate-adjusted odds ratio (aOR) of 1.04 and 95% confidence interval (CI) of 1.02-1.06. By contrast, no significant difference was observed between rural and urban areas (aOR = 1.01). Further stratified analyses suggest more evident urban-rural difference in PHC utilisation amongst children with low birth weight and foreign-born mothers. CONCLUSIONS: Given a universal health insurance coverage and embedded mechanisms in increasing the availability of healthcare resources in Taiwan, a slight urban-rural difference is observed in PHC utilisation amongst children. Hence, sociodemographic inequality in utilisation of PHC still exists. This issue should be addressed through policy intervention.

8.
Osteoporos Int ; 2020 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-32246167

RESUMO

The receptor activator of nuclear factor-kappa B ligand (RANKL)/RANK/osteoprotegerin system is dysregulated in hyperparathyroid bone diseases. The introduction of denosumab preceding elective surgery as an alternative option when surgery is not possible immediately. INTRODUCTION: The effects of denosumab on vascular calcification in patients with chronic renal failure and low bone mass have been a subject of interest. Therefore, this investigation aimed to determine the short-term changes in vascular calcification after denosumab treatment using a serial electrocardiography-gated computed tomography (CT) to measure coronary artery calcification (CAC) in patients with secondary hyperparathyroidism (SHPT) and low bone mass. METHODS: This 6-month study enrolled patients with SHPT and low bone mass (T-score < - 2.5) owing to dialysis. The 2 groups administered denosumab at a dose of 60 mg (denosumab group), and conventional treatment (control group) had 21 patients each. All patients underwent CT scans at baseline and at the follow-up examination at 6 months to determine the bone mineral density and CAC. RESULTS: The control group demonstrated a significant increase in Agatston scores (187.79 ± 72.27) (P = 0.004). However, no significant change was noted in the denosumab group (P = 0.41). In the denosumab group, only the baseline serum alkaline phosphatase levels correlated negatively with changes in the CAC score (P = 0.01); the baseline alkaline phosphatase levels were the deciding biomarkers for non-responsive CAC scores by Berry Criteria after denosumab treatment (P = 0.02). The denosumab group demonstrated significantly increased bone mineral density in the femoral neck and lumbar spine (P < 0.01). CONCLUSION: The findings provide evidence that denosumab may suppress the progression of CAC and also regress osseous calcification in severe cases of high bone turnover.

10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 207-212, 2020 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-32164131

RESUMO

Objective: To detect the spatial clustering and high risk areas of pulmonary tuberculosis (PTB) in Sichuan province in 2018 and, to compare the effects of application on both SaTScan 9.4.1 software and FleXScan 3.1.2 software to detect the PTB spatial clusters. Methods: Geographic information database was established by using the incidence data of PTB and demographic data reported in the 'China disease prevention of infectious disease reporting information management system' in Sichuan province in 2018. Spatial clustering analysis was conducted using the Poisson model in software SaTScan 9.4.1 and FleXScan 3.1.2 to detect the high risk areas of PTB by software ArcGIS 10.5. Differences of clusters locations and scopes in the two scanning methods were compared. Results: The reported incidence rate of PTB was 57.34/100 000 (47 601 cases) in Sichuan province in 2018, presenting an obvious clustering distribution. SaTScan and FleXScan scanned 8 and 10 clusters showed statistically significant differences (P<0.05), with log-likelihood ratio (LLR) as 24.62-2 416.05 and 1.48-2 618.96, respectively. Results from scanning of the two methods showed that the most likely clusters appeared in the Daliangshan and Xiaoliangshan of Liangshan Yi ethnic aggregation areas. The other clustering areas would include some minority areas in the western Sichuan plateau, detected by both two methods differences in the shape and scope of the clustering were detected by both methods. The clustering scopes detected by SaTScan covered some counties, in which the actual incidence was not high. FleXScan could distinguish the clusters and detect more irregular shaped clusters. Conclusions: Obvious spatial clusters of PTB distribution were found in Sichuan in 2018. Areas of Daliangshan, Xiaoliangshan and the minority areas in Western Sichuan plateau appeared at high risk, suggesting these were the key areas for prevention and control. FleXScan seemed more conducive in accurately distinguishing the "cold spot" areas in the highly aggregated areas, and more suitable for the application of spatial clustering detection for TB, in Sichuan province.

11.
IEEE Trans Cybern ; 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32175888

RESUMO

The wide availability of online social networks (OSNs) facilitates positive information spread and sharing. However, the high autonomy and openness of the OSNs also allow for the rapid spread of negative information, such as unsubstantiated rumors and other forms of misinformation that often elicit widespread public cognitive misleads and huge economic losses. Therefore, how to effectively control the negative information spread accompanied by positive information has emerged as a challenging issue. Unfortunately, this issue still remains largely unexplored to date. To fill this gap, we propose an efficient feedback control mechanism for the simultaneous spread of the positive and negative information in OSNs. Specifically, a novel computational model is first proposed to present the temporal dynamics of the positive and negative information spread. Furthermore, the proposed mechanism restrains the negative information spread with minimal system expenses by devising and performing three synergetic intervention strategies. Technically, this mechanism intensively evaluates the number of seed users performing three intervention strategies. Besides, each seed user performs the received control task independently, and then the control plan for the next time step is adjusted dynamically according to the previous feedback results. Finally, we evaluate the efficiency of the proposed mechanism based on the extensive experimental results obtained from two real-world networks.

12.
Fa Yi Xue Za Zhi ; 36(1): 16-20, 2020 Feb 25.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32198986

RESUMO

Abstract: Since 2003, coronavirus has caused multiple major public health events that resulted in global epidemics such as, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and corona virus disease 2019 (COVID-19). Especially since COVID-19 has outbroken in Wuhan, Hubei, in December 2019, coronavirus has had a significant impact on people's health and lives. But so far, the pathological diagnosis of COVID-19 has been relatively deficient: it is still confined to the pathological findings of punctured organs, and the majority of medical workers have poor awareness of its pathological characteristics. The COVID-19, as same as SARS and MERS, is caused by coronaviruses and can cause viral pneumonia. They have certain similarities. This article comprehensively reviews the pathological features observed in the autopsies of the aforementioned three diseases, in order to provide reference to the analysis of pathological changes of COVID-19.

13.
J Nutr Health Aging ; 24(3): 330-338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32115616

RESUMO

OBJECTIVES: The oldest old population has become the fastest growing segment with excess need of care and social support, it is crucial to improve the health-related quality of life (HRQoL) of these populations. This study seeks to evaluate the health status and to investigate modifiable factors associated with health-related quality of life for oldest old adults in China. DESIGN: A cross-sectional population-based study. SETTING: Hainan Province in the south of China. PARTICIPANTS: 1,278 adults aged 80 years or older. METHODS: HRQoL was assessed by three-level EuroQol-5D scale (EQ-5D-3L) and a visual analogue scale (VAS). Demographic and health-related variables were analysed by estimating mean values and standard deviations for continuous variables, percentages and standard deviations for categorical variables. Tobit regressions, ordinary least Squared (OLS) regressions and ordered probit regressions were adopted to determine the associated factors for overall HRQoL and for each health dimension. RESULTS: Anxiety/depression was the least reported problem while mobility was the most frequently reported with problem. Female respondents had lower EQ-5D score (0.76 vs. 0.86) and VAS score (66.55 vs. 69.84) than male respondents. Better health-related quality of life was significantly associated with higher BMI, no drinking habit, more leisure activities, living with family members, good sleeping quality, closer social and family connections, fewer numbers of drugs consumed per day, without having hearing or visual impairment, and fewer chronic conditions, after controlling for potential confounders. CONCLUSION: Findings from this study suggested that quality of life was not only associated with age-related diseases, but also correlated with a range of health-related lifestyles, and factors indicating social and family support.

14.
IEEE Trans Cybern ; 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32203051

RESUMO

This article proposes a novel regularization deep cascade broad learning system (DCBLS) architecture, which includes one cascaded feature mapping nodes layer and one cascaded enhancement nodes layer. Then, the transformation feature representation is easily obtained by incorporating the enhancement nodes and the feature mapping nodes. Once such a representation is established, a final output layer is constructed by implementing a simple convex optimization model. Furthermore, a parallelization framework on the new method is designed to make it compatible with large-scale data. Simultaneously, an adaptive regularization parameter criterion is adopted under some conditions. Moreover, the stability and error estimate of this method are discussed and proved mathematically. The proposed method could extract sufficient available information from the raw data compared with the standard broad learning system and could achieve compellent successes in image denoising. The experiments results on benchmark datasets, including natural images as well as hyperspectral images, verify the effectiveness and superiority of the proposed method in comparison with the state-of-the-art approaches for image denoising.

15.
Zhonghua Nei Ke Za Zhi ; 59(4): 297-302, 2020 Apr 01.
Artigo em Chinês | MEDLINE | ID: mdl-32209196

RESUMO

Objective: To study the clinical characteristics and classification of gastric neuroendocrine neoplasm(NEN) and prognostic factors of mixed adenoneuroendocrine carcinoma (MANEC) and gastric neuroendocrine carcinoma(NEC). Methods: A total of 148 gastric NENs were divided into type Ⅰ, type Ⅱ and type Ⅲ based on the classification of European Neuroendocrine Tumor Society (ENETS). Kaplan-Meier test and Cox regression model were used in univariate and multivariate survival analysis in 108 cases with pathological G3 gastric NEN. Results: In this study, the percentages of type Ⅰ, type Ⅱ and type Ⅲ were 25.0%(37), 3.4%(5) and 71.6%(106) respectively. Among type Ⅰ patients, 28(75.7%) lesions were located in gastric fundus or body, 29(78.4%) had bumps. Lymph node involvement was found in 4 (10.8%) patients. Twenty-six (70.3%) patients received endoscopic treatment and 11 (29.7%) with surgery. All 5 type Ⅱ patients presented lesions in gastric fundus or body, including 4 with ulcers, who were all treated by endoscope. Three type Ⅱ patients had gastrinoma, and 2 combined with multiple endocrine neoplasmⅠ. In type Ⅲ patients, 56(52.8%) showed ulcerative lesions. The majority of patients (102, 96.2%) had a single lesion, 94(88.7%) with lymph node or other organ metastasis. In this study, no deaths were reported in gastric NEN with a pathological grade of G1 or G2. The mortality rate was 38.9%(42/108) in patients with G3 NEN. Survival analysis suggested that age, metastasis of tumor were associated with poor prognosis (P=0.041, 0.025). Conclusions: Patients with gastric NEN have heterogenous clinical presentations according to gender, age, endoscopic features, infiltration and metastasis, and pathological grade. Aging and metastasis are negative prognostic factors of G3 gastric NEN.

16.
Zhonghua Shao Shang Za Zhi ; 36(0): E005, 2020 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-32114747

RESUMO

Corona Virus Disease 2019 (COVID-19) has seriously affected the treatment of patients and social stability. In the later stage of disease, some COVID-19 patients may develop into acute respiratory distress syndrome or even multiple organ failure. However, one of the most important mechanism underlying the deterioration of disease is cytokine storm. At present, some therapies such as interleukin-6 antibody blocker, stem cell therapy, and transfusion of convalescent plasma have been applied to counteract the cytokine storm and have made some progress. This article reviews the influences of cytokine storm syndrome on the COVID-19 and the corresponding immunotherapies to resist cytokine storm.

17.
J Hosp Med ; 15(2): e1-e8, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32118564

RESUMO

BACKGROUND AND OBJECTIVES: Understanding disparities in child health-related quality of life (HRQoL) may reveal opportunities for targeted improvement. This study examined associations between social disadvantage, access to care, and child physical functioning before and after hospitalization for acute respiratory illness. METHODS: From July 1, 2014, to June 30, 2016, children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children's hospitals for three common respiratory illnesses completed a survey on admission and within 2 to 8 weeks after discharge. Survey items assessed social disadvantage (minority race/ ethnicity, limited English proficiency, low education, and low income), difficulty/delays accessing care, and baseline and follow-up HRQoL physical functioning using the Pediatric Quality of Life Inventory (PedsQL, range 0-100). We examined associations between these three variables at baseline and follow-up using multivariable, mixed-effects linear regression models with multiple imputation sensitivity analyses for missing data. RESULTS: A total of 1,325 patients and/or their caregivers completed both PedsQL assessments. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage markers, compared with those of patients with none (78.7 for >3 markers versus 85.5 for no markers, difference -6.1 points (95% CI: -8.7, -3.5). The number of social disadvantage markers was not associated with mean follow-up PedsQL scores. Difficulty/delays accessing care were associated with lower PedsQL scores at both time points, but it was not a significant effect modifier between social disadvantage and PedsQL scores. CONCLUSIONS: Having social disadvantage markers or difficulty/delays accessing care was associated with lower baseline physical functioning; however, differences were reduced after hospital discharge.

18.
IEEE Trans Cybern ; 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32112691

RESUMO

This article investigates a fuzzy adaptive two-bit-triggered control for uncertain nonlinear systems with actuator failures and dead-zone constraint. Actuator failures and dead-zone constraint exist frequently in practical systems, which will affect the system performance greatly. Based on the improved fuzzy-logic systems (FLSs), a fuzzy adaptive compensation control is established to address these issues. The approximation error is introduced to the control design as a time-varying function. In addition, for the limited transmission resources of the practical system, a two-bit-triggered control mechanism is proposed to further save system transmission resources. It is proved that the proposed method can guarantee the system tracking performance and all the signals are bounded. Its effectiveness is verified by the simulation examples.

19.
IEEE Trans Cybern ; 2020 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-32149672

RESUMO

Constrained autonomous vehicle overtaking trajectories are usually difficult to generate due to certain practical requirements and complex environmental limitations. This problem becomes more challenging when multiple contradicting objectives are required to be optimized and the on-road objects to be overtaken are irregularly placed. In this article, a novel swarm intelligence-based algorithm is proposed for producing the multiobjective optimal overtaking trajectory of autonomous ground vehicles. The proposed method solves a multiobjective optimal control model in order to optimize the maneuver time duration, the trajectory smoothness, and the vehicle visibility, while taking into account different types of mission-dependent constraints. However, one problem that could have an impact on the optimization process is the selection of algorithm control parameters. To desensitize the negative influence, a novel fuzzy adaptive strategy is proposed and embedded in the algorithm framework. This allows the optimization process to dynamically balance the local exploitation and global exploration, thereby exploring the tradeoff between objectives more effectively. The performance of using the designed fuzzy adaptive multiobjective method is analyzed and validated by executing a number of simulation studies. The results confirm the effectiveness of applying the proposed algorithm to produce multiobjective optimal overtaking trajectories for autonomous ground vehicles. Moreover, the comparison to other state-of-the-art multiobjective optimization schemes shows that the designed strategy tends to be more capable in terms of producing a set of widespread and high-quality Pareto-optimal solutions.

20.
Zhonghua Xin Xue Guan Bing Za Zhi ; 48(0): E008, 2020 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-32141280

RESUMO

Objective: To evaluate the cardiovascular damage of patients with COVID-19, and determine the correlation of serum N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin-I (cTnI) with the severity of COVID-19, and the impact of concomitant cardiovascular disease on severity of COVID-19 was also evaluated. Methods: A cross-sectional study was designed on 150 consecutive patients with COVID-19 in the fever clinic of Tongji Hospital in Wuhan from January to February in 2020, including 126 mild cases and 24 cases in critical care. Both univariate and multivariate logistic regression were used to analyze the correlation of past medical history including hypertension, diabetes and coronary heart disease (CHD) , as well as the levels of serum NT-proBNP and cTnI to the disease severity of COVID-19 patients. Results: Age, hypersensitive C-reactive protein(hs-CRP) and serum creatinine levels of the patients were higher in critical care cases than in mild cases(all P<0.05). Prevalence of male, elevated NT-proBNP and cTnI, hypertension and coronary heart disease were significantly higher in critical cases care patients than in the mild cases(all P<0.05). Univariate logistic regression analysis showed that age, male, elevated NT-proBNP, elevated cTnI, elevated hs-CRP, elevated serum creatinine, hypertension, and CHD were significantly correlated with critical disease status(all P<0.05). Multivariate logistic regression analysis showed that elevated cTnI(OR=26.909, 95%CI 4.086-177.226, P=0.001) and CHD (OR=16.609, 95%CI 2.288-120.577, P=0.005) were the independent risk factors of critical disease status. Conclusions: COVID-19 can significantly affect the heart function and lead to myocardial injury. The past medical history of CHD and increased level of cTnI are two independent determinants of clinical disease status in patients with COVID-19.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA