In recent years,with the rapid development of the Chinese economy,the“two sessions”in March of every year which sponsored by the ministry of foreign affairs attract more and more journalists from all over the world....In recent years,with the rapid development of the Chinese economy,the“two sessions”in March of every year which sponsored by the ministry of foreign affairs attract more and more journalists from all over the world.The press conference in the“two sessions”likes an important window to show China’s policies and claims to the world.Meanwhile,the premier who answers questions in the press conference,respectively,shows the world the eloquence and polite manners of China’s premier,such as Premier Wen Jiabao and Premier Li Keqiang.Their astute response,excellent,and emotional expression makes a deep impression on audiences.Moreover,as a bridge between the speaker and the listeners,the interpretation once is incorrect will cause some mistakes even conflicts.Therefore,the interpreter plays a most important role in the press conference.How to improve the interpretation level in the press conference is a significant topic.The thesis mainly introduces the content of press conference interpreting from 2012 to 2014.At present,the practical study of press conference interpretation is far from enough.The last part gives the summary of the study and points out the main findings for the further study.展开更多
The total number of cancer patients who are eligible for and will benefit from immune checkpoint inhibitors(ICIs)in China has not been quantified.This cross-sectional study was conducted to estimate the number of Chin...The total number of cancer patients who are eligible for and will benefit from immune checkpoint inhibitors(ICIs)in China has not been quantified.This cross-sectional study was conducted to estimate the number of Chinese cancer patients with eligibility and response to ICIs based on the 2015 Chinese cancer statistics and the immune checkpoint inhibitor clinical practice guideline of the Chinese Society of Clinical Oncology.A total of 11 ICIs were recommended for 17 cancer types.The estimated number of eligible patients annually was 1290156(55.18%),which included 888738 males(60.05%)and 400468 females(46.67%).The estimated number of responders annually was 448972(19.20%),which included 309023 males(20.88%)and 139764 females(16.29%).Gastric cancer(n=291000,12.45%),non-small-cell lung cancer(n=289629,12.39%),and hepatocellular carcinoma(n=277100,11.85%)were the top three cancer types with the highest number of eligible patients.Non-small-cell lung cancer(n=180022,7.70%),hepatocellular carcinoma(n=75648,3.24%),and small-cell lung cancer(n=64362,2.75%)were the top three cancer types with the highest number of responders.In conclusion,ICIs provide considerable benefit in Chinese cancer patients under optimal estimation.展开更多
Fabric dyeing is a critical production process in the clothing industry and heavily relies on batch processing machines(BPM).In this study,the parallel BPM scheduling problem with machine eligibility in fabric dyeing ...Fabric dyeing is a critical production process in the clothing industry and heavily relies on batch processing machines(BPM).In this study,the parallel BPM scheduling problem with machine eligibility in fabric dyeing is considered,and an adaptive cooperated shuffled frog-leaping algorithm(ACSFLA)is proposed to minimize makespan and total tardiness simultaneously.ACSFLA determines the search times for each memeplex based on its quality,with more searches in high-quality memeplexes.An adaptive cooperated and diversified search mechanism is applied,dynamically adjusting search strategies for each memeplex based on their dominance relationships and quality.During the cooperated search,ACSFLA uses a segmented and dynamic targeted search approach,while in non-cooperated scenarios,the search focuses on local search around superior solutions to improve efficiency.Furthermore,ACSFLA employs adaptive population division and partial population shuffling strategies.Through these strategies,memeplexes with low evolutionary potential are selected for reconstruction in the next generation,while thosewithhighevolutionarypotential are retained to continue their evolution.Toevaluate the performance of ACSFLA,comparative experiments were conducted using ACSFLA,SFLA,ASFLA,MOABC,and NSGA-CC in 90 instances.The computational results reveal that ACSFLA outperforms the other algorithms in 78 of the 90 test cases,highlighting its advantages in solving the parallel BPM scheduling problem with machine eligibility.展开更多
Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the waitl...Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the waitlist an increase in the number of donors is necessary. Patients with devastating irreversible brain injury, if medically suitable, are potential deceased donors and strategies are needed to successfully convert them into actual donors. Multiple steps in the process of deceased organ donation can be targeted to increase the number of organs suitable for transplant. In this review, after describing this process, we discuss current challenges and potential strategies to expand the pool of deceased donors.展开更多
We present a novel scheme for embedding secret data into a binary image without introducing noticeable artifacts. Unlike some block-based methods, the proposed scheme encodes the secret bits directly into boundary pix...We present a novel scheme for embedding secret data into a binary image without introducing noticeable artifacts. Unlike some block-based methods, the proposed scheme encodes the secret bits directly into boundary pixels by checking each pixel of the cover image in a pseudo-random order for embedding eligibility. A set of rules ensures correct identification of data-carrying pixels in blind extraction. The proposed scheme does not generate isolated dots, and can incorporate various coding methods such as matrix encoding to further improve the embedding performance. It is shown that up to one fourth of the boundary pixels may be used to carry secret data. Experimental results indicate that the method can achieve good visual quality with fairly large data capacity.展开更多
Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of ...Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.展开更多
Although hepatocellular carcinoma is considered a highly lethal malignancy,recent therapeutic advances have been achieved during the last 10 years.This scenario resulted in an unprecedented improvement in survival for...Although hepatocellular carcinoma is considered a highly lethal malignancy,recent therapeutic advances have been achieved during the last 10 years.This scenario resulted in an unprecedented improvement in survival for patients with advanced hepatocellular carcinoma,almost reaching 20-26 mo of overall survival after first-second line sequential treatment.The advent of the combination of atezolizumab with bevacizumab showed,for the first time,superiority over sorafenib with improvement in overall survival.However,first and second-line trials were correctly based on the premise that a strict selection of patients enhances the power to capture the positive effect of treatment by excluding competing risks for mortality such as liver failure,decompensated cirrhosis or other underlying medical conditions.As a result,the inclusion criteria used in clinical trials do not support the use of novel therapies in several real-world scenarios involving underrepresented subgroups,such as patients with unpreserved liver function,other comorbid conditions,a history of solid-organ transplantation,autoimmune disorders and those with a high risk of bleeding.The present text aims at discussing treatment strategies in these subgroups.展开更多
Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have b...Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases.The European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line evaluation.Nevertheless,transthoracic echocardiography has been hypothesized to have a primary role in the PPs.This review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's heart.Once properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.展开更多
The application of reinforcement learning is widely used by multi-agent systems in recent years. An agent uses a multi-agent system to cooperate with other agents to accomplish the given task, and one agent′s behavio...The application of reinforcement learning is widely used by multi-agent systems in recent years. An agent uses a multi-agent system to cooperate with other agents to accomplish the given task, and one agent′s behavior usually affects the others′ behaviors. In traditional reinforcement learning, one agent takes the others location, so it is difficult to consider the others′ behavior, which decreases the learning efficiency. This paper proposes multi-agent reinforcement learning with cooperation based on eligibility traces, i.e. one agent estimates the other agent′s behavior with the other agent′s eligibility traces. The results of this simulation prove the validity of the proposed learning method.展开更多
BACKGROUND Few studies have evaluated the frequency of and the reasons behind the refusal of listing liver transplantation candidates.AIM To assess the ineligibility rate for liver transplantation and its motivations....BACKGROUND Few studies have evaluated the frequency of and the reasons behind the refusal of listing liver transplantation candidates.AIM To assess the ineligibility rate for liver transplantation and its motivations.METHODS A single-center retrospective study was conducted on adult patients which entailed a formal multidisciplinary assessment for liver transplantation eligibility.The predictors for listing were evaluated using multivariable logistic regression.RESULTS In our center,314 patients underwent multidisciplinary work-up before liver transplantation enlisting over a three-year period.The most frequent reasons for transplant evaluation were decompensated cirrhosis(51.6%)and hepatocellular carcinoma(35.7%).The non-listing rate was 53.8%and the transplant rate was 34.4%for the whole cohort.Two hundred and five motivations for ineligibility were collected.The most common contraindications were psychological(9.3%),cardiovascular(6.8%),and surgical(5.9%).Inappropriate or premature referral accounted for 76(37.1%)cases.On multivariable analysis,a referral from another hospital(OR:2.113;95%CI:1.259–3.548)served as an independent predictor of non-listing.CONCLUSION A non-listing decision occurred in half of our cohort and was based on an inappropriate or premature referral in one case out of three.The referral from another hospital was taken as a strong predictor of non-listing.展开更多
Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility ...Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.展开更多
From the author, there are not less than a dozen of rather significant recent publications in scientific editions anticipating some aspects of importance to innovation such as “bigger data”, AI, IP, and frontier tec...From the author, there are not less than a dozen of rather significant recent publications in scientific editions anticipating some aspects of importance to innovation such as “bigger data”, AI, IP, and frontier technology with a central massive contribution in 2020 on AI, IP, and EI. Nonetheless, the IP associated with AI remains still barely covered in scientific publications. Especially patent discussion tends to be rather a legal matter. Another trilogy, 2013, “Business Strategy-IP Strategy-R&D Strategy: An All-in-One Business Model” proposed by the author, marked the advent, and customized implementation of a new strategy level. After the two trilogies’ volumes, the AI-IP “accessibility” chapter was a logical step brought to the attention of a larger public by the author. The time now to bring to light another chapter, namely the IP eligibility of AI innovation steps in ad hoc inventions. The main objectives of this short, principally illustrated communication, are to: 1) Revise the best mode requirement status, i.e. the best way to enable the reproducibility of claimed matter, reviewing its need for improvement when AI is involved. And proposing a unique sequence of evolution inspired by IP’s current and evolving practices. 2) Give a new dimension to visual aids to help the Best Mode description, demystify AI complexity, and underline frontier traits that may hinder a confident adoption or well-argued rejection. 3) Further illustrations take into account the fact that IoT, AI, and 3D can be simpler than perceived. 4) Finally ATA©, Adjacent Technology Analysis, is timely refreshed in a unique challenging, indeed tumultuous, environment. 5) Bias, such as semantic ones is consistently monitored. 6) Overall leaving space for innovative pleasurable interpretation. The emphasis is on educational, illustrative and demonstrative value.展开更多
CD38 is highly expressed on various immune cells,including long-lived plasma cells,making it a potential therapeutic target in autoimmune diseases.This phase Ib/IIa study aimed to explore the safety,pharmacokinetics,p...CD38 is highly expressed on various immune cells,including long-lived plasma cells,making it a potential therapeutic target in autoimmune diseases.This phase Ib/IIa study aimed to explore the safety,pharmacokinetics,pharmacodynamics,and preliminary efficacy of CM313,an anti-CD38 antibody,in patients with systemic lupus erythematosus(SLE).Eligible patients were sequentially enrolled in four ascending dose groups(2,4,8,and 16 mg/kg)and randomized 4:1 to receive CM313 or placebo intravenously at days 1,29,36,43,and 50.The primary endpoint was safety,and efficacy was exploratorily investigated.Between October 14,2022,and March 7,2024,40 patients were enrolled,including 8 patients in each CM313 dose group and the pooled placebo group.Adverse events occurred in 90.6%and 62.5%of participants receiving CM313 and placebo,all of which were mild or moderate.Upper respiratory tract infection(87.5%/62.5%vs.12.5%),urinary tract infection(12.5%/25.0%vs.0),and herpes zoster(25.0%/0 vs.0)were more frequent in CM3138 and 16 mg/kg groups than the placebo group.The CM313 groups had greater reductions in antids-DNA antibodies,immunoglobulin G(IgG),IgA,IgM,IgE,and greater increases in complement C3 and C4 compared with placebo.Systemic Lupus Erythematosus Responder Index-4 response rates were 33.3%,40.0%,62.5%,71.4%,and 37.5%in CM3132,4,8,16 mg/kg,and placebo groups at day 57,respectively.CM313 showed a manageable safety profile in SLE patients at 2–16 mg/kg and encouraging clinical efficacy at 8 and 16 mg/kg.The results support further investigation of CM313 for treating SLE patients(ClinicalTrials.gov ID:NCT05465707).展开更多
Objective To explore the impact of baseline remnant cholesterol levels at a single time point and cumulative remnant cholesterol exposure on the progression trajectories of arterial stiffness.Methods This prospective ...Objective To explore the impact of baseline remnant cholesterol levels at a single time point and cumulative remnant cholesterol exposure on the progression trajectories of arterial stiffness.Methods This prospective cohort study included 2401 eligible participants from the Beijing Health Management Cohort who consecutively attended health examinations in 2010-2011,2012-2013,and 2014-2015.The remnant cholesterol value measured in 2014-2015 served as the baseline remnant cholesterol level at a single time point.The cumulative exposure indices were calculated based on remnant cholesterol values from three health examinations from 2010 to 2015,including cumulative exposure,cumulative exposure burden,and duration of high remnant cholesterol exposure.Arterial stiffness was assessed by brachialankle pulse wave velocity(baPWV).The follow-up continued until December 31,2019,with annual checkups.During the follow-up period,a group-based trajectory model was employed to construct the progression trajectories of baPWV.The associations between the baseline remnant cholesterol level,cumulative exposure indices of remnant cholesterolandbaPWV trajectories were examined using ordinal logisticcregression models,adjusting for traditional cardiovascular risk factors and low-density lipoprotein cholesterol(LDL-C)levels.Results The age of the 2401 participants was 61(54,69)years,with 1801(75.01%)being male.The group-based trajectory model indicated that the best-fit model categorized the participants into three subgroups:low-rising group(1036 individuals,43.15%),moderaterising group(1137 individuals,47.36%),and highrising group(228 individuals,9.50%).After adjusting for traditional cardiovascular risk factors,baseline remnant cholesterol levels at a single point(OR=1.170,95%Cl:1.074-1.274),cumulative remnant cholesterol exposure(0R=1.194,95%Cl:1.096-1.303),cumulative remnant cholesterol exposure burden(OR=1.270,95%CI:1.071-1.507),and high-remnant cholesterol exposure duration(6 years:OR=1.351,95%Cl:1.077-1.695)were significantly associated with the risk of developing a poor baPWV progression trajectory.TTheseresults remainedsignificanttafter adjusting for cumulative average LDL-C levels.The association between baseline remnant cholesterol levels and baPWV progression became insignificant after adjusting for cumulative remnant cholesterol levels(OR=1.053,95%CI:0.923-1.197),while the association between cumulative remnant cholesterol exposure and baPWV progression remained significant after adjusting for baseline remnant cholesterol levels(OR=1.145,95%CI:1.008-1.305).Conclusion Higher levels of baseline remnant cholesterol and cumulative remnant cholesterol are independent risk factors forthe progression of arterial stiffness.Theseassociations remain significant even after adjusting for traditional cardiovascularrisk factorsandLDL-Clevels.Furthermore,the effect of cumulative remnant cholesterol levels on the progression of arterial stiffness is stronger than the effect of baseline remnant cholesterol levels.展开更多
Trial eligibility criteria,which define an appropriate evaluable population through inclusion and exclusion criteria,are fundamental for reliable evidence and should be tailored to the question that the trial sets out...Trial eligibility criteria,which define an appropriate evaluable population through inclusion and exclusion criteria,are fundamental for reliable evidence and should be tailored to the question that the trial sets out to answer[1].However,exclusion criteria for cancer trials have become increasingly restrictive over the years,with the median number increased from 21 in 1986 to 46 in 2016[2,3].These restrictive exclusion criteria have created substantial barriers to patient access to novel therapies,hindered trial recruitment and limited the generalizability of trial results,presenting not only practical and scientific problem,but also raises important issues of equity that affect everyone[4].展开更多
INTRODUCTION The National Health Service(NHS)cervical screeningprogramme has significantly reduced the incidence and mortality of cervical cancer.However,this vital service may not reach the whole eligible population....INTRODUCTION The National Health Service(NHS)cervical screeningprogramme has significantly reduced the incidence and mortality of cervical cancer.However,this vital service may not reach the whole eligible population.The national coverage remains below the 80%target,with only 68.7%of eligible people screened in 2023 in England.展开更多
Hepatitis B virus(HBV)infection remains a major global health issue,with nearly 86 million people in China living with chronic hepatitis B(CHB).1 Recommendations for antiviral treatment are based on a comprehensive as...Hepatitis B virus(HBV)infection remains a major global health issue,with nearly 86 million people in China living with chronic hepatitis B(CHB).1 Recommendations for antiviral treatment are based on a comprehensive assessment of serum HBV DNA levels,alanine transaminase(ALT)levels,severity of liver disease,and risk factors such as age and family history.Although ALT is a key indicator for initiating antiviral therapy,the treatment thresholds recommended by major international guidelines vary significantly.In 2024,the World Health Organization(WHO)published updated guidelines for CHB,recommending an upper limit of normal(ULN)for ALT of 30 U/L for males and 19 U/L for females.2 The European Association for the Study of the Liver(EASL)2017 guideline,and the Asia Pacific Association for the Study of the Liver(APASL)2015 guideline defined a ULN for ALT of 40 U/L for both males and females.展开更多
文摘In recent years,with the rapid development of the Chinese economy,the“two sessions”in March of every year which sponsored by the ministry of foreign affairs attract more and more journalists from all over the world.The press conference in the“two sessions”likes an important window to show China’s policies and claims to the world.Meanwhile,the premier who answers questions in the press conference,respectively,shows the world the eloquence and polite manners of China’s premier,such as Premier Wen Jiabao and Premier Li Keqiang.Their astute response,excellent,and emotional expression makes a deep impression on audiences.Moreover,as a bridge between the speaker and the listeners,the interpretation once is incorrect will cause some mistakes even conflicts.Therefore,the interpreter plays a most important role in the press conference.How to improve the interpretation level in the press conference is a significant topic.The thesis mainly introduces the content of press conference interpreting from 2012 to 2014.At present,the practical study of press conference interpretation is far from enough.The last part gives the summary of the study and points out the main findings for the further study.
基金This work was supported by the National Natural Science Foundation of China(No.61435001)CAMS Innovation Fund for Medical Sciences(Nos.2017-I2M-4-003 and 2016-I2M-1-001).
文摘The total number of cancer patients who are eligible for and will benefit from immune checkpoint inhibitors(ICIs)in China has not been quantified.This cross-sectional study was conducted to estimate the number of Chinese cancer patients with eligibility and response to ICIs based on the 2015 Chinese cancer statistics and the immune checkpoint inhibitor clinical practice guideline of the Chinese Society of Clinical Oncology.A total of 11 ICIs were recommended for 17 cancer types.The estimated number of eligible patients annually was 1290156(55.18%),which included 888738 males(60.05%)and 400468 females(46.67%).The estimated number of responders annually was 448972(19.20%),which included 309023 males(20.88%)and 139764 females(16.29%).Gastric cancer(n=291000,12.45%),non-small-cell lung cancer(n=289629,12.39%),and hepatocellular carcinoma(n=277100,11.85%)were the top three cancer types with the highest number of eligible patients.Non-small-cell lung cancer(n=180022,7.70%),hepatocellular carcinoma(n=75648,3.24%),and small-cell lung cancer(n=64362,2.75%)were the top three cancer types with the highest number of responders.In conclusion,ICIs provide considerable benefit in Chinese cancer patients under optimal estimation.
文摘Fabric dyeing is a critical production process in the clothing industry and heavily relies on batch processing machines(BPM).In this study,the parallel BPM scheduling problem with machine eligibility in fabric dyeing is considered,and an adaptive cooperated shuffled frog-leaping algorithm(ACSFLA)is proposed to minimize makespan and total tardiness simultaneously.ACSFLA determines the search times for each memeplex based on its quality,with more searches in high-quality memeplexes.An adaptive cooperated and diversified search mechanism is applied,dynamically adjusting search strategies for each memeplex based on their dominance relationships and quality.During the cooperated search,ACSFLA uses a segmented and dynamic targeted search approach,while in non-cooperated scenarios,the search focuses on local search around superior solutions to improve efficiency.Furthermore,ACSFLA employs adaptive population division and partial population shuffling strategies.Through these strategies,memeplexes with low evolutionary potential are selected for reconstruction in the next generation,while thosewithhighevolutionarypotential are retained to continue their evolution.Toevaluate the performance of ACSFLA,comparative experiments were conducted using ACSFLA,SFLA,ASFLA,MOABC,and NSGA-CC in 90 instances.The computational results reveal that ACSFLA outperforms the other algorithms in 78 of the 90 test cases,highlighting its advantages in solving the parallel BPM scheduling problem with machine eligibility.
文摘Organ transplantation saves thousands of lives every year but the shortage of donors is a major limiting factor to increase transplantation rates. To allow more patients to be transplanted before they die on the waitlist an increase in the number of donors is necessary. Patients with devastating irreversible brain injury, if medically suitable, are potential deceased donors and strategies are needed to successfully convert them into actual donors. Multiple steps in the process of deceased organ donation can be targeted to increase the number of organs suitable for transplant. In this review, after describing this process, we discuss current challenges and potential strategies to expand the pool of deceased donors.
基金Project supported by the National Natural Science Foundation of China （Grant Nos.60372090, 60502039）, and the Key Project of Shanghai Municipality for Basic Research （Grant No.04JC14037）
文摘We present a novel scheme for embedding secret data into a binary image without introducing noticeable artifacts. Unlike some block-based methods, the proposed scheme encodes the secret bits directly into boundary pixels by checking each pixel of the cover image in a pseudo-random order for embedding eligibility. A set of rules ensures correct identification of data-carrying pixels in blind extraction. The proposed scheme does not generate isolated dots, and can incorporate various coding methods such as matrix encoding to further improve the embedding performance. It is shown that up to one fourth of the boundary pixels may be used to carry secret data. Experimental results indicate that the method can achieve good visual quality with fairly large data capacity.
基金project was supported by the Shanxi Province Soft Science Research Program in China(No.2017041041-1)
文摘Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.
文摘Although hepatocellular carcinoma is considered a highly lethal malignancy,recent therapeutic advances have been achieved during the last 10 years.This scenario resulted in an unprecedented improvement in survival for patients with advanced hepatocellular carcinoma,almost reaching 20-26 mo of overall survival after first-second line sequential treatment.The advent of the combination of atezolizumab with bevacizumab showed,for the first time,superiority over sorafenib with improvement in overall survival.However,first and second-line trials were correctly based on the premise that a strict selection of patients enhances the power to capture the positive effect of treatment by excluding competing risks for mortality such as liver failure,decompensated cirrhosis or other underlying medical conditions.As a result,the inclusion criteria used in clinical trials do not support the use of novel therapies in several real-world scenarios involving underrepresented subgroups,such as patients with unpreserved liver function,other comorbid conditions,a history of solid-organ transplantation,autoimmune disorders and those with a high risk of bleeding.The present text aims at discussing treatment strategies in these subgroups.
文摘Sudden cardiac death(SCD)of an athlete is a rare but tragic event and sport activity might play a trigger role in athletes with underlying structural or electrical heart diseases.Preparticipation screenings(PPs)have been conceived for the potential to prevent SCD in young athletes by early identification of cardiac diseases.The European Society of Cardiology protocol for PPs includes history collection,physical examination and baseline electrocardiogram,while further examinations are reserved to individuals with abnormalities at first-line evaluation.Nevertheless,transthoracic echocardiography has been hypothesized to have a primary role in the PPs.This review aims to describe how to approach an athlete-focused echocardiogram,highlighting what is crucial to focus on for the different diseases(cardiomyopathies,valvulopathies,congenital heart disease,myocarditis and pericarditis)and when is needed to pay attention to overlap diagnostic zone(“grey zone”)with the athlete's heart.Once properly tested,focused echocardiography by sports medicine physicians may become standard practice in larger screening practices,potentially available during first-line evaluation.
文摘The application of reinforcement learning is widely used by multi-agent systems in recent years. An agent uses a multi-agent system to cooperate with other agents to accomplish the given task, and one agent′s behavior usually affects the others′ behaviors. In traditional reinforcement learning, one agent takes the others location, so it is difficult to consider the others′ behavior, which decreases the learning efficiency. This paper proposes multi-agent reinforcement learning with cooperation based on eligibility traces, i.e. one agent estimates the other agent′s behavior with the other agent′s eligibility traces. The results of this simulation prove the validity of the proposed learning method.
文摘BACKGROUND Few studies have evaluated the frequency of and the reasons behind the refusal of listing liver transplantation candidates.AIM To assess the ineligibility rate for liver transplantation and its motivations.METHODS A single-center retrospective study was conducted on adult patients which entailed a formal multidisciplinary assessment for liver transplantation eligibility.The predictors for listing were evaluated using multivariable logistic regression.RESULTS In our center,314 patients underwent multidisciplinary work-up before liver transplantation enlisting over a three-year period.The most frequent reasons for transplant evaluation were decompensated cirrhosis(51.6%)and hepatocellular carcinoma(35.7%).The non-listing rate was 53.8%and the transplant rate was 34.4%for the whole cohort.Two hundred and five motivations for ineligibility were collected.The most common contraindications were psychological(9.3%),cardiovascular(6.8%),and surgical(5.9%).Inappropriate or premature referral accounted for 76(37.1%)cases.On multivariable analysis,a referral from another hospital(OR:2.113;95%CI:1.259–3.548)served as an independent predictor of non-listing.CONCLUSION A non-listing decision occurred in half of our cohort and was based on an inappropriate or premature referral in one case out of three.The referral from another hospital was taken as a strong predictor of non-listing.
文摘Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.
文摘From the author, there are not less than a dozen of rather significant recent publications in scientific editions anticipating some aspects of importance to innovation such as “bigger data”, AI, IP, and frontier technology with a central massive contribution in 2020 on AI, IP, and EI. Nonetheless, the IP associated with AI remains still barely covered in scientific publications. Especially patent discussion tends to be rather a legal matter. Another trilogy, 2013, “Business Strategy-IP Strategy-R&D Strategy: An All-in-One Business Model” proposed by the author, marked the advent, and customized implementation of a new strategy level. After the two trilogies’ volumes, the AI-IP “accessibility” chapter was a logical step brought to the attention of a larger public by the author. The time now to bring to light another chapter, namely the IP eligibility of AI innovation steps in ad hoc inventions. The main objectives of this short, principally illustrated communication, are to: 1) Revise the best mode requirement status, i.e. the best way to enable the reproducibility of claimed matter, reviewing its need for improvement when AI is involved. And proposing a unique sequence of evolution inspired by IP’s current and evolving practices. 2) Give a new dimension to visual aids to help the Best Mode description, demystify AI complexity, and underline frontier traits that may hinder a confident adoption or well-argued rejection. 3) Further illustrations take into account the fact that IoT, AI, and 3D can be simpler than perceived. 4) Finally ATA©, Adjacent Technology Analysis, is timely refreshed in a unique challenging, indeed tumultuous, environment. 5) Bias, such as semantic ones is consistently monitored. 6) Overall leaving space for innovative pleasurable interpretation. The emphasis is on educational, illustrative and demonstrative value.
基金sponsored by Keymed Biosciences(Chengdu)Co.,Ltd.
文摘CD38 is highly expressed on various immune cells,including long-lived plasma cells,making it a potential therapeutic target in autoimmune diseases.This phase Ib/IIa study aimed to explore the safety,pharmacokinetics,pharmacodynamics,and preliminary efficacy of CM313,an anti-CD38 antibody,in patients with systemic lupus erythematosus(SLE).Eligible patients were sequentially enrolled in four ascending dose groups(2,4,8,and 16 mg/kg)and randomized 4:1 to receive CM313 or placebo intravenously at days 1,29,36,43,and 50.The primary endpoint was safety,and efficacy was exploratorily investigated.Between October 14,2022,and March 7,2024,40 patients were enrolled,including 8 patients in each CM313 dose group and the pooled placebo group.Adverse events occurred in 90.6%and 62.5%of participants receiving CM313 and placebo,all of which were mild or moderate.Upper respiratory tract infection(87.5%/62.5%vs.12.5%),urinary tract infection(12.5%/25.0%vs.0),and herpes zoster(25.0%/0 vs.0)were more frequent in CM3138 and 16 mg/kg groups than the placebo group.The CM313 groups had greater reductions in antids-DNA antibodies,immunoglobulin G(IgG),IgA,IgM,IgE,and greater increases in complement C3 and C4 compared with placebo.Systemic Lupus Erythematosus Responder Index-4 response rates were 33.3%,40.0%,62.5%,71.4%,and 37.5%in CM3132,4,8,16 mg/kg,and placebo groups at day 57,respectively.CM313 showed a manageable safety profile in SLE patients at 2–16 mg/kg and encouraging clinical efficacy at 8 and 16 mg/kg.The results support further investigation of CM313 for treating SLE patients(ClinicalTrials.gov ID:NCT05465707).
文摘Objective To explore the impact of baseline remnant cholesterol levels at a single time point and cumulative remnant cholesterol exposure on the progression trajectories of arterial stiffness.Methods This prospective cohort study included 2401 eligible participants from the Beijing Health Management Cohort who consecutively attended health examinations in 2010-2011,2012-2013,and 2014-2015.The remnant cholesterol value measured in 2014-2015 served as the baseline remnant cholesterol level at a single time point.The cumulative exposure indices were calculated based on remnant cholesterol values from three health examinations from 2010 to 2015,including cumulative exposure,cumulative exposure burden,and duration of high remnant cholesterol exposure.Arterial stiffness was assessed by brachialankle pulse wave velocity(baPWV).The follow-up continued until December 31,2019,with annual checkups.During the follow-up period,a group-based trajectory model was employed to construct the progression trajectories of baPWV.The associations between the baseline remnant cholesterol level,cumulative exposure indices of remnant cholesterolandbaPWV trajectories were examined using ordinal logisticcregression models,adjusting for traditional cardiovascular risk factors and low-density lipoprotein cholesterol(LDL-C)levels.Results The age of the 2401 participants was 61(54,69)years,with 1801(75.01%)being male.The group-based trajectory model indicated that the best-fit model categorized the participants into three subgroups:low-rising group(1036 individuals,43.15%),moderaterising group(1137 individuals,47.36%),and highrising group(228 individuals,9.50%).After adjusting for traditional cardiovascular risk factors,baseline remnant cholesterol levels at a single point(OR=1.170,95%Cl:1.074-1.274),cumulative remnant cholesterol exposure(0R=1.194,95%Cl:1.096-1.303),cumulative remnant cholesterol exposure burden(OR=1.270,95%CI:1.071-1.507),and high-remnant cholesterol exposure duration(6 years:OR=1.351,95%Cl:1.077-1.695)were significantly associated with the risk of developing a poor baPWV progression trajectory.TTheseresults remainedsignificanttafter adjusting for cumulative average LDL-C levels.The association between baseline remnant cholesterol levels and baPWV progression became insignificant after adjusting for cumulative remnant cholesterol levels(OR=1.053,95%CI:0.923-1.197),while the association between cumulative remnant cholesterol exposure and baPWV progression remained significant after adjusting for baseline remnant cholesterol levels(OR=1.145,95%CI:1.008-1.305).Conclusion Higher levels of baseline remnant cholesterol and cumulative remnant cholesterol are independent risk factors forthe progression of arterial stiffness.Theseassociations remain significant even after adjusting for traditional cardiovascularrisk factorsandLDL-Clevels.Furthermore,the effect of cumulative remnant cholesterol levels on the progression of arterial stiffness is stronger than the effect of baseline remnant cholesterol levels.
基金supported by the National Natural Science Foundation of China(82303955)AstraZeneca Global R&D Study Fund(Project Code:D901DX00002).
文摘Trial eligibility criteria,which define an appropriate evaluable population through inclusion and exclusion criteria,are fundamental for reliable evidence and should be tailored to the question that the trial sets out to answer[1].However,exclusion criteria for cancer trials have become increasingly restrictive over the years,with the median number increased from 21 in 1986 to 46 in 2016[2,3].These restrictive exclusion criteria have created substantial barriers to patient access to novel therapies,hindered trial recruitment and limited the generalizability of trial results,presenting not only practical and scientific problem,but also raises important issues of equity that affect everyone[4].
文摘INTRODUCTION The National Health Service(NHS)cervical screeningprogramme has significantly reduced the incidence and mortality of cervical cancer.However,this vital service may not reach the whole eligible population.The national coverage remains below the 80%target,with only 68.7%of eligible people screened in 2023 in England.
基金supported by research grants from the National Key Research and Development Program,China(2023YFC2306902,2023YFC2306900)High-level Public Health Technical Talents of the Beijing Municipal Health Commission,China(XUEKEGUGAN-010-018)+1 种基金Beijing Municipal Administration of Hospitals Incubating Program(PX2024003)Research Grant of Capital Medical University(PYZ21051,PYZ23073).
文摘Hepatitis B virus(HBV)infection remains a major global health issue,with nearly 86 million people in China living with chronic hepatitis B(CHB).1 Recommendations for antiviral treatment are based on a comprehensive assessment of serum HBV DNA levels,alanine transaminase(ALT)levels,severity of liver disease,and risk factors such as age and family history.Although ALT is a key indicator for initiating antiviral therapy,the treatment thresholds recommended by major international guidelines vary significantly.In 2024,the World Health Organization(WHO)published updated guidelines for CHB,recommending an upper limit of normal(ULN)for ALT of 30 U/L for males and 19 U/L for females.2 The European Association for the Study of the Liver(EASL)2017 guideline,and the Asia Pacific Association for the Study of the Liver(APASL)2015 guideline defined a ULN for ALT of 40 U/L for both males and females.
