bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on Energy Management Strategy of Pure Electric Vacuum Vehicle Based on Fuzzy Control
Authors: Wang Yujie , Lei Yu , Zhang Licheng , Zhong Shengshi 
Published: June 2022

The current pure electric vacuum vehicle is equipped with main and auxiliary motors, and the two motors work independently without affecting each other. The traditional auxiliary motor usually operates with constant power while the main motor is only responsible for the vehicle driving. The lack of cooperation between the two motors results in high energy consumption. Therefore, formulating a reasonable strategy for the two motors has a significant effect on the performance of the vacuum vehicle. This paper takes a pure electric vacuum vehicle as an example to propose an energy management strategy based on fuzzy control. First, for the working motor, a fuzzy controller is designed by taking the vehicle speed and acceleration as input and motor speed and torque as output. Therefore, the vacuum vehicle can automatically adjust the operating power of the cleaning system according to the real-time road conditions; the driving motor control strategy adopts a closed-loop control strategy that combines driver input and vehicle state parameter feedback based on considering the operating motor. Finally, the effectiveness of the strategy is verified by simulation. The results show that the energy-saving control strategy effectively reduces the power consumption per 100 km and increases the driving range, which is of great significance to the development and design of the vacuum vehicle.
How Well Does the ERA5 Reanalysis Capture the Extreme Climate Events Over China? Part I: Extreme Precipitation
Authors: Lei Xiangyong , Xu Wanling , Chen Shiting , Yu Tingting , Hu Zengyun , Zhang Meng , Jiang Lizhi , Bao Ruijuan , Guan Xiaojun , Ma Miaomiao , Wei Jianhui , Feng Aixia , Gao Lu 
Published: June 2022

ERA5 is the fifth-generation atmospheric reanalysis of the European Center for Medium-Range Weather Forecasts, with high spatiotemporal resolution and global coverage. However, the reliability of ERA5 for simulating extreme precipitation events is still unclear over China. In this study, 12 extreme precipitation indices and a comprehensive quantitative distance between indices of simulation and observation were used to evaluate ERA5 precipitation from three fundamental aspects: intensity, frequency, and duration. The geomorphological regionalization method was used to divide the subregions of China. The results showed that the ability of ERA5 to simulate annual total precipitation was better than that of daily precipitation. For the intensity indices, ERA5 performs well for simulating the PRCPTOT (annual total wet days precipitation) over China. ERA5 performs better on RX5day (max 5-days precipitation amount) and R95p (very wet days), especially in eastern China, than on RX1day (max 1-day precipitation amount) and R99p (extremely wet days). For the frequency indices, the ability of the ERA5 simulation increased as the amount of precipitation increased, except for northwestern China. However, the ability of ERA5 to simulate R50 mm (number of extreme heavy precipitation days) decreased. For the duration indices, ERA5 was better at simulating drought events than wet events in eastern China. Our results highlight the need for ERA5 to enhance the simulation of trend changes in extreme precipitation events.
Memory T Cell Subpopulations as Early Predictors of Remission to Vedolizumab in Ulcerative Colitis
Authors: Gonzalez-Vivo Maria , Lund Tiirikainen Minna K. , Andreu Montserrat , Fernandez-Clotet Agnes , López-García Alicia , Murciano Gonzalo Francisca , Abril Rodriguez Lourdes , de Jesús-Gil Carmen , Ruiz-Romeu Ester , Sans-de San Nicolàs Lídia , Santamaria-Babí Lluis F. , Márquez-Mosquera Lucía 
Published: June 2022

BackgroundVedolizumab is a humanized monoclonal antibody targeting the α4β7 integrin used for the treatment of ulcerative colitis. Few biomarkers related to vedolizumab response have been identified. The aim of this work was to assess whether baseline circulating CD4+ and CD8+ memory T-lymphocyte subpopulations could help to identify patients with response to vedolizumab treatment in ulcerative colitis.MethodsProspective pilot study in 15 patients with active ulcerative colitis and previous failure to anti-TNFα starting vedolizumab treatment. Peripheral blood samples were obtained before the first dose of vedolizumab and at week 6 and 14 of treatment. Clinical remission was defined as a Mayo Clinic partial score of ≤2 points without any concomitant dose of steroids. Biochemical remission or endoscopic improvement was defined as fecal calprotectin &lt;250 mcg/g or Mayo endoscopic subscore ≤1.ResultsAt week 14, nine patients achieved clinical remission and eight patients achieved biochemical remission or endoscopic improvement. Patients in clinical remission presented higher baseline CD8 α4β7+ memory T cells concentration when compared with patients with no remission. In addition, patients with biochemical remission or endoscopic improvement at week 14 presented higher baseline concentration of CD8 α4β7+ memory T cells. No differences were identified according to flare severity, extent of disease or type of anti-TNFα failure. There were no significant differences regarding changes in T cell subsets during vedolizumab induction.ConclusionCD8+ α4β7+ memory T cells before starting vedolizumab therapy could be an early predictor of remission in ulcerative colitis patients and therefore help to select a subset of responders.
Development and Validation of Machine Learning Models for Real-Time Mortality Prediction in Critically Ill Patients With Sepsis-Associated Acute Kidney Injury
Authors: Luo Xiao-Qin , Yan Ping , Duan Shao-Bin , Kang Yi-Xin , Deng Ying-Hao , Liu Qian , Wu Ting , Wu Xi 
Published: June 2022

BackgroundSepsis-associated acute kidney injury (SA-AKI) is common in critically ill patients, which is associated with significantly increased mortality. Existing mortality prediction tools showed insufficient predictive power or failed to reflect patients' dynamic clinical evolution. Therefore, the study aimed to develop and validate machine learning-based models for real-time mortality prediction in critically ill patients with SA-AKI.MethodsThe multi-center retrospective study included patients from two distinct databases. A total of 12,132 SA-AKI patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) were randomly allocated to the training, validation, and internal test sets. An additional 3,741 patients from the eICU Collaborative Research Database (eICU-CRD) served as an external test set. For every 12 h during the ICU stays, the state-of-the-art eXtreme Gradient Boosting (XGBoost) algorithm was used to predict the risk of in-hospital death in the following 48, 72, and 120 h and in the first 28 days after ICU admission. Area under the receiver operating characteristic curves (AUCs) were calculated to evaluate the models' performance.ResultsThe XGBoost models, based on routine clinical variables updated every 12 h, showed better performance in mortality prediction than the SOFA score and SAPS-II. The AUCs of the XGBoost models for mortality over different time periods ranged from 0.848 to 0.804 in the internal test set and from 0.818 to 0.748 in the external test set. The shapley additive explanation method provided interpretability for the XGBoost models, which improved the understanding of the association between the predictor variables and future mortality.ConclusionsThe interpretable machine learning XGBoost models showed promising performance in real-time mortality prediction in critically ill patients with SA-AKI, which are useful tools for early identification of high-risk patients and timely clinical interventions.
Transcutaneous Electrical Acupoint Stimulation Combined With Auricular Acupressure Reduces Postoperative Delirium Among Elderly Patients Following Major Abdominal Surgery: A Randomized Clinical Trial
Authors: Fan Qianqian , Lei Chong , Wang Yonghui , Yu Nannan , Wang Lini , Fu Jingwen , Dong Hailong , Lu Zhihong , Xiong Lize 
Published: June 2022

BackgroundPostoperative delirium is common in elderly patients following major surgery. This study aimed to assess the effect of transcutaneous electrical acupoint stimulation combined with auricular acupressure on the incidence of postoperative delirium among older patients undergoing major abdominal surgery.MethodsIn this single-center, randomized controlled clinical trial, 210 patients aged 65 years or older undergoing major abdominal surgery were randomized to receive either intervention treatment (transcutaneous electrical acupoint stimulation started at 30 min before anesthesia until the end of the surgery, followed by intermittent auricular acupressure in the first three postoperative days; n = 105) or standard care (n = 105). The primary outcome was the incidence of delirium at the first seven postoperative days or until hospitalization depended on which came first. Secondary outcomes included delirium severity, opioid consumption, postoperative pain score, sleep quality, length of postoperative hospital stay, and postoperative 30-day complications. Enrollment was from April 2019 to March 2020, with follow-up ending in April 2020.ResultsAll of the 210 randomized patients [median age, 69.5 years, 142 (67.6%) male] completed the trial. The incidence of postoperative delirium was significantly reduced in patients received intervention treatment (19/105 (18.1%) vs. 8/105 (7.6%), difference, –10.5% [95% CI, –1.5% to –19.4%]; hazard ratio, 0.41 [95% CI, 0.18 to 0.95]; P= 0.023). Patients in the control group had a higher postoperative Memorial Delirium Assessment Scale (4 vs. 3; difference, –1; 95% CI, –1 to 0; P = 0.014) and a greater increase in Pittsburgh Sleep Quality Index score from baseline to postoperative day three (2.5 vs. 2.0; difference, –1; 95% CI, –2 to –1; P &lt; 0.001) than patients in the intervention group. No significant difference was observed as of other secondary outcomes.ConclusionIn elderly patients undergoing major abdominal surgery, transcutaneous electrical acupoint stimulation combined with auricular acupressure reduced the incidence of postoperative in-hospital delirium compared with standard care. A multicenter, randomized clinical trial with a larger sample size is necessary to verify these findings.Clinical Trial Registration[https://clinicaltrials.gov], identifier [NCT03726073].
Three-Dimensional Multi-Task Deep Learning Model to Detect Glaucomatous Optic Neuropathy and Myopic Features From Optical Coherence Tomography Scans: A Retrospective Multi-Centre Study
Authors: Ran An Ran , Wang Xi , Chan Poemen P. , Chan Noel C. , Yip Wilson , Young Alvin L. , Wong Mandy O. M. , Yung Hon-Wah , Chang Robert T. , Mannil Suria S. , Tham Yih Chung , Cheng Ching-Yu , Chen Hao , Li Fei , Zhang Xiulan , Heng Pheng-Ann , Tham Clement C. , Cheung Carol Y. 
Published: June 2022

PurposeWe aim to develop a multi-task three-dimensional (3D) deep learning (DL) model to detect glaucomatous optic neuropathy (GON) and myopic features (MF) simultaneously from spectral-domain optical coherence tomography (SDOCT) volumetric scans.MethodsEach volumetric scan was labelled as GON according to the criteria of retinal nerve fibre layer (RNFL) thinning, with a structural defect that correlated in position with the visual field defect (i.e., reference standard). MF were graded by the SDOCT en face images, defined as presence of peripapillary atrophy (PPA), optic disc tilting, or fundus tessellation. The multi-task DL model was developed by ResNet with output of Yes/No GON and Yes/No MF. SDOCT scans were collected in a tertiary eye hospital (Hong Kong SAR, China) for training (80%), tuning (10%), and internal validation (10%). External testing was performed on five independent datasets from eye centres in Hong Kong, the United States, and Singapore, respectively. For GON detection, we compared the model to the average RNFL thickness measurement generated from the SDOCT device. To investigate whether MF can affect the model’s performance on GON detection, we conducted subgroup analyses in groups stratified by Yes/No MF. The area under the receiver operating characteristic curve (AUROC), sensitivity, specificity, and accuracy were reported.ResultsA total of 8,151 SDOCT volumetric scans from 3,609 eyes were collected. For detecting GON, in the internal validation, the proposed 3D model had significantly higher AUROC (0.949 vs. 0.913, p &lt; 0.001) than average RNFL thickness in discriminating GON from normal. In the external testing, the two approaches had comparable performance. In the subgroup analysis, the multi-task DL model performed significantly better in the group of “no MF” (0.883 vs. 0.965, p-value &lt; 0.001) in one external testing dataset, but no significant difference in internal validation and other external testing datasets. The multi-task DL model’s performance to detect MF was also generalizable in all datasets, with the AUROC values ranging from 0.855 to 0.896.ConclusionThe proposed multi-task 3D DL model demonstrated high generalizability in all the datasets and the presence of MF did not affect the accuracy of GON detection generally.
Next-Generation Sequencing Technology Combined With Multiplex Polymerase Chain Reaction as a Powerful Detection and Semiquantitative Method for Herpes Simplex Virus Type 1 in Adult Encephalitis: A Case Report
Authors: Chen Weibi , Wu Yingfeng , Zhang Yan 
Published: June 2022

BackgroundTraditional testing for specific microbes or categories of central nervous system (CNS) infectious diseases is often limited in sensitivity and timeliness. However, failure to initiate a timely etiological diagnosis and corresponding treatment in patients with neurologic infections contribute to poor outcomes.Case SummaryA 58 year-old male presented acutely with fever, abnormal mental behavior, seizures and decreased consciousness. Brain magnetic resonance imaging (MRI) showed an abnormal FLAIR/T2 signal mainly in the left thalamus, temporal lobe, insular lobe, and bilateral hippocampus. To identify the pathogen, the cerebrospinal fluid (CSF) sample of the patient was used for metagenomic next-generation sequencing (mNGS) analysis and multiplex polymerase chain reaction (mPCR). The results showed 188 herpes simplex virus (HSV-1)-specific sequences. After acyclovir and foscarnet sodium treatment, the ratio of HSV-1/internal reference reads decreased from 813/493 to 695/1961, which coincided with clinical remission.ConclusionThis study indicates that mNGS combined with mPCR may be an effective method for etiological diagnostic and dynamic clinical surveillance for HSV-1 encephalitis.
A New Predictive Model for the Prognosis of MDA5+ DM-ILD
Authors: Niu Qian , Zhao Li-qin , Ma Wan-li , Xiong Liang , Wang Xiao-rong , He Xin-liang , Yu Fan 
Published: June 2022

PurposeThe purpose of this study is to analyze clinical information and combine significant parameters to generate a predictive model and achieve a better prognosis prediction of dermatomyositis-associated interstitial lung disease with positive melanoma differentiation-associated gene 5 antibody (MDA5+ DM-ILD) and stratify patients according to prognostic risk factors appropriately.MethodsWe retrospectively reviewed 63 patients MDA5+ DM-ILD who were treated in our hospital from January 2018 to January 2021. Our study incorporated most clinical characteristics in clinical practice to explore the associations and predictive functions of clinical characteristics and prognosis. Student's t-test, Mann-Whitney U-test, chi-squared test, Pearson correlation analysis, Cox regression analysis, R, receiver operating characteristic curves (ROC curves), and Kaplan-Meier survival curves were performed to identify independent predictors for the prognosis of MDA5+DM-ILD.ResultsIn all the 63 patients with MDA5+DM-ILD, 44 improved but 19 did not. Poor prognosis was found more frequently in patients who were older, clinically amyopathic variant of dermatomyositis (CADM), and/or with short duration, short interval of DM and ILD, long length of stay, fever, dyspnea, non-arthralgia, pulmonary infection, pleural effusion (PE), high total computed tomography scores (TCTs), ground-glass opacity (GGO), consolidation score, reticular score and fibrosis score, decreased forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), albumin, A/G, glomerular filtration rate (GFR) and tumor necrosis factor α (TNFα), high titer of anti-MDA5, proteinuria, high levels of monocyte, lactate dehydrogenase (LDH), ferritin (FER), neuron specific enolase (NSE) and glucocorticoid, antibiotic, antiviral, and non-invasive positive pressure ventilation (NPPV). The multivariate Cox regression analysis demonstrated that duration, fever, PE, TCTs and aspartate transaminase (AST) were independent predictors of poor prognosis in patients with MDA5+DM-ILD. The nomogram model quantified the risk of 400-day death as: duration ≤ 4 months (5 points), fever (88 points), PE (21 points), TCTs ≥10 points (22 points), and AST ≥200 U/L (100 points) with high predictive accuracy and convenience. The ROC curves possessed good discriminative ability for combination of fever, PE, TCTs, and AST, as reflected by the area under curve (AUC) being.954, 95% CI 0.902–1.000, and sensitivity and specificity being 84.2 and 94.6%, respectively.ConclusionWe demonstrated that duration, fever, PE, TCTs, and AST could be integrated together to be independent predictors of poor prognosis in MDA5+ DM-ILD with highly predictive accuracy.
Overlap of Gastroesophageal Reflux Disease and Functional Dyspepsia and Yield of Esophagogastroduodenoscopy in Patients Clinically Fulfilling the Rome IV Criteria for Functional Dyspepsia
Authors: Quach Duc Trong , Ha Quoc Van , Nguyen Chuyen Thi-Ngoc , Le Quang Dinh , Nguyen Doan Thi-Nha , Vu Nhu Thi-Hanh , Dang Ngoc Le-Bich , Le Nhan Quang 
Published: June 2022

AimTo assess (1) the overlap rate of gastroesophageal reflux disease (GERD) and functional dyspepsia (FD) and (2) the yield of esophagogastroduodenoscopy in patients clinically presenting with FD.Materials and MethodsOutpatients aged ≥18 years with typical reflux symptoms ≥2 times a week or clinically fulfilling the Rome IV criteria for FD were recruited and underwent esophagogastroduodenoscopy. GERD was classified into non-erosive reflux disease (NERD) and erosive reflux disease (ERD), and FD was classified into epigastric pain syndrome and postprandial distress syndrome. The endoscopic findings that could explain patients’ symptoms were considered clinically significant endoscopic findings. After esophagogastroduodenoscopy, patients were categorized into three groups: GERD-only, FD-only, and GERD-FD overlap.ResultsThere were 439 patients with a mean age of 42.3 ± 11.6 years. Ninety-one (20.7%) patients had clinically significant endoscopic findings: 73 (16.6%) reflux esophagitis, 6 (1.4%) Barrett’s esophagus and 14 (3.2%) gastroduodenal ulcers. After excluding gastroduodenal ulcers, the numbers of patients with GERD-only, FD-only, and GERD-FD overlap were 69 (16.2%), 138 (32.5%), and 218 (51.3%), respectively. Postprandial distress syndrome was more prevalent in GERD-FD overlap than in FD-only (72.9 vs. 44.2%, p &lt; 0.001). The rates of gastroduodenal ulcers in patients clinically fulfilling the criteria for FD with and without reflux symptoms were 0.6 and 4.7%, respectively (p = 0.027).ConclusionThe GERD-FD overlap was more common than each disorder alone, of which postprandial distress syndrome was significantly prominent. Organic dyspepsia was uncommon in patients clinically fulfilling the Rome IV criteria for FD.
Evolution of Cortical Functional Networks in Healthy Infants
Authors: Hu Derek K. , Goetz Parker W. , To Phuc D. , Garner Cristal , Magers Amber L. , Skora Clare , Tran Nhi , Yuen Tammy , Hussain Shaun A. , Shrey Daniel W. , Lopour Beth A. 
Published: June 2022

During normal childhood development, functional brain networks evolve over time in parallel with changes in neuronal oscillations. Previous studies have demonstrated differences in network topology with age, particularly in neonates and in cohorts spanning from birth to early adulthood. Here, we evaluate the developmental changes in EEG functional connectivity with a specific focus on the first 2 years of life. Functional connectivity networks (FCNs) were calculated from the EEGs of 240 healthy infants aged 0–2 years during wakefulness and sleep using a cross-correlation-based measure and the weighted phase lag index. Topological features were assessed via network strength, global clustering coefficient, characteristic path length, and small world measures. We found that cross-correlation FCNs maintained a consistent small-world structure, and the connection strengths increased after the first 3 months of infancy. The strongest connections in these networks were consistently located in the frontal and occipital regions across age groups. In the delta and theta bands, weighted phase lag index networks decreased in strength after the first 3 months in both wakefulness and sleep, and a similar result was found in the alpha and beta bands during wakefulness. However, in the alpha band during sleep, FCNs exhibited a significant increase in strength with age, particularly in the 21–24 months age group. During this period, a majority of the strongest connections in the networks were located in frontocentral regions, and a qualitatively similar distribution was seen in the beta band during sleep for subjects older than 3 months. Graph theory analysis suggested a small world structure for weighted phase lag index networks, but to a lesser degree than those calculated using cross-correlation. In general, graph theory metrics showed little change over time, with no significant differences between age groups for the clustering coefficient (wakefulness and sleep), characteristics path length (sleep), and small world measure (sleep). These results suggest that infant FCNs evolve during the first 2 years with more significant changes to network strength than features of the network structure. This study quantifies normal brain networks during infant development and can serve as a baseline for future investigations in health and neurological disease.