179 research outputs found
Learning Mazes with Aliasing States: An LCS Algorithm with Associative Perception
Learning classifier systems (LCSs) belong to a class of algorithms based on the principle of self-organization and have frequently been applied to the task of solving mazes, an important type of reinforcement learning (RL) problem. Maze problems represent a simplified virtual model of real environments that can be used for developing core algorithms of many real-world applications related to the problem of navigation. However, the best achievements of LCSs in maze problems are still mostly bounded to non-aliasing environments, while LCS complexity seems to obstruct a proper analysis of the reasons of failure. We construct a new LCS agent that has a simpler and more transparent performance mechanism, but that can still solve mazes better than existing algorithms. We use the structure of a predictive LCS model, strip out the evolutionary mechanism, simplify the reinforcement learning procedure and equip the agent with the ability of associative perception, adopted from psychology. To improve our understanding of the nature and structure of maze environments, we analyze mazes used in research for the last two decades, introduce a set of maze complexity characteristics, and develop a set of new maze environments. We then run our new LCS with associative perception through the old and new aliasing mazes, which represent partially observable Markov decision problems (POMDP) and demonstrate that it performs at least as well as, and in some cases better than, other published systems
Reduced Hypoxia Risk in a Systemic Sclerosis Patient with Interstitial Lung Disease after Long-Term Pulmonary Rehabilitation
Pulmonary rehabilitation is effective for improving exercise capacity in patients with interstitial lung disease (ILD), and most programs last about 8 weeks. A 43-year-old male patient with systemic sclerosis and oxygen saturation (SpO2) declining because of severe ILD was hospitalized for treatment of chronic skin ulcers. During admission, he completed a 27-week walking exercise program with SpO2 monitoring. Consequently, continuous walking distance without severe hypoxia (SpO2 > 90%) increased from 60 m to 300 m after the program, although his six-minute walking distance remained the same. This suggests that walking exercise for several months may reduce the risk of hypoxia in patients with ILD, even though exercise capacity does not improve
CT and MRI of Hepatic Abscess in Patients with Chronic Granulomatous Disease
We describe the spectrum of radiologic appearances of hepatic
abscesses in patients with chronic granulomatous disease (CGD), a hereditary
immunodeficiency presenting in childhood that occurs at a rate of 1 in
200,000-250,000 live births and predisposes patients to infection with
catalase-positive organisms. CONCLUSION: Hepatic abscesses in patients with CGD
show an atypical radiologic appearance compared with sporadic hepatic abscesses,
and they are characterized by homogeneous enhancement and multiseptal
enhancement. In the appropriate clinical setting, the appearance of an enhancing
mass should suggest the possibility of a CGD-related hepatic absces
Subgraphs in random networks
Understanding the subgraph distribution in random networks is important for
modelling complex systems. In classic Erdos networks, which exhibit a
Poissonian degree distribution, the number of appearances of a subgraph G with
n nodes and g edges scales with network size as \mean{G} ~ N^{n-g}. However,
many natural networks have a non-Poissonian degree distribution. Here we
present approximate equations for the average number of subgraphs in an
ensemble of random sparse directed networks, characterized by an arbitrary
degree sequence. We find new scaling rules for the commonly occurring case of
directed scale-free networks, in which the outgoing degree distribution scales
as P(k) ~ k^{-\gamma}. Considering the power exponent of the degree
distribution, \gamma, as a control parameter, we show that random networks
exhibit transitions between three regimes. In each regime the subgraph number
of appearances follows a different scaling law, \mean{G} ~ N^{\alpha}, where
\alpha=n-g+s-1 for \gamma<2, \alpha=n-g+s+1-\gamma for 2<\gamma<\gamma_c, and
\alpha=n-g for \gamma>\gamma_c, s is the maximal outdegree in the subgraph, and
\gamma_c=s+1. We find that certain subgraphs appear much more frequently than
in Erdos networks. These results are in very good agreement with numerical
simulations. This has implications for detecting network motifs, subgraphs that
occur in natural networks significantly more than in their randomized
counterparts.Comment: 8 pages, 5 figure
Hepatic abnormalities in patients with chronic granulomatous disease
Chronic granulomatous disease (CGD) is a rare congenital disorder characterized
by repeated bacterial and fungal infections. Aside from a high incidence of liver
abscess, little is known about hepatic involvement in CGD. The aim of this study
was to describe the spectrum of liver abnormalities seen in CGD. The charts of
194 patients with CGD followed at the NIH were reviewed, with a focus on liver
abnormalities. Liver enzyme elevations occurred on at least one occasion in 73%
of patients during a mean of 8.9 years of follow-up. ALT elevations were
generally transient. Although transient alkaline phosphatase (ALP) elevations
were also common, persistent ALP elevations lasting up to 17.6 years were seen in
25% of patients. Liver abscess occurred in 35% of patients. Drug-induced
hepatotoxicity was documented in 15% of patients but likely occurred more
frequently. Hepatomegaly was found in 34% and splenomegaly in 56% of patients.
Liver histology showed granulomata in 75% and lobular hepatitis in 90% of
specimens. Venopathy of the portal vein was common (80%) and associated with
splenomegaly. Venopathy of the central vein was also common (63%) and was
associated with the number of abscess episodes. Nodular regenerative hyperplasia
(NRH) was seen in 9 patients, including 6 of 12 autopsy specimens. CONCLUSION:
Liver enzyme abnormalities occur frequently in patients with CGD. In addition to
liver abscesses and granulomata, drug hepatotoxicity is likely underappreciated.
Vascular lesions such as venopathy and--to a lesser extent--NRH are common. The
cause and clinical consequences of venopathy await prospective evaluation
Cytological changes related to Brucella canis variants uptake in vitro
In this study, evidence for in vitro uptake, invasion, and cytopathogonomic effects of normal and variant strains of B. canis on tissue culture, is presented. B. canis L-phase were penicillin-induced and these microorganisms produced revertants on penicillin-free media. Tissue culture (LLC-MK 2 ) cells were divided into different normal and variant-infected groups (I–IV), including controls. Bright-field and electron microscopic observations indicated uptake of all the strains and recognizable host cell damage (CPE) to varying degrees. At 72 h after infection, the extent of damage by L-phase was the least (55.5% CPE). The L-phase-derived revertants resulted in 80% damage; this approximates the adverse effect of normal B. canis (85%). In addition to these gross changes, various structural abnormalities, including pyknosis, nuclear disorganization, vacuolation, and karyorrhexis, were apparent. The implications of these findings and the indirect role of the L-phase in brucellosis due to B. canis are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47529/1/430_2005_Article_BF02123560.pd
IMG 305 - PEMBUNGKUSAN MAKANAN NOV.05.
We discuss the use of Agent-based Modelling for the development and testing of theories about emergent social phenomena in marketing and the social sciences in general. We address both theoretical aspects about the types of phenomena that are suitably addressed with this approach and practical guidelines to help plan and structure the development of a theory about the causes of such a phenomenon in conjunction with a matching ABM. We argue that research about complex social phenomena is still largely fundamental research and therefore an iterative and cyclical development process of both theory and model is to be expected. To better anticipate and manage this process, we provide theoretical and practical guidelines. These may help to identify and structure the domain of candidate explanations for a social phenomenon, and furthermore assist the process of model implementation and subsequent development. The main goal of this paper was to make research on complex social systems more accessible and help anticipate and structure the research process
Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission due to COVID-19 in the UK: a prospective multicentre cohort study
Background:
Sleep disturbance is common following hospital admission both for COVID-19 and other causes. The clinical associations of this for recovery after hospital admission are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. We aimed to investigate the prevalence and nature of sleep disturbance after discharge following hospital admission for COVID-19 and to assess whether this was associated with dyspnoea.
Methods:
CircCOVID was a prospective multicentre cohort substudy designed to investigate the effects of circadian disruption and sleep disturbance on recovery after COVID-19 in a cohort of participants aged 18 years or older, admitted to hospital for COVID-19 in the UK, and discharged between March, 2020, and October, 2021. Participants were recruited from the Post-hospitalisation COVID-19 study (PHOSP-COVID). Follow-up data were collected at two timepoints: an early time point 2–7 months after hospital discharge and a later time point 10–14 months after hospital discharge. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index questionnaire and a numerical rating scale. Sleep quality was also assessed with an accelerometer worn on the wrist (actigraphy) for 14 days. Participants were also clinically phenotyped, including assessment of symptoms (ie, anxiety [Generalised Anxiety Disorder 7-item scale questionnaire], muscle function [SARC-F questionnaire], dyspnoea [Dyspnoea-12 questionnaire] and measurement of lung function), at the early timepoint after discharge. Actigraphy results were also compared to a matched UK Biobank cohort (non-hospitalised individuals and recently hospitalised individuals). Multivariable linear regression was used to define associations of sleep disturbance with the primary outcome of breathlessness and the other clinical symptoms. PHOSP-COVID is registered on the ISRCTN Registry (ISRCTN10980107).
Findings:
2320 of 2468 participants in the PHOSP-COVID study attended an early timepoint research visit a median of 5 months (IQR 4–6) following discharge from 83 hospitals in the UK. Data for sleep quality were assessed by subjective measures (the Pittsburgh Sleep Quality Index questionnaire and the numerical rating scale) for 638 participants at the early time point. Sleep quality was also assessed using device-based measures (actigraphy) a median of 7 months (IQR 5–8 months) after discharge from hospital for 729 participants. After discharge from hospital, the majority (396 [62%] of 638) of participants who had been admitted to hospital for COVID-19 reported poor sleep quality in response to the Pittsburgh Sleep Quality Index questionnaire. A comparable proportion (338 [53%] of 638) of participants felt their sleep quality had deteriorated following discharge after COVID-19 admission, as assessed by the numerical rating scale. Device-based measurements were compared to an age-matched, sex-matched, BMI-matched, and time from discharge-matched UK Biobank cohort who had recently been admitted to hospital. Compared to the recently hospitalised matched UK Biobank cohort, participants in our study slept on average 65 min (95% CI 59 to 71) longer, had a lower sleep regularity index (–19%; 95% CI –20 to –16), and a lower sleep efficiency (3·83 percentage points; 95% CI 3·40 to 4·26). Similar results were obtained when comparisons were made with the non-hospitalised UK Biobank cohort. Overall sleep quality (unadjusted effect estimate 3·94; 95% CI 2·78 to 5·10), deterioration in sleep quality following hospital admission (3·00; 1·82 to 4·28), and sleep regularity (4·38; 2·10 to 6·65) were associated with higher dyspnoea scores. Poor sleep quality, deterioration in sleep quality, and sleep regularity were also associated with impaired lung function, as assessed by forced vital capacity. Depending on the sleep metric, anxiety mediated 18–39% of the effect of sleep disturbance on dyspnoea, while muscle weakness mediated 27–41% of this effect.
Interpretation:
Sleep disturbance following hospital admission for COVID-19 is associated with dyspnoea, anxiety, and muscle weakness. Due to the association with multiple symptoms, targeting sleep disturbance might be beneficial in treating the post-COVID-19 condition.
Funding:
UK Research and Innovation, National Institute for Health Research, and Engineering and Physical Sciences Research Council
Accelarated immune ageing is associated with COVID-19 disease severity
Background
The striking increase in COVID-19 severity in older adults provides a clear example of immunesenescence, the age-related remodelling of the immune system. To better characterise the association between convalescent immunesenescence and acute disease severity, we determined the immune phenotype of COVID-19 survivors and non-infected controls.
Results
We performed detailed immune phenotyping of peripheral blood mononuclear cells isolated from 103 COVID-19 survivors 3–5 months post recovery who were classified as having had severe (n = 56; age 53.12 ± 11.30 years), moderate (n = 32; age 52.28 ± 11.43 years) or mild (n = 15; age 49.67 ± 7.30 years) disease and compared with age and sex-matched healthy adults (n = 59; age 50.49 ± 10.68 years). We assessed a broad range of immune cell phenotypes to generate a composite score, IMM-AGE, to determine the degree of immune senescence. We found increased immunesenescence features in severe COVID-19 survivors compared to controls including: a reduced frequency and number of naïve CD4 and CD8 T cells (p < 0.0001); increased frequency of EMRA CD4 (p < 0.003) and CD8 T cells (p < 0.001); a higher frequency (p < 0.0001) and absolute numbers (p < 0.001) of CD28−ve CD57+ve senescent CD4 and CD8 T cells; higher frequency (p < 0.003) and absolute numbers (p < 0.02) of PD-1 expressing exhausted CD8 T cells; a two-fold increase in Th17 polarisation (p < 0.0001); higher frequency of memory B cells (p < 0.001) and increased frequency (p < 0.0001) and numbers (p < 0.001) of CD57+ve senescent NK cells. As a result, the IMM-AGE score was significantly higher in severe COVID-19 survivors than in controls (p < 0.001). Few differences were seen for those with moderate disease and none for mild disease. Regression analysis revealed the only pre-existing variable influencing the IMM-AGE score was South Asian ethnicity (
= 0.174, p = 0.043), with a major influence being disease severity (
= 0.188, p = 0.01).
Conclusions
Our analyses reveal a state of enhanced immune ageing in survivors of severe COVID-19 and suggest this could be related to SARS-Cov-2 infection. Our data support the rationale for trials of anti-immune ageing interventions for improving clinical outcomes in these patients with severe disease
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