Impacts of an aerosol layer on a mid-latitude continental system of cumulus clouds: how do these impacts depend on the vertical location of the aerosol layer?

Using the large-eddy simulation framework, effects of an aerosol layer on warm cumulus clouds in the Korean Peninsula when the layer is above or around the cloud tops in the upper atmosphere are examined. Also, these effects are compared to effects of an aerosol layer when it is around or below the cloud bases in the low atmosphere. Simulations show that when the aerosol layer is in the low atmosphere, aerosols absorb solar radiation and radiatively heat up air enough to induce greater instability, stronger updrafts and more cloud mass than when the layer is in the upper atmosphere. As aerosol concentrations in the layer decrease, the aerosol radiative heating gets weaker to lead to less instability, weaker updrafts and less cloud mass when the layer is in the low atmosphere. This in turn makes differences in cloud mass, which are between a situation when the layer is in the low atmosphere and that when the layer is in the upper atmosphere, smaller. It is found that the transportation of aerosols by updrafts reduces aerosol concentrations in the aerosol layer, which is in the low atmosphere, and in turn reduces the aerosol radiative heating, updraft intensity and cloud mass. It is also found that the presence of aerosol impacts on radiation suppresses updrafts and reduces clouds. Aerosols affect not only radiation but also aerosol activation. In the absence of aerosol impacts on radiation, aerosol impacts on the droplet nucleation increases cloud mass when the layer is in the low atmosphere as compared to a situation when the layer is in the upper atmosphere. As aerosol impacts on radiation team up with those on the droplet nucleation, differences in cloud mass, which are between a situation when the layer in the low atmosphere and that when the layer is in the upper atmosphere, get larger. This is as compared to a situation when there is no aerosol impacts on radiation and only aerosol impacts on the droplet nucleation.</p

RaidEnv: Exploring New Challenges in Automated Content Balancing for Boss Raid Games

The balance of game content significantly impacts the gaming experience. Unbalanced game content diminishes engagement or increases frustration because of repetitive failure. Although game designers intend to adjust the difficulty of game content, this is a repetitive, labor-intensive, and challenging process, especially for commercial-level games with extensive content. To address this issue, the game research community has explored automated game balancing using artificial intelligence (AI) techniques. However, previous studies have focused on limited game content and did not consider the importance of the generalization ability of playtesting agents when encountering content changes. In this study, we propose RaidEnv, a new game simulator that includes diverse and customizable content for the boss raid scenario in MMORPG games. Additionally, we design two benchmarks for the boss raid scenario that can aid in the practical application of game AI. These benchmarks address two open problems in automatic content balancing, and we introduce two evaluation metrics to provide guidance for AI in automatic content balancing. This novel game research platform expands the frontiers of automatic game balancing problems and offers a framework within a realistic game production pipeline.Comment: 14 pages, 6 figures, 6 tables, 2 algorithm

Effects of Lowering Dialysate Calcium Concentrations on Arterial Stiffness in Patients Undergoing Hemodialysis

BACKGROUND/AIMS: We assessed changes in hemodynamic and arterial stiffness parameters following reductions of dialysate calcium concentrations in patients undergoing hemodialysis. METHODS: In this prospective study, 20 patients on maintenance hemodialysis (10 females, 10 males) with dialysate calcium concentrations of 1.75 mmol/L were enrolled. At the start of the study, the dialysate calcium level was lowered to 1.50 mmol/L. Serial changes in biochemical, hemodynamic, and arterial stiffness parameters, including pulse wave velocity (PWV) and augmentation index (AIx), were assessed every 2 months for 6 months. We also examined changes in the calcification-inhibitory protein, serum fetuin-A. RESULTS: During the 6-month study period, serum total calcium and ionized calcium decreased consistently (9.5 ± 1.0 to 9.0 ± 0.7, p = 0.002 vs. 1.3 ± 0.1 to 1.1 ± 0.1, p = 0.035). Although no apparent changes in blood pressure were observed, heart-femoral PWW (hf-PWV) and AIx showed significant improvement (p = 0.012, 0.043, respectively). Repeated-measures ANOVA indicated a significant effect of lowering dialysate calcium on hf-PWV (F = 4.58, p = 0.004) and AIx (F = 2.55, p = 0.049). Accompanying the change in serum calcium, serum fetuin-A levels significantly increased (95.8 ± 45.8 pmol/mL at baseline to 124.9 ± 82.2 pmol/mL at 6 months, p = 0.043). CONCLUSIONS: Lowering dialysate calcium concentration significantly improved arterial stiffness parameters, which may have been associated with upregulation of serum fetuin-A.ope

Comparison of Clinical Efficacy of Newfactan® versus Surfacten® for the Treatment of Respiratory Distress Syndrome in the Newborn Infants

Newfactan® is a domestically developed, bovine lung-derived, semi-synthetic surfactant. The aim of this study was to compare the clinical efficacy of Newfactan® with that of Surfacten® in the treatment of respiratory distress syndrome (RDS). Newfactan® or Surfacten® was randomly allocated to 492 newborn infants who were diagnosed as RDS and required surfactant instillation in four participating hospitals. The comparisons were made individually in two subsets of infants by birth weight (<1,500 g group [n=253] and ≥1,500 g group [n=239]). Short-term responses to surfactant and acute complications, such as the total doses of surfactant instilled, response type, extubation rate, ventilator settings, changes in respiratory parameters, air leak, patent ductus arteriosus, pulmonary hemorrhage, and intraventricular hemorrhage, and mortality during the 96 hr after surfactant instillation were measured. Long-term outcome and complications, such as total duration of intubation, bronchopulmonary dysplasia and periventricular leukomalacia, and ultimate mortality were measured. There were no significant differences in demographic and perinatal variables, short-term responses to surfactant and acute complications, and long-term outcome and complications between Newfactan® and Surfacten® in both birth weight groups. We concluded that Newfactan® was comparable to Surfacten® in the clinical efficacy in the treatment of RDS in both birth weight groups

A novel de novo mutation in the serine-threonine kinase STK11 gene in a Korean patient with Peutz-Jeghers syndrome

BACKGROUND: Peutz-Jeghers syndrome (PJS) is an unusual autosomal dominant disorder characterized by mucocutaneous pigmentation and multiple gastrointestinal hamartomatous polyps. Patients with PJS are at an increased risk of developing multi-organ cancer, most frequently those involving the gastrointestinal tract. Germline mutation of the STK11 gene, which encodes a serine-threonine kinase, is responsible for PJS. METHODS: Using DNA samples obtained from the patient and his family members, we sequenced nine exons and flanking intron regions of the STK11 gene using polymerase chain reaction (PCR) and direct sequencing. RESULTS: Sequencing of the STK11 gene in the proband of the family revealed a novel 1-base pair deletion of guanine (G) in exon 6 (c.826delG; Gly276AlafsX11). This mutation resulted in a premature termination at codon 286, predicting a partial loss of the kinase domain and complete loss of the C-terminal domain. We did not observe this mutation in both parents of the PJS patient. Therefore, it is considered a novel de novo mutation. CONCLUSION: The results presented herein enlarge the spectrum of mutations of the STK11 gene by identifying a novel de novo mutation in a PJS patient and further support the hypothesis that STK11 mutations are disease-causing mutations for PJS with or without a positive family history

Large Oncocytic Adrenocortical Tumor with Uncertain Malignant Potential

Oncocytoma is a neoplasm consisting of oncocytes that is found in the salivary gland, kidney, and thyroid. Adrenocortical oncocytoma is particularly uncommon, and most cases reported are benign and nonfunctioning. Here, we report a 20 cm adrenal mass associated with necrosis that was identified as an oncocytic adrenocortical tumor with uncertain malignant potential through histopathological evaluation after its resection

Could Fractional Exhaled Nitric Oxide Test be Useful in Predicting Inhaled Corticosteroid Responsiveness in Chronic Cough? A Systematic Review

© 2016 Background Fractional exhaled nitric oxide (FENO) is a safe and convenient test for assessing T H 2 airway inflammation, which is potentially useful in the management of patients with chronic cough. Objective To summarize the current evidence on the diagnostic usefulness of FENO for predicting inhaled corticosteroid (ICS) responsiveness in patients with chronic cough. Methods A systematic literature review was conducted to identify articles published in peer-reviewed journals up to February 2015, without language restriction. We included studies that reported the usefulness of FENO (index test) for predicting ICS responsiveness (reference standard) in patients with chronic cough (target condition). The data were extracted to construct a 2 × 2 accuracy table. Study quality was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. Results We identified 5 original studies (2 prospective and 3 retrospective studies). We identified considerable heterogeneities in study design and outcome definitions, and thus were unable to perform a meta-analysis. The proportion of ICS responders ranged from 44% to 59%. Sensitivity and specificity ranged from 53% to 90%, and from 63% to 97%, respectively. The reported area under the curve ranged from abou t 0.60 to 0.87; however, studies with a prospective design and a lower prevalence of asthma had lower area under the curve values. None measured placebo effects or objective cough frequency. Conclusions We did not find strong evidence to support the use of FENO tests for predicting ICS responsiveness in chronic cough. Further studies need to have a randomized, placebo-controlled design, and should use validated measurement tools for cough. Standardization would facilitate the development of clinical evidence