Clinical phenotypes among patients with normal cardiac perfusion using unsupervised learning:a retrospective observational study

BACKGROUND: Myocardial perfusion imaging (MPI) is one of the most common cardiac scans and is used for diagnosis of coronary artery disease and assessment of cardiovascular risk. However, the large majority of MPI patients have normal results. We evaluated whether unsupervised machine learning could identify unique phenotypes among patients with normal scans and whether those phenotypes were associated with risk of death or myocardial infarction.METHODS: Patients from a large international multicenter MPI registry (10 sites) with normal perfusion by expert visual interpretation were included in this cohort analysis. The training population included 9849 patients, and external testing population 12,528 patients. Unsupervised cluster analysis was performed, with separate training and external testing cohorts, to identify clusters, with four distinct phenotypes. We evaluated the clinical and imaging features of clusters and their associations with death or myocardial infarction.FINDINGS: Patients in Clusters 1 and 2 almost exclusively underwent exercise stress, while patients in Clusters 3 and 4 mostly required pharmacologic stress. In external testing, the risk for Cluster 4 patients (20.2% of population, unadjusted hazard ratio [HR] 6.17, 95% confidence interval [CI] 4.64-8.20) was higher than the risk associated with pharmacologic stress (HR 3.03, 95% CI 2.53-3.63), or previous myocardial infarction (HR 1.82, 95% CI 1.40-2.36).INTERPRETATION: Unsupervised learning identified four distinct phenotypes of patients with normal perfusion scans, with a significant proportion of patients at very high risk of myocardial infarction or death. Our results suggest a potential role for patient phenotyping to improve risk stratification of patients with normal imaging results.FUNDING: This work was supported by the National Heart, Lung, and Blood Institute at the National Institutes of Health [R35HL161195 to PS]. The REFINE SPECT database was supported by the National Heart, Lung, and Blood Institute at the National Institutes of Health [R01HL089765 to PS]. MCW was supported by the British Heart Foundation [FS/ICRF/20/26002].</p

Transdermal Drug Delivery Aided by an Ultrasound Contrast Agent: An In Vitro Experimental Study

Sonophoresis temporarily increases skin permeability such that medicine can be delivered transdermally. Cavitation is believed to be the predominant mechanism in sonophoresis. In this study, an ultrasound contrast agent (UCA) strategy was adopted instead of low frequency ultrasound to assure that cavitation occurred, and the efficacy of sonophoresis with UCA was quantitatively analyzed by optical measurements. The target drug used in this study was 0.1 % Definity® in 70% glycerol, which was delivered into porcine skin samples. Glycerol was used because it is an optical clearing agent, and the efficiency of glycerol delivery could be analyzed with optical measurements. The applied acoustic pressure was approximately 600 kPa at 1 MHz ultrasound with a 10% duty cycle for 60 minutes. Experimental results indicated that the measured relative contrast (RC) after sonophoresis with UCA was approximately 80% higher than RC after sonophoresis without UCA. In addition, the variance of RC was also reduced by more than 50% with the addition of a UCA. The use of a UCA appeared to increase cavitation, demonstrating that the use of a UCA can be effective in transdermal drug delivery (TDD)

Research and Design of a Routing Protocol in Large-Scale Wireless Sensor Networks

无线传感器网络，作为全球未来十大技术之一，集成了传感器技术、嵌入式计算技术、分布式信息处理和自组织网技术，可实时感知、采集、处理、传输网络分布区域内的各种信息数据，在军事国防、生物医疗、环境监测、抢险救灾、防恐反恐、危险区域远程控制等领域具有十分广阔的应用前景。 本文研究分析了无线传感器网络的已有路由协议，并针对大规模的无线传感器网络设计了一种树状路由协议，它根据节点地址信息来形成路由，从而简化了复杂繁冗的路由表查找和维护，节省了不必要的开销，提高了路由效率，实现了快速有效的数据传输。 为支持此路由协议本文提出了一种自适应动态地址分配算——ADAR（AdaptiveDynamicAddre...As one of the ten high technologies in the future, wireless sensor network, which is the integration of micro-sensors, embedded computing, modern network and Ad Hoc technologies, can apperceive, collect, process and transmit various information data within the region. It can be used in military defense, biomedical, environmental monitoring, disaster relief, counter-terrorism, remote control of haz...学位：工学硕士院系专业：信息科学与技术学院通信工程系_通信与信息系统学号：2332007115216

Elucidating the origins of phase transformation hysteresis during electrochemical cycling of Li-Sb electrodes

We investigate the origins of phase transformation hysteresis in electrodes of Li-ion batteries, focusing on the alloying reaction of Li with Sb. Electrochemical measurements confirm that the reaction path followed during Li insertion into Sb electrodes differs from that followed upon subsequent Li extraction. Results from first-principles calculations and NMR measurements indicate that Li3Sb is capable of tolerating high Li-vacancy concentrations. An unusually high Li mobility in Li3Sb facilitates over potentials during charging, which leads to a substantially larger driving force for the nucleation of Sb compared to that of Li2Sb. The differences in nucleation driving forces arise from a lever effect that favors phases with large changes in Li concentration over phases that are closer in composition along the equilibrium path. These properties provide an explanation for the observed path hysteresis between charge and discharge in the Li–Sb system and likely also play a role in intercalation compounds and other alloying reactions exhibiting similar phase transformation hysteresis

Binary Spiky/Spherical Nanoparticle Films with Hierarchical Micro/Nanostructures for High-Performance Flexible Pressure Sensors

Flexible pressure sensors have been widely explored for their versatile applications in electronic skins, wearable healthcare monitoring devices, and robotics. However, fabrication of sensors with characteristics such as high sensitivity, linearity, and simple fabrication process remains a challenge. Therefore, we propose herein a highly flexible and sensitive pressure sensor based on a conductive binary spiky/spherical nanoparticle film that can be fabricated by a simple spray-coating method. The sea-urchin-shaped spiky nanoparticles are based on the core-shell structures of spherical silica nanoparticles decorated with conductive polyaniline spiky shells. The simple spray coating of binary spiky/spherical nanoparticles enables the formation of uniform conductive nanoparticle-based films with hierarchical nano/microstructures. The two differently shaped particles-based films (namely sea-urchin-shaped and spherical) when interlocked face-to-face to form a bilayer structure can be used as a highly sensitive piezoresistive pressure sensor. Our optimized pressure sensor exhibits high sensitivity (17.5 kPa(-1)) and linear responsivity over a wide pressure range (0.008-120 kPa), owing to the effects of stress concentration and gradual deformation of the hierarchical microporous structures with sharp nanoscale tips. Moreover, the sensor exhibits high durability over 6000 repeated cycles and practical applicability in wearable devices that can be used for healthcare monitoring and subtle airflow detection (1 L/min)

Liver Injury in Liver Transplant Recipients With Coronavirus Disease 2019 (COVID‐19): U.S. Multicenter Experience

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163939/1/hep31574.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163939/2/hep31574-sup-0001-Supinfo.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163939/3/hep31574_am.pd