Leveraging artificial intelligence to identify high-risk patients for postoperative sore throat: An observational study

Postoperative sore throat (POST) is a prevalent complication after general anesthesia and targeting high-risk patients helps in its prevention. This study developed and validated a machine learning model to predict POST. A total number of 834 patients who underwent general anesthesia with endotracheal intubation were included in this study. Data from a cohort of 685 patients was used for model development and validation, while a cohort of 149 patients served for external validation. The prediction performance of random forest (RF), neural network (NN), and extreme gradient boosting (XGBoost) models was compared using comprehensive performance metrics. The Local Interpretable Model-Agnostic Explanations (LIME) methods elucidated the best-performing model. POST incidences across training, validation, and testing cohorts were 41.7%, 38.4%, and 36.2%, respectively. Five predictors were age, sex, endotracheal tube cuff pressure, endotracheal tube insertion depth, and the time interval between extubation and the first drinking of water after extubation. After incorporating these variables, the NN model demonstrated superior generalization capabilities in predicting POST when compared to the XGBoost and RF models in external validation, achieving an area under the receiver operating characteristic curve (AUROC) of 0.81 (95% CI 0.74–0.89) and a precision–recall curve (AUPRC) of 0.77 (95% CI 0.66–0.86). The model also showed good calibration and clinical usage values. The NN model outperforms the XGBoost and RF models in predicting POST, with potential applications in the healthcare industry for reducing the incidence of this common postoperative complication

A Brain Storm Optimization with Multiinformation Interactions for Global Optimization Problems

The original BSO fails to consider some potential information interactions in its individual update pattern, causing the premature convergence for complex problems. To address this problem, we propose a BSO algorithm with multi-information interactions (MIIBSO). First, a multi-information interaction (MII) strategy is developed, thoroughly considering various information interactions among individuals. Specially, this strategy contains three new MII patterns. The first two patterns aim to reinforce information interaction capability between individuals. The third pattern provides interactions between the corresponding dimensions of different individuals. The collaboration of the above three patterns is established by an individual stagnation feedback (ISF) mechanism, contributing to preserve the diversity of the population and enhance the global search capability for MIIBSO. Second, a random grouping (RG) strategy is introduced to replace both the K-means algorithm and cluster center disruption of the original BSO algorithm, further enhancing the information interaction capability and reducing the computational cost of MIIBSO. Finally, a dynamic difference step-size (DDS), which can offer individual feedback information and improve search range, is designed to achieve an effective balance between global and local search capability for MIIBSO. By combining the MII strategy, RG, and DDS, MIIBSO achieves the effective improvement in the global search ability, convergence speed, and computational cost. MIIBSO is compared with 11 BSO algorithms and five other algorithms on the CEC2013 test suit. The results confirm that MIIBSO obtains the best global search capability and convergence speed amongst the 17 algorithms

TBR2 coordinates neurogenesis expansion and precise microcircuit organization via Protocadherin 19 in the mammalian cortex.

Cerebral cortex expansion is a hallmark of mammalian brain evolution; yet, how increased neurogenesis is coordinated with structural and functional development remains largely unclear. The T-box protein TBR2/EOMES is preferentially enriched in intermediate progenitors and supports cortical neurogenesis expansion. Here we show that TBR2 regulates fine-scale spatial and circuit organization of excitatory neurons in addition to enhancing neurogenesis in the mouse cortex. TBR2 removal leads to a significant reduction in neuronal, but not glial, output of individual radial glial progenitors as revealed by mosaic analysis with double markers. Moreover, in the absence of TBR2, clonally related excitatory neurons become more laterally dispersed and their preferential synapse development is impaired. Interestingly, TBR2 directly regulates the expression of Protocadherin 19 (PCDH19), and simultaneous PCDH19 expression rescues neurogenesis and neuronal organization defects caused by TBR2 removal. Together, these results suggest that TBR2 coordinates neurogenesis expansion and precise microcircuit assembly via PCDH19 in the mammalian cortex

Modeling on fluid flow and inclusion motion in centrifugal continuous casting strands

During the centrifugal continuous casting process, unreasonable casting parameters can cause violent level fluctuation, serious gas entrainment, and formation of frozen shell pieces at the meniscus. Thus, in the current study, a three-dimensional multiphase turbulent model was established to study the transport phenomena during centrifugal continuous casting process. The effects of nozzle position, casting and rotational speed on the flow pattern, centrifugal force acting on the molten steel, level fluctuation, gas entrainment, shear stress on mold wall, and motion of inclusions during centrifugal continuous casting process were investigated. Volume of Fluid model was used to simulate the molten steel-air two-phase. The level fluctuation and the gas entrainment during casting were calculated by user-developed subroutines. The trajectory of inclusions in the rotating system was calculated using the Lagrangian approach. The results show that during centrifugal continuous casting, a large amount of gas was entrained into the molten steel, and broken into bubbles of various sizes. The greater the distance to the mold wall, the smaller the centrifugal force. Rotation speed had the most important influence on the centrifugal force distribution at the side region. Angular moving angle of the nozzle with 8° and keeping the rotation speed with 60 revolutions per minute can somehow stabilize the level fluctuation. The increase of angular angle of nozzle from 8 to 18 deg and rotation speed from 40 to 80 revolutions per minute favored to decrease the total volume of entrained bubbles, while the increase of distance of nozzle moving left and casting speed had reverse effects. The trajectories of inclusions in the mold were irregular, and then rotated along the strand length. After penetrating a certain distance, the inclusions gradually moved to the center of billet and gathered there. More work, such as the heat transfer, the solidification, and the inclusions entrapment during centrifugal continuous casting, will be performed

Association of folic acid dosage with circulating unmetabolized folic acid in Chinese adults with H-type hypertension: a multicenter, double-blind, randomized controlled trial

BackgroundThere is growing concern regarding elevated levels of circulating unmetabolized folic acid (UMFA) due to excessive intake of folic acid (FA). However, no randomized clinical trial has been conducted to examine the FA-UMFA dose-response relationship.ObjectiveThis study aimed to investigate the FA-UMFA dose-response relationship in Chinese adults with hypertension and elevated homocysteine (H-type hypertension), a population with clear clinical indication for FA treatment.MethodsThe data for this study were derived from a randomized, double-blind, multicenter clinical trial of 8 FA dosages on efficacy of homocysteine (Hcy) lowering. The parent trial had three 3 stages: screening period (2–10 days), run-in period (0–2 weeks, baseline visit), and double-blind treatment period (8 weeks) with follow-up visits at the end of the 2nd, 4th, 6th, and 8th weeks of treatment. Participants were randomly assigned to 8 treatment groups corresponding to FA dosages of 0, 0.4, 0.6, 0.8, 1.2, 1.6, 2.0 mg to 2.4 mg.ResultsThis study included 1,567 Chinese adults aged ≥45 years with H-type hypertension. There was a positive but non-linear association between FA supplementation and UMFA levels in the dosage range of 0 mg to 2.4 mg. In the regression analysis, the coefficients for the linear and quadratic terms of FA dosage were both statistically significant (P < 0.001). Notably, the slope for UMFA was greater for FA dosages >0.8 mg (ß = 11.21, 95% CI: 8.97, 13.45) compared to FA dosages ≤0.8 mg (ß = 2.94, 95% CI: 2.59, 3.29). Furthermore, FA dosages higher than 0.8 mg did not confer additional benefits in terms of increasing 5-methyl tetrahydrofolic acid (5-MTHF, active form of folate) or reducing homocysteine (Hcy).ConclusionIn Chinese adults with H-type hypertension, this study showed a positive, non-linear, dosage-response relationship between FA supplementation ranging from 0 to 2.4 mg and circulating UMFA levels. It revealed that 0.8 mg FA is an optimal dosage in terms of balancing efficacy (increasing 5-MTHF and lowering Hcy) while minimizing undesirable elevation of UMFA.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT03472508?term=NCT03472508&draw=2&rank=1, identifier NCT03472508

Simulation Analysis of the Motion of Superparamagnetic Particles in Liquid-Phase Fluid under a Magnetic Field

Based on the magnetic response of magnetic particles, the targeting of particles to a target area under the modulation of an external magnetic field has been used in many applications. An accurate kinematic model is helpful to achieve accurate targeting of magnetic particles and to investigate the factors influencing the motion of the particles. In the present paper, a segmental magnetization model was proposed based on the real magnetization process of superparamagnetic particles to calculate the magnetic force, and this was compared with a traditional magnetization model. The effects of magnetic field strength and particle diameter on the trajectory of magnetic particles in fluids under a magnetic field were further analyzed using a finite element analysis software. The simulation results show that changing the particle size only affected the velocity of the particles and did not affect the trajectory. When magnetic field strength changed, magnetic particles showed different trajectories. Notably, when the magnetic field force in the Y direction was too large, meaning the gravity could be neglected, the trajectory of the particles no longer changed when the magnetic field strength was varied

Significance of Determination Methods on Shear Modulus Measurements of Fujian Sand in Cyclic Triaxial Testing

It has long been known that the hysteresis loops of sand under cyclic loading gradually become asymmetric with the increase of strain amplitudes, but a symmetrical hysteresis loop is widely assumed in current practice. Despite several methods which have been proposed recently to consider the hysteresis loop irregularities, previous research has lacked a quantitative study on the effects of determination methods on the shear modulus G and modulus reduction curve G/Gmax. The primary objective of the current study is to evaluate the uncertainties associated with the shear modulus measurements introduced by four determination methods. Reconstituted sand specimens prepared at three relative densities are tested using strain-controlled cyclic triaxial tests, at various effective confining pressures. The results in terms of G and G/Gmax with increasing shear strain are presented, following by the difference quantification in the calculated G/Gmax caused by the determination methods, the Gmax definition and the cycle number. The results show that the calculated G/Gmax may differ significantly for the same hysteresis loop, with a maximum percentage change of 40~50%. The aggravated influence at low confining pressure highlights that careful consideration of the asymmetrical hysteresis loop at large strains is warranted

Significance of Determination Methods on Shear Modulus Measurements of Fujian Sand in Cyclic Triaxial Testing

It has long been known that the hysteresis loops of sand under cyclic loading gradually become asymmetric with the increase of strain amplitudes, but a symmetrical hysteresis loop is widely assumed in current practice. Despite several methods which have been proposed recently to consider the hysteresis loop irregularities, previous research has lacked a quantitative study on the effects of determination methods on the shear modulus G and modulus reduction curve G/Gmax. The primary objective of the current study is to evaluate the uncertainties associated with the shear modulus measurements introduced by four determination methods. Reconstituted sand specimens prepared at three relative densities are tested using strain-controlled cyclic triaxial tests, at various effective confining pressures. The results in terms of G and G/Gmax with increasing shear strain are presented, following by the difference quantification in the calculated G/Gmax caused by the determination methods, the Gmax definition and the cycle number. The results show that the calculated G/Gmax may differ significantly for the same hysteresis loop, with a maximum percentage change of 40~50%. The aggravated influence at low confining pressure highlights that careful consideration of the asymmetrical hysteresis loop at large strains is warranted

Development and Test Application of an Auxiliary Power-Integrated System

This paper focuses on the design and test technique of an auxiliary power unit (APU) for a range-extended electric vehicle (RE-EV). The APU system is designed to improve RE-EV power and economy; it integrates the power system, generator system, battery system, and APU controller. The parameters of the APU parts are computed and optimized considering the vehicle power demand and the matching characteristic of the engine and generator. The hardware and software systems are developed for the APU-integrated control system. The APU test bench, combined with the displaying part, the control part, and the bench with its accessory, is constructed. Communication connection in the APU system is established by controller area network (CAN) bus. The APU controller outputs a corresponding signal to the engine control unit (ECU) and motor controller. To verify the rationality of the control strategy and the validity of the control logic, the engine speed control and integrated control experiment of the APU system are completed on the test bench. The test results showed that the test control system is reliable and the relevant control logic is in agreement with simulation analysis. The APU-integrated system could be well suited for application in RE-EVs