Retinal Hemorrhages in 4 Patients with Dengue Fever

We report 4 patients with retinal hemorrhages that developed during hospitalization for dengue fever. Onset of symptoms coincided with resolution of fever and the nadir of thrombocytopenia. Retinal hemorrhages may reflect the rising incidence of dengue in Singapore or may be caused by changes in the predominant serotype of the dengue virus

Increasing Incidence of Clostridium difficile-associated Disease, Singapore

10.3201/eid1409.070043Emerging Infectious Diseases1491487-148

A scalable xeno-free microcarrier suspension bioreactor system for regenerative medicine biomanufacturing of hMSCs

An economical biomanufacturing paradigm for human mesenchymal stem/stromal cells (hMSCs) is in critical need, as indicated by over 800 clinical trials investigating the use of hMSCs for regenerative medicine. To meet the demand for clinical manufacturing, a scalable process and production technology platform that can generate billions to trillions of cells per manufacturing lot is needed. Suspension bioreactors show great promise in reaching commercially-viable working volumes, however, scalability of cell production remains an issue. Overcoming this challenge is necessary to drive widespread adoption of this culture system for hMSCs. We have taken the Quality by Design (QbD) approach to develop a scalable xeno-free (XF) hMSC bioreactor process that maintains the final cell population doubling level (PDL) within the recommended range of 16-20 to ensure product quality. Our strategic XF bioprocess was designed using high volume XF cell banks, an optimized XF fed-batch media system, and XF microcarriers, all combined in a scalable bioreactor system to meet our design criteria and streamlined production at different culture scales. Please click Additional Files below to see the full abstract

MPGemmFI: A Fault Injection Technique for Mixed Precision GEMM in ML Applications

Emerging deep learning workloads urgently need fast general matrix multiplication (GEMM). To meet such demand, one of the critical features of machine-learning-specific accelerators such as NVIDIA Tensor Cores, AMD Matrix Cores, and Google TPUs is the support of mixed-precision enabled GEMM. For DNN models, lower-precision FP data formats and computation offer acceptable correctness but significant performance, area, and memory footprint improvement. While promising, the mixed-precision computation on error resilience remains unexplored. To this end, we develop a fault injection framework that systematically injects fault into the mixed-precision computation results. We investigate how the faults affect the accuracy of machine learning applications. Based on the error resilience characteristics, we offer lightweight error detection and correction solutions that significantly improve the overall model accuracy if the models experience hardware faults. The solutions can be efficiently integrated into the accelerator's pipelines

Untangling the drivers of energy reduction in the UK productive sectors: Efficiency or offshoring?

The UK has been one of the few countries that has successfully decoupled final energy consumption from economic growth over the past 15 years. This study investigates the drivers of final energy consumption in the UK productive sectors between 1997 and 2013 using a decomposition analysis that incorporates two novel features. Firstly, it investigates to what extent changes in thermodynamic efficiency have contributed to overall changes in sectoral energy intensities. Secondly, it analyses how much of the structural change in the UK economy is driven by the offshoring of energy-intensive production overseas. The results show that energy intensity reductions are the strongest factor reducing energy consumption. However, only a third of the energy savings from energy intensity reductions can be attributed to reductions in thermodynamic efficiency with re- ductions in the exergy intensity of production making up the reminder. In addition the majority of energy savings from structural change are a result of offshoring, which constitutes the second biggest factor reducing energy consumption. In recent years the contributions of all decomposition factors have been declining with very little change in energy consumption after 2009. This suggests that a return to the strong reductions in energy consumption observed between 2001 and 2009 in the UK productive sectors should not be taken for granted. Given that further reductions in UK final energy consumption are needed to achieve global targets for climate change mitigation, additional policy interventions are needed. Such policies should adopt a holistic approach, taking into account all sectors in the UK economy as well as the relationship between the structural change in the UK and in the global supply chains delivering the goods and service for consumption and investment in the UK

Associations of staple food consumption and types of cooking oil with waist circumference and body mass index in older Chinese men and women: a panel analysis

Background: The dietary landscape has changed rapidly in China in the past few decades. This research investigates the associations of older adults’ choices and consumption of staple foods and cooking oils with obesity related measurements. Methods: Panel data were extracted from the Chinese Longitudinal Health Longevity Survey from3253 older participants with 6506 observations. Ordinary least squares and ordered logistic regression models were estimated with the outcomes of obesity determined by waist circumference (WC) and body mass index (BMI), respectively. Results: Older men who consumed wheat had wider WCs (β=2.84 [95% confidence interval {CI} 1.55 to 4.13], p\u3c0.01) and higher BMIs (adjusted odds ratio 1.74 [95% CI 1.40 to 2.17], p\u3c0.01) than those who preferred rice. Female participants who used animal-based cooking oil had lower WCs and BMIs than their counterparts who consumed vegetable-based cooking oil. Increased consumption of staple foods was associated with increased rates of obesity in both sexes. Conclusion: Dieticians and nutritionists should design appropriate dietary plans to help reduce obesity and chronic diseases among older Chinese adults. Further clinical trials are needed to continue investigating this topic

Endovascular Thrombectomy for Ischemic Stroke Increases Disability-Free Survival, Quality of Life, and Life Expectancy and Reduces Cost

Background: Endovascular thrombectomy improves functional outcome in large vessel occlusion ischemic stroke. We examined disability, quality of life, survival and acute care costs in the EXTEND-IA trial, which used CT-perfusion imaging selection. Methods: Large vessel ischemic stroke patients with favorable CT-perfusion were randomized to endovascular thrombectomy after alteplase versus alteplase-only. Clinical outcome was prospectively measured using 90-day modified Rankin scale (mRS). Individual patient expected survival and net difference in Disability/Quality-adjusted life years (DALY/QALY) up to 15 years from stroke were modeled using age, sex, 90-day mRS, and utility scores. Level of care within the first 90 days was prospectively measured and used to estimate procedure and inpatient care costs (US$reference year 2014). Results: There were 70 patients, 35 in each arm, mean age 69, median NIHSS 15 (IQR 12-19). The median (IQR) disability-weighted utility score at 90 days was 0.65 (0.00-0.91) in the alteplase-only versus 0.91 (0.65-1.00) in the endovascular group (p = 0.005). Modeled life expectancy was greater in the endovascular versus alteplaseonly group (median 15.6 versus 11.2 years, p = 0.02). The endovascular thrombectomy group had fewer simulated DALYs lost over 15 years [median (IQR) 5.5 (3.2-8.7) versus 8.9 (4.7-13.8), p = 0.02] and more QALY gained [median (IQR) 9.3 (4.2-13.1) versus 4.9 (0.3-8.5), p = 0.03]. Endovascular patients spent less time in hospital [median (IQR) 5 (3-11) days versus 8 (5-14) days, p = 0.04] and rehabilitation [median (IQR) 0 (0-28) versus 27 (0-65) days, p = 0.03]. The estimated inpatient costs in the first 90 days were less in the thrombectomy group (average US$15,689 versus US$30,569, p = 0.008) offsetting the costs of interhospital transport and the thrombectomy procedure (average US$10,515). The average saving per patient treated with thrombectomy was US$4,365. c Conclusion: Thrombectomy patients with large vessel occlusion and salvageable tissue on CT-perfusion had reduced length of stay and overall costs to 90 days. There was evidence of clinically relevant improvement in long-term survival and quality of life.Peer reviewe

Beyond spectroscopy. II. Stellar parameters for over twenty million stars in the northern sky from SAGES DR1 and Gaia DR3

We present precise photometric estimates of stellar parameters, including effective temperature, metallicity, luminosity classification, distance, and stellar age, for nearly 26 million stars using the methodology developed in the first paper of this series, based on the stellar colors from the Stellar Abundances and Galactic Evolution Survey (SAGES) DR1 and Gaia EDR3. The optimal design of stellar-parameter sensitive $uv$ filters by SAGES has enabled us to determine photometric-metallicity estimates down to $-3.5$, similar to our previous results with the SkyMapper Southern Survey (SMSS), yielding a large sample of over five million metal-poor (MP; [Fe/H]$\le -1.0$) stars and nearly one million very metal-poor (VMP; [Fe/H]$\le -2.0$) stars. The typical precision is around $0.1$ dex for both dwarf and giant stars with [Fe/H]$>-1.0$, and 0.15-0.25/0.3-0.4 dex for dwarf/giant stars with [Fe/H]$<-1.0$. Using the precise parallax measurements and stellar colors from Gaia, effective temperature, luminosity classification, distance and stellar age are further derived for our sample stars. This huge data set in the Northern sky from SAGES, together with similar data in the Southern sky from SMSS, will greatly advance our understanding of the Milky Way, in particular its formation and evolution.Comment: 14 pages, 14 figures, 3 tables, accepted by ApJ. arXiv admin note: text overlap with arXiv:2104.1415

Regional Radiomics Similarity Networks Reveal Distinct Subtypes and Abnormality Patterns in Mild Cognitive Impairment.

Funder: Startup Funds for Leading Talents at Beijing Normal UniversityIndividuals with mild cognitive impairment (MCI) of different subtypes show distinct alterations in network patterns. The first aim of this study is to identify the subtypes of MCI by employing a regional radiomics similarity network (R2SN). The second aim is to characterize the abnormality patterns associated with the clinical manifestations of each subtype. An individual-level R2SN is constructed for N = 605 normal controls (NCs), N = 766 MCI patients, and N = 283 Alzheimer's disease (AD) patients. MCI patients' R2SN profiles are clustered into two subtypes using nonnegative matrix factorization. The patterns of brain alterations, gene expression, and the risk of cognitive decline in each subtype are evaluated. MCI patients are clustered into "similar to the pattern of NCs" (N-CI, N = 252) and "similar to the pattern of AD" (A-CI, N = 514) subgroups. Significant differences are observed between the subtypes with respect to the following: 1) clinical measures; 2) multimodal neuroimaging; 3) the proportion of progression to dementia (61.54% for A-CI and 21.77% for N-CI) within three years; 4) enriched genes for potassium-ion transport and synaptic transmission. Stratification into the two subtypes provides new insight for risk assessment and precise early intervention for MCI patients