Embedded Large-Scale Handwritten Chinese Character Recognition

As handwriting input becomes more prevalent, the large symbol inventory required to support Chinese handwriting recognition poses unique challenges. This paper describes how the Apple deep learning recognition system can accurately handle up to 30,000 Chinese characters while running in real-time across a range of mobile devices. To achieve acceptable accuracy, we paid particular attention to data collection conditions, representativeness of writing styles, and training regimen. We found that, with proper care, even larger inventories are within reach. Our experiments show that accuracy only degrades slowly as the inventory increases, as long as we use training data of sufficient quality and in sufficient quantity.Comment: 5 pages, 7 figure

The radiation effect on low noise amplifier implemented in the space-aerial–terrestrial integrated 5G networks

This paper provides the details of a study on the effects of electron irradiation on two Low Noise Amplifiers (LNA), the Gallium-Arsenide (GaAs) pseudomorphic high electron mobility transistor (pHEMT) based and the Silicon-Germanium (SiGe) Heterojunction Bipolar Transistor (HBT)-based. Previous studies have shown that the properties of GaAs and SiGe HBT’s are very tolerant of gamma, neutron, and proton irradiation without additional radiation hardening. Nowadays, commercials on the shelves (COTS) LNAs have been used in CubeSat space communication systems which may be connected to other communication networks for the implementation of the space-aerial- terrestrial integrated 5G network (SATIN) systems projects, for satellites, launched into Low and Medium Earth Orbits. Previous studies suggest that the electron radiation in space may degrade the LNAs’ performance and might even lead to its failure. Located at the front end of the communication receiver system, this paper conducted such investigation to evaluate the performance under the radiation of the GaAs and SiGe LNAs considering the physics of the technology of each LNA, respectively. The results indicate that both SiGe and GaAs technologies are affected after electron irradiation. As a result, this degradation of the LNAs’ performance affected the communications system performance of the inter-satellite radio link. After the assessment of the quality performance of the communication link at the system level, it has been found that the inter-satellite space link will be at risk under high space radiation dose and the link BER degrades proportionally to the radiation dose level

Clinical trial management: a profession in crisis?

Clinical trial managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist role due to a complex set of factors, most likely to have come to a head due to the COVID-19 pandemic. Academic clinical trial units and departments are struggling to recruit trial managers to vacant positions, and multiple influences are affecting the retention of this highly skilled workforce. Without tackling this issue, we face major challenges in the delivery on the Department of Health and Social Care’s Future of UK Clinical Research Delivery implementation plan. This article, led by a leading network of and for UK Trial Managers, presents some of the issues and ways in which national stakeholders may be able to address this

Typologie des stratégies d’adaptation des éleveuses de petits ruminants au nord du Bénin face au changement climatique

Climate change (CC) has a direct impact on ruminant farming, given that it mobilizes resources whose seasonality and productivity are strongly linked to the climate. Small ruminant farmers react to the effects of CC by adopting various adaptation strategies. Knowledge of these strategies is essential in identifying and prioritizing the best of them. It is in this context that this study aims to achieve the typology of adaptation strategies developed by small ruminant women farmers in the dry and sub-humid tropical zones of Benin. For this purpose, a survey was conducted with 120 small ruminant women farmers in eight villages of two climatic zones. The data collected related to the socio-demographic characteristics of small ruminant women farmers, their perceptions and adaptation strategies. Using a Factorial Analysis of Multiple Correspondence (FACM) method, a typology of 3 groups of adaptation strategies was established: (1) integrating crops with animal husbandry (Group 1: ICA) developed by 51.7 % of the women surveyed, i.e. 60 women; (2) integrating crops with animal husbandry and shrubs (Group 2: ICArA) implemented by 13.3 % of respondents (i.e. 16 women) and finally (3) the strategy based on agro-industrial by-products and crop residues (ASPR) developed by 35.0 % of the women farmers surveyed, i.e. 42 women. This typology constitutes a starting point for the evaluation of the productivity of small ruminant farms in relation to the adaptation strategies developed by the women owners of these farms. Keywords: Climate change, goats, sheep, women, adaptation strategies.Le changement climatique (CC) a un impact direct sur l’élevage des ruminants, étant donné qu’il mobilise des ressources dont la saisonnalité et la productivité sont fortement liées au climat. Les éleveuses de petits ruminants réagissent aux effets du CC en adoptant différentes stratégies d’adaptation. La connaissance de ces stratégies s’avère indispensable dans la mesure où elle permettra d’identifier et de vulgariser les meilleures d’ente elles. C’est dans ce cadre que cette étude vise à réaliser la typologie des stratégies d’adaptation développées par les éleveuses de petits ruminants des zones tropicales sèche et subhumide du Bénin. À cet effet, une enquête a été menée auprès de 120 éleveuses de petits ruminants dans 8 villages des deux zones climatiques. Les données collectées ont été relatives aux caractéristiques socio-démographiques, aux perceptions et stratégies d’adaptation développées par ces éleveuses. À l’aide des méthodes d’Analyse Factorielle des Correspondances Multiples (AFCM), une typologie de trois groupes de stratégies d’adaptation a été établie. Il s’agit de (1) la stratégie d’intégration des cultures aux animaux (Groupe 1: ICA) développée par 51,7 % des femmes enquêtées, soit 60 personnes; (2) de la stratégie d’intégration des cultures, arbustes et animaux (Groupe 2: ICArA) mise en place par 13,3 % des enquêtés (soit 16 femmes) et enfin (3) de la stratégie d’alimentation basée sur les sous-produits agroindustriels et les résidus de récoltes (ASPR) développées par 35,0 % des femmes éleveuses enquêtées, soit 42 individus. Cette typologie constitue un point de départ pour l’évaluation de la productivité des élevages des petits ruminants en lien avec les stratégies d’adaptation développées par les femmes détentrices de ces élevages. Mots clés: Changement climatique, caprins, ovins, femmes, stratégies d’adaptation

Establishing Core Outcome Domains in Hemodialysis: Report of the Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Consensus Workshop

Evidence-informed decision making in clinical care and policy in nephrology is undermined by trials that selectively report a large number of heterogeneous outcomes, many of which are not patient centered. The Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Initiative convened an international consensus workshop on November 7, 2015, to discuss the identification and implementation of a potential core outcome set for all trials in hemodialysis. The purpose of this article is to report qualitative analyses of the workshop discussions, describing the key aspects to consider when establishing core outcomes in trials involving patients on hemodialysis therapy. Key stakeholders including 8 patients/caregivers and 47 health professionals (nephrologists, policymakers, industry, and researchers) attended the workshop. Attendees suggested that identifying core outcomes required equitable stakeholder engagement to ensure relevance across patient populations, flexibility to consider evolving priorities over time, deconstruction of language and meaning for conceptual consistency and clarity, understanding of potential overlap and associations between outcomes, and an assessment of applicability to the range of interventions in hemodialysis. For implementation, they proposed that core outcomes must have simple, inexpensive, and validated outcome measures that could be used in clinical care (quality indicators) and trials (including pragmatic trials) and endorsement by regulatory agencies. Integrating these recommendations may foster acceptance and optimize the uptake and translation of core outcomes in hemodialysis, leading to more informative research, for better treatment and improved patient outcomes

Standard of care in advanced HIV disease: review of HIV treatment guidelines in six sub-Saharan African countries.

BACKGROUND: The World Health Organization (WHO) recommends an evidence-based package of care to reduce mortality and morbidity among people with advanced HIV disease (AHD). Adoption of these recommendations by national guidelines in sub-Saharan Africa is poorly documented. We aimed to review national guidelines for AHD management across six selected countries in sub-Saharan Africa for benchmarking against the 2021 WHO recommendations. METHODS: We reviewed national guidelines from six countries participating in an ongoing randomized controlled trial recruiting people with AHD. We extracted information addressing 18 items of AHD diagnosis and management across the following domains: [1] Definition of AHD, [2] Screening, [3] Prophylaxis, [4] Supportive care, and [5] HIV treatment. Data from national guideline documents were compared to the 2021 WHO consolidated guidelines on HIV and an agreement score was produced to evaluate extent of guideline adoption. RESULTS: The distribution of categories of agreement varied for the national documents. Four of the six countries addressed all 18 items (Malawi, Nigeria, Sierra Leone, Uganda). Overall agreement with the WHO 2021 guidelines ranged from 9 to 15.5 out of 18 possible points: Malawi 15.5 points, Nigeria, and Sierra Leone 14.5 points, South Africa 13.5 points, Uganda 13.0 points and Botswana with 9.0 points. Most inconsistencies were reported for the delay of antiretroviral therapy (ART) in presence of opportunistic diseases. None of the six national guidelines aligned with WHO recommendations around ART timing in patients with tuberculosis. Agreement correlated with the year of publication of the national guideline. CONCLUSION: National guidelines addressing the care of advanced HIV disease in sub-Saharan Africa are available. Besides optimal timing for start of ART in presence of tuberculosis, most national recommendations are in line with the 2021 WHO standards

Developing a Set of Core Outcomes for Trials in Haemodialysis: An International Delphi Survey

AIM: To generate a consensus-based, prioritized list of core outcomes for trials in haemodialysis. BACKGROUND: Survival and quality of life for patients on haemodialysis remain poor despite substantial research efforts. Existing trials often report surrogate outcomes that may not be relevant to patients and clinicians. A core outcome set that reflects stakeholder priorities would improve the relevance, efficiency, and comparability of haemodialysis trials. METHODS: In an online Delphi survey, participants rated the importance of outcomes using a 9-point Likert scale. In Round 2 and 3, participants reviewed the scores and comments of other respondents and re-rated the outcomes. For each outcome, we calculated the median, mean, and proportion rating 7-9 (“critically important”). RESULTS: 1,181 participants (202 [17%] patients/caregivers, 979 health professionals) from 73 countries completed Round 1 and 838 (150 [18%] patients/caregivers) completed Round 3 (71% response rate). Outcomes achieving consensus as high priorities across both groups were: vascular access complications, cardiovascular disease, mortality, dialysis adequacy and fatigue. Patients/caregivers rated four outcomes higher than health professionals: ability to travel (mean difference 0.9), dialysis-free time (0.5), dialysis adequacy (0.3), and washed out after dialysis (0.2). Health professionals rated 11 outcomes higher: mortality (1.0), hospitalization (1.0), drop in blood pressure (1.0), vascular access complications (0.9), depression (0.9), cardiovascular disease (0.8), target weight (0.7), infection (0.4), potassium (0.4), ability to work (0.3), and pain (0.3). CONCLUSIONS: The top stakeholder prioritized outcomes were vascular access problems, cardiovascular disease, mortality, dialysis adequacy and fatigue. Patients/caregivers gave higher priority to lifestyle-related outcomes than health professionals. This prioritized set of outcomes can inform the establishment of a core outcome set, to improve the value of trial evidence to support decision-making for people on haemodialysis

A pragmatic approach to managing antiretroviral therapy-experienced patients diagnosed with HIV-associated cryptococcal meningitis: impact of antiretroviral therapy adherence and duration

Cryptococcal meningitis accounts for 15% of all HIV-related deaths [1]. The overall number of cryptococcal meningitis cases has remained relatively stable in many low-to-middle income countries (LMICs) despite increasing roll-out of antiretroviral therapy (ART). Increasing numbers of patients are at risk of developing cryptococcal meningitis following ART failure or discontinuation, offsetting declines in those presenting for the first time with advanced HIV [2–4]. Over half of patients diagnosed with cryptococcal meningitis in recent studies in sub-Saharan Africa are ART-experienced (i.e. currently receiving or previously received ART) [5,6]. Although there is robust evidence from prospective randomized trials that ART initiation should be delayed until 4–6 weeks after starting antifungal therapy in ART-naïve cryptococcal meningitis patients [7,8], the approach to ART management among ART-experienced cryptococcal meningitis patients lacks adequate evidence, with a paucity of published data