Metric Learning for Projections Bias of Generalized Zero-shot Learning

Generalized zero-shot learning models (GZSL) aim to recognize samples from seen or unseen classes using only samples from seen classes as training data. During inference, GZSL methods are often biased towards seen classes due to the visibility of seen class samples during training. Most current GZSL methods try to learn an accurate projection function (from visual space to semantic space) to avoid bias and ensure the effectiveness of GZSL methods. However, during inference, the computation of distance will be important when we classify the projection of any sample into its nearest class since we may learn a biased projection function in the model. In our work, we attempt to learn a parameterized Mahalanobis distance within the framework of VAEGAN (Variational Autoencoder \& Generative Adversarial Networks), where the weight matrix depends on the network's output. In particular, we improved the network structure of VAEGAN to leverage the discriminative models of two branches to separately predict the seen samples and the unseen samples generated by this seen one. We proposed a new loss function with two branches to help us learn the optimized Mahalanobis distance representation. Comprehensive evaluation benchmarks on four datasets demonstrate the superiority of our method over the state-of-the-art counterparts. Our codes are available at https://anonymous.4open.science/r/111hxr.Comment: 9 pages, 2 figure

Optically Levitated Nanodumbbell Torsion Balance and GHz Nanomechanical Rotor

Levitated optomechanics has great potentials in precision measurements, thermodynamics, macroscopic quantum mechanics and quantum sensing. Here we synthesize and optically levitate silica nanodumbbells in high vacuum. With a linearly polarized laser, we observe the torsional vibration of an optically levitated nanodumbbell in vacuum. The linearly-polarized optical tweezer provides a restoring torque to confine the orientation of the nanodumbbell, in analog to the torsion wire which provides restoring torque for suspended lead spheres in the Cavendish torsion balance. Our calculation shows its torque detection sensitivity can exceed that of the current state-of-the-art torsion balance by several orders. The levitated nanodumbbell torsion balance provides rare opportunities to observe the Casimir torque and probe the quantum nature of gravity as proposed recently. With a circularly-polarized laser, we drive a 170-nm-diameter nanodumbbell to rotate beyond 1~GHz, which is the fastest nanomechanical rotor realized to date. Our calculations show that smaller silica nanodumbbells can sustain rotation frequency beyond 10 GHz. Such ultrafast rotation may be used to study material properties and probe vacuum friction

A Simple and Effective Baseline for Attentional Generative Adversarial Networks

Synthesising a text-to-image model of high-quality images by guiding the generative model through the Text description is an innovative and challenging task. In recent years, AttnGAN based on the Attention mechanism to guide GAN training has been proposed, SD-GAN, which adopts a self-distillation technique to improve the performance of the generator and the quality of image generation, and Stack-GAN++, which gradually improves the details and quality of the image by stacking multiple generators and discriminators. However, this series of improvements to GAN all have redundancy to a certain extent, which affects the generation performance and complexity to a certain extent. We use the popular simple and effective idea (1) to remove redundancy structure and improve the backbone network of AttnGAN. (2) to integrate and reconstruct multiple losses of DAMSM. Our improvements have significantly improved the model size and training efficiency while ensuring that the model's performance is unchanged and finally proposed our \textbf{SEAttnGAN}. Code is avalilable at https://github.com/jmyissb/SEAttnGAN.Comment: 12 pages, 3 figure

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67-0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49-0.94]) and secondary (HR, 0.85 [95% CI, 0.69-1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61-1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59-1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56-1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Risk genes for the development of chronic hepatitis B cirrhosis assessed by prediction analysis of microarrays

ObjectiveTo investigate the risk genes for predicting the development of chronic hepatitis B (CHB) cirrhosis using gene chip technology. MethodsA total of 40 CHB patients who visited Shanghai First People′s Hospital from April 2008 to December 2010 were enrolled as a clinical cohort and were divided into S0, S1, S2, S3, and S4 groups, with 8 patients in each group. Liver biopsy was performed to determine fibrosis stage with the Scheuer pathological score as the criteria, and clinical data and liver tissue samples were reserved. The Human Affymetrix GeneChip was used to establish the gene expression profiles of liver tissues in CHB patients, and the significance analysis of microarrays (SAM) and prediction analysis of microarrays (PAM) were used to screen out the risk genomes for predicting the development of CHB cirrhosis. Quantitative real-time PCR was used to measure the mRNA expression of risk genes in liver tissue. The chi-square test was used for comparison of categorical data. The t-test and a one-way analysis of variance were used for comparison of normally distributed continuous data, and SNK-q test was used for further comparison between any two groups; the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data. ResultsA total of 1674 differentially expressed genes were screened out by Affymetrix GeneChip. A cluster analysis of these genes showed that gene expression showed differences between groups with different fibrosis stages, which suggested that the gene expression profile was well consistent with fibrosis stage. Four different classification methods were used for analysis, and 87 significant genes were screened out by SAM and 14 “high-risk” genes were screened out by PAM. The quantitative real-time PCR showed the expression of 6 risk genes (CD24, CXCL6, EHF, ITGBL1, LUM, and SOX9) differed significantly between groups S0, S1-3, and S4 (P＜0.05), and the S1-3 and S4 groups showed significantly upregulated expression of these genes compared with the S0 group (all P＜0.05). ConclusionThe 6 high-risk factors screened out and verified by gene chip technology help to predict the probability of developing liver cirrhosis in CHB patients and can be used as the diagnostic genes for predicting hepatitis B cirrhosis

Hyperkalaemia prevalence and dialysis patterns in Chinese patients on haemodialysis: an interim analysis of a prospective cohort study (PRECEDE-K)

Abstract Background Hyperkalaemia is a known risk factor for cardiac arrhythmia and mortality in patients on haemodialysis. Despite standard adequate haemodialysis, hyperkalaemia is common in patients with end-stage renal disease (ESRD) at interdialytic intervals. Data on hyperkalaemia burden and its effects on dialysis patterns and serum potassium (sK) fluctuations in patients on haemodialysis in China remain limited. The prospective, observational cohort study (PRECEDE-K; NCT04799067) investigated the prevalence, recurrence, and treatment patterns of hyperkalaemia in Chinese patients with ESRD on haemodialysis. Methods Six hundred adult patients were consecutively enrolled from 15 secondary and tertiary hospitals in China. In this interim analysis, we report the baseline characteristics of the cohort, the prevalence of predialysis hyperkalaemia (sK > 5.0 mmol/L), and the trends in serum–dialysate potassium gradient and intradialytic sK shift at Visit 1 (following a long interdialytic interval [LIDI]). Results At baseline, most patients (85.6%) received three-times weekly dialysis; mean duration was 4.0 h. Mean urea reduction ratio was 68.0% and Kt/V was 1.45; 60.0% of patients had prior hyperkalaemia (previous 6 months). At Visit 1, mean predialysis sK was 4.83 mmol/L, and 39.6% of patients had hyperkalaemia. Most patients (97.7%) received a dialysate potassium concentration of 2.0 mmol/L. The serum–dialysate potassium gradient was greater than 3 mmol/L for over 40% of the cohort (1– < 2, 2– < 3, 3– < 4, and ≥ 4 mmol/L in 13.6%, 45.1%, 35.7%, and 5.2% of patients, respectively; mean: 2.8 mmol/L). The intradialytic sK reduction was 1– < 3 mmol/L for most patients (0– < 1, 1– < 2, 2– < 3, and ≥ 3 mmol/L in 24.2%, 62.2%, 12.8%, and 0.9% of patients, respectively; mean: 1.4 mmol/L). Conclusions Hyperkalaemia after a LIDI was common in this real-world cohort of Chinese patients despite standard adequate haemodialysis, and led to large serum–dialysate potassium gradients and intradialytic sK shifts. Previous studies have shown hyperkalaemia and sK fluctuations are highly correlated with poor prognosis. Effective potassium-lowering treatments should be evaluated for the improvement of long-term prognosis through the control of hyperkalaemia and sK fluctuations. Trial registration ClinicalTrials.gov, NCT04799067