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Machine learning (ML) models have been developed to identify randomised controlled trials (RCTs) to accelerate systematic reviews (SRs). However, their use has been limited due to concerns about their performance and practical benefits. We developed a high-recall ensemble learning model using Cochrane RCT data to enhance the identification of RCTs for rapid title and abstract screening in SRs and evaluated the model externally with our annotated RCT datasets. Additionally, we assessed the practical impact in terms of labour time savings and recall improvement under two scenarios: ML-assisted double screening (where ML and one reviewer screened all citations in parallel) and ML-assisted stepwise screening (where ML flagged all potential RCTs, and at least two reviewers subsequently filtered the flagged citations). Our model achieved twice the precision compared to the existing SVM model while maintaining a recall of 0.99 in both internal and external tests. In a practical evaluation with ML-assisted double screening, our model led to significant labour time savings (average 45.4%) and improved recall (average 0.998 compared to 0.919 for a single reviewer). In ML-assisted stepwise screening, the model performed similarly to standard manual screening but with average labour time savings of 74.4%. In conclusion, compared with existing methods, the proposed model can reduce workload while maintaining comparable recall when identifying RCTs during the title and abstract screening stages, thereby accelerating SRs. We propose practical recommendations to effectively apply ML-assisted manual screening when conducting SRs, depending on reviewer availability (ML-assisted double screening) or time constraints (ML-assisted stepwise screening).
This study explores the implementation of an online control strategy based on dynamic mode decomposition in the context of flow control. The investigation is conducted mainly with a fixed Reynolds number of $Re = 100$, focusing on the flow past a circular cylinder constrained between two walls to mitigate vortex shedding. The control approach involves the activation of two synthetic jets on the cylinder through blowing and suction. Velocity fluctuations in the wake, specifically in the $x$-direction, are harnessed to ascertain the mass flow rate of the jets using the linear quadratic regulator and online dynamic mode decomposition. The study systematically assesses the control performance across various configurations, including different values of the input penalty factor ${\boldsymbol {R}}$, varying numbers of probes and distinct probe arrangement methods. The synthetic jets prove effective in stabilising the separation bubble, and their interaction with the unsteady wake leads to a notable reduction in drag force, its fluctuations and the amplitude of the lift force. Specifically, the mean and standard deviation of the drag coefficient witness reductions of $7.44\,\%$ and $96.67\,\%$, respectively, and the standard deviation of the lift coefficient experiences an impressive reduction of $85.18\,\%$. The robustness of the proposed control method has also been tested on two more complicated cases, involving unsteady incoming flows with multiple frequency components. Comparatively, the methodology employed in this paper yields results akin to those obtained through deep reinforcement learning in terms of control effectiveness. However, a noteworthy advantage lies in the substantial reduction of computational resource consumption, highlighting the efficiency of the proposed approach.
This study aims to gain insight into each attribute as presented in the value of implantable medical devices, quantify attributes’ strength and their relative importance, and identify the determinants of stakeholders’ preferences.
Methods
A mixed-methods design was used to identify attributes and levels reflecting stakeholders’ preference toward the value of implantable medical devices. This design combined literature reviewing, expert’s consultation, one-on-one interactions with stakeholders, and a pilot testing. Based on the design, six attributes and their levels were settled. Among 144 hypothetical profiles, 30 optimal choice sets were developed, and healthcare professionals (decision-makers, health technology assessment experts, hospital administrators, medical doctors) and patients as stakeholders in China were surveyed. A total of 134 respondents participated in the survey. Results were analyzed by mixed logit model and conditional logit model.
Results
The results of the mixed logit model showed that all the six attributes had a significant impact on respondents’ choices on implantable medical devices. Respondents were willing to pay the highest for medical devices that provided improvements in clinical safety, followed by increased clinical effectiveness, technology for treating severe diseases, improved implement capacity, and innovative technology (without substitutes).
Conclusions
The findings of DCE will improve the current evaluation on the value of implantable medical devices in China and provide decision-makers with the relative importance of the criteria in pricing and reimbursement decision-making of implantable medical devices.
Chemical defoliants are widely used in cotton (Gossypium L.) to accelerate leaf abscission and boll maturation, as well as, to facilitate mechanical harvesting. The current study was conducted to determine the interactive effect of cotton cultivars and spraying time of defoliant on defoliation, boll opening, fibre yield and quality. An experiment was performed with four cultivars and three defoliant spraying time during 2019 and 2020 in split plot design with three replications. At harvest, the defoliation and boll opening rate of all treatments after spraying defoliant was 94.6 and 85.4%, while the blank control (water) was 73.9 and 79.1%, respectively. After spraying defoliant, the effects of defoliation rate, boll opening rate, fibre yield and quality were different among cultivars, indicating that different cultivars had different responses to defoliant. Among them, L7619 was the most sensitive to defoliant, with the average defoliation rate of 95.6% and a seed cotton yield reduction of 882.9 kg/ha. Among the different time of applications, late spraying (17 September, B3) of defoliant recorded the highest defoliation rate (97.3%), boll opening rate (89.8%), seed cotton yield (3991 kg/ha) and steadily increased the fibre strength by 0.59 cN/tex compared with the control. Late spraying of defoliant had little or even no adverse effect on the remaining fibre quality traits (length, uniformity, micronaire and elongation). In general, these results suggested that the appropriate time for spraying defoliant can be determined based on the sensitivity of the cotton cultivar, the weather conditions at the field and the harvest time.
The purpose of this study is to further deepen our understanding of the relationship between community resilience and disaster risk perception of residents, so as to provide beneficial enlightenment for the construction of community resilience disaster prevention system and disaster risk management.
Methods:
This study surveyed 327 rural households in four counties of Sichuan Province, China, that were affected by the Wenchuan and Lushan earthquakes. Community disaster resilience was divided into five dimensions: connection and caring, resources, transformative potential, disaster management, and information and communication. Residents’ disaster risk perception was divided into three dimensions: possibility, threat, and worry. This study analyzed the characteristics of community disaster resilience and residents’ disaster risk perceptions. Ordinary least squares (OLS) methods were used to explore the correlations between these factors.
Results:
The results show that (1) Residents’ overall disaster risk perception was at a moderate level, and the community’s overall disaster resilience were above the moderate level. (2) Community connection and caring has a positive significant correlation with the possibility perception of disaster occurrence; transformative potential has a negative significant correlation with the possibility perception of disaster occurrence; the overall community disaster resilience has negative significant correlations with the possibility and the overall residents’ perception of disaster risk occurrence.
Conclusions:
The implication for the local government is that the government should appropriately increase its contact with external institutions/organizations, especially some Non-Governmental Organization, to strengthen the resilience and disaster prevention capacity of the community. Establish and improve information and communication networks to ensure the timely and effective transmission of effective disaster information, and strengthen the supervision of the dissemination of false information to reduce the losses caused by false information to residents. Attention should be paid to psychological counseling for people in disaster-hit areas to reduce the psychological trauma of the disaster.
The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
A 1178 J near diffraction limited 527 nm laser is realized in a complete closed-loop adaptive optics (AO) controlled off-axis multi-pass amplification laser system. Generated from a fiber laser and amplified by the pre-amplifier and the main amplifier, a 1053 nm laser beam with the energy of 1900 J is obtained and converted into a 527 nm laser beam by a KDP crystal with 62% conversion efficiency, 1178 J and beam quality of 7.93 times the diffraction limit (DL). By using a complete closed-loop AO configuration, the static and dynamic wavefront distortions of the laser system are measured and compensated. After correction, the diameter of the circle enclosing 80% energy is improved remarkably from 7.93DL to 1.29DL. The focal spot is highly concentrated and the 1178 J, 527 nm near diffraction limited laser is achieved.
To investigate the clinical impact of ventilator-associated events (VAEs) on adverse prognoses and risk factors for mortality among intensive care unit (ICU) patients receiving invasive mechanical ventilation (IMV) based on an ICU healthcare-associated infection (ICU-HAI) registry.
Design:
A cohort study was conducted based on an ICU-HAI registry including 30,830 patients between 2015 and 2018.
Setting:
The study was conducted using data from 5 adult ICUs of a referral hospital.
Patients:
Adult patients in the ICU-HAI registry who received ≥4 consecutive IMV days.
Methods:
Clinical outcomes and mortality risk factors for VAEs were analyzed using propensity score matching (PSM), multivariate regression models, and sensitivity analyses.
Results:
Of 6,426 included patients, 1,803 developed 1,899 VAEs. After PSM, patients with VAEs did have prolonged length of stay in the ICU and in the hospital, increased hospitalization costs, longer days on mechanical ventilation, higher proportion of ≥9 days on mechanical ventilation, higher rate of failure in extubating mechanical ventilation, and excess all-cause mortality in the ICU. Older age (adjusted OR [aOR], 1.02), higher APACHE II score on ICU admission (aOR, 1.06), pneumonia (aOR, 1.49), blood transfusion (aOR 1.43), immunosuppressive drugs (aOR, 1.69), central-line catheter (aOR, 2.06), and ≥2 VAEs in the ICU (aOR, 1.99) were associated with higher risks for all-cause mortality in an ICU.
Conclusions:
Patients with VAEs indeed had poorer clinical outcomes. Older age, higher APACHE II score on ICU admission, pneumonia, blood transfusion, immunosuppressive drugs, central-line catheter, and ≥2 VAEs in the ICU were risk factors for all-cause mortality of VAE patients in the ICU.
This study aimed to explore the impacts of COVID-19 outbreak on mental health status in general population in different affected areas in China.
Methods
This was a comparative study including two groups of participants: (1) general population in an online survey in Ya'an and Jingzhou cities during the COVID-19 outbreak from 10–20 February 2020; and (2) matching general population selected from the mental health survey in Ya'an in 2019 (from January to May 2019). General Health Questionnaire (GHQ-12), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used.
Results
There were 1775 participants (Ya'an in 2019 and 2020: 537 respectively; Jingzhou in 2020: 701). Participants in Ya'an had a significantly higher rate of general health problems (GHQ scores ⩾3) in 2020 (14.7%) than in 2019 (5.2%) (p < 0.001). Compared with Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (SAS scores ⩾50, 24.1%) (p < 0.001). Participants in Ya'an in 2020 had a significantly higher rate of depression (SDS scores ⩾53, 55.3%) than in Jingzhou (16.3%) (p < 0.001). The risk factors of anxiety symptoms included female, number of family members (⩾6 persons), and frequent outdoor activities. The risk factors of depression symptoms included participants in Ya'an and uptake self-protective measures.
Conclusions
The prevalence of psychological symptoms has increased sharply in general population during the COVID-19 outbreak. People in COVID-19 severely affected areas may have higher scores of GHQ and anxiety symptoms. Culture-specific and individual-based psychosocial interventions should be developed for those in need during the COVID-19 outbreak.
Understanding the patterns of treatment response is critical for the treatment of patients with schizophrenia; one way to achieve this is through using a longitudinal dynamic process study design.
Aims
This study aims to explore the response trajectory of antipsychotics and compare the treatment responses of seven different antipsychotics over 6 weeks in patients with schizoprenia (trial registration: Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).
Method
Data were collected from a multicentre, randomised open-label clinical trial. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up at weeks 2, 4 and 6. Trajectory groups were classified by the method of k-means cluster modelling for longitudinal data. Trajectory analyses were also employed for the seven antipsychotic groups.
Results
The early treatment response trajectories were classified into a high-trajectory group of better responders and a low-trajectory group of worse responders. The results of trajectory analysis showed differences compared with the classification method characterised by a 50% reduction in PANSS scores at week 6. A total of 349 patients were inconsistently grouped by the two methods, with a significant difference in the composition ratio of treatment response groups using these two methods (χ2 = 43.37, P < 0.001). There was no differential contribution of high- and low trajectories to different drugs (χ2 = 12.52, P = 0.051); olanzapine and risperidone, which had a larger proportion in the >50% reduction at week 6, performed better than aripiprazole, quetiapine, ziprasidone and perphenazine.
Conclusions
The trajectory analysis of treatment response to schizophrenia revealed two distinct trajectories. Comparing the treatment responses to different antipsychotics through longitudinal analysis may offer a new perspective for evaluating antipsychotics.
Dietary salt intake may vary depending on different lifestyles. We aimed to estimate the different salt intakes and evaluate the knowledge and self-awareness about salt among people speaking the Teochew, Teochew–Hakka and Hakka dialects in the Chaoshan region of southern China.
Design:
The study followed a cluster sampling of residents in Chaoshan region. General characteristics, lifestyles, health status as well as knowledge and self-awareness related to salt intake were investigated using a questionnaire. Anthropometric variables as well as Na and K excretion in a 24-h urine collection were measured.
Setting:
Chaoshan region of China.
Participants:
Four hundred fifteen adults who spoke only one of these three dialects.
Results:
The salt intake of adults who spoke the Teochew, Teochew–Hakka and Hakka dialects was 7·19 (interquartile range (IQR) 5·29–10·17), 9·03 (IQR 6·62–11·54) and 10·12 (IQR 7·61–12·82) g/d, respectively, with significant differences between Teochew and Teochew–Hakka speakers and between Teochew and Hakka speakers (both P < 0·05). The Na:K ratio for adults who spoke the three dialects was 3·00 (IQR 2·00–4·11), 3·50 (IQR 2·64–4·82) and 4·52 (IQR 3·35–5·97), respectively, and differed significantly among the groups (all P < 0·05). Multiple linear regression analysis showed increased Na:K ratio associated with hypertension (β = 0·71, P = 0·043) in Hakka speakers. Knowledge and self-awareness about salt intake were poor in this population.
Conclusions:
Salt intake was closely related to lifestyles and was higher than the upper limit (5 g/d) recommended by the WHO in adults of Chaoshan, especially those speaking the Hakka dialect.
The microbiota–gut–brain axis, especially the microbial tryptophan (Trp) biosynthesis and metabolism pathway (MiTBamp), may play a critical role in the pathogenesis of major depressive disorder (MDD). However, studies on the MiTBamp in MDD are lacking. The aim of the present study was to analyze the gut microbiota composition and the MiTBamp in MDD patients.
Methods
We performed shotgun metagenomic sequencing of stool samples from 26 MDD patients and 29 healthy controls (HCs). In addition to the microbiota community and the MiTBamp analyses, we also built a classification based on the Random Forests (RF) and Boruta algorithm to identify the gut microbiota as biomarkers for MDD.
Results
The Bacteroidetes abundance was strongly reduced whereas that of Actinobacteria was significantly increased in the MDD patients compared with the abundance in the HCs. Most noteworthy, the MDD patients had increased levels of Bifidobacterium, which is commonly used as a probiotic. Four Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K01817, K11358, K01626, K01667) abundances in the MiTBamp were significantly lower in the MDD group. Furthermore, we found a negative correlation between the K01626 abundance and the HAMD scores in the MDD group. Finally, RF classification at the genus level can achieve an area under the receiver operating characteristic curve of 0.890.
Conclusions
The present findings enabled a better understanding of the changes in gut microbiota and the related Trp pathway in MDD. Alterations of the gut microbiota may have the potential as biomarkers for distinguishing MDD patients form HCs.
This paper presents the simulation of complex separation flows over a modern fighter model at high angle of attack by using an unstructured/hybrid grid based Detached Eddy Simulation (DES) solver with an adaptive dissipation second-order hybrid scheme. Simulation results, including the complex vortex structures, as well as vortex breakdown phenomenon and the overall aerodynamic performance, are analyzed and compared with experimental data and unsteady Reynolds-Averaged Navier-Stokes (URANS) results, which indicates that with the DES solver, clearer vortical flow structures are captured and more accurate aerodynamic coefficients are obtained. The unsteady properties of DES flow field are investigated in detail by correlation coefficient analysis, power spectral density (PSD) analysis and proper orthogonal decomposition (POD) analysis, which indicates that the spiral motion of the primary vortex on the leeward side of the aircraft model is highly nonlinear and dominates the flow field. Through the comparisons of flow topology and pressure distributions with URANS results, the reason why higher and more accurate lift can be obtained by DES is discussed. Overall, these results show the potential capability of present DES solver in industrial applications.
The propagation of a pre-existing center crack in single crystal tungsten under cyclic loading was examined by molecular dynamics (MD) simulations at various temperatures. The results indicated that the deformation mechanism and fracture behavior at crack tip were differences for variously oriented cracks. The [001](010) crack propagated as the form of the formation of slip, while the deformation mechanisms of [10−1](101) crack were blunting voids at 300 K. At higher temperature, many more slip systems were activated resulting in the change of mode of crack propagation. Simulated results showed that the effect of temperature on deformation mechanism and fracture behavior of [001](010) crack was more sensitive than that of [10−1](101) crack. Meanwhile, the influence of a 5〈310〉{110} model grain boundary (GB) on crack propagation was also discussed. Detailed analysis showed that the grain boundary resisted the crack growth by changing the deformation mechanisms and the path of crack propagation at crack tip before the crack reached the grain boundary, and had an important influence on the crack growth rate.
In this paper, field effect transistors (FET) based on different kinds of non-graphene materials are introduced, which are MoS2, WSe2 and black phosphorus (BP). Those devices have their unique features in fabrication process compared with conventional FETs. Among them, MoS2 FET shows better electrical characteristics by applying a SiO2 protective layer; WSe2 FET is fabricated based on a new low pressure chemical vapor deposition (LPCVD) method; BP FET acquires high on/off ratio and high hole mobility by using a simple dry transfer method. Those novel non-graphene materials inspire new design and fabrication process of basic logic device.
A hybrid grid based second-order finite volume algorithm has been developed for Detached-Eddy Simulation (DES) of turbulent flows. To alleviate the effect caused by the numerical dissipation of the commonly used second order upwind schemes in implementing DES with unstructured computational fluid dynamics (CFD) algorithms, an improved second-order hybrid scheme is established through modifying the dissipation term of the standard Roe's flux-difference splitting scheme and the numerical dissipation of the scheme can be self-adapted according to the DES flow field information. By Fourier analysis, the dissipative and dispersive features of the new scheme are discussed. To validate the numerical method, DES formulations based on the two most popular background turbulence models, namely, the one equation Spalart-Allmaras (SA) turbulence model and the two equation k–ω Shear Stress Transport model (SST), have been calibrated and tested with three typical numerical examples (decay of isotropic turbulence, NACA0021 airfoil at 60° incidence and 65° swept delta wing). Computational results indicate that the issue of numerical dissipation in implementing DES can be alleviated with the hybrid scheme, the resolution for turbulence structures is significantly improved and the corresponding solutions match the experimental data better. The results demonstrate the potentiality of the present DES solver for complex geometries.
Optics surface phase defects induced intensity modulation in high-power laser facility for inertial confinement fusion research is studied. Calculations and experiments reveal an exact mapping of the modulation patterns and the optics damage spot distributions from the surface phase defects. Origins are discussed during the processes of optics manufacturing and diagnostics, revealing potential improvements for future optics manufacturing techniques and diagnostic index, which is meaningful for fusion level laser facility construction and its operation safety.
An extruded Mg–8Gd–4Y–1Nd–0.5Zr alloy was preheated at 500 °C for 0.5 h and then subjected to hot compression to a true strain of 0.69 at temperature 450 °C and a strain rate of 0.2 s−1. It is observed that boundaries of small grains (∼3 μm) in the extruded alloy are decorated with irregular-shaped particles; small grains show a weak texture of three main components of $\left\langle {0001} \right\rangle //{\rm{TD}}$, $\left\langle {11\overline 2 1} \right\rangle //{\rm{ND}}$, and $\left\langle {10\overline 1 0} \right\rangle //{\rm{ED}}$. Dynamic recrystallization is concurrent with dynamic precipitation of particles during hot compression, resulting in both a uniform grain structure and a redistribution of particles. The retained particles before compression keep the texture unchanged during compression, leading to the same texture type of $\left\langle {0001} \right\rangle //{\rm{TD}}$ of the compressed alloy as that of the preheated alloy. The compressed alloy exhibits a better aging hardening ability than the extruded alloy. After peak aging, the compressed alloy presents an ultimate tensile strength of 416 MPa, a yield tensile strength of 317 MPa, and an elongation of 2.7%.
The high repetition rate 10 J/10 ns Yb:YAG laser system and its key techniques are reported. The amplifiers in this system have a multi-pass V-shape structure and the heat in the amplifiers is removed by means of laminar water flow. In the main amplifier, the laser is four-pass, and an approximately 8.5 J/1 Hz/10 ns output is achieved in the primary test. The far-field of the output beam is approximately 10 times the diffraction limit. Because of the higher levels of amplified spontaneous emission (ASE) in the main amplifier, the output energy is lower than expected. At the end we discuss some measures that can improve the properties of the laser system.