脑卒中多分类预后预测的深度集成优化方法

诊疗前预测急性缺血性脑卒中（AIS）的预后分级,有利于揭示预后转归水平并指导治疗策略,提升方法的预测性能是实现精准医疗的重要指导。利用临床和影像组学的融合特征实施脑卒中的多分类预测,并提出了一种基于融合特征的深度集成优化方法（IABC-DEL）模型,其特征选择方法为Embedded嵌入法和卡方检验,数据不平衡处理方式为Borderline-SMOTE算法,利用Stacking构建深度集成优化模型,基学习器包括深度神经网络（DNN）、长短期记忆网络（LSTM）和门控循环单元（GRU）,优化方法为改良人工蜂群算法（IABC）。研究结果表明,深度集成优化方法的预后预测性能优于经典方法和既往研究,Macro-F1 score为87.88%,Macro-AUC为96.27%,ACC为88.02%。因此,基于深度集成优化学习的急性缺血性脑卒中预后模型可对临床诊治和预后康复提供指导意义,并为研究预测提供新的建模思路。     

Recent advances in CKD and ESRD: A literature update

The past year has seen interesting publications in the fields of chronic kidney disease and end stage renal disease. This review highlights some of these important papers and places their findings in the context of clinical care.     

Driver injury severity outcome analysis in rural interstate highway crashes: a two-level Bayesian logistic regression interpretation

There is a high potential of severe injury outcomes in traffic crashes on rural interstate highways due to the significant amount of high speed traffic on these corridors. Hierarchical Bayesian models are capable of incorporating between-crash variance and within-crash correlations into traffic crash data analysis and are increasingly utilized in traffic crash severity analysis. This paper applies a hierarchical Bayesian logistic model to examine the significant factors at crash and vehicle/driver levels and their heterogeneous impacts on driver injury severity in rural interstate highway crashes. Analysis results indicate that the majority of the total variance is induced by the between-crash variance, showing the appropriateness of the utilized hierarchical modeling approach. Three crash-level variables and six vehicle/driver-level variables are found significant in predicting driver injury severities: road curve, maximum vehicle damage in a crash, number of vehicles in a crash, wet road surface, vehicle type, driver age, driver gender, driver seatbelt use and driver alcohol or drug involvement. Among these variables, road curve, functional and disabled vehicle damage in crash, single-vehicle crashes, female drivers, senior drivers, motorcycles and driver alcohol or drug involvement tend to increase the odds of drivers being incapably injured or killed in rural interstate crashes, while wet road surface, male drivers and driver seatbelt use are more likely to decrease the probability of severe driver injuries. The developed methodology and estimation results provide insightful understanding of the internal mechanism of rural interstate crashes and beneficial references for developing effective countermeasures for rural interstate crash prevention.     

A simulation study on the US rehabilitation service process for patients with modest-to-severe traumatic brain injury

Traumatic brain injury (TBI) is a devastating injury with severe consequences. In this paper, we conduct a simulation study on the commonly implemented care delivery process for TBI rehabilitation in the US, which covers three care categories: inpatient acute, outpatient sub-acute and general residential care. Our investigation is focused on assessing how coverage duration of publicly funded rehabilitation impacts two key system outcomes: sub-acute rehabilitation readmission and total rehabilitation spending. We develop prediction models on the above two outcomes for patients of different conditions. We introduce the notions of forceful transition and medical necessity adjustment, and embed the notions in a state-transition simulation model. Our simulation results suggest that to minimise the care spending, the duration of publicly insured outpatient sub-acute rehab be set smaller than what is currently implemented but not to the point where coverage should be completely removed. Our sensitivity analysis justifies the robustness of our results under variations on model parameters.     

雷击对碳纤维增强型航空复合材料损伤的影响

依据有限元仿真软件ABAQUS,建立碳纤维增强型复合材料(CFRP)层合板雷击损伤热-电耦合有限元仿真模型。利用叠加温度场的方法来近似表示内部受损状态,通过对比实验验证热-电耦合仿真方法的正确性与有效性。利用回归统计分析技术,定量分析雷电参数与CFRP雷击损伤的相关性,并绘制相关曲线。结果表明:雷电流比能是决定CFRP雷击损伤的关键因素,纤维破坏面积、分层面积与比能具有线性相关性,树脂破坏面积、分层厚度与比能具有对数相关性。     

Practices and risks associated with operation of tie-down lashings in the vehicle transport industry

Load restraint systems in automobile transport utilise tie-down lashings placed over the car’s tyres, which are tensioned manually by the operator using a ratchet assembly. This process has been identified as a significant manual handling injury risk. The aim of this study was to gain insight on the current practices associated with tie-down lashings operation, and identify the gaps between current and optimal practice. We approached this with qualitative and quantitative assessments and one numerical simulation to establish: (i) insight into the factors involved in ratcheting; (ii) the required tension to hold the car on the trailer; and (iii) the tension achieved by drivers in practice and associated joint loads. We identified that the method recommended to the drivers was not used in practice. Drivers instead tensioned the straps to the maximum of their capability, leading to over-tensioning and mechanical overload at the shoulder and elbow. We identified the postures and strategies that resulted in the lowest loads on the upper body during ratcheting (using both hands and performing the task with their full body). This research marks the first step towards the development of a training programme aiming at changing practice to reduce injury risks associated with the operation of tie-down lashings in the automobile transport industry.

Practitioner Summary: The study investigated current practice associated with the operation of tie-down lashings through qualitative (interviews) and quantitative (biomechanical analysis) methods. Operators tended to systematically over-tension the lashings and consequently overexert, increasing injury risks.     

Adventure tourism and adventure sports injury: the New Zealand experience

The primary aims of this study were to establish a client injury baseline for the New Zealand adventure tourism and adventure sport sector, and to examine patterns and trends in claims for injury during participation in adventure activities. Content analysis of narrative text data for compensated injuries occurring in a place for recreation and sport over a 12-month period produced over 15,000 cases involving adventure tourism and adventure sport. As found in previous studies in New Zealand, highest claim counts were observed for activities that are often undertaken independently, rather than commercially. Horse riding, tramping, surfing and mountain biking were found to have highest claim counts, while hang gliding/paragliding/parasailing and jet boating injuries had highest claim costs, suggesting greatest injury severity. Highest claim incidence was observed for horse riding, with female claimants over-represented for this activity. Younger male claimants comprised the largest proportion of adventure injuries, and falls were the most common injury mechanism.     

葡萄贮藏中SO2伤害与活性氧代谢的关系

以耐SO2品种巨峰和不耐SO2品种红地球葡萄为材料,研究了葡萄贮藏中SO2伤害与活性氧代谢的关系,结果表明,SO2伤害葡萄体内活性氧水平,GSH含理和ASP活性增加,SOD和CAT活性降低,与红地球相比,巨峰具有较高的SOD活性和GSH水平,受SO2伤害后,巨峰的ASP活性上升幅度大于红地球,其SOD活性和CAT活性的下降幅度低于红地球。