With the rapid development of machine learning,the demand for high-efficient computing becomes more and more urgent.To break the bottleneck of the traditional Von Neumann architecture,computing-in-memory(CIM)has attra...With the rapid development of machine learning,the demand for high-efficient computing becomes more and more urgent.To break the bottleneck of the traditional Von Neumann architecture,computing-in-memory(CIM)has attracted increasing attention in recent years.In this work,to provide a feasible CIM solution for the large-scale neural networks(NN)requiring continuous weight updating in online training,a flash-based computing-in-memory with high endurance(10^(9) cycles)and ultrafast programming speed is investigated.On the one hand,the proposed programming scheme of channel hot electron injection(CHEI)and hot hole injection(HHI)demonstrate high linearity,symmetric potentiation,and a depression process,which help to improve the training speed and accuracy.On the other hand,the low-damage programming scheme and memory window(MW)optimizations can suppress cell degradation effectively with improved computing accuracy.Even after 109 cycles,the leakage current(I_(off))of cells remains sub-10pA,ensuring the large-scale computing ability of memory.Further characterizations are done on read disturb to demonstrate its robust reliabilities.By processing CIFAR-10 tasks,it is evident that~90%accuracy can be achieved after 109 cycles in both ResNet50 and VGG16 NN.Our results suggest that flash-based CIM has great potential to overcome the limitations of traditional Von Neumann architectures and enable high-performance NN online training,which pave the way for further development of artificial intelligence(AI)accelerators.展开更多
The Belt and Road Initiative has brought rich and diverse possibilities to global cooperation,recommending that countries strengthen multilateral cooperation,help each other,and jointly face and resolve various risks.
Purpose:The aim of this umbrella review was to determine the impact of resistance training(RT)and individual RT prescription variables on muscle mass,strength,and physical function in healthy adults.Methods:Following ...Purpose:The aim of this umbrella review was to determine the impact of resistance training(RT)and individual RT prescription variables on muscle mass,strength,and physical function in healthy adults.Methods:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,we systematically searched and screened eligible systematic reviews reporting the effects of differing RT prescription variables on muscle mass(or its proxies),strength,and/or physical function in healthy adults aged>18 years.Results:We identified 44 systematic reviews that met our inclusion criteria.The methodological quality of these reviews was assessed using A Measurement Tool to Assess Systematic Reviews;standardized effectiveness statements were generated.We found that RT was consistently a potent stimulus for increasing skeletal muscle mass(4/4 reviews provide some or sufficient evidence),strength(4/6 reviews provided some or sufficient evidence),and physical function(1/1 review provided some evidence).RT load(6/8 reviews provided some or sufficient evidence),weekly frequency(2/4 reviews provided some or sufficient evidence),volume(3/7 reviews provided some or sufficient evidence),and exercise order(1/1 review provided some evidence)impacted RT-induced increases in muscular strength.We discovered that 2/3 reviews provided some or sufficient evidence that RT volume and contraction velocity influenced skeletal muscle mass,while 4/7 reviews provided insufficient evidence in favor of RT load impacting skeletal muscle mass.There was insufficient evidence to conclude that time of day,periodization,inter-set rest,set configuration,set end point,contraction velocity/time under tension,or exercise order(only pertaining to hypertrophy)influenced skeletal muscle adaptations.A paucity of data limited insights into the impact of RT prescription variables on physical function.Conclusion:Overall,RT increased muscle mass,strength,and physical function compared to no exercise.RT intensity(load)and weekly frequency impacted RT-induced increases in muscular strength but not muscle hypertrophy.RT volume(number of sets)influenced muscular strength and hypertrophy.展开更多
Dear Editor,In this letter, we introduce a novel online distributed data-driven robust control approach for learning controllers of unknown nonlinear multi-agent systems(MASs) using state-dependent representations.
For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein th...For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.展开更多
Objective:Transurethral resection of bladder tumor is one of the most common everyday urological procedures.This kind of surgery demands a set of skills that need training and experience.In this review,we aimed to inv...Objective:Transurethral resection of bladder tumor is one of the most common everyday urological procedures.This kind of surgery demands a set of skills that need training and experience.In this review,we aimed to investigate the current literature to find out if simulators,phantoms,and other training models could be used as a tool for teaching urologists.Methods:A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the recommendations of the European Association of Urology guidelines for conducting systematic reviews.Fifteen out of 932 studies met our inclusion criteria and are presented in the current review.Results:The UroTrainer(Karl Storz GmbH,Tuttlingen,Germany),a virtual reality training simulator,achieved positive feedback and an excellent face and construct validity by the participants.The inspection of bladder mucosa,blood loss,tumor resection,and procedural time was improved after the training,especially for inexperienced urologists and medical students.The construct validity of UroSim®(VirtaMed,Zurich,Switzerland)was established.SIMBLA simulator(Samed GmbH,Dresden,Germany)was found to be a realistic and useful tool by experts and urologists with intermediate experience.The test objective competency model based on SIMBLA simulator could be used for evaluating urologists.The porcine model of the Asian Urological Surgery Training and Education Group also received positive feedback by the participants that tried it.The Simulation and Technology Enhanced Learning Initiative Project had an extraordinary face and content validity,and 60%of participants would like to use the simulators in the future.The 5-day multimodal training curriculum“Boot Camp”in the United Kingdom achieved an increase of the level of confidence of the participants that lasted months after the project.Conclusion:Simulators and courses or curricula based on a simulator training could be a valuable learning tool for any surgeon,and there is no doubt that they should be a part of every urologist's technical education.展开更多
Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was p...Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was performed for randomized controlled trials in PubMed,Scopus,Web of Science,and SciELO.Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity,metabolic risk,and inflammation with a control group(CG) were included.Independent reviewers selected the studies,extracted the data,and performed the risk of bias and certainty of the evidence(Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)) evaluations.Total body and abdominal adiposity,blood lipids,glucose,and C-reactive protein were included for meta-analysis.A random-effects model,standardized mean difference(Hedges’ g),and 95% confidence interval(95%CI) were used for meta-analysis.Results:Twenty randomized controlled trials(overall risk of bias:some concerns;GRADE:low to very low) with overweight/obese postmenopausal and older females were included.RT groups were divided into low-volume RT(LVRT,~44 sets/week) and high-volume RT(HVRT,~77 sets/week).Both RT groups presented improved body adiposity,metabolic risk,and inflammation when compared to CG.However,HVRT demonstrated higher effect sizes than LVRT for glucose(HVRT=-1.19;95%CI:-1.63 to-0.74;LVRT=-0.78;95%CI:-1.15 to-0.41) and C-reactive protein(HVRT=-1.00;95%CI:-1.32 to-0.67;LVRT=-0.34;95%CI,-0.63 to-0.04)) when compared to CG.Conclusion:Compared to CG,HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.展开更多
In recent years,various adversarial defense methods have been proposed to improve the robustness of deep neural networks.Adversarial training is one of the most potent methods to defend against adversarial attacks.How...In recent years,various adversarial defense methods have been proposed to improve the robustness of deep neural networks.Adversarial training is one of the most potent methods to defend against adversarial attacks.However,the difference in the feature space between natural and adversarial examples hinders the accuracy and robustness of the model in adversarial training.This paper proposes a learnable distribution adversarial training method,aiming to construct the same distribution for training data utilizing the Gaussian mixture model.The distribution centroid is built to classify samples and constrain the distribution of the sample features.The natural and adversarial examples are pushed to the same distribution centroid to improve the accuracy and robustness of the model.The proposed method generates adversarial examples to close the distribution gap between the natural and adversarial examples through an attack algorithm explicitly designed for adversarial training.This algorithm gradually increases the accuracy and robustness of the model by scaling perturbation.Finally,the proposed method outputs the predicted labels and the distance between the sample and the distribution centroid.The distribution characteristics of the samples can be utilized to detect adversarial cases that can potentially evade the model defense.The effectiveness of the proposed method is demonstrated through comprehensive experiments.展开更多
●AIM:To determine the teaching effects of a real-time three dimensional(3D)visualization system in the operating room for early-stage phacoemulsification training.●METHODS:A total of 10 ophthalmology residents of th...●AIM:To determine the teaching effects of a real-time three dimensional(3D)visualization system in the operating room for early-stage phacoemulsification training.●METHODS:A total of 10 ophthalmology residents of the first-year postgraduate were included.All the residents were novices to cataract surgery.Real-time cataract surgical observations were performed using a custom-built 3D visualization system.The training lasted 4wk(32h)in all.A modified International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric(ICO-OSCAR)containing 4 specific steps of cataract surgery was applied.The self-assessment(self)and expert-assessment(expert)were performed through the microsurgical attempts in the wet lab for each participant.●RESULTS:Compared with pre-training assessments(self 3.2±0.8,expert 2.5±0.6),the overall mean scores of posttraining(self 5.2±0.4,expert 4.7±0.6)were significantly improved after real-time observation training of 3D visualization system(P<0.05).Scores of 4 surgical items were significantly improved both self and expert assessment after training(P<0.05).●CONCLUSION:The 3D observation training provides novice ophthalmic residents with a better understanding of intraocular microsurgical techniques.It is a useful tool to improve teaching efficiency of surgical education.展开更多
Quantized training has been proven to be a prominent method to achieve deep neural network training under limited computational resources.It uses low bit-width arithmetics with a proper scaling factor to achieve negli...Quantized training has been proven to be a prominent method to achieve deep neural network training under limited computational resources.It uses low bit-width arithmetics with a proper scaling factor to achieve negligible accuracy loss.Cambricon-Q is the ASIC design proposed to efficiently support quantized training,and achieves significant performance improvement.However,there are still two caveats in the design.First,Cambricon-Q with different hardware specifications may lead to different numerical errors,resulting in non-reproducible behaviors which may become a major concern in critical applications.Second,Cambricon-Q cannot leverage data sparsity,where considerable cycles could still be squeezed out.To address the caveats,the acceleration core of Cambricon-Q is redesigned to support fine-grained irregular data processing.The new design not only enables acceleration on sparse data,but also enables performing local dynamic quantization by contiguous value ranges(which is hardware independent),instead of contiguous addresses(which is dependent on hardware factors).Experimental results show that the accuracy loss of the method still keeps negligible,and the accelerator achieves 1.61×performance improvement over Cambricon-Q,with about 10%energy increase.展开更多
The human brain is highly plastic.Cognitive training is usually used to modify functional connectivity of brain networks.Moreover,the structures of brain networks may determine its dynamic behavior which is related to...The human brain is highly plastic.Cognitive training is usually used to modify functional connectivity of brain networks.Moreover,the structures of brain networks may determine its dynamic behavior which is related to human cognitive abilities.To study the effect of functional connectivity on the brain dynamics,the dynamic model based on functional connections of the brain and the Hindmarsh–Rose model is utilized in this work.The resting-state fMRI data from the experimental group undergoing abacus-based mental calculation(AMC)training and from the control group are used to construct the functional brain networks.The dynamic behavior of brain at the resting and task states for the AMC group and the control group are simulated with the above-mentioned dynamic model.In the resting state,there are the differences of brain activation between the AMC group and the control group,and more brain regions are inspired in the AMC group.A stimulus with sinusoidal signals to brain networks is introduced to simulate the brain dynamics in the task states.The dynamic characteristics are extracted by the excitation rates,the response intensities and the state distributions.The change in the functional connectivity of brain networks with the AMC training would in turn improve the brain response to external stimulus,and make the brain more efficient in processing tasks.展开更多
The online car-hailing industry, which provides the right of use, has a certain impact on the traditional automobile market, but there is no unified theory on whether it has a positive impact or a negative impact. Bas...The online car-hailing industry, which provides the right of use, has a certain impact on the traditional automobile market, but there is no unified theory on whether it has a positive impact or a negative impact. Based on 362 consumer questionnaire data, this study builds a structural equation model to discuss the driving factors of residents’ choice of online car-hailing and whether the development of online car-hailing will have a certain substitution impact on the sales of private cars. From the perspective of consumers’ purchase intention, the research results show that consumers’ price consciousness, convenience consciousness, environmental protection consciousness and possession tendency will affect their choice of travel mode, and the use of online car-hailing is positively correlated with consumers’ willingness to replace private car ownership with online car-hailing.展开更多
This paper aims to analyze the present conditions of the social responsibility ecosystem in online audiovisual enterprises in the digital age. It focuses on the governance of social responsibility in these enterprises...This paper aims to analyze the present conditions of the social responsibility ecosystem in online audiovisual enterprises in the digital age. It focuses on the governance of social responsibility in these enterprises and conducts an in-depth analysis of the problems and influencing factors related to the social responsibility aberrations of online audiovisual enterprises. Drawing upon social responsibility theory and collaborative governance theory, this research constructs a social responsibility guidance and governance system guided by the public, supported by the voluntary fulfillment of responsibilities by online audiovisual enterprises, and based on the collaborative participation of diverse stakeholders. It explores and optimizes the implementation pathways of this system, providing theoretical support and practical guidance for promoting the sustainable development of online audiovisual enterprises. Furthermore, it aims to contribute to the creation of a harmonious Internet ecosystem.展开更多
BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been es...BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been established.The article reports the case of a 65-year-old female patient with AC and CC who was treated with central and peripheral interventions to alleviate symptoms.CASE SUMMARY We present the case of a 65-year-old female PD patient with AC and CC.The course of the disease was 5 years.She was treated with rehabilitation strategies such as sensory tricks and trunk strength training.During the inpatient period,we compared and analyzed the patient's gait,rehabilitation assessment scale score,and angles of her abnormal trunk posture in the first week,the third week,and the fifth week.The patient's stride length increased,indicating that the patient's walking ability was improved.The Unified Parkinson's Disease Scale Part Three score and CC severity score decreased.Furthermore,the score of the other scale increased.In addition,the patient showed significant improvements in AC,upper CC,and lower CC angles.CONCLUSION This case study suggested that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC.展开更多
In engineering application,there is only one adaptive weights estimated by most of traditional early warning radars for adaptive interference suppression in a pulse reputation interval(PRI).Therefore,if the training s...In engineering application,there is only one adaptive weights estimated by most of traditional early warning radars for adaptive interference suppression in a pulse reputation interval(PRI).Therefore,if the training samples used to calculate the weight vector does not contain the jamming,then the jamming cannot be removed by adaptive spatial filtering.If the weight vector is constantly updated in the range dimension,the training data may contain target echo signals,resulting in signal cancellation effect.To cope with the situation that the training samples are contaminated by target signal,an iterative training sample selection method based on non-homogeneous detector(NHD)is proposed in this paper for updating the weight vector in entire range dimension.The principle is presented,and the validity is proven by simulation results.展开更多
The user’s intent to seek online information has been an active area of research in user profiling.User profiling considers user characteristics,behaviors,activities,and preferences to sketch user intentions,interest...The user’s intent to seek online information has been an active area of research in user profiling.User profiling considers user characteristics,behaviors,activities,and preferences to sketch user intentions,interests,and motivations.Determining user characteristics can help capture implicit and explicit preferences and intentions for effective user-centric and customized content presentation.The user’s complete online experience in seeking information is a blend of activities such as searching,verifying,and sharing it on social platforms.However,a combination of multiple behaviors in profiling users has yet to be considered.This research takes a novel approach and explores user intent types based on multidimensional online behavior in information acquisition.This research explores information search,verification,and dissemination behavior and identifies diverse types of users based on their online engagement using machine learning.The research proposes a generic user profile template that explains the user characteristics based on the internet experience and uses it as ground truth for data annotation.User feedback is based on online behavior and practices collected by using a survey method.The participants include both males and females from different occupation sectors and different ages.The data collected is subject to feature engineering,and the significant features are presented to unsupervised machine learning methods to identify user intent classes or profiles and their characteristics.Different techniques are evaluated,and the K-Mean clustering method successfully generates five user groups observing different user characteristics with an average silhouette of 0.36 and a distortion score of 1136.Feature average is computed to identify user intent type characteristics.The user intent classes are then further generalized to create a user intent template with an Inter-Rater Reliability of 75%.This research successfully extracts different user types based on their preferences in online content,platforms,criteria,and frequency.The study also validates the proposed template on user feedback data through Inter-Rater Agreement process using an external human rater.展开更多
Background Laparoscopic surgery is a surgical technique in which special instruments are inserted through small incision holes inside the body.For some time,efforts have been made to improve surgical pre training thro...Background Laparoscopic surgery is a surgical technique in which special instruments are inserted through small incision holes inside the body.For some time,efforts have been made to improve surgical pre training through practical exercises on abstracted and reduced models.Methods The authors strive for a portable,easy to use and cost-effective Virtual Reality-based(VR)laparoscopic pre-training platform and therefore address the question of how such a system has to be designed to achieve the quality of today's gold standard using real tissue specimens.Current VR controllers are limited regarding haptic feedback.Since haptic feedback is necessary or at least beneficial for laparoscopic surgery training,the platform to be developed consists of a newly designed prototype laparoscopic VR controller with haptic feedback,a commercially available head-mounted display,a VR environment for simulating a laparoscopic surgery,and a training concept.Results To take full advantage of benefits such as repeatability and cost-effectiveness of VR-based training,the system shall not require a tissue sample for haptic feedback.It is currently calculated and visually displayed to the user in the VR environment.On the prototype controller,a first axis was provided with perceptible feedback for test purposes.Two of the prototype VR controllers can be combined to simulate a typical both-handed use case,e.g.,laparoscopic suturing.A Unity based VR prototype allows the execution of simple standard pre-trainings.Conclusions The first prototype enables full operation of a virtual laparoscopic instrument in VR.In addition,the simulation can compute simple interaction forces.Major challenges lie in a realistic real-time tissue simulation and calculation of forces for the haptic feedback.Mechanical weaknesses were identified in the first hardware prototype,which will be improved in subsequent versions.All degrees of freedom of the controller are to be provided with haptic feedback.To make forces tangible in the simulation,characteristic values need to be determined using real tissue samples.The system has yet to be validated by cross-comparing real and VR haptics with surgeons.展开更多
基金This work was supported by the National Natural Science Foundation of China(Nos.62034006,92264201,and 91964105)the Natural Science Foundation of Shandong Province(Nos.ZR2020JQ28 and ZR2020KF016)the Program of Qilu Young Scholars of Shandong University.
文摘With the rapid development of machine learning,the demand for high-efficient computing becomes more and more urgent.To break the bottleneck of the traditional Von Neumann architecture,computing-in-memory(CIM)has attracted increasing attention in recent years.In this work,to provide a feasible CIM solution for the large-scale neural networks(NN)requiring continuous weight updating in online training,a flash-based computing-in-memory with high endurance(10^(9) cycles)and ultrafast programming speed is investigated.On the one hand,the proposed programming scheme of channel hot electron injection(CHEI)and hot hole injection(HHI)demonstrate high linearity,symmetric potentiation,and a depression process,which help to improve the training speed and accuracy.On the other hand,the low-damage programming scheme and memory window(MW)optimizations can suppress cell degradation effectively with improved computing accuracy.Even after 109 cycles,the leakage current(I_(off))of cells remains sub-10pA,ensuring the large-scale computing ability of memory.Further characterizations are done on read disturb to demonstrate its robust reliabilities.By processing CIFAR-10 tasks,it is evident that~90%accuracy can be achieved after 109 cycles in both ResNet50 and VGG16 NN.Our results suggest that flash-based CIM has great potential to overcome the limitations of traditional Von Neumann architectures and enable high-performance NN online training,which pave the way for further development of artificial intelligence(AI)accelerators.
文摘The Belt and Road Initiative has brought rich and diverse possibilities to global cooperation,recommending that countries strengthen multilateral cooperation,help each other,and jointly face and resolve various risks.
基金suppoited by an Alexander Graliam Bell Canada Graduate Scholarship-Doctoralsupported by an Ontario Graduate Scholarshipsupported by the Canada Research Chairs programme。
文摘Purpose:The aim of this umbrella review was to determine the impact of resistance training(RT)and individual RT prescription variables on muscle mass,strength,and physical function in healthy adults.Methods:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,we systematically searched and screened eligible systematic reviews reporting the effects of differing RT prescription variables on muscle mass(or its proxies),strength,and/or physical function in healthy adults aged>18 years.Results:We identified 44 systematic reviews that met our inclusion criteria.The methodological quality of these reviews was assessed using A Measurement Tool to Assess Systematic Reviews;standardized effectiveness statements were generated.We found that RT was consistently a potent stimulus for increasing skeletal muscle mass(4/4 reviews provide some or sufficient evidence),strength(4/6 reviews provided some or sufficient evidence),and physical function(1/1 review provided some evidence).RT load(6/8 reviews provided some or sufficient evidence),weekly frequency(2/4 reviews provided some or sufficient evidence),volume(3/7 reviews provided some or sufficient evidence),and exercise order(1/1 review provided some evidence)impacted RT-induced increases in muscular strength.We discovered that 2/3 reviews provided some or sufficient evidence that RT volume and contraction velocity influenced skeletal muscle mass,while 4/7 reviews provided insufficient evidence in favor of RT load impacting skeletal muscle mass.There was insufficient evidence to conclude that time of day,periodization,inter-set rest,set configuration,set end point,contraction velocity/time under tension,or exercise order(only pertaining to hypertrophy)influenced skeletal muscle adaptations.A paucity of data limited insights into the impact of RT prescription variables on physical function.Conclusion:Overall,RT increased muscle mass,strength,and physical function compared to no exercise.RT intensity(load)and weekly frequency impacted RT-induced increases in muscular strength but not muscle hypertrophy.RT volume(number of sets)influenced muscular strength and hypertrophy.
基金partially supported by the National Key R&D Program of China (2022ZD0119302)the National Natural Science Foundation of China (U23B2059, 61925303, 62173034, 62088101)。
文摘Dear Editor,In this letter, we introduce a novel online distributed data-driven robust control approach for learning controllers of unknown nonlinear multi-agent systems(MASs) using state-dependent representations.
基金supported by Hong Kong Spinal Cord Injury Fund (HKSCIF),China (to HZ)。
文摘For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.
文摘Objective:Transurethral resection of bladder tumor is one of the most common everyday urological procedures.This kind of surgery demands a set of skills that need training and experience.In this review,we aimed to investigate the current literature to find out if simulators,phantoms,and other training models could be used as a tool for teaching urologists.Methods:A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and the recommendations of the European Association of Urology guidelines for conducting systematic reviews.Fifteen out of 932 studies met our inclusion criteria and are presented in the current review.Results:The UroTrainer(Karl Storz GmbH,Tuttlingen,Germany),a virtual reality training simulator,achieved positive feedback and an excellent face and construct validity by the participants.The inspection of bladder mucosa,blood loss,tumor resection,and procedural time was improved after the training,especially for inexperienced urologists and medical students.The construct validity of UroSim®(VirtaMed,Zurich,Switzerland)was established.SIMBLA simulator(Samed GmbH,Dresden,Germany)was found to be a realistic and useful tool by experts and urologists with intermediate experience.The test objective competency model based on SIMBLA simulator could be used for evaluating urologists.The porcine model of the Asian Urological Surgery Training and Education Group also received positive feedback by the participants that tried it.The Simulation and Technology Enhanced Learning Initiative Project had an extraordinary face and content validity,and 60%of participants would like to use the simulators in the future.The 5-day multimodal training curriculum“Boot Camp”in the United Kingdom achieved an increase of the level of confidence of the participants that lasted months after the project.Conclusion:Simulators and courses or curricula based on a simulator training could be a valuable learning tool for any surgeon,and there is no doubt that they should be a part of every urologist's technical education.
基金supported by the Minas Gerais State University (UEMG/Brazil)a Research Productivity Scholarship Program (UEMG-PQ08/2021)+1 种基金a doctorate scholarship from the National Council of Technological and Scientific Development (CNPq/Brazil-Process140473/2020-3)a doctorate scholarship fromthe Coordination of Improvement of Higher Education Personnel (CAPES/Brazil-Code 001)。
文摘Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was performed for randomized controlled trials in PubMed,Scopus,Web of Science,and SciELO.Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity,metabolic risk,and inflammation with a control group(CG) were included.Independent reviewers selected the studies,extracted the data,and performed the risk of bias and certainty of the evidence(Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)) evaluations.Total body and abdominal adiposity,blood lipids,glucose,and C-reactive protein were included for meta-analysis.A random-effects model,standardized mean difference(Hedges’ g),and 95% confidence interval(95%CI) were used for meta-analysis.Results:Twenty randomized controlled trials(overall risk of bias:some concerns;GRADE:low to very low) with overweight/obese postmenopausal and older females were included.RT groups were divided into low-volume RT(LVRT,~44 sets/week) and high-volume RT(HVRT,~77 sets/week).Both RT groups presented improved body adiposity,metabolic risk,and inflammation when compared to CG.However,HVRT demonstrated higher effect sizes than LVRT for glucose(HVRT=-1.19;95%CI:-1.63 to-0.74;LVRT=-0.78;95%CI:-1.15 to-0.41) and C-reactive protein(HVRT=-1.00;95%CI:-1.32 to-0.67;LVRT=-0.34;95%CI,-0.63 to-0.04)) when compared to CG.Conclusion:Compared to CG,HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.
基金supported by the National Natural Science Foundation of China(No.U21B2003,62072250,62072250,62172435,U1804263,U20B2065,61872203,71802110,61802212)the National Key R&D Program of China(No.2021QY0700)+4 种基金the Key Laboratory of Intelligent Support Technology for Complex Environments(Nanjing University of Information Science and Technology),Ministry of Education,and the Natural Science Foundation of Jiangsu Province(No.BK20200750)Open Foundation of Henan Key Laboratory of Cyberspace Situation Awareness(No.HNTS2022002)Post Graduate Research&Practice Innvoation Program of Jiangsu Province(No.KYCX200974)Open Project Fund of Shandong Provincial Key Laboratory of Computer Network(No.SDKLCN-2022-05)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)Fund and Graduate Student Scientific Research Innovation Projects of Jiangsu Province(No.KYCX231359).
文摘In recent years,various adversarial defense methods have been proposed to improve the robustness of deep neural networks.Adversarial training is one of the most potent methods to defend against adversarial attacks.However,the difference in the feature space between natural and adversarial examples hinders the accuracy and robustness of the model in adversarial training.This paper proposes a learnable distribution adversarial training method,aiming to construct the same distribution for training data utilizing the Gaussian mixture model.The distribution centroid is built to classify samples and constrain the distribution of the sample features.The natural and adversarial examples are pushed to the same distribution centroid to improve the accuracy and robustness of the model.The proposed method generates adversarial examples to close the distribution gap between the natural and adversarial examples through an attack algorithm explicitly designed for adversarial training.This algorithm gradually increases the accuracy and robustness of the model by scaling perturbation.Finally,the proposed method outputs the predicted labels and the distance between the sample and the distribution centroid.The distribution characteristics of the samples can be utilized to detect adversarial cases that can potentially evade the model defense.The effectiveness of the proposed method is demonstrated through comprehensive experiments.
基金Supported by research grants from the National Key Research and Development Program of China(No.2020YFE0204400)the National Natural Science Foundation of China(No.82271042+1 种基金No.52203191)the Zhejiang Province Key Research and Development Program(No.2023C03090).
文摘●AIM:To determine the teaching effects of a real-time three dimensional(3D)visualization system in the operating room for early-stage phacoemulsification training.●METHODS:A total of 10 ophthalmology residents of the first-year postgraduate were included.All the residents were novices to cataract surgery.Real-time cataract surgical observations were performed using a custom-built 3D visualization system.The training lasted 4wk(32h)in all.A modified International Council of Ophthalmology’s Ophthalmology Surgical Competency Assessment Rubric(ICO-OSCAR)containing 4 specific steps of cataract surgery was applied.The self-assessment(self)and expert-assessment(expert)were performed through the microsurgical attempts in the wet lab for each participant.●RESULTS:Compared with pre-training assessments(self 3.2±0.8,expert 2.5±0.6),the overall mean scores of posttraining(self 5.2±0.4,expert 4.7±0.6)were significantly improved after real-time observation training of 3D visualization system(P<0.05).Scores of 4 surgical items were significantly improved both self and expert assessment after training(P<0.05).●CONCLUSION:The 3D observation training provides novice ophthalmic residents with a better understanding of intraocular microsurgical techniques.It is a useful tool to improve teaching efficiency of surgical education.
基金the National Key Research and Devecopment Program of China(No.2022YFB4501601)the National Natural Science Foundation of China(No.62102398,U20A20227,62222214,62002338,U22A2028,U19B2019)+1 种基金the Chinese Academy of Sciences Project for Young Scientists in Basic Research(YSBR-029)Youth Innovation Promotion Association Chinese Academy of Sciences。
文摘Quantized training has been proven to be a prominent method to achieve deep neural network training under limited computational resources.It uses low bit-width arithmetics with a proper scaling factor to achieve negligible accuracy loss.Cambricon-Q is the ASIC design proposed to efficiently support quantized training,and achieves significant performance improvement.However,there are still two caveats in the design.First,Cambricon-Q with different hardware specifications may lead to different numerical errors,resulting in non-reproducible behaviors which may become a major concern in critical applications.Second,Cambricon-Q cannot leverage data sparsity,where considerable cycles could still be squeezed out.To address the caveats,the acceleration core of Cambricon-Q is redesigned to support fine-grained irregular data processing.The new design not only enables acceleration on sparse data,but also enables performing local dynamic quantization by contiguous value ranges(which is hardware independent),instead of contiguous addresses(which is dependent on hardware factors).Experimental results show that the accuracy loss of the method still keeps negligible,and the accelerator achieves 1.61×performance improvement over Cambricon-Q,with about 10%energy increase.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.62276229 and 32071096).
文摘The human brain is highly plastic.Cognitive training is usually used to modify functional connectivity of brain networks.Moreover,the structures of brain networks may determine its dynamic behavior which is related to human cognitive abilities.To study the effect of functional connectivity on the brain dynamics,the dynamic model based on functional connections of the brain and the Hindmarsh–Rose model is utilized in this work.The resting-state fMRI data from the experimental group undergoing abacus-based mental calculation(AMC)training and from the control group are used to construct the functional brain networks.The dynamic behavior of brain at the resting and task states for the AMC group and the control group are simulated with the above-mentioned dynamic model.In the resting state,there are the differences of brain activation between the AMC group and the control group,and more brain regions are inspired in the AMC group.A stimulus with sinusoidal signals to brain networks is introduced to simulate the brain dynamics in the task states.The dynamic characteristics are extracted by the excitation rates,the response intensities and the state distributions.The change in the functional connectivity of brain networks with the AMC training would in turn improve the brain response to external stimulus,and make the brain more efficient in processing tasks.
文摘The online car-hailing industry, which provides the right of use, has a certain impact on the traditional automobile market, but there is no unified theory on whether it has a positive impact or a negative impact. Based on 362 consumer questionnaire data, this study builds a structural equation model to discuss the driving factors of residents’ choice of online car-hailing and whether the development of online car-hailing will have a certain substitution impact on the sales of private cars. From the perspective of consumers’ purchase intention, the research results show that consumers’ price consciousness, convenience consciousness, environmental protection consciousness and possession tendency will affect their choice of travel mode, and the use of online car-hailing is positively correlated with consumers’ willingness to replace private car ownership with online car-hailing.
文摘This paper aims to analyze the present conditions of the social responsibility ecosystem in online audiovisual enterprises in the digital age. It focuses on the governance of social responsibility in these enterprises and conducts an in-depth analysis of the problems and influencing factors related to the social responsibility aberrations of online audiovisual enterprises. Drawing upon social responsibility theory and collaborative governance theory, this research constructs a social responsibility guidance and governance system guided by the public, supported by the voluntary fulfillment of responsibilities by online audiovisual enterprises, and based on the collaborative participation of diverse stakeholders. It explores and optimizes the implementation pathways of this system, providing theoretical support and practical guidance for promoting the sustainable development of online audiovisual enterprises. Furthermore, it aims to contribute to the creation of a harmonious Internet ecosystem.
文摘BACKGROUND Patients with Parkinson's disease(PD)exhibit symptoms such as antecollis(AC)and camptocormia(CC).The pathology of these two conditions is unclear.Additionally,standard treatment methods have not been established.The article reports the case of a 65-year-old female patient with AC and CC who was treated with central and peripheral interventions to alleviate symptoms.CASE SUMMARY We present the case of a 65-year-old female PD patient with AC and CC.The course of the disease was 5 years.She was treated with rehabilitation strategies such as sensory tricks and trunk strength training.During the inpatient period,we compared and analyzed the patient's gait,rehabilitation assessment scale score,and angles of her abnormal trunk posture in the first week,the third week,and the fifth week.The patient's stride length increased,indicating that the patient's walking ability was improved.The Unified Parkinson's Disease Scale Part Three score and CC severity score decreased.Furthermore,the score of the other scale increased.In addition,the patient showed significant improvements in AC,upper CC,and lower CC angles.CONCLUSION This case study suggested that sensory tricks and trunk strength training are beneficial and safe for patients with AC and CC.
基金supported by the National Natural Science Foundation of China(62371049)。
文摘In engineering application,there is only one adaptive weights estimated by most of traditional early warning radars for adaptive interference suppression in a pulse reputation interval(PRI).Therefore,if the training samples used to calculate the weight vector does not contain the jamming,then the jamming cannot be removed by adaptive spatial filtering.If the weight vector is constantly updated in the range dimension,the training data may contain target echo signals,resulting in signal cancellation effect.To cope with the situation that the training samples are contaminated by target signal,an iterative training sample selection method based on non-homogeneous detector(NHD)is proposed in this paper for updating the weight vector in entire range dimension.The principle is presented,and the validity is proven by simulation results.
文摘The user’s intent to seek online information has been an active area of research in user profiling.User profiling considers user characteristics,behaviors,activities,and preferences to sketch user intentions,interests,and motivations.Determining user characteristics can help capture implicit and explicit preferences and intentions for effective user-centric and customized content presentation.The user’s complete online experience in seeking information is a blend of activities such as searching,verifying,and sharing it on social platforms.However,a combination of multiple behaviors in profiling users has yet to be considered.This research takes a novel approach and explores user intent types based on multidimensional online behavior in information acquisition.This research explores information search,verification,and dissemination behavior and identifies diverse types of users based on their online engagement using machine learning.The research proposes a generic user profile template that explains the user characteristics based on the internet experience and uses it as ground truth for data annotation.User feedback is based on online behavior and practices collected by using a survey method.The participants include both males and females from different occupation sectors and different ages.The data collected is subject to feature engineering,and the significant features are presented to unsupervised machine learning methods to identify user intent classes or profiles and their characteristics.Different techniques are evaluated,and the K-Mean clustering method successfully generates five user groups observing different user characteristics with an average silhouette of 0.36 and a distortion score of 1136.Feature average is computed to identify user intent type characteristics.The user intent classes are then further generalized to create a user intent template with an Inter-Rater Reliability of 75%.This research successfully extracts different user types based on their preferences in online content,platforms,criteria,and frequency.The study also validates the proposed template on user feedback data through Inter-Rater Agreement process using an external human rater.
文摘Background Laparoscopic surgery is a surgical technique in which special instruments are inserted through small incision holes inside the body.For some time,efforts have been made to improve surgical pre training through practical exercises on abstracted and reduced models.Methods The authors strive for a portable,easy to use and cost-effective Virtual Reality-based(VR)laparoscopic pre-training platform and therefore address the question of how such a system has to be designed to achieve the quality of today's gold standard using real tissue specimens.Current VR controllers are limited regarding haptic feedback.Since haptic feedback is necessary or at least beneficial for laparoscopic surgery training,the platform to be developed consists of a newly designed prototype laparoscopic VR controller with haptic feedback,a commercially available head-mounted display,a VR environment for simulating a laparoscopic surgery,and a training concept.Results To take full advantage of benefits such as repeatability and cost-effectiveness of VR-based training,the system shall not require a tissue sample for haptic feedback.It is currently calculated and visually displayed to the user in the VR environment.On the prototype controller,a first axis was provided with perceptible feedback for test purposes.Two of the prototype VR controllers can be combined to simulate a typical both-handed use case,e.g.,laparoscopic suturing.A Unity based VR prototype allows the execution of simple standard pre-trainings.Conclusions The first prototype enables full operation of a virtual laparoscopic instrument in VR.In addition,the simulation can compute simple interaction forces.Major challenges lie in a realistic real-time tissue simulation and calculation of forces for the haptic feedback.Mechanical weaknesses were identified in the first hardware prototype,which will be improved in subsequent versions.All degrees of freedom of the controller are to be provided with haptic feedback.To make forces tangible in the simulation,characteristic values need to be determined using real tissue samples.The system has yet to be validated by cross-comparing real and VR haptics with surgeons.
