Isolated Lumbar Extension Resistance Training Is Effective at Improving Extension Power and Disability in Subjects with Diagnosed Lumbar Multifidus Dysfunction

Background: Lumbar multifidus dysfunction is a prevalent cause of disability in individuals with lower back pain. Previous research highlights the benefits of isolated lumbar extension training for non-specific lower back pain, however, studies examining its efficacy in lumbar multifidus dysfunction are lacking. Objective: To evaluate the effectiveness of isolated lumbar extension resistance training on disability and strength in individuals with lumbar multifidus dysfunction. Methods: Subjects underwent a physiotherapy led structured rehabilitation program incorporating isolated lumbar extension. Sessions were conducted twice weekly targeting momentary muscular failure with time under load 90 - 120 seconds and progressions aimed at 5 - 10 lbs increments. Outcomes were assessed using the Oswestry Disability Index and lumbar extension strength testing at baseline and after 12 weeks, with statistical analysis using t-test and chi-squared 2 × 2. Results: Forty-five subjects (24 male, 21 female) with a median age of 48 completed the intervention. Improvements were noted in Oswestry Disability Index scores (median pre: 24, post: 15) and maximal lumbar extension strength (median pre: 122 lb, post: 186 lb), with p ≤ 0.05. Overall, 89% showed improvement in disability scores, 67% moved to a better disability category, and 51% saw at least a 50% increase in strength. No significant gender differences were observed. Conclusions: Isolated lumbar extension resistance training is effective at improving extension power and disability in subjects with lumbar multifidus dysfunction.

The influence of resistance exercise training prescription variables on skeletal muscle mass,strength,and physical function in healthy adults:An umbrella review

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.

Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

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.

ZnO Additive Boosts Charging Speed and Cycling Stability of Electrolytic Zn–Mn Batteries

Electrolytic aqueous zinc-manganese(Zn–Mn) batteries have the advantage of high discharge voltage and high capacity due to two-electron reactions. However, the pitfall of electrolytic Zn–Mn batteries is the sluggish deposition reaction kinetics of manganese oxide during the charge process and short cycle life. We show that, incorporating ZnO electrolyte additive can form a neutral and highly viscous gel-like electrolyte and render a new form of electrolytic Zn–Mn batteries with significantly improved charging capabilities. Specifically, the ZnO gel-like electrolyte activates the zinc sulfate hydroxide hydrate assisted Mn^(2+) deposition reaction and induces phase and structure change of the deposited manganese oxide(Zn_(2)Mn_(3)O_8·H_(2)O nanorods array), resulting in a significant enhancement of the charge capability and discharge efficiency. The charge capacity increases to 2.5 mAh cm^(-2) after 1 h constant-voltage charging at 2.0 V vs. Zn/Zn^(2+), and the capacity can retain for up to 2000 cycles with negligible attenuation. This research lays the foundation for the advancement of electrolytic Zn–Mn batteries with enhanced charging capability.

Whole-process case management effects on mental state and selfcare ability in patients with liver cancer

BACKGROUND Regarding the incidence of malignant tumors in China,the incidence of liver cancer ranks fourth,second only to lung,gastric,and esophageal cancers.The case fatality rate ranks third after lung and cervical cancer.In a previous study,the whole-process management model was applied to patients with breast cancer,which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction.METHODS In this single-center,randomized,controlled study,60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group(n=30),who received whole-process case management on the basis of routine nursing mea-sures,and a control group(n=30),who were given routine nursing measures.We compared differences between the two groups in terms of anxiety,depression,the level of hope,self-care ability,symptom distress,sleep quality,and quality of life.RESULTS Post-intervention,Hamilton anxiety scale,Hamilton depression scale,memory symptom assessment scale,and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention,and the observation group had lower scores than the control group(P<0.05).Herth hope index,self-care ability assessment scale-revision in Chinese,and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention,with higher scores in the observation group compared with the control group(P<0.05).CONCLUSION Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer,alleviate symptoms and problems,and improve the level of hope,self-care ability,sleep quality,and quality of life,as well as provide feasible nursing alternatives for patients with liver cancer.

Application value research of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke

BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of the application value of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke.METHODS This study selected 86 patients with swallowing disorders after stroke admitted to our rehabilitation department from February 2022 to December 2023 as research subjects.They were divided into a control group(n=43)and an observation group(n=43)according to the treatment.The control group received swallowing rehabilitation training,while the observation group received swallowing treatment device in addition to the training.Both groups underwent continuous intervention for two courses of treatment.RESULTS The total effective rate in the observation group(93.02%)was higher than that in the control group(76.74%)(P=0.035).After intervention,the oral transit time,swallowing response time,pharyngeal transit time,and laryngeal closure time decreased in both groups compared to before intervention.In the observation group,the oral transit time,swallowing response time,and pharyngeal transit time were shorter than those in the control group after intervention.However,the laryngeal closure time after intervention in the observation group was compared with that in the control group(P=0.142).After intervention,average amplitude value and duration of the genioglossus muscle group during empty swallowing and swallowing 5 mL of water are reduced compared to before intervention in both groups.After intervention,the scores of the chin-tuck swallowing exercise and the Standardized Swallowing Assessment are both reduced compared to pre-intervention levels in both groups.However,the observation group scores lower than the control group after intervention.Additionally,the Functional Oral Intake Scale scores of both groups are increased after intervention compared to pre-intervention levels,with the observation group scoring higher than the control group after intervention(P<0.001).The cumulative incidence of complications in the observation group is 9.30%,which is lower than the 27.91%in the control group(P=0.027).CONCLUSION The combination of swallowing therapy equipment with swallowing rehabilitation training can improve the muscle movement level of the genioglossus muscle group,enhance swallowing function,and prevent the occurrence of swallowing-related complications after stroke.

Analysis of the impact of ERAS-based respiratory function training on older patients’ability to prevent pulmonary complications after abdominal surgery

BACKGROUND In China,as the population grows older,the number of elderly people who have died from respiratory problems has increased.AIM To investigate whether enhanced recovery after surgery(ERAS)-based respiratory function training may help older patients who had abdominal surgery suffer fewer pulmonary problems,shorter hospital stays,and improved lung function.METHODS The data of 231 elderly individuals having abdominal surgery was retrospectively analyzed.Based on whether ERAS-based respiratory function training was provided,patients were divided into ERAS group(n=112)and control group(n=119).Deep vein thrombosis(DVT),pulmonary embolism(PE),and respiratory tract infection(RTI)were the primary outcome variables.Secondary outcome variables included the Borg score Scale,FEV1/FVC and postoperative hospital stay.RESULTS The percentage of 18.75%of ERAS group participants and 34.45%of control group participants,respectively,had respiratory infections(P=0.007).None of the individuals experienced PE or DVT.The ERAS group’s median postoperative hospital stay was 9.5 d(3-21 d)whereas the control groups was 11 d(4-18 d)(P=0.028).The Borg score decreased on the 4th d following surgery in the ERAS group compared to the 2nd d prior(P=0.003).The incidence of RTIs was greater in the control group than in the ERAS group among patients who spent more than 2 d in the hospital before surgery(P=0.029).CONCLUSION ERAS-based respiratory function training may reduce the risk of pulmonary complications in older individuals undergoing abdominal surgery.

Mediation Effect of Employee Training on Implementation of Hotel Environmental Management Practices for Hotel Business Sustainability in Tanzania

The study assessed the mediation effect of employee training on implementation of hotel management practices for hotel business sustainability in Tanzania.Study was conducted in two cities Arusha and Dar es Salaam whereby a structured questionnaire with Likert scale range from one to five was used to collect information from the sample of 400 hotels’managers.The findings of the hypothesis indicate that two hypotheses were significant at significant at p<0.001 and one was not significant.The first hypothesis found that environmental management practice has positive effect on business sustainability highly significant at p<0.001.The second hypothesis was that there was positive relationship between environmental management practices and employee training at highly significant of p<0.001 and was accepted.Third hypothesis was that employee training has no mediation effect on the hotel business sustainability whereby p>0.05 hence rejected.It was also found the direct effect was significance at p<0.01 while indirect effect was not significance at p>0.05 and total effect was significance at p<0.01.It was concluded that,employees’training does not mediate the implementation of hotel environmental management practices for sustainability of hotel business in Tanzania.

Research and Practice of Cardiopulmonary Rehabilitation Training Programs

In today’s society, the incidence of cardiopulmonary diseases is increasing annually, seriously affecting patients’ quality of life. Therefore, developing a scientific and effective rehabilitation training program is of great significance. This study first analyzes the theoretical basis of cardiopulmonary rehabilitation training, including the effects of aerobic exercise, interval training, and strength training on cardiopulmonary function. Based on this, a comprehensive rehabilitation training program is designed, which includes personalized training plans, comprehensive interventions, multidisciplinary collaboration, patient education, and regular follow-up visits. The cardiopulmonary rehabilitation training plan developed in this study has certain scientific practicability, which provides a theoretical basis for cardiopulmonary rehabilitation training, and also provides a reference for medical institutions, rehabilitation centers and communities, which is helpful for promotion and application to a wider range of patients with cardiopulmonary diseases.

Impact of task-oriented training based on acupuncture rehabilitation on upper extremity function and quality of life of patients with early stroke

BACKGROUND Eighty percent of stroke patients develop upper limb dysfunction,especially hand dysfunction,which has a very slow recovery,resulting in economic burden to families and society.AIM To investigate the impact of task-oriented training based on acupuncture therapy on upper extremity function in patients with early stroke.METHODS Patients with early stroke hemiplegia who visited our hospital between January 2021 and October 2022 were divided into a control group and an observation group,each with 50 cases.The control group underwent head acupuncture plus routine upper limb rehabilitation training(acupuncture therapy).In addition to acupuncture and rehabilitation,the observation group underwent upper limb task-oriented training(30 min).Each group underwent treatment 5 d/wk for 4 wk.Upper extremity function was assessed in both groups using the Fugl-Meyer Assessment-Upper Extremity(FMA-UE),Wolf Motor Function Rating Scale(WMFT),modified Barthel Index(MBI),and Canadian Occupational Performance Measure(COPM).Quality of life was evaluated using the Short-Form 36-Item Health Survey(SF-36).Clinical efficacy of the interventions was also evaluated.RESULTS Before intervention,no significant differences were observed in the FMA-UE,MBI,and WMFT scores between the two groups(P>0.05).After intervention,the FMA-UE,WMFT,MBI,COPM-Functional Mobility and Satisfaction,and SF-36 scores increased in both groups(P<0.05),with even higher scores in the observation group(P<0.05).The observation group also obtained a higher total effective rate than the control group(P<0.05).CONCLUSION Task-oriented training based on acupuncture rehabilitation significantly enhanced upper extremity mobility,quality of life,and clinical efficacy in patients with early stroke.

Influencing factors of self-management ability among dry eye patients in west China

AIM:To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China.METHODS:A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University.All participants completed the rating scale of health self-management skill for adults(AHSMSRS),Huaxi Emotional-Distress Index(HEI),e-health literacy scale(e-HEALS)and Brief Illness Perception Questionnaire(Brief-IPQ).A generalized linear model was employed to establish a multivariate linear model with demographic data,psychological state,e-HEALS,and illness perception as independent variables and health selfmanagement skill score as the dependent variable.RESULTS:The mean score for health self-management skill was 165.58±15.79.Multivariate analysis revealed that advanced age,better illness perception and improved psychological state were associated with better health selfmanagement ability among dry eye patients.Furthermore,the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y.CONCLUSION:The health self-management ability of dry eye patients in west China is relatively high.Age,duration of disease,illness perception and psychological state are the influencing factors on the health selfmanagement ability of dry eye patients.

Experimental Study on Wire Melting Control Ability of Twin-Body Plasma Arc

The twin-body plasma arc has the decoupling control ability of heat transfer and mass transfer,which is beneficial to shape and property control in wire arc additive manufacturing.In this paper,with the wire feeding speed as a characteristic quantity,the wire melting control ability of twin-body plasma arc was studied by adjusting the current separation ratio(under the condition of a constant total current),the wire current/main current and the position of the wire in the arc axial direction.The results showed that under the premise that the total current remains unchanged(100 A),as the current separation ratio increased,the middle and minimum melting amounts increased approximately synchronously under the effect of anode effect power,the first melting mass range remained constant;the maximum melting amount increased twice as fast as the middle melting amount under the effect of the wire feeding speed,and the second melting mass range was expanded.When the wire current increased,the anode effect power and the plasma arc power were both factors causing the increase in the wire melting amount;however,when the main current increased,the plasma arc power was the only factor causing the increase in the wire melting amount.The average wire melting increment caused by the anode effect power was approximately 2.7 times that caused by the plasma arc power.The minimum melting amount was not affected by the wire-torch distance under any current separation ratio tested.When the current separation ratio increased and reached a threshold,the middle melting amount remained constant with increasing wire-torch distance.When the current separation ratio continued to increase and reached the next threshold,the maximum melting amount remained constant with the increasing wire-torch distance.The effect of the wire-torch distance on the wire melting amount reduced with the increase in the current separation ratio.Through this study,the decoupling mechanism and ability of this innovative arc heat source is more clearly.

Transurethral resection of bladder tumor: A systematic review of simulator-based training courses and curricula

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.

Passive activity enhances residual control ability in patients with complete spinal cord injury

Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.

Beam Training and Tracking in mmWave Communication:A Survey

Communicating on millimeter wave(mmWave)bands is ushering in a new epoch of mobile communication which provides the availability of 10 Gbps high data rate transmission.However,mmWave links are easily prone to short transmission range communication because of the serious free space path loss and the blockage by obstacles.To overcome these challenges,highly directional beams are exploited to achieve robust links by hybrid beamforming.Accurately aligning the transmitter and receiver beams,i.e.beam training,is vitally important to high data rate transmission.However,it may cause huge overhead which has negative effects on initial access,handover,and tracking.Besides,the mobility patterns of users are complicated and dynamic,which may cause tracking error and large tracking latency.An efficient beam tracking method has a positive effect on sustaining robust links.This article provides an overview of the beam training and tracking technologies on mmWave bands and reveals the insights for future research in the 6th Generation(6G)mobile network.Especially,some open research problems are proposed to realize fast,accurate,and robust beam training and tracking.We hope that this survey provides guidelines for the researchers in the area of mmWave communications.

Enhancing clinical proficiency through laparoscopic training using Japanese origami

Objective This study aimed to investigate the clinical efficacy of laparoscopic training using origami,a traditional Japanese papercraft,using laparoscopic forceps to create origami cranes.Methods In this retrospective study,4 surgeons were randomly divided into 2 groups:The training group,consisting of surgeons 1 and 2,and the non-training group,consisting of surgeons 3 and 4.Over the course of a one-year study period,the training group regularly underwent laparoscopic surgery training with a dry box,wherein they folded a total of 1000 origami cranes using laparoscopic instruments.The non-training group periodically underwent common laparoscopic surgery training of techniques such as suturing and ligation.Each surgeon regularly performed the transabdominal preperitoneal approach for inguinal hernias.Each training was conducted concurrently with the surgeries.The procedure time(peritoneum detachment,mesh placement,and closure of the peritoneum),total operation time(time from peritoneum detachment to closure of the peritoneum),and surgical outcomes were examined.Results The training group showed greater improvement in the total operation time and more stable performance than the non-training group.Additionally,the time taken for peritoneum detachment was significantly shorter in the training group.Conclusion Laparoscopic training using origami has the potential to enhance laparoscopic surgical skills and improve surgical outcomes.

Effect of resistance training volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females:Systematic review and meta-analysis of randomized controlled trials

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.

Optimized operation scheme of flash-memory-based neural network online training with ultra-high endurance

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.

Boosting Adversarial Training with Learnable Distribution

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.

Utility of real-time 3D visualization system in the early stage of phacoemulsification training

●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.