Paradoxical herniation associated with hyperbaric oxygen therapy after decompressive craniectomy: A case report

BACKGROUND Whether hyperbaric oxygen therapy(HBOT)can cause paradoxical herniation is still unclear.CASE SUMMARY A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery.HBOT was administered 22 d after surgery due to speech impairment.Paradoxical herniation appeared on the second day after treatment,and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital.After timely skull repair,the paradoxical herniation was resolved,and the patient regained consciousness and had a good recovery as observed at the follow-up visit.CONCLUSION Paradoxical herniation is rare and may be caused by HBOT.However,the underlying mechanism is unknown,and the understanding of this phenomenon is insufficient.The use of mannitol may worsen this condition.Timely skull repair can treat paradoxical herniation and prevent serious complications.

Scheme Based on Multi-Level Patch Attention and Lesion Localization for Diabetic Retinopathy Grading

Early screening of diabetes retinopathy(DR)plays an important role in preventing irreversible blindness.Existing research has failed to fully explore effective DR lesion information in fundus maps.Besides,traditional attention schemes have not considered the impact of lesion type differences on grading,resulting in unreasonable extraction of important lesion features.Therefore,this paper proposes a DR diagnosis scheme that integrates a multi-level patch attention generator(MPAG)and a lesion localization module(LLM).Firstly,MPAGis used to predict patches of different sizes and generate a weighted attention map based on the prediction score and the types of lesions contained in the patches,fully considering the impact of lesion type differences on grading,solving the problem that the attention maps of lesions cannot be further refined and then adapted to the final DR diagnosis task.Secondly,the LLM generates a global attention map based on localization.Finally,the weighted attention map and global attention map are weighted with the fundus map to fully explore effective DR lesion information and increase the attention of the classification network to lesion details.This paper demonstrates the effectiveness of the proposed method through extensive experiments on the public DDR dataset,obtaining an accuracy of 0.8064.

Deep neural network based on multi-level wavelet and attention for structured illumination microscopy

Structured illumination microscopy(SIM)is a popular and powerful super-resolution(SR)technique in biomedical research.However,the conventional reconstruction algorithm for SIM heavily relies on the accurate prior knowledge of illumination patterns and signal-to-noise ratio(SNR)of raw images.To obtain high-quality SR images,several raw images need to be captured under high fluorescence level,which further restricts SIM’s temporal resolution and its applications.Deep learning(DL)is a data-driven technology that has been used to expand the limits of optical microscopy.In this study,we propose a deep neural network based on multi-level wavelet and attention mechanism(MWAM)for SIM.Our results show that the MWAM network can extract high-frequency information contained in SIM raw images and accurately integrate it into the output image,resulting in superior SR images compared to those generated using wide-field images as input data.We also demonstrate that the number of SIM raw images can be reduced to three,with one image in each illumination orientation,to achieve the optimal tradeoff between temporal and spatial resolution.Furthermore,our MWAM network exhibits superior reconstruction ability on low-SNR images compared to conventional SIM algorithms.We have also analyzed the adaptability of this network on other biological samples and successfully applied the pretrained model to other SIM systems.

The AI Paradox: Mapping the Unintended Disruptions in IT and Beyond

In the realm of Artificial Intelligence (AI), there exists a complex landscape where promises of efficiency and innovation clash with unforeseen disruptions across Information Technology (IT) and broader societal realms. This paper sets out on a journey to explore the intricate paradoxes inherent in AI, focusing on the unintended consequences that ripple through IT and beyond. Through a thorough examination of literature and analysis of related works, this study aims to shed light on the complexities surrounding the AI paradox. It delves into how this paradox appears in various domains, such as algorithmic biases, job displacement, ethical dilemmas, and privacy concerns. By mapping out these unintended disruptions, this research seeks to offer a nuanced understanding of the challenges brought forth by AI-driven transformations. Ultimately, its goal is to pave the way for the responsible development and deployment of AI, fostering a harmonious integration of technological progress with societal values and priorities.

Solving the Olbers’s Paradox, Explaining the “Red-Shift”, and Challenging the Relativities by “Sun Matters Theory” and “Sun Model of Universe”, an Evolution of the Einstein’s Static Universe Model

Olbers’s paradox, known as the dark night paradox, is an argument in astrophysics that the darkness of the night sky conflicts with the assumption of an infinite and eternal static universe. Big-Bang theory was used to partially explain this paradox, while introducing new problems. Hereby, we propose a better theory, named Sun Matters Theory, to explain this paradox. Moreover, this unique theory supports and extended the Einstein’s static universe model proposed by Albert Einstein in 1917. Further, we proposed our new universe model, “Sun Model of Universe”. Based on the new model and novel theory, we generated innovative field equation by upgrading Einstein’s Field Equation through adding back the cosmological constant, introducing a new variable and modifying the gravitationally-related concepts. According to the Sun Model of Universe, the dark matter and dark energy comprise the so-called “Sun Matters”. The observed phenomenon like the red shift is explained as due to the interaction of ordinary light with Sun Matters leading to its energy and frequency decrease. In Sun Model, our big universe consists of many universes with ordinary matter at the core mixed and surrounded with the Sun Matters. In those universes, the laws of physics may be completely or partially different from that of our ordinary universe with parallel civilizations. The darkness of night can be easily explained as resulting from the interaction of light with the Sun Matters leading to the sharp decrease in the light intensity. Sun Matters also scatter the light from a star, which makes it shining as observed by Hubble. Further, there is a kind of Sun Matters named “Sun Waters”, surrounding every starts. When lights pass by the sun, the Sun Waters deflect the lights to bend the light path. According to the Sun Model, it is the light bent not the space bent that was proposed in the theory of relativities.

Multiple paradoxical embolisms caused by central venous catheter thrombus passing through a patent foramen ovale: A case report

BACKGROUND To date,this is the first case of a paradoxical embolism(PDE)that concurrently manifested in the coronary and lower limb arteries and was secondary to a central venous catheter(CVC)thrombus via a patent foramen ovale(PFO).CASE SUMMARY Here,we report a case of simultaneous coronary and lower limb artery embolism in a PFO patient carrier of a CVC.The patient presented to the hospital with acute chest pain and lower limb fatigue.Doppler ultrasound showed a large thrombus in the right internal jugular vein,precisely at the tip of the CVC.Transthoracic and transesophageal echocardiography confirmed the existence of a PFO,with inducible right-to-left shunting by the Valsalva maneuver.The patient was administered an extended course of anticoagulation therapy,and then the CVC was successfully removed.Percutaneous PFO closure was not undertaken.There was no recurrence during follow-up.CONCLUSION Thus,CVC-associated thrombosis is a potential source for multiple PDE in PFO patients.

COVID-19 mortality paradox(United States vs Africa):Mass vaccination vs early treatment

The coronavirus disease 2019(COVID-19)mortality rate in 55 African countries is almost 4.5 times lower than in the coronavirus disease 2019(COVID-19)despite Africa having over 4.2 times more people.This mortality paradox is also evident when comparing Nigeria,a heavily populated,poorly vaccinated and weakly mandated country to Israel,a small,highly vaccinated and strictly mandated country.Nigeria has almost 4 times lower COVID mortality than Israel.In this Field of Vision perspective,I explain how this paradox has evolved drawing upon my academic,clinical and social experience.Since April 2020,I’ve developed and been using the Egyptian immune-modulatory Kelleni’s protocol to manage COVID-19 patients including pediatric,geriatric,pregnant,immune-compromised and other individuals suffering from multiple comorbidities.It’s unfortunate that severe acute respiratory syndrome coronavirus 2 is still evolving accompanied by more deaths.However in Africa,we’ve been able to live without anxiety or mandates throughout the pandemic because we trust science and adopted early treatment using safe,and effective repurposed drugs that have saved the majority of COVID-19 patients.This article represents an African and Egyptian tale of honor.

Twin Paradox and Proper Time

Professors Mohazzbi and Luo [1] published “Despite several attempts have been made to explain the twin paradox … none of the explanations … resolved the paradox. If the paradox can be ever resolved, it requires a much deeper understanding … of the theory of relativity”. The deeper understanding of resolving the paradox is by applying more explicit definitions of proper time interval, Lorentz transform, time dilation, and aging time.

Deep reinforcement learning based multi-level dynamic reconfiguration for urban distribution network:a cloud-edge collaboration architecture

With the construction of the power Internet of Things(IoT),communication between smart devices in urban distribution networks has been gradually moving towards high speed,high compatibility,and low latency,which provides reliable support for reconfiguration optimization in urban distribution networks.Thus,this study proposed a deep reinforcement learning based multi-level dynamic reconfiguration method for urban distribution networks in a cloud-edge collaboration architecture to obtain a real-time optimal multi-level dynamic reconfiguration solution.First,the multi-level dynamic reconfiguration method was discussed,which included feeder-,transformer-,and substation-levels.Subsequently,the multi-agent system was combined with the cloud-edge collaboration architecture to build a deep reinforcement learning model for multi-level dynamic reconfiguration in an urban distribution network.The cloud-edge collaboration architecture can effectively support the multi-agent system to conduct“centralized training and decentralized execution”operation modes and improve the learning efficiency of the model.Thereafter,for a multi-agent system,this study adopted a combination of offline and online learning to endow the model with the ability to realize automatic optimization and updation of the strategy.In the offline learning phase,a Q-learning-based multi-agent conservative Q-learning(MACQL)algorithm was proposed to stabilize the learning results and reduce the risk of the next online learning phase.In the online learning phase,a multi-agent deep deterministic policy gradient(MADDPG)algorithm based on policy gradients was proposed to explore the action space and update the experience pool.Finally,the effectiveness of the proposed method was verified through a simulation analysis of a real-world 445-node system.

FPGA based hardware platform for trapped-ion-based multi-level quantum systems

We report a design and implementation of a field-programmable-gate-arrays(FPGA)based hardware platform,which is used to realize control and signal readout of trapped-ion-based multi-level quantum systems.This platform integrates a four-channel 2.8 Gsps@14 bits arbitrary waveform generator,a 16-channel 1 Gsps@14 bits direct-digital-synthesisbased radio-frequency generator,a 16-channel 8 ns resolution pulse generator,a 10-channel 16 bits digital-to-analogconverter module,and a 2-channel proportion integration differentiation controller.The hardware platform can be applied in the trapped-ion-based multi-level quantum systems,enabling quantum control of multi-level quantum system and highdimensional quantum simulation.The platform is scalable and more channels for control and signal readout can be implemented by utilizing more parallel duplications of the hardware.The hardware platform also has a bright future to be applied in scaled trapped-ion-based quantum systems.

Paradoxical roles of inhibitory autapse and excitatory synapse in formation of counterintuitive anticipated synchronization

Different from the common delayed synchronization(DS)in which response appears after stimulation,anticipated synchronization(AS)in unidirectionally coupled neurons denotes a counterintuitive phenomenon in which response of the receiver neuron appears before stimulation of the sender neuron,showing an interesting function of brain to anticipate the future.The dynamical mechanism for the AS remains unclear due to complex dynamics of inhibitory and excitatory modulations.In this article,the paradoxical roles of excitatory synapse and inhibitory autapse in the formation of AS are acquired.Firstly,in addition to the common roles such that inhibitory modulation delays and excitatory modulation advances spike,paradoxical roles of excitatory stimulation to delay spike via type-II phase response and of inhibitory autapse to advance spike are obtained in suitable parameter regions,extending the dynamics and functions of the excitatory and inhibitory modulations.Secondly,AS is related to the paradoxical roles of the excitatory and inhibitory modulations,presenting deep understandings to the AS.Inhibitory autapse induces spike of the receiver neuron advanced to appear before that of the sender neuron at first,and then excitatory synapse plays a delay role to prevent the spike further advanced,resulting in the AS as the advance and delay effects realize a dynamic balance.Lastly,inhibitory autapse with strong advance,middle advance,and weak advance and delay effects induce phase drift(spike of the receiver neuron advances continuously),AS,and DS,respectively,presenting comprehensive relationships between AS and other behaviors.The results present potential measures to modulate AS related to brain function.

Paradoxical vocal fold motion masquerading as post-anesthetic respiratory distress:A case report

BACKGROUND Functional vocal cord disorders can be a differential diagnosis for postoperative upper airway obstruction requiring urgent intervention.However,this may be unfamiliar to anesthesiologists who would favor inappropriate airway intervention and increased morbidity.CASE SUMMARY A 61-year-old woman underwent cervical laminectomy,followed by laparoscopic cholecystectomy 10 mo later.Despite adequate reversal of neuromuscular blockade,the patient experienced repetitive respiratory difficulty with inspiratory stridor after extubation.After the second operation,the patient was diagnosed with paradoxical vocal fold motion(PVFM)by an otolaryngologist based on the clinical features and fiberoptic bronchoscopy results,and the patient was successfully treated.CONCLUSION PVFM should be considered a differential diagnosis if a patient presents with stridor after general anesthesia.

Probability Distributions Arising in Connection with the Inspection Paradox for Bernoulli Trials

In renewal theory, the Inspection Paradox refers to the fact that an interarrival period in a renewal process which contains a fixed inspection time tends to be longer than one for the corresponding uninspected process. We focus on the paradox for Bernoulli trials. Probability distributions and moments for the lengths of the interarrival periods are derived for the inspected process, and we compare them to those for the uninspected case.

Probability Distributions Arising in Connection with the Inspection Paradox for the Poisson Process

The Inspection Paradox refers to the fact that in a Renewal Process, the length of the interarrival period which contains a fixed time is stochastically larger than the length of a typical interarrival period. To provide a more complete understanding of this phenomenon, conditioning arguments are used to obtain the distributions and moments of the lengths of the interarrival periods other than the one containing this fixed time for the case of the time-homogeneous Poisson Process. Distributions of the waiting times for events that occur both before and after this fixed time are derived. This provides a fairly complete probabilistic analysis of the Inspection Paradox.

Resolving the Information Paradox with Probabilistic Spacetime

It has been 50 years since Hawking described the black hole (BH) information paradox. The combination of BH radiation and subsequent BH evaporation was found to take trapped information into oblivion contrary to the law of conservation of quantum information. Numerous attempts have been made since to resolve this paradox. A brief review herein documents how all these attempts have significant shortcomings, meaning the paradox is still unresolved. A relatively new cosmological theory offers a resolution despite not being developed for that purpose. The theory, entitled the probabilistic spacetime theory (PST), starts with an alteration in one basic assumption compared to all current cosmological theories. Spacetime, instead of being seen as a void or container of other entities, is viewed as the most fundamental entity in the universe, composed of energy fragments, and (in keeping with the conservation principle) impermeable to destruction. The potential contribution of the PST in resolving the information paradox is delineated, with the finding that the single change in the conceptualization of spacetime results in the disappearance of the paradox and not information.

论生成式人工智能的技术创新伦理周期——以ChatGPT为例

生成式人工智能在推动技术创新突破性应用的同时,也带来了许多社会伦理风险:隐私暴露与信息安全控制风险;虚假信息派生所带来的信息传播风险;算法偏见所带来的决策和政策风险以及责任界定模糊风险。运用“索洛悖论”理论,将伦理进步看作是科技创新投入的增函数,可以发现生成式人工智能对伦理推动的“技术创新索洛周期”。基于此,要跨越生成式人工智能“伦理风险鸿沟”可以采取以下对策:健全生成式人工智能法律规制,推动构建生成式人工智能治理体系;加强平台监管,完善流程标准化管理,规范保障生成式人工智能安全发展;落实优化生成式人工智能可持续发展环境,探索更多行业重塑的可能。

Neighborhood Effects and Political Trust: A Multi-level Analysis of Chinese Rural-to-Urban Migrants’ Trust in County Government

Massive rural-to-urban migration in China is consequential for political trust: rural-to-urban migrants have been found to hold lower levels of trust in local government than their rural peers who choose to stay in the countryside (mean 4.92 and 6.34 out of 10, respectively, p < 0.001). This article explores why migrants have a certain level of political trust in their county-level government. Using data of rural-to-urban migrants from the China Family Panel Survey, this study performs a hierarchical linear modeling (HLM) to unpack the multi-level explanatory factors of rural-to-urban migrants’ political trust. Findings show that the individual-level socio-economic characteristics and perceptions of government performance (Level-1), the neighborhood-level characteristics-the physical and social status and environment of neighborhoods (Level-2), and the objective macroeconomic performance of county-level government (Level-3), work together to explain migrants’ trust levels. These results suggest that considering the effects of neighborhood-level factors on rural-to-urban migrants’ political trust merits policy and public management attention in rapidly urbanizing countries.

战略变革情境中的组织多层级悖论网构建--基于经典扎根理论的研究

战略变革情境中充斥着各种悖论问题,这些悖论问题相互交错、影响、撬动、传递,形成复杂、混沌的战略变革情境特征,增加了决策者剥离情境探寻制定新战略根源性依据的难度,使得归纳各悖论之间链接规律并系统性刻画战略变革情境成为迫切需求.加上悖论在非变革情境下往往呈隐匿状态,不易被识别,而在战略变革情境中呈凸显状态,容易被识别,因此战略变革情境为系统探究悖论及相互链接关系提供了可能.本研究以十家企业的战略变革数据为样本,采用经典扎根理论和认知地图组成的混合研究方法,从多层级悖论视角分析战略变革情境中的悖论问题,构建组织多层级悖论网模型.研究发现:1)战略变革情境中存在“利益-责任”等18个悖论类型,归属于执行悖论等6种悖论类别,符合“政策导向-需求-目标-方向-价值观-过程”的划分逻辑;2)悖论纵向分布于组织个体层、运营层、战略层、制度层,横向跨越规制、运营、研发、生产、市场五个职能部门,纵横交错,构成组织多层级悖论网的位置形态;3)悖论类型内部由构成悖论四个基本条件的因果或顺次关系构成,同一层级悖论类型之间存在“同层链状顺序”和“同层嵌套”两种关系,跨层级悖论类型之间存在“跨层链状顺序”、“跨层链状共存”和“跨层嵌套”三种关系,构成组织多层级悖论网的关系形态;4)整合组织多层级悖论网的位置形态和关系形态构建组织多层级悖论网模型,系统展示战略变革情境中由悖论的关系和位置构成的复杂状态,表明不同悖论类型之间普遍存在引发性和传递性特征.本研究基于多层级悖论视角,将复杂、混沌的战略变革情境具体化清晰化,为决策者正确认知战略变革情境,准确把握组织困境产生的根源,并做出有效战略决策提供理论参考.

Unbearable suffering obviates euthanasia:definitionally derived set of propositions comprising euthanasia’s purpose,claim,and benefit lead to contradiction establishing the paradox of euthanasia

Relying on euthanasia’s definitionally derived set of propositions to provide its purpose,claims,and benefit,we obtain the core concept.Nonetheless,given its core concept,euthanasia is demonstrated to provide no benefit to the animal to justify its use.Euthanasia 1)cannot possibly,and therefore does not,end unbearable suffering,2)it fails to hasten death,and 3)it,therefore,provides no perceptible relief to the patient.These findings are significant because the argument’s validity does not permit euthanasia to satisfy its definitionally derived purpose,claims,or benefit on logical grounds.In other words,the argument is that as a form of legalized assisted suicide,euthanasia is wrong but not in the way principled arguments would suggest.Additionally,irrespective of euthanasia actually doing what it claims,if it is allowed to be provisioned,then euthanasia will affect vulnerable populations exactly like nonprincipled arguments claim.Therefore,despite sharing aspects with each type of argument in the extant literature,my argument against euthanasia can be categorized as neither principled nor nonprincipled,which makes it significant because it may be the first of a new category of argument against the concept and practice to enter the discourse on euthanasia.As a corollary,since we prove that unbearable suffering logically entails death,when it is authentic signifying that death is imminent,because euthanasia’s only purpose is to end unbearable suffering by inducing death,euthanasia is completely obviated.

延长产假对流动女性“生育—失业”的影响基于全国流动人口调查数据

本研究提出延长产假的“社会分化效应假说”,来重新解释因为延长产假而在流动女性群体中出现的“生育—失业悖论”,并利用2016年中国各省份的《人口与计划生育条例》修订这一外生事件和2016年、2018年全国流动人口调查数据,对该理论进行检验。研究发现,延长产假能够有效提升流动女性的二孩生育意愿,但同时也会显著增加流动女性的失业风险,产假每延长1个月,流动女性失业的概率就会增加11.76%。但是,产假延长只提升了高社会经济地位流动女性的二孩生育意愿,却使得低社会经济地位流动女性的失业风险升高。作为保护弱势群体的家庭政策,产假延长政策在实施过程中产生了新的不平等,使低社会经济地位流动女性陷入更困难的境地。本研究不仅拓展了低生育问题研究视域,也为完善公共政策和引导现代家庭发展提供了理论参考。