Development of diabetic complications and influencing factors among 32653 type 2 diabetes patients:retrospective cohort study using a multi-state Markov

Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.

A Two-Step Algorithm to Estimate Variable Importance for Multi-State Data:An Application to COVID-19

Survival data with amulti-state structure are frequently observed in follow-up studies.An analytic approach based on a multi-state model(MSM)should be used in longitudinal health studies in which a patient experiences a sequence of clinical progression events.One main objective in the MSM framework is variable selection,where attempts are made to identify the risk factors associated with the transition hazard rates or probabilities of disease progression.The usual variable selection methods,including stepwise and penalized methods,do not provide information about the importance of variables.In this context,we present a two-step algorithm to evaluate the importance of variables formulti-state data.Three differentmachine learning approaches(randomforest,gradient boosting,and neural network)as themost widely usedmethods are considered to estimate the variable importance in order to identify the factors affecting disease progression and rank these factors according to their importance.The performance of our proposed methods is validated by simulation and applied to the COVID-19 data set.The results revealed that the proposed two-stage method has promising performance for estimating variable importance.

Prescribed Performance Tracking Control of Time-Delay Nonlinear Systems With Output Constraints

The problem of prescribed performance tracking control for unknown time-delay nonlinear systems subject to output constraints is dealt with in this paper. In contrast with related works, only the most fundamental requirements, i.e., boundedness and the local Lipschitz condition, are assumed for the allowable time delays. Moreover, we focus on the case where the reference is unknown beforehand, which renders the standard prescribed performance control designs under output constraints infeasible. To conquer these challenges, a novel robust prescribed performance control approach is put forward in this paper.Herein, a reverse tuning function is skillfully constructed and automatically generates a performance envelop for the tracking error. In addition, a unified performance analysis framework based on proof by contradiction and the barrier function is established to reveal the inherent robustness of the control system against the time delays. It turns out that the system output tracks the reference with a preassigned settling time and good accuracy,without constraint violations. A comparative simulation on a two-stage chemical reactor is carried out to illustrate the above theoretical findings.

Geometric Error Identification of Gantry-Type CNC Machine Tool Based on Multi-Station Synchronization Laser Tracers

Laser tracers are a three-dimensional coordinate measurement system that are widely used in industrial measurement.We propose a geometric error identification method based on multi-station synchronization laser tracers to enable the rapid and high-precision measurement of geometric errors for gantry-type computer numerical control(CNC)machine tools.This method also improves on the existing measurement efficiency issues in the single-base station measurement method and multi-base station time-sharing measurement method.We consider a three-axis gantry-type CNC machine tool,and the geometric error mathematical model is derived and established based on the combination of screw theory and a topological analysis of the machine kinematic chain.The four-station laser tracers position and measurement points are realized based on the multi-point positioning principle.A self-calibration algorithm is proposed for the coordinate calibration process of a laser tracer using the Levenberg-Marquardt nonlinear least squares method,and the geometric error is solved using Taylor’s first-order linearization iteration.The experimental results show that the geometric error calculated based on this modeling method is comparable to the results from the Etalon laser tracer.For a volume of 800 mm×1000 mm×350 mm,the maximum differences of the linear,angular,and spatial position errors were 2.0μm,2.7μrad,and 12.0μm,respectively,which verifies the accuracy of the proposed algorithm.This research proposes a modeling method for the precise measurement of errors in machine tools,and the applied nature of this study also makes it relevant both to researchers and those in the industrial sector.

A fast forward computational method for nuclear measurement using volumetric detection constraints

Owing to the complex lithology of unconventional reservoirs,field interpreters usually need to provide a basis for interpretation using logging simulation models.Among the various detection tools that use nuclear sources,the detector response can reflect various types of information of the medium.The Monte Carlo method is one of the primary methods used to obtain nuclear detection responses in complex environments.However,this requires a computational process with extensive random sampling,consumes considerable resources,and does not provide real-time response results.Therefore,a novel fast forward computational method(FFCM)for nuclear measurement that uses volumetric detection constraints to rapidly calculate the detector response in various complex environments is proposed.First,the data library required for the FFCM is built by collecting the detection volume,detector counts,and flux sensitivity functions through a Monte Carlo simulation.Then,based on perturbation theory and the Rytov approximation,a model for the detector response is derived using the flux sensitivity function method and a one-group diffusion model.The environmental perturbation is constrained to optimize the model according to the tool structure and the impact of the formation and borehole within the effective detection volume.Finally,the method is applied to a neutron porosity tool for verification.In various complex simulation environments,the maximum relative error between the calculated porosity results of Monte Carlo and FFCM was 6.80%,with a rootmean-square error of 0.62 p.u.In field well applications,the formation porosity model obtained using FFCM was in good agreement with the model obtained by interpreters,which demonstrates the validity and accuracy of the proposed method.

Characterization and quantification of multi-field coupling in lithium-ion batteries under mechanical constraints

The safety and durability of lithium-ion batteries under mechanical constraints depend significantly on electrochemical,thermal,and mechanical fields in applications.Characterizing and quantifying the multi-field coupling behaviors requires interdisciplinary efforts.Here,we design experiments under mechanical constraints and introduce an in-situ analytical framework to clarify the complex interaction mechanisms and coupling degrees among multi-physics fields.The proposed analytical framework integrates the parameterization of equivalent models,in-situ mechanical analysis,and quantitative assessment of coupling behavior.The results indicate that the significant impact of pressure on impedance at low temperatures results from the diffusion-controlled step,enhancing kinetics when external pressure,like 180 to 240 k Pa at 10℃,is applied.The diversity in control steps for the electrochemical reaction accounts for the varying impact of pressure on battery performance across different temperatures.The thermal expansion rate suggests that the swelling force varies by less than 1.60%per unit of elevated temperature during the lithiation process.By introducing a composite metric,we quantify the coupling correlation and intensity between characteristic parameters and physical fields,uncovering the highest coupling degree in electrochemical-thermal fields.These results underscore the potential of analytical approaches in revealing the mechanisms of interaction among multi-fields,with the goal of enhancing battery performance and advancing battery management.

Probabilistic-Ellipsoid Hybrid Reliability Multi-Material Topology Optimization Method Based on Stress Constraint

This paper proposes a multi-material topology optimization method based on the hybrid reliability of the probability-ellipsoid model with stress constraint for the stochastic uncertainty and epistemic uncertainty of mechanical loads in optimization design.The probabilistic model is combined with the ellipsoidal model to describe the uncertainty of mechanical loads.The topology optimization formula is combined with the ordered solid isotropic material with penalization(ordered-SIMP)multi-material interpolation model.The stresses of all elements are integrated into a global stress measurement that approximates the maximum stress using the normalized p-norm function.Furthermore,the sequential optimization and reliability assessment(SORA)is applied to transform the original uncertainty optimization problem into an equivalent deterministic topology optimization(DTO)problem.Stochastic response surface and sparse grid technique are combined with SORA to get accurate information on the most probable failure point(MPP).In each cycle,the equivalent topology optimization formula is updated according to the MPP information obtained in the previous cycle.The adjoint variable method is used for deriving the sensitivity of the stress constraint and the moving asymptote method(MMA)is used to update design variables.Finally,the validity and feasibility of the method are verified by the numerical example of L-shape beam design,T-shape structure design,steering knuckle,and 3D T-shaped beam.

Power Allocation for SE Maximization in Uplink Massive MIMO System Under Minimum Rate Constraint

In this paper,we optimize the spectrum efficiency(SE)of uplink massive multiple-input multiple-output(MIMO)system with imperfect channel state information(CSI)over Rayleigh fading channel.The SE optimization problem is formulated under the constraints of maximum power and minimum rate of each user.Then,we develop a near-optimal power allocation(PA)scheme by using the successive convex approximation(SCA)method,Lagrange multiplier method,and block coordinate descent(BCD)method,and it can obtain almost the same SE as the benchmark scheme with lower complexity.Since this scheme needs three-layer iteration,a suboptimal PA scheme is developed to further reduce the complexity,where the characteristic of massive MIMO(i.e.,numerous receive antennas)is utilized for convex reformulation,and the rate constraint is converted to linear constraints.This suboptimal scheme only needs single-layer iteration,thus has lower complexity than the near-optimal scheme.Finally,we joint design the pilot power and data power to further improve the performance,and propose an two-stage algorithm to obtain joint PA.Simulation results verify the effectiveness of the proposed schemes,and superior SE performance is achieved.

Nonlinear Registration of Brain Magnetic Resonance Images with Cross Constraints of Intensity and Structure

Many deep learning-based registration methods rely on a single-stream encoder-decoder network for computing deformation fields between 3D volumes.However,these methods often lack constraint information and overlook semantic consistency,limiting their performance.To address these issues,we present a novel approach for medical image registration called theDual-VoxelMorph,featuring a dual-channel cross-constraint network.This innovative network utilizes both intensity and segmentation images,which share identical semantic information and feature representations.Two encoder-decoder structures calculate deformation fields for intensity and segmentation images,as generated by the dual-channel cross-constraint network.This design facilitates bidirectional communication between grayscale and segmentation information,enabling the model to better learn the corresponding grayscale and segmentation details of the same anatomical structures.To ensure semantic and directional consistency,we introduce constraints and apply the cosine similarity function to enhance semantic consistency.Evaluation on four public datasets demonstrates superior performance compared to the baselinemethod,achieving Dice scores of 79.9%,64.5%,69.9%,and 63.5%for OASIS-1,OASIS-3,LPBA40,and ADNI,respectively.

Adaptive H_(∞)Filtering Algorithm for Train Positioning Based on Prior Combination Constraints

To solve the problem of data fusion for prior information such as track information and train status in train positioning,an adaptive H∞filtering algorithm with combination constraint is proposed,which fuses prior information with other sensor information in the form of constraints.Firstly,the train precise track constraint method of the train is proposed,and the plane position constraint and train motion state constraints are analysed.A model for combining prior information with constraints is established.Then an adaptive H∞filter with combination constraints is derived based on the adaptive adjustment method of the robustness factor.Finally,the positioning effect of the proposed algorithm is simulated and analysed under the conditions of a straight track and a curved track.The results show that the positioning accuracy of the algorithm with constrained filtering is significantly better than that of the algorithm without constrained filtering and that the algorithm with constrained filtering can achieve better performance when combined with track and condition information,which can significantly reduce the train positioning error.The effectiveness of the proposed algorithm is verified.

Dynamic characteristics of multi-span spinning beams with elastic constraints under an axial compressive force

A theoretical model for the multi-span spinning beams with elastic constraints under an axial compressive force is proposed.The displacement and bending angle functions are represented through an improved Fourier series,which ensures the continuity of the derivative at the boundary and enhances the convergence.The exact characteristic equations of the multi-span spinning beams with elastic constraints under an axial compressive force are derived by the Lagrange equation.The efficiency and accuracy of the present method are validated in comparison with the finite element method(FEM)and other methods.The effects of the boundary spring stiffness,the number of spans,the spinning velocity,and the axial compressive force on the dynamic characteristics of the multi-span spinning beams are studied.The results show that the present method can freely simulate any boundary constraints without modifying the solution process.The elastic range of linear springs is larger than that of torsion springs,and it is not affected by the number of spans.With an increase in the axial compressive force,the attenuation rate of the natural frequency of a spinning beam with a large number of spans becomes larger,while the attenuation rate with an elastic boundary is lower than that under a classic simply supported boundary.

Dynamic Constraint-Driven Event-Triggered Control of Strict-Feedback Systems Without Max/Min Values on Irregular Constraints

This work proposes an event-triggered adaptive control approach for a class of uncertain nonlinear systems under irregular constraints.Unlike the constraints considered in most existing papers,here the external irregular constraints are considered and a constraints switching mechanism(CSM)is introduced to circumvent the difficulties arising from irregular output constraints.Based on the CSM,a new class of generalized barrier functions are constructed,which allows the control results to be independent of the maximum and minimum values(MMVs)of constraints and thus extends the existing results.Finally,we proposed a novel dynamic constraint-driven event-triggered strategy(DCDETS),under which the stress on signal transmission is reduced greatly and no constraints are violated by making a dynamic trade-off among system state,external constraints,and inter-execution intervals.It is proved that the system output is driven to close to the reference trajectory and the semi-global stability is guaranteed under the proposed control scheme,regardless of the external irregular output constraints.Simulation also verifies the effectiveness and benefits of the proposed method.

Constraints Separation Based Evolutionary Multitasking for Constrained Multi-Objective Optimization Problems

Constrained multi-objective optimization problems(CMOPs)generally contain multiple constraints,which not only form multiple discrete feasible regions but also reduce the size of optimal feasible regions,thus they propose serious challenges for solvers.Among all constraints,some constraints are highly correlated with optimal feasible regions;thus they can provide effective help to find feasible Pareto front.However,most of the existing constrained multi-objective evolutionary algorithms tackle constraints by regarding all constraints as a whole or directly ignoring all constraints,and do not consider judging the relations among constraints and do not utilize the information from promising single constraints.Therefore,this paper attempts to identify promising single constraints and utilize them to help solve CMOPs.To be specific,a CMOP is transformed into a multitasking optimization problem,where multiple auxiliary tasks are created to search for the Pareto fronts that only consider a single constraint respectively.Besides,an auxiliary task priority method is designed to identify and retain some high-related auxiliary tasks according to the information of relative positions and dominance relationships.Moreover,an improved tentative method is designed to find and transfer useful knowledge among tasks.Experimental results on three benchmark test suites and 11 realworld problems with different numbers of constraints show better or competitive performance of the proposed method when compared with eight state-of-the-art peer methods.

Stress tensor determination by modified hydraulic tests on pre-existing fractures:Method and stress constraints

The hydraulic testing of pre-existing fractures(HTPF)is one of the most promising in situ stress measurement methods,particularly for three-dimensional stress tensor determination.However,the stress tensor determination based on the HTPF method requires at least six tests or a minimum of 14-15 tests(under different conditions)for reliable results.In this study,we modified the HTPF method by considering the shear stress on each pre-existing fracture,which increased the number of equations for the stress tensor determination and decreased the number of tests required.Different shear stresses were attributed to different fractures by random sampling;therefore,the stress tensors were obtained by searching for the optimal solution using the least squares criterion based on the Monte Carlo method.Thereafter,we constrained the stress tensor based on the tensile strength criterion,compressive strength criterion,and vertical stress constraints.The inverted stress tensors were presented and analyzed based on the tensorial nature of the stress using the Euclidean mean stress tensor.Two stress-measurement campaigns in Weifang(Shandong Province,China)and Mercantour road tunnel(France)were implemented to highlight the validity and efficiency of the modified HTPF(M-HTPF)method.The results showed that the M-HTPF method can be applied for stress tensor inversion using only three to four tests on pre-existing fractures,neglecting the stress gradient.The inversion results were confined to relatively small distribution dispersions and were significantly reliable and stable due to the shear stresses on the fractures and the stress constraints employed.The M-HTPF method is highly feasible and efficient for complete stress tensor determination in a single borehole.

Guaranteed Cost Attitude Tracking Control for Uncertain Quadrotor Unmanned Aerial Vehicle Under Safety Constraints

In this paper,guaranteed cost attitude tracking con-trol for uncertain quadrotor unmanned aerial vehicle(QUAV)under safety constraints is studied.First,an augmented system is constructed by the tracking error system and reference system.This transformation aims to convert the tracking control prob-lem into a stabilization control problem.Then,control barrier function and disturbance attenuation function are designed to characterize the violations of safety constraints and tolerance of uncertain disturbances,and they are incorporated into the reward function as penalty items.Based on the modified reward function,the problem is simplified as the optimal regulation problem of the nominal augmented system,and a new Hamilton-Jacobi-Bellman equation is developed.Finally,critic-only rein-forcement learning algorithm with a concurrent learning tech-nique is employed to solve the Hamilton-Jacobi-Bellman equa-tion and obtain the optimal controller.The proposed algorithm can not only ensure the reward function within an upper bound in the presence of uncertain disturbances,but also enforce safety constraints.The performance of the algorithm is evaluated by the numerical simulation.

Research on the navigation method of large-scale differential tail-control improvised guided munitions based on rotational speed constraints

In the process of launching guided projectile under the conventional system, it is difficult to effectively obtain the precise navigation parameters of the projectile in the high dynamic environment. Aiming at this problem, this paper describes a new system of guided ammunition based on tail spin reduction. After analyzing the mechanism of the ammunition's tail spin reduction, a navigation method of large scale difference tail control simple guided ammunition based on speed constraint is proposed. In this method,the corresponding navigation constraints can be carried out by combining the rotation speed state of the ammunition itself, and the optimal solution of navigation parameters during the flight of the missile can be obtained by Extended Kalman Filter(EKF). Finally, the performance of the proposed method was verified by the simulation environment, and the hardware-in-the-loop simulation test and flight test were carried out to verify the performance of the method in the real environment. The experimental results show that the proposed method can achieve the optimal estimation of navigation parameters for simple guided ammunition with large-scale difference tail control. Under the conditions of simulation test and hardware-in-loop simulation test, the position and velocity errors calculated by the method in this paper converged. Under the condition of flight test, the spatial average error calculated by the method described in this paper is 6.17 m, and the spatial error of the final landing point is 3.50 m.Through this method, the accurate acquisition of navigation parameters in the process of projectile launching is effectively realized.

Energy-Saving Distributed Flexible Job Shop Scheduling Optimization with Dual Resource Constraints Based on Integrated Q-Learning Multi-Objective Grey Wolf Optimizer

The distributed flexible job shop scheduling problem(DFJSP)has attracted great attention with the growth of the global manufacturing industry.General DFJSP research only considers machine constraints and ignores worker constraints.As one critical factor of production,effective utilization of worker resources can increase productivity.Meanwhile,energy consumption is a growing concern due to the increasingly serious environmental issues.Therefore,the distributed flexible job shop scheduling problem with dual resource constraints(DFJSP-DRC)for minimizing makespan and total energy consumption is studied in this paper.To solve the problem,we present a multi-objective mathematical model for DFJSP-DRC and propose a Q-learning-based multi-objective grey wolf optimizer(Q-MOGWO).In Q-MOGWO,high-quality initial solutions are generated by a hybrid initialization strategy,and an improved active decoding strategy is designed to obtain the scheduling schemes.To further enhance the local search capability and expand the solution space,two wolf predation strategies and three critical factory neighborhood structures based on Q-learning are proposed.These strategies and structures enable Q-MOGWO to explore the solution space more efficiently and thus find better Pareto solutions.The effectiveness of Q-MOGWO in addressing DFJSP-DRC is verified through comparison with four algorithms using 45 instances.The results reveal that Q-MOGWO outperforms comparison algorithms in terms of solution quality.

Evaluating and Addressing Interoperability Constraints in Health Information Systems for Enhanced Healthcare Delivery in Zimbabwe

Interoperability constraints in health information systems pose significant challenges to the seamless exchange and utilization of health data, hindering effective healthcare delivery. This paper aims to evaluate and address these constraints to enhance healthcare delivery. The study examines the current state of interoperability in health information systems, identifies the key constraints, and explores their impact on healthcare outcomes. Various approaches and strategies for addressing interoperability constraints are discussed, including the adoption of standardized data formats, implementation of interoperability frameworks, and establishment of robust data governance mechanisms. Furthermore, the study highlights the importance of stakeholder collaboration, policy development, and technical advancements in achieving enhanced interoperability. The findings emphasize the need for a comprehensive evaluation of interoperability constraints and the implementation of targeted interventions to promote seamless data exchange, improve care coordination, and enhance patient outcomes in healthcare settings.

Scheduling Model and Algorithm of Construction Equipment under Milestone Constraint

The scheduling of construction equipment is a means to realize network planning.With the large-scale and low-cost requirements of engineering construction,the cooperation among members of the engineering supply chain has become very important,and effective coordination of project plans at all levels to optimize the resource management and scheduling of a project is helpful to reduce project duration and cost.In this paper,under the milestone constraint conditions,the scheduling problems of multiple construction devices in the same sequence of operation were described and hypothesized mathematically,and the scheduling models of multiple equipment were established.The Palmer algorithm,CDS algorithm and Gupta algorithm were respectively used to solve the optimal scheduling of construction equipment to achieve the optimization of the construction period.The optimization scheduling of a single construction device and multiple construction devices was solved by using sequencing theory under milestone constraint,and these methods can obtain reasonable results,which has important guiding significance for the scheduling of construction equipment.

An intelligent automatic correlation method of oilbearing strata based on pattern constraints:An example of accretionary stratigraphy of Shishen 100 block in Shinan Oilfield of Bohai Bay Basin,East China

Aiming at the problem that the data-driven automatic correlation methods which are difficult to adapt to the automatic correlation of oil-bearing strata with large changes in lateral sedimentary facies and strata thickness,an intelligent automatic correlation method of oil-bearing strata based on pattern constraints is formed.We propose to introduce knowledge-driven in automatic correlation of oil-bearing strata,constraining the correlation process by stratigraphic sedimentary patterns and improving the similarity measuring machine and conditional constraint dynamic time warping algorithm to automate the correlation of marker layers and the interfaces of each stratum.The application in Shishen 100 block in the Shinan Oilfield of the Bohai Bay Basin shows that the coincidence rate of the marker layers identified by this method is over 95.00%,and the average coincidence rate of identified oil-bearing strata reaches 90.02% compared to artificial correlation results,which is about 17 percentage points higher than that of the existing automatic correlation methods.The accuracy of the automatic correlation of oil-bearing strata has been effectively improved.