基于双曲嵌入的露天矿区暗光环境下道路多目标检测模型

露天矿环境特殊,道路场景复杂多变,在光照不足时会导致矿区道路多目标识别不清、定位不准,进而影响检测效果,给矿区无人矿用卡车的安全行驶带来严重安全隐患。目前的道路障碍物检测模型不能有效解决矿区暗光环境对模型检测效果的影响,同时对矿区小目标障碍物的识别也有较大误差,不适用于矿区特殊环境下障碍物的检测与识别。针对上述问题,提出了一种基于双曲嵌入的露天矿区暗光环境下多目标检测模型。首先,在模型的图像预处理阶段引入卷积神经网路Retinex-Net对暗图像进行增强,提高图像清晰度;然后,针对数据集中特征过多而无重点偏好的问题,在加强特征提取部分添加全局注意力机制,聚集3个维度上更关键的特征信息;最后,在检测模型预测阶段引入双曲全连接层,以减少特征丢失,并防止过拟合现象。实验结果表明:(1)基于双曲嵌入的露天矿区暗光环境下道路多目标检测模型不仅对露天矿区暗光环境下的大尺度目标具有较高的分类与定位精度,对矿用卡车及较远距离的小尺度目标即行人也可准确检测与定位,能够满足无人矿用卡车在矿区特殊环境下驾驶的安全需求。(2)模型的检测准确率达98.6%,检测速度为51.52帧/s,较SSD、YOLOv4、YOLOv5、YOLOx、YOLOv7分别提高20.31%,18.51%,10.53%,8.39%,13.24%,对于矿区道路上的行人、矿用卡车及挖机的检测精度达97%以上。

An intelligent active probing and trace-back scheme for IoT anomaly detection

Due to their simple hardware,sensor nodes in IoT are vulnerable to attack,leading to data routing blockages or malicious tampering,which significantly disrupts secure data collection.An Intelligent Active Probing and Trace-back Scheme for IoT Anomaly Detection(APTAD)is proposed to collect integrated IoT data by recruiting Mobile Edge Users(MEUs).(a)An intelligent unsupervised learning approach is used to identify anomalous data from the collected data by MEUs and help to identify anomalous nodes.(b)Recruit MEUs to trace back and propose a series of trust calculation methods to determine the trust of nodes.(c)The last,the number of active detection packets and detection paths are designed,so as to accurately identify the trust of nodes in IoT at the minimum cost of the network.A large number of experimental results show that the recruiting cost and average anomaly detection time are reduced by 6.5 times and 34.33%respectively,while the accuracy of trust identification is improved by 20%.

Prevalence of non-alcoholic fatty liver disease in patients with nephrotic syndrome:A population-based study

BACKGROUND Non-alcoholic fatty liver disease(NAFLD) is a global health concern with a prevalence of about 25% amongst United States adults. Its increased prevalence is attributed to increase in patients with obesity and metabolic syndrome, partly due to similar mechanisms of injury. Nephrotic syndrome(NS) is a clinical entity resulting from extensive proteinuria leading to hypoalbuminemia, hyperlipidemia, edema, and other complications. Given its association with hyperlipidemia, there is concern that patients with NS may be at increased risk of NAFLD.AIM To perform a cross-sectional population-based study to investigate the prevalence and risk factors of NAFLD in patients with NS.METHODS A large multicenter database(Explorys Inc., Cleveland, OH, United States) was utilized for this retrospective cohort study. A cohort of 49700 patients with a diagnosis of “Non-Alcoholic fatty liver disease” using the Systematized Nomenclature of Medicine-Clinical Terms(SNOMED-CT) between 1999-2022 was identified. Inclusion criteria were age ≥ 18 years, presence of NAFLD, presence of NS. There were no specific exclusion criteria. Univariate and multivariate analysis were performed to adjust for multiple risk factors including age, gender, Caucasian race, NS, type Ⅱ diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease. Statistical analysis was conducted using R, and for all analyses, a 2-sided P value of < 0.05 was considered statistically significant.RESULTS Among the 78734750 individuals screened in this database, there were a total of 49700 subjects with NAFLD. In univariate analysis, the odds of having NAFLD in patients with NS, type 2 diabetes mellitus, hypothyroidism, dyslipidemia, obesity, metabolic syndrome and chronic kidney disease were 14.84 [95% confidence interval(95%CI) 13.67-16.10], 17.05(95%CI 16.78-17.32), 6.99(95%CI 6.87-7.11), 13.61(95%CI 13.38-13.84), 19.19(95%CI 18.89-19.50), 29.09(95%CI 28.26--29.95), and 9.05(95%CI 8.88-9.22), respectively. In multivariate analysis, the odds of having NAFLD amongst patients with NS were increased to 1.85(95%Cl 1.70-2.02), while the odds were also remained high in patients that have type 2 diabetes mellitus [odds ratio(OR) 3.84], hypothyroidism(OR 1.57), obesity(OR 5.10), hyperlipidemia(OR 3.09), metabolic syndrome(OR 3.42) and chronic kidney disease(OR 1.33).CONCLUSION Patients with NS are frequently found to have NAFLD, even when adjusting for common risk factors. Hence, clinicians should maintain a high index of suspicion regarding presence of NAFLD in patients with NS.

Psychiatric aspects of brain tumors:A review

Infrequently, psychiatric symptoms may be the only manifestation of brain tumors. They may present with mood symptoms, psychosis, memory problems, personality changes, anxiety, or anorexia. Symptoms may be misleading, complicating the clinical picture. A comprehensive review of the literature was conducted regarding reports of brain tumors and psychiatric symptoms from 1956-2014. Search engines used include Pub Med, Ovid, Psych Info, MEDLINE, and Med Scape. Search terms included psychiatric manifestations/symptoms, brain tumors/neoplasms. Our literature search yielded case reports, case studies, and case series. There are no double blind studies except for post-diagnosis/-surgery studies. Early diagnosis is critical for improved quality of life. Symptoms that suggest work-up with neuroimaging include: new-onset psychosis, mood/memory symptoms, occurrence of new or atypical symptoms, personality changes, and anorexia without body dysmorphic symptoms. This article reviews the existing literature regarding the diagnosis and management of this clinically complex condition.

Stem cell therapy for heart failure:Medical breakthrough,or dead end?

Heart failure continues to be one of the leading causes of morbidity and mortality worldwide.Myocardial infarction is the primary causative agent of chronic heart failure resulting in cardiomyocyte necrosis and the subsequent formation of fibrotic scar tissue.Current pharmacological and non-pharmacological therapies focus on managing symptoms of heart failure yet remain unable to reverse the underlying pathology.Heart transplantation usually cannot be relied on,as there is a major discrepancy between the availability of donors and recipients.As a result,heart failure carries a poor prognosis and high mortality rate.As the heart lacks significant endogenous regeneration potential,novel therapeutic approaches have incorporated the use of stem cells as a vehicle to treat heart failure as they possess the ability to self-renew and differentiate into multiple cell lineages and tissues.This review will discuss past,present,and future clinical trials,factors that influence stem cell therapy outcomes as well as ethical and safety considerations.Preclinical and clinical studies have shown a wide spectrum of outcomes when applying stem cells to improve cardiac function.This may reflect the infancy of clinical trials and the limited knowledge on the optimal cell type,dosing,route of administration,patient parameters and other important variables that contribute to successful stem cell therapy.Nonetheless,the field of stem cell therapeutics continues to advance at an unprecedented pace.We remain cautiously optimistic that stem cells will play a role in heart failure management in years to come.

Influence of Genista Tinctoria L or Methylparaben on Subchronic Toxicity of Bisphenol A in Rats

Objective To evaluate the influence of an extract of Genista tinctoria L. herba （GT） or methylparaben （MP） on histopathological changes and 2 biomarkers of oxidative stress in rats subchronicly exposed to bisphenol A （BPA）. Methods Adult female Wistar rats were orally exposed for 90 d to BPA （50 mg/kg）, BPA＋GT （35 mg isoflavones/kg） or BPA＋MP （250 mg/kg）. Plasma and tissue samples were taken from liver, kidney, thyroid, uterus, ovary, and mammary gland after 30, 60, and 90 d of exposure respectively. Lipid peroxidation and in vivo hydroxyl radical production were evaluated by histological analysis along with malondialdehyde and 2,3-dihydroxybenzoic acid detection. Results The severity of histopathological changes in liver and kidneys was lower after GT treatment than after BPA or BPA＋MP treatment. A minimal thyroid receptor antagonist effect was only observed after BPA＋MP treatment. The abnormal folliculogenesis increased in a time-dependent manner, and the number of corpus luteum decreased. No significant histological alterations were found in the uterus. The mammary gland displayed specific estrogen stimulation changes at all periods. Both MP and GT revealed antioxidant properties reducing lipid peroxidation and BPA-induced hydroxyl radical generation. Conclusion GT L. extract ameliorates the toxic effects of BPA and is proved to have antioxidant potential and antitoxic effect. MP has antioxidant properties, but has either no effect or exacerbates the BPA-induced histopathological changes.

Concurrent Multi-Modality Treatment of Keloids (CMTK) Not Manageable by Conventional Postoperative Radiotherapy

Objective: To design and test a treatment regimen which is clinically responsive, readily available, cost effective, and applicable especially to children and women of child bearing age. Design Setting: A prospective cohort study. Setting: Two major postgraduate teaching hospitals: one in Tripoli, Libya and the other in Jeddah, Saudi Arabia. Participants: Fifty-seven patients with 79 keloids, referred from Plastic Surgery Units between April 1996 and January 2005. Main Outcome Measure: Degree of flattening of the keloidal lesion and symptomatic recovery. Results: Result of treatment has been analyzed using unified set criteria. Seventy-seven percent of this cohort had complete response. 19% of cases had partial response, 50% acknowledged the treatment outcome had been “satisfactory” and 44% had an “acceptable” outcome. There was no significant acute or delayed reaction. Conclusion: The technique appears universally adaptable, cost effective, and can safely be prescribed for children and women of child-bearing age. In spite of prolonged treatment course, compliance was excellent.

A Case of Post Varicella Recurrent Presternal Butterfly Keloid

Presternal butterfly keloid management remains a clinical challenge. This case indicates, with hypo fractionated external beam electron therapy a significant symptomatic and cosmetic benefit may be achieved without any unacceptable acute, chronic or long term toxicity.

A Case for “Radiolysis” in Radiotherapy of Keloids

Successful treatment of keloids has eluded the medical community since their first description. Multitudes of therapeutic options are available, but none achieves satisfactory resolution of keloids. One major stumbling block is lack of understanding about their genesis. Assuming keloids are tumors, attempts have been made to treat this condition with standard radiotherapy, with dismal results. Keloidal masses are not an active biological entity. They are aggregations of cellular, hypovascular, hypoxic bundles of collagen, which are produced by atypical fibroblasts in the wounds and eventually cease production due to a hostile biological environment. Having no demonstrable inherent process of disposal of these collagen bundles, this excessive collagen tends to linger to form the bulk of keloids. The lesions eventually become symptomatic and aesthetically unacceptable, and therapeutic intervention is sought. Of all available treatments, such as post-resection radiotherapy, primary radiotherapy in selected cases and primary brachytherapy stand out above any other form of treatment. Be it brachytherapy or external beam treatment, one fundamental aspect of radiation action is the process of “radiolysis”, explaining why “radiobiological” approaches have been ineffective.

Intravenous haloperidol for the treatment of intractable vomiting,cyclical vomiting,and gastroparesis

Dear editor,The incidence of emergency department(ED)visits from gastroparesis and cannabinoid hyperemesis syndrome has increased by two folds over the past decade.[1-3]Roldan et al[4]reported that patients with these conditions often have prolonged ED stays and are likely to be hospitalized because of the danger of dehydration and challenges inherent in relieving symptoms.Opioid analgesia is a particularly troublesome treatment modality;these conditions are often chronic with frequent recurrences,and repeated opiate therapy can cause opioid dependency and narcotic bowel syndrome.[5]Haloperidol(HP)and droperidol,members of the butyrophenone class,have potent antidopaminergic activity in the chemoreceptor trigger zone.[6,7]Intramuscular administration of HP is being used increasingly in the ED to treat nausea,vomiting secondary to gastroparesis,[6]intractable vomiting,[8]and cyclical vomiting.

Effect of administration of phenylephrine immediately after low dose insemination on pregnancy rates in mares

There is considerable pressure on equine veterinarians to achieve good pregnancy rates with very small doses of semen. Phenylephrine administration in the rabbit increased numbers of oviductal, uterine, and cervical sperm, myometrial contractions, and fertilized ova after low dose insemination. The use of phenylephrine to enhance uterine contractility and fertility has not been investigated in the mare. Thus, the objective of this study was to determine if phenylephrine administration would result in clinically acceptable pregnancy rates in mares bred by low dose insemination. The hypothesis (Ha) was that pregnancy rates would be significantly higher in mares receiving phenylephrine compared to saline controls. Six pony mares and eight horse mares were enrolled in this study. Mares were inseminated within 24 hours of ovulation with 30 million progressively motile spermatozoa from a single fertile stallion. Immediately following insemination, mares were administered either phenylephrine (0.06 mg/kg) or 1mL of saline via IV injection. Pregnancy status was determined 14 days following ovulation via transrectal ultrasonography. Pregnancy rates in phenylephrine treated mares were 44% (4/9) while 22% (2/9) in saline-treated mares (P > 0.05).

Effects of Hepatitis B Virus Co-Infection and Antiretroviral Therapy on Disease Progression among HIV Patients Treated at the Buea Regional Hospital, Southwest Region, Cameroon: A Case-Control Study

In the era of “test and treat”, when AIDS-defining events have been drastically reduced, chronic liver disease associated with viral hepatitis and antiretroviral therapy (ART) remains an important cause of non-AIDS morbidity and mortality among HIV-infected patients. Compared to the general population, HIV-infected patients are about 10-times at risk of hepatitis B virus infection. Additionally, several antiretroviral regimens are hepatotoxic. Therefore, effective monitoring and management of ART and HBV co-infection are essential to ending the AIDS epidemic and eliminating viral hepatitis by 2030. This was a hospital-based, matched (age and sex) case-control study. HIV patients (case patients) on ART for at least six months and “healthy” controls aged 18 years and older were enrolled. Blood samples were collected for immuno-hematologic indices and transaminases measurements. Data were presented as counts, percentages, median (IQR) and means (SD), and a p-value 1.5) and mild (0.6 - 1.5) liver fibrosis based on the APRI score was 0.5% and 8%, respectively. Significant fibrosis (>3.25) was 0.9%, while 18.4% had inconclusive fibrosis (1.45 - 3.25) based on the FIB-4 score. HIV/HBV co-infected patients had a higher occurrence of liver fibrosis (APRI: 0.5% vs FIB-4: 0.9%). Co-infections with HBV increase the risk of liver-related morbidity in HIV patients. Therefore, screening for serological markers of chronic HBV infection and hepatic transaminase levels in HIV patients remains crucial in the continuum of care.

Blunt Trauma to the Penis Post Penile Augmentation Surgery: Case Report

Introduction: Blunt trauma to the penis is a rare but potentially serious injury that can occur by various mechanisms (e.g., kicks, accidents, sexual activity, and falls). The most common clinical presentation is sudden pain, swelling, and discoloration. Depending on the type and severity of injury, management can include conservative treatment or surgery, with the ultimate goal being the prevention of delayed complications. Case presentation: A 30-year-old male presented with penile pain, swelling, and redness as a result of blunt trauma to his penis 1 week after penile enhancement surgery using a subcutaneous soft silicone implant. Once the patient’s blood pressure was stabilized, surgical management consisted of exploration with evacuation of a large hematoma and removal of the subcutaneous penile implant to avoid further perioperative and postoperative bleeding. Discussion: Postoperative bleeding is a risk factor associated with almost all types of surgical procedures, and its prevention is best achieved by identification and elimination of potential causes pre- and postoperatively. Hypertension is another risk factor for excessive postsurgical bleeding, particularly bleeding associated with prosthetic implant surgeries, and should be considered for any potential surgical patient. Conclusion: With penile prosthesis and implant surgery, hypertension is an especially serious risk factor. Early surgical management is warranted in cases involving a major hematoma and swelling. Even cases with minimal bleeding should be evaluated in a timely manner, with surgical treatment indicated, rather than watchful waiting, to prevent further damage to the penis.

Schizophreniform Disorder after Onset of Menopause

Schizophrenia is one of the psychotic disorders that is a huge concern with prevalence increasing every year. In this case report, we are discussing the case of a 49-year-old female with no prior history of psychiatric illness and a recent diagnosis of menopause, presenting with signs and symptoms of schizophreniform disorder and menopause. After undergoing treatment with estrogen and risperidone, she experienced complete resolution of her delusions and hallucinations.

Preoperative [18]fluorodeoxyglucose-positron emission tomography/computed tomography in early stage breast cancer: Rates of distant metastases

AIM To investigate rates of distant metastases(DM) detected with [18]fluorodeoxyglucose-positron emissiontomography/computed tomography(^(18)FDG-PET/CT) in early stage invasive breast cancer.METHODS We searched the English language literature databases of PubM ed, EMBASE, ISI Web of Knowledge, Web of Science and Google Scholar, for publications on DM detected in patients who had ^(18)FDG-PET/CT scans as part of the staging for early stages of breast cancer(stage Ⅰ?and Ⅱ), prior to or immediately following surgery. Reports published between 2011 and 2017 were considered. The systematic review was conducted according to the PRISMA guidelines.RESULTS Among the 18 total studies included in the analysis, the risk of DM ranged from 0% to 8.3% and 0% to 12.9% for stage Ⅰ?and Ⅱ invasive breast cancer, respectively. Among the patients with clinical stage Ⅱ, the rate of occult metastases diagnosed by ^(18)FDG-PET/CT was 7.2%(range, 0%-19.6%) for stage ⅡA and 15.8%(range, 0%-40.8%) for stage ⅡB. In young patients(< 40-yearold), ^(18)FDG-PET/CT demonstrated a higher prevalence of DM at the time of diagnosis for those with aggressive histology(i.e., triple-negative receptors and poorly differentiated grade).CONCLUSION Young patients with poorly differentiated tumors and stage ⅡB triple-negative breast cancer may benefit from ^(18)FDG-PET/CT at initial staging to detect occult DM prior to surgery.

Rationalizing Optimal Timing for Adjuvant Hormone Therapy for Patients with Breast Cancer: Impact on Limited Resource Countries

Modern day cancer chemotherapy is complex and involves multiple drugs given either sequentially or concurrently, as an adjuvant or neo-adjuvant. Besides the concentration of the drug, timing, duration and sequencing of individual drugs in combination with other similar agents play a vital role in the final therapeutic outcome. This study constitutes an exhaustive overview of current knowledge of timing and sequencing, specifically of Tamoxifen, based on tumor’s hormone receptor status, as part of a comprehensive treatment plan. It has become apparent that inappropriate timing or sequencing can be detrimental. On the other hand, appropriate timing and sequencing of Tamoxifen, based on breast cancer cell-biology, pharmacokinetics and pharmacodynamics of drugs, the body’s homeostatic response to drugs;surgery and radiation, yield huge benefit for locoregional control, long-term survival and reducing complications in patients with breast cancer. Conclusion: A rational plan for use of Tamoxifen has been recommended, based on this study;for optimal therapeutic benefit. It has also been suggested that in receptor “unknown cases”, it is beneficial to prescribe Tamoxifen, since 75% of breast cancers are likely to be estrogen receptor positive and side effects can be minimized with planned vigilance.

Acute renal failure secondary to lupus nephritis confirmed by renal biopsy with an unusually normal immunological profile

The gold standard to diagnose the lupus nephritis is the renal biopsy. It provides information not only for diagnosis but also for the treatment plan and the prognosis. Laboratory studies, including the immunological profile, play an essential role in diagnosing and evaluating the lupus nephritis activity. The patient is unlikely to have the active lupus nephritis with the combination of anti-ds DNA, anti-C1q, C3 and C4 being within normal limits. In this case report, we present a patient with moderately active diffuse proliferative lupus glomerulonephritis (Class IV) confirmed by the renal biopsy, while her immunological profile is unusually normal.

Major Depressive Disorder as a Post COVID Infection Sequela

COVID-19 has taken the world by storm, producing a multitude of concerning sequela in all genders and age groups. One surprising finding is the onset of depression post COVID recovery in patients with no past medical history of psychiatric illness. The following case report discusses a 52-year-old female with a past medical history of pneumonia secondary to COVID-19 in April 2021, who presented with recurrent falls and a syncopal episode. On review of systems, it was discovered that the patient has new onset depression since recovering from COVID related pneumonia. Patient has yet to follow up with an outpatient psychiatrist.

Central nervous system recurrence in a patient treated for acute promyelocytic leukemia,resulting in sideroblastic anemia:A case report

BACKGROUND Previous cases that have been stated in this article have displayed that around 1%to 7%of patients that have been treated with chemotherapy for acute promyelocytic leukemia developed myelodysplastic syndrome or acute myeloid leukemia.One can see that’s why this case presentation of a 60-year-old man that had a good response to acute promyelocytic leukemia treatment,that later presented with a central nervous system recurrence of acute promyelocytic leukemia and acquired sideroblastic anemia(a form of myelodysplasia)from treatment is a unique case report.CASE SUMMARY The presence of central nervous system relapse in acute promyelocytic leukemia patients is very unlikely compared to recurring mainly in the bone marrow.It is also uncommon to be diagnosed with sideroblastic anemia(form of myelodysplastic syndrome)as a result from treatment for acute promyelocytic leukemia.This case report highlights the detection,treatment/maintenance with idarubicin,all-trans-retinoic-acid,arsenic trioxide,methotrexate,6-mercaptopurine,and ommaya reservoir intrathecal methotrexate administration in a patient that had central nervous system relapse of acute promyelocytic leukemia and acquired sideroblastic anemia.CONCLUSION In essence,first time relapse concerning the central nervous system in treated acute promyelocytic leukemia patients who had a good response to therapy is very uncommon.The acquirement of a myelodysplastic syndrome such as ringed sideroblastic anemia is also rare regarding this patient population.Although such cases are infrequent,this case report represents a unique insight of the detection,treatment,and maintenance of a 60-year-old man diagnosed with acute promyelocytic leukemia,resulting in the acquirement of sideroblastic anemia and central nervous system relapse.

Overview of genetic signaling pathway interactions within cutaneous malignancies

Melanoma and non-melanoma cutaneous malignancies are some of the leading causes of cancer-related death in the United States.Though melanoma is more known to have a high mortality rate,the total mortality per year is nearly equal for between melanoma and non-melanoma skin cancer.Moreover,the non-melanoma types of cutaneous malignancies have potential to become locally invasive and even metastasize with very little to no treatment options when advanced.The development of these malignancies involves various genetic pathways through the four hallmarks of cancer development:malignant cell growth,apoptosis evasion,the use of supporting stroma and vascularization,and modulating and promoting an inadequate immune response.The genetic signaling pathways of basal cell carcinoma,squamous cell carcinoma,verrucous carcinoma,basosquamous cell carcinoma,melanoma,and cutaneous T-cell lymphoma interact with each other through genetic predisposition as well as with environmental exposures.Furthermore,solar ultraviolet radiation and chronic inflammatory states are found to initiate the progression of many of these cutaneous malignancies.This paper includes validated models of genetic pathways,emerging pathways,and crosstalk between genetic pathways through the four hallmarks of cancer development.Moreover,unlike most reviews addressing oncogenetics of the well-recognized,as well as newly discovered,genetic pathway mutations,this review stresses that these pathways are not fixed but rather exist in dynamic,interrelated,interactive,complex,and adaptive flux states.