Showing papers by "University at Buffalo published in 2019"
TL;DR: GO-CAM, a new framework for representing gene function that is more expressive than standard GO annotations, has been released, and users can now explore the growing repository of these models.
Abstract: The Gene Ontology resource (GO; http://geneontology.org) provides structured, computable knowledge regarding the functions of genes and gene products. Founded in 1998, GO has become widely adopted in the life sciences, and its contents are under continual improvement, both in quantity and in quality. Here, we report the major developments of the GO resource during the past two years. Each monthly release of the GO resource is now packaged and given a unique identifier (DOI), enabling GO-based analyses on a specific release to be reproduced in the future. The molecular function ontology has been refactored to better represent the overall activities of gene products, with a focus on transcription regulator activities. Quality assurance efforts have been ramped up to address potentially out-of-date or inaccurate annotations. New evidence codes for high-throughput experiments now enable users to filter out annotations obtained from these sources. GO-CAM, a new framework for representing gene function that is more expressive than standard GO annotations, has been released, and users can now explore the growing repository of these models. We also provide the ‘GO ribbon’ widget for visualizing GO annotations to a gene; the widget can be easily embedded in any web page.
2,138 citations
TL;DR: Exposure to and sharing of fake news by registered voters on Twitter was examined and it was found that engagement with fake news sources was extremely concentrated and individuals most likely to engage withfake news sources were conservative leaning, older, and highly engaged with political news.
Abstract: The spread of fake news on social media became a public concern in the United States after the 2016 presidential election. We examined exposure to and sharing of fake news by registered voters on Twitter and found that engagement with fake news sources was extremely concentrated. Only 1% of individuals accounted for 80% of fake news source exposures, and 0.1% accounted for nearly 80% of fake news sources shared. Individuals most likely to engage with fake news sources were conservative leaning, older, and highly engaged with political news. A cluster of fake news sources shared overlapping audiences on the extreme right, but for people across the political spectrum, most political news exposure still came from mainstream media outlets.
872 citations
TL;DR: Combined measurements of the production and decay rates of the Higgs boson, as well as its couplings to vector bosons and fermions, are presented and constraints are placed on various two Higgs doublet models.
Abstract: Combined measurements of the production and decay rates of the Higgs boson, as well as its couplings to vector bosons and fermions, are presented. The analysis uses the LHC proton–proton collision data set recorded with the CMS detector in 2016 at $\sqrt{s}=13\,\text {Te}\text {V} $ , corresponding to an integrated luminosity of 35.9 ${\,\text {fb}^{-1}} $ . The combination is based on analyses targeting the five main Higgs boson production mechanisms (gluon fusion, vector boson fusion, and associated production with a $\mathrm {W}$ or $\mathrm {Z}$ boson, or a top quark-antiquark pair) and the following decay modes: $\mathrm {H} \rightarrow \gamma \gamma $ , $\mathrm {Z}\mathrm {Z}$ , $\mathrm {W}\mathrm {W}$ , $\mathrm {\tau }\mathrm {\tau }$ , $\mathrm {b} \mathrm {b} $ , and $\mathrm {\mu }\mathrm {\mu }$ . Searches for invisible Higgs boson decays are also considered. The best-fit ratio of the signal yield to the standard model expectation is measured to be $\mu =1.17\pm 0.10$ , assuming a Higgs boson mass of $125.09\,\text {Ge}\text {V} $ . Additional results are given for various assumptions on the scaling behavior of the production and decay modes, including generic parametrizations based on ratios of cross sections and branching fractions or couplings. The results are compatible with the standard model predictions in all parametrizations considered. In addition, constraints are placed on various two Higgs doublet models.
451 citations
01 Jun 2019
TL;DR: This paper proposes an effective structured pruning approach that jointly prunes filters as well as other structures in an end-to-end manner and effectively solves the optimization problem by generative adversarial learning (GAL), which learns a sparse soft mask in a label-free and an end to end manner.
Abstract: Structured pruning of filters or neurons has received increased focus for compressing convolutional neural networks. Most existing methods rely on multi-stage optimizations in a layer-wise manner for iteratively pruning and retraining which may not be optimal and may be computation intensive. Besides, these methods are designed for pruning a specific structure, such as filter or block structures without jointly pruning heterogeneous structures. In this paper, we propose an effective structured pruning approach that jointly prunes filters as well as other structures in an end-to-end manner. To accomplish this, we first introduce a soft mask to scale the output of these structures by defining a new objective function with sparsity regularization to align the output of baseline and network with this mask. We then effectively solve the optimization problem by generative adversarial learning (GAL), which learns a sparse soft mask in a label-free and an end-to-end manner. By forcing more scale factors in the soft mask to zero, the fast iterative shrinkage-thresholding algorithm (FISTA) can be leveraged to fast and reliably remove the corresponding structures. Extensive experiments demonstrate the effectiveness of GAL on different datasets, including MNIST, CIFAR-10 and ImageNet ILSVRC 2012. For example, on ImageNet ILSVRC 2012, the pruned ResNet-50 achieves 10.88% Top-5 error and results in a factor of 3.7x speedup. This significantly outperforms state-of-the-art methods.
447 citations
TL;DR: In this article, a search for invisible decays of a Higgs boson via vector boson fusion is performed using proton-proton collision data collected with the CMS detector at the LHC in 2016 at a center-of-mass energy root s = 13 TeV, corresponding to an integrated luminosity of 35.9fb(-1).
347 citations
01 Oct 2019
TL;DR: A novel graph-based method to tackle the problem of 3D human body and 3D hand pose estimation from a short sequence of 2D joint detections, where domain knowledge about the human hand (body) configurations is explicitly incorporated into the graph convolutional operations to meet the specific demand of the 3D pose estimation.
Abstract: Despite great progress in 3D pose estimation from single-view images or videos, it remains a challenging task due to the substantial depth ambiguity and severe self-occlusions. Motivated by the effectiveness of incorporating spatial dependencies and temporal consistencies to alleviate these issues, we propose a novel graph-based method to tackle the problem of 3D human body and 3D hand pose estimation from a short sequence of 2D joint detections. Particularly, domain knowledge about the human hand (body) configurations is explicitly incorporated into the graph convolutional operations to meet the specific demand of the 3D pose estimation. Furthermore, we introduce a local-to-global network architecture, which is capable of learning multi-scale features for the graph-based representations. We evaluate the proposed method on challenging benchmark datasets for both 3D hand pose estimation and 3D body pose estimation. Experimental results show that our method achieves state-of-the-art performance on both tasks.
340 citations
TL;DR: The NFI transcription factors (Nfia, Nfib, and Nfix) are identified as selectively expressed in late retinal progenitor cells and show that they control bipolar interneuron and Müller glia cell fate specification and promote proliferative quiescence.
303 citations
05 Aug 2019
TL;DR: In this paper, a planar polydimethylsiloxane (PDMS)/metal thermal emitter thin film structure was fabricated using a fast solution coating process that is scalable for large-area manufacturing.
Abstract: Radiative cooling is a passive cooling strategy with zero consumption of electricity that can be used to radiate heat from buildings to reduce air-conditioning requirements. Although this technology can work well during optimal atmospheric conditions at night, it is essential to achieve efficient cooling during the daytime when peak cooling demand actually occurs. Here we report an inexpensive planar polydimethylsiloxane (PDMS)/metal thermal emitter thin film structure, which was fabricated using a fast solution coating process that is scalable for large-area manufacturing. By performing tests under different environmental conditions, temperature reductions of 9.5 °C and 11.0 °C were demonstrated in the laboratory and an outside environment, respectively, with an average cooling power of ~120 W m–2 for the thin film thermal emitter. In addition, a spectral-selective structure was designed and implemented to suppress the solar input and control the divergence of the thermal emission beam. This enhanced the directionality of the thermal emissions, so the emitter’s cooling performance was less dependent on the surrounding environment. Outside experiments were performed in Buffalo, New York, realizing continuous all-day cooling of ~2–9 °C on a typical clear sunny day at Northern United States latitudes. This practical strategy that cools without electricity input could have a significant impact on global energy consumption. Radiative cooling can reduce air-conditioning requirements. In this study, the authors demonstrated an inexpensive thermal emitter that provided continuous daytime cooling up to 9 °C outdoors on a clear, sunny New York day.
302 citations
University of Chicago1, Pennsylvania State University2, University of California, Berkeley3, University of Wisconsin-Madison4, University of California, Santa Barbara5, Cornell University6, Colorado School of Mines7, National Institute of Standards and Technology8, University of Texas at Austin9, University of Massachusetts Amherst10, Université catholique de Louvain11, University of Maryland, College Park12, University at Buffalo13, Stanford University14, University of Michigan15, Ohio State University16
TL;DR: The Materials Genome Initiative (MGI) advanced a new paradigm for materials discovery and design, namely that the pace of new materials deployment could be accelerated through complementary efforts in theory, computation, and experiment as mentioned in this paper.
Abstract: The Materials Genome Initiative (MGI) advanced a new paradigm for materials discovery and design, namely that the pace of new materials deployment could be accelerated through complementary efforts in theory, computation, and experiment. Along with numerous successes, new challenges are inviting researchers to refocus the efforts and approaches that were originally inspired by the MGI. In May 2017, the National Science Foundation sponsored the workshop “Advancing and Accelerating Materials Innovation Through the Synergistic Interaction among Computation, Experiment, and Theory: Opening New Frontiers” to review accomplishments that emerged from investments in science and infrastructure under the MGI, identify scientific opportunities in this new environment, examine how to effectively utilize new materials innovation infrastructure, and discuss challenges in achieving accelerated materials research through the seamless integration of experiment, computation, and theory. This article summarizes key findings from the workshop and provides perspectives that aim to guide the direction of future materials research and its translation into societal impacts.
296 citations
Jean H. Humphrey1, Mduduzi N. N. Mbuya, Robert Ntozini, Lawrence H. Moulton1 +607 more•Institutions (8)
TL;DR: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea.
290 citations
01 Jun 2019
TL;DR: Zhang et al. as discussed by the authors proposed a graph convolutional neural network (Graph CNN) based method to reconstruct a full 3D mesh of hand surface that contains richer information of both 3D hand shape and pose.
Abstract: This work addresses a novel and challenging problem of estimating the full 3D hand shape and pose from a single RGB image. Most current methods in 3D hand analysis from monocular RGB images only focus on estimating the 3D locations of hand keypoints, which cannot fully express the 3D shape of hand. In contrast, we propose a Graph Convolutional Neural Network (Graph CNN) based method to reconstruct a full 3D mesh of hand surface that contains richer information of both 3D hand shape and pose. To train networks with full supervision, we create a large-scale synthetic dataset containing both ground truth 3D meshes and 3D poses. When fine-tuning the networks on real-world datasets without 3D ground truth, we propose a weakly-supervised approach by leveraging the depth map as a weak supervision in training. Through extensive evaluations on our proposed new datasets and two public datasets, we show that our proposed method can produce accurate and reasonable 3D hand mesh, and can achieve superior 3D hand pose estimation accuracy when compared with state-of-the-art methods.
Rutgers University1, National Center for Atmospheric Research2, University of Virginia3, Pennsylvania State University4, University of Utah5, University of California, Berkeley6, Boise State University7, Oregon State University8, ETH Zurich9, University at Buffalo10, University of Saskatchewan11, United States Geological Survey12, University of Kansas13, University of California, Santa Barbara14, University of California, Riverside15, Duke University16, University of Freiburg17, University of Arizona18, Ghent University19, University of Bristol20, Northeastern University21, Purdue University22, Pacific Northwest National Laboratory23, University of Colorado Boulder24, Texas A&M University25, University of Washington26, United States Department of Agriculture27, University of California, Merced28, University of Nevada, Reno29, University of Tokyo30
TL;DR: In this paper, the authors bring together hydrologists, critical zone scientists, and ESM developers to explore how hillslope structures may modulate ESM grid-level water, energy, and biogeochemical fluxes.
Abstract: Earth System Models (ESMs) are essential tools for understanding and predicting global change, but they cannot explicitly resolve hillslope‐scale terrain structures that fundamentally organize water, energy, and biogeochemical stores and fluxes at subgrid scales. Here we bring together hydrologists, Critical Zone scientists, and ESM developers, to explore how hillslope structures may modulate ESM grid‐level water, energy, and biogeochemical fluxes. In contrast to the one‐dimensional (1‐D), 2‐ to 3‐m deep, and free‐draining soil hydrology in most ESM land models, we hypothesize that 3‐D, lateral ridge‐to‐valley flow through shallow and deep paths and insolation contrasts between sunny and shady slopes are the top two globally quantifiable organizers of water and energy (and vegetation) within an ESM grid cell. We hypothesize that these two processes are likely to impact ESM predictions where (and when) water and/or energy are limiting. We further hypothesize that, if implemented in ESM land models, these processes will increase simulated continental water storage and residence time, buffering terrestrial ecosystems against seasonal and interannual droughts. We explore efficient ways to capture these mechanisms in ESMs and identify critical knowledge gaps preventing us from scaling up hillslope to global processes. One such gap is our extremely limited knowledge of the subsurface, where water is stored (supporting vegetation) and released to stream baseflow (supporting aquatic ecosystems). We conclude with a set of organizing hypotheses and a call for global syntheses activities and model experiments to assess the impact of hillslope hydrology on global change predictions.
Greenville Health System1, University at Buffalo2, Icahn School of Medicine at Mount Sinai3, Stony Brook University4, Medical University of South Carolina5, West Virginia University6, Abbott Northwestern Hospital7, University of Saskatchewan8, University of Tennessee9, California Pacific Medical Center10, Wake Forest Baptist Medical Center11
TL;DR: This study supports the use of direct aspiration as an alternative to stent retriever as first-line therapy for stroke thrombectomy and assesses whether patients treated with aspiration as first pass have non-inferior functional outcomes to those treated with a stent retrievers as first line.
Bruce C.V. Campbell1, Charles B. L. M. Majoie2, Gregory W. Albers3, Bijoy K Menon4 +1293 more•Institutions (26)
TL;DR: Estimated ischaemic core volume was independently associated with functional independence and functional improvement but did not modify the treatment benefit of endovascular thrombectomy over standard medical therapy for improved functional outcome.
Abstract: BACKGROUND: CT perfusion (CTP) and diffusion or perfusion MRI might assist patient selection for endovascular thrombectomy. We aimed to establish whether imaging assessments of irreversibly injured ischaemic core and potentially salvageable penumbra volumes were associated with functional outcome and whether they interacted with the treatment effect of endovascular thrombectomy on functional outcome. METHODS: In this systematic review and meta-analysis, the HERMES collaboration pooled patient-level data from all randomised controlled trials that compared endovascular thrombectomy (predominantly using stent retrievers) with standard medical therapy in patients with anterior circulation ischaemic stroke, published in PubMed from Jan 1, 2010, to May 31, 2017. The primary endpoint was functional outcome, assessed by the modified Rankin Scale (mRS) at 90 days after stroke. Ischaemic core was estimated, before treatment with either endovascular thrombectomy or standard medical therapy, by CTP as relative cerebral blood flow less than 30% of normal brain blood flow or by MRI as an apparent diffusion coefficient less than 620 μm2/s. Critically hypoperfused tissue was estimated as the volume of tissue with a CTP time to maximum longer than 6 s. Mismatch volume (ie, the estimated penumbral volume) was calculated as critically hypoperfused tissue volume minus ischaemic core volume. The association of ischaemic core and penumbral volumes with 90-day mRS score was analysed with multivariable logistic regression (functional independence, defined as mRS score 0-2) and ordinal logistic regression (functional improvement by at least one mRS category) in all patients and in a subset of those with more than 50% endovascular reperfusion, adjusted for baseline prognostic variables. The meta-analysis was prospectively designed by the HERMES executive committee, but not registered. FINDINGS: We identified seven studies with 1764 patients, all of which were included in the meta-analysis. CTP was available and assessable for 591 (34%) patients and diffusion MRI for 309 (18%) patients. Functional independence was worse in patients who had CTP versus those who had diffusion MRI, after adjustment for ischaemic core volume (odds ratio [OR] 0·47 [95% CI 0·30-0·72], p=0·0007), so the imaging modalities were not pooled. Increasing ischaemic core volume was associated with reduced likelihood of functional independence (CTP OR 0·77 [0·69-0·86] per 10 mL, pinteraction=0·29; diffusion MRI OR 0·87 [0·81-0·94] per 10 mL, pinteraction=0·94). Mismatch volume, examined only in the CTP group because of the small numbers of patients who had perfusion MRI, was not associated with either functional independence or functional improvement. In patients with CTP with more than 50% endovascular reperfusion (n=186), age, ischaemic core volume, and imaging-to-reperfusion time were independently associated with functional improvement. Risk of bias between studies was generally low. INTERPRETATION: Estimated ischaemic core volume was independently associated with functional independence and functional improvement but did not modify the treatment benefit of endovascular thrombectomy over standard medical therapy for improved functional outcome. Combining ischaemic core volume with age and expected imaging-to-reperfusion time will improve assessment of prognosis and might inform endovascular thrombectomy treatment decisions. FUNDING: Medtronic.
TL;DR: The proliferation of morally based leadership approaches has resulted in a surge of interest in the 21st century in ethical, authentic, and servant leadership.
Abstract: Moral forms of leadership such as ethical, authentic, and servant leadership have seen a surge of interest in the 21st century. The proliferation of morally based leadership approaches has resulted...
University of Washington1, University of Florida2, Virginia Commonwealth University3, Philippines National Collegiate Athletic Association4, University of North Carolina at Chapel Hill5, University of Pittsburgh6, University at Buffalo7, Medical College of Wisconsin8, University of Colorado Denver9, Princeton University10, Rutgers University11, University of Colorado Boulder12, University of Minnesota13
TL;DR: The American Medical Society for Sports Medicine (AMSSM) formed a writing group to review the existing literature on SRC, update its previous position statement, and to address current evidence and knowledge gaps regarding SRC.
Abstract: Sport-related concussion (SRC) is a common injury in recreational and organised sport. Over the past 30 years, there has been significant progress in our scientific understanding of SRC, which in turn has driven the development of clinical guidelines for diagnosis, assessment and management of SRC. In addition to a growing need for knowledgeable healthcare professionals to provide evidence-based care for athletes with SRC, media attention and legislation have created awareness and, in some cases, fear about many issues and unknowns surrounding SRC. The American Medical Society for Sports Medicine (AMSSM) formed a writing group to review the existing literature on SRC, update its previous position statement, and to address current evidence and knowledge gaps regarding SRC. The absence of definitive outcomes-based data is challenging and requires relying on the best available evidence integrated with clinical experience and patient values. This statement reviews the definition, pathophysiology and epidemiology of SRC, the diagnosis and management of both acute and persistent concussion symptoms, the short-term and long-term risks of SRC and repetitive head impact exposure, SRC prevention strategies, and potential future directions for SRC research. The AMSSM is committed to best clinical practices, evidence-based research and educational initiatives that positively impact the health and safety of athletes.
TL;DR: In human breast cancer cells, the acute 17β-estradiol-dependent activation of functional enhancers requires assembly of an enhancer RNA–dependent ribonucleoprotein (eRNP) complex exhibiting properties of phase-separated condensates, which serve as determinants of rapid ligand-dependent alterations in chromosomal architecture and cooperative enhancer activation.
Abstract: A crucial feature of differentiated cells is the rapid activation of enhancer-driven transcriptional programs in response to signals. The potential contributions of physicochemical properties of enhancer assembly in signaling events remain poorly understood. Here we report that in human breast cancer cells, the acute 17β-estradiol-dependent activation of functional enhancers requires assembly of an enhancer RNA-dependent ribonucleoprotein (eRNP) complex exhibiting properties of phase-separated condensates. Unexpectedly, while acute ligand-dependent assembly of eRNPs resulted in enhancer activation sensitive to chemical disruption of phase separation, chronically activated enhancers proved resistant to such disruption, with progressive maturation of eRNPs to a more gel-like state. Acute, but not chronic, stimulation resulted in ligand-induced, condensin-dependent changes in spatial chromatin conformation based on homotypic enhancer association, resulting in cooperative enhancer-activation events. Thus, distinct physicochemical properties of eRNP condensates on enhancers serve as determinants of rapid ligand-dependent alterations in chromosomal architecture and cooperative enhancer activation.
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TL;DR: This paper proposes a trellis encoder-decoder network (TEDnet) for crowd counting that achieves the best overall performance in terms of both density map quality and counting accuracy, and proposes a new combinatorial loss to enforce similarities in local coherence and spatial correlation between maps.
Abstract: Crowd counting has recently attracted increasing interest in computer vision but remains a challenging problem. In this paper, we propose a trellis encoder-decoder network (TEDnet) for crowd counting, which focuses on generating high-quality density estimation maps. The major contributions are four-fold. First, we develop a new trellis architecture that incorporates multiple decoding paths to hierarchically aggregate features at different encoding stages, which can handle large variations of objects. Second, we design dense skip connections interleaved across paths to facilitate sufficient multi-scale feature fusions and to absorb the supervision information. Third, we propose a new combinatorial loss to enforce local coherence and spatial correlation in density maps. By distributedly imposing this combinatorial loss on intermediate outputs, gradient vanishing can be largely alleviated for better back-propagation and faster convergence. Finally, our TEDnet achieves new state-of-the art performance on four benchmarks, with an improvement up to 14% in terms of MAE.
TL;DR: In this cohort study conducted between 2000 and 2018 in 6 US metropolitan regions, long-term exposure to ambient air pollutants was significantly associated with increasing emphysema assessed quantitatively using CT imaging and lung function.
Abstract: Importance While air pollutants at historical levels have been associated with cardiovascular and respiratory diseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema. Objective To assess the longitudinal association of ambient ozone (O3), fine particulate matter (PM2.5), oxides of nitrogen (NOx), and black carbon exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function. Design, Setting, and Participants This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018. Exposures Residence-specific air pollutant concentrations (O3, PM2.5, NOx, and black carbon) were estimated by validated spatiotemporal models incorporating cohort-specific monitoring, determined from 1999 through the end of follow-up. Main Outcomes and Measures Percent emphysema, defined as the percent of lung pixels less than −950 Hounsfield units, was assessed up to 5 times per participant via cardiac CT scan (2000-2007) and equivalent regions on lung CT scans (2010-2018). Spirometry was performed up to 3 times per participant (2004-2018). Results Among 7071 study participants (mean [range] age at recruitment, 60 [45-84] years; 3330 [47.1%] were men), 5780 were assigned outdoor residential air pollution concentrations in the year of their baseline examination and during the follow-up period and had at least 1 follow-up CT scan, and 2772 had at least 1 follow-up spirometric assessment, over a median of 10 years. Median percent emphysema was 3% at baseline and increased a mean of 0.58 percentage points per 10 years. Mean ambient concentrations of PM2.5and NOx, but not O3, decreased substantially during follow-up. Ambient concentrations of O3, PM2.5, NOx, and black carbon at study baseline were significantly associated with greater increases in percent emphysema per 10 years (O3: 0.13 per 3 parts per billion [95% CI, 0.03-0.24]; PM2.5: 0.11 per 2 μg/m3[95% CI, 0.03-0.19]; NOx: 0.06 per 10 parts per billion [95% CI, 0.01-0.12]; black carbon: 0.10 per 0.2 μg/m3[95% CI, 0.01-0.18]). Ambient O3and NOxconcentrations, but not PM2.5concentrations, during follow-up were also significantly associated with greater increases in percent emphysema. Ambient O3concentrations, but not other pollutants, at baseline and during follow-up were significantly associated with a greater decline in forced expiratory volume in 1 second per 10 years (baseline: 13.41 mL per 3 parts per billion [95% CI, 0.7-26.1]; follow-up: 18.15 mL per 3 parts per billion [95% CI, 1.59-34.71]). Conclusions and Relevance In this cohort study conducted between 2000 and 2018 in 6 US metropolitan regions, long-term exposure to ambient air pollutants was significantly associated with increasing emphysema assessed quantitatively using CT imaging and lung function.
TL;DR: Great reductions from baseline were seen with sacubitril-valsartan than with enalapril in all others, including left atrial volume and left ventricular end-systolic and end-diastolic volume indexes (LVESVI and LVEDVI), and ventricular-vascular coupling ratio.
Abstract: Importance Compared with enalapril, sacubitril-valsartan reduces cardiovascular mortality and heart failure hospitalization in patients with heart failure and reduced ejection fraction (HFrEF). These benefits may be related to effects on hemodynamics and cardiac remodeling. Objective To determine whether treatment of HFrEF with sacubitril-valsartan improves central aortic stiffness and cardiac remodeling compared with enalapril. Design, Setting, and Participants Randomized, double-blind clinical trial of 464 participants with heart failure and ejection fraction of 40% or less enrolled across 85 US sites between August 17, 2016, and June 28, 2018. Follow-up was completed on January 26, 2019. Interventions Randomization (1:1) to sacubitril-valsartan (n = 231; target dosage, 97/103 mg twice daily) vs enalapril (n = 233; target dosage, 10 mg twice daily) for 12 weeks. Main Outcomes and Measures The primary outcome was change from baseline to week 12 in aortic characteristic impedance (Zc), a measure of central aortic stiffness. Prespecified secondary outcomes included change from baseline to week 12 in N-terminal pro–B-type natriuretic peptide, ejection fraction, global longitudinal strain, mitral annular relaxation velocity, mitral E/e′ ratio, left ventricular end-systolic and end-diastolic volume indexes (LVESVI and LVEDVI), left atrial volume index, and ventricular-vascular coupling ratio. Results Of 464 validly randomized participants (mean age, 67.3 [SD, 9.1] years; 23.5% women), 427 completed the study. At 12 weeks, Zc decreased from 223.8 to 218.9 dyne × s/cm5in the sacubitril-valsartan group and increased from 213.2 to 214.4 dyne × s/cm5in the enalapril group (treatment difference, −2.2 [95% CI, −17.6 to 13.2] dyne × s/cm5;P = .78). Of 9 prespecified secondary end points, no significant between-group difference in change from baseline was seen in 4, including left ventricular ejection fraction (34%-36% with sacubitril-valsartan vs 33 to 35% with enalapril; treatment difference, 0.6% [95% CI, −0.4% to 1.7%];P = .24). However, greater reductions from baseline were seen with sacubitril-valsartan than with enalapril in all others, including left atrial volume (from 30.4 mL/m2to 28.2 mL/m2vs from 29.8 mL/m2to 30.5 mL/m2; treatment difference, −2.8 mL/m2[95% CI, −4.0 to −1.6 mL/m2];P Conclusions and Relevance Treatment of HFrEF with sacubitril-valsartan, compared with enalapril, did not significantly reduce central aortic stiffness. The study findings may provide insight into mechanisms underlying the effects of sacubitril-valsartan in HFrEF. Trial Registration ClinicalTrials.gov Identifier:NCT02874794
TL;DR: In the treatment of ROP, ranibizumab 0·2 mg might be superior to laser therapy, with fewer unfavourable ocular outcomes than laser therapy and with an acceptable 24-week safety profile.
01 Jun 2019
TL;DR: TEDnet as mentioned in this paper proposes a trellis encoder-decoder network for crowd counting, which employs dense skip connections interleaved across paths to facilitate multi-scale feature fusions, which also helps TEDnet to absorb the supervision information.
Abstract: Crowd counting has recently attracted increasing interest in computer vision but remains a challenging problem. In this paper, we propose a trellis encoder-decoder network (TEDnet) for crowd counting, which focuses on generating high-quality density estimation maps. The major contributions are four-fold. First, we develop a new trellis architecture that incorporates multiple decoding paths to hierarchically aggregate features at different encoding stages, which improves the representative capability of convolutional features for large variations in objects. Second, we employ dense skip connections interleaved across paths to facilitate sufficient multi-scale feature fusions, which also helps TEDnet to absorb the supervision information. Third, we propose a new combinatorial loss to enforce similarities in local coherence and spatial correlation between maps. By distributedly imposing this combinatorial loss on intermediate outputs, TEDnet can improve the back-propagation process and alleviate the gradient vanishing problem. Finally, on four widely-used benchmarks, our TEDnet achieves the best overall performance in terms of both density map quality and counting accuracy, with an improvement up to 14% in MAE metric. These results validate the effectiveness of TEDnet for crowd counting.
University of California, Davis1, Columbia University2, New York University3, University of Pittsburgh4, Medical College of Wisconsin5, Anschutz Medical Campus6, Cincinnati Children's Hospital Medical Center7, University of Cincinnati8, University of Colorado Denver9, University of Michigan10, Northwestern University11, Harvard University12, Washington University in St. Louis13, Boston Children's Hospital14, Brown University15, University at Buffalo16, Western Michigan University17, Spectrum Health18, University of Utah19, University of Maryland, Baltimore20, Baylor College of Medicine21, Yeshiva University22, Ohio State University23, Nationwide Children's Hospital24, University of Rochester25, Hurley Medical Center26, Alfred I. duPont Hospital for Children27, Children's National Medical Center28, Johns Hopkins University29, University of Pennsylvania30, Wayne State University31
TL;DR: An accurate prediction rule to identify febrile infants 60 days and younger at low risk for SBIs using the urinalysis, ANC, and procalcitonin levels is derived and validated.
Abstract: Importance In young febrile infants, serious bacterial infections (SBIs), including urinary tract infections, bacteremia, and meningitis, may lead to dangerous complications. However, lumbar punctures and hospitalizations involve risks and costs. Clinical prediction rules using biomarkers beyond the white blood cell count (WBC) may accurately identify febrile infants at low risk for SBIs. Objective To derive and validate a prediction rule to identify febrile infants 60 days and younger at low risk for SBIs. Design, Setting, and Participants Prospective, observational study between March 2011 and May 2013 at 26 emergency departments. Convenience sample of previously healthy febrile infants 60 days and younger who were evaluated for SBIs. Data were analyzed between April 2014 and April 2018. Exposures Clinical and laboratory data (blood and urine) including patient demographics, fever height and duration, clinical appearance, WBC, absolute neutrophil count (ANC), serum procalcitonin, and urinalysis. We derived and validated a prediction rule based on these variables using binary recursive partitioning analysis. Main Outcomes and Measures Serious bacterial infection, defined as urinary tract infection, bacteremia, or bacterial meningitis. Results We derived the prediction rule on a random sample of 908 infants and validated it on 913 infants (mean age was 36 days, 765 were girls [42%], 781 were white and non-Hispanic [43%], 366 were black [20%], and 535 were Hispanic [29%]). Serious bacterial infections were present in 170 of 1821 infants (9.3%), including 26 (1.4%) with bacteremia, 151 (8.3%) with urinary tract infections, and 10 (0.5%) with bacterial meningitis; 16 (0.9%) had concurrent SBIs. The prediction rule identified infants at low risk of SBI using a negative urinalysis result, an ANC of 4090/µL or less (to convert to ×109per liter, multiply by 0.001), and serum procalcitonin of 1.71 ng/mL or less. In the validation cohort, the rule sensitivity was 97.7% (95% CI, 91.3-99.6), specificity was 60.0% (95% CI, 56.6-63.3), negative predictive value was 99.6% (95% CI, 98.4-99.9), and negative likelihood ratio was 0.04 (95% CI, 0.01-0.15). One infant with bacteremia and 2 infants with urinary tract infections were misclassified. No patients with bacterial meningitis were missed by the rule. The rule performance was nearly identical when the outcome was restricted to bacteremia and/or bacterial meningitis, missing the same infant with bacteremia. Conclusions and Relevance We derived and validated an accurate prediction rule to identify febrile infants 60 days and younger at low risk for SBIs using the urinalysis, ANC, and procalcitonin levels. Once further validated on an independent cohort, clinical application of the rule has the potential to decrease unnecessary lumbar punctures, antibiotic administration, and hospitalizations.
TL;DR: This is the first RCT to show that individualized subsymptom threshold aerobic exercise treatment prescribed to adolescents with concussion symptoms during the first week after SRC speeds recovery and may reduce the incidence of delayed recovery.
Abstract: Importance Sport-related concussion (SRC) is a significant public health problem without an effective treatment. Objective To assess the effectiveness of subsymptom threshold aerobic exercise vs a placebo-like stretching program prescribed to adolescents in the acute phase of recovery from SRC. Design, Setting, and Participants This multicenter prospective randomized clinical trial was conducted at university concussion centers. Male and female adolescent athletes (age 13-18 years) presenting within 10 days of SRC were randomly assigned to aerobic exercise or a placebo-like stretching regimen. Interventions After systematic determination of treadmill exercise tolerance on the first visit, participants were randomly assigned to a progressive subsymptom threshold aerobic exercise or a progressive placebo-like stretching program (that would not substantially elevate heart rate). Both forms of exercise were performed approximately 20 minutes per day, and participants reported daily symptoms and compliance with exercise prescription via a website. Main Outcomes and Measures Days from injury to recovery; recovery was defined as being asymptomatic, having recovery confirmed through an assessment by a physician blinded to treatment group, and returning to normal exercise tolerance on treadmill testing. Participants were also classified as having normal ( Results A total of 103 participants were included (aerobic exercise: n = 52; 24 female [46%]; stretching, n = 51; 24 female [47%]). Participants in the aerobic exercise group were seen a mean (SD) of 4.9 (2.2) days after the SRC, and those in the stretching group were seen a mean (SD) of 4.8 (2.4) days after the SRC. There were no differences in age, sex, previous concussions, time from injury, initial symptom severity score, or initial exercise treadmill test and physical examination results. Aerobic exercise participants recovered in a median of 13 (interquartile range [IQR], 10-18.5) days, whereas stretching participants recovered in 17 (IQR, 13-23) days (P = .009 by Mann-Whitney test). There was a nonsignificant lower incidence of delayed recovery in the aerobic exercise group (2 participants [4%] in the aerobic group vs 7 [14%] in the placebo group;P = .08). Conclusions and Relevance This is, to our knowledge, the first RCT to show that individualized subsymptom threshold aerobic exercise treatment prescribed to adolescents with concussion symptoms during the first week after SRC speeds recovery and may reduce the incidence of delayed recovery. Trial Registration ClinicalTrials.gov identifier:NCT02710123
TL;DR: In this article, the authors showed that in ST-segment-elevation myocardial infarction (STEMI), infarct size correlates directly with heart failure and mortality.
Abstract: Background: In ST-segment–elevation myocardial infarction (STEMI), infarct size correlates directly with heart failure and mortality. Preclinical testing has shown that, in comparison with reperfus...
Medical Corps1, University at Buffalo2, University of Brescia3, Federal University of Pernambuco4, Griffith University5, Mount Sinai Hospital6, University Medical Center Groningen7, University of Rochester Medical Center8, Bar-Ilan University9, University of Florida10, University of Connecticut11, National University of Singapore12
TL;DR: The evidence supports the use of specific settings of PBM therapy for the prevention of OM in specific patient populations and No Guideline Possible for treatment of established OM or for management of chemotherapy-related OM is recommended.
Abstract: To systematically review the literature and update the evidence-based clinical practice guidelines for the use of photobiomodulation (PBM), such as laser and other light therapies, for the prevention and/or treatment of oral mucositis (OM). A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using PubMed and Web of Science. We followed the MASCC methods for systematic review and guidelines development. The rigorously evaluated evidence for each intervention, in each cancer treatment setting, was assigned a level-of-evidence (LoE). Based on the LoE, one of the following guidelines was determined: Recommendation, Suggestion, or No Guideline Possible. Recommendations are made for the prevention of OM and related pain with PBM therapy in cancer patients treated with one of the following modalities: hematopoietic stem cell transplantation, head and neck (HN the clinician should adhere to all parameters of the protocol selected. Due to inadequate evidence, currently, No Guideline Possible for treatment of established OM or for management of chemotherapy-related OM. The reported clinical settings were extremely variable, limiting data integration. The evidence supports the use of specific settings of PBM therapy for the prevention of OM in specific patient populations. Under these circumstances, PBM is recommended for the prevention of OM. The guidelines are subject to continuous update based on new published data.
TL;DR: In this article, the performance of missing transverse momentum (Tmiss) reconstruction algorithms for the CMS experiment is presented, using proton-proton collisions at a center of mass energy of 13 TeV, collected at the CERN LHC in 2016.
Abstract: The performance of missing transverse momentum (Tmiss) reconstruction algorithms for the CMS experiment is presented, using proton-proton collisions at a center-of-mass energy of 13 TeV, collected at the CERN LHC in 2016. The data sample corresponds to an integrated luminosity of 35.9 fb-1. The results include measurements of the scale and resolution of Tmiss, and detailed studies of events identified with anomalous Tmiss. The performance is presented of a Tmiss reconstruction algorithm that mitigates the effects of multiple proton-proton interactions, using the "pileup per particle identification" method. The performance is shown of an algorithm used to estimate the compatibility of the reconstructed Tmiss with the hypothesis that it originates from resolution effects.
TL;DR: In this paper, the authors consider single-field inflation in light of string-motivated "swampland" conjectures suggesting that effective scalar field theories with a consistent UV completion must have field excursion, in combination with a sufficiently steep potential.
Abstract: We consider single-field inflation in light of string-motivated ‘swampland’ conjectures suggesting that effective scalar field theories with a consistent UV completion must have field excursion , in combination with a sufficiently steep potential, . Here, we show that the swampland conjectures are inconsistent with existing observational constraints on single-field inflation. Focusing on the observationally favoured class of concave potentials, we map the allowed swampland region onto the n S -r ‘zoo plot’ of inflationary models, and find that consistency with the Planck satellite and BICEP2/Keck Array requires and , in strong tension with swampland conjectures. Extension to non-canonical models such as DBI Inflation does not significantly weaken the bound.
TL;DR: This paper proposes a lightweight blockchain system called LightChain, which is resource-efficient and suitable for power-constrained IIoT scenarios, and presents a green consensus mechanism named Synergistic Multiple Proof for stimulating the cooperation ofIIoT devices, and a lightweight data structure called LightBlock to streamline broadcast content.
Abstract: While the intersection of blockchain and Industrial Internet of Things (IIoT) has received considerable research interest lately, the conflict between the high resource requirements of blockchain and the generally inadequate performance of IIoT devices has not been well tackled. On one hand, due to the introductions of mathematical concepts, including Public Key Infrastructure, Merkle Hash Tree, and Proof of Work (PoW), deploying blockchain demands huge computing power. On the other hand, full nodes should synchronize massive block data and deal with numerous transactions in peer-to-peer network, whose occupation of storage capacity and bandwidth makes IIoT devices difficult to afford. In this paper, we propose a lightweight blockchain system called LightChain , which is resource-efficient and suitable for power-constrained IIoT scenarios. Specifically, we present a green consensus mechanism named Synergistic Multiple Proof for stimulating the cooperation of IIoT devices, and a lightweight data structure called LightBlock to streamline broadcast content. Furthermore, we design a novel Unrelated Block Offloading Filter to avoid the unlimited growth of ledger without affecting blockchain's traceability. The extensive experiments demonstrate that LightChain can reduce the individual computational cost to 39.32% and speed up the block generation by up to 74.06%. In terms of storage and network usage, the reductions are 43.35% and 90.55%, respectively.
TL;DR: This Introductory Overview presents reasons for embedding formal optimization approaches in environmental decision-making processes, details how environmental problems are formulated as optimization problems and outlines how single- and multi-objective optimization approaches find good solutions to environmental problems.
Abstract: Environmental models are used extensively to evaluate the effectiveness of a range of design, planning, operational, management and policy options. However, the number of options that can be evaluated manually is generally limited, making it difficult to identify the most suitable options to consider in decision-making processes. By linking environmental models with evolutionary and other metaheuristic optimization algorithms, the decision options that make best use of scarce resources, achieve the best environmental outcomes for a given budget or provide the best trade-offs between competing objectives can be identified. This Introductory Overview presents reasons for embedding formal optimization approaches in environmental decision-making processes, details how environmental problems are formulated as optimization problems and outlines how single- and multi-objective optimization approaches find good solutions to environmental problems. Practical guidance and potential challenges are also provided.