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Showing papers by "University of California published in 2022"


Journal ArticleDOI
TL;DR: In this paper , the authors evaluated Relugolix, an oral gonadotropin-releasing hormone receptor antagonist, combined with estradiol and a progestin, for treatment of endometriosis-associated pain.

22 citations


Journal ArticleDOI
TL;DR: In this paper , a ligand riveting strategy for perovskite quantum dots (PQDs) was proposed to substantially inhibit the lattice distortion and simultaneously efficiently passivate the surface of PQDs for PQD solar cells with an efficiency of over 16.6%.
Abstract: A feasible ligand riveting strategy for perovskite quantum dots (PQDs) is reported to substantially inhibit the lattice distortion and simultaneously efficiently passivate the surface of PQDs for PQD solar cells with an efficiency of over 16.6%.

17 citations


Journal ArticleDOI
TL;DR: In this paper , an improved hierarchical, linearized, and analytic spectral graph theory-based model was proposed to capture the frequency spectra obtained from magnetoencephalography recordings of resting healthy subjects.

14 citations


Journal ArticleDOI
TL;DR: In this article , a gastight rotating cylinder electrode cell with well-defined mass transport characteristics is proposed to experimentally decouple mass transfer effects from intrinsic kinetics in electrocatalytic systems.
Abstract: Decoupling and understanding the various mass, charge, and heat transport phenomena involved in the electrocatalytic transformation of small molecules (i.e., CO2, CO, H2, N2, NH3, O2, and CH4) is challenging but it can be readily achieved using dimensionless quantities (i.e., Reynolds, Sherwood, Schmidt, Damköhler, Nusselt, Prandtl, and Peclet Numbers) to simplify the characterization of systems with multiple interacting physical phenomena. Herein we report the development of a gastight rotating cylinder electrode cell with well-defined mass transport characteristics that can be applied to experimentally decouple mass transfer effects from intrinsic kinetics in electrocatalytic systems. The gastight rotating cylinder electrode cell enables the dimensionless analysis of electrocatalytic systems and should enable the rigorous research and development of electrocatalytic technologies.

13 citations


Journal ArticleDOI
TL;DR: In this paper , the authors developed a local delivery strategy based upon an array of soluble microneedles (MN) for head and neck squamous cell carcinoma (HNSCC) treatment.
Abstract: Abstract Head and neck squamous cell carcinoma (HNSCC) ranks sixth in cancer incidence worldwide and has a 5-year survival rate of only 63%. Immunotherapies—principally immune checkpoint inhibitors (ICI), such as anti-PD-1 and anti-CTLA-4 antibodies that restore endogenous antitumor T-cell immunity—offer the greatest promise for HNSCC treatment. Anti-PD-1 has been recently approved for first-line treatment of recurrent and metastatic HNSCC; however, less than 20% of patients show clinical benefit and durable responses. In addition, the clinical application of ICI has been limited by immune-related adverse events (irAE) consequent to compromised peripheral immune tolerance. Although irAEs are often reversible, they can become severe, prompting premature therapy termination or becoming life threatening. To address the irAEs inherent to systemic ICI therapy, we developed a novel, local delivery strategy based upon an array of soluble microneedles (MN). Using our recently reported syngeneic, tobacco-signature murine HNSCC model, we found that both systemic and local-MN anti-CTLA-4 therapy lead to >90% tumor response, which is dependent on CD8 T cells and conventional dendritic cell type 1 (cDC1). However, local-MN delivery limited the distribution of anti-CTLA-4 antibody from areas distal to draining lymphatic basins. Employing Foxp3-GFPDTR transgenic mice to interrogate irAEs in vivo, we found that local-MN delivery of anti-CTLA-4 protects animals from irAEs observed with systemic therapy. Taken together, our findings support the exploration of MN-intratumoral ICI delivery as a viable strategy for HNSCC treatment with reduced irAEs, and the opportunity to target cDC1s as part of multimodal treatment options to boost ICI therapy.

13 citations


Journal ArticleDOI
TL;DR: In this article , a hierarchical hierarchical tzBiVO4/msBiV4 phase junction was designed to elucidate the photogenerated carrier migration process and its correlated band alignment.

12 citations


Journal ArticleDOI
TL;DR: In this paper , the surface properties of the perovskite are manipulated using dimethylamine hydroiodide (DMAI) and 1-[4-(Trifluoromethyl) phenyl] hydrazine hydrochloride (TFMPHC) synergistic system for inverted planar PSCs with a p-i-n device architecture.

12 citations


Journal ArticleDOI
TL;DR: In this paper, a thermoelectric magnetoconvection (TEMC) model is developed that successfully predicts the zeroth-order magnetoprecession dynamics in a cylindrical volume of liquid gallium heated from below and cooled from above.
Abstract: We present laboratory measurements of the interaction between thermoelectric currents and turbulent magnetoconvection. In a cylindrical volume of liquid gallium heated from below and cooled from above and subject to a vertical magnetic field, it is found that the large-scale circulation (LSC) can undergo a slow axial precession. Our experiments demonstrate that this LSC precession occurs only when electrically conducting boundary conditions are employed, and that the precession direction reverses when the axial magnetic field direction is flipped. A thermoelectric magnetoconvection (TEMC) model is developed that successfully predicts the zeroth-order magnetoprecession dynamics. Our TEMC magnetoprecession model hinges on thermoelectric current loops at the top and bottom boundaries, which create Lorentz forces that generate horizontal torques on the overturning large-scale circulatory flow. The thermoelectric torques in our model act to drive a precessional motion of the LSC. This model yields precession frequency predictions that are in good agreement with the experimental observations. We postulate that thermoelectric effects in convective flows, long argued to be relevant in liquid metal heat transfer and mixing processes, may also have applications in planetary interior magnetohydrodynamics.

11 citations


Journal ArticleDOI
TL;DR: In this paper , the authors developed computer vision models for image-based differentiation of bacterial and fungal corneal ulcers and compared their performance against human experts, achieving a statistically significantly higher area under the receiver operating characteristic curve (AUC) individually and for each group collectively.
Abstract: Develop computer vision models for image-based differentiation of bacterial and fungal corneal ulcers and compare their performance against human experts.Cross-sectional comparison of diagnostic performance.Patients with acute, culture-proven bacterial or fungal keratitis from 4 centers in South India.Five convolutional neural networks (CNNs) were trained using images from handheld cameras collected from patients with culture-proven corneal ulcers in South India recruited as part of clinical trials conducted between 2006 and 2015. Their performance was evaluated on 2 hold-out test sets (1 single center and 1 multicenter) from South India. Twelve local expert cornea specialists performed remote interpretation of the images in the multicenter test set to enable direct comparison against CNN performance.Area under the receiver operating characteristic curve (AUC) individually and for each group collectively (i.e., CNN ensemble and human ensemble).The best-performing CNN architecture was MobileNet, which attained an AUC of 0.86 on the single-center test set (other CNNs range, 0.68-0.84) and 0.83 on the multicenter test set (other CNNs range, 0.75-0.83). Expert human AUCs on the multicenter test set ranged from 0.42 to 0.79. The CNN ensemble achieved a statistically significantly higher AUC (0.84) than the human ensemble (0.76; P < 0.01). CNNs showed relatively higher accuracy for fungal (81%) versus bacterial (75%) ulcers, whereas humans showed relatively higher accuracy for bacterial (88%) versus fungal (56%) ulcers. An ensemble of the best-performing CNN and best-performing human achieved the highest AUC of 0.87, although this was not statistically significantly higher than the best CNN (0.83; P = 0.17) or best human (0.79; P = 0.09).Computer vision models achieved superhuman performance in identifying the underlying infectious cause of corneal ulcers compared with cornea specialists. The best-performing model, MobileNet, attained an AUC of 0.83 to 0.86 without any additional clinical or historical information. These findings suggest the potential for future implementation of these models to enable earlier directed antimicrobial therapy in the management of infectious keratitis, which may improve visual outcomes. Additional studies are ongoing to incorporate clinical history and expert opinion into predictive models.

11 citations


Journal ArticleDOI
TL;DR: In this article , a deep learning approach was proposed to diagnose fungal keratitis based on corneal photographs, which is the current standard of care for determining empiric therapy in the absence of microbiologic data.

10 citations


Journal ArticleDOI
TL;DR: The robust PET-only processing (rPOP) as discussed by the authors is a MATLAB-based MRI-free pipeline implementing non-linear warping and differential smoothing of amyloid-PET scans performed with any of the FDA-approved radiotracers.

Journal ArticleDOI
TL;DR: In this paper , the authors comprehensively characterized immune and non-immune cell types in the endometrium of women with or without disease and their dynamic changes across the menstrual cycle through integrating whole-tissue deconvolution and single-cell RNAseq.
Abstract: The uterine lining (endometrium) exhibits a pro-inflammatory phenotype in women with endometriosis, resulting in pain, infertility, and poor pregnancy outcomes. The full complement of cell types contributing to this phenotype has yet to be identified, as most studies have focused on bulk tissue or select cell populations. Herein, through integrating whole-tissue deconvolution and single-cell RNAseq, we comprehensively characterized immune and nonimmune cell types in the endometrium of women with or without disease and their dynamic changes across the menstrual cycle. We designed metrics to evaluate specificity of deconvolution signatures that resulted in single-cell identification of 13 novel signatures for immune cell subtypes in healthy endometrium. Guided by statistical metrics, we identified contributions of endometrial epithelial, endothelial, plasmacytoid dendritic cells, classical dendritic cells, monocytes, macrophages, and granulocytes to the endometrial pro-inflammatory phenotype, underscoring roles for nonimmune as well as immune cells to the dysfunctionality of this tissue.

Journal ArticleDOI
TL;DR: A review of evidence for synaptic dopamine dysfunction in ASD and in animal models of ASD is presented in this paper , which provides a scaffold for scientists and clinicians to consider subcategorizing the ASD diagnosis based on the genetic changes, neurobiological difference, and behavioral features identified in individuals with ASD.

Journal ArticleDOI
18 Feb 2022-Cornea
TL;DR: In this paper , the authors investigated the social determinants of health for keratoconus and found that socioeconomic factors were more consistent predictors of severity at presentation and corneal transplantation compared with clinical factors that have received relatively greater attention in the literature, including non-White race/ethnicity, limited English proficiency, and unemployment.
Abstract: Purpose: The purpose of this study was to investigate the social determinants of health for keratoconus. Methods: In this retrospective cohort study of patients with keratoconus, the electronic health record was reviewed for keratometry, treatments received, clinical comorbidities, and social characteristics. Outcomes included severe keratoconus at presentation (steep keratometry ≥52 diopters), disease progression (≥0.75 diopters increase from the first to the most recent clinical visit), and corneal transplantation. Logistic regression was used to evaluate factors associated with severity at presentation and corneal transplantation. Cox proportional hazards modeling was used to evaluate progression. Results: A total of 1038 patients with keratoconus were identified, 725 (70%) of whom had baseline imaging. Compared with commercially insured patients, Medicaid recipients were more likely to have severe keratoconus, independent of social and clinical confounders [odds ratio (OR) 1.94, 95% confidence interval (CI), 1.12–3.35, P = 0.017]. Male sex was independently associated with progression (hazard ratio = 1.38, 95% CI, 1.03–1.84, P = 0.030). Medicare and Medicaid recipients were more likely to require transplantation compared with commercially insured patients (OR 2.71, 95% CI, 1.65–4.46, P < 0.001 and OR 1.74, 95% CI, 1.08–2.80, P = 0.022, respectively). Other social determinants of health, including non-White race/ethnicity, limited English proficiency, and unemployment, were associated with the outcomes only in univariate analysis. Obstructive sleep apnea, atopy, body mass index, and tobacco use were not associated with any outcome. Conclusions: Socioeconomic factors were more consistent predictors of keratoconus severity and corneal transplantation compared with clinical factors that have received relatively greater attention in the keratoconus literature.

Journal ArticleDOI
TL;DR: In this article , a metal-organic framework, ZnL, is proposed as a multifunctional surface treatment material for perovskite solar cells, with amine-containing counterions in its pore, dense oxygen sites on the skeleton and anionic porous framework.

Journal ArticleDOI
TL;DR: In this article , the authors compared the adjusted, lifetime cost-effectiveness between nivolumab-ipilimumab, pembrolizumabaxitinib, and sunitinsib for patients with metastatic, clear-cell, renal cell carcinoma (mRCC) based on results from CheckMate 214 and KEYNOTE-426.
Abstract: The US Food and Drug Administration (FDA) approved nivolumab-ipilimumab and pembrolizumab-axitinib as first-line treatments for metastatic, clear-cell, renal cell carcinoma (mRCC) based on results from CheckMate 214 and KEYNOTE-426. Our objective was to compare the adjusted, lifetime cost-effectiveness between nivolumab-ipilimumab, pembrolizumab-axitinib, and sunitinib for patients with mRCC.A 3-state Markov model was developed comparing nivolumab-ipilimumab and pembrolizumab-axitinib to each other and sunitinib, over a 20-year lifetime horizon from a US medical center perspective. The clinical outcomes of nivolumab-ipilimumab and pembrolizumab-axitinib were compared using matching-adjusted indirect comparison. Costs of drug treatment, adverse events, and utilities associated with different health states and adverse events were determined using national sources and published literature. Our outcome was incremental cost-effectiveness ratio (ICER) using quality-adjusted life years (QALY). One-way and probabilistic sensitivity analyses were conducted.Nivolumab-ipilimumab was the most cost-effective option in the base case analysis with an ICER of $34,190/QALY compared with sunitinib, while the pembrolizumab-axitinib ICER was dominated by nivolumab-ipilimumab and was not cost-effective (ICER=$12,630,828/QALY) compared with sunitinib. The mean total costs per patient for the nivolumab-ipilimumab and pembrolizumab-axitinib arms were $284,683 and $457,769, respectively, compared with sunitinib at $241,656. QALY was longer for nivolumab-ipilimumab (3.23 QALY) than for adjusted pembrolizumab-axitinib (1.99 QALY), which was longer than sunitinib's (1.98 QALY). These results were most sensitive to treatment cost in both groups, but plausible changes did not alter the conclusions.The base case scenario indicated that nivolumab-ipilimumab was the most cost-effective treatment option for mRCC compared with pembrolizumab-axitinib and sunitinib.

Journal ArticleDOI
TL;DR: In this article , the effect of gender-affirming facial feminization surgery (FFS) on psychosocial outcomes in patients with gender dysphoria was investigated, and the authors reported improved scores anxiety, anger, depression, global mental health, global physical health, satisfaction with sex life, positive affect, emotional support, social isolation, companionship, and meaning and purpose.
Abstract: Objective: This study investigates the effect of gender-affirming facial feminization surgery (FFS) on psychosocial outcomes in patients with gender dysphoria. Background: Comprehensive analyses of psychosocial outcomes after gender-affirming FFS are absent in the literature resulting in a paucity of information on the impact of FFS on quality of life as well as ramifications in health insurance coverage of FFS. Methods: Scores from 11 validated, quantitative instruments from the Patient-Reported Outcomes Measurement Information System (PROMIS) assessing anxiety, anger, depression, global mental health, global physical health, satisfaction with sex life, positive affect, emotional support, social isolation, companionship, and meaning and purpose. Patients within the preoperative group (pre-FFS) were evaluated >30 days before surgery and patients within the postoperative group (post-FFS) were evaluated 10 weeks after surgery. Results: A total of 169 patients [mean (SD) age, 33.5 (10.8) years] were included. Compared with the pre-FFS group (n=107), the post-FFS group (n=62) reported improved scores anxiety (56.8±8.8 vs 60.1±7.9, P=0.01), anger (47.4±7.6 vs 51.2±9.6, P=0.01), depression (52.2±9.2 vs 57.0±8.9, P=0.001), positive affect (46.6±8.9 vs 42.9±8.7, P=0.01), meaning and purpose (49.9±10.7 vs 46.2±10.5, P=0.03), global mental health (46.7±7.6 vs 43.1±9.2, P=0.01), and social isolation (52.2±7.5 vs 55.4±7.4, P=0.01). Multivariable analysis to account for the effects of other gender-affirming surgeries, hormone therapy duration, preexisting mental health diagnoses, socioeconomic disparities, and patient-reported quality of social relationships on psychosocial functioning demonstrated that completion of FFS was independently predictive of improved scores. Conclusions: Gender-affirming FFS improves the quality of life by multiple psychosocial domains in transfeminine patients.

Journal ArticleDOI
TL;DR: In this paper , the grain boundary energy has been used to predict grain boundary energies to within a mean absolute error of 0.13 J m−2 for polycrystalline metals.

Journal ArticleDOI
TL;DR: In this article , the role of macrophage-derived exosomes in the progression of diabetic nephropathy was explored, and the results showed that HG-exo could induce dysfunction, autophagy inhibition, and inflammation in mouse tubular epithelial cell (mTEC) and C57 mouse kidney.
Abstract: Macrophage infiltration plays an important role in the progression of diabetic nephropathy (DN). Previously, we demonstrated that highglucose-stimulated macrophage-derived exosomes (HG-exo) induces proliferation and extracellular matrix accumulation in glomerular mesangial cells, but its effect on tubular cells is unclear. This study aimed to explore the role of HG-exo on renal tubular injury in DN. The results show that HG-exo could induce dysfunction, autophagy inhibition, and inflammation in mouse tubular epithelial cell (mTEC) and C57 mouse kidney. Moreover, miR-7002-5p was differentially expressed in HG-exo based on miRNAs sequencing and bioinformatics analysis. A dual-luciferase reporter assay confirmed that Atg9b was the direct target gene of miR-7002-5p. Further experimentation showed that miR-7002-5p inhibition in vivo and vitro reserves HG-exo effects. These results demonstrated that HG-exo carries excessive miR-7002-5p and inhibits autophagy through targeting Atg9b; this process then induces renal tubular dysfunction and inflammation. In conclusion, our study clarifies the important role of macrophage-derived exosomes in DN and is expected to provide new insight on DN prevention and treatment.

Journal ArticleDOI
TL;DR: In this paper , Radial artery cannulation for arterial blood pressure monitoring is a safe and effective procedure that can reasonably be performed in the prehospital setting by both physicians and nonphysicians.

Journal ArticleDOI
TL;DR: Wang et al. as discussed by the authors evaluated the response to the use of the optimized STS regimen for the treatment of calciphylaxis in Chinese patients during the first three courses of treatment.
Abstract: Background Sodium thiosulfate (STS) can be used to treat patients diagnosed with calciphylaxis, which is a rare life-threatening syndrome. However, our patients treated with the recommended STS regimen presented with serious adverse events, resulting in treatment withdrawal. Then an optimized STS regimen was used to increase the tolerance of patients to STS and improve treatment continuation. The curative effect of the new regimen is not yet definite. Therefore, this study aimed to evaluate the response to the use of the optimized STS regimen for the treatment of calciphylaxis in Chinese patients during the first three courses of treatment.Methods Demographic, clinical, and laboratory data were retrospectively collected on 31 calciphylaxis patients with chronic kidney disease (CKD) or end-stage kidney disease (ESKD) treated with the optimized STS regimen. The primary outcome was a clinical improvement. The secondary outcomes included survival rate and adverse events.Results Twenty-five patients (over 80%) achieved clinical improvement considering improvement or nonspecific changes of skin lesions (80.65%) and pain relief (100%). Furthermore, 54.84% of patients did not experience any adverse events and none died from complications. During a median follow-up of 9 months (interquartile range 4‒19), 27 patients (87.10%) survived; additionally, 13 patients (41.94%) survived after a one-year follow-up period.Conclusion The optimized STS regimen is relatively safe, associated with satisfactory outcomes, and well tolerated by patients for short to medium treatment duration. Hence, it is a promising approach for the treatment of patients diagnosed with calciphylaxis.

Journal ArticleDOI
TL;DR: In this paper , the authors proposed an empirical method to analyze data from first-price procurements where bidders are asymmetric in their risk-aversion (CRRA) coefficients and distributions of private costs.
Abstract: We propose an empirical method to analyze data from first-price procurements where bidders are asymmetric in their risk-aversion (CRRA) coefficients and distributions of private costs. Our Bayesian approach evaluates the likelihood by solving type-symmetric equilibria using the boundary-value method and integrates out unobserved heterogeneity through data augmentation. We study a new dataset from Russian government procurements focusing on the category of printing papers. We find that there is no unobserved heterogeneity (presumably because the job is routine), but bidders are highly asymmetric in their cost and risk-aversion. Our counterfactual study shows that choosing a type-specific cost-minimizing reserve price marginally reduces the procurement cost; however, inviting one more bidder substantially reduces the cost, by at least 5.5%. Furthermore, incorrectly imposing risk-neutrality would severely mislead inference and policy recommendations, but the bias from imposing homogeneity in risk-aversion is small.

Journal ArticleDOI
TL;DR: In this article , a case of vasodilatory shock secondary to metformin overdose requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) support was reported.
Abstract: Metformin overdose may result in vasodilatory shock, lactic acidosis and death. Hemodialysis is an effective means of extracorporeal elimination, but may be insufficient in the shock setting. We present a case of a 39 yo male who presented with hypotension, coma, hypoglycemia, and lactate of 6.5 mmol/L after ingesting an unknown medication. Metformin overdose was suspected, and he was started on hemodialysis. He developed profound vasoplegia refractory to high doses of norepinephrine, vasopressin, epinephrine and phenylephrine. Venoarterial extracorporeal membrane oxygenation (VA ECMO) was initiated and he had full recovery. Serum analysis with high resolution liquid chromatography mass spectrometry revealed a metformin level of 678 μg/mL and trazodone level of 2.1 μg/mL. This case is one of only a handful of reported cases of metformin overdose requiring ECMO support, and we report the highest serum metformin levels in the literature to date. We recommend early aggressive hemodialysis and vasopressor support in all suspected cases of metformin toxicity as well as VA ECMO if refractory to these therapies.We present a case of vasodilatory shock secondary to metformin overdose requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) support. This case is one of only a handful of reported cases of metformin overdose requiring ECMO support, and we report the highest serum metformin levels in the literature to date.University of San Francisco, Fresno.Case report.Clinical records and high resolution liquid chromatography mass spectroscopy analysis.None.Venoarterial ECMO provided an effective means of hemodynamic support for a patient with severe metformin toxicity.

Journal ArticleDOI
TL;DR: In this paper , the authors developed a discrete-choice instrument and used it to determine how 90 people with Type 1 diabetes weigh the risks and benefits of pancreatic islet cell transplantation to inform regulatory decisions.
Abstract: Background. The advisory panel for US Food and Drug Administration (FDA) recently endorsed pancreatic islet cell transplantation (ICT) therapy for suboptimally controlled type 1 diabetes (T1D), and FDA approval is under consideration. An important part of regulatory approval includes the patient perspective, through discrete choice. We developed a discrete-choice instrument and used it to determine how 90 people with T1D weigh the risks and benefits of ICT to inform regulatory decisions. Methods. Sawtooth software created a random, full-profile, balanced-overlap experimental design for a measure with 8 attributes of ICT risks/benefits, each with 3 to 5 levels. We asked 18 random task pairs, sociodemographics, diabetes management, and hypoglycemia questions. Analysis was performed using random parameters logistic regression technique. Results. The strongest preference was for avoiding the highest chance (15%) of serious procedure-related complications (β = −2.03, P < 0.001). The strongest positive preference was for gaining 5-y insulin independence (β = 1.75, P < 0.001). The desire for 5-y HbA1C-defined clinical treatment success was also strong (β = 1.39, P < 0.001). Subgroup analysis suggested strong gender differences with women showing much higher preferences for all benefits (68% higher for 5-y insulin independence), and men were generally more risk averse than women. Those with high versus low diabetes distress showed 3 times stronger preference for 5-y insulin independence but also twice preference to avoid risks of serious complications. Conclusions. Despite showing the most preference for avoiding serious ICT complications, people with T1D had a strong preference for achieving ICT benefits, especially insulin independence. We identified important attributes of ICT and demonstrated that patients are willing to make these trade-offs, showing support for the introduction of ICT.

Journal ArticleDOI
TL;DR: In this article , the authors evaluate if and how students adapted their academic and personal lives in response to the COVID-19 pandemic and find that students did not significantly change their overall study time and any self-care-related activities in the transition to virtual learning.
Abstract: Background In response to the COVID-19 pandemic, most U.S. medical schools acutely transitioned from regimented in-person learning to highly flexible virtual asynchronous learning. This transition at our medical school provided a unique opportunity to evaluate if and how students adapted their academic and personal lives in response.Methods Medical students in a single class that made this transition were retrospectively provided with 24-hour diaries for three periods – one shortly before the transition, a second early in the transition, and third several months into the transition – and asked to select the academic or personal activities done in each hour. The percentage of medical students performing each activity each hour was analyzed, as was the time spent on each activity per day, and per morning, afternoon, per evening within the day.Results Overall study time did not change in either virtual period but shifted significantly to the morning (6 AM to 12 PM). Time spent studying in groups fell significantly during both virtual periods, concordant with a significant increase in alone study time in the early virtual period. Early in the transition to virtual learning, students replaced in-person didactics with online faculty lectures; several months later in virtual learning, they had replaced online faculty lectures with commercial products. There was no significant change in time spent on specific personal activities.Conclusions Consistent with extensive constraints imposed by the heavy cognitive load of a medical school curriculum, students did not significantly change their overall study time and any self-care-related activities in the transition to virtual learning. However, transitioning to virtual learning allowed our students to adapt their study strategies, i.e. reducing group study time and increasing lone studying time. Furthermore, students shifted studying time to the morning to optimize the management of the cognitive task-load they faced.

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TL;DR: In this paper , the authors reviewed patients with trauma triaged in 2016 through 2020 from January to May and compared them with previous years at the level I trauma center in the US.

Journal ArticleDOI
TL;DR: Wang et al. as discussed by the authors proposed a solution to the particularity optimization algorithm of network topology feature extraction using graph neural network, which effectively reduces the end-to-end delay and increases the network throughput.
Abstract: With the rapid development and wide application of cloud computing, security protection in cloud environment has become an urgent problem to be solved. However, traditional security service equipment is closely coupled with the network topology, so it is difficult to upgrade and expand the security service, which cannot change with the change of network application security requirements. Building a security service function chain (SSFC) makes the deployment of security service functions more dynamic and scalable. Based on a software defined network (SDN) and network function virtualization (NFV) environment, this paper proposes a solution to the particularity optimization algorithm of network topology feature extraction using graph neural network. The experimental results show that, compared with the shortest path, greedy algorithm and hybrid bee colony algorithm, the average success rate of the graph neural network algorithm in the construction of the security service function chain is more than 90%, far more than other algorithms, and far less than other algorithms in construction time. It effectively reduces the end-to-end delay and increases the network throughput.

Journal ArticleDOI
TL;DR: In this article, the authors investigated the relationship between down-regulation of IKBKG gene expression and hepatocyte senescence induced by sodium fluoride (NaF) in chronic fluorosis rats and NaF-exposure human liver L02 cells.

Journal ArticleDOI
01 Jan 2022
TL;DR: In this article , the authors report two cases of cat scratch fever with atypical posterior segment manifestations including one case of focal retinitis and another case presenting with bilateral optic nerve edema.
Abstract: In Brief Purpose: To report two cases of cat-scratch fever with atypical posterior segment manifestations. Methods: Two cases were retrospectively reviewed. Results: A 27-year-old woman presented with painless blurring of central vision in her left eye. Clinical examination revealed a small focal area of retinitis within the macula associated with a subtle macular star. Spectral-domain optical coherence tomography showed a hyper-reflective inner retinal lesion in addition to subretinal and intraretinal fluid as well as hyperreflective foci within the outer plexiform layer. Serology was positive for anti–B. henselae IgM (titer 1:32). A 34-year-old woman presented with painless loss of vision in both eyes associated with headaches and pain with extraocular movement. Spectral-domain optical coherence tomography depicted subretinal fluid, intraretinal fluid, and hyperreflective deposits within the outer plexiform layer. A focal collection of vitreous cell was observed overlying the optic nerve in the left eye. Bilateral disk leakage was identified on fluorescein angiography. Serology revealed high-titer anti–B. henselae antibodies (IgM titers 1:32, IgG titers 1:256). Conclusion: Our cases highlight the necessity of recognizing more unusual posterior segment presentations of ocular bartonellosis. Multimodal retinal imaging including spectral-domain optical coherence tomography may help better characterize lesions. We report multimodal retinal imaging in two cases of cat-scratch disease with atypical posterior segment manifestations including one case of focal retinitis and another case presenting with bilateral optic nerve edema.

Journal ArticleDOI
TL;DR: In this paper , the thermoelectric properties of different types of graphynes, i.e., 6, 6,6,6-, 6,12, 12, 14,14,18-, and 18,18,18-graphyne, are systematically investigated.
Abstract: The application of carbon-based nanomaterials in the field of thermoelectric is enormously restricted for its high thermal conductivity. Graphyne, as the allotrope of graphene, expresses low thermal conductivity; therefore, it can be expected to break the limitation of carbon-based materials in thermoelectric field. By using the first-principles calculation combined with the Boltzmann theory, the thermoelectric properties of types of graphynes, i.e., 6,6,6-, 6,6,12-, 14,14,18-, and 18,18,18-graphyne, are systematically investigated. It is interesting to find that 14,14,18-graphyne presents excellent thermoelectric properties, whose maximum value of ZT can reach 1.6 at room temperature; therefore, it can be seen as an excellent carbon-based thermoelectric material. More importantly, its ZT at low temperature is abnormally higher than that at high temperature, which breaks the traditional view that the higher ZT exists in a high temperature range. Furthermore, it can also be noticed that the other three types of graphynes exhibit unexpected special thermoelectric properties: (1) 6,6,6-graphyne shows the highest Seebeck coefficient; however, its ZT value is the lowest. Moreover, its ZT value for n-type doping is twice as that for p-type doping. (2) The ZT of 6,6,12-graphyne expresses enormous anisotropy, whose value along the zigzag direction is even 1–2 orders of magnitude higher than that along the armchair direction. (3) The ZT of 18,18,18-graphyne shows completely opposite anisotropy compared with the other three types of graphynes, and its ZT value along the armchair direction is higher. Our research provides some meaningful results for enhancing the thermoelectric performance of carbon-based nanomaterials, especially for the development of high-performance thermoelectric materials at room temperature.