Abstract: Importance The coronavirus disease 2019 (COVID-19) pandemic is threatening billions of people worldwide. Tocilizumab has shown promising results in retrospective studies in patients with COVID-19 pneumonia with a good safety profile. Objective To evaluate the effect of early tocilizumab administration vs standard therapy in preventing clinical worsening in patients hospitalized with COVID-19 pneumonia. Design, Setting, and Participants Prospective, open-label, randomized clinical trial that randomized patients hospitalized between March 31 and June 11, 2020, with COVID-19 pneumonia to receive tocilizumab or standard of care in 24 hospitals in Italy. Cases of COVID-19 were confirmed by polymerase chain reaction method with nasopharyngeal swab. Eligibility criteria included COVID-19 pneumonia documented by radiologic imaging, partial pressure of arterial oxygen to fraction of inspired oxygen (Pao2/Fio2) ratio between 200 and 300 mm Hg, and an inflammatory phenotype defined by fever and elevated C-reactive protein. Interventions Patients in the experimental arm received intravenous tocilizumab within 8 hours from randomization (8 mg/kg up to a maximum of 800 mg), followed by a second dose after 12 hours. Patients in the control arm received supportive care following the protocols of each clinical center until clinical worsening and then could receive tocilizumab as a rescue therapy. Main Outcome and Measures The primary composite outcome was defined as entry into the intensive care unit with invasive mechanical ventilation, death from all causes, or clinical aggravation documented by the finding of a Pao2/Fio2ratio less than 150 mm Hg, whichever came first. Results A total of 126 patients were randomized (60 to the tocilizumab group; 66 to the control group). The median (interquartile range) age was 60.0 (53.0-72.0) years, and the majority of patients were male (77 of 126, 61.1%). Three patients withdrew from the study, leaving 123 patients available for the intention-to-treat analyses. Seventeen patients of 60 (28.3%) in the tocilizumab arm and 17 of 63 (27.0%) in the standard care group showed clinical worsening within 14 days since randomization (rate ratio, 1.05; 95% CI, 0.59-1.86). Two patients in the experimental group and 1 in the control group died before 30 days from randomization, and 6 and 5 patients were intubated in the 2 groups, respectively. The trial was prematurely interrupted after an interim analysis for futility. Conclusions and Relevance In this randomized clinical trial of hospitalized adult patients with COVID-19 pneumonia and Pao2/Fio2ratio between 200 and 300 mm Hg who received tocilizumab, no benefit on disease progression was observed compared with standard care. Further blinded, placebo-controlled randomized clinical trials are needed to confirm the results and to evaluate possible applications of tocilizumab in different stages of the disease. Trial Registration ClinicalTrials.gov Identifier:NCT04346355; EudraCT Identifier:2020-001386-37

Abstract: Infodemics, often including rumors, stigma, and conspiracy theories, have been common during the COVID-19 pandemic. Monitoring social media data has been identified as the best method for tracking rumors in real time and as a possible way to dispel misinformation and reduce stigma. However, the detection, assessment, and response to rumors, stigma, and conspiracy theories in real time are a challenge. Therefore, we followed and examined COVID-19-related rumors, stigma, and conspiracy theories circulating on online platforms, including fact-checking agency websites, Facebook, Twitter, and online newspapers, and their impacts on public health. Information was extracted between December 31, 2019 and April 5, 2020, and descriptively analyzed. We performed a content analysis of the news articles to compare and contrast data collected from other sources. We identified 2,311 reports of rumors, stigma, and conspiracy theories in 25 languages from 87 countries. Claims were related to illness, transmission and mortality (24%), control measures (21%), treatment and cure (19%), cause of disease including the origin (15%), violence (1%), and miscellaneous (20%). Of the 2,276 reports for which text ratings were available, 1,856 claims were false (82%). Misinformation fueled by rumors, stigma, and conspiracy theories can have potentially serious implications on the individual and community if prioritized over evidence-based guidelines. Health agencies must track misinformation associated with the COVID-19 in real time, and engage local communities and government stakeholders to debunk misinformation.

Abstract: Viruses influence ecosystems by modulating microbial population size, diversity, metabolic outputs, and gene flow. Here, we use quantitative double-stranded DNA (dsDNA) viral-fraction metagenomes (viromes) and whole viral community morphological data sets from 43 Tara Oceans expedition samples to assess viral community patterns and structure in the upper ocean. Protein cluster cataloging defined pelagic upper-ocean viral community pan and core gene sets and suggested that this sequence space is well-sampled. Analyses of viral protein clusters, populations, and morphology revealed biogeographic patterns whereby viral communities were passively transported on oceanic currents and locally structured by environmental conditions that affect host community structure. Together, these investigations establish a global ocean dsDNA viromic data set with analyses supporting the seed-bank hypothesis to explain how oceanic viral communities maintain high local diversity.

Abstract: Community ecology aims to understand what factors determine the assembly and dynamics of species assemblages at different spatiotemporal scales. To facilitate the integration between conceptual and statistical approaches in community ecology, we propose Hierarchical Modelling of Species Communities (HMSC) as a general, flexible framework for modern analysis of community data. While non-manipulative data allow for only correlative and not causal inference, this framework facilitates the formulation of data-driven hypotheses regarding the processes that structure communities. We model environmental filtering by variation and covariation in the responses of individual species to the characteristics of their environment, with potential contingencies on species traits and phylogenetic relationships. We capture biotic assembly rules by species-to-species association matrices, which may be estimated at multiple spatial or temporal scales. We operationalise the HMSC framework as a hierarchical Bayesian joint species distribution model, and implement it as R- and Matlab-packages which enable computationally efficient analyses of large data sets. Armed with this tool, community ecologists can make sense of many types of data, including spatially explicit data and time-series data. We illustrate the use of this framework through a series of diverse ecological examples.

Abstract: Semantic segmentation of medical images aims to associate a pixel with a label in a medical image without human initialization. The success of semantic segmentation algorithms is contingent on the availability of high-quality imaging data with corresponding labels provided by experts. We sought to create a large collection of annotated medical image datasets of various clinically relevant anatomies available under open source license to facilitate the development of semantic segmentation algorithms. Such a resource would allow: 1) objective assessment of general-purpose segmentation methods through comprehensive benchmarking and 2) open and free access to medical image data for any researcher interested in the problem domain. Through a multi-institutional effort, we generated a large, curated dataset representative of several highly variable segmentation tasks that was used in a crowd-sourced challenge - the Medical Segmentation Decathlon held during the 2018 Medical Image Computing and Computer Aided Interventions Conference in Granada, Spain. Here, we describe these ten labeled image datasets so that these data may be effectively reused by the research community.

Abstract: Importance Nonalcoholic steatohepatitis (NASH) is the inflammatory subtype of nonalcoholic fatty liver disease (NAFLD) and is associated with disease progression, development of cirrhosis, and need for liver transplant. Despite its importance, NASH is underrecognized in clinical practice. Observations NASH affects an estimated 3% to 6% of the US population and the prevalence is increasing. NASH is strongly associated with obesity, dyslipidemia, type 2 diabetes, and metabolic syndrome. Although a number of noninvasive tests and scoring systems exist to characterize NAFLD and NASH, liver biopsy is the only accepted method for diagnosis of NASH. Currently, no NASH-specific therapies are approved by the US Food and Drug Administration. Lifestyle modification is the mainstay of treatment, including dietary changes and exercise, with the primary goal being weight loss. Substantial improvement in histologic outcomes, including fibrosis, is directly correlated with increasing weight loss. In some cases, bariatric surgery may be indicated to achieve and maintain the necessary degree of weight loss required for therapeutic effect. An estimated 20% of patients with NASH will develop cirrhosis, and NASH is predicted to become the leading indication for liver transplants in the US. The mortality rate among patients with NASH is substantially higher than the general population or patients without this inflammatory subtype of NAFLD, with annual all-cause mortality rate of 25.56 per 1000 person-years and a liver-specific mortality rate of 11.77 per 1000 person-years. Conclusions and Relevance Nonalcoholic steatohepatitis affects 3% to 6% of the US population, is more prevalent in patients with metabolic disease and obesity, progresses to cirrhosis in approximately 20% of cases, and is associated with increased rates of liver-specific and overall mortality. Early identification and targeted treatment of patients with nonalcoholic steatohepatitis are needed to improve patient outcomes, including directing patients toward intensive lifestyle modification to promote weight loss and referral for bariatric surgery as indicated for management of obesity and metabolic disease.

Abstract: The European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) have collaborated to produce these post-resuscitation care guidelines for adults, which are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations. The topics covered include the post-cardiac arrest syndrome, diagnosis of cause of cardiac arrest, control of oxygenation and ventilation, coronary reperfusion, haemodynamic monitoring and management, control of seizures, temperature control, general intensive care management, prognostication, long-term outcome, rehabilitation and organ donation.

Abstract: Super-stretchable, skin-mountable, and ultra-soft strain sensors are presented by using carbon nanotube percolation network–silicone rubber nanocomposite thin films. The applicability of the strain sensors as epidermal electronic systems, in which mechanical compliance like human skin and high stretchability (e>100%) are required, has been explored. The sensitivity of the strain sensors can be tuned by the number density of the carbon nanotube percolation network. The strain sensors show excellent hysteresis performance at different strain levels and rates with high linearity and small drift. We found that the carbon nanotube–silicone rubber based strain sensors possess super-stretchability and high reliability for strains as large as 500%. The nanocomposite thin films exhibit high robustness and excellent resistance–strain dependency for over ∼1380% mechanical strain. Finally, we performed skin motion detection by mounting the strain sensors on different parts of the body. The maximum induced strain by the bending of the finger, wrist, and elbow was measured to be ∼ 42%, 45% and 63%, respectively. S Online supplementary data available from stacks.iop.org/NANO/26/375501/mmedia

Abstract: A key aspect of cancer metastases is the tendency for specific cancer cells to home to defined subsets of secondary organs. Despite these known tendencies, the underlying mechanisms remain poorly understood. Here we develop a microfluidic 3D in vitro model to analyze organ-specific human breast cancer cell extravasation into bone- and muscle-mimicking microenvironments through a microvascular network concentrically wrapped with mural cells. Extravasation rates and microvasculature permeabilities were significantly different in the bone-mimicking microenvironment compared with unconditioned or myoblast containing matrices. Blocking breast cancer cell A3 adenosine receptors resulted in higher extravasation rates of cancer cells into the myoblast-containing matrices compared with untreated cells, suggesting a role for adenosine in reducing extravasation. These results demonstrate the efficacy of our model as a drug screening platform and a promising tool to investigate specific molecular pathways involved in cancer biology, with potential applications to personalized medicine.

Abstract: The novel coronavirus disease is currently causing a major pandemic. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a member of the Betacoronavirus genus that also includes the SARS-CoV and Middle East respiratory syndrome coronavirus. While patients typically present with fever and a respiratory illness, some patients also report gastrointestinal symptoms such as diarrhea, vomiting, and abdominal pain. Studies have identified the SARS-CoV-2 RNA in stool specimens of infected patients, and its viral receptor angiotensin converting enzyme 2 was found to be highly expressed in gastrointestinal epithelial cells. These suggest that SARS-CoV-2 can actively infect and replicate in the gastrointestinal tract. This has important implications to the disease management, transmission, and infection control. In this article, we review the important gastrointestinal aspects of the disease.

Abstract: Deep learning algorithms have been shown to perform extremely well on many classical machine learning problems. However, recent studies have shown that deep learning, like other machine learning techniques, is vulnerable to adversarial samples: inputs crafted to force a deep neural network (DNN) to provide adversary-selected outputs. Such attacks can seriously undermine the security of the system supported by the DNN, sometimes with devastating consequences. For example, autonomous vehicles can be crashed, illicit or illegal content can bypass content filters, or biometric authentication systems can be manipulated to allow improper access. In this work, we introduce a defensive mechanism called defensive distillation to reduce the effectiveness of adversarial samples on DNNs. We analytically investigate the generalizability and robustness properties granted by the use of defensive distillation when training DNNs. We also empirically study the effectiveness of our defense mechanisms on two DNNs placed in adversarial settings. The study shows that defensive distillation can reduce effectiveness of sample creation from 95% to less than 0.5% on a studied DNN. Such dramatic gains can be explained by the fact that distillation leads gradients used in adversarial sample creation to be reduced by a factor of 10^30. We also find that distillation increases the average minimum number of features that need to be modified to create adversarial samples by about 800% on one of the DNNs we tested.

Abstract: This paper argues that the social dimension is important to effectiveness of Asynchronous Learning Networks (ALNs) and needs to be taken into account in the design of courses. Evidence from an ethnographic study of the Teaching and Learning Online (TLO) course offered by the Institute of Education Technology at the Open University is presented in support of this argument. This study found that individual success or failure on the course depended upon the extent to which students were able to cross a threshold from feeling like outsiders to feeling like insiders. Factors affecting the construction of a sense of community are drawn out from interviews with students. The significance of these findings is discussed in relation to a situated model of learning as induction into a community of practice. Finally recommendations are made for the support of community building in the design of courses.

Abstract: Recommendations Infection Control • For health care workers who are performing aerosol-generating procedures on patients with COVID-19, the COVID-19 Treatment Guidelines Panel (the Panel) recommends using an N95 respirator (or equivalent or higher-level respirator) rather than surgical masks, in addition to other personal protective equipment (PPE) (i.e., gloves, gown, and eye protection such as a face shield or safety goggles) (AIII). • The Panel recommends minimizing the use of aerosol-generating procedures on intensive care unit patients with COVID-19 and carrying out any necessary aerosol-generating procedures in a negative-pressure room, also known as an airborne infection isolation room, when available (AIII). • For health care workers who are providing usual care for nonventilated patients with COVID-19, the Panel recommends using an N95 respirator (or equivalent or higher-level respirator) or a surgical mask in addition to other PPE (i.e., gloves, gown, and eye protection such as a face shield or safety goggles) (AII). • For health care workers who are performing non-aerosol-generating procedures on patients with COVID-19 who are on closed-circuit mechanical ventilation, the Panel recommends using an N95 respirator (or equivalent or higher-level respirator) in addition to other PPE (i.e., gloves, gown, and eye protection such as a face shield or safety goggles) because ventilator circuits may become disrupted unexpectedly (BIII). • The Panel recommends that endotracheal intubation in patients with COVID-19 be performed by health care providers with extensive airway management experience, if possible (AIII). • The Panel recommends that intubation be performed using video laryngoscopy, if possible (CIII).

Abstract: Suicide is a major public health concern accounting for 800 000 deaths globally each year. Although there have been many advances in understanding suicide risk in recent decades, our ability to pre...

Abstract: We present designs for scalable quantum computers composed of qubits encoded in aggregates of four or more Majorana zero modes, realized at the ends of topological superconducting wire segments that are assembled into superconducting islands with significant charging energy. Quantum information can be manipulated according to a measurement-only protocol, which is facilitated by tunable couplings between Majorana zero modes and nearby semiconductor quantum dots. Our proposed architecture designs have the following principal virtues: (1) the magnetic field can be aligned in the direction of all of the topological superconducting wires since they are all parallel; (2) topological T junctions are not used, obviating possible difficulties in their fabrication and utilization; (3) quasiparticle poisoning is abated by the charging energy; (4) Clifford operations are executed by a relatively standard measurement: detection of corrections to quantum dot energy, charge, or differential capacitance induced by quantum fluctuations; (5) it is compatible with strategies for producing good approximate magic states.

Abstract: Beccarria's influential Treatise On Crimes and Punishments is considered a foundation work in the modern field of criminology. As Newman and Marongiu note in their introduction to the work, three master themes of the Enlightenment run through the Treatise: the idea of the social contract, the idea of science, and the belief in progress. The idea of the social contact forms the moral and political basis of the work's reformist zeal. Th e idea of science supports a dispassionate and reasoned appeal for reforms. The belief in progress is inextricably bound to the idea of science. All three provide the necessary foundation for accepting Beccaria's proposals.It is virtually impossible to ascertain which of several versions of the Treatise that appeared during his lifetime best reflected Becccaria's own thought. His use of many ideas of Enlightenment thinkers also makes it diffi cult to interpret what he has written. While Enlightenment thinkers wanted to break the chains of religion and advocated free men and free minds, there was considerable disagreement as to how this might be achieved, except in the most general terms.The editors have based this translation on the Francioni (1984) text, by far the most exhaustive critical Italian edition of Dei delitti e delle pene. This edition is undoubtedly the last that Beccaria personally oversaw and revised. This new translation, which includes an outstanding opening essay by the editors, is a welcome introduction to Beccaria and to the modern beginnings of criminology.

Abstract: This chapter attempts to defend a view which Mr. Justice Holmes, among others, held and for which he and they have been much criticized. The nonpejorative name "Legal Positivism", like most terms which are used as missiles in intellectual battles, has come to stand for a baffling multitude of different sins. One of them is the sin, real or alleged, of insisting, as Austin and Bentham did, on the separation of law as it is and law as it ought to be. They stood firmly but on their own utilitarian ground for all the principles of liberalism in law and government. The chapter focuses on a distinctively American criticism of the separation of the law that is from the law that ought to be. It emerged from the critical study of the judicial process with which American jurisprudence has been on the whole so beneficially occupied.

Abstract: Determining the stability of molecules and condensed phases is the cornerstone of atomistic modeling, underpinning our understanding of chemical and materials properties and transformations We show that a machine-learning model, based on a local description of chemical environments and Bayesian statistical learning, provides a unified framework to predict atomic-scale properties It captures the quantum mechanical effects governing the complex surface reconstructions of silicon, predicts the stability of different classes of molecules with chemical accuracy, and distinguishes active and inactive protein ligands with more than 99% reliability The universality and the systematic nature of our framework provide new insight into the potential energy surface of materials and molecules

Abstract: We provide two methods for monitoring reinfection trends in routine surveillance data to identify signatures of changes in reinfection risk and apply these approaches to data from South Africa’s severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic to date. Although we found no evidence of increased reinfection risk associated with circulation of the Beta (B.1.351) or Delta (B.1.617.2) variants, we did find clear, population-level evidence to suggest immune evasion by the Omicron (B.1.1.529) variant in previously infected individuals in South Africa. Reinfections occurring between 1 November 2021 and 31 January 2022 were detected in individuals infected in all three previous waves, and there has been an increase in the risk of having a third infection since mid-November 2021. Description Omicron and reinfection risk So far, our experience with pandemic coronavirus has been that the emergence of new variants is not detected until there has been substantial community transmission. Early in November 2021, South African scientists spotted reinfections consistent with the timing of the emergence of the Omicron variant (B.1.1.529). In a population largely untouched by vaccines but widely infected, Pulliam et al. found that Beta or Delta variants rarely caused reinfection. However, after 31 October 2021, individuals were found who had had three experiences of infection (see the Perspective by Zelner and Eisenberg). The culprit was the rapidly emerging Omicron variant, with multiple mutations in the Spike protein. This variant’s chief advantage is its ability to evade naturally acquired immunity. Fortunately, the Omicron variant does not fully evade vaccine-derived immunity, but only those privileged to have been vaccinated can benefit. —CA Analysis of routine surveillance data from South Africa indicates that the Omicron variant of SARS-CoV-2 evades immunity from prior infection. INTRODUCTION Globally, there have been more than 404 million cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with 5.8 million confirmed deaths as of February 2022. South Africa has experienced four waves of SARS-CoV-2 transmission, with the second, third, and fourth waves being driven by the Beta, Delta, and Omicron variants, respectively. A key question with the emergence of new variants is the extent to which they are able to reinfect those who have had a prior natural infection. RATIONALE We developed two approaches to monitor routine epidemiological surveillance data to determine whether SARS-CoV-2 reinfection risk has changed through time in South Africa in the context of the emergence of the Beta (B.1.351), Delta (B.1.617.2), and Omicron (B.1.1.529) variants. We analyzed line-list data on positive tests for SARS-CoV-2 with specimen receipt dates between 4 March 2020 and 31 January 2022 collected through South Africa’s National Notifiable Medical Conditions Surveillance System. Individuals having sequential positive tests at least 90 days apart were considered to have suspected reinfections. Our routine monitoring of reinfection risk included comparison of reinfection rates with the expectation under a null model (approach 1) and estimation of the time-varying hazards of infection and reinfection throughout the epidemic (approach 2) based on model-based reconstruction of the susceptible populations eligible for primary and second infections. RESULTS A total of 105,323 suspected reinfections were identified among 2,942,248 individuals with laboratory-confirmed SARS-CoV-2 who had a positive test result at least 90 days before 31 January 2022. The number of reinfections observed through the end of the third wave in September 2021 was consistent with the null model of no change in reinfection risk (approach 1). Although increases in the hazard of primary infection were observed after the introduction of both the Beta and Delta variants, no corresponding increase was observed in the reinfection hazard (approach 2). Contrary to expectation, the estimated hazard ratio for reinfection versus primary infection was lower during waves driven by the Beta and Delta variants than for the first wave: the relative hazard ratio for wave 2 versus wave 1 was 0.71 [95% confidence interval (95% CI): 0.60 to 0.85]; the relative hazard ratio for wave 3 versus wave 1 was 0.54 (95% CI: 0.45 to 0.64). By contrast, the recent spread of the Omicron variant has been associated with an increase in reinfection hazard coefficient. The estimated relative hazard ratio for reinfection versus primary infection versus wave 1 was 1.75 (95% CI: 1.48 to 2.10) for the period of Omicron emergence (1 November 2021 to 30 November 2021) and 1.70 (95% CI: 1.44 to 2.04) for wave 4 versus wave 1. Individuals with identified reinfections since 1 November 2021 had experienced primary infections in all three prior waves, and an increase in third infections has been detected since mid-November 2021. Many individuals experiencing third infections had second infections during the third (Delta) wave that ended in September 2021, strongly suggesting that these infections resulted from immune evasion rather than waning immunity. CONCLUSION Population-level evidence suggests that the Omicron variant is associated with a marked ability to evade immunity from prior infection. In contrast, there is no population-wide epidemiological evidence of immune escape associated with the Beta or Delta variants. This finding has important implications for public health planning, particularly in countries such as South Africa with high rates of immunity from prior infection. The further development of methods to track reinfection risk during pathogen emergence, including refinements to assess the impact of waning immunity, account for vaccine-derived protection, and monitor the risk of multiple reinfections, will be important for future pandemic preparedness. SARS-CoV-2 reinfection patterns in South Africa. South Africa has experienced four waves of SARS-CoV-2 transmission, each driven by the emergence of a new variant. Reinfection of previously infected individuals was relatively rare through the end of the third wave. Methods developed in South Africa to monitor reinfection trends led to the early detection of increased reinfection risk associated with the Omicron variant.

Abstract: Causal evidence on microcredit impacts informs theory, practice, and debates about its effectiveness as a development tool. The six randomized evaluations in this volume use a variety of sampling, data collection, experimental design, and econometric strategies to identify causal effects of expanded access to microcredit on bor rowers and/or communities. These methods are deployed across an impressive range of locations—six countries on four continents, urban and rural areas—borrower characteristics, loan character istics, and lender characteristics. Summarizing and interpreting results across studies, we note a consistent pattern of modestly positive, but not transformative, effects. We also discuss directions for future research. (JEL D14, G21, I38, O15, O16, P34, P36)

Abstract: Importance Pituitary adenomas may hypersecrete hormones or cause mass effects. Therefore, early diagnosis and treatment are important. Observations Prevalence of pituitary adenomas ranges from 1 in 865 adults to 1 in 2688 adults. Approximately 50% are microadenomas ( Conclusions and Relevance Patients with pituitary adenomas should be identified at an early stage so that effective treatment can be implemented. For prolactinomas, initial therapy is generally dopamine agonists. For all other pituitary adenomas, initial therapy is generally transsphenoidal surgery with medical therapy being reserved for those not cured by surgery.

Abstract: Prior research indicates that Facebook usage predicts declines in subjective well-being over time. How does this come about? We examined this issue in 2 studies using experimental and field methods. In Study 1, cueing people in the laboratory to use Facebook passively (rather than actively) led to declines in affective well-being over time. Study 2 replicated these findings in the field using experience-sampling techniques. It also demonstrated how passive Facebook usage leads to declines in affective well-being: by increasing envy. Critically, the relationship between passive Facebook usage and changes in affective well-being remained significant when controlling for active Facebook use, non-Facebook online social network usage, and direct social interactions, highlighting the specificity of this result. These findings demonstrate that passive Facebook usage undermines affective well-being.

Abstract: Pre-eclampsia is a common disorder that particularly affects first pregnancies. The clinical presentation is highly variable but hypertension and proteinuria are usually seen. These systemic signs arise from soluble factors released from the placenta as a result of a response to stress of syncytiotrophoblast. There are two sub-types: early and late onset pre-eclampsia, with others almost certainly yet to be identified. Early onset pre-eclampsia arises owing to defective placentation, whilst late onset pre-eclampsia may center around interactions between normal senescence of the placenta and a maternal genetic predisposition to cardiovascular and metabolic disease. The causes, placental and maternal, vary among individuals. Recent research has focused on placental-uterine interactions in early pregnancy. The aim now is to translate these findings into new ways to predict, prevent, and treat pre-eclampsia.

Abstract: Superior self-healability and stretchability are critical elements for the practical wide-scale adoption of personalized electronics such as portable and wearable energy storage devices. However, the low healing efficiency of self-healable supercapacitors and the small strain of stretchable supercapacitors are fundamentally limited by conventional polyvinyl alcohol-based acidic electrolytes, which are intrinsically neither self-healable nor highly stretchable. Here we report an electrolyte comprising polyacrylic acid dual crosslinked by hydrogen bonding and vinyl hybrid silica nanoparticles, which displays all superior functions and provides a solution to the intrinsic self-healability and high stretchability problems of a supercapacitor. Supercapacitors with this electrolyte are non-autonomic self-healable, retaining the capacitance completely even after 20 cycles of breaking/healing. These supercapacitors are stretched up to 600% strain with enhanced performance using a designed facile electrode fabrication procedure.

Abstract: Although promising results have been achieved in the areas of traffic-sign detection and classification, few works have provided simultaneous solutions to these two tasks for realistic real world images. We make two contributions to this problem. Firstly, we have created a large traffic-sign benchmark from 100000 Tencent Street View panoramas, going beyond previous benchmarks. It provides 100000 images containing 30000 traffic-sign instances. These images cover large variations in illuminance and weather conditions. Each traffic-sign in the benchmark is annotated with a class label, its bounding box and pixel mask. We call this benchmark Tsinghua-Tencent 100K. Secondly, we demonstrate how a robust end-to-end convolutional neural network (CNN) can simultaneously detect and classify trafficsigns. Most previous CNN image processing solutions target objects that occupy a large proportion of an image, and such networks do not work well for target objects occupying only a small fraction of an image like the traffic-signs here. Experimental results show the robustness of our network and its superiority to alternatives. The benchmark, source code and the CNN model introduced in this paper is publicly available1.

Abstract: BackgroundThe efficacy of fusion surgery in addition to decompression surgery in patients who have lumbar spinal stenosis, with or without degenerative spondylolisthesis, has not been substantiated in controlled trials. MethodsWe randomly assigned 247 patients between 50 and 80 years of age who had lumbar spinal stenosis at one or two adjacent vertebral levels to undergo either decompression surgery plus fusion surgery (fusion group) or decompression surgery alone (decompression-alone group). Randomization was stratified according to the presence of preoperative degenerative spondylolisthesis (in 135 patients) or its absence. Outcomes were assessed with the use of patient-reported outcome measures, a 6-minute walk test, and a health economic evaluation. The primary outcome was the score on the Oswestry Disability Index (ODI; which ranges from 0 to 100, with higher scores indicating more severe disability) 2 years after surgery. The primary analysis, which was a per-protocol analysis, did not include the 1...

Abstract: Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent. However, for the intensivist, challenges often exist that complicate patient support and stabilization. Furthermore, burn wounds are complex and can present unique difficulties that require late intervention or life-long rehabilitation. In addition to improvements in patient stabilization and care, research in burn wound care has yielded advancements that will continue to improve functional recovery. This article reviews recent advancements in the care of burn patients with a focus on the pathophysiology and treatment of burn wounds.