Pareto-Optimal Estimation and Policy Learning on Short-term and Long-term Treatment Effects

This paper focuses on developing Pareto-optimal estimation and policy learning to identify the most effective treatment that maximizes the total reward from both short-term and long-term effects, which might conflict with each other. For example, a higher dosage of medication might increase the speed of a patient's recovery (short-term) but could also result in severe long-term side effects. Although recent works have investigated the problems about short-term or long-term effects or the both, how to trade-off between them to achieve optimal treatment remains an open challenge. Moreover, when multiple objectives are directly estimated using conventional causal representation learning, the optimization directions among various tasks can conflict as well. In this paper, we systematically investigate these issues and introduce a Pareto-Efficient algorithm, comprising Pareto-Optimal Estimation (POE) and Pareto-Optimal Policy Learning (POPL), to tackle them. POE incorporates a continuous Pareto module with representation balancing, enhancing estimation efficiency across multiple tasks. As for POPL, it involves deriving short-term and long-term outcomes linked with various treatment levels, facilitating an exploration of the Pareto frontier emanating from these outcomes. Results on both the synthetic and real-world datasets demonstrate the superiority of our method

Optimization of shotcrete manipulator motion trajectory based on AIWCPSO algorithm

To address issues in traditional shotcrete manipulator trajectory planning algorithms, such as abrupt transitions between multiple path segments and low shotcrete efficiency and uniformity caused by frequent starts and stops, an optimized motion trajectory method based on the adaptive inertia weight and acceleration coefficient particle swarm optimization (AIWCPSO) algorithm was proposed. An improved multi-segment trajectory planning algorithm was developed, which incorporated a transition strategy combining linear and arc trajectories. Vertical linear motion was replaced with arc motion. Additionally, a sinusoidal acceleration and deceleration start-stop algorithm was used to plan the trajectory of the end effector of the manipulator at start and stop points to prevent abrupt changes in acceleration. The middle segment of linear and arc trajectories was planned for uniform motion, ensuring smooth and uniform movement at the end effector of the manipulator. Using the AIWCPSO algorithm, motion parameters were optimized under kinematic constraints to achieve the optimal shotcrete time and speed, thereby improving the efficiency and uniformity of the shotcrete manipulator. Experimental results showed that, compared with traditional trajectory planning algorithms, the improved multi-segment trajectory planning algorithm increased average shotcrete efficiency by 25.42% and significantly improved the uniformity of shotcrete trajectory. After optimization with the AIWCPSO algorithm, shotcrete efficiency increased by 1.330 8%

Can ischemic stroke patients with mTICI of 2b achieve similar outcomes compared to those with complete recanalization following endovascular therapy?

Background and purposeEndovascular therapy (EVT) has been used as a standard treatment method for patients with large vessel ischemic stroke within 24 h of the onset. The extent of recanalization after EVT can be assessed using the modified thrombolysis in cerebral infarction (mTICI) scale as an accepted angiographic grading system. In this study, we aimed to investigate whether patients with a mTICI grade of 2b achieve similar outcomes compared to those with complete recanalization (mTICI of 3) following EVT for acute ischemic stroke.MethodsA retrospective analysis was conducted on 196 consecutive patients who underwent EVT in a comprehensive stroke center. In the final study, 176 patients were included based on the inclusion criteria. The primary outcome was the 3-month modified Rankin Scale (mRS) of 0–2 considered as a favorable outcome, while excellent outcomes were defined as mRS scores of 0–1.ResultsOur data showed that 59.46% of patients in the mTICI 2b group achieved a favorable outcome, comparable to 58.99% observed in the mTICI 3 group (p = 0.959). Additionally, 54.05% (n = 37) of patients with mTICI 2b achieved an excellent outcome, compared to 51.80% (n = 139) in the mTICI 3 group (p = 0.807). The case fatality rates were also comparable between the groups, with 8.11% in the mTICI 2b group and 10.79% in the mTICI 3 group (p = 0.632). Overall, there were no statistically significant differences between the two groups in terms of 3-month favorable outcomes, excellent outcomes, or mortality.ConclusionSimilar 3-month outcomes can be achieved for ischemic stroke patients undergoing EVT with a mTICI grade of 2b compared to those with a mTICI grade of 3. These data can help clinicians in setting realistic expectations and making informed decisions during EVT procedures

Age-Dependent Up-Regulation of HCN Channels in Spiral Ganglion Neurons Coincide With Hearing Loss in Mice

Age-related hearing loss (AHL) is the most common sensory disorder in the elderly population, and the etiologies are diverse. To understand the underlying mechanisms of AHL, one strategy is to identify correlates of the disease for comprehensive evaluation of treatment approaches. Dysfunction and degeneration of spiral ganglion neurons (SGNs) are major contributors to AHL. Previously, we showed that one of the changes in the aging auditory system is SGN excitability increase in mice. Since hyperpolarization-activated cyclic nucleotide-gated (HCN) channels play important roles in determining neuronal excitability, we predicted that HCN channels in SGNs are involved in AHL. To investigate the contribution of HCN channels to AHL, we examined the expression and biophysical properties of HCN channels in SGNs from adult (2–3 months) and 11–12-month-old mice. We report a dramatic increase of HCN channel current (Ih) in SGNs in old mice (11–12 months old). The results matched well with increased expression of HCN1 and HCN2 subunits, suggesting that upregulation of HCN channels in SGNs is one of the important facets of the aging SGNs. Moreover, the activity of Ih produced a major impact on the firing properties of SGNs in older mice. The upregulation of Ih may contribute to AHL by regulating SGN excitability. We assessed whether increased SGNs excitability dovetail with neurodegeneration. Apoptosis-inducing factor (AIF)-mediated apoptosis in SGNs was observed in old mice and activation of HCN channels mediates AIF activation. Thus, these findings demonstrate stark correlation between age-dependent increased expression of HCN channels and Ih, and apoptosis in SGNs, which may contribute towards the varied mechanisms of AHL

Safety and Efficacy of Direct Oral Anticoagulants in Stroke Prevention in Patients With Atrial Fibrillation Complicated With Anemia and/or Thrombocytopenia: A Retrospective Cohort Study

BACKGROUND: There are limited data about the clinical benefits and harm of direct oral anticoagulants (DOACs) in stroke prevention in patients with atrial fibrillation (AF) complicated with anemia or thrombocytopenia. METHODS: This is a multi-center retrospective cohort study involving 5469 AF patients from 15 hospitals in China. Patients were divided into three groups according to hemoglobin and platelet levels: Group 1 (hemoglobin male ≥ 130 g/L; female ≥ 120 g/L and platelet ≥ 100 × 10 RESULTS: Higher hemoglobin levels were associated with a reduced risk of total bleeding and major bleeding, while platelet counts were not associated with any event. Compared with Group 1, Group 2 had a higher risk of major bleeding (aOR 1.70, 95%CI 1.12-2.57, P = 0.012), and the composite endpoint of major bleeding and thrombosis (aOR 1.70, 95%CI 1.19-2.44, P = 0.004). Compared with Group 1, Group 3 had a higher total bleeding risk (aOR 2.15, 95%CI 1.14-4.05, P = 0.018). Compared with dabigatran, rivaroxaban was associated with higher composite risk in Group 1 (aOR 2.91, 95% CI 1.66-5.16, P \u3c 0.001) and Group 2 (aOR 3.05, 95%CI 1.46-6.39, P = 0.003), but there was no significant difference in Group 3 (aOR 1.78, 95%CI 0.23-13.54, P = 0.577). CONCLUSIONS: Higher hemoglobin levels are associated with a reduced risk of total bleeding and major bleeding in patients with AF. Dabigatran was associated with better clinical outcomes than rivaroxaban in patients with anemia or thrombocytopenia but not in those with anemia and thrombocytopenia

ATOMS : ALMA Three-millimeter Observations of Massive Star-forming regions - VIII. A search for hot cores by using C2H5CN, CH3OCHO, and CH3OH lines

Hot cores characterized by rich lines of complex organic molecules are considered as ideal sites for investigating the physical and chemical environments of massive star formation. We present a search for hot cores by using typical nitrogen- and oxygen-bearing complex organic molecules (C2H5CN, CH3OCHO, and CH3OH), based on ALMA Three-millimeter Observations of Massive Star-forming regions (ATOMS). The angular resolutions and line sensitivities of the ALMA observations are better than 2 arcsec and 10 mJy beam(-1), respectively. A total of 60 hot cores are identified with 45 being newly detected, in which the complex organic molecules have high gas temperatures (> 100 K) and hot cores have small source sizes (< 0.1 pc). So far, this is the largest sample of hot cores observed with similar angular resolution and spectral coverage. The observations have also shown nitrogen and oxygen differentiation in both line emission and gas distribution in 29 hot cores. Column densities of CH3OH and CH3OCHO increase as rotation temperatures rise. The column density of CH3OCHO correlates tightly with that of CH3OH. The pathways for production of different species are discussed. Based on the spatial position difference between hot cores and ultracompact H ii (UC H ii) regions, we conclude that 24 hot cores are externally heated, while the other hot cores are internally heated. The observations presented here will potentially help establish a hot core template for studying massive star formation and astrochemistry.Peer reviewe

ATOMS : ALMA three-millimeter observations of massive star-forming regions - III. Catalogues of candidate hot molecular cores and hyper/ultra compact H II regions

A correction has been published: Monthly Notices of the Royal Astronomical Society, Volume 511, Issue 1, March 2022, Pages 501–505, https://doi.org/10.1093/mnras/stac039We have identified 453 compact dense cores in 3mm continuum emission maps in the ALMA Three-millimetre Observations of Massive Star-forming regions survey, and compiled three catalogues of high-mass star-forming cores. One catalogue, referred to as hyper/ultra compact (H/UC)-HII catalogue, includes 89 cores that enshroud H/UC HII regions as characterized by associated compact H40 alpha emission. A second catalogue, referred to as pure s-cHMC, includes 32 candidate hot molecular cores (HMCs) showing rich spectra (N >= 20 lines) of complex organic molecules (COMs) and not associated with H/UC-HII regions. The third catalogue, referred to as pure w-cHMC, includes 58 candidate HMCs with relatively low levels of COM richness and not associated with H/UC-Hii regions. These three catalogues of dense cores provide an important foundation for future studies of the early stages of high-mass star formation across the Milky Way. We also find that nearly half of H/UC-HII cores are candidate HMCs. From the number counts of COM-containing and H/UC-HII cores, we suggest that the duration of high-mass protostellar cores showing chemically rich features is at least comparable to the lifetime of H/UC-HII regions. For cores in the H/UC-HII catalogue, the width of the H40 alpha line increases as the core size decreases, suggesting that the non-thermal dynamical and/or pressure line-broadening mechanisms dominate on the smaller scales of the H/UC-HII cores.Peer reviewe