一种改进的多学习教与学优化算法

针对传统教与学算法在解决复杂多峰函数优化问题时,具有局部最优且搜索开发能力较差的缺点,提出了一种改进的多学习教与学优化算法,新算法为学员的每一维加入不同的教学因子,设计了基于学员均值比较的教师选择策略和向教师及学员学习的多学习策略。基于多个单峰和多峰函数的仿真结果表明,新算法跟传统的、改进的教与学算法相比,在稳定性、寻优精度和收敛速度方面更具优势。     

Discordant fetal sex on NIPT and ultrasound

Prenatal diagnosis of sex discordance is a relatively new phenomenon. Prior to cell-free DNA testing, the diagnosis of a disorder of sexual differentiation was serendipitous, either through identification of ambiguous genitalia at the midtrimester morphology ultrasound or discovery of genotype-phenotype discordance in cases where preimplantation genetic diagnosis or invasive prenatal testing had occurred. The widespread integration of cfDNA testing into modern antenatal screening has made sex chromosome assessment possible from 10 weeks of gestation, and discordant fetal sex is now more commonly diagnosed prenatally, with a prevalence of approximately 1 in 1500-2000 pregnancies. Early detection of phenotype-genotype sex discordance is important as it may indicate an underlying genetic, chromosomal or biochemical condition and it also allows for time-critical postnatal treatment. The aim of this article is to review cfDNA and ultrasound diagnosis of fetal sex, identify possible causes of phenotype-genotype discordance and provide a systematic approach for clinicians when counseling and managing couples in this circumstance.     

Placental MRI and its application to fetal intervention

Objective

Magnetic resonance imaging (MRI) of placental invasion has been part of clinical practice for many years. The possibility of being better able to assess placental vascularization and function using MRI has multiple potential applications. This review summarises up-to-date research on placental function using different MRI modalities.

Method

We discuss how combinations of these MRI techniques have much to contribute to fetal conditions amenable for therapy such as singletons at high risk for fetal growth restriction (FGR) and monochorionic twin pregnancies for planning surgery and counselling for selective growth restriction and transfusion conditions.

Results

The whole placenta can easily be visualized on MRI, with a clear boundary against the amniotic fluid, and a less clear placental-uterine boundary. Contrasts such as diffusion weighted imaging, relaxometry, blood oxygenation level dependent MRI and flow and metabolite measurement by dynamic contrast enhanced MRI, arterial spin labeling, or spectroscopic techniques are contributing to our wider understanding of placental function.

Conclusion

The future of placental MRI is exciting, with the increasing availability of multiple contrasts and new models that will boost the capability of MRI to measure oxygen saturation and placental exchange, enabling examination of placental function in complicated pregnancies.     

An assessment of land-based climate and carbon reversibility in the Australian Community Climate and Earth System Simulator

Future levels of climate change depend not only on carbon emissions but also on carbon uptake by the land and the ocean. Here we are using the Earth system model (ESM1) version of the Australian Community Climate and Earth System Simulator (ACCESS) to explore the potential and impact of removing carbon dioxide (CO₂) from the atmosphere through the climate and carbon cycle reversibility experiment. This experiment builds on the standard Coupled Model Intercomparison Project (CMIP) experiment, increasing CO₂ at 1% per year until 4xCO₂ is reached. The atmospheric CO₂ levels are then decreased at the same rate which brings the CO₂ back to pre-industrial levels. We then continue to run the model with constant CO₂ for another 350 years. Our analysis focuses on the response of the land carbon cycle. We find that carbon stores are largely reversible at the global scale over the timescale of changing CO₂. However, carbon stores continue to decrease after CO₂ returns to its initial value, and the land loses another 40 Pg of carbon (PgC) with the largest change in the tropics. It takes about 300 years beyond the period of changing CO₂ for the carbon stores to recover. Interestingly, we saw strong regional variations in the strength of the land response to changing CO₂. Australia showed the largest increase/decrease in biomass carbon (about 40%) and the largest variability in productivity, which was strongly correlated with rainfall. This highlights the importance of assessing the regional response to understanding the processes underlying the response and the sensitivity of these processes within each model. This understanding will benefit future multi-model analyses of this reversibility experiment. It also illustrates more generally the potential to use Earth system model experiments as part of the evaluation of proposed applications of carbon dioxide removal (CDR) technologies. As such, we recommend that these types of modelling experiments be included when mitigation policies are developed.

     

Comparing the usability and reliability of a generic and a domain-specific medical error taxonomy

Medical error taxonomies are used to report and analyse patient safety incidents. Medical error taxonomies can be generic or domain-specific. In comparing generic and domain-specific medical error taxonomies, the literature compares the information both type of taxonomies classify. There is little evidence the taxonomies have been compared in terms of usability and reliability. Twenty nurses and 21 pharmacists participated in a study comparing the usability and reliability of a generic medical error taxonomy and a medication error taxonomy. The medical error taxonomies utilized were the Patient Safety Event Taxonomy and the NCC MERP Taxonomy of Medication Error. The study found no significant difference in the usability ratings of both taxonomies. The taxonomies required different amount of time to classify patient safety incidents and had significantly different reliability levels. The reliability of the NCC MERP Taxonomy of Medication Error was significantly different when used by nurses and pharmacists. The taxonomy was also preferred by the majority of participants. Some recommendations are made about the design of future medical error taxonomies.     

Associations between soil lead concentrations and populations by race/ethnicity and income-to-poverty ratio in urban and rural areas

Lead (Pb) is a well-studied environmental contaminant that has many negative health effects, especially for children. Both racial/ethnic and income disparities have been documented with respect to exposure to Pb in soils. The objectives of this study were to assess whether soil Pb concentrations in rural and urban areas of South Carolina USA, previously identified as having clusters of intellectual disabilities (ID) in children, were positively associated with populations of minority and low-income individuals and children (≤6 years of age). Surface soils from two rural and two urban areas with identified clusters of ID were analyzed for Pb and concentrations were spatially interpolated using inverse distance weighted analysis. Population race/ethnicity and income-to-poverty ratio (ITPR) from United States Census 2000 block group data were aerially interpolated by block group within each area. Urban areas had significantly higher concentrations of Pb than rural areas. Significant positive associations between black, non-Hispanic Latino, individuals and children ≤6 years of age and mean estimated Pb concentrations were observed in both urban (r = 0.38, p = 0.0007) and rural (r = 0.53, p = 0.04) areas. Significant positive associations also were observed between individuals and children with an ITPR < 1.00 and Pb concentrations, though primarily in urban areas. Racial/ethnic minorities and low ITPR individuals, including children, may be at elevated risk for exposure to Pb in soils.     

Space-time stick-breaking processes for small area disease cluster estimation

We propose a space-time stick-breaking process for the disease cluster estimation. The dependencies for spatial and temporal effects are introduced by using space-time covariate dependent kernel stick-breaking processes. We compared this model with the space-time standard random effect model by checking each model’s ability in terms of cluster detection of various shapes and sizes. This comparison was made for simulated data where the true risks were known. For the simulated data, we have observed that space-time stick-breaking process performs better in detecting medium- and high-risk clusters. For the real data, county specific low birth weight incidences for the state of South Carolina for the years 1997–2007, we have illustrated how the proposed model can be used to find grouping of counties of higher incidence rate.