Aceso: PICO-guided Evidence Summarization on Medical Literature

Evidence-Based Medicine (EBM) aims to apply the best available evidence gained from scientific methods to clinical decision making. A generally accepted criterion to formulate evidence is to use the PICO framework, where PICO stands for Problem/Population, Intervention, Comparison, and Outcome. Automatic extraction of PICO-related sentences from medical literature is crucial to the success of many EBM applications. In this work, we present our Aceso system, which automatically generates PICO-based evidence summaries from medical literature. In Aceso 1, we adopt an active learning paradigm, which helps to minimize the cost of manual labeling and to optimize the quality of summarization with limited labeled data. An UMLS2Vec model is proposed to learn a vector representation of medical concepts in UMLS 2, and we fuse the embedding of medical knowledge with textual features in summarization. The evaluation shows that our approach is better on identifying PICO sentences against state-of-the-art studies and outperforms baseline methods on producing high-quality evidence summaries.

An energy efficient time-mode digit classification neural network implementation

This paper presents the design of an ultra-low energy neural network that uses time-mode signal processing). Handwritten digit classification using a single-layer artificial neural network (ANN) with a Softmin-based activation function is described as an implementation example. To realize time-mode operation, the presented design makes use of monostable multivibrator-based multiplying analogue-to-time converters, fixed-width pulse generators and basic digital gates. The time-mode digit classification ANN was designed in a standard CMOS 0.18 μm IC process and operates from a supply voltage of 0.6 V. The system operates on the MNIST database of handwritten digits with quantized neuron weights and has a classification accuracy of 88%, which is typical for single-layer ANNs, while dissipating 65.74 pJ per classification with a speed of 2.37 k classifications per second. This article is part of the theme issue 'Harmonizing energy-autonomous computing and intelligence'.

The Effect of Type 2 Diabetes Mellitus on Neuropsychological Symptoms in Chinese Early Alzheimer's Disease Population

OBJECTIVE

To explore the effect of Type 2 diabetes mellitus (T2DM) on the development of neuropsychiatric symptoms (NPS) in early Alzheimer's disease (AD).

METHODS

From September 2017 to March 2019, a cross-sectional study was conducted on the clinical data of 158 early AD patients over 65 years old in the Department of Neurology of Daping Hospital. All early stage of AD patients were divided into early stage of AD with NPS group and early stage of AD without NPS group according to the presence or absence of NPS. Clinical data of age, sex, body mass index (BMI), smoking and alcohol consumption, history of hypertension, hyperlipidemia, white matter leisure (WML) and T2DM, MMSE, CDR and NPI-Q scores were collected. Multivariate logistic regression analyses were performed to examine the relationship between T2DM and NPS in early AD.

RESULTS

Compared with the early stage of AD group without NPS, the early stage of AD group with NPS was older, the proportion of women was higher, the proportion of T2DM, hypertension, hyperlipidemia and WML was higher, and the MMSE score was lower (P< 0.05). T2DM was an independent risk factor for NPS in early stage of AD patients (OR 3.48, 95% CI 2.91-3.84). The incidence of T2DM in AD patients with depression, anxiety, nighttime behavioral disturbances, and appetite disturbances was significantly higher than in AD patients without these symptoms. T2DM was an independent risk factor of depression (OR 2.04, 95% CI 1.71-2.38), anxiety (OR 1.69, 95% CI 1.38-1.97), nighttime behavioral disturbances (OR 1.95, 95% CI 1.75-2.13) and appetite disturbances (OR 1.62, 95% CI 1.33-1.94) in early AD patients.

CONCLUSION

T2DM was an important independent risk factor for NPS in early AD, which promotes the occurrence of depression, anxiety, nighttime behavioral disturbances and appetite disturbances in early AD.

[Protective effect of excretory-secretory protein from adult Trichinella spiralis on ovalbumin-induced allergic rhinitis in mice]

OBJECTIVE

To investigate the protective effect of excretory-secretory protein (AES) from adult Trichinella spiralis on ovalbumin (OVA)-induced allergic rhinitis in mice.

METHODS

Eighteen female BALB/c mice were randomly divided into three groups, including the blank control group (Group A), OVA-induced rhinitis group (Group B) and AES treatment group (Group C). Mice in Group A were given PBS. Mice in Group B were intraperitoneally injected with antigen adjuvant suspension for systemic sensitization, once every other day for seven times; then, local excitation was intranasally induced with 5% OVA solution once a day for seven times to establish a mouse model of allergic rhinitis. In addition to induction of allergic rhinitis, mice in Group C were given 25 μg AES at baseline sensitization and local excitation. Following the final challenge, mice were observed for 30 min in each group, and the behavioral score was evaluated. The serum levels of IFN-γ, IL-4, IL-5, IL-10 and TGF-β were determined using an enzyme-linked immunosorbent assay in mice, and the pathological changes of mouse nasal mucosa were observed under a microscope.

RESULTS

There was a significant difference in the mouse behavioral scores among the three groups (F = 110.12, P < 0.01). The mouse behavioral score was significantly higher in Group B than in Group A (7.17 ± 0.75 vs. 1.33 ± 0.52, P < 0.01), and more remarkable pathological damages of mouse nasal mucosa were seen in Group B than in Group A, while the mouse behavioral score was significantly decreased in Group C than in Group B (P < 0.01), and the pathological damages of mouse nasal mucosa remarkably alleviated in Group C relative to Group B. There was a significant difference in serum IFN-γ level among the three groups (F = 7.50, P < 0.01) and the serum IFN-γ level in Group B was significantly lower than in group A and C (both P < 0.05). There were significant differences in serum IL-4 (F = 470.81, P < 0.01) and IL-5 levels (F =68.20, P < 0.01) among the three groups, and significantly greater serum IL-4 and IL-5 levels were detected in Group B than in Group A (P < 0.01), while significantly lower serum IL-4 and IL-5 levels were detected in Group C than in Group B (P < 0.01). There were significant differences in serum IL-10 (F = 174.91, P < 0.01) and TGF-β levels (F = 9.39, P < 0.01) among the three groups, and significantly greater serum IL-10 and TGF-β levels were seen in Group C than in Group B (both P < 0.05).

CONCLUSIONS

T. spiralis AES has a remarkable protective activity against OVA-induced allergic rhinitis in mice.

MicroRNA-200c suppressed cervical cancer cell metastasis and growth via targeting MAP4K4

OBJECTIVE

To dissect the functioning mode of miR-200c on cervical cancer cell metastasis and growth and provide therapeutic targets for cervical cancer.

PATIENTS AND METHODS

By quantitative Real-time polymerase chain reaction, the miR-200c expression level in 42 pairs of cervical cancer tissue samples and six cervical cancer-derived cell lines were examined. Using miR-200c mimics, we analyzed the effects of miR-200c over-expression on cell proliferation, invasion, and migration. Dual-luciferase activity assay was recruited to examine the potential target gene MAP4K4 that predicted by several databases. Protein level was studied using Western blot.

RESULTS

miR-200c expressed significantly lower in cervical cancer tissue samples and cell lines. And over-expression of miR-200c in cervical cancer cells significantly decreased the cell invasion, migration and proliferation abilities. Dual-luciferase and Western blot confirmed MAP4K4 as a target gene of miR-200c. Furthermore, up-regulation of MAP4K4 counteracted the suppressive effect of miR-200c over-expression on cell growth and metastasis.

CONCLUSIONS

miR-200c could suppress cervical cancer cell proliferation and progression via regulating MAP4K4, which might provide a new target for cervical cancer diagnosis and therapy.

2223Effect of ticagrelor plus aspirin, ticagrelor alone, or aspirin alone on vein-graft patency 1 year after coronary artery bypass grafting with or without diabetes: a post-hoc analysis of the DACAB tria

Introduction

The association of diabetes and vein graft patency after coronary artery bypass grafting (CABG) remains controversial. In patients with diabetes, impaired endothelial function in vein grafts and high platelet turnover might result in early vein graft failure. The DACAB trial showed ticagrelor plus aspirin significantly increased 1-year vein graft patency vs. aspirin alone, while no significant difference between ticagrelor alone and aspirin alone. However, whether the results is different between the patients with or without diabetes is unknown.

Purpose

To assess the effects of ticagrelor with or without aspirin vs. aspirin alone on 1-year vein grafts patency after CABG in patients with or without diabetes.

Methods

We examined the subgroups of patients with and without diabetes from DACAB trial (NCT02201771), in which 500 patients were randomized to 1 of 3 antiplatelet regimens (ticagrelor 90mg twice daily plus aspirin 100mg once daily, T+A group; ticagrelor 90mg twice daily, T group; or aspirin 100mg once daily, A group) within 24 hours post-CABG. The primary outcome was 1-year vein graft patency (FitzGibbon grade A) assessed by multi-slice computed tomographic angiography or coronary angiography.

Results

According to the baseline medical history and/or glycated hemoglobin (HbA1c) ≥6.5%, 283 patients with 818 vein grafts were allocated to the non-diabetes subgroup, remaining 217 patients with 642 vein grafts to the diabetes subgroup. By per-graft analysis, no significant difference on 1-year vein graft patency rate was observed between non-diabetes and diabetes subgroup (84.6% [692/881] for non-diabetes vs. 80.2% [515/642] for diabetes, adjusted odds ratio (OR) =1.39, 95% CI: 0.92–2.09, P=0.116). In T+A group, 1-year vein graft patency rates were 91.0% (244/268) for non-diabetes vs. 85.8% (188/219) for diabetes; In T group, 85.0% (221/260) for non-diabetes vs. 80.3% (183/228) for diabetes; In A group, 78.3% (227/290) for non-diabetes vs. 73.9% (144/195) for diabetes. Ticagrelor plus aspirin showed higher vein graft patency rate than aspirin alone in both non-diabetes and diabetes subgroup (non-diabetes: adjusted OR = 0.34, 95% CI: 0.17–0.69, and diabetes: adjusted OR = 0.42, 95% CI: 0.19–0.91, P for interaction = 0.524), whereas ticagrelor alone did not show improvement on vein graft patency compared with aspirin alone in both subgroups (non-diabetes: adjusted OR=0.62, 95% CI: 0.32–1.20, and diabetes: adjusted OR = 0.65, 95% CI: 0.33–1.31, P for interaction = 0.795). Similar results were showed by per-patient analysis. A total 16 major adverse cardiovascular events occurred, 8 (2.8%) for non-diabetes and 8 (3.7%) for diabetes.

Conclusion

In the DACAB trial, diabetes was not found to be associated with decreased vein graft patency at 1 year after CABG. The effect of ticagrelor plus aspirin on improvement of 1-year vein graft patency, when compared with aspirin alone, is consistent in patients with or without diabetes.

Acknowledgement/Funding

AstraZeneca

[Clinical effects of expanded super-thin perforator flaps in the shoulder, neck, and chest in reconstruction of extensive burn scars in the face]

Objective: To explore the clinical effects and key techniques of expanded super-thin perforator flaps in the shoulder, neck, and chest in reconstruction of extensive burn scars in the face. Methods: From January 2008 to November 2018, 22 patients with extensive burn scars in the face were admitted to the Department of Plastic Surgery of Dongguan Kanghua Hospital and the Department of Plastic Surgery of Dermatology Hospital of Southern Medical University, with 3 males and 19 females, aged from 4 to 48 years. There were 16 cases of type Ⅱ and 6 cases of type Ⅲ in facial scars. Before the first stage of expansion surgery, Doppler blood flow survey meter or multi-slice CT was used to locate the perforator vessels. One to four expanders with rated capacity ranged from 100 to 600 mL were placed in the patients. We gave 20% to 30% of the rated capacity of expander intro-operation and common injection with 10% to 15% of the rated capacity of expander per week post-operation until the volume reached 1.5 to 2.5 times of the rated capacity of expander during the past 3 to 4 months. At the second stage of surgery, the perforators were located again before surgery with the same method. The size of defects after the excision of facial scars ranged from 6 cm×4 cm to 18 cm×16 cm. With perforators used as nutrient vessels, narrow pedicle flaps or random flaps ranging from 6 cm×6 cm to 22 cm×18 cm were elevated as rotating or advancing to reconstruct the defects. The donor sites were sutured directly. Some of the flaps needed stage Ⅲ operation for cutting the pedicle. The survival of flaps, post-operation complications, and follow-up were assessed. Results: All flaps of 22 patients survived. All the donor sites were closed simultaneously. One patient underwent an additional surgery for 5 cm×4 cm necrosis on distal part of flap caused by subcutaneous hematoma. Two patients with epidermis blister on the flaps were healed by themselves after dressing change. Due to rapid expansion, blood capillary proliferation appeared on the central part of the flap in 3 cases, after slowing down the expansion speed properly, which had no impact on flap transfer. No ischemia or venous congestion phenomenon were observed in the other flaps. During follow-up of 5 to 48 months, the flaps of patients showed no significant bloated appearance, with good complexion and texture, and even could reproduce facial fine-grained expressions naturally. Conclusions: For the reconstruction of extensive burn scars in the face, expanded super-thin perforator flaps can not only acquire large and thin flaps with high matching degree surface skin defect, but also reproduce facial fine-grained expressions. It is a simple and safe method which conforms to the facial aesthetic standard.

Outcome-Driven Clustering of Acute Coronary Syndrome Patients Using Multi-Task Neural Network with Attention

Cluster analysis aims at separating patients into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. It is an important approach in data-driven disease classification and subtyping. Acute coronary syndrome (ACS) is a syndrome due to sudden decrease of coronary artery blood flow, where disease classification would help to inform therapeutic strategies and provide prognostic insights. Here we conducted an outcome-driven cluster analysis of ACS patients, which jointly considers treatment and patient outcome as indicators for patient state. Multi-task neural network with attention was used as a modeling framework, including learning of the patient state, cluster analysis, and feature importance profiling. Seven patient clusters were discovered. The clusters have different characteristics, as well as different risk profiles to the outcome of in-hospital major adverse cardiac events. The results demonstrate cluster analysis using outcome-driven multi-task neural network as promising for patient classification and subtyping.

Knowledge Learning Symbiosis for Developing Risk Prediction Models from Regional EHR Repositories

Secondary use of regional EHR data suffers several problems, including data selection bias and limited data size caused by data incompleteness. Here, we propose knowledge learning symbiosis (KLS) as a framework to incorporate domain knowledge to address the problems and make better secondary use of EHR data. Under the framework, we introduce three main categories of methods: knowledge injection to input features, objective functions, and output labels, where knowledge-enhanced neural network (KENN) was first introduced to inject knowledge into objective functions. A case study was conducted to build a cardiovascular disease risk prediction model on the type 2 diabetes patient cohort using regional EHR repositories. By incorporating a well-established knowledge risk model as domain knowledge under our KLS framework, we increased risk prediction performance both on small and biased data, where KENN showed the best performance among all methods.

Facilitating Clinical Trial Recruitment by Recommending Cost-Efficient Medical Exams

Clinical trials are key and essential processes for researchers to develop new treatments as well as evaluate their effectiveness and safety, whilst more than half of all clinical trials experience delays, which leads to a considerable amount of cost. In this paper, we present a cost-effective framework to reduce the time and monetary cost in the stage of recruiting and screening eligible clinical trial participants. By leveraging patients' observed conditions and the cost of medical examinations, the proposed framework uses collaborative filtering techniques to predict the utilized cost for the to-do medical examinations and then rank patients and medical examinations. The preliminary experiment results indicate that the framework is promising to reduce the cost spent on medical examinations by three quarters or even more and accelerate the recruitment process in the screening stage.

Liraglutide suppresses TNF-α-induced degradation of extracellular matrix in human chondrocytes: a therapeutic implication in osteoarthritis

Osteoarthritis (OA) is a major global health problem; however, the etiology of the disease remains unknown and a reliable treatment strategy has yet to be discovered. Modulation of the receptor for glucagon-like peptide 1 (GLP-1) has emerged as a potential treatment strategy for various diseases including OA. In the present study, we investigated the effects of the specific GLP-1 receptor agonist liraglutide on factors of the pathogenesis of OA induced by tumor necrosis factor-α (TNF-α), including oxidative stress, expression of proinflammatory cytokines, degradation of articular cartilage extracellular matrix, and activation of the nuclear factor-κB (NF-κB) pathway. Our findings demonstrate that liraglutide exerted a potent beneficial effect in human primary chondrocytes by downregulating generation of reactive oxygen species and NADPH oxidase 4, suppressing expression of interleukin-6 and monocyte chemoattractant protein 1, rescuing type II collagen and aggrecan from degradation my matrix metalloproteinases and a disintegrin and metalloproteinase with type I thrombospondin motif, and inhibiting activation of the proinflammatory NF-κB signaling pathway. These findings demonstrate a potential role of GLP-1 receptor in the pathogenesis of OA and lay a foundation for further research on the mechanisms behind the potential therapeutic application of liraglutide in the treatment and prevention of OA.

[The existence of orthopaedic clinic in the Qingming Shanghe Tu]

Qingming Shanghe Tu(Along the River During the Qingming Festival) is a traditional Chinese painting created by Zhang Zeduan, a Northern Song Dynasty painter. The painting, which showed us the daily life of citizens in Northern Song's Bianjing(capital of the country), had an important value for studying the society and folkways of the Northern Song Dynasty.Therefore, many articles and books refer to the signboard with words "specialized in the bone-setting" as an evidence to prove the existence of orthopaedic clinics in Northern Song Dynasty.Through textual research, we found signboard with words "specialized in the bone-setting" did not exist in the Qingming Shanghe Tu, but in one of its facsimile titled "Qing Court Version" . The "Qing Court Version" depicted the daily life and culture of the Ming and Qing Dynasties. In conclusion: the previous inference that the orthopaedic therapy was widely applicated among the people of Northern Song Dynasty is inaccurate.

Mutation of the rice TCM12 gene encoding 2,3-bisphosphoglycerate-independent phosphoglycerate mutase affects chlorophyll synthesis, photosynthesis and chloroplast development at seedling stage at low temperatures

Glycolysis is a central metabolic pathway that provides energy and products of primary metabolites. 2,3-Biphosphoglycerate-independent phosphoglycerate mutase (iPGAM) is a key enzyme that catalyses the reversible interconversion of 3-phosphoglycerate (3-PGA) to 2-phosphoglycerate (2-PGA) in glycolysis. Low temperature is a common abiotic stress in rice production. However, the mechanism for rice iPGAM genes is not fully understood at low temperature. In this study, the rice mutant tcm12, with chlorosis, malformed chloroplasts and impaired photosynthesis, was grown at a low temperature (<20 °C) to the three-leaf stage, while the normal phenotype at 32 °C was used. Chlorophyll fluorescence analysis and transmission electron microscopy were used to examine features of the tcm12 mutant. The inheritance behaviour and function of TCM12 were then analysed thorough map-based cloning, transgenic complementation and subcellular localisation. The thermo-sensitive chlorosis phenotype was caused by a single nucleotide mutation (T→C) on the fifth exon of TCM12 (LOC_Os12g35040) encoding iPGAM, localised to both nucleus and membranes. In addition, TCM12 was constitutively expressed, and its disruption resulted in down-regulation of some genes associated with chlorophyll biosynthesis and photosynthesis at low temperatures (20 °C). This is the first report of the involvement of rice iPGAM gene in chlorophyll synthesis, photosynthesis and chloroplast development, providing new insights into the mechanisms underlying early growth of rice at low temperatures.

Association of the Polygenic Risk Score with the Incidence Risk of Parkinson's Disease and Cerebrospinal Fluid α-Synuclein in a Chinese Cohort

Parkinson's disease (PD) is attributed to interactions among genes and environmental and lifestyle factors, but the genetic architecture of PD is complex and not completely understood. To evaluate whether the genetic profile modifies PD development and cerebrospinal fluid (CSF) pathological biomarkers, we enrolled 418 PD patients and 426 age- and sex-matched normal controls. Forty-six single nucleotide polymorphisms (SNPs) that were reported to be significantly associated with PD in large-scale genome-wide association studies (GWASs) were genotyped and analysed. The alleles associated with PD were used to build polygenic risk score (PRS) models to represent polygenic risk. The Cox proportional hazards model and receiver operating characteristic (ROC) analyses were used to evaluate the prediction value of the PRS for PD risk and age at onset. The CSF α-synuclein levels were measured in a subgroup of control subjects (n = 262), and its relationship with the PRS was analysed. We found that some SNPs identified from other populations had significant correlations with PD in our Chinese cohort. The PRS we built had prediction value for PD risk and age at onset. The CSF α-synuclein level had no correlation with the PRS in normal subjects.

Differential expression of sonic hedgehog in lung adenocarcinoma and lung squamous cell carcinoma

Overexpression of Sonic hedgehog (Shh) is associated with progression of several cancers. The expression of Shh in non-small cell lung cancer (NSCLC) has been reported with inconsistent results. Lung adenocarcinoma (LAC) and lung squamous cell carcinoma (LSCC) are two major subtypes of NSCLC, which have different genetic genotypes and clinical therapeutic options. The expression of Shh in specimen of patients with NSCLC has yet to be comprehensively determined according to histological subtypes. Shh expression level was determined in 167 NSCLC patients (56 LAC patients and 111 LSCC patients) by immunohistochemical assay (IHC) and disease-free survival and overall survival of patients were analyzed using the Kaplan-Meier method. Shh protein level in pleural effusion from patients with pneumonia or pleural empyema, tuberculosis, LAC and LSCC was measured with enzyme-linked immunoassay (ELISA). We found that Shh expression is increased in tumor tissues from both LAC and LSCC patients compared with the paired adjacent tissues, while Shh level is negatively correlated with tumor differentiation only in LSCC, LSCC patients containing higher-Shh expression have a poorer prognosis. Furthermore, Shh level is elevated in pleural effusion from LSCC patients compared with that of parapneumonic and LAC pleural effusion. Shh expression in tumor tissues or pleural effusion may represent a potential diagnostic and prognostic marker of LSCC patients, pleural effusion Shh may assist to distinguish between LAC and LSCC.

Genetic Association Between NGFR, ADAM17 Gene Polymorphism, and Parkinson's Disease in the Chinese Han Population

Parkinson's disease (PD) is a common neurodegenerative disease characterized by neuronal loss in the substantia nigra. The p75 neurotrophin receptor (p75NTR, encoded by NGFR) was found to play an important role in the selective neuronal death of dopamine neurons in the substantia nigra, as well as the pathogenesis and development of PD. To assess the association between NGFR gene polymorphism and the susceptibility of PD, this case-control study consisting of 414 PD patients and 623 age- and sex-matched controls in a Chinese Han cohort was conducted. Twelve tag-single nucleotide polymorphisms (tag-SNPs) were selected from the NGFR gene through the construction of linkage disequilibrium blocks. One tag-SNP from the ADAM17 gene was also selected owing to its function of encoding tumor necrosis factor α-converting enzyme, which is responsible for the shedding of the extracellular domain of p75NTR. A multiplex polymerase chain reaction-ligase detection reaction (PCR-LDR) method was applied for genotyping. The associations between tag-SNPs and the risk of PD with the adjustment for age and sex were analyzed by unconditional logistic regression, and five genetic models including codominant, dominant, recessive, over-dominant, and additive models were applied. The results showed that among the 13 tag-SNPs, rs741073 was associated with a reduced risk of PD in the codominant (OR = 0.71, 95% CI = 0.54-0.93, P = 0.037), dominant (OR = 0.76, 95% CI = 0.58-0.98, P = 0.033), and over-dominant models (OR = 0.71, 95% CI = 0.54-0.92, P = 0.010), and rs1804011 was also associated with a reduced risk of PD in the codominant (OR = 0.69, 95% CI = 0.50-0.95, P = 0.049), dominant (OR = 0.69, 95% CI = 0.50-0.93, P = 0.014), over-dominant (OR = 0.70, 95% CI = 0.51-0.96, P = 0.025), and additive models (OR = 0.72, 95% CI = 0.54-0.94, P = 0.016). However, these associations did not retain after Bonferroni correction. Conclusively, our study failed to reveal the association between the selected tag-SNPs within NGFR, ADAM17, and the susceptibility of PD. The role of p75NTR and its gene polymorphisms in the pathogenesis of PD needs to be further studied.

Application of PICCO During Anesthesia of Patients Undergoing Transcatheter Ventricular Isolation Plasty Due to Left Ventricular Aneurysm

INTRODUCTION

Left ventricular aneurysm is a common complication type of myocardial infarction. Percutaneous ventricular restoration (PVR) is a new and minimally invasive surgical method for left ventricular aneurysm. Due to its complication and high demand on the surgeon, careful cooperation of anesthesia work is of great significance for the successful implementation of the operation.

CASE PRESENTATION

During anesthesia, Pulse Index Continuous Cardiac Output (PICCO) not only monitors general hemodynamic parameters, but also displays parameters such as cardiac output, myocardial contractility, pre-cardiac load, etc., which provides important guidance for the anesthetic procedures.

CONCLUSIONS

This study aimed to explore the application of PICCO in the anesthesia of patients by analyzing the clinical anesthesia management of 3 cases of patients undergoing transcatheter ventricular partitioning restoration (TVPR) due to left ventricular aneurysm in the case of analysis.

First Observation of P-odd γ Asymmetry in Polarized Neutron Capture on Hydrogen

We report the first observation of the parity-violating gamma-ray asymmetry A_{γ}^{np} in neutron-proton capture using polarized cold neutrons incident on a liquid parahydrogen target at the Spallation Neutron Source at Oak Ridge National Laboratory. A_{γ}^{np} isolates the ΔI=1, ^{3}S_{1}→^{3}P_{1} component of the weak nucleon-nucleon interaction, which is dominated by pion exchange and can be directly related to a single coupling constant in either the DDH meson exchange model or pionless effective field theory. We measured A_{γ}^{np}=[-3.0±1.4(stat)±0.2(syst)]×10^{-8}, which implies a DDH weak πNN coupling of h_{π}^{1}=[2.6±1.2(stat)±0.2(syst)]×10^{-7} and a pionless EFT constant of C^{^{3}S_{1}→^{3}P_{1}}/C_{0}=[-7.4±3.5(stat)±0.5(syst)]×10^{-11}  MeV^{-1}. We describe the experiment, data analysis, systematic uncertainties, and implications of the result.

Mining Disease-Symptom Relation from Massive Biomedical Literature and Its Application in Severe Disease Diagnosis

Disease-symptom relation is an important biomedical relation that can be used for clinical decision support including building medical diagnostic systems. Here we present a study on mining disease-symptom relation from massive biomedical literature and constructing biomedical knowledge graph from the relation. From 15,970,134 MEDLINE/PubMed citation records, occurrences of 8,514 disease concepts from the Human Disease Ontology and 842 symptom concepts from the Symptom Ontology and their relation were analyzed and characterized. We improve previous disease-symptom relation mining work by: (1) leveraging the hierarchy information of concepts in medical entity association discovery; and (2) including more exquisite relationship with weights between entities for knowledge graph construction. A medical diagnostic system for severe disease diagnosis was implemented based on the constructed knowledge graph and achieved the best performance compared to all other methods.