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关键词： Stroke   physiotherapy   occupational therapy   speech and language therapy   psychology   length of stay   disability   rehabilitation  

摘要： Objective: To create a classification system based on stroke-related impairments. Data source: All adults with stroke admitted for at least 72 hours in England, Wales and Northern Ireland from July 2013 to July 2015 extracted from the Sentinel Stroke National Audit Programme Analysis: Impairments were defined using the National Institute of Health Stroke Scale scores at admission. Common combinations of impairments were identified based on geometric coding and expert knowledge. Validity of the classification was assessed using standard descriptive statistics to report and compare patients' characteristics, therapy received and outcomes in each group. Results: Data from 94,905 patients were extracted. The items of the National Institute of Health Stroke Scale (on admission) were initially grouped into four body systems: Cognitive, Motor, Sensory and Consciousness. Seven common combinations of these impairments were identified (in order of stroke severity);Patients with Loss of Consciousness (n = 6034, 6.4%);those with Motor + Cognitive + Sensory impairments (n = 28,226, 29.7%);Motor + Cognitive impairments (n = 16,967, 17.9%);Motor + Sensory impairments (n = 9882, 10.4%);Motor Only impairments (n = 20,471, 21.6%);Any Non-Motor impairments (n = 7498, 7.9%);and No Impairments (n = 5827, 6.1%). There was a gradation of age, premorbid disability, mortality and disability on discharge. People with the most and least severe categories were least likely to receive therapy, and received least therapy (-20 minutes/day of stay) compared to -35 minutes/day of stay for the moderately severe categories. Conclusions: A classification system of seven Stroke Impairment Categories has been presented.

关键词： debris‐   covered glaciers   Himalaya   mountain meteorology   WRF  

摘要： Many of the glaciers in the Nepalese Himalaya are partially covered in a layer of loose rock known as debris cover. In the Dudh Koshi River Basin, Nepal, approximately 25% of glaciers are debris-covered. Debris-covered glaciers have been shown to have a substantial impact on near-surface meteorological variables and the surface energy balance, in comparison to clean-ice glaciers. The Weather Research and Forecasting (WRF) model is often used for high-resolution weather and climate modelling, however representation of debris-covered glaciers is not included in the standard land cover and soil categories. Here we include a simple representation of thick debris-covered glaciers in the WRF model, and investigate the impact on the near-surface atmosphere over the Dudh Koshi River Basin for July 2013. Inclusion of this new category is found to improve the model representation of near-surface temperature and relative humidity, in comparison with a simulation using the default category of clean-ice glaciers, when compared to observations. The addition of the new debris-cover category in the model warms the near-surface air over the debris-covered portion of the glacier, and the wind continues further up the valley, compared to the simulation using clean-ice. This has consequent effects on water vapour and column-integrated total water path, over both the portions of the glacier with and without debris cover. Correctly simulating meteorological variables such as these is vital for accurate precipitation forecasts over glacierized regions, and therefore estimating future glacier melt and river runoff in the Himalaya. These results highlight the need for debris cover to be included in high-resolution regional climate models over debris-covered glaciers.

关键词： accelerated failure time (AFT) model   categorical covariate   Laplace transform   risk-adjusted control chart   three-point frailty model  

摘要： Monitoring surgical outcomes is of paramount importance especially by accounting for health conditions of the patients prior to surgery. However, the problem arises as the effect of some covariates is pronounced but cannot be measured. In this paper, in order to deal with the effect of measured and unmeasured (categorical) covariates simultaneously, a class of survival analysis regression models called accelerated failure time (AFT) model and discrete frailty models is integrated and some Phase II risk-adjusted control schemes are devised to monitor the patients' lifetime. Three monitoring procedures including the cumulative sum (CUSUM), exponentially weighted moving average (EWMA), and probability limits-based control charts are developed in the presence and absence of censored observations. The performance analysis reveals that the proposed AFT frailty-based CUSUM control chart outweighs the competing counterparts in detecting shifts under various scenarios. Subsequently, two CUSUM control charts have been constructed corresponding to the cases of neglecting both the unmeasured and measured covariates and ignoring just the unmeasured covariate. The results clearly indicate that the detection ability for both of the mentioned CUSUM control charts declines, and including the unmeasured and measured covariates is critical while monitoring surgical outcomes. Finally, a real case study in a cardiac surgical center in the United Kingdom has been provided to investigate the application of the proposed AFT frailty-based CUSUM control scheme.

关键词： Read-across   Uncertainty   Read-across assessment framework   New approach methodology   Triazole fungicides  

摘要： A group of triazole compounds was selected to investigate the confidence that may be associated with read-across of a complex data gap: repeated dose toxicity. The read-across was evaluated using Assessment Elements (AEs) from the European Chemicals Agency's (ECHA's) Read-Across Assessment Framework (RAAF), alongside appraisal of associated uncertainties. Following an initial read-across based on chemical structure and properties, uncertainties were reduced by the integration of data streams such as those from New Approach Methodologies (NAM) and other existing data. In addition, addressing the findings of the ECHA RAAF framework, complemented with specific questions concerning uncertainties, increased the confidence that can be placed in read-across. Although a data rich group of compounds with a strong mechanistic basis was analysed, it was clearly demonstrated that NAM data available from publicly available resources could be applied to support read-across. It is acknowledged that most read-across studies will not be so data rich or mechanistically robust, therefore some targeted experimentation may be required to fill the data gaps. In this sense, NAMs should constitute new experimental tests performed with the specific goal of reducing the uncertainties and demonstrating the read-across hypothesis.

关键词： cancer-specific survival   differentiated thyroid carcinoma   extrathyroidal extension   SEER   strap muscles  

摘要： Objective As per the eighth edition of the American Joint Committee on Cancer (AJCC) staging system for differentiated thyroid carcinoma (DTC), minimal extrathyroidal extension (mETE) has been removed. Instead, gross ETE (gETE) invading only strap muscles has been designated as a new T3b category. Our objective was to investigate the impact of the T3b category on survival in order to establish its prognostic value in DTC. Design In this retrospective study, we included patients who had undergone thyroidectomy between 2004 and 2012. Data from the Surveillance, Epidemiology and End Results (SEER) database were examined. Methods We used the Kaplan-Meier method and log-rank test to analyse overall survival (OS) and cancer-specific survival (CSS). The effect of potential predictors associated with survival were estimated using the Cox regression model. To minimize selection bias, propensity-score matching (PSM) was performed. Results A total of 63 315 patients were included in our study. During the average follow-up duration of nearly 78 months, significant differences were observed in cancer-specific survival among patients with no ETE, mETE, gETE invading only strap muscles (T3b) and gETE invading perithyroidal structures other than strap muscles (T4) (P < .05). In univariable and multivariate analysis, both mETE and T3b exhibited significant poorer CSS compared with no ETE. After adjusting for patient features with PSM, it was confirmed that T3b was associated with worse CSS compared with no ETE and mETE. Conclusions Both mETE and gETE are independent factors for DTC, implying that the new T3b category is worthy of reference for medical workers. Furthermore, mETE was significantly associated with poorer outcome. Our conclusion may provide support for the modification of the TNM staging system in the future.

关键词： Clustering algorithms  

摘要： Nowadays, urban multimodal big data are freely available to the public due to the growing number of cities, which plays a critical role in many fields such as transportation, education, medical treatment, and land resource management. The successful completion of poverty-relief work can greatly improve the quality of people's life and ensure the sustainable development of the society. Poverty is a severe challenge for human society. It is of great significance to apply machine learning to mine different categories of poverty-stricken households and further provide decision support for poverty alleviation. Traditional poverty alleviation methods need to consume a lot of manpower, material resources, and financial resources. Based on the density-based spatial clustering of applications with noise (DBSCAN), this paper designs the hierarchical DBSCAN clustering algorithm to identify and analyze the categories of poverty-stricken households in China. First, the proposed method adjusts the neighborhood radius dynamically for dividing the data space into several initial clusters with different densities. Then, neighbor clusters are identified by the border and inner distances constantly and aggregated recursively to form new clusters. Based on the idea of division and aggregation, the proposed method can recognize clusters of different forms and deal with noises effectively in the data space with imbalanced density distribution. The experiments indicate that the method has the ideal performance of clustering, which identifies the commonness and difference in characteristics of poverty-stricken households reasonably. In terms of the specific indicator "Accuracy," the accuracy increases by 2.3% compared with other methods.

关键词： Multi-adjoint concept lattice   Formal concept analysis   Rough set theory   Quantaloid   Isbell adjunction   Kan adjunction  

摘要： With quantaloids carefully constructed from multi-adjoint frames, it is shown that multi-adjoint concept lattices, multi-adjoint property-oriented concept lattices and multi-adjoint object-oriented concept lattices are derivable from Isbell adjunctions, Kan adjunctions and dual Kan adjunctions between quantaloid-enriched categories, respectively. (C) 2020 Elsevier B.V. All rights reserved.

关键词： n-exangulated categories   (n+2)-angulated categories   n-exact categories  

摘要： Herschend-Liu-Nakaoka introduced the notion of n-exangulated categories. It is not only a higher dimensional analogue of extriangulated categories defined by Nakaoka-Palu, but also gives a simultaneous generalization of n-exact categories and (n + 2)-angulated categories. Let C be an n-exangulated category and X a full subcategory of C. If X satisfies X subset of P boolean AND J, then we give a necessary and sufficient condition for the ideal quotient C / X to be an n-exangulated category, where P (resp. J) is the full subcategory of projective (resp. injective) objects in In addition, we define the notion of n-proper class in C. If xi is an n-proper class in C, then we prove that C admits a new n-exangulated structure. These two ways give n-exangulated categories which are neither n-exact nor (n + 2)-angulated in general. (C) 2020 Elsevier Inc. All rights reserved.

关键词： Generalized near-group fusion category   Generalized Tambara-Yamagami fusion category   Group extension   Fibonacci category  

摘要： We describe the structure of a generalized near-group fusion category and present an example of this class of fusion categories which arises from the extension of a Fibonacci category. We then classify slightly degenerate generalized near-group fusion categories. We also prove a structure result for braided generalized Tambara-Yamagami fusion categories. (C) 2020 Elsevier Inc. All rights reserved.