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Nitrogen oxide (NOx) emissions from heavy-duty diesel vehicles (HDDVs) have adverse effects on human health and the environment. On-board monitoring (OBM), which can continuously collect vehicle performance and NOx emissions throughout the operation lifespan, is recognized as the core technology for future vehicle in-use compliance, but its large-scale application has not been reported. Here, we utilized OBM data from 22,520 HDDVs in China to evaluate their real-world NOx emissions. Our findings showed that China VI HDDVs had a 73% NOx emission reduction compared with China V vehicles, but a considerable proportion still faced a significant risk of higher NOx emissions than the corresponding limits...

BACKGROUND: Many factors contribute to developing and conducting a successful multi-data source, non-interventional, post-authorization safety study (NI-PASS) for submission to multiple health authorities. Such studies are often large undertakings; evaluating and sharing lessons learned can provide useful insights to others considering similar studies. OBJECTIVES: We discuss challenges and key methodological and organizational factors that led to the delivery of a successful post-marketing requirement (PMR)/PASS program investigating the risk of cardiovascular and cancer events among users of mirabegron, an oral medication for the treatment of overactive bladder...

In the Netherlands, drug regulatory science is a vibrant national and internationally oriented community. In this review, we present the factors that have contributed to this successful collaboration between relevant stakeholders and that led to a surge of activities around how regulatory science became embedded in the ecosystem of medicines research, clinical pharmacology, policymaking and regulation. We distinguished three pivotal episodes: (i) TI Pharma Escher-project, (ii) Dutch Medicines Evaluation Board as catalyst of the big jump, and (iii) Regulatory Science Network Netherlands and multistakeholder engagement...

Sebaceous gland carcinomas are rare malignant cutaneous adnexal tumors with sebocytic differentiation. The typical predilection area is the head and neck region, where sebaceous gland carcinomas are the most common malignant adnexal tumors of the skin. According to their localization a distinction is made between periocular and extraocular sebaceous gland carcinomas. Muir-Torre syndrome (MTS) should always be ruled out if it is suspected. In terms of prognosis, sebaceous gland carcinomas are potentially aggressive tumors with a clear tendency to recur and metastasize...

INTRODUCTION: SARS COVID-19 pandemic resulted in major changes to how daily life was conducted. Health officials instituted policies to decelerate the spread of the virus, resulting in changes in physical activity patterns of school-aged children. The aim of this study was to utilize a wearable activity monitor to assess ambulatory activity in elementary-school aged children in their home environment during a COVID-19 Stay-at-Home mandate. METHODS: This institutional review board approved research study was performed between April 3rd - May 1st of 2020 during which health officials issued several stay-at-home (shelter-in-place) orders...

In this work, we demonstrate the training, conversion, and implementation flow of an FPGA-based bin-ratio ensemble spiking neural network applied for radioisotope identification. The combination of techniques including learned step quantisation (LSQ) and pruning facilitated the implementation by compressing the network's parameters down to 30% yet retaining the accuracy of 97.04% with an accuracy loss of less than 1%. Meanwhile, the proposed ensemble network of 20 3-layer spiking neural networks (SNNs), which incorporates 1160 spiking neurons, only needs 334 μs for a single inference with the given clock frequency of 100 MHz...

High-power-density electronic devices under vibrations call for soft and damping thermal interface materials (TIMs) for efficient heat dissipation. However, integrating low hardness, high damping, and superior heat transfer capability into one TIM is highly challenging. Herein, soft, damping, and thermally conductive TIMs are designed and prepared by constructing a honeycomb-board-mimetic boron nitride nanosheet (BNNS) network in a dynamic polyimine via one-step horizontal centrifugal casting. The unique filler network makes the TIMs perform a high through-plane thermal conductivity (> 7...

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CONTEXT: Pain is a prevalent symptom in patients with serious illness and often requires interventional approaches for adequate treatment. Little is known about referral patterns and collaborative attitudes of palliative physicians regarding pain management specialists. OBJECTIVES: To evaluate referral rates, co-management strategies, and beliefs of palliative physicians about the value of Pain Medicine specialists in patients with serious illness. METHODS: A 30-question survey with demographic, referral/practice, and attitudes/belief questions was mailed to 1000 AAHPM physician members...

Adequate protection of the environment is one of the hot spots of concern for all sectors of society due to severe environmental pollution. The solution to this issue is friendly management of the environment. With the rapid growth of Chinese Manufacturing SMEs for economic development, environmental pollution and abuse of resources are arising. To resolve these issues, Chinese manufacturing SMEs are accelerating the implementation of green innovation in their industries. However, it is a complex task that involves enterprise, government, and social considerations...

INTRODUCTION: Revision Anterior cruciate ligament reconstruction (ACLR) is a challenging surgery occurring in 3-24% of primary reconstructions. A meticulous planning to study the precise size and location of both femoral and tibial bone tunnels is mandatory. The aim of the study was to evaluate the intra- and inter-operator differences in the decision-making process between experienced surgeons after they were asked to make pre-operative planning for ACL revision reconstruction with the use of both the CT scan and a 3D printed model of the knee...

OBJECTIVES: Robustness of radiomic features in physiological tissue is an important prerequisite for quantitative analysis of tumor biology and response assessment. In contrast to previous studies which focused on different tumors with mostly short scan-re-scan intervals, this study aimed to evaluate the robustness of radiomic features in cancer-free patients and over a clinically encountered inter-scan interval. MATERIALS AND METHODS: Patients without visible tumor burden who underwent at least two portal-venous phase dual energy CT examinations of the abdomen between May 2016 and January 2020 were included, while macroscopic tumor burden was excluded based upon follow-up imaging for all patients (≥3 months)...

BACKGROUND: Oral assessments are essential components of board certification in numerous fields, as they provide insight into problem-solving capacity and clinical reasoning. The development of clinical reasoning often begins in undergraduate medical education and remains a challenge to assess. OBJECTIVE: We developed a pilot oral assessment to evaluate medical student oral presentations and systematically assess clinical reasoning. This was incorporated into a previously existing cumulative assessment at the conclusion of the third year of medical school, with the intent to demonstrate feasibility and future reliability of this exam format...

OBJECTIVE: This study aims to evaluate ChatGPT's performance in addressing real-world otolaryngology patient questions, focusing on accuracy, comprehensiveness, and patient safety, to assess its suitability for integration into healthcare. METHODS: A cross-sectional study was conducted using patient questions from the public online forum Reddit's r/AskDocs, where medical advice is sought from healthcare professionals. Patient questions were input into ChatGPT (GPT-3...

INTRODUCTION: Emergency clinical research has played an important role in improving outcomes for acutely ill patients. This is due in part to regulatory measures that allow Exception From Informed Consent (EFIC) trials. The Food and Drug Administration (FDA) requires sponsor-investigators to engage in community consultation and public disclosure activities prior to initiating an Exception From Informed Consent trial. Various approaches to community consultation and public disclosure have been described and adapted to local contexts and Institutional Review Board (IRB) interpretations...

BACKGROUND Clinical Trials (CTs) are essential for the formation of a new medicine. This questionnaire-based study included 179 male third- and fourth-year PharmD undergraduate students from Riyadh, Saudi Arabia, between 18 and 23 years of age, was conducted in 2022, and aimed to evaluate student knowledge and attitudes toward CTs. MATERIAL AND METHODS A cross-sectional study was conducted using self-administered questionnaires. The data was collected using convenience sampling. Part 1 of the study collected demographics, with 6 items; part 2 measured knowledge about CTs (9 items); part 3 measured attitudes (5 items) measured on a 5-point Likert scale...

Recently, there has been increased interest in adopting novel sensing technologies for continuously monitoring structural systems. In this respect, micro-electrical mechanical system (MEMS) sensors are widely used in several applications, including structural health monitoring (SHM), in which accelerometric samples are acquired to perform modal analysis. Thanks to their significantly lower cost, ease of installation in the structure, and lower power consumption, they enable extensive, pervasive, and battery-less monitoring systems...

Recently, the community has seen a rise in interest and development regarding holographic antennas. The planar hologram is made of subwavelength metal patches printed on a grounded dielectric board, constituting flat metasurfaces. When a known reference wave is launched, the hologram produces a pencil beam towards a prescribed direction. Most earlier works on such antennas have considered only a single beam. For the few later ones that studied multiple beams, they were achieved either by having each beam taken care of by a distinct frequency or by partitioning the hologram, thereby depriving each beam of the directivity it could have had it not shared the holographic aperture with other beams...

Solid-state hydrogen storage technology has emerged as a disruptive solution to the "last mile" challenge in large-scale hydrogen energy applications, garnering significant global research attention. This paper systematically reviews the Chinese research progress in solid-state hydrogen storage material systems, thermodynamic mechanisms, and system integration. It also quantitatively assesses the market potential of solid-state hydrogen storage across four major application scenarios: on-board hydrogen storage, hydrogen refueling stations, backup power supplies, and power grid peak shaving...

This paper illustrates an experimental activity for the closed-loop position control of an actuator made using shape memory alloy (SMA) wire. A solution with the self-sensing effect was implemented to miniaturize the systems, i.e., without external sensors. A proportional control algorithm was initially used, demonstrating the idea's feasibility; the wire can behave simultaneously as an actuator and sensor. An experimental investigation was subsequently conducted for the optimization of the developed actuator...