With aging populations and the increased incidence of cerebrovascular disease, diabetes, and other diseases, more and more patients suffer from pressure injuries. Pressure injuries are often difficult to heal because of the presence of sinus tracts, which make it difficult to clean and change dressings. Sinus wounds are common in patients with pressure injuries, but also occur after abdominal wall incision and in patients who have experienced a physical trauma that created a wound. It is difficult for clinicians to observe, evaluate, and repair sinus wounds because of the small surface defect and large and deep basement of each wound. This article reviews existing assessment methods and treatments for sinus wounds and proposes a new evaluation method and treatment (three-dimensional reconstruction and endoscopic techniques) to further improve treatment and provide better quality of care for patients with this type of wound.=20

3D audio effects can provide immersive auditory experience, but we often face the so-called in-head localization (IHL) problem in headphone sound reproduction. To address this problem, we propose an effective sound image externalization approach. Specifically, we consider several important factors related to sound propagation, which include image-source model based early reflections with distance decay, wall absorption and air absorption, late reverberation and other dynamic factors like head movement. We apply our sound image externalization approach to a headphone based real-time 3D audio system. Subjective listening tests show that the sound image externalization performance is significantly improved and the sound source direction is preserved as well. A/B preference test further shows that, as compared with a recent popular approach, the proposed approach is mostly preferred by the listeners.

Beamforming using sensor array is widely used in spatial signal processing since it offers better spatial focusing capability than single sensor. However, in practical applications for broadband signal, there always exists a trade-off issue between the directivity capability of an array and its robustness on system errors. In this paper, in order to combine merits of different beamformers instead of trade-off their performances, we propose a constrained minimum-power combination method. We firstly analyze two optimal beamformers that maximize Directivity Factor (DF) and White Noise Gain (WNG) respectively. Then we propose a non-linear combination method, which automatically selects the best beamformer that has the minimum output power, so as to control the unwanted white noise amplification and keep the maximum DF if possible. Two solutions to the proposed combination strategy are given. They do not need to determine the correct trade-off factor used in linear combination method, and avoid challenge estimations on noise and target statistics required in adaptive beamforming. The performance of the proposed beamformer is evaluated in ideal noise fields and complicated noise fields respectively. It is shown that the proposed beamformer integrates merits of different beamformers. It always achieves the best speech quality and biggest noise reduction compared to other popular beamformers.

The aim of the present study was to determine the effects of early anticoagulation treatment on severe burns complicated by inhalation injury in a rabbit model. Under anesthetization, an electrical burns instrument (100=CB=9AC) was used to scald the backs of rabbits for 15sec, which established a 30% III severe burns model. Treatment of the rabbits with early anticoagulation effectively improved the severe burns complicated by inhalation injury=E2=80=91induced lung injury, reduced PaO2, PaCO2 and SPO2 levels, suppressed the expression of tumor necrosis factor=E2=80=91alpha, interleukin (IL)=E2=80=911beta and IL=E2=80=916, and increased the activity of IL=E2=80=9110. In addition, it was found that early anticoagulation treatment effectively suppressed the activities of caspase=E2=80=913 and caspase=E2=80=919, upregulated the protein expression of vascular endothelial growth factor (VEGF) and decreased the protein expression of protease=E2=80=91activated receptor 1 (PAR1) in the severe burns model. It was concluded that early anticoagulation treatment affected the severe burns complicated by inhalation injury in a rabbit model through the upregulation of VEGF and downregulation of PAR1 signaling pathways. Thus, early anticoagulation is a potential therapeutic option for severe burns complicated by inhalation injury.=20

Objectives: Recently it was reported that the loose connective tissue in the subcutaneous layer rapidly responded to mechanical forces evoked by acupuncture, massage, and normal physical movements. However, there were no clinical studies to substantiate these findings so far. Fu's Subcutaneous Needling (FSN) is the innovative needling strategy acting specifically in the subcutaneous layer. A single-blinded and randomized trial was designed to compare the immediate effects of FSN with different needling directions on myofascial trigger points (MTrP) in the neck. Design: For simplicity, we chose two mutually perpendicular needle directions in this study. In one group, the needle was along the local muscle fibers and pointed to the MTrP (Along Group). In the other group, the needle was across the local muscle fibers and also pointed to the MTrP (Across Group). Subjects: Forty-seven (47) patients were randomly divided into two groups: the Along Group (n = 22) and the Across Group (n = 25). There were no significant differences with respect to age, duration of pain, and gender between the two groups. Interventions: FSN needles were inserted and swayed in the subcutaneous layer 200 times in 2 minutes. Results: Before and after FSN treatment, patients were subjected to the assessment of the following three parameters: motion-related pain, pain under pressure, and the range of cervical movement. Three parameters were all reduced after the FSN intervention. There were no significant differences in variation of the three parameters between the two groups. Conclusion: Immediate effects of FSN on alleviating MTrP in the neck were not relevant to the needling directions.

Audio classification is an essential task in multimedia content analysis, which is a prerequisite to a variety of tasks such as segmentation, indexing and retrieval. This paper describes our study on multi-class audio classification on broadcast news, a popular multimedia repository with rich audio types. Motivated by the tonal regulations of music, we propose two pitch-density-based features, namely average pitch-density (APD) and relative tonal power density (RTPD). We use an SVM binary tree (SVM-BT) to hierarchically classify an audio clip into five classes: pure speech, music, environment sound, speech with music and speech with environment sound. Since SVM is a binary classifier, we use the SVM-BT architecture to realize coarse-to-fine multi-class classification with high accuracy and efficiency. Experiments show that the proposed one-dimensional APD and RTPD features are able to achieve comparable accuracy with popular high-dimensional features in speech/music discrimination, and the SVM-BT approach demonstrates superior performance in multi-class audio classification. With the help of the pitch-density-based features, we can achieve a high average accuracy of 94.2% in the five-class audio classification task.

Recently high-frequency electric knife and abdominal binder are widely used in the abdominal operation in China. Nevertheless, with the high occurrence of the abdominal wound, we think that whether both these operations could be used or not. Here, we report the case of a 40-year-old female patient where negative pressure wound therapy (NPWT) was applied to her dehisced abdominal wound as well as fat liquefaction and large skin necrosis with pleasing results. The patient with high fever was referred to our department from her earlier hospital for 6 days after cesarean delivery. During the surgery, her earlier doctor used a high-frequency electric knife for convenient-using, and after the operation, the patient immediately used an abdominal binder for good shape. However, the abdominal surgical incision was opened at postoperative day 3, with fat liquefaction releasing large fatty acids along both abdominal sides with penetration under the abdominal binder. After admitted at postoperative day 6 with aggravating wound, surgery was considered because of no reduction in the size of the wound. A series of vacuum sealing drainage (VSD) or vacuum-assisted closure (VAC) as well as others, were operated. In the admitted 25th day, the wound was completely closed. NPWT is a practical and effective therapy for the treatment of numerous refractory and intractable wounds. Therefore, we suggest that the high-frequency electric knife and an abdominal binder should be avoided using an abdominal operation. This case is the first report of the use of NPWT over a dehisced abdominal wound with fat liquefaction and large skin necrosis on a postpartum patient in China.=20

Speech enhancement under nonstationary environments is a challenging problem. This paper addresses the problem of speech presence probability (SPP) estimation. According to the fact that speech is approximately sparse in time-frequency domain, we integrate time and frequency minimum tracking results to estimate the noise power spectral density and the a posteriori signal-to-noise ratio. A sparseness measure is proposed to adjust the SPP estimates. By applying Bayes rule, we present the final SPP estimates, which control the time varying smoothing of the noise power spectrum. We show that under slowly and highly nonstationary noise conditions, the integrated minimum tracking (IMT) approach can update the noise estimates faster than the competitive methods. When integrated into a speech enhancement system, it achieves improved speech quality and lower residual noise.

Theoretical insights on the comparison between the champion dyes SM315 and C275 used for high-performance dye-sensitized solar cells (DSSCs) reaching over 12% efficiency with different electron donors only (porphyrin for SM315 and indenoperylene for C275) were explored for the first time. The intrinsic reasons for the significantly improved monochromatic photon-to-electric current conversion efficiency (IPCE) and open circuit voltage (V-OC) of C275-based DSSCs over those of SM315 were revealed. According to our results, we find that the larger IPCE of C275 is attributed to its larger electronic coupling, smaller reorganization energy, reduced exciton binding energy and enhanced charge transfer character, all of which when combined lead to a larger electron injection efficiency. In addition, the larger Voc of C275 is due to a greater number of injected electrons, a smaller molecular volume and a smaller projected area, which lead to a more compact adsorption layer with a hindered charge recombination process. Thus, C275 is expected to have more potential to further optimize high-performance DSSCs. In view of the primary shortcoming of C275, which is its relatively narrow absorption spectrum, further optimization was made through structural modification using a series of heterocyclic anchoring groups. Using the same evaluation criteria, the theoretical screening of these dyes based on C275 is carried out. We find that indenoperylene dye with a barbituric acid (BA) anchoring group is a promising candidate for the experimental synthesis of high-performance DSSCs with improved J(SC), V-OC and adsorption stability. (C) 2019 Elsevier B.V. All rights reserved.