Block Center

Topological descriptors, such as the Euler characteristic function and the persistence diagram, have grown increasingly popular for representing complex data. Recent work showed that a carefully chosen set of these descriptors encodes all of the geometric and topological information about a shape in R^d. In practice, epsilon nets are often used to find samples in one of two extremes. On one hand, making strong geometric assumptions about the shape allows us to choose epsilon small enough (corresponding to a high enough density sample) in order to guarantee a faithful representation, resulting in oversampling. On the other hand, if we choose a larger epsilon in order to allow faster computations, this leads to an incomplete description of the shape and a discretized transform that lacks theoretical guarantees. In this work, we investigate how many directions are really needed to represent geometric simplicial complexes, exploring both synthetic and real-world datasets. We provide constructive proofs that help establish size bounds and an experimental investigation giving insights into the consequences of over- and undersampling.

To address identity forgery and privacy leakage in Internet of vehicles (IoV) within intelligent transportation systems, we propose an efficient cross-domain identity authentication (IA) scheme based on blockchain and certificateless cryptography. However, existing IA schemes often suffer from high computational overhead, limited scalability, or inadequate support for cross-domain scenarios. First, a distributed authentication architecture is designed, and an off-chain storage mechanism combining blockchain and distributed hash table (DHT) to reduce storage costs. Second, a key generation scheme based on certificateless cryptography is designed to address key escrow problem. Third, a conditional privacy protection mechanism is proposed to achieve both anonymity and traceability of vehicle identities. A formal privacy evaluation is provided based on k-anonymity quantifies anonymity level under realistic adversary models. Finally, performance evaluations are conducted in terms of authentication delay, throughput, and success rate, demonstrating that the proposed scheme improves authentication efficiency while enhancing the system security and privacy.

Purpose: This clinical focus article presents a modified user-centered design framework in order to facilitate the role of pediatric clinicians who treat feeding/swallowing disorders in redesigning the clinical experience in order to improve outcomes. The article establishes a physiologically based design framework and presents a user-centered design tool that clinicians may utilize to view the patient interaction from a design mindset in their practice. Method: Two case studies are presented to demonstrate the clinical application of the user-centered design tool. Case 1 applies the tool to controlled flow drinking cups and includes a pilot study that explores prototype testing of a novel cup design and the resulting patient experience. Case 2 presents a unique pediatric patient and the application of the user-centered method to analyze a modified treatment experience. Conclusions: Clinicians who treat pediatric feeding and swallowing disorders can benefit from the utilization of a user-centered design approach to observe the patient experience from a design perspective. This approach provides a structure to guide individual clinicians to key insights that may lead to improved treatments. Furthermore, user-centered methods may facilitate the analysis of complex patient scenarios by clinician-led teams, which may result in novel solutions.

Life began, developed and matured within the biosphere of the Earth. The 5 fundamental forces of physical reality played a major role in bringing together the material resources that made up the Earth upon which the biosphere was created and that allowed life to flourish.

Today, the coronavirus infection COVID-2019 deals a devastating blow to the economies of most countries due to disruption of production chains, the bankruptcy of small and medium-sized businesses, increasing the number of unemployed, and more. Under these conditions, the coverage of digitalization of all sectors of the economy and basic spheres of life of citizens becomes especially important. The article is devoted to the analysis of the possibilities of the latest blockchain technologies, artificial intelligence, and the Internet of Things in view of their impact on the transformation of the business process management system. The study used methods of bibliographic analysis of scientific publications and analytical reports of international organizations related to the concept of “Industry 4.0” and diseases of coronavirus infection, analyzing from the audit point of view, how to reinforce the principles of transparency, responsibility, and participation. It has been proven that blockchain technology is able to service online payments without intermediaries, receipt, and transfer of digital assets, as well as political elections and voting. Artificial intelligence models can help map, manage, predict, and model complex processes, reducing uncertainty, and supporting professionals in decision-making. The Internet of Things allows you to transfer information, improve control and automation, and provide opportunities to optimize the company’s operating costs. The result of the study can be practically valuable for many stakeholders: auditors – conducting audits by artificial intelligence; public administration – developing measures to address the economic, social and political crisis triggered by the pandemic, by building trust between government and citizens through communication, and by ensuring transparency and accountability. Keywords: blockchain, artificial intelligence, Internet of Things, COVID-19, health care crisis, economic crisis, political crisis, control, public administration, financial management.

Purpose Patients undergoing chemoradiation for treatment of head and neck cancer often develop swallowing problems that necessitate a percutaneous gastrostomy (PEG) tube. Studies comparing various outcomes related to timing of PEG tubes placed either prophylactically or reactively do not show a clear advantage to either method; however, pertinent patient factors may help determine an educated and evidence-based decision. Additionally, patients may not be included in decision making regarding PEG placement and may not receive adequate education regarding PEG tubes, resulting in fears and concerns. Thus, patients may wish to avoid or at least delay PEG tube placement until necessary. The purpose of this viewpoint article is to review relevant literature and describe patient concerns to better facilitate joint decision making of PEG tube timing with the patient and care team. Conclusion Patient counseling and inclusion can be useful in helping patients understand why and when a PEG tube may be beneficial or necessary during treatment. A simplified decision tree is introduced that incorporates several relevant patient factors based on the current literature and can be used jointly by clinicians and patients to reach a mutual decision by incorporating clinical factors while being mindful of patient values.

e21650 Background: Cancer patients develop symptoms that are pathognomonic of a failing circadian organization [CO]. Our concurrent study of 84 advanced cancer patients on randomly timed chemotherapy revealed that each suffered more disrupted circadian rhythms, sleep disorders, anxiety/depression, and quality of life scores compared to healthy age-adjusted controls, as well as poor survival. Herein, we report relationships between CO of advanced cancer patients and their functioning, symptoms, mood, and quality of life during chemotherapy in a clinic that uses comprehensive integrative therapies to maintain patient CO. Methods: 30 patients with advanced cancer participated in a randomized single-blind crossover trial of whether nightly use of blue-light blocking eyeglasses improved circadian organization during chemotherapy. Chemotherapy was applied at or near times of day known to be least toxic and most effective. CO was measured serially using actigraphy and patients provided data on their sleep quality [PSQI], mood [HADS], fatigue [Piper], and quality of life [EORTC QLQ-C30 and Ferrans/Powers QLI]. Kruskal-Wallis tests were used to detect the differences between groups [p < 0.05]. Results: These cancer patients’ actigraphy data were indistinguishable from a convenience control of healthy individuals. Sleep quality, Piper Fatigue, and HADS scores were in the non-symptomatic range; and all functional and symptomatic parameters of the EORTC QLQ-C30 and three of four QLI subscales were within population-based norms. Only the EORTC health-related quality of life and the QLI health/function parameters were lower than non-cancer controls. Median overall survival was 38.4 months. Conclusions: Actigraphy-measured COs of advanced cancer patients are damped, disorganized and accompanied by a heavy symptom burden. These cancer patients reported good quality sleep, normal function, good mood, low intensity of cancer-related symptoms and extended survival while undergoing circadian timed cancer chemotherapy and integrative support. This CO maintenance among such cancer patients is unprecedented and requires attention especially as it is achievable entirely without risk. Clinical trial information: ISRCTN16219928.

Targeted therapies and the consequent adoption of "personalized" oncology have achieved notable successes in some cancers; however, significant problems remain with this approach. Many targeted therapies are highly toxic, costs are extremely high, and most patients experience relapse after a few disease-free months. Relapses arise from genetic heterogeneity in tumors, which harbor therapy-resistant immortalized cells that have adopted alternate and compensatory pathways (i.e., pathways that are not reliant upon the same mechanisms as those which have been targeted). To address these limitations, an international task force of 180 scientists was assembled to explore the concept of a low-toxicity "broad-spectrum" therapeutic approach that could simultaneously target many key pathways and mechanisms. Using cancer hallmark phenotypes and the tumor microenvironment to account for the various aspects of relevant cancer biology, interdisciplinary teams reviewed each hallmark area and nominated a wide range of high-priority targets (74 in total) that could be modified to improve patient outcomes. For these targets, corresponding low-toxicity therapeutic approaches were then suggested, many of which were phytochemicals. Proposed actions on each target and all of the approaches were further reviewed for known effects on other hallmark areas and the tumor microenvironment. Potential contrary or procarcinogenic effects were found for 3.9% of the relationships between targets and hallmarks, and mixed evidence of complementary and contrary relationships was found for 7.1%. Approximately 67% of the relationships revealed potentially complementary effects, and the remainder had no known relationship. Among the approaches, 1.1% had contrary, 2.8% had mixed and 62.1% had complementary relationships. These results suggest that a broad-spectrum approach should be feasible from a safety standpoint. This novel approach has potential to be relatively inexpensive, it should help us address stages and types of cancer that lack conventional treatment, and it may reduce relapse risks. A proposed agenda for future research is offered.

Laribacter hongkongensis is a potential emerging pathogen associated with community-acquired gastroenteritis and traveler's diarrhea. We report the isolation of L. hongkongensis from the stool of a patient who had no history of travel outside the United States. The organism was identified by phenotypic tests, mass spectrometry, and gene sequencing.