Background In laboratory animals, exposure to most general anaesthetics leads to neurotoxicity manifested by neuronal cell death and abnormal behaviour and cognition. Some large human cohort studies have shown an association between general anaesthesia at a young age and subsequent neurodevelopmental deficits, but these studies are prone to bias. Others have found no evidence for an association. We aimed to establish whether general anaesthesia in early infancy affects neurodevelopmental outcomes. Methods In this international, assessor-masked, equivalence, randomised, controlled trial conducted at 28 hospitals in Australia, Italy, the USA, the UK, Canada, the Netherlands, and New Zealand, we recruited infants of less than 60 weeks' postmenstrual age who were born at more than 26 weeks' gestation and were undergoing inguinal herniorrhaphy, without previous exposure to general anaesthesia or risk factors for neurological injury. Patients were randomly assigned (1:1) by use of a web-based randomisation service to receive either awake-regional anaesthetic or sevoflurane-based general anaesthetic. Anaesthetists were aware of group allocation, but individuals administering the neurodevelopmental assessments were not. Parents were informed of their infants group allocation upon request, but were told to mask this information from assessors. The primary outcome measure was full-scale intelligence quotient (FSIQ) on the Wechsler Preschool and Primary Scale of Intelligence, third edition (WPPSI-III), at 5 years of age. The primary analysis was done on a per-protocol basis, adjusted for gestational age at birth and country, with multiple imputation used to account for missing data. An intention-totreat analysis was also done. A difference in means of 5 points was predefined as the clinical equivalence margin. This completed trial is registered with ANZCTR, number ACTRN12606000441516, and ClinicalTrials.gov, number NCT00756600. Findings Between Feb 9, 2007, and Jan 31, 2013, 4023 infants were screened and 722 were randomly allocated: 363 (50%) to the awake-regional anaesthesia group and 359 (50%) to the general anaesthesia group. There were 74 protocol violations in the awake-regional anaesthesia group and two in the general anaesthesia group. Primary outcome data for the per-protocol analysis were obtained from 205 children in the awake-regional anaesthesia group and 242 in the general anaesthesia group. The median duration of general anaesthesia was 54 min (IQR 41-70). The mean FSIQ score was 99•08 (SD 18•35) in the awake-regional anaesthesia group and 98•97 (19•66) in the general anaesthesia group, with a difference in means (awake-regional anaesthesia minus general anaesthesia) of 0•23 (95% CI-2•59 to 3•06), providing strong evidence of equivalence. The results of the intention-to-treat analysis were similar to those of the per-protocol analysis. Interpretation Slightly less than 1 h of general anaesthesia in early infancy does not alter neurodevelopmental outcome at age 5 years compared with awake-regional anaesthesia ...
Forecast of prices of financial assets including gold is of considerable importance for planning the economy. For centuries, people have been holding gold for many important reasons such as smoothening inflation fluctuations, protection from an economic crisis, sound investment etc.. Forecasting of gold prices is therefore an ever important exercise undertaken both by individuals and groups. Various local, global, political, psychological and economic factors make such a forecast a complex problem. Data analysts have been increasingly applying Artificial Intelligence (AI) techniques to make such forecasts. In the present work an inter comparison of gold price forecasting in Indian market is first done by employing a few classical Artificial Neural Network (ANN) techniques, namely Gradient Descent Method (GDM), Resilient Backpropagation method (RP), Scaled Conjugate Gradient method (SCG), Levenberg-Marquardt method (LM), Bayesian Regularization method (BR), One Step Secant method (OSS) and BFGS Quasi Newton method (BFG). Improvement in forecasting accuracy is achieved by proposing and developing a few modified GDM algorithms that incorporate different optimization functions by replacing the standard quadratic error function of classical GDM. Various optimization functions investigated in the present work are Mean median error function (MMD), Cauchy error function (CCY), Minkowski error function (MKW), Log cosh error function (LCH) and Negative logarithmic likelihood function (NLG). Modified algorithms incorporating these optimization functions are referred to here by GDM_MMD, GDM_CCY, GDM_KWK, GDM_LCH and GDM_NLG respectively. Gold price forecasting is then done by employing these algorithms and the results are analysed. The results of our study suggest that the forecasting efficiency improves considerably on applying the modified methods proposed by us.
The necessity for scholarly knowledge mining and management has grown significantly as academic literature and its linkages to authors produce enormously. Information extraction, ontology matching, and accessing academic components with relations have become more critical than ever. Therefore, with the advancement of scientific literature, scholarly knowledge graphs have become critical to various applications where semantics can impart meanings to concepts. The objective of study is to report a literature review regarding knowledge graph construction, refinement and utilization in scholarly domain. Based on scholarly literature, the study presents a complete assessment of current state-of-the-art techniques. We presented an analytical methodology to investigate the existing status of scholarly knowledge graphs (SKG) by structuring scholarly communication. This review paper investigates the field of applying machine learning, rule-based learning, and natural language processing tools and approaches to construct SKG. It further presents the review of knowledge graph utilization and refinement to provide a view of current research efforts. In addition, we offer existing applications and challenges across the board in construction, refinement and utilization collectively. This research will help to identify frontier trends of SKG which will motivate future researchers to carry forward their work.
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