Being one of the most multifaceted cyber-physical systems, smart grids (SGs) are arguably more prone to cyber-threats. A covert data integrity assault (CDIA) on a communications network may be lethal ...to the reliability and safety of SG operations. They are intelligently designed to sidestep the traditional bad data detector in power control centers, and this type of assault can compromise the integrity of the data, causing a false estimation of the state that further severely distresses the entire power system operation. In this paper, we propose an unsupervised machine learning-based scheme to detect CDIAs in SG communications networks utilizing non-labeled data. The proposed scheme employs a state-of-the-art algorithm, called isolation forest, and detects CDIAs based on the hypothesis that the assault has the shortest average path length in a constructed random forest. To tackle the dimensionality issue from the growth in power systems, we use a principal component analysis-based feature extraction technique. The evaluation of the proposed scheme is carried out through standard IEEE 14-bus, 39-bus, 57-bus, and 118-bus systems. The simulation results show that the proposed scheme is proficient at handling non-labeled historical measurement datasets and results in a significant improvement in attack detection accuracy.
Developing high‐energy‐density electrodes for lithium ion batteries (LIBs) is of primary importance to meet the challenges in electronics and automobile industries in the near future. Conversion ...reaction‐based transition metal oxides are attractive candidates for LIB anodes because of their high theoretical capacities. This review summarizes recent advances on the development of nanostructured transition metal oxides for use in lithium ion battery anodes based on conversion reactions. The oxide materials covered in this review include oxides of iron, manganese, cobalt, copper, nickel, molybdenum, zinc, ruthenium, chromium, and tungsten, and mixed metal oxides. Various kinds of nanostructured materials including nanowires, nanosheets, hollow structures, porous structures, and oxide/carbon nanocomposites are discussed in terms of their LIB anode applications.
Conversion reaction‐based oxides are considered promising anode materials to replace graphite due to their high theoretical capacity. This review summarizes recent advances in the development of nanostructured transition metal oxides for use in lithium ion battery anodes based on conversion reactions. Moreover, some important aspects and future directions for designing high‐performance anodes are discussed.
Single‐atom M‒N‒C catalysts have attracted tremendous attention for their application to electrocatalysis. Nitrogen‐coordinated mononuclear metal moieties (MNx moities) are bio‐inspired active sites ...that are analogous to various metal‐porphyrin cofactors. Given that the functions of metal‐porphyrin cofactors are highly dependent on the local coordination environments around the mononuclear active site, engineering MNx active sites in heterogeneous M‒N‒C catalysts would provide an additional degree of freedom for boosting their electrocatalytic activity. This work presents a local coordination structure modification of FeN4 moieties via morphological engineering of graphene support. Introducing highly wrinkled structure in graphene matrix induces nonplanar distortion of FeN4 moieties, resulting in the modification of electronic structure of mononuclear Fe. Electrochemical analysis combined with first‐principles calculations reveal that enhanced electrocatalytic lithium polysulfide conversion, especially the Li2S redox step, is attributed to the local structure modified FeN4 active sites, while increased specific surface area also contributes to improved performance at low C‐rates. Owing to the synergistic combination of atomic‐level modified FeN4 active sites and morphological advantage of graphene support, Fe‒N‒C catalysts with wrinkled graphene morphology show superior lithium–sulfur battery performance at both low and high C‐rates (particularly 915.9 mAh g−1 at 5 C) with promising cycling stability.
Atomic‐level engineering of MNx active sites is a desirable strategy to enhance and fine‐tune electrocatalytic performance of M‒N‒C catalysts. FeN4 active sites on wrinkled graphene support exhibits different structural and electronic properties compared to square‐planar FeN4 moieties. The synergistic combination of modified FeN4 active sites and morphological advantage of wrinkled graphene support improves the electrocatalytic performance for lithium–sulfur conversion chemistry.
Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients with acute coronary ...syndrome. However, available data about the optimal duration of DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention are scant. We aimed to investigate whether a 6-month duration of DAPT would be non-inferior to the conventional 12-month or longer duration of DAPT in this population.
We did a randomised, open-label, non-inferiority trial at 31 centres in South Korea. Patients were eligible if they had unstable angina, non-ST-segment elevation myocardial infarction, or ST-segment elevation myocardial infarction, and underwent percutaneous coronary intervention. Enrolled patients were randomly assigned, via a web-based system by computer-generated block randomisation, to either the 6-month DAPT group or to the 12-month or longer DAPT group, with stratification by site, clinical presentation, and diabetes. Assessors were masked to treatment allocation. The primary endpoint was a composite of all-cause death, myocardial infarction, or stroke at 18 months after the index procedure in the intention-to-treat population. Secondary endpoints were the individual components of the primary endpoint; definite or probable stent thrombosis as defined by the Academic Research Consortium; and Bleeding Academic Research Consortium (BARC) type 2–5 bleeding at 18 months after the index procedure. The primary endpoint was also analysed per protocol. This trial is registered with ClinicalTrials.gov, number NCT01701453.
Between Sept 5, 2012, and Dec 31, 2015, we randomly assigned 2712 patients; 1357 to the 6-month DAPT group and 1355 to the 12-month or longer DAPT group. Clopidogrel was used as a P2Y12 inhibitor for DAPT in 1082 (79·7%) patients in the 6-month DAPT group and in 1109 (81·8%) patients in the 12-month or longer DAPT group. The primary endpoint occurred in 63 patients in the 6-month DAPT group and in 56 patients in the 12-month or longer DAPT group (cumulative event rate 4·7% vs 4·2%; absolute risk difference 0·5%; upper limit of one-sided 95% CI 1·8%; pnon-inferiority=0·03 with a predefined non-inferiority margin of 2·0%). Although all-cause mortality did not differ significantly between the 6-month DAPT group and the 12-month or longer DAPT group (35 2·6% patients vs 39 2·9%; hazard ratio HR 0·90 95% CI 0·57–1·42; p=0·90) and neither did stroke (11 0·8% patients vs 12 0·9%; 0·92 0·41–2·08; p=0·84), myocardial infarction occurred more frequently in the 6-month DAPT group than in the 12-month or longer DAPT group (24 1·8% patients vs ten 0·8%; 2·41 1·15–5·05; p=0·02). 15 (1·1%) patients had stent thrombosis in the 6-month DAPT group compared with ten (0·7%) in the 12-month or longer DAPT group (HR 1·50 95% CI 0·68–3·35; p=0·32). The rate of BARC type 2–5 bleeding was 2·7% (35 patients) in the 6-month DAPT group and 3·9% (51 patients) in the 12-month or longer DAPT group (HR 0·69 95% CI 0·45–1·05; p=0·09). Results from the per-protocol analysis were similar to those from the intention-to-treat analysis.
The increased risk of myocardial infarction with 6-month DAPT and the wide non-inferiority margin prevent us from concluding that short-term DAPT is safe in patients with acute coronary syndrome undergoing percutaneous coronary intervention with current-generation DES. Prolonged DAPT in patients with acute coronary syndrome without excessive risk of bleeding should remain the standard of care.
Abbott Vascular Korea, Medtronic Vascular Korea, Biosensors Inc, and Dong-A ST.
In this paper, we propose a novel method for monocular depth estimation using the hourglass neck module. The proposed method has the following originality. First, feature maps are extracted from Swin ...Transformer V2 using a masked image modeling (MIM) pretrained model. Since Swin Transformer V2 has a different patch size for each attention stage, it is easier to extract local and global features from images input by the vision transformer (ViT)-based encoder. Second, to maintain the polymorphism and local inductive bias of the feature map extracted from Swin Transformer V2, a feature map is input into the hourglass neck module. Third, deformable attention can be used at the waist of the hourglass neck module to reduce the computation cost and highlight the locality of the feature map. Finally, the feature map traverses the neck and proceeds through a decoder, comprised of a deconvolution layer and an upsampling layer, to generate a depth image. To evaluate the objective reliability of the proposed method in this paper, we used the NYU Depth V2 dataset to compare and evaluate the methods published in other papers. As a result of the experiment, the RMSE value of the novel method for monocular depth estimation using the hourglass neck module proposed in this paper was 0.274, which was lower than those published in other papers. The lower the RMSE value, the better the depth estimation method; therefore, its efficiency compared to other techniques has been proven.
Optimal antiplatelet monotherapy during the chronic maintenance period in patients who undergo coronary stenting is unknown. We aimed to compare head to head the efficacy and safety of aspirin and ...clopidogrel monotherapy in this population.
We did an investigator-initiated, prospective, randomised, open-label, multicentre trial at 37 study sites in South Korea. We enrolled patients aged at least 20 years who maintained dual antiplatelet therapy without clinical events for 6–18 months after percutaneous coronary intervention with drug-eluting stents (DES). We excluded patients with any ischaemic and major bleeding complications. Patients were randomly assigned (1:1) to receive a monotherapy agent of clopidogrel 75 mg once daily or aspirin 100 mg once daily for 24 months. The primary endpoint was a composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and Bleeding Academic Research Consortium (BARC) bleeding type 3 or greater, in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT02044250.
Between March 26, 2014, and May 29, 2018, we enrolled 5530 patients. 5438 (98·3%) patients were randomly assigned to either the clopidogrel group (2710 49·8%) or to the aspirin group (2728 50·2%). Ascertainment of the primary endpoint was completed in 5338 (98·2%) patients. During 24-month follow-up, the primary outcome occurred in 152 (5·7%) patients in the clopidogrel group and 207 (7·7%) in the aspirin group (hazard ratio 0·73 95% CI 0·59–0·90; p=0·0035).
Clopidogrel monotherapy, compared with aspirin monotherapy during the chronic maintenance period after percutaneous coronary intervention with DES significantly reduced the risk of the composite of all-cause death, non-fatal myocardial infarction, stroke, readmission due to acute coronary syndrome, and BARC bleeding type 3 or greater. In patients requiring indefinite antiplatelet monotherapy after percutaneous coronary intervention, clopidogrel monotherapy was superior to aspirin monotherapy in preventing future adverse clinical events.
ChongKunDang, SamJin, HanMi, DaeWoong, and the South Korea Ministry of Health and Welfare.
Native extracellular matrix (ECM) can exhibit cyclic nanoscale stretching and shrinking of ligands to regulate complex cell–material interactions. Designing materials that allow cyclic control of ...changes in intrinsic ligand‐presenting nanostructures in situ can emulate ECM dynamicity to regulate cellular adhesion. Unprecedented remote control of rapid, cyclic, and mechanical stretching (“ON”) and shrinking (“OFF”) of cell‐adhesive RGD ligand‐presenting magnetic nanocoils on a material surface in five repeated cycles are reported, thereby independently increasing and decreasing ligand pitch in nanocoils, respectively, without modulating ligand‐presenting surface area per nanocoil. It is demonstrated that cyclic switching “ON” (ligand nanostretching) facilitates time‐regulated integrin ligation, focal adhesion, spreading, YAP/TAZ mechanosensing, and differentiation of viable stem cells, both in vitro and in vivo. Fluorescence resonance energy transfer (FRET) imaging reveals magnetic switching “ON” (stretching) and “OFF” (shrinking) of the nanocoils inside animals. Versatile tuning of physical dimensions and elements of nanocoils by regulating electrodeposition conditions is also demonstrated. The study sheds novel insight into designing materials with connected ligand nanostructures that exhibit nanocoil‐specific nano‐spaced declustering, which is ineffective in nanowires, to facilitate cell adhesion. This unprecedented, independent, remote, and cytocompatible control of ligand nanopitch is promising for regulating the mechanosensing‐mediated differentiation of stem cells in vivo.
Materials allowing unprecedented, remote, and cytocompatible control of in situ and time‐regulated nanoscale stretching and shrinking of ligand‐presenting magnetic nanocoils, that independently modulate the ligand pitch in the nanocoils, are presented. It is demonstrated that magnetic control of ligand nanostretching promotes cyclic adhesion and mechanotransduction of stem cells, both in vitro and in vivo, which facilitates their consequential differentiation.
The risks and benefits of long-term dual antiplatelet therapy remain unclear.
This prospective, multicenter, open-label, randomized comparison trial was conducted in 24 clinical centers in Korea. In ...total, 5045 patients who received drug-eluting stents and were free of major adverse cardiovascular events and major bleeding for at least 12 months after stent placement were enrolled between July 2007 and July 2011. Patients were randomized to receive aspirin alone (n=2514) or clopidogrel plus aspirin (n=2531). The primary end point was a composite of death resulting from cardiac causes, myocardial infarction, or stroke 24 months after randomization. At 24 months, the primary end point occurred in 57 aspirin-alone group patients (2.4%) and 61 dual-therapy group patients (2.6%; hazard ratio, 0.94; 95% confidence interval, 0.66-1.35; P=0.75). The 2 groups did not differ significantly in terms of the individual risks of death resulting from any cause, myocardial infarction, stent thrombosis, or stroke. Major bleeding occurred in 24 (1.1%) and 34 (1.4%) of the aspirin-alone group and dual-therapy group patients, respectively (hazard ratio, 0.71; 95% confidence interval, 0.42-1.20; P=0.20).
Among patients who were on 12-month dual antiplatelet therapy without complications, an additional 24 months of dual antiplatelet therapy versus aspirin alone did not reduce the risk of the composite end point of death from cardiac causes, myocardial infarction, or stroke.
http://www.clinicaltrials.gov. Unique identifier: NCT01186146.
Objective
To investigate sleep disturbances that induce cognitive changes over 4 years in nondemented elderlies.
Methods
Data were acquired from a nationwide, population‐based, prospective cohort of ...Korean elderlies (2,238 normal cognition NC and 655 mild cognitive impairment MCI). At baseline and 4‐year follow‐up assessments, sleep‐related parameters (midsleep time, sleep duration, sleep latency, subjective sleep quality, sleep efficiency, and daytime dysfunction) and cognitive status were measured using the Pittsburgh Sleep Quality Index and Consortium to Establish a Registry for Alzheimer's Disease Assessment, respectively. We used logistic regression models adjusted for covariates including age, sex, education, apolipoprotein E genotype, Geriatric Depression Scale, Cumulative Illness Rating Scale, and physical activity.
Results
In participants with NC, long sleep latency (>30 minutes), long sleep duration (≥7.95 hours), and late midsleep time (after 3:00 am) at baseline were related to the risk of cognitive decline at 4‐year follow‐up assessment; odds ratio (OR) was 1.40 for long sleep latency, 1.67 for long sleep duration, and 0.61 for late midsleep time. These relationships remained significant when these variables maintained their status throughout the follow‐up period. Newly developed long sleep latency also doubled the risk of cognitive decline. In those with MCI, however, only long sleep latency reduced the chance of reversion to NC (OR = 0.69).
Interpretation
As early markers of cognitive decline, long sleep latency can be used for elderlies with NC or MCI, whereas long sleep duration and relatively early sleep time might be used for cognitively normal elderlies only. Ann Neurol 2018;83:472–482
Long-term outcomes of antiplatelet monotherapy in patients who receive percutaneous coronary intervention are unknown. The HOST-EXAM (Harmonizing Optimal Strategy for Treatment of Coronary Artery ...Stenosis-Extended Antiplatelet Monotherapy) Extended study reports the posttrial follow-up results of the original HOST-EXAM trial.
From March 2014 through May 2018, 5438 patients who maintained dual antiplatelet therapy without clinical events for 12±6 months after percutaneous coronary intervention with drug-eluting stents were randomly assigned in a 1:1 ratio to receive clopidogrel (75 mg once daily) or aspirin (100 mg once daily). The primary end point (a composite of all-cause death, nonfatal myocardial infarction, stroke, readmission attributable to acute coronary syndrome, and Bleeding Academic Research Consortium type 3 or greater bleeding), secondary thrombotic end point (cardiac death, nonfatal myocardial infarction, ischemic stroke, readmission attributable to acute coronary syndrome, and definite or probable stent thrombosis), and bleeding end point (Bleeding Academic Research Consortium type 2 or greater bleeding) were analyzed during the extended follow-up period. Analysis was performed on the per-protocol population (2431 patients in the clopidogrel group and 2286 patients in the aspirin group).
During a median follow-up of 5.8 years (interquartile range, 4.8-6.2 years), the primary end point occurred in 12.8% and 16.9% in the clopidogrel and aspirin groups, respectively (hazard ratio, 0.74 95% CI, 0.63-0.86;
<0.001). The clopidogrel group had a lower risk for the secondary thrombotic end point (7.9% versus 11.9%; hazard ratio, 0.66 95% CI, 0.55-0.79;
<0.001) and secondary bleeding end point (4.5% versus 6.1%; hazard ratio, 0.74 95% CI, 0.57-0.94;
=0.016). There was no significant difference in the incidence of all-cause death between the 2 groups (6.2% versus 6.0%; hazard ratio, 1.04 95% CI, 0.82-1.31;
=0.742). Landmark analysis at 2 years showed that the beneficial effect of clopidogrel was consistent throughout the follow-up period.
During an extended follow-up of >5 years after randomization, clopidogrel monotherapy compared with aspirin monotherapy was associated with lower rates of the composite net clinical outcome in patients without clinical events for 12±6 months after percutaneous coronary intervention with drug-eluting stents.
URL: https://www.
gov; Unique identifier: NCT02044250.
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