bluuebunny/crossref_metadata_2025 huggingface dataset:
Facilitating treatment of HCV in primary care in regional Australia: closing the access gap
Authors: White Lauren , Azzam Ali , Burrage Lauren , Orme Clare , Kay Barbara , Higgins Sarah , Kaye Simone , Sloss Andrew , Broom Jennifer , Weston Nicola , Mitchell Jonathan , O’Beirne James
Published: October 2018

Background

Australia has unrestricted access to direct-acting antivirals (DAA) for hepatitis C virus (HCV) treatment. In order to increase access to treatment, primary care providers are able to prescribe DAA after fibrosis assessment and specialist consultation. Transient elastography (TE) is recommended prior to commencement of HCV treatment; however, TE is rarely available outside secondary care centres in Australia and therefore a requirement for TE could represent a barrier to access to HCV treatment in primary care.

Objectives

In order to bridge this access gap, we developed a community-based TE service across the Sunshine Coast and Wide Bay areas of Queensland.

Design

Retrospective analysis of a prospectively recorded HCV treatment database.

Interventions

A nurse-led service equipped with two mobile Fibroscan units assesses patients in eight locations across regional Queensland. Patients are referred into the service via primary care and undergo nurse-led TE at a location convenient to the patient. Patients are discussed at a weekly multidisciplinary team meeting and a treatment recommendation made to the referring GP. Treatment is initiated and monitored in primary care. Patients with cirrhosis are offered follow-up in secondary care.

Results

327 patients have undergone assessment and commenced treatment in primary care. Median age 48 years (IQR 38–56), 66% male. 57% genotype 1, 40% genotype 3; 82% treatment naïve; 10% had cirrhosis (liver stiffness >12.5 kPa). The majority were treated with sofosbuvir-based regimens. 26% treated with 8-week regimens. All patients had treatment prescribed and monitored in primary care. Telephone follow-up to confirm sustained virological response (SVR) was performed by clinic nurses. 147 patients remain on treatment. 180 patients have completed treatment. SVR data were not available for 19 patients (lost to follow-up). Intention-to-treat SVR rate was 85.5%. In patients with complete data SVR rate was 95.6%.

Conclusion

Community-based TE assessment facilitates access to HCV treatment in primary care with excellent SVR rates.
Prion-related peripheral neuropathy in sporadic Creutzfeldt-Jakob disease
Authors: Baiardi Simone , Redaelli Veronica , Ripellino Paolo , Rossi Marcello , Franceschini Alessia , Moggio Maurizio , Sola Patrizia , Ladogana Anna , Fociani Paolo , Magherini Anna , Capellari Sabina , Giese Armin , Caughey Byron , Caroppo Paola , Parchi Piero
Published: October 2018

Objective

To assess whether the involvement of the peripheral nervous system (PNS) belongs to the phenotypic spectrum of sporadic Creutzfeldt-Jakob disease (sCJD).

Methods

We examined medical records of 117 sCJDVV2 (ataxic type), 65 sCJDMV2K (kuru-plaque type) and 121 sCJDMM(V)1 (myoclonic type) subjects for clinical symptoms, objective signs and neurophysiological data. We reviewed two diagnostic nerve biopsies and looked for abnormal prion protein (PrPSc) by western blotting and real-time quaking-induced conversion (RT-QuIC) in postmortem PNS samples from 14 subjects.

Results

Seventy-five (41.2%) VV2-MV2K patients, but only 11 (9.1%) MM(V)1, had symptoms or signs suggestive of PNS involvement occurring at onset in 18 cases (17 VV2-MV2K, 9.3%; and 1 MM(V)1, 0.8%) and isolated in 6. Nerve biopsy showed a mixed predominantly axonal and demyelinating neuropathy in two sCJDMV2K. Electromyography showed signs of neuropathy in half of the examined VV2-MV2K patients. Prion RT-QuIC was positive in all CJD PNS samples, whereas western blotting detected PrPScin the sciatic nerve in one VV2 and one MV2K.

Conclusions

Peripheral neuropathy, likely related to PrPScdeposition, belongs to the phenotypic spectrum of sCJDMV2K and VV2 and may mark the clinical onset. The significantly lower prevalence of PNS involvement in typical sCJDMM(V)1 suggests that the PNS tropism of sCJD prions is strain dependent.
A quantum approach for time series data based on graph and Schrödinger equations methods
Authors: Singh Pritpal , Dhiman Gaurav , Kaur Amandeep
Published: October 2018

The supremacy of quantum approach is able to solve the problems which are not practically feasible on classical machines. It suggests a significant speed up of the simulations and decreases the chance of error rates. This paper introduces a new quantum model for time series data which depends on the appropriate length of intervals. To provide effective solution of this problem, this study suggests a new graph-based quantum approach. This technique is useful in discretization and representation of logical relationships. Then, we divide these logical relations into various groups to obtain efficient results. The proposed model is verified and validated with various approaches. Experimental results signify that the proposed model is more precise than existing competing models.
Attribute-Priming Effects on Presidential Approval: The Role of Risk Perception and Trust in Government Regulation
Authors: TAN YUE , SHAW PING
Published: October 2018

Combining data from a content analysis of leading newspapers, a random-sampled national survey ([Formula: see text]), and a semantic network analysis of Facebook postings, this study applies Network Agenda Setting and attribute-priming effects to examine how perceptions of risks, benefits, and trust in government regulation influenced the public’s evaluation of the Presidential performance in the 2012 controversy over imports of American beef in Taiwan. The results show that only perceived risks to health directly affected the public’s evaluation of the President; other types of risks damaged the public’s trust in government regulation, which consequently harmed their evaluation of the President’s performance.
The composition of the distributions x−λlnsx− and x+−r/λ
Authors: Fisher Brian , Özçağ Emin
Published: October 2018

The composition [Formula: see text] of a distribution [Formula: see text] and a locally summable function [Formula: see text] is defined as the neutrix limit of the regular sequence [Formula: see text] In this paper, we prove that the neutrix composition of the distributions [Formula: see text] and [Formula: see text] exists and equals [Formula: see text] for [Formula: see text], [Formula: see text] [Formula: see text] and [Formula: see text] where [Formula: see text] denotes the Beta function, [Formula: see text] for [Formula: see text] and [Formula: see text] for [Formula: see text] and [Formula: see text] for [Formula: see text]
Mean value of an arithmetic function associated with the Piltz divisor function
Authors: Karras Meselem , Derbal Abdallah
Published: October 2018

Let [Formula: see text] be a fixed integer, we define the multiplicative function [Formula: see text], where [Formula: see text] is the Piltz divisor function and [Formula: see text] is the unitary analogue function of [Formula: see text]. The main purpose of this paper to use elementary methods to study the mean value of the function [Formula: see text].
Carbon-metal oxide nanocomposites as lithium-sulfur battery cathodes
Authors: Zhu Sheng , Li Yan
Published: October 2018

In rechargeable lithium-sulfur (Li-S) batteries, the conductive carbon materials with high surface areas can greatly enhance the electrical conductivity of sulfur cathode, and metal oxides can restrain the dissolution of lithium polysulfides within the electrolyte through strong chemical bindings. The rational design of carbon-metal oxide nanocomposite cathodes has been considered as an effective solution to increase the sulfur utilization and improve cycling performance of Li-S batteries. Here, we summarize the recent progresses in the carbon-metal oxide composites for Li-S battery cathodes. Some insights are also offered on the future directions of carbon-metal oxide hybrid cathodes for high performance Li-S batteries.
Design Space Exploration of 3D Network-on-Chip
Authors: Lee Dongjin , Das Sourav , Kim Dae Hyun , Doppa Janardhan Rao , Pande Partha Pratim
Published: October 2018

High-performance and energy-efficient Network-on-Chip (NoC) architecture is one of the crucial components of the manycore processing platforms. A very promising NoC architecture recently proposed in the literature is the three-dimensional small-world NoC (3D SWNoC). Due to short vertical links in 3D integration and the robustness of small-world networks, the 3D SWNoC architecture outperforms its other 3D counterparts. However, the performance of 3D SWNoC is highly dependent on the placement of the links and associated routers. In this article, we propose a sensitivity-based link placement algorithm (SEN) to optimize the performance of 3D SWNoC. The sensitivity of a link in a NoC measures the importance of the link. The SEN algorithm optimizes the performance of 3D SWNoC by calculating the sensitivities of all the links in the NoC and removing the least important link repeatedly. We compare the performance of SEN algorithm with simulated annealing- (SA) and recently proposed machine-learning-based (ML) optimization algorithm. The optimized 3D SWNoC obtained by the proposed SEN algorithm achieves, on average, 11.5% and 13.6% lower latency and 18.4% and 21.7% lower energy-delay product than those optimized by the SA and ML algorithms respectively. In addition, the SEN algorithm is 26 to 33 times faster than the SA algorithm for the optimization of 64-, 128-, and 256-core 3D SWNoC designs. The performance gain provided by the SEN-, SA-, and ML-based methods also depend on the characteristics of the benchmarks under consideration. If the traffic pattern generated by a benchmark does not have enough variation, then the ML-based method does not have adequate opportunity to optimize the network. However, we find that ML-based methodology has faster convergence time than SEN and SA for bigger systems. The ML-based optimization algorithm is almost 4 and 97 times faster than the SEN- and SA-based algorithm for a system with 256 cores.
IMFlexCom
Authors: Parveen Farhana , Angizi Shaahin , Fan Deliang
Published: October 2018

In this article, we propose an In-Memory Flexible Computing platform (IMFlexCom) using a novel Spin Orbit Torque Magnetic Random Access Memory (SOT-MRAM) array architecture, which could work in dual mode: memory mode and computing mode. Such intrinsic in-memory logic (AND/OR/XOR) could be used to process data within memory to greatly reduce power-hungry and long distance massive data communication in conventional Von Neumann computing systems. A comprehensive reliability analysis is performed, which confirms ∼90mV and ∼10mV (worst-case) sense margin for memory and in-memory logic operation in variations on resistance-area product and tunnel magnetoresistance. We further show that sense margin for in-memory logic computation can be significantly increased by increasing the oxide thickness. Furthermore, we employ bulk bitwise vector operation and data encryption engine as case studies to investigate the performance of our proposed design. IMFlexCom shows ∼35× energy saving and ∼18× speedup for bulk bitwise in-memory vector AND/OR operation compared to DRAM-based in-memory logic. Again, IMFlexCom can achieve 77.27% and 85.4% lower energy consumption compared to CMOS-ASIC- and CMOL-based Advanced Encryption Standard (AES) implementations, respectively. It offers almost similar energy consumption as recent DW-AES implementation with 66.7% less area overhead.
System-Level Analysis of 3D ICs with Thermal TSVs
Authors: Alqahtani Ayed , Ren Zongqing , Lee Jaeho , Bagherzadeh Nader
Published: October 2018

3D stacking of integrated circuits (ICs) provides significant advantages in saving device footprints, improving power management, and continuing performance enhancement, particularly for many-core systems. However, the stacked structure makes the heat dissipation a challenging issue. While Thermal Through Silicon Via (TTSV) is a promising way of lowering the thermal resistance of dies, past research has either overestimated or underestimated the effects of TTSVs as a consequence of the lack of detailed 3D IC models or system-level simulations. Here, we propose a simulation flow to accurately simulate TTSV effects on 3D ICs. We adopt benchmarks from Splash-2 running on a full-system mode of the gem5 simulator, which generates all the system component activities. McPAT is used to generate the corresponding power consumption and the power traces are fed to HotSpot for thermal simulation. The temperature profiles of 2D and 3D Nehalem-like ×86 processors are compared. TTSVs are later placed close to hotspot regions to facilitate heat dissipation; the peak temperature of 3D Nehalem is reduced by 5--25% with a small area overhead of 6%. By using a detailed 3D thermal model, full-system simulation, and a validated thermal simulator, our results show accurate thermal analysis of 3D ICs.
Parallelization of dynamic languages: synchronizing built-in collections
Authors: Daloze Benoit , Tal Arie , Marr Stefan , Mössenböck Hanspeter , Petrank Erez
Published: October 2018

Dynamic programming languages such as Python and Ruby are widely used, and much effort is spent on making them efficient. One substantial research effort in this direction is the enabling of parallel code execution. While there has been significant progress, making dynamic collections efficient, scalable, and thread-safe is an open issue. Typical programs in dynamic languages use few but versatile collection types. Such collections are an important ingredient of dynamic environments, but are difficult to make safe, efficient, and scalable.

In this paper, we propose an approach for efficient and concurrent collections by gradually increasing synchronization levels according to the dynamic needs of each collection instance. Collections reachable only by a single thread have no synchronization, arrays accessed in bounds have minimal synchronization, and for the general case, we adopt the Layout Lock paradigm and extend its design with a lightweight version that fits the setting of dynamic languages. We apply our approach to Ruby's Array and Hash collections. Our experiments show that our approach has no overhead on single-threaded benchmarks, scales linearly for Array and Hash accesses, achieves the same scalability as Fortran and Java for classic parallel algorithms, and scales better than other Ruby implementations on Ruby workloads.
Julia: dynamism and performance reconciled by design
Authors: Bezanson Jeff , Chen Jiahao , Chung Benjamin , Karpinski Stefan , Shah Viral B. , Vitek Jan , Zoubritzky Lionel
Published: October 2018

Julia is a programming language for the scientific community that combines features of productivity languages, such as Python or MATLAB, with characteristics of performance-oriented languages, such as C++ or Fortran. Julia's productivity features include: dynamic typing, automatic memory management, rich type annotations, and multiple dispatch. At the same time, Julia allows programmers to control memory layout and leverages a specializing just-in-time compiler to eliminate much of the overhead of those features. This paper details the design choices made by the creators of Julia and reflects on the implications of those choices for performance and usability.
Concurrency-aware object-oriented programming with roles
Authors: Faes Michael , Gross Thomas R.
Published: October 2018

Object-oriented Programming has been effective in reducing code complexity in sequential programs, but in current practice,
concurrent
programs still present a number of challenges. We present here a model of object-oriented programming that identifies concurrent tasks and the
relationship between objects and tasks
, effectively making objects
concurrency-aware
. This awareness is formalized in a parallel programming model where every object
plays a role
in every task (e.g., the
readonly
role). When an object is shared with a new task, it adapts to the new sharing pattern by changing its roles, and therefore its behavior, i.e., the operations that can be performed with this object. This mechanism can be leveraged to prevent interfering accesses from concurrently executing tasks, and therefore makes parallel execution deterministic.

To this end, we present a role-based programming language that includes several novel concepts (role transitions, guarding, slicing) to enable practical, object-oriented deterministic parallel programming. We show that this language can be used to
safely
implement programs with a range of different parallel patterns. The implementations to 8 widely used programming problems achieve substantial parallel speedups and demonstrate that this approach delivers performance roughly on par with manually synchronized implementations.
Sound deadlock prediction
Authors: Kalhauge Christian Gram , Palsberg Jens
Published: October 2018

For a concurrent program, a prediction tool maps the history of a single run to a prediction of bugs in an exponential number of other runs. If all those bugs can occur, then the tool is sound. This is the case for some data race tools like RVPredict, but was, until now, not the case for deadlock tools. We present the first sound tool for predicting deadlocks in Java. Unlike previous work, we use request events and a novel form of executability constraints that enable sound and effective deadlock prediction. We model prediction as a general decision problem, which we show is decidable and can be instantiated to both deadlocks and data races. Our proof of decidability maps the decision problem to an equivalent constraint problem that we solve using an SMT-solver. Our experiments show that our tool finds real deadlocks effectively, including some missed by DeadlockFuzzer, which verifies each deadlock candidate by re-executing the input program. Our experiments also show that our tool can be used to predict more, real data races than RVPredict.
DeepBugs: a learning approach to name-based bug detection
Authors: Pradel Michael , Sen Koushik
Published: October 2018

Natural language elements in source code, e.g., the names of variables and functions, convey useful information. However, most existing bug detection tools ignore this information and therefore miss some classes of bugs. The few existing name-based bug detection approaches reason about names on a syntactic level and rely on manually designed and tuned algorithms to detect bugs. This paper presents DeepBugs, a learning approach to name-based bug detection, which reasons about names based on a semantic representation and which automatically learns bug detectors instead of manually writing them. We formulate bug detection as a binary classification problem and train a classifier that distinguishes correct from incorrect code. To address the challenge that effectively learning a bug detector requires examples of both correct and incorrect code, we create likely incorrect code examples from an existing corpus of code through simple code transformations. A novel insight learned from our work is that learning from artificially seeded bugs yields bug detectors that are effective at finding bugs in real-world code. We implement our idea into a framework for learning-based and name-based bug detection. Three bug detectors built on top of the framework detect accidentally swapped function arguments, incorrect binary operators, and incorrect operands in binary operations. Applying the approach to a corpus of 150,000 JavaScript files yields bug detectors that have a high accuracy (between 89% and 95%), are very efficient (less than 20 milliseconds per analyzed file), and reveal 102 programming mistakes (with 68% true positive rate) in real-world code.
ExceLint: automatically finding spreadsheet formula errors
Authors: Barowy Daniel W. , Berger Emery D. , Zorn Benjamin
Published: October 2018

Spreadsheets are one of the most widely used programming environments, and are widely deployed in domains like finance where errors can have catastrophic consequences. We present a static analysis specifically designed to find spreadsheet formula errors. Our analysis directly leverages the rectangular character of spreadsheets. It uses an information-theoretic approach to identify formulas that are especially surprising disruptions to nearby rectangular regions. We present ExceLint, an implementation of our static analysis for Microsoft Excel. We demonstrate that ExceLint is fast and effective: across a corpus of 70 spreadsheets, ExceLint takes a median of 8 seconds per spreadsheet, and it significantly outperforms the state of the art analysis.
Finding code that explodes under symbolic evaluation
Authors: Bornholt James , Torlak Emina
Published: October 2018

Solver-aided tools rely on symbolic evaluation to reduce programming tasks, such as verification and synthesis, to satisfiability queries. Many reusable symbolic evaluation engines are now available as part of solver-aided languages and frameworks, which have made it possible for a broad population of programmers to create and apply solver-aided tools to new domains. But to achieve results for real-world problems, programmers still need to write code that makes effective use of the underlying engine, and understand where their code needs careful design to elicit the best performance. This task is made difficult by the all-paths execution model of symbolic evaluators, which defies both human intuition and standard profiling techniques.

This paper presents symbolic profiling, a new approach to identifying and diagnosing performance bottlenecks in programs under symbolic evaluation. To help with diagnosis, we develop a catalog of common performance anti-patterns in solver-aided code. To locate these bottlenecks, we develop SymPro, a new profiling technique for symbolic evaluation. SymPro identifies bottlenecks by analyzing two implicit resources at the core of every symbolic evaluation engine: the symbolic heap and symbolic evaluation graph. These resources form a novel performance model of symbolic evaluation that is general (encompassing all forms of symbolic evaluation), explainable (providing programmers with a conceptual framework for understanding symbolic evaluation), and actionable (enabling precise localization of bottlenecks). Performant solver-aided code carefully manages the shape of these implicit structures; SymPro makes their evolution explicit to the programmer.

To evaluate SymPro, we implement profilers for the Rosette solver-aided language and the Jalangi program analysis framework. Applying SymPro to 15 published solver-aided tools, we discover 8 previously undiagnosed performance issues. Repairing these issues improves performance by orders of magnitude, and our patches were accepted by the tools' developers. We also conduct a small user study with Rosette programmers, finding that SymPro helps them both understand what the symbolic evaluator is doing and identify performance issues they could not otherwise locate.
Object-oriented recovery for non-volatile memory
Authors: Cohen Nachshon , Aksun David T. , Larus James R.
Published: October 2018

New non-volatile memory (NVM) technologies enable direct, durable storage of data in an application's heap. Durable, randomly accessible memory facilitates the construction of applications that do not lose data at system shutdown or power failure. Existing NVM programming frameworks provide mechanisms to consistently capture a running application's state. They do not, however, fully support object-oriented languages or ensure that the persistent heap is consistent with the environment when the application is restarted.

In this paper, we propose a new NVM language extension and runtime system that supports object-oriented NVM programming and avoids the pitfalls of prior approaches. At the heart of our technique is object reconstruction, which transparently restores and reconstructs a persistent object's state during program restart. It is implemented in NVMReconstruction, a Clang/LLVM extension and runtime library that provides: (i) transient fields in persistent objects, (ii) support for virtual functions and function pointers, (iii) direct representation of persistent pointers as virtual addresses, and (iv) type-specific reconstruction of a persistent object during program restart. In addition, NVMReconstruction supports updating an application's code, even if this causes objects to expand, by providing object migration. NVMReconstruction also can compact the persistent heap to reduce fragmentation. In experiments, we demonstrate the versatility and usability of object reconstruction and its low runtime performance cost.
Automatic diagnosis and correction of logical errors for functional programming assignments
Authors: Lee Junho , Song Dowon , So Sunbeom , Oh Hakjoo
Published: October 2018

We present FixML, a system for automatically generating feedback on logical errors in functional programming assignments. As functional languages have been gaining popularity, the number of students enrolling functional programming courses has increased significantly. However, the quality of feedback, in particular for logical errors, is hardly satisfying. To provide personalized feedback on logical errors, we present a new error-correction algorithm for functional languages, which combines statistical error-localization and type-directed program synthesis enhanced with components reduction and search space pruning using symbolic execution. We implemented our algorithm in a tool, called FixML, and evaluated it with 497 students’ submissions from 13 exercises, including not only introductory but also more advanced problems. Our experimental results show that our tool effectively corrects various and complex errors: it fixed 43% of the 497 submissions in 5.4 seconds on average and managed to fix a hard-to-find error in a large submission, consisting of 154 lines. We also performed user study with 18 undergraduate students and confirmed that our system actually helps students to better understand their programming errors.
Leto: verifying application-specific hardware fault tolerance with programmable execution models
Authors: Boston Brett , Gong Zoe , Carbin Michael
Published: October 2018

Researchers have recently designed a number of application-specific fault tolerance mechanisms that enable applications to either be naturally resilient to errors or include additional detection and correction steps that can bring the overall execution of an application back into an envelope for which an acceptable execution is eventually guaranteed. A major challenge to building an application that leverages these mechanisms, however, is to verify that the implementation satisfies the basic invariants that these mechanisms require---given a model of how faults may manifest during the application's execution.

To this end we present Leto, an SMT-based automatic verification system that enables developers to verify their applications with respect to an execution model specification. Namely, Leto enables software and platform developers to programmatically specify the execution semantics of the underlying hardware system as well as verify assertions about the behavior of the application's resulting execution. In this paper, we present the Leto programming language and its corresponding verification system. We also demonstrate Leto on several applications that leverage application-specific fault tolerance
Bladder decompensation and reduction in nerve density in a rat model of chronic bladder outlet obstruction are attenuated with the NLRP3 inhibitor glyburide
Authors: Hughes Francis M. , Sexton Stephanie J. , Ledig Patrick D. , Yun Chloe E. , Jin Huixia , Purves J. Todd
Published: October 2018

Bladder outlet obstruction (BOO) leads to progressive voiding dysfunction. Acutely, obstruction triggers inflammation that drives bladder dysfunction. Over time, inflammation leads to decreased bladder nerve density and increased fibrosis, responsible for eventual decompensation and irreversibility. We have previously shown that BOO triggers inflammation, reduced bladder nerve density and increased fibrosis via activation of the NLRP3 inflammasome in an acutely obstructed (12-day) rat model. However, as BOO progresses, the bladder may become decompensated with an increase in postvoid residual volume and decreased voiding efficiency. Currently, we have examined rat bladder function and nerve densities after chronic BOO to determine whether NLRP3 plays a role in the decompensation at this stage. Four groups were examined: control, sham-operated, BOO, or BOO+gly (glyburide; an NLRP3 inhibitor). After 42 days, bladder weight, inflammation (Evans blue), urodynamics, and nerve density were measured. BOO greatly enhanced bladder weights and inflammation, while inflammation was prevented by glyburide. Voiding pressures were increased, and flow rates decreased in BOO and BOO+gly groups, demonstrating physical obstruction. No difference in frequency or voided volume was detected. However, postvoid residual volumes were greatly increased in BOO rats while BOO+gly rats were not different than controls. Moreover, there was a dramatic decrease in voiding efficiency in the chronic BOO rats, which was prevented with glyburide treatment. Finally, a reduction in nerve density was apparent with BOO and attenuated with glyburide. Together the results suggest a critical role for NLRP3 in mediating bladder decompensation and nerve density during chronic BOO.
Intensity matters: effects of cadence and power output on corticospinal excitability during arm cycling are phase and muscle dependent
Authors: Lockyer E. J. , Benson R. J. , Hynes A. P. , Alcock L. R. , Spence A. J. , Button D. C. , Power K. E.
Published: October 2018

The present study investigated the effects of cadence and power output on corticospinal excitability to the biceps (BB) and triceps brachii (TB) during arm cycling. Supraspinal and spinal excitability were assessed using transcranial magnetic stimulation (TMS) of the motor cortex and transmastoid electrical stimulation (TMES) of the corticospinal tract, respectively. Motor-evoked potentials (MEPs) elicited by TMS and cervicomedullary motor-evoked potentials (CMEPs) elicited by TMES were recorded at two positions during arm cycling corresponding to mid-elbow flexion and mid-elbow extension (i.e., 6 and 12 o’clock made relative to a clock face, respectively). Arm cycling was performed at combinations of two cadences (60 and 90 rpm) at three relative power outputs (20, 40, and 60% peak power output). At the 6 o’clock position, BB MEPs increased ~11.5% as cadence increased and up to ~57.2% as power output increased ( P < 0.05). In the TB, MEPs increased ~15.2% with cadence ( P = 0.013) but were not affected by power output, while CMEPs increased with cadence (~16.3%) and power output (up to ~19.1%, P < 0.05). At the 12 o’clock position, BB MEPs increased ~26.8% as cadence increased and up to ~96.1% as power output increased ( P < 0.05), while CMEPs decreased ~29.7% with cadence ( P = 0.013) and did not change with power output ( P = 0.851). In contrast, TB MEPs were not different with cadence or power output, while CMEPs increased ~12.8% with cadence and up to ~23.1% with power output ( P < 0.05). These data suggest that the “type” of intensity differentially modulates supraspinal and spinal excitability in a manner that is phase- and muscle dependent.

NEW & NOTEWORTHY There is currently little information available on how changes in locomotor intensity influence excitability within the corticospinal pathway. This study investigated the effects of arm cycling intensity (i.e., alterations in cadence and power output) on corticospinal excitability projecting to the biceps and triceps brachii during arm cycling. We demonstrate that corticospinal excitability is modulated differentially by cadence and power output and that these modulations are dependent on the phase and the muscle examined.
Development of a Five‐Degree‐of‐Freedom Seated Human Model and Parametric Studies for Its Vibrational Characteristics
Authors: Bae Jong-Jin , Kang Namcheol
Published: October 2018

This study focuses on the biodynamic responses of a seated human model to whole‐body vibrations in a vehicle. Five‐degree‐of‐freedom nonlinear equations of motion for a human model were derived, and human parameters such as spring constants and damping coefficients were extracted using a three‐step optimization processes that applied the experimental data to the mathematical human model. The natural frequencies and mode shapes of the linearized model were also calculated. In order to examine the effects of the human parameters, parametric studies involving initial segment angles and stiffness values were performed. Interestingly, mode veering was observed between the fourth and fifth human modes when combining two different spring stiffness values. Finally, through the frequency responses of the human model, nonlinear characteristics such as frequency shift and jump phenomena were clearly observed.
Pterostilbene 4 ′‐β‐Glucoside Attenuates LPS‐Induced Acute Lung Injury via Induction of Heme Oxygenase‐1
Authors: Park Jeongmin , Chen Yingqing , Zheng Min , Ryu Jinhyun , Cho Gyeong Jae , Surh Young-Joon , Sato Daisuke , Hamada Hiroki , Ryter Stefan W. , Kim Uh-Hyun , Joe Yeonsoo , Chung Hun Taeg
Published: October 2018

Heme oxygenase‐1 (HO‐1) can exert anti‐inflammatory and antioxidant effects. Acute lung injury (ALI) is associated with increased inflammation and influx of proinflammatory cells and mediators in the airspaces and lung parenchyma. In this study, we demonstrate that pterostilbene 4 ′‐β‐glucoside (4‐PG), the glycosylated form of the antioxidant pterostilbene (PTER), can protect against lipopolysaccharide‐ (LPS‐) or Pseudomonas aeruginosa- (P. aeruginosa‐) induced ALI when applied as a pretreatment or therapeutic post‐treatment, via the induction of HO‐1. To determine whether HO‐1 mediates the antioxidant and anti‐inflammatory effects of 4‐PG, we subjected mice genetically deficient in Hmox-1 to LPS‐induced ALI and evaluated histological changes, HO‐1 expression, and proinflammatory cytokine levels in bronchoalveolar lavage (BAL) fluid. 4‐PG exhibited protective effects on LPS‐ or P. aeruginosa-induced ALI by ameliorating pathological changes in lung tissue and decreasing proinflammatory cytokines. In addition, HO‐1 expression was significantly increased by 4‐PG in cells and in mouse lung tissues. The glycosylated form of pterostilbene (4‐PG) was more effective than PTER in inducing HO‐1 expression. Genetic deletion of Hmox-1 abolished the protective effects of 4‐PG against LPS‐induced inflammatory responses. Furthermore, we found that 4‐PG decreased both intracellular ROS levels and mitochondrial (mt) ROS production in a manner dependent on HO‐1. Pharmacological application of the HO‐1 reaction product carbon monoxide (CO), but not biliverdin or iron, conferred protection in Hmox-1‐deficient macrophages. Taken together, these results demonstrate that 4‐PG can increase HO‐1 expression, which plays a critical role in ameliorating intracellular and mitochondrial ROS production, as well as in downregulating inflammatory responses induced by LPS. Therefore, these findings strongly suggest that HO‐1 mediates the antioxidant and anti‐inflammatory effects of 4‐PG.
Exploiting Opportunistic Scheduling for Physical‐Layer Security in Multitwo User NOMA Networks
Authors: Shim Kyusung , An Beongku
Published: October 2018

In this paper, we address the opportunistic scheduling in multitwo user NOMA system consisting of one base station, multinear user, multifar user, and one eavesdropper. To improve the secrecy performance, we propose the users selection scheme, called best‐secure‐near‐user best‐secure‐far‐user (BSNBSF) scheme. The BSNBSF scheme aims to select the best near‐far user pair, whose data transmission is the most robust against the overhearing of an eavesdropper. In order to facilitate the performance analysis of the BSNBSF scheme in terms of secrecy outage performance, we derive the exact closed‐form expression for secrecy outage probability (SOP) of the selected near user and the tight approximated closed‐form expression for SOP of the selected far user, respectively. Additionally, we propose the descent‐based search method to find the optimal values of the power allocation coefficients that can minimize the total secrecy outage probability (TSOP). The developed analyses are corroborated through Monte Carlo simulation. Comparisons with the random‐near‐user random‐far‐user (RNRF) scheme are performed and show that the proposed scheme significantly improves the secrecy performance.
Pediatric HIV Disclosure in Northern India: Evaluation of Its Prevalence, Perceptions amongst Caregivers, and Its Impact on CLHIV
Authors: Meena Rajesh , Hemal Alok , Arora Shilpa Khanna
Published: October 2018

Background. With improving standards of care of children living with HIV (CLHIV), pediatric HIV related mortality rates are declining. New challenges like HIV status disclosure are emerging which need to be addressed to ensure their smooth transition into adulthood. Poor disease disclosure rates are observed in CLHIV globally. Aims. This study was done to assess the prevalence of HIV disclosure in North Indian CLHIV, know the perceptions of caregivers regarding disclosure, and evaluate the impact of disclosure on CLHIV. Methods. It was a questionnaire based cross-sectional study carried out amongst 144 caregivers of CLHIV aged 6-16 years attending the pediatric HIV clinic of a tertiary care teaching hospital. Results. Though the majority (93.8%) caregivers felt that it is important to disclose but only 33% of the children were actually disclosed. Eighty five percent felt that disclosure must be done by one of the family members and correspondingly 73% of the disclosed children were actually disclosed by their parents. Forty seven percent believed that the most appropriate age for disclosure is 10-12 years. The mean age at which disclosure was actually done was 11.06 ± 1.62 years. Comparison of the disclosed and undisclosed CLHIV revealed that the disclosed group had significantly higher age, longer duration of taking ART, and higher proportion of paternal orphans. Age of the CLHIV was the only significant factor for disclosure. Several reasons were cited by the caregivers for nondisclosure. The caregivers observed improved drug adherence in 47.9% of the children following disclosure. Conclusions. There is a need to develop region specific pediatric HIV disclosure guidelines keeping in mind the caregivers’ perceptions. The guidelines must be age appropriate, systematic, and socioculturally acceptable. The most suitable age for disclosure appears to be 10-12 years. Involvement of caregivers and health care providers in the process is a must.
Metastatic Small Cell Carcinoma of the Urinary Bladder That Recurred in the Vagina 6 Years after Radical Cystectomy: A Case Report
Authors: Isono Makoto , Ito Keiichi , Hamada Shinsuke , Takahashi Masahiro , Sasa Hidenori , Shimazaki Hideyuki , Asano Tomohiko
Published: October 2018

Small cell carcinoma (SCC) of the urinary bladder is highly aggressive and portends a poor outcome. Herein, we report a patient with recurrent SCC of the urinary bladder who experienced an unusually long-term disease-free duration after radical cystectomy. The patient was a 60-year-old woman who had undergone transurethral resection followed by radical cystectomy for muscle-invasive bladder cancer (high-grade urothelial carcinoma with adenocarcinomatous differentiation) 6 years prior; the surgical specimen had a negative surgical margin. She was referred to our hospital because of continuous bleeding from her vagina. Magnetic resonance imaging showed a mass located at the anterior wall of her residual vagina, a biopsy of which confirmed a pathological diagnosis of adenocarcinoma. The vaginal tumor and a section of the sigmoid colon were resected en bloc and were pathologically diagnosed as adenocarcinoma and SCC. We reevaluated the initial transurethral resection specimen and found SCC with foci of adenocarcinoma concomitant with high-grade urothelial carcinoma. Local recurrence and metastasis at the pelvic bone occurred 4 months later; although radiation therapy was performed, she died of the progressive disease.
SCCAF: A Secure and Compliant Continuous Assessment Framework in Cloud‐Based IoT Context
Authors: Li Xiang , Jin Xin , Wang Qixu , Cao Mingsheng , Chen Xingshu
Published: October 2018

The Internet of Things (IoT) offers a wide variety of benefits to our daily lives in many ways, ranging from smart wearable devices to industrial systems. However, it also brings well‐known security and compliance concerns, especially in the physical layer. In addition, due to numerous IoT architectures which have been developed and deployed based on the cloud, the security and compliance of IoT depend on the cloud thoroughly. In this paper, a secure and compliant continuous assessment framework (SCCAF) is proposed to evaluate the security and compliance levels of cloud services in life‐cycle. The SCCAF facilitates cloud service to customers to select an optimal cloud service provider (CSP) which satisfies their desired security requirements. Moreover, it also enables cloud service customers to evaluate the compliance of the selected CSP in the process of using cloud services. To evaluate the performance and availability of SCCAF, we carry out a series of experiments with case study and real‐world scenario datasets. Experimental results show that SCCAF can assess the security and compliance of CSPs efficiently and effectively.
PrimaryKlebsiella pneumoniaeOsteomyelitis with Bacteremia and Sepsis in a Patient with Cirrhosis
Authors: Khatri Akshay , Kanaparthy Naga Sasidhar , Selvaraj Bright Jebaraj , Cho Eunna , El Khoury Marc Y.
Published: October 2018

Osteomyelitis is commonly caused byStaphylococci,Streptococci,Escherichia coli, and anaerobes. There have been cases of rare organisms likeKlebsiella pneumoniae(Kp) being initially overlooked as causes of osteomyelitis. We report a case of an elderly cirrhotic adult male transferred for further management of liver failure, who was subsequently diagnosed withKposteomyelitis and sepsis. He had a history of blunt leg trauma, and MRI of the leg revealed osteomyelitis, with a negative workup for other sources of infection.Kposteomyelitis is reported in less than 100 cases, mainly in pediatric and sickle-cell patients. There are no pathognomonic imaging findings. Lesions may be metastatic, with rapid widespread destruction and exuberant periosteal reaction.Kpis a rare, under recognized cause of osteomyelitis in immune-suppressed adults. Given its pathogenicity, early identification is critical.
Beneficial Effects of Qigong Wuqinxi in the Improvement of Health Condition, Prevention, and Treatment of Chronic Diseases: Evidence from a Systematic Review
Authors: Guo Yu , Xu Mingmin , Wei Zeren , Hu Qingchuan , Chen Yue , Yan Jian , Wei Yulong
Published: October 2018

Purpose. Qigong is a modality of traditional Chinese mind‐body medicine that has been used to prevent and cure ailments, to improve health in China for thousands of years. Wuqinxi, a Chinese traditional Qigong that focuses on mind‐body integration, is thought to be an effective exercise in promoting physical and mental wellbeing. Thus, we summarized the evidence and aim to unravel effects of Wuqinxi on health outcomes. Methods. We performed a systematic review of Wuqinxi studies published in English or Chinese since 1979. Relevant English and Chinese language electronic data bases were used for literature search. The selection of studies, data extraction, and validation were performed independently by two reviewers. Results. A total of 28 eligible studies were included in this review, among which three are 3 in English and 25 in Chinese. The studies included in this review involve three different experimental designs: (1) 16 RCTs; (2) 2 historical cohort studies; and (3) 10 pretest and posttest studies (PPS). Participants in this review are categorized as either healthy or clinical populations. The results from this systematic review support the notion that Wuqinxi may be effective as an adjunctive rehabilitation method for improving psychological and physiological wellbeing among different age of healthy populations in addition to alleviating and treating diseases among various clinical populations. Conclusion. The results indicated that Wuqinxi has been thought to be beneficial to improve health and treat chronic diseases. However, the methodological problems in the majority of included studies make it difficult to draw firm conclusive statements. More methodologically rigorous designed large‐scale RCTs with a long‐term follow‐up assessment should be further conducted to examine the effects of Wuqixi on health‐related parameters and disease‐specific measures in different health conditions. This systematic review lends insight for future studies on Wuqinxi and its potential application in preventive and rehabilitation medicine.
The Patient-Reported Outcomes Thermometer–5-Item Scale (5T-PROs): Validation of a New Tool for the Quick Assessment of Overall Health Status in Painful Rheumatic Diseases
Authors: Salaffi Fausto , Di Carlo Marco , Carotti Marina , Farah Sonia
Published: October 2018

Objective. To investigate the construct validity, reliability (internal consistency and retest reliability), and feasibility of the patient-reported outcomes thermometer–5-item scale (5T-PROs), a new tool to measure overall health status in patients with painful chronic rheumatic diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (axialSpA), and fibromyalgia (FM).Methods. Consecutive patients have been involved in this study. The following analyses were performed to establish the validity of the 5T-PROs: (1) principal component factor analysis was used to identify the presence of a relatively small number of underlying latent factors than can be used to represent relations among sets of many variables; (2) Cronbach’s alpha was calculated as an indicator of internal consistency; and (3) Pearson product-moment correlations were conducted to assess the convergent validity. The 5T-PROs was also administered a second time (two weeks after the initial administration) to a subset of sample (n= 426) to allow for calculation of test-retest reliability. We used the intraclass correlation coefficient (ICC) as an estimate of test-retest reliability. Additionally, discriminant validity was tested using analysis of variance (ANOVA) with Bonferroni post hoc multiple comparisons, in different disease conditions. Feasibility was analyzed by the time taken in completing the 5T-PROs and the proportion of patients able to complete the 5 item.Results. 1,199 patients (572 with RA, 251 with axialSpA, 150 with PsA, and 226 with FM) were examined. The mean age was 55.7 (standard deviation: 13.1; range: 20 to 80) years. Factor analysis yielded two factors which accounted for 62.54% of the variance of the 5T-PROs. The first factor “Symptom Summary Score” (35.57% of the variance) revealed a good internal consistency (alpha = 0.88); the internal consistency of the second factor “Psychological Summary Score” (26.97% of the variance) was moderate (alpha = 0.69). The reliability of the whole instrument was good (alpha = 0.82). A very high correlation was obtained between Symptom Summary Score and SF-36 PCS and between pain thermometer intensity and SF-36 bodily pain. For all five items and summary scale scores of the SF-36, there was strong evidence that the mean rank of the scores differs significantly between the groups (Kruskal–Wallis tests,p<0.001). Discriminant validity, assessed by comparing the 5T-PRO dimensions in patients with different states of disease activity, showed that the 5T-PROs show moderate association with the presence of comorbidities. It was also noted that it was inversely correlated (p=0.01) to years of formal education.Conclusion. The 5T-PROs is easily administered, reliable and a valid instrument for evaluating the extensive multidimensional impact associated with chronic painful rheumatic conditions.