bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality evaluation and future priorities for delivering acute myocardial infarction care in Sri Lanka
Authors: Ranasinghe Walithotage Gotabhaya , Beane Abi , Vithanage Thamal Dasitha Palligoda , Priyadarshani Gamage Dona Dilanthi , Colombage Don Dhanushka Eranga , Ponnamperuma Chandrike Janminda , Karunarathne Suneth , Schultsz Constance , Dondorp Arjen M , Haniffa Rashan
Published: December 2019

Aim

This study evaluates the quality of care for patients admitted with acute myocardial infarction (AMI) in a tertiary hospital in Colombo using the European Society of Cardiology Quality of Care Working Group’s guidelines (2017).

Methods

A recently implemented electronic AMI registry m-Health tool was used for prospective data collection. Each patient was assessed for eligibility for each of the six domains of quality. Global Registry of Acute Coronary Events Risk Model for predicted probability of mortality, and scores for risk of bleeding complications (CRUSADE) and severity of heart failure (Killip classification) were calculated as per published guidelines. A composite measure of quality was derived from compliance with the six domains. Patients were followed up via telephone at 30 days following discharge to evaluate outcome and satisfaction. Organisational information was assessed by administrative review and interview.

Results

Between March 2017 and April 2018, 934 patients with AMI presented to the cardiology department. The majority of patients (90.4%) presented with features of ST-elevation myocardial infarction (STEMI). Mean (SD) overall compliance with the composite quality indicator (CQI) was 44% (0.07). Compliance of ≥50% to the CQI was achieved in 9.8% of STEMI patients. The highest compliance was observed for antithrombotics during hospitalisation (79.1%) and continuous measure of patient satisfaction (76.1%). The lowest compliance was for organisational structure and care processes (22.4%).

Conclusion

This study reports a registry-based continuous evaluation of the quality of AMI care from a low and middle-income country. Priorities for improvement include improved referral, and networking of primary and secondary health facilities with the percutaneous coronary intervention centre.
Lifetime cardiovascular management of patients with previous Kawasaki disease
Authors: Brogan Paul , Burns Jane C , Cornish Jacqueline , Diwakar Vinod , Eleftheriou Despina , Gordon John B , Gray Huon Hamilton , Johnson Thomas William , Levin Michael , Malik Iqbal , MacCarthy Philip , McCormack Rachael , Miller Owen , Tulloh Robert M R
Published: December 2019

Kawasaki disease (KD) is an inflammatory disorder of young children, associated with vasculitis of the coronary arteries with subsequent aneurysm formation in up to one-third of untreated patients. Those who develop aneurysms are at life-long risk of coronary thrombosis or the development of stenotic lesions, which may lead to myocardial ischaemia, infarction or death. The incidence of KD is increasing worldwide, and in more economically developed countries, KD is now the most common cause of acquired heart disease in children. However, many clinicians in the UK are unaware of the disorder and its long-term cardiac complications, potentially leading to late diagnosis, delayed treatment and poorer outcomes. Increasing numbers of patients who suffered KD in childhood are transitioning to the care of adult services where there is significantly less awareness and experience of the condition than in paediatric services. The aim of this document is to provide guidance on the long-term management of patients who have vascular complications of KD and guidance on the emergency management of acute coronary complications. Guidance on the management of acute KD is published elsewhere.
Biomechanical thrombosis: the dark side of force and dawn of mechano-medicine
Authors: Chen Yunfeng , Ju Lining Arnold
Published: December 2019

Arterial thrombosis is in part contributed by excessive platelet aggregation, which can lead to blood clotting and subsequent heart attack and stroke. Platelets are sensitive to the haemodynamic environment. Rapid haemodynamcis and disturbed blood flow, which occur in vessels with growing thrombi and atherosclerotic plaques or is caused by medical device implantation and intervention, promotes platelet aggregation and thrombus formation. In such situations, conventional antiplatelet drugs often have suboptimal efficacy and a serious side effect of excessive bleeding. Investigating the mechanisms of platelet biomechanical activation provides insights distinct from the classic views of agonist-stimulated platelet thrombus formation. In this work, we review the recent discoveries underlying haemodynamic force-reinforced platelet binding and mechanosensing primarily mediated by three platelet receptors: glycoprotein Ib (GPIb), glycoprotein IIb/IIIa (GPIIb/IIIa) and glycoprotein VI (GPVI), and their implications for development of antithrombotic ‘mechano-medicine’ .
Reversal of warfarin anticoagulation in geriatric traumatic brain injury due to ground-level falls
Authors: Paisley Michael John , Johnson Arianne , Price Spencer , Chow Bernard , Limon Liliana , Sharma Rohit , Kaminski Stephen
Published: December 2019

Background

The efficacy of prothrombin complex concentrate (PCC) compared with fresh frozen plasma (FFP) for reversal of oral anticoagulants has not been investigated in geriatric patients suffering intracranial hemorrhage (ICH) due to a ground-level fall (GLF).

Methods

Patients 65 years and older who were treated at Santa Barbara Cottage Hospital between January 2011 and March 2018 with ICH after a GLF while taking warfarin were reviewed. Patients were reversed with either FFP (n=25) or PCC (n=27) and patient outcomes were compared. Separate analyses were conducted for patients who received adjuvant vitamin K administration and those who did not.

Results

Mortality rates, hospital length of stay, intensive care unit admission and length of stay were similar for both FFP and PCC intervention. There was no difference in radiological progression of hemorrhage within the first 24 hours of admission (FFP: 36%, PCC: 43%, p=0.365). In patients who had international normalized ratio (INR) values measured prior to intervention, 81% (17 out of 21) of the PCC group reached an INR value below 1.5 within an 8-hour period, whereas only 29% (4 out of 14) of the FFP group did (p=0.002). Vitamin K was concomitantly given to 28% of the patients receiving FFP, and 81% of those patients receiving PCC. No significant differences in outcomes were found whether adjunctive vitamin K was administered or not, in either FFP or PCC group. However, when vitamin K was not administered, the PCC group had a higher rate of INR reversal (80% vs. 10% for FFP, p=0.006).

Conclusion

Administration of PCC is as effective in short-term outcomes as FFP in treating geriatric patients on warfarin sustaining an ICH after a GLF. INR reversal was more successful, significantly faster, and required lower infusion volumes in patients receiving PCC.

Level of evidence

Level III.
Chronic lameness associated with congenital hypothyroidism in three dogs
Authors: Kopke Matthew A , Mukorera Varaidzo , Leisewitz Andrew L , Ruaux Craig G
Published: December 2019

A 4‐month‐old female entire Saint Bernard, a 10‐month‐old female spayed Great Dane and a 5‐year‐old male neutered Miniature Schnauzer cross poodle were presented with the primary complaint of chronic lameness. Subjectively, all three dogs were disproportionate dwarfs. Epiphysial dysgenesis was identified on survey radiographs in all three cases, along with varying degrees of secondary osteoarthrosis. Low serum thyroxine, in conjunction with low‐to‐normal thyroid stimulating hormone concentration, and the presence of epiphysial dysgenesis, served to confirm congenital hypothyroidism. Following commencement of synthetic thyroid hormone supplementation, resolution of clinical signs was noted within a 1‐month period. Improvement in radiographic abnormalities was also seen over a 6‐month period.
Frost heave and thaw consolidation modelling. Part 1: A water flux function for frost heaving
Authors: Yu Fan , Guo Peijun , Lai Yuanming , Stolle Dieter
Published: December 2019

Although much effort has been made to develop various frost heave models in the past decades, a simple yet versatile model is still needed for engineering applications. This paper presents a method to estimate frost heave in frozen soil using a macroscopic water flux function that extends the segregation potential to make it applicable for both steady state and transient freezing and thawing states. The formation of an individual ice lens is modelled by combining previously developed stress and strain criteria. The water flux function, which includes various factors in accordance with the porosity rate function, can describe the growth of both new and old ice lenses. More importantly, every component of the water flux function is physically explained by the theory of pre-melting dynamics, where all the influencing factors are traced back to their impacts on the ice volume distribution. The performance of the model is demonstrated via simulations of one-dimensional freezing and thawing processes after the model is validated by a specific case from previous literature. Although adequate data are not available for a stricter experimental verification of the model, it is observed that the simulations predict the general course of events together with significant specific features that were identified in previous experimental studies.
What did you see? A study to measure personalization in Google’s search engine
Authors: Krafft Tobias D. , Gamer Michael , Zweig Katharina A.
Published: December 2019

In this paper we present the results of the project “#Datenspende” where during the German election in 2017 more than 4000 people contributed their search results regarding keywords connected to the German election campaign.

Analyzing the donated result lists we prove, that the room for personalization of the search results is very small. Thus the opportunity for the effect mentioned in Eli Pariser’s filter bubble theory to occur in this data is also very small, to a degree that it is negligible. We achieved these results by applying various similarity measures to the result lists that were donated. The first approach using the number of common results as a similarity measure showed that the space for personalization is less than two results out of ten on average when searching for persons and at most four regarding the search for parties. Application of other, more specific measures show that the space is indeed smaller, so that the presence of filter bubbles is not evident.

Moreover this project is also a proof of concept, as it enables society to permanently monitor a search engine’s degree of personalization for any desired search terms. The general design can also be transferred to intermediaries, if appropriate APIs restrict selective access to contents relevant to the study in order to establish a similar degree of trustworthiness.
A verification method for identifying critical segments considering highly correlated characteristics of traffic flow
Authors: Zhang Zundong , Zhu Mengyao , Ban Jeff , Zhang Yifan
Published: December 2019

Since critical segments on a transportation network vary over time and are determined by the nature of traffic systems, the identification of critical segments is the basis for realizing area-wide traffic coordination control and regional traffic state optimization. For decades, the identification of critical segments of dynamic traffic flow networks has attracted wide attention. In recent years, some important advances have been made in the related research on the identification of critical segments using the theory of percolation which validates the impact of critical segments by increasing the speed value of critical segments. However, most of them failed to take into account highly correlated characteristics between adjacent segments, which causes identification results cannot be validated effectively and efficiently. In this paper, we improve the existing critical segments identification methods by considering the highly correlated characteristics. A verification method based on ego-networks is proposed that improves the ego-networks speed of critical segments to verify the accuracy of identification results. The experiment shows the method can verify the validity of critical segments recognition results more accurately.
The study of chained routing algorithm for WNS based on group perception
Authors: Wang Yunlan , Li Fang
Published: December 2019

In order to effectively solve the problem of routing efficiency in wireless sensor networks, a new chained routing algorithm based on group perception is proposed in this paper. First, the performance index parameters such as energy consumption and area coverage are given. Meanwhile, a chained routing strategy based on node utility value is established, which combines the “storage-carrying-forwarding” opportunistic transmission mode and decides whether a message needs to be forwarded to an encounter node according to a message forwarding strategy. Finally, the key factors affecting the chained routing algorithm are studied through simulation experiments. The results show that compared with random routing, the chained routing algorithm has great advantages in message delivery rate, collision probability, accuracy, etc.
Jordan isomorphisms of skew incidence rings
Authors: Fornaroli Érica Z.
Published: December 2019

Let [Formula: see text] be a finite partially ordered set, [Formula: see text] a commutative domain and [Formula: see text] an endomorphism of [Formula: see text]. We define the skew incidence ring [Formula: see text] and we prove that each Jordan isomorphism of [Formula: see text] onto an associative ring [Formula: see text] is a near-sum of a homomorphism and an anti-homomorphism.
Fluorescent gold nanoclusters prepared in the presence of DNA
Authors: Karpushkin Evgeny , Ivanova Natalia , Lopatina Larisa , Sergeyev Vladimir
Published: December 2019

Gold nanoclusters have been prepared using DNA as the stabilizer. The accompanying changes in the system at different components ratios have been discussed; the obtained products have been comprehensively characterized using a set of spectroscopy and microscopy techniques. Complexity of the underlying mechanism and the many-faceted role of DNA in the synthesis have been demonstrated. The obtained nanoclusters can serve as efficient homogeneous catalysts and in vivo biosensors.
The approach to optimization of finite-difference schemes for the advective stage of finite-difference-based lattice Boltzmann method
Authors: Krivovichev Gerasim V. , Marnopolskaya Elena S.
Published: December 2019

The approach to optimization of finite-difference (FD) schemes for the linear advection equation (LAE) is proposed. The FD schemes dependent on the scalar dimensionless parameter are considered. The parameter is included in the expression, which approximates the term with spatial derivatives. The approach is based on the considering of the dispersive and dissipative characteristics of the schemes as the functions of the parameter. For the proper choice of the parameter, these functions are minimized. The approach is applied to the optimization of two-step schemes with an asymmetric approximation of time derivative and with various approximations of the spatial term. The cases of schemes from first to fourth approximation orders are considered. The optimal values of the parameter are obtained. Schemes with the optimal values are applied to the solution of test problems with smooth and discontinuous initial conditions. Also, schemes are used in the FD-based lattice Boltzmann method (LBM) for modeling of the compressible gas flow. The obtained numerical results demonstrate the convergence of the schemes and decaying of the numerical dispersion.
A Comparative Analysis of Different Rapid Prototyping Techniques for Making Intricately Shaped Structure
Authors: Ali Ayisha , Soni Manoj , Javaid Mohd , Haleem Abid
Published: December 2019

Rapid Prototyping (RP) encompasses a group of technologies being used to produce a scaled model of a physical object using a three-dimensional (3D) computer-aided design (CAD) data. The objective of this paper is to see how the manufacturing productivity of intricately shaped jewelry designs is possible using different RP techniques. In this research, we have used RP techniques for the efficient development and production of an intricately shaped jewelry structure, which otherwise is difficult to produce with existing technologies. The primary purpose of this research is to find the economical and efficient method for three-dimensional printing of artificial jewelry structures. Stereolithography (SLA), fused deposition modeling (FDM) and Projet 3D printing technologies are used for the production of some intricate jewelry. By using RP, artificial jewelry makers can produce 3D printed parts quickly, and customize limited-edition jewelry as it enables the production of beautiful and colorful pieces that previously required large-scale, complex and expensive machinery.
Steganographer Detection via Multi-Scale Embedding Probability Estimation
Authors: Zhong Sheng-Hua , Wang Yuantian , Ren Tongwei , Zheng Mingjie , Liu Yan , Wu Gangshan
Published: December 2019

Steganographer detection aims to identify the guilty user who utilizes steganographic methods to hide secret information in the spread of multimedia data, especially image data, from a large amount of innocent users on social networks. A true embedding probability map illustrates the probability distribution of embedding secret information in the corresponding images by specific steganographic methods and settings, which has been successfully used as the guidance for content-adaptive steganographic and steganalytic methods. Unfortunately, in real-world situation, the detailed steganographic settings adopted by the guilty user cannot be known in advance. It thus becomes necessary to propose an automatic embedding probability estimation method. In this article, we propose a novel content-adaptive steganographer detection method via embedding probability estimation. The embedding probability estimation is first formulated as a learning-based saliency detection problem and the multi-scale estimated map is then integrated into the CNN to extract steganalytic features. Finally, the guilty user is detected via an efficient Gaussian vote method with the extracted steganalytic features. The experimental results prove that the proposed method is superior to the state-of-the-art methods in both spatial and frequency domains.
Graph-based Recommendation Meets Bayes and Similarity Measures
Authors: Lopes Ramon , Assunção Renato , Santos Rodrygo L. T.
Published: December 2019

Graph-based approaches provide an effective memory-based alternative to latent factor models for collaborative recommendation. Modern approaches rely on either sampling short walks or enumerating short paths starting from the target user in a user-item bipartite graph. While the effectiveness of random walk sampling heavily depends on the underlying path sampling strategy, path enumeration is sensitive to the strategy adopted for scoring each individual path. In this article, we demonstrate how both strategies can be improved through Bayesian reasoning. In particular, we propose to improve random walk sampling by exploiting distributional aspects of items’ ratings on the sampled paths. Likewise, we extend existing path enumeration approaches to leverage categorical ratings and to scale the score of each path proportionally to the affinity of pairs of users and pairs of items on the path. Experiments on several publicly available datasets demonstrate the effectiveness of our proposed approaches compared to state-of-the-art graph-based recommenders.
Objective Assessment of Human Workload in Physical Human-robot Cooperation Using Brain Monitoring
Authors: Memar Amirhossein H. , Esfahani Ehsan T.
Published: December 2019

The notions of safe and compliant interaction are not sufficient to ensure effective physical human-robot cooperation. To obtain an optimal compliant behavior (e.g., variable impedance/admittance control), assessment techniques are required to measure the effectiveness of the interaction in terms of perceived workload by users. This study investigates electroencephalography (EEG) monitoring as an objective measure to classify workload in cooperative manipulation with compliance. An experimental study is conducted including two types of manipulation (gross and fine) with two admittance levels (low- and high-damping). Performance and self-reported measures indicate that a proper admittance level that enhances perceived workload is task-dependent. This information is used to form a binary classification problem (low- and high-workload) with spectral power density and coherence as the features extracted from EEG data. Using a subject-independent feature selection approach, a subject-dependent Linear Discriminant Analysis (LDA) is used for classification. An average classification rate of 81% is achieved that indicates the reliability of the proposed approach for assessing human workload in interaction with varying compliance across the gross and fine manipulation. Furthermore, to validate our proposed objective measure of workload, we have conducted a second experiment composed of both fine and gross motor tasks. Compared to interaction with a constant admittance, a lower EEG-based workload is observed with an open-loop variable admittance controller. This observation is in agreement with the subjective workload score (NASA-TLX).
Mice lacking uterine enhancer of zeste homolog 2 have transcriptomic changes associated with uterine epithelial proliferation
Authors: Mesa Ana M. , Mao Jiude , Nanjappa Manjunatha K. , Medrano Theresa I. , Tevosian Sergei , Yu Fahong , Kinkade Jessica , Lyu Zhen , Liu Yang , Joshi Trupti , Wang Duolin , Rosenfeld Cheryl S. , Cooke Paul S.
Published: December 2019

Enhancer of zeste homolog 2 (EZH2) is a histone methyltransferase that suppresses gene expression. Previously, we developed a conditional null model where EZH2 is knocked out in uterus. Deletion of uterine EZH2 increased proliferation of luminal and glandular epithelial cells. Herein, we used RNA-Seq in wild-type (WT) and EZH2 conditional knockout ( Ezh2cKO) uteri to obtain mechanistic insights into the gene expression changes that underpin the pathogenesis observed in these mice. Ovariectomized adult Ezh2cKO mice were treated with vehicle (V) or 17β-estradiol (E2; 1 ng/g). Uteri were collected at postnatal day (PND) 75 for RNA-Seq or immunostaining for epithelial proliferation. Weighted gene coexpression network analysis was used to link uterine gene expression patterns and epithelial proliferation. In V-treated mice, 88 transcripts were differentially expressed (DEG) in Ezh2cKO mice, and Bmp5, Crabp2, Lgr5, and Sprr2f were upregulated. E2 treatment resulted in 40 DEG with Krt5, Krt15, Olig3, Crabp1, and Serpinb7 upregulated in Ezh2cKO compared with control mice. Transcript analysis relative to proliferation rates revealed two module eigengenes correlated with epithelial proliferation in WT V vs. Ezh2cKO V and WT E2 vs. Ezh2cKO E2 mice, with a positive relationship in the former and inverse in the latter. Notably, the ESR1, Wnt, and Hippo signaling pathways were among those functionally enriched in Ezh2cKO females. Current results reveal unique gene expression patterns in Ezh2cKO uterus and provide insight into how loss of this critical epigenetic regulator assumingly contributes to uterine abnormalities.
EGFRvIII: An Oncogene with Ambiguous Role
Authors: Rutkowska Adrianna , Stoczyńska-Fidelus Ewelina , Janik Karolina , Włodarczyk Aneta , Rieske Piotr
Published: December 2019

Epidermal growth factor receptor variant III (EGFRvIII) seems to constitute the perfect therapeutic target for glioblastoma (GB), as it is specifically present on up to 28–30% of GB cells. In case of other tumor types, expression and possible role of this oncogene still remain controversial. In spite of EGFRvIIImechanism of action being crucial for the design of small active anticancer molecules and immunotherapies, i.e., CAR-T technology, it is yet to be precisely defined. EGFRvIIIis known to be resistant to degradation, but it is still unclear whether it heterodimerizes with EGF-activated wild-type EGFR (EGFRWT) or homodimerizes (including covalent homodimerization). Constitutive kinase activity of this mutated receptor is relatively low, and some researchers even claim that a nuclear, but not a membrane function, is crucial for its activity. Based on the analyses of recurrent tumors that are often lacking EGFRvIIIexpression despite its initial presence in corresponding primary foci, this oncogene is suggested to play a marginal role during later stages of carcinogenesis, while even in primary tumors EGFRvIIIexpression is detected only in a small percentage of tumor cells, undermining the rationality of EGFRvIII-targeting therapies. On the other hand, EGFRvIII-positive cells are resistant to apoptosis, more invasive, and characterized with enhanced proliferation rate. Moreover, expression of this oncogenic receptor was also postulated to be a marker of cancer stem cells. Opinions regarding the role that EGFRvIIIplays in tumorigenesis and for tumor aggressiveness are clearly contradictory and, therefore, it is crucial not only to determine its mechanism of action, but also to unambiguously define its role at early and advanced cancer stages.
Traumatic Craniocervical Dissociation in Patients with Congenital Assimilation of the Atlas to the Occiput
Authors: Tavolaro Celeste , Pulido Hector , Bransford Richard , Bellabarba Carlo
Published: December 2019

Traumatic atlantooccipital dissociation (AOD) is a severe and usually fatal injury. Patients with assimilation of the atlas to the skull are exposed to a higher risk of injury and delay diagnosis due to the abnormal anatomy. We report two cases of acute traumatic craniocervical dislocation in patients with baseline congenital assimilation of the atlas to the skull. Computer tomography (CT) was used to identify the injury. Computer tomography angiography (CTA) showed variations of the vertebral arteries’ location on both patients. Assimilation of the atlas was complete in patient one and partial in patient two. Emergent surgical instrumentation and fusion were performed with a very careful and meticulous posterior dissection. As general rule, most of the patients with CCD will undergo occiput to C2 posterior segmental instrumentation and fusion. In the presented cases, a more extensive fusion was necessary based on the type and severity of the CCJ injury and the anatomical anomalies associated. Postoperatively, patient one remained neurologically intact and patient two died. Alternative fixation techniques should be used to minimize risk of VA injury during the surgical procedures.
Significance of Serum p53 Antibody as a Tumor Marker in Colorectal Cancer
Authors: Takahashi Rina , Sakamoto Kazuhiro , Sugimoto Kiichi , Motegi Shunsuke , Tsukamoto Ryoichi , Ichikawa Ryosuke , Okazawa Yu , Aoki Jun , Ishiyama Shun , Takahashi Makoto , Kojima Yutaka , Okuzawa Atsushi , Tomiki Yuichi , Matsuoka Joe
Published: December 2019

Objective. We examined serum anti-p53 antibodies (S-p53Ab) in colorectal cancer. Specifically, we retrospectively investigated the use of S-p53Ab as a prognostic marker after surgery for colorectal cancer. Materials and Methods. The levels of S-p53Ab, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) were measured in 160 colorectal cancer patients who underwent surgical treatment. The rate of postoperative change (RPC) in the S-p53Ab titer was calculated as [subsequent antibody titer-lowest titer]/lowest titer. Results. A relationship between recurrence and RPC in the S-p53Ab titer was not observed in patients who tested negative for S-p53Ab preoperatively. In addition, no patients, who tested negative for S-p53Ab preoperatively, tested positive for S-p53Ab at the follow-up after surgery. Of the patients who tested positive for S-p53Ab preoperatively, those recurrences had a significantly higher RPC compared with those who did not (p<0.001). Conclusions. Although S-p53Ab is not a significant tumor marker in patients who test negative preoperatively, increases in the S-p53Ab titer should be continuously monitored and measured in patients who are positive for this antibody preoperatively, regardless of whether they later test negative.
Energy-Efficient Computation Offloading and Transmit Power Allocation Scheme for Mobile Edge Computing
Authors: Gu Xiaohui , Jin Li , Zhao Nan , Zhang Guoan
Published: December 2019

Mobile edge computing (MEC) is considered a promising technique that prolongs battery life and enhances the computation capacity of mobile devices (MDs) by offloading computation-intensive tasks to the resource-rich cloud located at the edges of mobile networks. In this study, the problem of energy-efficient computation offloading with guaranteed performance in multiuser MEC systems was investigated. Given that MDs typically seek lower energy consumption and improve the performance of computing tasks, we provide an energy-efficient computation offloading and transmit power allocation scheme that reduces energy consumption and completion time. We formulate the energy efficiency cost minimization problem, which satisfies the completion time deadline constraint of MDs in an MEC system. In addition, the corresponding Karush–Kuhn–Tucker conditions are applied to solve the optimization problem, and a new algorithm comprising the computation offloading policy and transmission power allocation is presented. Numerical results demonstrate that our proposed scheme, with the optimal computation offloading policy and adapted transmission power for MDs, outperforms local computing and full offloading methods in terms of energy consumption and completion delay. Consequently, our proposed system could help overcome the restrictions on computation resources and battery life of mobile devices to meet the requirements of new applications.
Impact of Health-Promoting Lifestyle Education Intervention on Health-Promoting Behaviors and Health Status of Postmenopausal Women: A Quasi-Experimental Study from Sri Lanka
Authors: Rathnayake Nirmala , Alwis Gayani , Lenora Janaka , Lekamwasam Sarath
Published: December 2019

Health promotion through lifestyle education is an important measure to enhance health status of postmenopausal women (PMW). This study evaluated the effectiveness of health-promoting lifestyle education intervention (HPLEI) on adhering to health-promoting behaviors (HPB) and enhancing the health status in a group of Sri Lankan PMW. A quasi-experimental study was conducted with randomly selected, sociodemographic status matched, 72 PMW from two geographically separated areas in Galle District, Sri Lanka, allocated as experimental (n = 37, 54.6 ± 4.5 years) and control (n = 35, 56.5 ± 3.4 years) groups. Education intervention focused on postmenopausal health management including lifestyle modifications was performed only for the experimental group during 8 weeks, and a health education package was provided. The control group was not given any planned education programme. Both groups were followed up for a 6-month period. HPB and menopausal symptoms severity were evaluated by validated Health Promoting Lifestyle Profile-II and Menopause Rating Scale, respectively. Anthropometric adiposity indices (AAIs) including weight, body mass index (BMI), waist (WC) and hip (HC) circumferences, and waist to hip ratio (WHR); cardiovascular disease risk indicators (CVDRI) including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), total cholesterol and triglycerides, muscle strength; hand grip strength (HGS) and physical performance (PP); gait speed (GS) were measured. All parameters were evaluated before the intervention (baseline) and after follow-up of 6 months. All evaluated parameters were not different between experimental and control groups (p>0.05) at the baseline. In the follow-up evaluation, HPB (p<0.001), menopausal symptom scores (p<0.001), AAI (p<0.001), CVDRI (SBP, DBP, and FBS) (p<0.05) and HGS and GS (p<0.001) were significantly improved in the experimental group but not in the control group. Health education intervention focused on health-promoting lifestyle modifications is effective in improving the adherence to HPB and enhances the health status in PMW. This provides positive impact in lifestyle medicine.
Hypoxia-Inducible Factor 1A Upregulates HMGN5 by Increasing the Expression of GATA1 and Plays a Role in Osteosarcoma Metastasis
Authors: Xu Enjie , Ji Zhe , Jiang Heng , Lin Tao , Ma Jun , Zhou Xuhui
Published: December 2019

Osteosarcoma is one of the most common malignant tumors in children and adolescents and is characterized by early metastasis. High-mobility group N (HMGN) domains are involved in the development of several tumors. Our previous study found that HMGN5 is highly expressed in osteosarcoma tissues and knockdown of HMGN5 inhibits migration and invasion of U-2 OS and Saos-2 cells. A hypoxic environment is commonly found in solid tumors such as osteosarcoma and is likely to be associated with tumor metastasis, so we further explored the relationship between HMGN5 and the hypoxic environment. Hypoxia-inducible factor 1A (HIF1A) is an adaptive factor in the hypoxic environment. We found that HIF1A and HMGN5 were upregulated in osteosarcoma (OS) cells cultured in the hypoxic environment, and the results of overexpression and knockdown experiments showed that HIF1A upregulated the transcription factor GATA1 and further promoted the expression of HMGN5. In addition, MMP2 and MMP9 were subsequently upregulated through the c-jun pathway, and finally, this promoted the migration and invasion of OS cells. It is suggested that HMGN5 may be an important downstream factor for HIF1A to promote osteosarcoma metastasis. It has an important clinical significance for the selection of therapeutic targets for osteosarcoma.
Autophagy and Age-Related Eye Diseases
Authors: Yang Xue , Pan Xinan , Zhao Xiaorui , Luo Jin , Xu Mingpu , Bai Daoming , Hu Yan , Liu Xu , Yu Qiongfang , Gao Dian
Published: December 2019

Background. Autophagy is a catabolic process that depends on the lysosome. It is usually used to maintain cellular homeostasis, survival and development by degrading abnormal substances and dysfunctional organelles, especially when the cell is exposed to starvation or other stresses. Increasing studies have reported that autophagy is associated with various eye diseases, of which aging is one of the important factors. Objective. To summarize the functional and regulatory role of autophagy in ocular diseases with aging, and discuss the possibility of autophagy-targeted therapy in age-related diseases. Methods. PubMed searches were performed to identify relevant articles published mostly in the last 5 years. The key words were used to retrieve including “autophagy”, “aging”, “oxidative stress AND autophagy”, “dry eye AND autophagy”, “corneal disease AND autophagy”, “glaucoma AND autophagy”, “cataract AND autophagy”, “AMD AND autophagy”, “cardiovascular diseases AND autophagy”, “diabetes AND autophagy”. After being classified and assessed, the most relevant full texts in English were chosen. Results. Apart from review articles, more than two research articles for each age-related eye diseases related to autophagy were retrieved. We only included the most relevant and recent studies for summary and discussion. Conclusion. Autophagy has both protective and detrimental effects on the progress of age-related eye diseases. Different types of studies based on certain situations in vitro showed distinct results, which do not necessarily coincide with the actual situation in human bodies completely. It means the exact role and regulatory function of autophagy in ocular diseases remains largely unknown. Although autophagy as a potential therapeutic target has been proposed, many problems still need to be solved before it applies to clinical practice.
Comparative Analysis of the Transcriptome of Latent Autoimmune Diabetes in Adult (LADA) Patients from Eastern China
Authors: Ji Yuqiao , Jiang Dongmei , Liu Jian , Chen Xiaolong , Xia Tian , Yin Zhujun , Li Lei , Jin Hao , Chen Hongmei , Sun Mingzhong
Published: December 2019

Latent autoimmune diabetes in adults (LADA) is characterized as a slow-progressing form of autoimmune diabetes. LADA resembles some phenotypes of type 1 diabetes (T1D) and type 2 diabetes (T2D), frequently leading to misdiagnosis and inappropriate therapeutic strategies. Understanding its transcriptome profiles aids in revealing the detailed molecular mechanisms of LADA and its therapy. In the present study, we performed RNA-seq analysis of LADA patients from Eastern China and showed that LADA exhibited 277 differentially expressed genes (DEGs) with 199 upregulated and 78 downregulated. Gene ontology and KEGG pathway enrichment analysis revealed that these DEGs were mainly related to immune function and cell death and growth. Furthermore, a comparison of DEGs in LADA with those in T1D and T2D identified from the online databases showed that there are very few overlapped genes between LADA and T1D or T2D, confirming LADA to be a distinct type of diabetes from T1D or T2D. In summary, our comprehensive analysis may aid in the understanding and treatment of LADA patients in Eastern China.
Systemic Lupus Erythematosus (SLE) with Acute Nephritis, Antineutrophil Cytoplasmic Antibody- (ANCA-) Associated Vasculitis, and Thrombotic Thrombocytopenic Purpura (TTP): A Rare Case Report with Literature Review
Authors: Farshad Sohail , Kanaan Christopher , Savedchuk Solomiia , Karmo Dillon S. , Halalau Alexandra , Swami Abhishek
Published: December 2019

Thrombotic thrombocytopenic purpura (TTP) is a potentially fatal disorder that requires urgent identification and treatment. The association of TTP with systemic lupus erythematosus (SLE) and vasculitis has been reported, however, never simultaneously. A 33-year-old woman with a history of SLE presented with acute abdominal pain, fever, arthralgias, and skin rash. She had acute severe hypertension, diffuse abdominal tenderness, and petechial rash. Diagnostic work-up revealed active urine sediment with proteinuria and hematuria and elevated creatinine, anemia, and thrombocytopenia. She was diagnosed with acute lupus nephritis and early microangiopathic hemolytic anemia in the setting of hypertensive urgency and started on intravenous methylprednisolone 500 mg once a day. Within 48 hours, she developed shock with multiorgan dysfunction and succumbed to her illness. Laboratory tests later showed ADAMTS13 activity less than 10% consistent with TTP and p-antineutrophil cytoplasmic antibody (ANCA) positivity. Autopsy revealed small-vessel vasculitis of the visceral organs. Kidney biopsy demonstrated diffuse proliferative glomerulonephritis. This case illustrates the occurrence of SLE nephritis, p-ANCA vasculitis, and severe TTP with rapidly fatal course, and the importance of having a low threshold for initiating plasma exchange therapy. Here, we discuss the case and provide a literature review on cases of TTP with SLE and vasculitis.
Diagnostic Value Investigation and Bioinformatics Analysis of miR-31 in Patients with Lymph Node Metastasis of Colorectal Cancer
Authors: Zhang Wu-wen , Ming Xin-liang , Rong Yuan , Huang Chao-qun , Weng Hong , Chen Hao , Bian Jun-mei , Wang Fu-bing
Published: December 2019

Colorectal cancer (CRC) is one of the most frequent cancers occurring in developed countries. Distant CRC metastasis causes more than 90% of CRC-associated mortality. MicroRNAs (miRNAs) play a key role in regulating tumor metastasis and could be potential diagnostic biomarkers in CRC patients. This study is aimed at identifying miRNAs that can be used as diagnostic biomarkers for CRC metastasis. Towards this goal, we compared the expression of five miRNAs commonly associated with metastasis (i.e., miR-10b, miR-200c, miR-155, miR-21, and miR-31) between primary CRC (pCRC) tissues and corresponding metastatic lymph nodes (mCRC). Further, bioinformatics analysis of miR-31 was performed to predict target genes and related signaling pathways. Results showed that miR-31, miR-21, miR-10b, and miR-155 expression was increased to different extents, while miR-200c expression was lower in mCRC than that in pCRC. Moreover, we found that the level of both miR-31 and miR-21 was notably increased in pCRC when lymph node metastasis (LNM) was present, and the increase of miR-31 expression was more profound. Hence, upregulated miR-31 and miR-21 expression might be a miRNA signature in CRC metastasis. Moreover, we detected a higher miR-31 level in the plasma of CRC patients with LNM compared to patients without LNM or healthy individuals. With the bioinformatics analysis of miR-31, 121 putative target genes and transition of mitotic cell cycle and Wnt signaling pathway were identified to possibly play a role in CRC progression. We next identified seven hub genes via module analysis; of these, TNS1 was most likely to be the target of miR-31 and had significant prognostic value for CRC patients. In conclusion, miR-31 is significantly increased in the cancer tissues and plasma of CRC patients with LNM; thus, a high level of miR-31 in the plasma is a potential biomarker for the diagnosis of LNM of CRC.
Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths
Authors: Ozdede Melih , Akay Gulsun , Karadag Ozge , Peker Ilkay
Published: December 2019

Objective: A tonsillolith is a concretion of the tonsillar crypt. The aim of this retrospective study was to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the detection of tonsilloliths. Materials and Methods: The CBCT images of 527 patients with maxillofacial volume were evaluated retrospectively. Of these, 175 patients (81 females, 94 males; mean age 51.05 years) had unilateral or bilateral tonsilloliths. In total, 151 of them (67 females, 84 males; mean age, 51.03 years) had PR images performed in the same period and were included in the study. The PR images were examined to ascertain whether known tonsilloliths (from CBCT images) could be detected. The location (unilateral; left or right and bilateral), size, and number of the tonsilloliths were examined on both CBCT and PR images. Descriptive analysis, Spearman’s rho correlation coefficient, and χ2 tests were used for the statistical analysis. Results: The detection rate of tonsillolith was 33.2% on CBCT images. Only 51.4% of the tonsilloliths detected on CBCT were evaluated by PR; the correlation between CBCT and PR was found to be significant (Spearman’s r = 0.399, p = 0.000). PR was not adequate to detect tonsilloliths 1 mm or smaller in size. All the calcifications larger than 5 mm were detected on PR images. Conclusion: The results of this study showed that more than half of the tonsilloliths observed in CBCT were also detected in PR. Tonsilloliths larger than 2 mm were more likely to be detected on PR images.
Association of Follow-Up Care With Long-Term Death and Subsequent Hospitalization in Patients With Atrial Fibrillation Who Receive Emergency Care in the Province of Ontario
Authors: Atzema Clare L. , Yu Bing , Schull Michael J. , Jackevicius Cynthia A. , Ivers Noah M. , Lee Douglas S. , Rochon Paula A. , Austin Peter C.
Published: December 2019

Background:

Currently, 11% of patients seen in the emergency department for atrial fibrillation die within 1 year of the visit. Our objective was to examine the association of rapid (within 3 days), early (7 days), and basic (30 days) outpatient physician follow-up with short- and long-term outcomes in patients with atrial fibrillation discharged from an emergency department.

Methods:

This retrospective cohort study included all adult patients discharged from one of the 163 emergency departments in Ontario, Canada with a primary diagnosis of atrial fibrillation, 2007 to 2014. We used a landmark analysis with propensity score matching, and logistic regression, to assess all-cause mortality and cardiovascular hospitalizations at 1 year and 90 days, 30-day return emergency visits, and 1-year oral anticoagulation prescription fills.

Results:

In the 10 657 patients with rapid follow-up care who were propensity score matched to a patient with follow-up between days 4 and 7, the hazard of a return emergency visit was reduced by 11% (HR, 0.89 [95% CI, 0.80–0.98]). It was not associated with mortality or hospitalization. In the 17 234 patients with early follow-up who were matched to a patient with care between days 8 and 30, the rate of 1-year mortality was 11% lower (HR, 0.89 [95% CI, 0.81–0.97]) and 1-year hospitalization was 6% lower (HR, 0.94 [95% CI, 0.89–1.00]). Relative to no 30-day care, basic follow-up care was associated with an increased hazard of 90-day hospitalization (HR, 1.32 [95% CI, 1.12–1.56]) but was no longer associated with mortality. In patients with early follow-up, the odds of filling an oral anticoagulation prescription a year later were 64% higher than those without it (OR, 1.64 [95% CI, 1.54–1.78]).

Conclusions:

Compared with follow-up care between days 8 and 30, follow-up within a week after discharge from an emergency department with atrial fibrillation was associated with a reduction in the rate of death and hospitalization within 1 year, an association that was not present with 30-day follow-up.
Ambient Airborne Particulates of Diameter ≤1 μm, a Leading Contributor to the Association Between Ambient Airborne Particulates of Diameter ≤2.5 μm and Children’s Blood Pressure
Authors: Wu Qi-Zhen , Li Shanshan , Yang Bo-Yi , Bloom Michael , Shi Zhidong , Knibbs Luke , Dharmage Shyamali , Leskinen Ari , Jalaludin Bin , Jalava Pasi , Roponen Marjut , Lin Shao , Chen Gongbo , Guo Yuming , Xu Shu-Li , Yu Hong-Yao , Zeeshan Mohammed , Hu Li-Wen , Yu Yunjiang , Zeng Xiao-Wen , Dong Guang-Hui
Published: December 2019

Evidence on the associations between airborne particulates of diameter ≤1 μm (PM
1
) and airborne particulates of diameter ≤2.5 μm (PM
2.5
) and childhood blood pressure (BP) is scarce. To help to address this literature gap, we conducted a study to explore the associations in Chinese children. Between 2012 and 2013, we recruited 9354 children, aged 5 to 17 years, from 62 schools in 7 northeastern Chinese cities. We measured their BP with a mercury sphygmomanometer. We used a spatiotemporal model to estimate daily ambient PM
1
and PM
2.5
exposures, which we assigned to participants’ home addresses. Associations between particulate matter exposure and BP were evaluated with generalized linear mixed regression models. The findings indicated that exposure to each 10 mg/m
3
greater PM
1
was significantly associated with 2.56 mm Hg (95% CI, 1.47–3.65) higher systolic BP and 61% greater odds for hypertension (odds ratio=1.61 [95% CI, 1.18–2.18]). PM
1
appears to play an important role in associations reported between PM
2.5
exposure and BP, and we found that the ambient PM
1
/PM
2.5
ratio (range, 0.80–0.96) was associated with BP and with hypertension. Age and body weight modified associations between air pollutants and BP (
P
<0.01), with stronger associations among younger (aged ≤11 years) and overweight/obese children. This study provides the first evidence that long-term exposure to PM
1
is associated with hypertension in children, and that PM
1
might be a leading contributor to the hypertensive effect of PM
2.5
. Researchers and policy makers should pay closer attention to the potential health impacts of PM
1
.