An Investigation on Network Relationship of Elderly Nursing Home

All developed countries have been facing the trend of aging population and view it as an importance social policy which has to plan care and nurse senior citizens. The elderly caring and nursing organizations are obligated to provide more comfortable and suitable environment for a high quality life of elders. Based upon Maslow’s Hierarchy of Needs Theory, there is a hierarchy of five needs within each individual, including physiological needs, safety needs, belongingness and love Needs, self-esteem needs and self-actualization needs. Individuals would acquire emotional support, materiality and service through social network. This study investigates two main issues related to network relationship of elderly nursing home. First, this study demonstrates the network relationship between elderly nursing home and other related groups, including family and friends of elderly resident, exclusive volunteers, neighborhood community centre, religion groups and other welfare associations. Second, this study investigates what the network relationships would influence the satisfaction of five elderly residents’ needs. To better understanding the real connection among groups related to nursing home, this study uses case study with the perceptions of social network to know the network relationship in the nursing home and what it influences their residents’ needs

A Review on the Relationship between SGLT2 Inhibitors and Cancer

Risk of increasing breast and bladder cancer remains a safety issue of SGLT2 (sodium glucose cotransporter type 2) inhibitors, a novel class of antidiabetic agent. We reviewed related papers published before January 29, 2014, through Pubmed search. Dapagliflozin and canagliflozin are the first two approved SGLT2 inhibitors for diabetes therapy. Although preclinical animal toxicology did not suggest a cancer risk of dapagliflozin and overall tumor did not increase, excess numbers of female breast cancer and male bladder cancer were noted in preclinical trials (without statistical significance). This concern of cancer risk hindered its approval by the US FDA in January, 2012. New clinical data suggested that the imbalance of bladder and breast cancer might be due to early diagnosis rather than a real increase of cancer incidence. No increased risk of overall bladder or breast cancer was noted for canagliflozin. Therefore, the imbalance observed with dapagliflozin treatment should not be considered as a class effect of SGLT2 inhibitors and the relationship with cancer for each specific SGLT2 inhibitor should be examined individually. Relationship between SGLT2 inhibition and cancer formation is still inconclusive and studies with larger sample size, longer exposure duration, and different ethnicities are warranted

A preliminary study on the dynamic friction behavior of a one-third scale-down vertical cylindrical cask

In Taiwan, the capacities of spent fuel pools for temporary storage in nuclear power plant will reach depletion soon, and the site of final disposal facility is still to be decided. Therefore, the installation of dry-type interim storage facilities is urgent. The dry storage systems in Taiwan utilize a freestanding cask and design to non-anchored to the foundation pad. It is necessary to establish the simulation techniques for the non-anchored structure, such as the dry storage cask, for the reasonable assessment of its seismic behavior when the earthquake hit. This study is cast a 1/3 scale-down pedestal specimen of the INER-dry storage cask system, which were conducted to acquire the actual friction coefficient at the cask/pad interface as well as the effect of normal stress and sliding rate on it. Based on the results of cyclic loading testing, the cyclic frequency almost had no influence on the friction coefficient but the friction coefficient increased with the normal stress increased. Apparent rocking of the cask was induced at a higher friction coefficient, while sliding dominated the cask motion at a lower one. In addition, the cast motions were almost purely sliding and the range of the friction coefficient was between 0.60 and 0.73 under various compositions of dry storage cask system

The Clinical COPD Questionnaire Correlated with BODE Index-A Cross-Sectional Study

The Global initiative for Chronic Obstructive Lung Disease (GOLD) staging has widely used in the stratification of the severity of COPD, while BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index was proven superior to FEV1 in predicting mortality, exacerbation and disease severity in patients with COPD. Clinical COPD Questionnaire (CCQ), a questionnaire with ten items categorized into three domains (symptoms, functional state and mental state) was developed to measure health status of COPD patients. However, little is known about the relationship between CCQ score and BODE index. We performed a prospective study with the inclusion of 89 patients who were clinically stable after a 6-week-therapy for COPD symptoms comparing their health status assessed by CCQ, BODE index and GOLD staging. We found that the total CCQ score was correlated with BODE score (P < 0.001) and GOLD staging (P < 0.001); of three CCQ domains, the functional status correlated the most with BODE index (rS = 0.670) and GOLD staging (rS = 0.531), followed by symptoms (rS = 0.482; rS = 0.346, respectively), and mental status (rS = 0.340; rS = 0.236, respectively). Our data suggest that CCQ is a reliable and convenient alternative tool to evaluate the severity of COPD

Lightly Weighted Automatic Audio Parameter Extraction for the Quality Assessment of Consensus Auditory-Perceptual Evaluation of Voice

The Consensus Auditory-Perceptual Evaluation of Voice is a widely employed tool in clinical voice quality assessment that is significant for streaming communication among clinical professionals and benchmarking for the determination of further treatment. Currently, because the assessment relies on experienced clinicians, it tends to be inconsistent, and thus, difficult to standardize. To address this problem, we propose to leverage lightly weighted automatic audio parameter extraction, to increase the clinical relevance, reduce the complexity, and enhance the interpretability of voice quality assessment. The proposed method utilizes age, sex, and five audio parameters: jitter, absolute jitter, shimmer, harmonic-to-noise ratio (HNR), and zero crossing. A classical machine learning approach is employed. The result reveals that our approach performs similar to state-of-the-art (SOTA) methods, and outperforms the latent representation obtained by using popular audio pre-trained models. This approach provide insights into the feasibility of different feature extraction approaches for voice evaluation. Audio parameters such as jitter and the HNR are proven to be suitable for characterizing voice quality attributes, such as roughness and strain. Conversely, pre-trained models exhibit limitations in effectively addressing noise-related scorings. This study contributes toward more comprehensive and precise voice quality evaluations, achieved by a comprehensively exploring diverse assessment methodologies.Comment: Published in IEEE 42th International Conference on Consumer Electronics (ICCE 2024

Discovery of dominant and dormant genes from expression data using a novel generalization of SNR for multi-class problems

<p>Abstract</p> <p>Background</p> <p>The Signal-to-Noise-Ratio (SNR) is often used for identification of biomarkers for two-class problems and no formal and useful generalization of SNR is available for multiclass problems. We propose innovative generalizations of SNR for multiclass cancer discrimination through introduction of two indices, Gene Dominant Index and Gene Dormant Index (GDIs). These two indices lead to the concepts of dominant and dormant genes with biological significance. We use these indices to develop methodologies for discovery of dominant and dormant biomarkers with interesting biological significance. The dominancy and dormancy of the identified biomarkers and their excellent discriminating power are also demonstrated pictorially using the scatterplot of individual gene and 2-D Sammon's projection of the selected set of genes. Using information from the literature we have shown that the GDI based method can identify dominant and dormant genes that play significant roles in cancer biology. These biomarkers are also used to design diagnostic prediction systems.</p> <p>Results and discussion</p> <p>To evaluate the effectiveness of the GDIs, we have used four multiclass cancer data sets (Small Round Blue Cell Tumors, Leukemia, Central Nervous System Tumors, and Lung Cancer). For each data set we demonstrate that the new indices can find biologically meaningful genes that can act as biomarkers. We then use six machine learning tools, Nearest Neighbor Classifier (NNC), Nearest Mean Classifier (NMC), Support Vector Machine (SVM) classifier with linear kernel, and SVM classifier with Gaussian kernel, where both SVMs are used in conjunction with one-vs-all (OVA) and one-vs-one (OVO) strategies. We found GDIs to be very effective in identifying biomarkers with strong class specific signatures. With all six tools and for all data sets we could achieve better or comparable prediction accuracies usually with fewer marker genes than results reported in the literature using the same computational protocols. The dominant genes are usually easy to find while good dormant genes may not always be available as dormant genes require stronger constraints to be satisfied; but when they are available, they can be used for authentication of diagnosis.</p> <p>Conclusion</p> <p>Since GDI based schemes can find a small set of dominant/dormant biomarkers that is adequate to design diagnostic prediction systems, it opens up the possibility of using real-time qPCR assays or antibody based methods such as ELISA for an easy and low cost diagnosis of diseases. The dominant and dormant genes found by GDIs can be used in different ways to design more reliable diagnostic prediction systems.</p

Percutaneous Transhepatic Cholangiography and Drainage is an Effective Rescue Therapy for Biliary Complications in Liver Transplant Recipients Who Fail Endoscopic Retrograde Cholangiopancreatography

BackgroundWe attempted to evaluate both the factors that predispose a patient to biliary complications after liver transplantation and the results of percutaneous transhepatic cholangiography and drainage (PTCD) for the management of those complications.MethodsThis study retrospectively reviewed the cases of 81 patients who received liver transplants at Taipei Veterans General Hospital between February 2003 and June 2008. Biliary complications were diagnosed on the basis of clinical findings, laboratory data, and the results of imaging studies.ResultsA total of 18 patients (22.2%) developed biliary complications, and living donor liver transplantation (LDLT) was a significant risk factor (p = 0.035), compared to cadaveric liver transplantation. Eight patients with biliary complications received PTCD as the first treatment modality and 6 had successful results. An additional 10 patients received endoscopic retrograde cholangiopancreatography (ERCP) initially, but only 2 patients were effectively managed. One patient received conservative treatment after ERCP failure. One patient died from sepsis after ERCP. The remaining 6 patients with failed ERCP were successfully managed with PTCD. The overall mortality rate in these patients with biliary complications was 16.7%. No significant prognostic predictors were identified, including age, sex, biochemical data, and model for end-stage liver disease scores.ConclusionBiochemical markers cannot predict biliary complications preoperatively. LDLT increases the risk of biliary complications. PTCD is an effective rescue therapy when ERCP fails

Simulation and Measurement Analysis of an Integrated Flow Battery Energy-Storage System with Hybrid Wind/Wave Power Generation

This study aims to evaluate the power-system stability and the mitigation of fluctuations in a hybrid wind/wave power-generation system (HWWPGS) under different operating and disturbance conditions. This evaluation is performed by employing a vanadium redox flow battery-based energy storage system (VRFB-ESS) as proposed. The measurement results obtained from a laboratory-scale HWWPGS platform integrated with the VRFB-ESS, operating under specific conditions, are used to develop the laboratory-scale simulation model. The capacity rating of this laboratory-scale simulation model is then enlarged to develop an MW-scale power-system model of the HWWPGS. Both operating characteristics and power-system stability of the MW-scale HWWPGS power system model are evaluated through frequency-domain analysis (based on eigenvalue) and time-domain analysis (based on nonlinear-model simulations) under various operating conditions and disturbance conditions. The simulation results demonstrate that the fluctuations and stability of the studied HWWPGS under different operating and disturbance conditions can be effectively smoothed and stabilized by the proposed VRFB-ESS

Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery. METHODS: We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume. RESULTS: In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, −9.34 to 159.58). CONCLUSIONS: The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema