Analyzing Panel Count Data with Informative Observation Times

In this paper, we study panel count data with informative observation times. We assume nonparametric and semiparametric proportional rate models for the underlying recurrent event process, where the form of the baseline rate function is left unspecified and a subject-specific frailty variable inflates or deflates the rate function multiplicatively. The proposed models allow the recurrent event processes and observation times to be correlated through their connections with the unobserved frailty; moreover, the distributions of both the frailty variable and observation times are considered as nuisance parameters. The baseline rate function and the regression parameters are estimated by maximizing a conditional likelihood function of observed event counts and solving estimation equations. Large sample properties of the proposed estimators are studied. Numerical studies demonstrate that the proposed estimation procedures perform well for moderate sample sizes. An application to a bladder tumor study is presented to illustrate the use of the proposed methods

Hepatic hydrothorax after blunt chest trauma

AbstractWe report a successful treatment result in a rare case of hepatitis C virus-related cirrhosis, who had sustained hydrothorax after blunt thoracoabdominal trauma. This was a female patient with liver cirrhosis, Child–Turcotte–Pugh class A, without ascites before injury. She sustained blunt thoracoabdominal trauma with a left clavicle fracture dislocation and right rib fractures. There was no hemopneumothorax at initial presentation. However, dyspnea and right pleural effusion developed gradually. We inserted a chest tube to relieve the patient's symptoms, and the daily drainage amount remained consistent. Hepatic hydrothorax was confirmed by the intraperitoneal injection of radioisotope 99mTc-sulfur colloid that demonstrated one-way transdiaphragmatic flow of fluid from the peritoneal cavity to pleural cavities. Finally, the hydrothorax was treated successfully by minocycline-induced pleural symphysis. To the best of our knowledge, this is the first case of hepatic hydrothorax developed after thoracoabdominal trauma

Associations between child maltreatment, PTSD, and internet addiction among Taiwanese students

AbstractThis study examines (1) the associations between multiple types of child maltreatment and Internet addiction, and (2) the mediating effects of post-traumatic stress disorder (PTSD) on these associations. We collected data from a national proportionately stratified random sample of 6233 fourth-grade students in Taiwan in 2014. We conducted bivariate correlations and sets of multiple regression analyses to examine the associations between multiple types of maltreatment (5 types in total) and Internet addiction, and to identify the mediating role of PTSD. The results reveal that being male and experiencing abuse (psychological neglect, physical neglect, paternal physical violence, sexual violence) were associated with increased risk among children of developing PTSD and Internet addiction. Moreover, PTSD mediated the associations between multiple types of maltreatment (except maternal physical violence) and Internet addiction. This study demonstrates (1) the effects of multiple types of maltreatment on the PTSD and Internet addiction of children and (2) the importance of early prevention and intervention in addressing related public-health concerns

Spleen artery embolization increases the success of nonoperative management following blunt splenic injury

AbstractBackgroundSpleen artery embolization (SAE) may increase the success rate of nonoperative management (NOM). The present study investigated the clinical outcome after the installation of SAE in the management of blunt splenic injury.MethodsA retrospective review of hospital records was performed to enroll patients with blunt injury of the spleen. Demographic data and information about the injury severity score, organ injury scale, hospitalization days, management and final outcomes were evaluated. Patients were separated into early and late groups according to the year that SAE was selectively used (2003–2004 and 2005–2008).ResultsSix of eleven (55%) patients in the early group were successfully managed without surgery for blunt splenic injury, whereas all of the 38 patients (100%) in the late group were successfully managed without surgery. Eleven patients (11 of 38; 28.9%) received SAE in the late group. The rate of NOM increased from 55% in the early group to 100% in the late group (p < 0.001). Both early and late groups had similar injury severity score, length of hospitalization, blood transfusion, and complications, and there was no mortality.ConclusionPerformance of SAE for the patients with blunt splenic injury could increase the successful rate of NOM significantly and safely. An algorithm including the angioembolization might be beneficial in the management of patients with blunt spleen trauma

A Classification and Prediction Hybrid Model Construction with the IQPSO-SVM Algorithm for Atrial Fibrillation Arrhythmia

Atrial fibrillation (AF) is the most common cardiovascular disease (CVD); and most existing algorithms are usually designed for the diagnosis (i.e.; feature classification) or prediction of AF. Artificial intelligence (AI) algorithms integrate the diagnosis of AF electrocardiogram (ECG) and predict the possibility that AF will occur in the future. In this paper; we utilized the MIT-BIH AF Database (AFDB); which is composed of data from normal people and patients with AF and onset characteristics; and the AFPDB database (i.e.; PAF Prediction Challenge Database); which consists of data from patients with Paroxysmal AF (PAF; the records contain the ECG preceding an episode of PAF); and subjects who do not have documented AF. We extracted the respective characteristics of the databases and used them in modeling diagnosis and prediction. In the aspect of model construction; we regarded diagnosis and prediction as two classification problems; adopted the traditional support vector machine (SVM) algorithm; and combined them. The improved quantum particle swarm optimization support vector machine (IQPSO-SVM) algorithm was used to speed the training time. During the verification process; the clinical FZU-FPH database created by Fuzhou University and Fujian Provincial Hospital was used for hybrid model testing. The data were obtained from the Holter monitor of the hospital and encrypted. We proposed an algorithm for transforming the PDF ECG waveform images of hospital examination reports into digital data. For the diagnosis model and prediction model trained using the training set of the AFDB and AFPDB databases; the sensitivity; specificity; and accuracy measures were 99.2% and 99.2%; 99.2% and 93.3%; and 91.7% and 92.5% for the test set of the AFDB and AFPDB databases; respectively. Moreover; the sensitivity; specificity; and accuracy were 94.2%; 79.7%; and 87.0%; respectively; when tested using the FZU-FPH database with 138 samples of the ECG composed of two labels. The composite classification and prediction model using a new water-fall ensemble method had a total accuracy of approximately 91% for the test set of the FZU-FPH database with 80 samples with 120 segments of ECG with three labels

N-Glycosylation of Human R-Spondin 1 Is Required for Efficient Secretion and Stability but Not for Its Heparin Binding Ability

[[abstract]]R-spondin 1 (Rspo1) plays an essential role in stem cell biology by potentiating Wnt signaling activity. Despite the fact that Rspo1 holds therapeutic potential for a number of diseases, its biogenesis is not fully elucidated. All Rspo proteins feature two amino-terminal furin-like repeats, which are responsible for Wnt signal potentiation, and a thrombospondin type 1 (TSR1) domain that can provide affinity towards heparan sulfate proteoglycans. Using chemical inhibitors, deglycosylase and site-directed mutagenesis, we found that human Rspo1 and Rspo3 are both N-glycosylated at N137, a site near the C-terminus of the furin repeat 2 domain, and Rspo2 is N-glycosylated at N160, a position near the N-terminus of TSR1 domain. Elimination of N-glycosylation at these sites affects their accumulation in media but have no effect on the ability towards heparin. Introduction of the N-glycosylation site to Rspo2 mutant at the position homologous to N137 in Rspo1 restored full glycosylation and rescued the accumulation defect of nonglycosylated Rspo2 mutant in media. Similar effect can be observed in the N137 Rspo1 or Rspo3 mutant engineered with Rspo2 N-glycosylation site. The results highlight the importance of N-glycosylation at these two positions in efficient folding and secretion of Rspo family. Finally, we further showed that human Rspo1 is subjected to endoplasmic reticulum (ER) quality control in N-glycan-dependent manner. While N-glycan of Rspo1 plays a role in its intracellular stability, it had little effect on secreted Rspo1. Our findings provide evidence for the critical role of N-glycosylation in the biogenesis of Rspo1.[[notice]]補正完