1,480 research outputs found

    Determination of optimal successor function in phase-based control using neural network

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    A phase-based method for fixed-time signal control of traffic improves significantly the junction performance over conventional stage-based method of control due to the higher flexibility in specification of signal timings, where the control variables comprise the start and duration of green phases and the cycle time at which the junction is operated. The cycle-structure is specified by a successor function, a combination of 0 and 1 for all incompatible pairs of phases, which indicates the order of phases in a cycle. Normal procedure optimises the timings for each of these successor functions to determine the best timing plan. The computing time is found to be approximately proportional the number of such functions. To reduce the computational requirement, and hence enhance its applicability to real-time actuated control, a neural network is employed in this paper to help identify the optimal successor function for further optimization of timings. Encouraging results are obtained.published_or_final_versio

    Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis

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    This is a retrospective analysis of 4768 patients with undifferentiated or non-keratinising carcinoma of the nasopharynx who were treated during 1 January 1976 to 31 December 1985. The mean duration of symptoms before diagnosis was 8 months (range, 1-36 months for 95% of patients). A significant association between the duration of symptoms and the presenting stage was observed (P<0.001); 58% and 39% of stage I and stage V patients, respectively, reported as having had symptoms for less than 6 months. Of the later presenters (those having had symptoms for 6 months or longer), 89% were given a full course of radical megavoltage radiotherapy, but 6% were too advanced for any irradiation attempt. Consequently, the 10-year actuarial disease-specific survival was significantly higher among the early presenters: 48% versus 42% (P<0.001). The importance of early detection is emphasised.published_or_final_versio

    Brief Report: Is Impaired Classification of Subtle Facial Expressions in Children with Autism Spectrum Disorders Related to Atypical Emotion Category Boundaries?

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    Impairments in recognizing subtle facial expressions, in individuals with autism spectrum disorder (ASD), may relate to difficulties in constructing prototypes of these expressions. Eighteen children with predominantly intellectual low-functioning ASD (LFA, IQ <80) and two control groups (mental and chronological age matched), were assessed for their ability to classify emotional faces, of high, medium and low intensities, as happy or angry. For anger, the LFA group made more errors for lower intensity expressions than the control groups, classifications did not differ for happiness. This is the first study to find that the LFA group made more across-valence errors than controls. These data are consistent with atypical facial expression processing in ASD being associated with differences in the structure of emotion categories

    Esophagectomy without mortality: What can surgeons do?

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    Introduction: Surgical resection remains the mainstay treatment for patients with localized esophageal cancer. It is, however, a complex procedure. Mortality rate used to be high, but in recent years, death rate has been reduced to below 5% in specialized centers. Methods: Outcome of esophagectomy can be improved by paying attention to (1) appropriate patient section, (2) choice of surgical techniques and their execution, and (3) optimizing perioperative care. A volume-outcome relationship is also evident. Surgeons can perform esophagectomy without mortality, but a multi-disciplinary team management is essential to achieve this goal. © 2009 The Society for Surgery of the Alimentary Tract.postprin

    Family employment and child socioemotional behaviour: longitudinal findings from the UK Millennium Cohort Study

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    Background Levels of paid employment in two parent and lone parent families have increased in the UK but evidence of its impact on child socioemotional behaviour is limited and inconsistent. Methods We conducted a longitudinal analysis using the first four sweeps of the Millennium Cohort Study (9 months, 3 years, 5 years and 7 years) to investigate the influence of family employment trajectories in the early years on socioemotional behaviour at 7 years, unadjusted and adjusted for covariates. In addition, mothers’ employment was investigated separately. Results Children from families where no parent was employed for one or more sweeps were at a greater risk of socioemotional problem behaviour compared with those where a parent was continuously employed, even after adjustment for covariates. Children of mothers who were non-employed for one or more sweeps were at greater risk of problem behaviour compared with mothers who were employed at all sweeps. Adjustment for covariates fully attenuated the excess risk for children whose mothers had moved into employment by the time they were 7 years. In contrast, the elevated risk associated with continuous non-employment and a single transition out of employment was attenuated after adjustment for early covariates, fathers’ employment, household income and mothers’ psychological distress at 7 years, but remained significant. Conclusions Family and mothers’ employment were associated with a lower risk of problem behaviour for children in middle childhood, in part explained by sociodemographic characteristics of families and the apparent psychological and socioeconomic benefits of employment. Results for mothers’ transitions in or out of the labour market suggest that child problem behaviour is influenced by current status, over and above diverse earlier experiences of employment and non-employment

    The Use of a Compression Device as an Alternative to Hand-Sewn and Stapled Colorectal Anastomoses: Is Three a Crowd?

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    BackgroundThe NiTi CAR™ 27 is a newer device that uses compression to create an anastomosis. An analysis of this device in the creation of colorectal anastomoses in humans has yet to be reported in the USA.MethodsA non-randomized, prospective pilot study of the NiTi CAR™ 27 device in patients undergoing a left-sided colectomy between March 2008 and August 2009 was performed.ResultsTwenty-three patients (9 men and 14 women) underwent a left-sided colectomy and compression anastomosis with the CAR™ 27 device. Minor morbidities, 3 of 23 (13%) patients, included one small postoperative abscess requiring antibiotics alone and two postoperative anastomotic strictures requiring balloon dilation. Major morbidities, 1 of 23 (4%) patients, included a partial anastomotic dehiscence/leak requiring surgical dismantling of the anastomosis and diversion.ConclusionThe CAR™ 27 device shows promise as a safe and effective alternative for the creation of colorectal anastomoses. However, studies in a larger patient population are warranted to demonstrate equivalence of this device

    Glucocorticoid Effects on the Programming of AT1b Angiotensin Receptor Gene Methylation and Expression in the Rat

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    Adverse events in pregnancy may ‘programme’ offspring for the later development of cardiovascular disease and hypertension. Previously, using a rodent model of programmed hypertension we have demonstrated the role of the renin-angiotensin system in this process. More recently we showed that a maternal low protein diet resulted in undermethylation of the At1b angiotensin receptor promoter and the early overexpression of this gene in the adrenal of offspring. Here, we investigate the hypothesis that maternal glucocorticoid modulates this effect on fetal DNA methylation and gene expression. We investigated whether treatment of rat dams with the 11β-hydroxylase inhibitor metyrapone, could prevent the epigenetic and gene expression changes we observed. Offspring of mothers subjected to a low protein diet in pregnancy showed reduced adrenal Agtr1b methylation and increased adrenal gene expression as we observed previously. Treatment of mothers with metyrapone for the first 14 days of pregnancy reversed these changes and prevented the appearance of hypertension in the offspring at 4 weeks of age. As a control for non-specific effects of programmed hypertension we studied offspring of mothers treated with dexamethasone from day 15 of pregnancy and showed that, whilst they had raised blood pressure, they failed to show any evidence of Agtr1b methylation or increase in gene expression. We conclude that maternal glucocorticoid in early pregnancy may induce changes in methylation and expression of the Agtr1b gene as these are clearly reversed by an 11 beta-hydroxylase inhibitor. However in later pregnancy a converse effect with dexamethasone could not be demonstrated and this may reflect either an alternative mechanism of this glucocorticoid or a stage-specific influence
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