Impact of quality of life in developing cardiovascular disease later in life : graphical chain model of the English Longitudinal Study of Ageing (ELSA)

Introduction The aim of this paper is to demonstrate how graphical chain models can be used to model how cardiovascular disease affected quality of life in later life over the course of 17 years of data. Methods Waves 1-9 of the English Longitudinal Study of Ageing was used to investigate how quality of life changed over each wave using the CASP-19 questionnaire, and whether having experienced a cardiovascular event had an effect on quality of life. Results A total of 12,099 participants were included in the study. Participants had a mean age of 64.2 years, the majority of which were over 50 years old. Older people are more likely to have cardiac events. A one-unit rise in CES-D 8-item score was related with a 14% increased risk of CVD at Wave 1. Those with an O-level, A-level, or degree (or equivalent) had lower CVD risks than those with no education. Women had half the CVD risk of men. Living alone reduced the risk of a CVD-event by 15%. Moderate and vigorous exercise lowered cardiac event risk compared to no exercise. Current or ex-smokers have a 30% higher risk of CVD than non-smokers. Cardiovascular event was significantly associated with quality of life at waves 1 and 2 only. Discussion Events related to cardiovascular disease only affected quality of life in later life up to 4 years. Factors such as age, depression, perceived position on social ladder, and high levels of physical activity affected quality of life throughout the majority of waves

Ethnic differences between South Asians and White Caucasians in cardiovascular disease-related mortality in developed countries : a systematic literature review

Background Cardiovascular disease is the leading cause of death worldwide, with significantly worse mortality-related outcomes in ethnic minorities in developed countries. A systematic literature review and meta-analysis of observational studies was conducted to investigate cardiovascular disease-related mortality inequalities between South Asian and White Caucasian ethnic groups. Methods Published studies on mortality between South Asians and Whites in developed countries were retrieved from MEDLINE, PubMed, Embase, Web of Science, and grey literature sources (inception—April 2021) and critically appraised using the Quality in Prognosis Studies tool. Bayesian random-effects meta-analyses were performed for both primary and secondary outcomes. Heterogeneity was determined using the I2 statistic. Results Of the 9879 studies screened originally, 41 were deemed eligible. A further 3 studies were included via the later search. Of these, 15 reported cardiovascular disease-related mortality, 23 reported all-cause mortality, and 6 reported both. The meta-analysis results showed that South Asians had a significantly increased risk of cardiovascular disease mortality compared to Whites (risk ratio = 1.32; 95% credible interval = 1.14 to 1.54) and a decreased risk of all-cause mortality (risk ratio = 0.95; 95% credible interval = 0.83 to 1.12). Discussion South Asians had statistically significantly higher odds of cardiovascular disease-related mortality compared to Whites, but not for all-cause mortality. Risk of bias was a serious concern mainly due to a lack of confounders being reported. Systematic review registration PROSPERO: CRD4202124086

Translating potential improvement in the precision and accuracy of lung nodule measurements on computed tomography scans by software derived from artificial intelligence into impact on clinical practice:a simulation study

Objectives Accurate measurement of lung nodules is pivotal to lung cancer detection and management. Nodule size forms the main basis of risk categorisation in existing guidelines. However, measurements can be highly variable between manual readers. This paper explores the impact of potentially improved nodule size measurement assisted by generic artificial intelligence (AI)-derived software on clinical management compared with manual measurement. Methods The simulation study created a baseline cohort of people with lung nodules, guided by nodule size distributions reported in the literature. Precision and accuracy were simulated to emulate measurement of nodule size by radiologists with and without the assistance of AI-derived software and by the software alone. Nodule growth was modelled over a 4-year time frame, allowing evaluation of management strategies based on existing clinical guidelines. Results Measurement assisted by AI-derived software increased cancer detection compared to an unassisted radiologist for a combined solid and sub-solid nodule population (62.5% vs 61.4%). AI-assisted measurement also correctly identified more benign nodules (95.8% vs 95.4%), however it was associated with over an additional month of surveillance on average (5.12 vs 3.95 months). On average, with AI assistance people with cancer are diagnosed faster, and people without cancer are monitored longer. Conclusions In this simulation, the potential benefits of improved accuracy and precision associated with AI-based diameter measurement is associated with additional monitoring of non-cancerous nodules. AI may offer additional benefits not captured in this simulation, and it is important to generate data supporting these, and adjust guidelines as necessary. Advances in Knowledge This paper shows the effects of greater measurement accuracy associated with AI assistance compared with unassisted measurement

Fuzzy Logic Based Self-Adaptive Handover Algorithm for MobileWiMAX.

It is well known that WiMAX is a broadband technology that is capable of delivering triple play (voice, data, and video) services. However, mobility in WiMAX system is still a main issue when the mobile station (MS) moves across the base station (BS) coverage and be handed over between BSs. Among the challenging issues in mobile WiMAX handover are unnecessary handover, handover failure and handover delay, which may affect real-time applications. The conventional handover decision algorithm in mobile WiMAX is based on a single criterion, which usually uses the received signal strength indicator (RSSI) as an indicator, with the other fixed handover parameters such as handover threshold and handover margin. In this paper, a fuzzy logic based self-adaptive handover (FuzSAHO) algorithm is introduced. The proposed algorithm is derived from the self-adaptive handover parameters to overcome the mobile WiMAX ping-pong handover and handover delay issues. Hence, the proposed FuzSAHO is initiated to check whether a handover is necessary or not which depends on its fuzzy logic stage. The proposed FuzSAHO algorithm will first self-adapt the handover parameters based on a set of multiple criteria, which includes the RSSI and MS velocity. Then the handover decision will be executed according to the handover parameter values. Simulation results show that the proposed FuzSAHO algorithm reduces the number of ping-pong handover and its delay. When compared with RSSI based handover algorithm and mobility improved handover (MIHO) algorithm, respectively, FuzSAHO reduces the number of handovers by 12.5 and 7.5 %, respectively, when the MS velocity is <17 m/s. In term of handover delay, the proposed FuzSAHO algorithm shows an improvement of 27.8 and 8 % as compared to both conventional and MIHO algorithms, respectively. Thus, the proposed multi-criteria with fuzzy logic based self-adaptive handover algorithm called FuzSAHO, outperforms both conventional and MIHO handover algorithms

Angiomatoid giant cellular blue nevus of vaginal wall associated with pregnancy

<p>Abstract</p> <p>Background</p> <p>Blue nevi that arise from the Müllerian tract are rare melanocytic lesions. Several histopathologic variants of cellular blue nevi have been described. The angiomatoid variant is characterized by a vascular component, and is considered to be a rare variant. Few studies have explored the influence of pregnancy on melanocytic lesions.</p> <p>Case</p> <p>A 29-year-old woman was presented with a pigmented vaginal lesion that increased gradually during pregnancy. A full term gynecologic examination showed a tumor mass protruding into the vaginal canal. The mass was resected during cesarean-section under the clinical impression of vaginal hemangioma.</p> <p>Result</p> <p>Gross examination revealed a cystic mass measuring 6.0 × 4.3 × 3.5 cm, which was filled with dark friable material. Histologically, the mass showed a subepithelial cellular proliferation of heavily pigmented dendritic melanocytes with prominent vascular stroma. Cytologic pleomorphism, junctional activity, atypical mitosis, and necrosis were not found. The proliferation was immunoreactive for HMB-45, S-100 and melan-A, and non-immunoreactive for CD34, smooth muscle actin, and AE1/AE3. The MIB-1 proliferative index was less than 1%. The patient had a postoperative course without complication.</p> <p>Conclusions</p> <p>Angiomatoid giant cellular blue nevus arising from the vagina during pregnancy is extremely rare. The low proliferative index and absence of cytologic pleomorphism, or necrosis, supports a benign biological behavior. Clinical follow-up showed no evidence of recurrence at one year after the resection of the mass.</p

Central topography of cranial motor nuclei controlled by differential cadherin expression

Neuronal nuclei are prominent, evolutionarily conserved features of vertebrate central nervous system (CNS) organization [1]. Nuclei are clusters of soma of functionally related neurons and are located in highly stereotyped positions. Establishment of this CNS topography is critical to neural circuit assembly. However, little is known of either the cellular or molecular mechanisms that drive nucleus formation during development, a process termed nucleogenesis [2, 3, 4, 5]. Brainstem motor neurons, which contribute axons to distinct cranial nerves and whose functions are essential to vertebrate survival, are organized exclusively as nuclei. Cranial motor nuclei are composed of two main classes, termed branchiomotor/visceromotor and somatomotor [6]. Each of these classes innervates evolutionarily distinct structures, for example, the branchial arches and eyes, respectively. Additionally, each class is generated by distinct progenitor cell populations and is defined by differential transcription factor expression [7, 8]; for example, Hb9 distinguishes somatomotor from branchiomotor neurons. We characterized the time course of cranial motornucleogenesis, finding that despite differences in cellular origin, segregation of branchiomotor and somatomotor nuclei occurs actively, passing through a phase of each being intermingled. We also found that differential expression of cadherin cell adhesion family members uniquely defines each motor nucleus. We show that cadherin expression is critical to nucleogenesis as its perturbation degrades nucleus topography predictably

Prevalence and determinants of depression up to 5 years after colorectal cancer surgery : results from the ColoREctal Wellbeing (CREW) study

Aim: Depression experienced by people with colorectal cancer (CRC) is an important clinical problem affecting quality of life. Recognition of depression at key points in the pathway enables timely referral to support. This study aimed to examine depression before and 5 years after surgery to examine its prevalence and identify determinants. Method: The ColoREctal Wellbeing (CREW) study is a prospective UK cohort study involving 872 adults with nonmetastatic CRC recruited before surgery with curative intent. Questionnaires completed before surgery and 3, 9, 15, 24, 36, 48 and 60 months after surgery captured socio‐demographics and assessed depression (Centre for Epidemiologic Studies Depression Scale, CES‐D) and other psychosocial factors. Clinical details were also gathered. We present the prevalence of clinically significant depression (CES‐D ≥ 20) over time and its predictors assessed before and 2 years after surgery. Results: Before surgery, 21.0% of the cohort reported CES‐D ≥ 20 reducing to 14.7% 5 years after surgery. Presurgery risk factors predicting subsequent depression were clinically significant depression and anxiety, previous mental health service use, low self‐efficacy, poor health, having neoadjuvant treatment and low social support. Postsurgery risk factors at 2 years predicting subsequent depression were clinically significant depression, negative affect, cognitive dysfunction, accommodation type and poor health. Conclusion: Depression is highly pervasive in people with CRC, exceeding prevalence in the general population across follow‐up. Our findings emphasize the need to screen and treat depression across the pathway. Our novel data highlight key risk factors of later depression at important and opportune time points: before surgery and at the end of routine surveillance. Early recognition and timely referral to appropriate support is vital to improve long‐term psychological outcomes

Cell disruption technologies

Cell disruption is crucial for the valorization of algal biomass and has already led to a variety of technology developments. Challenges remain to (1) disrupt all algae species of interest and (2) evolve further to scalable and economic attractive disruption approaches that preserve the cell constituents as much as possible