Cell Selection Techniques in Heterogeneous LTE Advanced System

This survey paper provides a performance evaluation of cell selection technique s proposed for Pico cells in the Long Term Evolution - Advance d (LTE - A) networks. Pico cell is the focus of this study because i t can be deployed in areas with high volume of traffic so as to improve the system capacity. Cell selection which plays a important role in improving cell spectrum efficiency especially in heterogeneous systems is the process that allows the user equipments ( USEd) t o select a suitable cell in order to access available services. This paper analysis the new interference environment and the limitations of traditional cell selection method which caused by low power nodes, and propose anew cell selectio n strategy to resolve these problems in order to improve efficiency in L TE - A heterogeneous systems

Perinatal Experiences of People with Autism Spectrum Disorders: A Preliminary Scoping Review

Autism Spectrum Disorder (ASD) is a developmental disorder that is diagnosed in early childhood, typically in people who are assigned male at birth. However, this diagnosis and the sensory and behavioral divergence that comes with ASD stay with people throughout their lives. Based on the DSM-V diagnostic criteria and the history of how Autism and Autism Spectrum Disorders were first identified, many people who do not identify as male and/or present atypically do not receive a formal diagnosis until later in life or self-diagnose. This in turn has led to a lack of research in both populations that do not identify as cisgender male and in adult healthcare for people with ASD. This preliminary scoping review focuses on the perinatal (pregnancy, birth, and postnatal) experiences of people with Autism Spectrum Disorders. Currently there are very limited quantitative and qualitative studies exploring this topic and there are significant gaps in provider knowledge of atypical and/or adult presentations of ASD. In this review, I looked at papers published in English and available through the PubMed database that focused on one of the following three themes: perinatal experiences of the ASD population, healthcare experiences in general of the ASD population, and perinatal experiences of people with disabilities in general. After performing a scoping review of 6 papers, most people with ASD had increased sensitivity to sensory and physical stimuli during pregnancy, felt unprepared to address their body’s signals during birth, and unprepared to cope with the physical postnatal symptoms and sensory sensitivities associated with breastfeeding. Surprising to note was that many parents with ASD felt that their increased sensory sensitivities strengthened their response to the baby’s cues. All these sensory/physical experiences went unrecognized for the most part by physicians as the patients with ASD felt pressure to act in a socially normative way and many did not disclose their diagnosis to the physician whether due to a lack of formal diagnosis and/or due to fear of a negative impact on their healthcare interactions. This lack of disclosure and masking of behaviors led to patient needs being underestimated by the healthcare team and the development of multiple communication barriers such as lack of adjustment to patient needs whether it be via providing an advocate or different methods of providing information. These barriers highlighted the gaps in physician knowledge on how ASD is a spectrum and has many different manifestations and their ignorance in how to properly address and adapt to patient symptoms of meltdown/shutdown/sensory overload. Participants in all the papers reviewed emphasized that continuity of care and physician willingness to adjust to patient needs contributed to improved health outcomes. Recommendations made for medical training and physicians included increased training on ASD, diversity in how information is provided, and adjusting to individual patient needs. However, current research is very limited and most had multinational or populations outside of the USA in their studies. Future studies must focus on elucidating barriers specific to the USA and gauging physician knowledge of ASD and their perceptions of that population

Stabilization of a Tenofovir Alafenamide Fumarate Formulation for Use in a Subcutaneous Implant

Scientific advances in the last three decades have helped transform HIV from a fatal disease into a chronic condition for many people. There has been an increase in interest to explore strategies for the prevention of HIV, commonly known as Pre-exposure prophylaxis (PrEP). Currently Truvada®, a once-a-day oral pill, is the only FDA approved marketed regimen for HIV PrEP. Long-acting (LA) systems requiring less frequent dosing remain a major unmet need. A LA system currently under development is a polycaprolactone (PCL)-based biodegradable subcutaneous implant of Tenofovir alafenamide fumarate salt (TAF) in a castor oil paste. This implant showed sustained zero-order release of TAF over 3 months but failed to release drug in zero-order kinetics post 90 days due to poor drug stability. The present work involves the optimization of this implant to achieve stabilization of the TAF formulation inside the PCL device. First, a stability-indicating HPLC method was developed and validated. Then, a suite of pre-formulation studies were performed to better elucidate the mechanisms of TAF degradation in the device. Additionally, a novel stability model was developed that accelerated TAF degradation inside the implant over 8-folds for rapid formulation screening. This model was utilized to study a wide range of excipients belonging to the class of pH and HLB modifiers. Oil substitutes for castor oil were also explored. Controlling the intra-device pH between 5 – 5.5 was found to be the key determinant of TAF stability. pH modifiers showed most promise in stabilizing TAF, with TAF percent recovery between 90 – 110 % vs. control (<5%). Viable pH modifiers were further optimized for processability in scale-up efforts. Final optimized formulations containing either dibasic sodium phosphate or sodium citrate were found to stabilize TAF in the accelerated model for over 9 weeks. A percent recovery of 90 – 110 % vs. control (0 %) was obtained. In conclusion, two formulations were identified that increased the stability of TAF in the implant. These formulations can be potentially used as bi-annual, long acting subcutaneous systems for HIV PrEP

Endlessly Browsable Topic Recommendations

Some users of search engines may not want to (or may be unable to) type in or speak out a search query. As another example, users may have limited or no knowledge of popular search platforms or engines. There is currently no mechanism for a search engine to recommend related topics to a user to enable a semi-autonomous browsing experience that can be endless. This disclosure describes techniques that utilize a topic graph to enable users to browse topics or explore interesting and contextual information without requiring the entry of a search query

Status of quarkonia - like negative and positive parity states in a relativistic confinement scheme

Properties of quarkonia - like states in the charm and bottom sector have been studied in the frame work of relativistic Dirac formalism with a linear confinement potential. We have computed the mass spectroscopy and decay properties (vector decay constant and leptonic decay width) of several quarkonia - like states. Present study is also intended to identify some of the unexplained states as mixed P-wave and mixed S-D wave states of Charmonia and Bottomonia. The results indicate that the X(4140) state can be an admixture of two P states of charmonium. And the charmonium like states X(4630) and X(4660) are the admixed state of S - D waves. Similarly, the $X(10610)$ state recently reported by Belle II can be a mixed P - states of bottomonium. In the relativistic framework we have computed vector decay constant and the leptonic decay width for S wave charmonium and bottomonium. The leptonic decay width for the $J^{PC} = 1^{--}$ mixed states are also predicted. Further, both the masses and the leptonic decay width are considered for the identification of the quarkonia-like states.Comment: 14 pages, 2 figure

Obesity as a Risk Factor for Preeclampsia: Role of Inflammation and the Innate Immune System

Obesity is a known risk factor for preeclampsia, but the reason for this risk is unknown. We sought to demonstrate how obese individuals are predisposed to preeclampsia by mechanisms involving inflammation and the innate immune system. First, we used immunohistochemical studies to identify neutrophil infiltration, NF-κB activation and COX-2 expression in vascular tissue of obese women. We then demonstrated similar neutrophil infiltration and vascular inflammation in preeclamptic women.We used in vitro experiments to test if neutrophils and their products, reactive oxygen species (ROS) and tumor necrosis factor-alpha (TNFα) can activate NF-κB and cause expression of its inflammatory products, COX-2, thromboxane (TX) and IL-8. Co-culture of neutrophils or treatments of ROS or TNFα caused activation of NF-κB and expression of COX-2, TX and IL-8 in vascular smooth muscle cells.This investigation is the first to demonstrate activation of NF-κB and expression of COX-2 coincident with neutrophil infiltration in systemic vascular tissue of obese and preeclamptic women. These data implicate neutrophils as a cause of vascular inflammation. They also suggest that if an obese woman\u27s vasculature was in an inflamed state she is at increased risk for preeclampsia when exposed to the additional burden of oxidative stress and neutrophil activation imposed by the placenta, causing her to develop vascular dysfunction and clinical symptoms of PE (hypertension and edema)

Pain Forecasting using Self-supervised Learning and Patient Phenotyping: An attempt to prevent Opioid Addiction

Sickle Cell Disease (SCD) is a chronic genetic disorder characterized by recurrent acute painful episodes. Opioids are often used to manage these painful episodes; the extent of their use in managing pain in this disorder is an issue of debate. The risk of addiction and side effects of these opioid treatments can often lead to more pain episodes in the future. Hence, it is crucial to forecast future patient pain trajectories to help patients manage their SCD to improve their quality of life without compromising their treatment. It is challenging to obtain many pain records to design forecasting models since it is mainly recorded by patients' self-report. Therefore, it is expensive and painful (due to the need for patient compliance) to solve pain forecasting problems in a purely supervised manner. In light of this challenge, we propose to solve the pain forecasting problem using self-supervised learning methods. Also, clustering such time-series data is crucial for patient phenotyping, anticipating patients' prognoses by identifying "similar" patients, and designing treatment guidelines tailored to homogeneous patient subgroups. Hence, we propose a self-supervised learning approach for clustering time-series data, where each cluster comprises patients who share similar future pain profiles. Experiments on five years of real-world datasets show that our models achieve superior performance over state-of-the-art benchmarks and identify meaningful clusters that can be translated into actionable information for clinical decision-making.Comment: 8 page

Understanding Sleep in Pediatric Patients with Sickle Cell Disease Admitted for Vaso-Occlusive Pain Crisis through Objective Data

Sickle cell disease (SCD) is an inherited red cell disorder that leads to sickling of red blood cells, anemia and vaso-occlusion. The most common reason for hospitalization and morbidity in children is pain due to vaso-occlusive crisis (VOC). Importantly, poor sleep quality can lead to increased pain the subsequent day and nocturnal pain leads to reduced deep sleep, both which can then modify pain sensitivity. Studies using sleep diaries have shown this cyclical relationship between sleep and pain. Frequent occurrences of restless sleep are therefore believed to contribute to an increased severity and intensity of pain episodes. There is very little data, however, looking at objective data such as vital signs to define sleep in patients with SCD admitted for VOC. We aimed to make comparisons between sleep hours and daytime hours for pain scores, patient controlled analgesia (PCA) usage and vital sign data in effort to better define and understand sleep in SCD

Evaluation of the effect of topical cefadroxil on bacterial load of pathogenic staphylococci in anterior nares in human volunteers, comparative study between oral vs. topical cefadroxil and evaluation of effect of combination of oral plus topical cefadroxil in patients with staphylococcal superficial skin infections

Background: Cefadroxil has good tissue penetration & exerts more sustained action at the site of infection after oral absorption. Our aim of the study was to check topical cefadroxil has any efficacy over staphylococcal superficial skin infection or not.Methods: Pre-treatment nasal swabs were obtained from 25 healthy human volunteers and bacterial load was recorded. After single application of topical cefadroxil 3% in left anterior nare and placebo (vehicle) in right anterior nare nasal swabs were obtained and results were compared. 150 patients with staphylococcal superficial skin infections were distributed in 4 groups: Group A - oral cefadroxil 500 mg twice daily for 5 days, Group B - topical cefadroxil (0.5 % to 5%) twice daily, Group C - cefadroxil 500 mg orally plus placebo (vehicle) topically twice daily and Group D -cefadroxil 500 mg orally plus cefadroxil preparation topically twice daily. Bacterial load was measured before treatment, on follow up &after clinical cure and results were compared.Results: Topical cefadroxil significantly reduced bacterial load after single application in anterior nare. Topical cefadroxil cured and significantly reduced bacterial load in staphylococcal superficial skin infections within 3 days of treatment. Oral plus topical cefadroxil combination therapy significantly reduced bacterial load and cured infection within 3 days of treatment in patients with moderate to heavy bacterial growth. No any adverse effect was observed during entire study period in any of groups.Conclusions: Topical preparation of cefadroxil is safe and effective in treating staphylococcal superficial skin infections. Combination of oral plus topical cefadroxil showed synergistic effect in infections with moderate to heavy growth. This study is registered at CTRI [REG ID: CTRI/2013/02/003433 REF: REF/2013/02/004576]