Health Related Quality of Life in Clinical Studies for Chronic Diseases—Design and Analytical Considerations

The dissertation uses health related quality of life (HRQoL) for evaluating treatment effectiveness. The research settings in the dissertation include observational cohort study and randomized clinical trial. The first research project examines the effect of Sahaja Yoga Meditation on quality of life. The study investigates whether the post intervention HRQoL, perceived anxiety assessment and hypertensive control is different in patients treated with meditation plus conventional therapy than patients treated with conventional therapy alone. The study shows that Sahaja Yoga Meditation treatment is associated with significant improvements in quality of life, anxiety reduction and blood pressure control. The second research project examines the association of age on clinical and quality of life outcomes in the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial (BARI 2D); specifically, among patients with both type 2 diabetes and coronary heart disease, whether a treatment strategy (prompt revascularization or medical therapy for heart disease and insulin sensitizing or insulin providing drugs for type 2 diabetes) is more preferable for older individuals in terms of clinical and HRQoL endpoints. The study shows that older patients are at greater risk for cardiovascular events but the effectiveness of cardiac treatment strategies and glycemic control strategies does not differ by age. Older patients experience an accelerated decline in health status than their younger peers. The third research project investigates the longitudinal relationship between body mass index (BMI) and heath status outcomes in BARI 2D. The study reports an inverse association between BMI and health status outcomes in patients with both stable ischemic heart disease and type 2 diabetes. Weight reduction is desirable for obese patients, but may not be necessary for overweight but non-obese patients to achieve improvements in functional capacity and perceived Energy outcomes. The public health significance of the dissertation lies in the research findings on treatments that result in better clinical or quality of life outcomes for patients with chronic diseases, but also contrasts the strength and weakness of HRQoL studies and demonstrates strategies to overcome the methodological challenges in conducting HRQoL research in clinical studies

Electronic health record-wide association study for atrial fibrillation in a British cohort

Background: Atrial fibrillation (AF) confers a major healthcare burden from hospitalisations and AF-related complications, such as stroke and heart failure. We performed an electronic health records-wide association study to identify the most frequent reasons for healthcare utilization, pre and post new-onset AF. Methods: Prospective cohort study with the linked electronic health records of 5.6 million patients in the United Kingdom Clinical Practice Research Datalink (1998–2016). A cohort study with AF patients and their age-and sex matched controls was implemented to compare the top 100 reasons of frequent hospitalisation and primary consultation. Results: Of the 199,433 patients who developed AF, we found the most frequent healthcare interactions to be cardiac, cerebrovascular and peripheral-vascular conditions, both prior to AF diagnosis (41/100 conditions in secondary care, such as cerebral infarction and valve diseases; and 33/100 conditions in primary care), and subsequently (47/100 conditions hospital care and 48 conditions in primary care). There was a high representation of repeated visits for cancer and infection affecting multiple organ systems. We identified 10 novel conditions which have not yet been associated with AF: folic acid deficiency, pancytopenia, idiopathic thrombocytopenic purpura, seborrheic dermatitis, lymphoedema, angioedema, laryngopharyngeal reflux, rib fracture, haemorrhagic gastritis, inflammatory polyneuropathies. Conclusion: Our nationwide data provide knowledge and better understanding of the clinical needs of AF patients suggesting: (i) groups at higher risk of AF, where screening may be more cost-effective, and (ii) potential complications developing following new-onset AF that can be prevented through implementation of comprehensive integrated care management and more personalised, tailored treatment.</p

SASMU: boost the performance of generalized recognition model using synthetic face dataset

Nowadays, deploying a robust face recognition product becomes easy with the development of face recognition techniques for decades. Not only profile image verification but also the state-of-the-art method can handle the in-the-wild image almost perfectly. However, the concern of privacy issues raise rapidly since mainstream research results are powered by tons of web-crawled data, which faces the privacy invasion issue. The community tries to escape this predicament completely by training the face recognition model with synthetic data but faces severe domain gap issues, which still need to access real images and identity labels to fine-tune the model. In this paper, we propose SASMU, a simple, novel, and effective method for face recognition using a synthetic dataset. Our proposed method consists of spatial data augmentation (SA) and spectrum mixup (SMU). We first analyze the existing synthetic datasets for developing a face recognition system. Then, we reveal that heavy data augmentation is helpful for boosting performance when using synthetic data. By analyzing the previous frequency mixup studies, we proposed a novel method for domain generalization. Extensive experimental results have demonstrated the effectiveness of SASMU, achieving state-of-the-art performance on several common benchmarks, such as LFW, AgeDB-30, CA-LFW, CFP-FP, and CP-LFW.Comment: under revie

A Simple Model for Cavity Enhanced Slow Lights in Vertical Cavity Surface Emission Lasers

We develop a simple model for the slow lights in Vertical Cavity Surface Emission Lasers (VCSELs), with the combination of cavity and population pulsation effects. The dependences of probe signal power, injection bias current and wavelength detuning for the group delays are demonstrated numerically and experimentally. Up to 65 ps group delays and up to 10 GHz modulation frequency can be achieved in the room temperature at the wavelength of 1.3 $\mu$m. The most significant feature of our VCSEL device is that the length of active region is only several $\mu$m long. Based on the experimental parameters of quantum dot VCSEL structures, we show that the resonance effect of laser cavity plays a significant role to enhance the group delays

HLA typing in Taiwanese patients with oral squamous cell carcinoma

AbstractBackground/purposeThe human leukocyte antigen (HLA) system, which plays a vital role in immunity, is the most polymorphic gene complex found in the human genome. This study investigated HLA-related alleles and haplotypes in Taiwanese patients with oral squamous cell carcinoma (OSCC).Materials and methodsHLA class I (HLA-A and HLA-B) antigens and class II (HLA-DRB1) alleles were determined in 105 patients with OSCC and compared with those in 190 healthy controls. The antigens were measured serologically and the alleles by sequencing-based typing.ResultsCompared with the control group, patients with OSCC had higher frequencies of HLA-A24, HLA-B54, HLA-DRB1*0405, and HLA-DRB1*1201, while they had lower frequencies of HLA-B58 and HLA-DRB1*1302. Haplotype frequencies also varied significantly in individuals with OSCC, with certain haplotypes associated with lymph node metastases or a particular tumor stage.ConclusionThese results suggest that HLA genetic factors influence susceptibility to OSCC and perhaps to lymph node metastasis and tumor progression

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

Differential expression of centrosomal proteins at different stages of human glioma

BACKGROUND: High-grade gliomas have poor prognosis, requiring aggressive treatment. The aim of this study is to explore mitotic and centrosomal dysregulation in gliomas, which may provide novel targets for treatment. METHODS: A case-control study was performed using 34 resected gliomas, which were separated into low- and high-grade groups. Normal human brain tissue was used as a control. Using immunohistochemical analysis, immunofluorescent microscopy, and RT-PCR, detection of centrins 1 and 2, γ-tubulin, hNinein, Aurora A, and Aurora B, expression was performed. Analysis of the GBM8401 glioma cell line was also undertaken to complement the in vivo studies. RESULTS: In high-grade gliomas, the cells had greater than two very brightly staining centrioles within large, atypical nuclei, and moderate-to-strong Aurora A staining. Comparing with normal human brain tissue, most of the mRNAs expression in gliomas for centrosomal structural proteins, including centrin 3, γ-tubulin, and hNinein isoforms 1, 2, 5 and 6, Aurora A and Aurora B were elevated. The significant different expression was observed between high- and low-grade glioma in both γ-tubulin and Aurora A mRNA s. In the high-grade glioma group, 78.6% of the samples had higher than normal expression of γ-tubulin mRNA, which was significantly higher than in the low-grade glioma group (18.2%, p < 0.05). CONCLUSIONS: Markers for mitotic dysregulation, such as supernumerary centrosomes and altered expression of centrosome-related mRNA and proteins were more frequently detected in higher grade gliomas. Therefore, these results are clinically useful for glioma staging as well as the development of novel treatments strategies