The efficacy of aspartate aminotransferase-to-platelet ratio index for assessing hepatic fibrosis in childhood nonalcoholic steatohepatitis for medical practice

PurposeChildhood obesity is associated with nonalcoholic fatty liver disease (NAFLD), and it has become one of the most common causes of childhood chronic liver diseases which significant as a cause of liver related mortality and morbidity in children in the United States. The development of simpler and easier clinical indices for medical practice is needed to identify advanced hepatic fibrosis in childhood NAFLD instead of invasive method like liver biopsy. FibroScan and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) have been proposed as a simple and noninvasive predictor to evaluate hepatic fibrosis in several liver diseases. APRI could be a good alternative to detect pathologic change in childhood NAFLD. The purpose of this study is to validate the efficacy of APRI for assessing hepatic fibrosis in childhood NAFLD based on FibroScan.MethodsThis study included 23 children with NAFLD who underwent FibroScan. Clinical, laboratory and radiological evaluation including APRI was performed. To confirm the result of this study, 6 patients received liver biopsy.ResultsFactors associated with hepatic fibrosis (stiffness measurement >5.9 kPa Fibroscan) were triglyceride, AST, alanine aminotransferase, platelet count, APRI and collagen IV. In multivariate analysis, APRI were correlated with hepatic fibrosis (>5.9 kPa). In receiver operating characteristics curve, APRI of meaningful fibrosis (cutoff value, 0.4669; area under the receiver operating characteristics, 0.875) presented sensitivity of 94%, specificity of 66%, positive predictive value of 94%, and negative predictive value of 64%.ConclusionAPRI might be a noninvasive, simple, and readily available method for medical practice to predict hepatic fibrosis of childhood NAFLD

Correlation between the occurrence of acute gastroenteritis in children and regional temperature at a tertiary hospital emergency department in Korea

Purpose Several studies have investigated the association between acute gastroenteritis (AGE) and regional temperatures. We aimed to investigate the correlation between the occurrence of AGE and regional temperature in Korean children. Methods We reviewed the clinical characteristics of children aged 18 years or younger with AGE, defined according to the International Statistical Classification of Diseases, 10th Revision codes, who visited a Korean tertiary hospital emergency department (ED) between 2006 and 2016, and compared the children who were discharged from the ED and those who were hospitalized. Data on temperature in Seoul, Korea during the period were obtained from the Korea Meteorological Administration. Subsequently, we assessed correlations between the monthly mean numbers of the children with AGE and monthly mean temperature using Pearson’s correlation analysis. Results A total of 31,931 children with AGE visited the ED. Vomiting was the most common manifestation (62.0%). Fever, chills, cough, and sputum were more frequent in the hospitalized children (P < 0.05). Hospitalization rate was highest (2.7%) and monthly mean temperature was lowest (-2.4。C) in January. We observed negative correlations between the monthly mean numbers of the children with AGE and the monthly mean temperature (for ED visit, r = -0.845; for hospitalization, r = -0.923). Conclusion Children with AGE tend to visit the ED, and undergo hospitalization during the cold weather. This finding could help the guardians to expect the occurrence of AGE, and physicians to facilitate the allocation of resources for emergency medicine in winter

Normal serum alanine aminotransferase and non-alcoholic fatty liver disease among Korean adolescents: a cross-sectional study using data from KNHANES 2010–2015

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is complicated disease and increasing worldwide. Previously, many studies of NALFD prevalences have used alanine aminotransferase (ALT) of > 40 U/L to define NAFLD, although that is too high to be reliable among adolescents. This study aimed to define the upper normal limit of ALT among Korean adolescents, and use it to estimate the prevalence of NAFLD, based on data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods Data were obtained from 1785 healthy adolescents (916 boys and 869 girls, 10–18 years old) who participated in the KNHANES during 2010–2015. The International Diabetes Federation metabolic syndrome criteria for adolescents were used to exclude participants with metabolic syndrome components. Furthermore, participants who previously had diseases related to low HDL levels, high TG levels, diabetes, or very low/high body mass index and hepatitis B were excluded. The 95th percentiles level of ALT from healthy participants were evaluated. The definition of NAFLD was overweight status (≥85th percentile of body mass index) plus elevated ALT levels (95th percentile). Results The upper normal ALT were 24.1 U/L for boys and 17.7 U/L for girls. Based on these values, the estimated prevalences of NAFLD in 2015 were 8.9% among adolescents. Conclusion Defining the upper normal limit of ALT can be adjusted for each sex and ethnics in the general population. ALT laboratory thresholds used for children should be re-examined. The physicians should be aware not to underdiagnose NAFLD patient even ALT level is < 40 U/L

DFCloud: A TPM-based Secure Data Access Control Method of Cloud Storage in Mobile Devices

Using the cloud storage services, users can access their data in any time, at any place, even with any computing device including mobile devices. Although these properties provide flexibility and scalability in handling data, security issues should be handled especially when mobile devices try to access data stored in cloud storage. Currently, a typical cloud storage service, Dropbox, offers server-side data encryption for security purpose. However, we think such method is not secure enough because all the encryption keys are managed by software and there is no attestation on the client software integrity. Moreover, a simple user identification based on user ID and Password is also easy to be compromised. Data sharing which is critical in enterprise environment is significantly restricted because it is not easy to share encryption key among users. In this paper, we propose DFCloud, a secure data access control method of cloud storage services to handle these problems found in the typical cloud storage service Dropbox. DFCloud relies on Trusted Platform Module (TPM) [1] to manage all the encryption keys and define a key sharing protocol among legal users. We assume that each client is mobile device using ARM TrustZone [2] technology. The DFCloud server prototype is implemented using ARM Fastmodel 7.1 and Open Virtualization software stack for ARM TrustZone. For DFCloud client, TPM functions are developed in the secure domain of ARM TrustZone because most ARM-based mobile devices are not equipped with TPM chip. The DFCloud framework defines TPM-based secure channel setup, TPM-based key management, remote client attestation, and a secure key share protocol across multiple users/devices. It is shown that our concept works correctly through a prototype implementation.1113Nsciescopu

Identifying Technology Opportunities for Electric Motors of Railway Vehicles with Patent Analysis

An electric motor is a device that changes electrical energy into mechanical energy for railway vehicles. When developing the electric motor, it used to be developed simply for structures or control methods of the motor itself without considering convergence with other devices or technologies. However, as the railway vehicles become more advanced, technology development through convergence with other devices or technologies is spreading. Therefore, based on patent data related to the electric motors applied to the railway vehicles, this research aims to carry out technical forecasting for establishing research and development (R and D) direction for new technologies by predicting vacant technologies from the point of view of technology convergence. In other words, we studied how to find the vacant technologies in a field of convergence technology for the electric motor of the railway vehicles by analyzing the patent data. More specifically, we search the patents data associated with the electric motor of the railway vehicle that contain multiple IPC codes, and use multiple IPC codes to determine the field of convergence technology. In addition, we extract keywords from the patents data related to each of the determined convergence technologies and define the vacant technologies by interpreting the field of convergence technology and the extracted keywords