On the Quality of Experience of Content Sharing in Online Education and Online Meetings

The turn of the decade introduced a new era of global pandemics to the world through the appearance of COVID-19, which is still an active crisis at the time of this paper. As a countermeasure, the phenomena of home office and online education became not only widely available, but also mandatory in many countries. However, the performance, reliability and general usability of such real-time activities may be severely affected by unfavorable network conditions. In both contexts, content sharing is now a common practice, and the success of the related use cases may fundamentally depend on it. In this paper, we present our surveys and subjective studies on the Quality of Experience of content sharing in online education and online meetings. A total of 6 surveys and 5 experiments are detailed, addressing topics of student experience, user interface settings, sharing options of lecturers and employees of the private sector, the perceivable effects of network impairments and the related long-term adaptation, the rubber band effect of slide sharing, the overall perceived quality and the separate quality aspects of media loading times, and the preference between visual quality, average frame rate and frame rate uniformity. The findings of the subjective studies do not characterize the use cases of the investigated topics on a general, widely-applicable level, as only a single online platform is involved throughout the experiments. However, their experimental configurations are reinforced by comprehensive surveys and many results indicate statistically significant differences between the selected test conditions

On the quality of experience of content sharing in online education and online meetings

The turn of the decade introduced a new era of global pandemics to the world through the appearance of COVID-19, which is still an active crisis at the time of this paper. As a countermeasure, the phenomena of home office and online education became not only widely available, but also mandatory in many countries. However, the performance, reliability and general usability of such real-time activities may be severely affected by unfavorable network conditions. In both contexts, content sharing is now a common practice, and the success of the related use cases may fundamentally depend on it. In this paper, we present our surveys and subjective studies on the Quality of Experience of content sharing in online education and online meetings. A total of 6 surveys and 5 experiments are detailed, addressing topics of student experience, user interface settings, sharing options of lecturers and employees of the private sector, the perceivable effects of network impairments and the related long-term adaptation, the rubber band effect of slide sharing, the overall perceived quality and the separate quality aspects of media loading times, and the preference between visual quality, average frame rate and frame rate uniformity. The findings of the subjective studies do not characterize the use cases of the investigated topics on a general, widely-applicable level, as only a single online platform is involved throughout the experiments. However, their experimental configurations are reinforced by comprehensive surveys and many results indicate statistically significant differences between the selected test conditions

Ibrutinib-induced cardiomyopathy

The use of ibrutinib for the treatment of chronic lymphocytic leukemia (CLL) and other hematologic malignancies is blooming. Atrial fibrillation is a known side effect of ibrutinib but cardiomyopathy was not reported previously. We present an 88-year-old man with CLL who was admitted to the hospital with new-onset atrial fibrillation and symptomatic systolic congestive heart failure one month after ibrutinib initiation. Although ibrutinib was discontinued, the patient continues to have a low ejection fraction four months after discontinuation. Ischemic heart disease was ruled out with normal cardiac catheterization. This case highlights a possible new side effect of ibrutinib that needs to be monitored while patients receive this medication

Bilateral pulmonary nodules and intravascular pulmonary histiocytosis: A rare presentation of hemophagocytic lymphohistiocytosis secondary to Epstein-Barr Virus infection

A 61-year-old male presented with worsening dyspnoea and constitutional symptoms for few weeks followed by bloody diarrhoea and loss and fever. Physical exam revealed tachycardia, respiratory distress, and splenomegaly without lymphadenopathy. Work up showed pancytopenia, hypofibrinogenemia, acute kidney injury requiring haemodialysis, high ferritin level, positive IgG and IgM for EBV and positive soluble CD25. Chest CT scan showed bilateral pulmonary nodules. Lung biopsy showed intravascular pulmonary histiocytosis while bone marrow biopsy was negative for hemophagocytes. A diagnosis of hemophagocytic lymphohistiocytosis (HLH) was made based on fulfilling the diagnostic criteria and systemic steroids were initiated, which improved the patient's condition gradually with resolution of dyspnoea, AKI and pancytopenia. Repeat chest CT scan showed resolution of bilateral pulmonary nodules. The patient was transferred to a tertiary centre to receive HLH-specific therapy. We present a rare presentation of HLH with steroid-responsive bilateral pulmonary nodules and a rare histopathologic finding of pulmonary intravascular histiocytosis, which has never been described in HLH or the lung tree

Anti-atherosclerotic effect of incretin mimetics: a meta-analysis of randomized controlled trials

Background: Diabetes is a very common cause of cardiovascular disease, and metformin remains the first-line treatment of diabetes. Many trials were conducted to prove the efficacy and safety of other antidiabetic medication as the best add-on medication. Objectives: We aimed to evaluate the atherosclerotic effect of incretin mimetics in patients with diabetes.Methods: We searched in PubMed, clinicaltrials.gov and Cochrane Library for randomized controlled trials (RCTs) comparing incretin mimetic with conventional treatment. The primary outcome was the change in carotid intima-media thickness (CIMT) at the end of the trials.Results: Five RCTs (n = 1241), the mean age of patients included in the trials is 64.3 ± 11.4. The primary outcome was statistically significant for CIMT improvement in terms of long-term follow-up analysis between the incretin mimetic group and conventional group (mean difference [MD] −0.031; 95% Confidence interval [CI] −0.049 to 0.012; P = 0.001), whereas at short-term follow-up it wasn’t (MD −0.004; 95% CI −0.024 to 0.016; P = 0.7) in the overall group of study participants. Additionally, the mean change in body mass index (BMI) (MD 0.064; 95% CI −0.54 to 0.67; P = 0.8), and mean change in systolic blood pressure (MD −0.42; 95% CI −3.2 to 2.3; P = 0.8) or diastolic blood pressure (MD 0.25; 95% CI −1.18 to 1.68; P = 0.7) were not significant.Conclusion: Long-term use of incretin mimetic medication results in significant improvement of atherosclerosis, which leads to fewer vascular events, with no apparent effect on blood pressure or BMI. Further dedicated trials are required to show the superiority of adding these medications to conventional treatment versus placebo

Best duration of dual antiplatelet therapy after drug-eluting stent implantation: an updated network meta-analysis of randomized controlled trials

Background: Drug-eluting stent(DES) implantation is the main interventional treatment for coronary artery disease, and dual antiplatelet therapy(DAPT) remains the gold standard strategy to prevent ischemic events. However, the optimal duration of DAPT after DES implantation remains controversial. Therefore, we aimed to evaluate the best duration of DAPT following DES implantation. Method: We searched PubMed, Embase, Cochrane Library, and clinicaltrials.gov for all randomized clinical trials(RCTs) that compared different durations of DAPT after DES implantation. Major adverse cardiac events(MACE) and major bleeding were the primary and secondary outcomes, respectively. Results: We included 16 RCTs (n = 42,993). The mean age of included patients was 63.1 ± 10.1. The primary outcome was statistically significant for lower MACE in patients who received DAPT for 24–48 months (mo) following DES when compared with those who received 3–6 mo of DAPT (odds ratio [OR] 0.75; 95% credible interval [CI] 0.58–0.97). There was nonstatistically significant difference in MACE when comparing those who received 12 mo of DAPT to those taking either 3–6 mo of DAPT (OR 0.86; 95% CI 0.69–1.08) or 24–48 mo of DAPT (OR 0.87; 95% CI 0.72–1.05). In contrast, major bleeding was significantly lower in those who received 3–6 mo of DAPT (OR 0.32; 95% CI 0.17–0.54) and 12 mo of DAPT (OR 0.43; 95% CI 0.27–0.63) than in those who received 24–48 mo of DAPT. Conclusion: In patients who undergo DES implantation, a longer duration of DAPT is associated with lower MACE, despite the increased risk of major bleeding events. Therefore, individualizing the duration of DAPT after DES according to the patient’s risk of bleeding and recurrent ischemia is recommended

The role of vitamin D supplementation for primary prevention of cancer: meta-analysis of randomized controlled trials

Background: In the USA cancer is the second leading cause of mortality, as such, primary prevention of cancer is a major public health concern. Vitamin D supplementation has been studied as a primary prevention method for multiple diseases including cardiovascular disease, osteoporosis, diabetes mellitus and cancer. The role of Vitamin D as primary prevention of cancer is still controversial. With fast emergence of large randomized controlled trials (RCTs) in that regards, we aimed to evaluate the efficacy of Vitamin D supplementation as primary prophylaxis for cancer. Methods: A comprehensive electronic database search was conducted for all RCTs where comparison of Vitamin D supplementation versus placebo for the prevention of any type of disease with at least 3 years of Vitamin D supplementation was used and where cancer incidence or mortality was reported. The primary outcome was cancer-related mortality and cancer incidence. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) using a random-effects model at the longest follow-up. Results: We included 10 RCTs with 79,055 total patients, mean age of 68.07 years, a female percentage of 78.02% and a minimum follow-up of 4 years and more. Vitamin D was associated with significant reduction of cancer-related mortality compared with placebo (RR 0.87; 95% CI: 0.79–0.96; P = 0.05: I2 = 0%). Compared with placebo, Vitamin D was not associated with significant reduction of cancer incidence (RR: 0.96; 95% CI: 0.86–1.07; P = 0.46; I2 = 31%). Conclusion: With inclusion of studies, which did not primarily examine vitamin D for the purpose of preventing cancer or reducing cancer mortality our meta-analysis highlights that the use of vitamin D supplementation for primary prevention of cancer is encouraged as it does possibly decrease cancer-related mortality once cancer is diagnosed; however, it has no role or effect on cancer incidence