Prognostic significance of hemoglobin A1c level in patients hospitalized with coronary artery disease. A systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>The prognostic value of hemoglobin A1c (HbA1c) in coronary artery disease (CAD) remains controversial. Herein, we conducted a systematic review to quantify the association between elevated HbA1c levels and all-cause mortality among patients hospitalized with CAD.</p> <p>Methods</p> <p>A systematic search of electronic databases (PubMed, EMBASE, OVID, Web of Science, The Cochrane Library) for studies published from 1970 to May 2011 was performed. Cohort, case-control studies, and randomized controlled trials that examined the effect of HbA1c on all-cause mortality were included.</p> <p>Results</p> <p>Twenty studies met final inclusion criteria (total n = 13, 224). From the pooled analyses, elevated HbA1c level was significantly associated with increased short-term (OR 2.32, 95% CI, 1.61 to 3.35) and long-term (OR 1.54, 95% CI, 1.23 to 1.94) mortality risk. Subgroup analyses suggested elevated HbA1c level predicted higher mortality risk in patients without diabetes (OR 1.84, 95% CI, 1.51 to 2.24). In contrast, in patients with diabetes, elevated HbA1c level was not associated with increased risk of mortality (OR 0.95, 95% CI, 0.70 to 1.28). In a risk-adjusted sensitivity analyses, elevated HbA1c was also associated with a significantly high risk of adjusted mortality in patients without diabetes (adjusted OR 1.49, 95% CI, 1.24 to 1.79), but had a borderline effect in patients with diabetes (adjusted OR 1.05, 95% CI, 1.00 to 1.11).</p> <p>Conclusions</p> <p>Our findings demonstrate that elevated HbA1c level is an independent risk factor for mortality in CAD patients without diabetes, but not in patients with established diabetes. Prospective studies should further investigate whether glycemic control might improve outcomes in CAD patients without previously diagnosed diabetes.</p

Controller design for synchronization of an array of delayed neural networks using a controllable

This is the post-print version of the Article - Copyright @ 2011 ElsevierIn this paper, a controllable probabilistic particle swarm optimization (CPPSO) algorithm is introduced based on Bernoulli stochastic variables and a competitive penalized method. The CPPSO algorithm is proposed to solve optimization problems and is then applied to design the memoryless feedback controller, which is used in the synchronization of an array of delayed neural networks (DNNs). The learning strategies occur in a random way governed by Bernoulli stochastic variables. The expectations of Bernoulli stochastic variables are automatically updated by the search environment. The proposed method not only keeps the diversity of the swarm, but also maintains the rapid convergence of the CPPSO algorithm according to the competitive penalized mechanism. In addition, the convergence rate is improved because the inertia weight of each particle is automatically computed according to the feedback of fitness value. The efficiency of the proposed CPPSO algorithm is demonstrated by comparing it with some well-known PSO algorithms on benchmark test functions with and without rotations. In the end, the proposed CPPSO algorithm is used to design the controller for the synchronization of an array of continuous-time delayed neural networks.This research was partially supported by the National Natural Science Foundation of PR China (Grant No 60874113), the Research Fund for the Doctoral Program of Higher Education (Grant No 200802550007), the Key Creative Project of Shanghai Education Community (Grant No 09ZZ66), the Key Foundation Project of Shanghai(Grant No 09JC1400700), the Engineering and Physical Sciences Research Council EPSRC of the U.K. under Grant No. GR/S27658/01, an International Joint Project sponsored by the Royal Society of the U.K., and the Alexander von Humboldt Foundation of Germany

Surgical treatment of multivalvular endocarditis: Twenty-one–year single center experience

ObjectiveLittle information is available about surgical outcomes in patients with multivalvular endocarditis. The aim of this article is to review the 21-year experience with surgical treatment of patients with multivalvular endocarditis at our institution and, in particular, to determine the incidence, pathologic status, diagnosis, surgical strategies, and outcomes of patients with this disease.MethodsFrom January 1986 to December 2006, a total of 48 patients (40 men, 8 women), with a mean age of 42 ± 12 years, underwent surgery for multivalvular endocarditis. Endocarditis was active in 32 patients and healed in 16. Preoperative transthoracic echocardiographic evaluation was performed in all 48 patients with addition of transesophageal echocardiography in 22 (45.8%). Intraoperative findings showed that the endocarditis involved mostly the mitral and aortic valves (40/48 patients). Triple or quadruple valve involvement was found in 1 and 2 patients, respectively. Preoperative, perioperative, and postoperative data were retrospectively analyzed and risk factors for early and late survival were determined.ResultsIn only 24 (50.0%) patients was multivalvular endocarditis diagnosed by preoperative transthoracic echocardiography; 17 (77.3%) patients had multivalvular endocarditis confirmed by preoperative transesophageal echocardiography. The 30-day hospital mortality was 12.5% (n = 6). Preoperative renal failure, New York Heart Association class IV, and emergency surgery were identified as independent risk factors for hospital mortality. Overall long-term survival was 74% ± 6% at 5 years and 62% ± 3% at 10 years. Multivariate analysis revealed that renal failure and recurrent endocarditis were associated with increased late mortality. Ten-year freedom from recurrent endocarditis was 74% ± 5% and 10-year freedom from reoperation was 73% ± 6%.ConclusionsIn our institution, multivalvular endocarditis was diagnosed by transthoracic echocardiography in only half of the patients. Intraoperative transesophageal echocardiography provided a more effective means to identify this disease. Radical resection of all infected tissues for patients with multivalvular endocarditis and additional intraoperative interventions, depending on the intraoperative pathologic condition, produced satisfactory in-hospital and long-term results, similar to those in patients with a single infected heart valve

Feedback learning particle swarm optimization

This is the author’s version of a work that was accepted for publication in Applied Soft Computing. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published and is available at the link below - Copyright @ Elsevier 2011In this paper, a feedback learning particle swarm optimization algorithm with quadratic inertia weight (FLPSO-QIW) is developed to solve optimization problems. The proposed FLPSO-QIW consists of four steps. Firstly, the inertia weight is calculated by a designed quadratic function instead of conventional linearly decreasing function. Secondly, acceleration coefficients are determined not only by the generation number but also by the search environment described by each particle’s history best fitness information. Thirdly, the feedback fitness information of each particle is used to automatically design the learning probabilities. Fourthly, an elite stochastic learning (ELS) method is used to refine the solution. The FLPSO-QIW has been comprehensively evaluated on 18 unimodal, multimodal and composite benchmark functions with or without rotation. Compared with various state-of-the-art PSO algorithms, the performance of FLPSO-QIW is promising and competitive. The effects of parameter adaptation, parameter sensitivity and proposed mechanism are discussed in detail.This research was partially supported by the National Natural Science Foundation of PR China (Grant No 60874113), the Research Fund for the Doctoral Program of Higher Education (Grant No 200802550007), the Key Creative Project of Shanghai Education Community (Grant No 09ZZ66), the Key Foundation Project of Shanghai(Grant No 09JC1400700), the International Science and Technology Cooperation Project of China under Grant 2009DFA32050, and the Alexander von Humboldt Foundation of Germany

Traditional Chinese Herb Combined with Surgery versus Surgery for Varicocele Infertility: A Systematic Review and Meta-Analysis

Objective. The objective of this study was to conduct a systematic review to assess the effectiveness and safety of traditional Chinese herb combined with surgery for male varicocele infertility compared to surgery. Methods. Randomized controlled trials (RCTs) data of traditional Chinese herbs combined with surgery for male varicocele fertility versus surgery were collected by searching the Cochrane Library, Embase, PubMed, and Chinese databases. The risk of bias was assessed using Cochrane Handbook. Study outcomes were presented as risk ratios (RRs) for dichotomous data. Results. Seventeen of 72 potentially relevant trials met the inclusion criteria. The methodological qualities of the RCTs were low. Compared with the surgery group, the traditional Chinese herb combined with surgery group had superiority in pregnancy rate at 3-month (RR=1.76, and P=0.008), 6-month (RR=1.58, and P=0.0005), and 2-year (RR=1.58, and P=0.0005) follow-ups. No RCT was found to describe the side effects. Conclusion. On considering the low methodological quality of RCTs, there was no enough evidence on traditional Chinese herb with surgery for male varicocele infertility, and more high-quality RCTs of large sample sizes are required

Research in advance for FMD Novel Vaccines

Foot-and-Mouth Disease (FMD), as a major global animal disease, affects millions of animals worldwide and remains the main sanitary barrier to the international and national trade of animals and animal products. Inactivated vaccination is the most effective measure for prevention of FMD at present, but fail to induce long-term protection and content new requires for production of FMD vaccines. As a number of Researchers hope to obtain satisfactory novel vaccines by new bio-technology, novel vaccines have been studied for more than thirty years. Here reviews the latest research progress of new vaccines, summarizes some importance and raises several suggestions for the future of FMD vaccine

Human Papillomaviruses and Papillomatosis Lesions of the Female Lower Genital Tract

Objective: The objective of this study was to determine whether human papillomavirus (HPV) infections are involved in the development of papillomatosis lesions of the lower female genital tract