In this article, a deep reinforcement learning (DRL) control scheme is proposed to satisfy the strict Quality-of-Service (QoS) requirements of ultrareliability low-latency communication (URLLC) and ...enhanced mobile broadband (eMBB) using 5G multiple radio access technology (RAT)-based partial offloading and multiaccess edge-computing (MEC) resource allocation. In the proposed scheme, the user equipment (UE) makes optimal offloading decisions while the MEC server dynamically adjusts the server resources based on offloading requests from multiple UEs using DRL technology. The aim of the proposed scheme is to minimize the energy consumption of the UEs while maximizing the system utility (SU) performance, which is composed of the spectral efficiency (SE) and offloading success rate (OSR) of the MEC server. In addition, multiagent distributed learning technology and best experience push (BEP) techniques are used to enhance the learning efficiency of the DRL framework. The simulation result shows that the proposed scheme provides an improved SU and energy consumption performance compared to the benchmark offloading schemes.
Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer ...incidences for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of the trends in incidence of cancer in Georgia.
Incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 9 program, supported by the National Cancer Institute, spanning the years 1982 to 2011. To assess trends over time, age-adjusted cancer incidence rates relative to the 2000 Standard US population and annual percent changes (APCs) were calculated using SEER*Stat software.
In Georgia, cancer incidence rates for women increased from 365.1 per 100,000 in 1982 to 404.2 per 100,000 in 2011, with an overall APC of 0.3% (95% confidence interval: 0.2 to 0.4), but, for men, cancer incidence rates showed a slight decline from 528.0 per 100,000 in 1982 to 513.7 per 100,000 in 2011 (APC of 0.2%, 95% CI: -0.6 to 0.1). For Black, White, and Other (Asian/Pacific Islanders/American Indians) females, there were increases in incidence in this period, with APC values of 0.6, 0.4, and 0.3, respectively. For all males and for Black and White males, there were overall decreases in incidence, with APC values of -0.2. For Other males, however, the APC value was -0.9.
In Georgia, increases in cancer incidence rates occurred during 1982-2011 among the female population and within various racial groups in this population, but there was relative stability in incidence rates among the male population, except for Other males.
•Racial/ethnic minorities were less likely to complete the HPV vaccine series.•Patients living in urban regions were more likely to complete the series.•Few HIV-positive Medicaid beneficiaries ...completed the vaccine series.•Medicaid beneficiaries were more likely to receive the vaccine from physicians.
Cancers caused by human papillomavirus (HPV) can be prevented with the timely uptake and completion of the HPV vaccine series. Series completion is associated with increased vaccine effectiveness and longevity of protection. Medicaid beneficiaries are among populations with higher HPV vaccine uptake; however, little research describes factors that influence their HPV vaccine series completion. This study reports on a secondary data analysis of Arizona Medicaid data (Arizona Health Care Cost Containment System) from years 2008–2016. We summarized patient data using descriptive statistics and explored relationships between demographic variables and HPV vaccine administration information using bivariate logistic regression. Results of this analysis showed that females were more likely to complete the series as compared to males, and the age group that had the greatest odd of vaccine completion were 13–17-year-olds, the catch-up vaccine population. White Medicaid beneficiaries were most likely to adhere to HPV vaccine guidelines, followed by Hispanic beneficiaries. Patients receiving care in urban settings were more likely to complete the HPV vaccine series than people receiving care in rural areas of the state. Although statistically insignificant, people living with HIV were less likely to complete the 3-dose series. Future work should focus on ensuring that HPV vaccine age-eligible Medicaid, including people living with HIV, adhere to HPV vaccine guidelines. Expanding programs such as Vaccines for Children and scope of practice for dental professionals to offer the vaccine may provide additional options for Medicaid beneficiaries to vaccinate.
Due to the rapidly growing number of autonomous vehicles, establishing an intelligent transportation system (ITS) supported by the Internet-of-Vehicles (IoV) technology is important. The need for IoV ...technology is emphasized even more because recent accidents relating to autonomous vehicles show that there are limitations in the reliability of autonomous vehicles only using vehicle onboard sensors. In addition, a highly reliable support system for many vehicular applications is in strong demand, which is why there is a need for advanced vehicle-to-everything (V2X) technology. The two major types of V2X technology are dedicated short-range communication (DSRC) and cellular-V2X (C-V2X). Many vehicles are already equipped with DSRC; however, the use of C-V2X is highly supported by many mobile communication companies and the 5GAA, which is why C-V2X is expected to be very widely used. In this article, a hybrid V2X (H-V2X) scheme is proposed, which adaptively controls C-V2X to satisfy the key-performance indicator (KPI) requirements as much as possible, and uses DSRC transmission when the C-V2X required performance cannot be reliably supported. The performance analysis graphs show that the gain in performance of the proposed H-V2X scheme can provide an improved performance compared to other V2X schemes, which makes it more suitable to support reliable autonomous vehicles.
Advances have occurred in breast cancer survivorship but, for many African-American women, challenges and gaps in relevant information remain. This article identifies opportunities to address ...disparities in breast cancer survival and quality of life, and thereby to increase breast cancer survivorship among African-American women. For breast cancer survivors, common side effects, lasting for long periods after cancer treatment, include fatigue, loss of strength, difficulty sleeping, and sexual dysfunction. For addressing physical and mental health concerns, a variety of interventions have been evaluated, including exercise and weight training, dietary interventions, yoga and mindfulness-based stress reduction, and support groups or group therapy. Obesity has been associated with breast cancer recurrence and poorer survival. Relative to white survivors, African-American breast cancer survivors are more likely to be obese and less likely to engage in physical activity, although exercise improves overall quality of life and cancer-related fatigue. Considerable information exists about the effectiveness of such interventions for alleviating distress and improving quality of life among breast cancer survivors, but few studies have focused specifically on African-American women with a breast cancer diagnosis. Studies have identified a number of personal factors that are associated with resilience, increased quality of life, and positive adaptation to a breast cancer diagnosis. There is a need for a better understanding of breast cancer survivorship among African-American women. Additional evaluations of interventions for improving the quality of life and survival of African-American breast cancer survivors are desirable.
Acute chorioamnionitis is a well-established lesion of the placenta in cases with intra-amniotic infection. In contrast, the clinicopathological significance of chronic chorioamnionitis is unclear. ...This study was conducted to determine the frequency and severity of chronic chorioamnionitis in normal pregnancy and in various pregnancy complications. Placentas from the following patient groups were studied: (1) term not in labor (n=100), (2) term in labor (n=100), (3) preterm labor (n=100), (4) preterm prelabor rupture of membranes (n=100), (5) preeclampsia at term (n=100), (6) preterm preeclampsia (n=100), and (7) small-for-gestational-age at term (n=100). Amniotic fluid CXCL10 concentration was measured in 64 patients. CXCL9, CXCL10, and CXCL11 mRNA expressions in the chorioamniotic membranes were assessed using real-time quantitative reverse transcription-PCR. The frequency of chronic chorioamnionitis in the preterm labor group and the preterm prelabor rupture of membranes group was 34 and 39%, respectively, which was higher than that of normal-term placentas (term not in labor, 19%; term in labor, 8%; P<0.05 each). The frequency of chronic chorioamnionitis in the preeclampsia at term group, preterm preeclampsia group, and small-for-gestational-age group was 23, 16, and 13%, respectively. Concomitant villitis of unknown etiology was found in 38 and 36% of preterm labor cases and preterm prelabor rupture of membranes cases with chronic chorioamnionitis, respectively. Interestingly, the median gestational age of preterm chronic chorioamnionitis cases was higher than that of acute chorioamnionitis cases (P<0.05). The median amniotic fluid CXCL10 concentration was higher in cases with chronic chorioamnionitis than in those without, in both the preterm labor group and preterm prelabor rupture of membranes group (P<0.05 and P<0.01, respectively). CXCL9, CXCL10, and CXCL11 mRNA expression in the chorioamniotic membranes was also higher in cases with chronic chorioamnionitis than in those without chronic chorioamnionitis (P<0.05). We propose that chronic chorioamnionitis defines a common placental pathological lesion among the preterm labor and preterm prelabor rupture of membranes groups, especially in cases of late preterm birth. Its association with villitis of unknown etiology and the chemokine profile in amniotic fluid suggests an immunological origin, akin to transplantation rejection and graft-versus-host disease in the chorioamniotic membranes.
Weight gain after diagnosis and treatment is common among breast cancer survivors (BCSs). Little information exists regarding associations between body mass index (BMI) and lifestyle factors and ...health-related quality of life (HR-QoL) among African American (AA) BCSs. The present study sought to determine associations between BMI, dietary intake, and physical activity as lifestyle modification strategies and HR-QoL among AA BCSs.
For this cross-sectional study, a lifestyle assessment tool was administered to 195 AA BCSs. Possible predictor variables included socio-demographic and medical characteristics, dietary intake and physical activity patterns, and physical health. The outcome variable was BMI.
Many BCSs (63%) had BMIs ≥25 Kg/M
and presented with stage I cancer (41%) at diagnosis. Among those presenting with late-stage cancer (IIIA, IIIB, IV), 76% were overweight or obese (p=0.0008). Eighty-four percent reported excellent-to-good physical health (p=0.0499) and were less likely to have higher BMIs compared to those reporting fair-to-poor physical health (OR=0.616 CI=0.192-1.978). Responders with graduate level education were more likely to have healthy body weights than those attaining high school or less educational levels (OR=2.379 CI=0.617-9.166).
Most AA BCSs surveyed were overweight or obese, did not engage in recommended physical activity levels and failed to consume diets linked to breast cancer prevention. Interventions are needed to promote weight loss, improve dietary intake, and enhance physical activity among AA BCSs.
Fog computing is a new systematic paradigm which provides low latency enabled cloud services to mobile and Internet of Things (IoT) networks by provisioning the computation capability within the ...radio access network (RAN) assignable to mobile end users. In this letter, an energy optimal offloading scheme based on a probabilistic priority model of cloud tasks is investigated over fog computing networks. The optimization problem jointly minimizes the energy consumption of user equipment (UE) and the fog server. Simulation results show that the proposed joint UE and fog server energy optimization (JUFO) scheme provides a better performance compared to the conventional offloading scheme, which operates strictly within the determined delay bound.
PDF
