PurposeWe performed a systematic review and meta-analysis to summarise the geographic distribution of age-related macular degeneration (AMD) incidence.MethodsDatabases including PubMed, Embase and ...Web of Science were searched for publications of early and late AMD before September 2019. Studies were included if they applied a standardised photographic assessment and classification system. The proportion of participants with AMD in each eligible study was combined to obtain a pooled incidence from all studies using a random effects model. We also assessed sources of potential heterogeneity in the incidence of AMD using meta-regression analyses for both late and early AMD.ResultsTwenty-four population-based studies (70 123 individuals aged 55 years or older) were included in the meta-analysis. The pooled global annual incidences of early and late AMD were 1.59% (95% CI 1.12% to 2.10%) and 0.19% (95% CI: 0.13% to 0.28%), respectively. Individuals of European descent had the highest annual incidence of both early (2.73%, 95% CI 1.63% to 4.57%) and late (0.36%, 95% CI 0.17% to 0.75%) AMD than other ethnic groups. Average age (p=0.001) at baseline, ethnicity (p=0.001), region (p=0.043) and gender (p=0.011) were predictors for incident late AMD, while only average age (p=0.01) at baseline and ethnicity (p=0.025) was associated with incidence of early AMD.ConclusionsThis meta-analysis offers an up-to-date overview of AMD globally, which may provide scientific guidance for the design and implementation of public health strategies such as screening programmes for AMD in both specific geographic locations and ethnic groups, as well as worldwide.
It is crucial to identify spammers from online e-commerce platform to maintain the order of fairness. Existing methods have limitations to detect spammers if the underlying network is extreme sparse. ...In this paper, a novel method has been proposed to address this challenge from two folds. It is inspired by the idea that a trust-worthy rater will always give a reasonable rating which has been statistically significant and locates in an interval following normal distribution. To deal with low-degree spammers with limited information, rating patterns with preference are involved as well. Such two parts lead to an Interval Division-based Ranking (IDR) method. Experimental study on challenging sparse network Amazon demonstrates that the performance gain of recall is at least 15.4%. Top 50 movies selected by IDR from Douban have a high mean value 9.552 and a low variance 0.036.
•A novel method is proposed to identify spammers in rating systems with sparse data.•It has linear time complexity which is effective to deal with extreme large networks.•Interval Division Ranking (IDR) can identify spammers from normal users efficiently.•It can deal with both malicious spammers and random spammers effectively.
Numerous complex systems such as rating systems are highly affected by a small number of spamming attackers. How to design a fast and effective ranking method under the threat of spamming attacks is ...significant in practice. In this paper, we extract the user’s rating characteristics from personal historical ratings to determine whether the user is normal. It is discovered that reliable users have little bias and their rating scores follow the pattern of peak distribution. On the opposite, malicious users usually have biased ratings and their rating scores scarcely follow a known pattern. A new reputation ranking method IOR (Iterative Optimization Ranking) is proposed based on user rating deviation and rating characteristics. The experimental results on three real datasets show that this method is more efficient than existing states of art methods. This new fundamental idea can be contributed to a new way to solve spammer attacking problem. It can also be applied in large and sparse bipartite rating networks in a short time.
Although ATRA is involved in regulating the proliferation and differentiation of chondrocytes, its underlying mechanism remains unknown. Here we showed that ATRA could stimulate the proliferation of ...antler chondrocytes and expression of COL X and MMP13 which were two well‐known markers for hypertrophic chondrocytes. Silencing of CRABP2 prevented the induction of ATRA on chondrocyte terminal differentiation, while overexpression of CRABP2 exhibited the opposite effects. CYP26A1 and CYP26B1 weakened the sensitivity of antler chondrocytes to ATRA. Further analysis evidenced that ATRA might induce chondrocyte terminal differentiation and modulate the expression of BMP2, WNT4, and RUNX1 through RARα/RXRα. Knockdown of BMP2 enhanced the induction of ATRA on the expression of COL X and MMP13, whereas overexpression of BMP2 abrogated this effectiveness. WNT4 might mediate the effects of ATRA and BMP2 on chondrocyte terminal differentiation. Dysregulation of BMP2 impaired the regulation of ATRA on WNT4 expression. Administration of ATRA to antler chondrocytes transfected with RUNX1 siRNA failed to induce the differentiation. Conversely, rRUNX1 strengthened the stimulation of ATRA on the expression of COL X and MMP13. Simultaneously, RUNX1 was a downstream effector of BMP2 and WNT4 in chondrocyte terminal differentiation. Moreover, WNT4 might play an important role in the crosstalk between BMP2 and RUNX1. Attenuation of BMP2 or WNT4 enhanced the interaction between ATRA and RUNX1, while constitutive expression of BMP2 or WNT4 reversed the regulation of ATRA on RUNX1. Collectively, WNT4 may act downstream of BMP2 to mediate the effects of ATRA on the terminal differentiation of antler chondrocytes through targeting RUNX1.
ATRA may activate the expression of RARα/RXRα and induce terminal differentiation of antler chondrocytes through BMP2‐WNT4‐RUNX1 pathway. CRABP2 can enhance the sensitivity of antler chondrocytes to ATRA, while CYP26A1 and CYP26B1 render chondrocytes hyposensitive to ATRA.
Postoperative cognitive dysfunction (POCD) is a very common event in elderly noncardiac surgical patients. The effects of inhalational anaesthetics and propofol on the incidence of POCD and ...postoperative cognitive status at different time points after surgery are currently unclear.
We searched the Embase, Medline, Cochrane Library, and Web of Science databases for randomized controlled trials (RCTs), in which inhalation anaesthesia and propofol anaesthesia were compared. The incidence of POCD or postoperative cognitive status was assessed in elderly patients undergoing noncardiac surgery.
Fifteen RCTs with 1854 patients were included in this meta-analysis. The incidence of POCD on postoperative Days 2-6 after propofol anaesthesia was markedly lower than that after inhalation anaesthesia (risk ratio (RR): 0.37, 95% confidence interval (CI): 0.15-0.88, P = .025), and Mini-Mental State Examination (MMSE) scores after propofol anaesthesia were substantially higher than those after inhalation anaesthesia (standard mean difference (SMD): 0.59, 95% CI: 0.07-1.11, P = .026). The levels of interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) were much lower after propofol anaesthesia than after inhalation anaesthesia (SMD: -2.027, 95% CI: -3.748- -0.307, P = .021; SMD: -0.68, 95% CI: -0.93- -0.43, P < .001).
The moderate evidence from this meta-analysis shows that, in elderly noncardiac surgical patients, propofol anaesthesia is superior to inhalation anaesthesia for attenuating of early POCD incidence, and low-level evidence shows that cognitive status is higher and systemic inflammation is less severe after propofol anaesthesia in the early days after surgery.
The sample size was not sufficiently large for systemic inflammation, and the tools to identify POCD were not uniform in the included studies.
Abstract
Background
Clinical trials have shown that dexmedetomidine might decrease the occurrence of postoperative delirium after major surgery, but neurosurgical patients were excluded from these ...studies. We aimed to determine the feasibility of conducting a full-scale randomized controlled trial of the effect of prophylactic low-dose dexmedetomidine on postoperative delirium in patients after elective intracranial operation for brain tumors.
Methods
In this single-center, parallel-arm pilot randomized controlled trial, adult patients who underwent an elective intracranial operation for brain tumors were recruited. Dexmedetomidine (0.1 μg/kg/hour) or placebo was continuously infused from intensive care unit (ICU) admission on the day of surgery until 08:00 AM on postoperative day one. Adverse events during the study-drug administration were recorded. The primary feasibility endpoint was the occurrence of study-drug interruption. Delirium was assessed twice daily with the Confusion Assessment Method for the ICU during the first five postoperative days. The assessable rate of delirium evaluation was documented.
Results
Sixty participants were randomly assigned to receive either dexmedetomidine (
n
= 30) or placebo (n = 30). The study-drug was stopped in two patients (6.7%) in the placebo group due to desaturation after new-onset unconsciousness and an unplanned reoperation for hematoma evacuation and in one patient (3.3%) in the dexmedetomidine group due to unplanned discharge from the ICU. The absolute difference (95% confidence interval) of study-drug interruption between the two groups was 3.3% (− 18.6 to 12.0%), with a noninferiority
P
value of 0.009. During the study-drug infusion, no bradycardia occurred, and hypotension occurred in one patient (3.3%) in the dexmedetomidine group. Dexmedetomidine tended to decrease the incidence of tachycardia (10.0% vs. 23.3%) and hypertension (3.3% vs. 23.3%). Respiratory depression, desaturation, and unconsciousness occurred in the same patient with study-drug interruption in the placebo group (3.3%). Delirium was evaluated 600 times, of which 590 (98.3%) attempts were assessable except in one patient in the placebo group who remained in a coma after an unplanned reoperation.
Conclusions
The low rate of study-drug interruption and high assessable rate of delirium evaluation supported a fully powered trial to determine the effectiveness of low-dose dexmedetomidine on postoperative delirium in patients after intracranial operation for brain tumors.
Trial registration
The trial was registered at
ClinicalTrials.gov
(NCT04494828) on 31/07/2020.
Thyroid cancer is not among the top cancers in terms of diagnosis or mortality but it still ranks fifth among the cancers diagnosed in women. Infact, women are more likely to be diagnosed with ...thyroid cancer than the males. The burden of thyroid cancer has dramatically increased in last two decades in China and, in the United States, it is the most diagnosed cancer in young adults under the age of twenty-nine. All these factors make it worthwhile to fully understand the pathogenesis of thyroid cancer. Towards this end, microRNAs (miRNAs) have constantly emerged as the non-coding RNAs of interest in various thyroid cancer subtypes on which there have been numerous investigations over the last decade and half. This comprehensive review takes a look at the current knowledge on the topic with cataloging of miRNAs known so far, particularly related to their utility as epigenetic signatures of thyroid cancer progression and metastasis. Such information could be of immense use for the eventual development of miRNAs as therapeutic targets or even therapeutic agents for thyroid cancer therapy.
The design of transmitting waveforms is an effective way to improve the detection performance of sonar systems. For the problem of high-range sidelobe when designing reverberation-resistant ...waveforms, this paper proposes a high-resolution wideband composite waveform design with reverberation suppression performance and a waveform parameter improvement method. Firstly, we propose a novel wideband waveform, which utilizes linear frequency modulation (LFM) as the fundamental pulse, referred to as multi-parameter coded modulation LFM pulse (MPCM-LFM). Additionally, we deduce the wideband ambiguity function for waveform design. Then, we deduce the constraint relations of the waveform parameters for different sub-band overlaps, and according to the mathematical expressions of the obtained range ambiguity function, we analyze in detail the effects of the waveform parameters on the range ambiguity function under different constraints. Secondly, on the basis of the analysis, we also propose a hopping carrier frequency constraint rule to optimize the spectral performance, and the range sidelobe is restrained effectively in significant measure by this parameter improvement method. Finally, we analyze the computer simulation results. It is obvious that our proposed waveform parameter improvement method leads to good results. The proposed improved MPCM-LFM signal shows a “near-thumbtack” ambiguity function, whose sidelobe suppression performance is superior to other classical waveforms in the desired region, and it can realize high-precision parameter estimation. In addition, the proposed improved MPCM-LFM signal possesses good performance in detecting stationary and low Doppler targets in the background of reverberation.
Acute type A aortic dissection (ATAAD) and acute type A intramural hematoma (ATAIMH) are life-threatening diseases with high mortality. To better understand their clinical features in the Chinese ...population, we analyzed the data from the first Registry of Aortic Dissection in China (Sino-RAD) to promote the understanding and management of the diseases.
All patients with ATAAD and ATAIMH enrolled in Sino-RAD from January 1, 2012 to December 31, 2016 were involved. The data of patients' selection, history, symptoms, management, outcomes, and postoperation complications were analyzed in the study. The continuous variables were compared using the Student's t test for normal distributions and the Mann-Whitney U test for non-normal distributions. Categorical variables were compared using the Chi-square test or Fisher exact test.
A total of 1582 patients with ATAAD and 130 patients with ATAIMH were included. The mean age of all patients was 48.4 years. Patients with ATAAD were significantly younger than patients with ATAIMH (48.9 years vs. 55.6 years, P < 0.001). For the total cohort, males were dominant, but the male ratio of patients with ATAAD was significantly higher compared to those with ATAIMH (P = 0.01). The time range from the onset of symptom to hospitalization was 2.0 days. More patients of ATAIMH had hypertension than that of ATAAD (82.3% vs. 67.6%, P < 0.05). Chest and back pain were the most common clinical symptoms. Computerized tomography (CT) was the most common initial diagnostic imaging modality. 84.7% received surgical treatment and in-hospital mortality was 5.3%. Patients with ATAAD mainly received surgical treatment (89.6%), while most patients with ATAIMH received medical treatment (39.2%) or endovascular repair (35.4%).
Our study suggests that doctors should comprehensively use clinical examination and genetic background screening for patients with ATAAD and ATAIMH and further shorten the time range from symptoms onset to intervention, achieving early diagnosis and treatment, thereby reducing the mortality rate of patients with aortic dissection in China. We should standardize the procedures of aortic dissection treatment and improve people's understanding. Meanwhile, the curing and transferring efficiency should also be improved.
The identification of multiple spreaders on weighted complex networks is a crucial step towards efficient information diffusion, preventing epidemics spreading and etc. In this paper, we propose a ...novel approach WVoteRank to find multiple spreaders by extending VoteRank. VoteRank has limitations to select multiple spreaders on unweighted networks while various real networks are weighted networks such as trade networks, traffic flow networks and etc. Thus our approach WVoteRank is generalized to deal with both unweighted and weighted networks by considering both degree and weight in voting process. Experimental studies on LFR synthetic networks and real networks show that in the context of Susceptible–Infected–Recovered (SIR) propagation, WVoteRank outperforms existing states of arts methods such as weighted H-index, weighted K-shell, weighted degree centrality and weighted betweeness centrality on final affected scale. It obtains an improvement of final affected scale as much as 8.96%. Linear time complexity enables it to be applied on large networks effectively.
•WVoteRank is proposed to identify influential spreaders on weighted networks.•It is a simple yet effective method compared with benchmark ones.•It can be applied to extremely large weighted networks efficiently.
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