Dysphagia-associated pneumonia is a critical health issue especially in the elders and stroke patients which carries a poorer prognosis. Therefore, we aim to identify methods with the potentials to ...predict subsequent pneumonia in dysphagia patients, which will be of great value in the prevention and early management of pneumonia.
One-hundred dysphagia patients were enrolled and measurements including Dysphagia Severity Scale (DSS), Functional Oral Intake Scale (FOIS), Ohkuma Questionnaire, and Eating Assessment Tool-10 (EAT-10) were assessed by either videofluoroscopy (VF), videoendoscopy (VE), or the study nurse. The patients were categorized into mild or severe groups based on each screening method. All the patients were assessed for pneumonia at 1, 3, 6, and 20 months after the examinations.
VF-DSS (p=0.001) is the only measurement being significantly associated with subsequent pneumonia with sensitivity and specificity of 0.857 and 0.486. The Kaplan-Meier curves revealed that significant differences between the mild/severe groups start to emerge 3 months after VF-DSS (p=0.013). Cox regression models used for adjusted hazard ratio of severe VF-DSS in association with subsequent pneumonia of different timepoints after controlling the important covariates showed the following results: 3 months, p=0.026, HR=5.341, 95%CI=1.219-23.405; 6 months, p=0.015, HR=4.557, 95%CI=1.338-15.522; 20 months, p=0.004, HR=4.832, 95%CI=1.670-13.984.
Dysphagia severity evaluated by VE-DSS, VE-FOIS, VF-FOIS, Ohkuma Questionnaire, and EAT-10 is not associated with subsequent pneumonia. Only VF-DSS is associated with both short-term and long-term subsequent pneumonia. In patients with dysphagia, VF-DSS is predictive of subsequent pneumonia.
Most of routing protocols in VANETs are position-based due to their well scalability. The forwarding decisions of such protocols are simply based on the location information of forwarders' ...neighborhood and the destination node. Due to high mobility of vehicles, location-service protocols are required to provide the destination location. Location services protocols can be categorized as flooding-based and quorum-based. They are unrealistic for VANETs. In the former approaches, global network flooding require extreme high cost, while in the latter approaches, quorums' hand-off is impossible because of high volume of exchange data. In this paper, we present a routing by utilizing locality of vehicles' traces (i.e., left location information). Besides, by the aid of high mobility of vehicles and news exchange (new information about vehicles' location), vehicles' location information can be spread to improve the possibility of meeting a vehicle which has the location information of the destination. Our protocol is realistic and practical because neither global network flooding nor quorums are required. The simulation results show that our protocol works efficiently for VANETs in city environments and has higher successful query rate and lower cost.
Synthesis of 4-deoxy rollicosin analog
2
was completed in nine steps, which was based on palladium-catalyzed coupling of two building blocks
3
and
4
. Lactone
3
was synthesized from 5-hexyn-1-ol, and ...vinyl iodide
4
was accessed from
l-glutamate and 1-hexyne.
Synthesis of 4-deoxy rollicosin analog
2
was completed in nine steps, which was based on palladium-catalyzed coupling of two building blocks
3
and
4
. Lactone
3
was synthesized starting from 5-hexyn-1-ol, and vinyl iodide
4
was accessed from
l-glutamate and 1-hexyne.
We report the case of a 52-year-old woman suffering from breathlessness on exertion. A chest radiograph identified a lesion in the intrathoracic trachea. A tumor 0.4 × 0.5 × 0.7 cm in size causing an ...approximately 80% reduction in the cross-sectional area of the trachea 3 cm above the carina was removed, and histology showed moderately differentiated squamous cell carcinoma. Intrathoracic resection of the tumor and anastomosis was performed through a right lateral thoracotomy. The final histology examination showed atypical papilloma. Polymerase chain reaction–restriction fragment length polymorphism confirmed human papillomavirus-6b in the tumor. The patient remained well 18 months after surgical intervention without recurrence.
Materials characteristics and ferroelectric properties of thick xPb(Ni1/3Nb2/3)O3-(1-x)Pb(Zr0.52Ti0.48)O3 (x=0.3), PNN-PZT films, which were prepared by doctor-blade tape-casting and laser lift-off ...processes, were investigated. The underlying buffer materials were observed to influence significantly the densification behavior for the PNN-PZT sapphire layers. For PNN-PZT/sapphire films sintered without buffer layer, the substrates impose pronounced constraint on materials shrinkage, inducing the formation of porosity for the PNN-PZT layers. The proportion of pores is pronouncedly reduced when using a Pb(Zr0.52Ti0.48)O3 thin layer ( < 0.3 *mm) prepared by metal-organic decomposition process as buffer layer. The PNN-PZT films transferred to silicon substrates by laser lift-off processes exhibit large electrical polarization characteristics (Pr=41.9 *mC/cm2), with small coercive field (Ec=35.6 kV/cm).
This paper presents a new type of double ridged horn antenna design for both radiated immunity and emissions test of broadband applications in EMI measurement. The proposed antenna offers excellent ...performance over the frequency range of 18 to 50 GHz as required by the EMI regulation compliance tests (i.e. FCC, CE, MIL-STD-461, RTCA DO-160, FDA, SAE, etc.). The optimized antenna aperture dimension of flared section of pyramidal structure and improved the ridge profile are yielded the wide antenna beam-width across the bandwidth, lower VSWR, stable gain and symmetric radiation patterns with low side lobe level. Moreover, a coaxial probe structure in the feed section and fitted with by a 2.4 mm connector, while under the increased bandwidth for good impedance matching. To achive the charactistic of this well designed antenna, whose has been implement, measurement, and to reduce the difficulty and cost of daily use in laboratory environments for a standard semi-anechoic chamber.
Abstract Background The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8% in patients with atrioventricular nodal reentrant tachycardia (AVNRT) by several ...previous reports. However, most of those reports were limited by the absence of coronary sinus venography to confirm if the retrograde activation was truly left sided. The purposes of this study were to 1) determine the incidence of left sided retrograde atrial activation in our center, 2) determine the specific electrophysiologic characteristics of eccentric and concentric atrial activation and 3) determine the outcome of radiofrequency catheter ablation for AVNRT with eccentric retrograde atrial activation. Methods From November 2001 to July 2004, 290 consecutive patients with AVNRT who underwent an electrophysiologic study and radiofrequency ablation were included. Group 1 consisted of AVNRT patients with eccentric retrograde atrial activation; group 2 consisted of AVNRT patients with concentric retrograde atrial activation. The electrophysiologic characteristics of the group 1 and group 2 patients were then compared. Results The incidence of AVNRT with eccentric retrograde activation confirmed by CS venography was 6.5%. There were more females and atypical AVNRT in patients with retrograde eccentric conduction. There was more VA block after ablation and tachycardia induction by right ventricular pacing/extrastimuli in eccentric rather than concentric retrograde atrial activation. A shorter antegrade fast functional refractory period of the AV node was demonstrated in the atypical eccentric group as compared to the atypical concentric group. Conclusion This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Successful ablation sites were similar to the standard RA ablation sites in patients with retrograde eccentric conduction.
High-performance and low-power VLIW DSP processors are increasingly being deployed in mobile devices to process video and multimedia applications. The diverse applications of such systems has led to ...recent research efforts focusing on their resource management and kernel scheduling. In this paper, we address the enhancing the performance of the microkernel for a VLIW DSP processor, called PAC architectures. In order to reduce the number of read and write ports in register files of VLIW architectures, so as to reduce both the power consumption and implementation costs, a distributed register file and multibank register architectures are being adopted in PAC architectures. These methods present challenges for microkernel designs in terms of reducing context switch overhead. In our work, we propose a multiset descriptor mechanism with compiler support to reduce the context switch overheads associated with the use of registers. The experiments were done with the microkernel system called pCore which has an efficient and tiny design that prunes its code size down under 11 Kbytes. Experimental results show that our multiset context-switching mechanism may reduce the context switch overhead up to 30%.
Abstract only
4103
Background: Sorafenib (S) is the only approved systemic treatment for unresectable HCC. Nevertheless, there remains an unmet medical need for more effective treatment options for ...this disease. BAY 86-9766 (B) is an oral, allosteric inhibitor of MEK, a key component of the MAP kinase pathway. This study evaluated the efficacy and safety of a combination therapy with B plus S in patients (pts) with HCC. Methods: This is a single arm, open-label, phase 2 study. Eligible were pts with unresectable HCC, Child-Pugh Class A, performance status (PS) 0-1, and no prior systemic anticancer therapy for HCC. Pts started Cycle 1 (21 days) with B 50 mg bid orally plus S 600 mg daily (200 mg AM, 400 mg PM) orally. If there was no hand-foot skin reaction, fatigue, or gastrointestinal toxicity ≥ grade 2, S was escalated to 400 mg bid from Cycle 2 on. Treatment continued until progression or withdrawal criteria were met. Tumor assessment was performed every 6 weeks during treatment. Safety was evaluated every week for the first 6 weeks and every 3 weeks thereafter. Results: Seventy pts from Asia started study treatment. Pts were predominantly male (86%); median age was 56 years; 54% had PS of 0 and 46% PS of 1. The vast majority had liver cirrhosis (83%) and infection with HBV (76%) or HCV (17%). Sixty-five were evaluable for efficacy per protocol. Three pts (5%) had confirmed partial response and 25 pts (38%) had prolonged stable disease (≥10 weeks), with a disease control rate of 43%. Median time-to-progression was 4.1 months. Survival data are not mature, yet. The most frequent drug-related adverse events (AEs) were rash (60%), diarrhea (59%), AST elevation (43%), vomiting (30%), nausea (29%), ALT elevation (26%), and anorexia (26%). There were 4 Grade 5 related AEs (hepatic failure, sepsis/hepatic encephalopathy, tumor lysis syndrome, and unknown cause, respectively). Dose modifications due to AEs were necessary in almost all pts. The median daily dose was 64.2 mg for B and 443.3 mg for S, respectively. Conclusions: B in combination with S showed antitumor activity in pts with HCC. However, frequent dose modifications due to AEs might have limited the treatment effect of this combination.
