There is ongoing debate on whether screening for nonalcoholic fatty liver disease (NAFLD) is worthwhile in high‐risk groups. Because of shared risk factors, NAFLD is highly prevalent in patients with ...coronary artery disease. We aimed to test the hypothesis that NAFLD screening in patients requiring coronary angiogram would identify high‐risk patients and predict long‐term clinical outcomes. This was a prospective cohort study. NAFLD screening was performed by abdominal ultrasonography before coronary angiogram in 612 consecutive patients. At baseline, 356 (58.2%) patients had NAFLD. NAFLD patients, compared with those without, were more likely to have >50% stenosis in one or more coronary arteries (84.6% vs. 64.1%; P < 0.001) and therefore require percutaneous coronary intervention (68.3% vs. 43.4%; P < 0.001). During 3,679 patient‐years of follow‐up, 47 (13.2%) NAFLD patients and 59 (23.0%) patients without NAFLD died (age‐ and sex‐adjusted hazard ratio aHR: 0.36; 95% confidence interval CI: 0.18‐0.70; P = 0.003). Composite cardiovascular outcomes (cardiovascular deaths, nonfatal myocardial infarction, heart failure, or secondary interventions) were similar between groups (36.5% vs. 37.1%; aHR, 0.90; 95% CI: 0.69‐1.18). Older age and diabetes were the only independent factors associated with cardiovascular events. Only 2 patients, both in the NAFLD group, died of primary liver cancer. No other patients developed liver‐related complications. Conclusion: In patients with clinical indications for coronary angiogram, the presence of NAFLD is associated with coronary artery stenosis and need for coronary intervention, but not increased mortality or cardiovascular complications. Liver cancer and cirrhotic complications are rare. Our data do not support NAFLD screening in this patient group at present, but studies with a longer duration of follow‐up are needed. (Hepatology 2016;63:754–763)
This study examines the use of data analytics to evaluate students' behaviours during their participation in an online collaborative learning environment called SkyApp. To visualise the learning ...traits of engagement, emotion and motivation, students' inputs and activity data were captured and quantified for analysis. Experiments were first carried out in a primary school with 66 fifth-grade students. Each participating student collaborated with other group members using SkyApp through a personal computer in a classroom setting. While the students collaboratively solved mathematics questions in two quizzes, data about their learning traits were captured by SkyApp; various patterns of these data were then analysed. The findings based on the data analysis were triangulated with the results of questionnaires, revealing the relationship between student behaviours and collaborative learning as a kind of pedagogical intervention. The correlation between the data from the two approaches - data analytics and questionnaires - shows the potential of understanding students' behaviours through continuous data analysis of learner-produced data without the need to collect self-reported data from the students involved. This study demonstrates that teachers can monitor and identify the effects of specific pedagogical interventions on students' behaviours by looking at different snapshots taken over the course of e-learning activities.
Using vehicular ad-hoc network, smart vehicles can detect dangerous events on the road and announce warnings to other vehicles to ensure road safety. The other vehicles nearby may receive the warning ...messages and accordingly choose a different route. But, because of the presence of malicious users on the road and errors in the detection system, some warning messages may prove dubious. Therefore, to distinguish between genuine and dubious messages, an element of trust has to be infused into the warning system. One common approach for this is to enable the receivers count the popularity of the reports of a warning event, i.e., the trust level. Once the trust level meets a predefined threshold, the vehicle's on-board unit will trust the warning event and warn the driver. Yet, owing to security and privacy concerns, anonymous counting problem does exist, because it is hard to fulfill both anonymity and counting requirements. In this paper, the authors define the anonymous counting problem and then propose a conditional distinguishable pseudo identities scheme that achieves conditional anonymity to overcome the counting problem. To achieve this feature of pseudo identities, time slot was added to minimize the influence of the adversary. Randomized batch verification was applied to enhance efficiency. Furthermore, it is shown how to achieve those features and provide proof on pairing equations. Finally, the time complexity of the proposed scheme was analyzed and its performance evaluated by Simulation of Urban Mobility.
Aldosterone Receptor Antagonism Induces Reverse Remodeling When Added to Angiotensin Receptor Blockade in Chronic Heart Failure Anna K. Y. Chan, John E. Sanderson, Tian Wang, Wynnie Lam, Gabriel Yip, ...Mei Wang, Yat-Yin Lam, Yan Zhang, Leata Yeung, Eugene B. Wu, Wilson W. M. Chan, John T. H. Wong, Nina So, Cheuk-Man Yu This study evaluated the effect of combining spironolactone and angiotensin receptor blocker on left ventricular (LV) function and reverse remodeling in 51 patients with systolic heart failure. In patients randomized to this combination therapy for 1 year, there were significant increases in LV ejection fraction and reduction in LV volume and mass indices by cardiac magnetic resonance imaging. There were also improvements in systolic velocities and strain by tissue Doppler imaging and reduction in myocardial fibrosis by cyclic variation integrated backscatter. Such benefits, however, were not observed in those randomized to the control group (candesartan + placebo).
Palliative care: Experience from Hong Kong Lui, Louisa C; Yeung, Rebecca; Wong, Kam-Hung ...
Journal of pain management,
01/2018, Letnik:
11, Številka:
1
Journal Article
Recenzirano
The worldwide incidence of cancer is on a rising trend and Hong Kong is no exception. In 2014, there were about 30,000 new cases of cancer in Hong Kong with cancer death around 14,000. Drug companies ...have devoted a lot of resources to design novel medications in order to improve the outlook of this terrible disease. Recently immunotherapy and precision medicine have become very popular in oncology field. Although it can lead to prolonged survival in some individuals, about half of cancer patients still suffer from incurable disease. On the other hand, palliative care has been shown to improve the quality of life and even survival for these patients. Clinical oncologists play an important role in palliative care in Hong Kong, since besides providing oncology treatment, they also offer palliative care as a continuum of care. In recent years, with increasing awareness and attention on the integration of palliative care and oncology, this Hong Kong model may serve as one form of integration.
We have amplified and sequenced a novel, alternatively spliced variant of a human gene coding for the
f
our-and-a-
h
alf
L
IM domain protein
1
(FHL1). This gene is located at chromosome Xq27 and the ...spliced variant is named FHL1B. The ORF of FHL1B cDNA codes for a LIM-only protein that possesses a zinc finger and three tandem repeats of LIM domains at the N-terminus with an active bipartite nuclear localization signal (NLS) motif and a possible RBP-J binding region at the C-terminus. FHL1B and FHL1 have the same N-terminal three-and-a-half LIM domains but different C-terminal protein sequences, due to the presence of an additional alternative exon 4b in FHL1B causing a frame-shift in the 3′coding region. RT–PCR results revealed that the expression of
FHL1 is not restricted in skeletal muscle and heart, but is widely distributed in other tissues, including brain, placenta, lung, liver, kidney and pancreas, albeit as a low abundance transcript. In contrast,
FHL1B is specifically expressed in brain. The C-terminal alternative region in FHL1B is sufficient to localize FHL1B in the nucleus of mammalian cell. FHL1B is probably related to neural differentiation and certain fragile X syndrome.
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