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Background: The purpose of this study is to assess metabolic indicators and trends in microvascular complications among Chinese adults with newly diagnosed type 2 diabetes during 2000–2020. Methods: 3,907 patients were included and divided into three groups according to a time period of 7 years. This study analyzed trends in proportions of patients reached therapeutic targets of blood glucose, pressure and lipids, and trends in albuminuria, retinopathy, and peripheral neuropathy. Results: In the past 20 years, the age of adults with newly diagnosed type 2 diabetes tended to be younger, and the proportion of female patients increased. There seemed no improvements in blood glucose and pressure. The rate of awareness and treatment on target of hypertension was less than 50%. There was a significant decrease in the prevalence of retinopathy, but no changes in nephropathy or peripheral neuropathy. Complications were more common for patients who were smoker, male, or with hypertension and obesity. Conclusions: Over the past two decades, there have been encouraging reductions in retinopathy in Chinese adults with newly diagnosed diabetes, but no significant change in albuminuria and peripheral neuropathy. It may be related to the low awareness of diabetes and insufficient controlled blood glucose, pressure and lipids on target. [ABSTRACT FROM AUTHOR]

Due to the limited computation resources and lifetime of user equipment, we study the energy minimization problem for computation offloading in cognitive radio networks (CRNs). This work proposes a device-to-device (D2D)-assisted computation offloading scheme for non-orthogonal multiple access (NOMA)-enabled CRNs. Specifically, the secondary user (SU) can provide computation resources for the primary user (PU) to access the spectrum owned by the PU. With the constraints of task deadline and maximum transmit power, offloading decision and power control of PU and SU are optimized to minimize the energy consumption of CRNs. The solution is obtained by deploying the block coordinate descent method and successive convex approximation. Simulation results show the improvement of the proposed scheme in terms of energy consumption and computing performance compared with other methods. [ABSTRACT FROM AUTHOR]

Due to the limited computation resources of mobile devices in cognitive radio networks, the secondary users in the network can suffer from long executing time, which is not acceptable for latency‐sensitive and computation‐intensive tasks. To tackle this issue, this paper proposes to reduce the task computing latency for secondary networks by offloading the tasks to edge servers through leveraging mobile edge computing (MEC) that is emerging as a promising technology to augment the computation capacity of mobile devices. Specifically, under the conditions that the interference caused by secondary users is tolerable to primary user and within the available computation resources of the MEC server, the primary user and secondary users both can offload tasks to the MEC server through nonorthogonal multiple access. Thus, we jointly formulate the offloading decision and power control as an optimization problem, aiming at minimizing the overall computing latency for secondary networks. To overcome the computational complexity caused by the nonconvexity of the original problem, we transform the original problem to a solvable problem and decouple the transformed problem into the separate offloading decision and power control. An iterative algorithm is proposed based on block coordinate decent method to achieve the near‐optimal solution. Simulation results show that under the same parameters, such as the number of primary users, maximum transmit power, computational capability of the MEC server and the computational capability of the secondary users, the proposed NOMA‐enabled computation offloading scheme can effectively reduce the overall computing latency for the secondary network and improve the percentage of offloading secondary users than those of OMA‐enabled. [ABSTRACT FROM AUTHOR]

Virtualization technology enables multiple virtual machines (VMs) to share a single physical server. Commercial servers increasingly use the nonuniform memory access (NUMA) architecture due to its scalable memory performance. However, multiple VMs running on a NUMA physical server will cause performance overheads such as remote memory access latency and shared microarchitectural resource contention, which makes the VM performance less efficient and stable. These performance overheads are mainly caused by memory traffic from data-intensive workloads. In this paper, we propose a traffic-aware VM optimization (TAVO) scheme on NUMA systems. Based on the performance monitoring of the data traffic and CPU/memory resource usages in the system, TAVO addresses VM memory access locality and shared resource contention problems via automatic VM initial placement and NUMA-aware VM online scheduling. Our experimental results show that TAVO improves VM performance in terms of benchmark runtime by up to 22.6% compared with the default KVM CFS scheduler. TAVO also achieves a much stable performance with benchmark's average runtime variation under 3%. [ABSTRACT FROM PUBLISHER]

Hybrid storage systems that consist of flash-based solid state drives (SSDs) and traditional disks are now widely used. In hybrid storage systems, there exists a two-level cache hierarchy that regard dynamic random access memory (DRAM) as the first level cache and SSD as the second level cache for disk storage. However, this two-level cache hierarchy typically uses independent cache replacement policies for each level, which makes cache resource management inefficient and reduces system performance. In this paper, we propose a novel adaptive multi-level cache (AMC) replacement algorithm in hybrid storage systems. The AMC algorithm adaptively adjusts cache blocks between DRAM and SSD cache levels using an integrated solution. AMC uses combined selective promote and demote operations to dynamically determine the level in which the blocks are to be cached. In this manner, the AMC algorithm achieves multi-level cache exclusiveness and makes cache resource management more efficient. By using real-life storage traces, our evaluation shows the proposed algorithm improves hybrid multi-level cache performance and also increases the SSD lifetime compared with traditional multi-level cache replacement algorithms. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Task scheduling is critical for improving system performance in the distributed heterogeneous computing environment. The Directed Acyclic Graph (DAG) tasks scheduling problem is NP-complete and it is hard to find an optimal schedule. Due to its key importance, the DAG tasks scheduling problem has been extensively studied in the literature. However, many previously proposed traditional heuristic algorithms are usually based on greedy methods and also lack the consideration of scheduling tasks between trusted and untrusted entities, which makes the problem more complicated, but there still exists a large optimization space to be explored. In this paper, we propose a trust-aware adaptive DAG tasks scheduling algorithm using the reinforcement learning and Monte Carlo Tree Search (MCTS) methods. The scheduling problem is defined using the reinforcement learning model. Efficient scheduling state space, action space and reward function are designed to train the policy gradient-based REINFORCE agent. The MCTS method is proposed to determine actual scheduling policies when DAG tasks are simultaneously executed in trusted and untrusted entities. Leveraging the algorithm's capability of exploring long term reward, the proposed algorithm could achieve good scheduling policies while guaranteeing trusted tasks scheduled within trusted entities. Experimental results showed the effectiveness of the proposed algorithm compared with the classic HEFT/CPOP algorithms. [ABSTRACT FROM AUTHOR]

Purpose: To identify molecular subtypes of oxidative stress-related genes in head and neck squamous cell carcinoma (HNSCC) and to construct a scoring model of oxidative stress-related genes., Methods: R language based scRNA-seq and bulk RNA-seq analyses were used to identify molecular isoforms of oxidative stress-related genes in HNSCC. An oxidative stress-related gene scoring (OSRS) model was constructed, which were verified through online data and immunohistochemical staining of clinical samples., Results: Using TCGA-HNSCC datasets, nine predictive genes for overall patient survival, rarely reported in previous similar studies, were screened. AREG and CES1 were identified as prognostic risk factors. CSTA, FDCSP, JCHAIN, IFFO2, PGLYRP4, SPOCK2 and SPINK6 were identified as prognostic factors. Collectively, all genes formed a prognostic risk signature model for oxidative stress in HNSCC, which were validated in GSE41613, GSE103322 and PRJEB23709 datasets. Immunohistochemical staining of SPINK6 in nasopharyngeal cancer samples validated the gene panel. Subsequent analysis indicated that subgroups of the oxidative stress prognostic signature played important roles during cellular communication, the immune microenvironment, the differential activation of transcription factors, oxidative stress and immunotherapeutic responses., Conclusions: The risk model might predict HNSCC prognosis and immunotherapeutic responses.

Purpose: Chronic inflammation and lipid peroxidation (LPO) are associated with the pathogenesis of hepatocellular carcinoma (HCC), and γ-hydroxy-1, N 2 -propanodeoxyguanosine (γ-OHPdG) is a promutagenic DNA adduct derived from LPO. This study aimed to examine the relationship between γ-OHPdG and the progression of liver carcinogenesis., Methods: Primary HCC specimens were obtained from 228 patients and cirrhosis specimens from 46 patients. The patients were followed up with after surgery via outpatient visits and telephone calls. The levels of γ-OHPdG were determined by immunohistochemical analysis in the carcinomatous tissues together with adjacent and cirrhosis tissues., Results: γ-OHPdG levels in the cancerous tissues were significantly higher compared to adjacent tissues (P < 0.001) and also higher than the ones from the tissues of cirrhosis patients. Along with tumor size, histological grade, MVI grade, T stage, the percentage of ki67-positive cells and HCC progression, γ-OHPdG levels in cancerous tissues showed a gradually increasing trend. Moreover, prognostic analysis showed that higher γ-OHPdG levels in cancerous tissues were strongly correlated with lower overall survival (P < 0.001), lower intrahepatic recurrence-free survival (P < 0.001) and lower distant metastasis-free survival (P < 0.05). There was a trend, although not statistically significant, of increased levels of γ-OHPdG in cirrhosis cases that advanced to HCC, whereas γ-OHPdG levels reversely correlated with the period of time observed for cirrhosis advanced to HCC., Conclusions: These results suggest that γ-OHPdG is a prognostic biomarker for predicting outcomes in HCC, and may serve as a prospective indicator for predicting HCC in cirrhosis patients.

The role of long non-coding RNAs (lncRNAs) in colorectal cancer (CRC) tumorigenesis and metastasis remains poorly characterized. The aim of this study was to identify novel lncRNAs and their functions in CRC progression. Through microarray analysis of paired normal colorectal mucosa (NM), primary tumor (PT), and metastatic lymph node (MLN) tissues, lncRNA and mRNA expression patterns were identified. Further bioinformatic analyses were performed to compare the biological functions of lncRNAs between tumorigenesis and metastasis of CRC, which was further verified by TCGA-COAD and GSE82236. The expression of lncRNA MIR29B2CHG93 in paired CRC tissues was detected in a cohort of CRC patients. The effects of lncRNA MIR29B2CHG93 on proliferation, migration, and invasion were determined by in vitro experiments. We found that tumorigenesis-associated lncRNAs predominantly participated in the regulation of the EMT/P53/PI3K-Akt/KRAS signaling pathway as well as the processes related to cell cycle and cell mitosis, while metastasis-associated lncRNAs mainly regulated blood vessel morphogenesis and immune-related biological processes. Compared to the TCGA and GSE datasets, seven tumorigenesis-associated lncRNAs and eight metastasis-associated lncRNAs were identified. LncRNA MIR29B2CHG93 knockdown remarkably suppressed tumor growth and metastasis in vitro , which acted as a tumor promoter in CRC. The lncRNA MIR29B2CHG93 was significantly upregulated in CRC tissues and was indicator of unfavorable clinical outcome in CRC. These results revealed novel lncRNAs that provide new insights for an in-depth understanding of CRC progression. In particular, this study identified a novel lncRNA MIR29B2CHG93 in CRC progression, which might be a potential biomarker for diagnosis, prognosis and metastasis-prediction in CRC.

Primary hepatic pregnancy is an extremely rare event which is difficult to diagnose due to its unusual location; moreover the potential mortality rate is five to seven times higher than the rate found in other ectopic pregnancies. We report a case of primary hepatic pregnancy in a 23-year-old woman, who presented with a history of one cesarean section and had taken oral contraceptives within half a year prior to her presentation. Interestingly this patient has no history of amenorrhoea, and no clinical symptoms of chills, fever, nausea, vomiting and diarrhea. Imaging findings showed an abnormal mass on the lower part of the right lobe. The patient was misdiagnosed with a liver tumor prior to operation. Histopathologic examination found that chorionic villi with trophoblasts infiltrated the hepatic tissue. A few trophoblasts were detected in some hepatic veins. HCG immunostaining showed positive reactivity in the trophoblasts. We believe that some risk factors of primary hepatic pregnancy such as the history of cesarean section and oral contraceptive should be taken into serious consideration and raise the index of suspicion, especially in the women of reproductive age, with or without a history of amenorrhoea. Timely diagnosis should be made in order to avoid mortality from rupture of the gestational sac., Competing Interests: None., (IJCEP Copyright © 2019.)

The study aims to develop and assess and validate a brief diabetic foot ulceration risk checklist among diabetic patients through a longitudinal study. Patients who had diabetes mellitus and had no foot ulceration and severe systematic disorders were recruited from eleven tertiary hospitals in nine provinces or municipalities of China. Internal consistency reliability, construct validity, concurrent validity, item property, and measurement invariance of the tool were assessed. The predictive capability of the tool was validated by the follow-up data using the receiver operating characteristic curve. At baseline, 477 valid cases were collected. Twelve items were remained after initial selection. Cronbach's alpha was 0.56. Confirmatory factor analysis showed that the model had acceptable goodness-of-fit yet local dependency between two items. Item response theory showed that most items had acceptable discrimination and difficulty parameters. Differential item functioning showed that tool had measurement invariance. 278 were followed up one year after the baseline. Follow-up showed that one-year incidence of ulceration among the patients was 3.6%, and the area under the receiver operating characteristic curve was 0.77 (95% confidence interval: 0.61-0.93). The cut-off point of the tool was 4, when sensitivity and specificity were 0.62 and 0.75 respectively. The checklist has good psychometric properties according to mixed evidences from classical and modern test theory, and has good predictive capability.

Solid pseudopapillary neoplasm occurring as a primary tumor outside the pancreas is a rare event. We report a case of an ovarian primary occurring with an ill-defined cystic mass in a 39-year-old woman. The morphologic and immunohistochemical features of the ovarian neoplasm described in this report are compatible with those of solid pseudopapillary neoplasm of the pancreas. Histologically, the tumor cells of the case we report infiltrate into the ovarian parenchyma. Because of the diagnosis is not clear before surgery, the patient had a reoccurrence two months after the operation in which laparoscopic simple ovarian cystectomy and part ovarian tissue removal, followed by the right salpingo-oophorectomy. The case herein confirms that solid pseudopapillary neoplasm of the ovary belongs to the class of low-grade malignant tumor with certain invasiveness. The diagnosis should be taken into serious consideration in order to avoid missed diagnosis and delay treatment. Through this case we have a better understanding of the biological behavior of solid pseudopapillary neoplasm of the ovary.