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The key to generating the best deep learning model for predicting molecular property is to test and apply various optimization methods. While individual optimization methods from different past works outside the pharmaceutical domain each succeeded in improving the model performance, better improvement may be achieved when specific combinations of these methods and practices are applied. In this work, three high-performance optimization methods in the literature that have been shown to dramatically improve model performance from other fields are used and discussed, eventually resulting in a general procedure for generating optimized CNN models on different properties of molecules. The three techniques are the dynamic batch size strategy for different enumeration ratios of the SMILES representation of compounds, Bayesian optimization for selecting the hyperparameters of a model and feature learning using chemical features obtained by a feedforward neural network, which are concatenated with the learned molecular feature vector. A total of seven different molecular properties (water solubility, lipophilicity, hydration energy, electronic properties, blood–brain barrier permeability and inhibition) are used. We demonstrate how each of the three techniques can affect the model and how the best model can generally benefit from using Bayesian optimization combined with dynamic batch size tuning.

OBJECTIVES An oral health disparity exists between native and immigrant children in Taiwan. This study evaluated the long-term effectiveness of a lay health advisor (LHA) intervention on immigrant children's dental caries and maternal preventive behaviours. METHODS Fifty-one immigrant mother-child pairs were randomly assigned to LHA intervention (n = 23) and control (n = 28) groups. Mothers in the LHA group received a four-chapter one-on-one lesson plan, which included dental caries-related knowledge, brushing techniques, caries prevention and free preventive services, from the LHA over 4 weeks. Mothers in the control group received only a health brochure. Baseline and 1-week, 2-month, and 8-month follow-up information was collected using dental examinations and questionnaires. RESULTS The mean ages of the children in the LHA and control groups were 4.0 ± 1.4 and 4.2 ± 1.5, respectively. The decayed, missing due to caries, filled teeth (dmft) index in the LHA and control groups was 4.8 ± 6.0 and 5.4 ± 5.4, respectively, at baseline. At the 8-month postintervention follow-up, the number of filled teeth (ft) in the LHA group was higher than that in the control group (β = 8.3, P = .033). The effect size (ES) demonstrated an upward trend at 1-week, 2-month and 8-month follow-ups in ft (ES = 0.21, 0.50 and 0.59, respectively) and a decrease in the number of decayed teeth (dt) (ES = 0.30, 0.43 and 0.57, respectively). The mothers in the LHA group were observed to be 10.9 times more likely than control mothers to assist their children in toothbrushing for 3 min at the 1-week follow-up (95% CI = 1.98-59.40, P = .006). CONCLUSIONS The LHA intervention strategy had positive effects on the immigrant children's new dt and ft and on maternal preventive behaviour, such as assisting their children in toothbrushing.

This study developed a novel chair-side tongue pressure (TP) measuring instrument with a disposable positioning mouthpiece controlled using a smartphone application (APP), denoted as the TP wireless application (TPWA). The mouthpiece was designed with a palate-shaped air balloon containing a tongue contact bump and a plastic bite positioning tube. Fatigue load testing was performed to evaluate mouthpiece durability by applying 700 displacement cycles (50 times a day for one week during training, with twice the safety factor) on the air balloon. The main component used in developing this instrument was a silicon pressure sensor equipped with wireless Bluetooth connection. Young (52 adults, mean age = 20.23 ± 2.17) and elderly (40 adults, mean age = 72.60 ± 7.03) individuals participated in the test with the new instrument, with the results compared to those of a commercial device. The TPWA mouthpiece fatigue test showed that mean response pressures were maintained at 12 kPa. No significant (p &gt, 0.05) differences were found during testing repetitions 0–10 and 701–710. There were no significant differences in the maximum TP values presented between the test sequences using different instruments for young and elderly participants. The TPWA results showed that TP values gradually decreased with increasing age (40.77 kPa for young and 16.55 kPa for elderly participants). The maximum TP for males (43.51 kPa) was significantly larger than that for females (35.14 kPa) in the young group, but an opposite trend was seen in the elderly group (12.97 for males and 17.59 for females). Thus, this study developed a novel chair-side TP measurement instrument with Bluetooth wireless mobile application control. A durable positioning oral mouthpiece was approved for measuring pressure sufficiently, reliably, and precisely for TP screening.

An oral hygiene board game was designed as an intervention tool and applied to explore the effectiveness for the oral health related knowledge (OHK) score and plaque index (PI) of adults with intellectual disability (ID). This one-group pre/post-test design study was conducted in a residential long-term care facility for 42 participants. The study had one pre-test (baseline) and three post-tests evaluated in both control and intervention stages, respectively. The participants participated in a 60-min oral hygiene board game twice a week during the intervention stage. Total OHK score and PI of the participants were recorded to determine the effectiveness of intervention. There were no differences in OHK score and PI between the two stages at baseline. The results in intervention stage demonstrated a significant gradual increase and reduction in the OHK score when compared with the control stage. A statistically significant improvement in the OHK score and PI (42.29% and &minus, 33.28%, respectively) at the end of intervention between two stages was recorded. This study proved a board game is deemed an effective education method applicable to promote the OHK and skills of ID adults.

BackgroundNumerous studies have documented factors that are associated with substance use behaviors among college-aged individuals. However, relatively few studies have considered the heterogeneity of the college experience by field of study (i.e., college major) and how that educational context might affect students’ health behaviors differently. Drawing from theories and prior research, this study investigates whether college majors are associated with different substance use behaviors, both during college and upon graduation.MethodsThe study analyzed longitudinal data from the National Longitudinal Survey of Youth 97 (N = 1031), specifically data on individuals who obtained a bachelor’s degree, to examine the associations between college fields of study and trajectories of three substance use behaviors: smoking, heavy alcohol use, and marijuana use.ResultsThe results indicate that social science and business majors were associated with more substance use behaviors than arts and humanities and STEM majors. However, social science majors were associated with a faster decrease in substance use behaviors over time. Importantly, the differences we found in mean levels of substance use behaviors and trajectories were not explained by demographic characteristics, family SES background, childhood health conditions, and employment experience. Further analysis that examined college major and each substance use behavior individually suggests that the associations were stronger for heavy alcohol use and marijuana use. Moreover, we found the associations were more pronounced in men than women.ConclusionsThe study finds that not all college majors show the same level of engagement in substance use behaviors over time, and that the associations also vary by (1) the specific substance use behavior examined and (2) by gender. These findings suggest it is important to consider that the different learning and educational contexts that college majors provide may also be more or less supportive of certain health behaviors, such as substance use. Practical implications are discussed.

Background The impact of poor oral health on older adults’ quality of life is a public health problem. In this study, the mediating effects of dental status, occlusal condition, dysphagia, and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) were assessed in the older adult population. Methods Stratified cluster sampling was used to recruit 1076 community-dwelling adults aged 65 years and older from Kaohsiung, Taiwan. Community care centers were randomly selected according to their geographic classifications (urban, rural, or mountainous areas). Assessments of dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, dysphagia and depression was collected through face-to-face interviews. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using the Geriatric Oral Health Assessment Index. Hierarchical regression models were used to assess the relationships between OHRQoL and physical function, dental status and oral function in older adults. Path analysis was used to estimate direct and indirect pathways between xerostomia and OHRQoL. Results Participants with xerostomia exhibited a 0.20 OHRQoL reduction (p p p p p Conclusions Dysphagia and masticatory performance may serve as pathways through which xerostomia affects quality of life. Early oral function intervention may be a valuable and actionable target for older adults to maintain quality of life. Our results further suggest that checkup and screening for oral dysfunction are essential to prevent or delay the onset of complications.

Background: The adverse impact of poor oral conditions in older adults on their quality of life is a public health problem. This study assessed the mediating effects of dental status, occlusal condition, dysphagia and masticatory performance on the association between xerostomia and oral health-related quality of life (OHRQoL) in the older population. Methods: A total of 1100 representative community-dwelling adults aged 65 years and older were recruited from a large-scale survey conducted in Kaohsiung, Taiwan. Dental status and occlusal condition were performed by dentists. Information on demographics, physical function, xerostomia, and dysphagia was collected using face-to-face interview. Masticatory performance was evaluated using color-changeable chewing gum. OHRQoL was measured using Geriatric Oral Health Assessment Index. Results: Comparing with non-xerostomia, participants with xerostomia had a 0.20 decrease in the level of OHRQoL (p< .001), and the direct effect was accounted for 83.3% of the total effect. The dysphagia and the masticatory performance were found to have a significant mediating effect on the association between xerostomia and OHRQoL (βs = 0.20 and −0.13, respectively; βs = 0.05 and −0.08, respectively) and 10.8% of the effect was attributed to dysphagia mediation. Furthermore, the functional teeth and occlusal condition had a significant mediating effect on the association between xerostomia and masticatory performance , and the functional teeth was accounted for 43.6% of the effect. Conclusions: Xerostomia had the greatest effect on OHRQoL. The mediating role of dysphagia and masticatory performance on the association between xerostomia and OHRQoL was significant and deserves further attention. Older adults could improve their OHRQoL through a community-based oral function intervention. Our results further suggest that early screening for swallowing and masticatory function is essential to prevent or delay the onset of complications.

Aqueous solubility is the key property driving many chemical and biological phenomena and impacts experimental and computational attempts to assess those phenomena. Accurate prediction of solubility is essential and challenging, even with modern computational algorithms. Fingerprint-based, feature-based and molecular graph-based representations have all been used with different deep learning methods for aqueous solubility prediction. It has been clearly demonstrated that different molecular representations impact the model prediction and explainability. In this work, we reviewed different representations and also focused on using graph and line notations for modeling. In general, one canonical chemical structure is used to represent one molecule when computing its properties. We carefully examined the commonly used simplified molecular-input line-entry specification (SMILES) notation representing a single molecule and proposed to use the full enumerations in SMILES to achieve better accuracy. A convolutional neural network (CNN) was used. The full enumeration of SMILES can improve the presentation of a molecule and describe the molecule with all possible angles. This CNN model can be very robust when dealing with large datasets since no additional explicit chemistry knowledge is necessary to predict the solubility. Also, traditionally it is hard to use a neural network to explain the contribution of chemical substructures to a single property. We demonstrated the use of attention in the decoding network to detect the part of a molecule that is relevant to solubility, which can be used to explain the contribution from the CNN.

This study develops a robust automatic algorithm for clustering probability density functions based on the previous research. Unlike other existing methods that often pre-determine the number of cl...

Oral health and dentition have been associated with cognitive ability and frailty, but an applicable screening tool has not yet been developed. This study aimed to establish risk prediction models for dementia and frailty. A sample of 2905 community-dwelling older adults aged &ge, 58 years using the Taiwan Longitudinal Study on Aging (TLSA) survey was adapted and analyzed for this study. Risk scores were estimated by stepwise logistic regression. In models adjusted for covariates, increased age, female sex, no dental prosthesis (adjusted Odds ratio [adjOR], 1.61, 95% confidence interval [CI], 1.11&ndash, 2.35), diabetes mellitus, chronic kidney disease, and an increased Oral Health Impact Profile (OHIP)-7T Q3 score (adjOR, 1.33, 95% CI, 1.19&ndash, 1.49) were all significantly associated with frailty. In addition to these factors, an inability to self-report height or weight (adjOR, 4.52, 95% CI, 3.52&ndash, 5.81) and an increased OHIP-7T Q7 score (adjOR, 1.21, 95% CI, 1.06&ndash, 1.37) were significantly associated with dementia. The cut-off points of the risk scores for frailty and dementia were 80 (sensitivity, 80.0%, specificity, 81.2%) and 77 (sensitivity, 83.4%, specificity, 71.5%), respectively. The findings highlighted a number of composite risk factors of frailty and dementia. Importantly, the developed prediction models were easily applicable to screen for frailty and dementia in communities or dental clinics.

Backgroud The objectives of this study were to try to identify the key dimension in satisfaction from the combination of satisfaction clusters, and its effect on the change of OHRQoL(Oral Health-related Quality of Life) of elderly denture users. Methods This follow-up study was conducted in subjects aged 65 years and over. All participants (n = 2128) completed questionnaires before and approximately 6 months after receiving complete denture. Information obtained by questionnaire included demographic characteristics, patients’ self-satisfaction rate and OHRQoL. The 6 satisfaction dimensions (including speaking, stability, esthetic, chewing, doctor and general dimensions) were classified as 5 cluster groups, which is the group of not at all satisfied in all dimensions (NAS); only satisfied with doctor and general dimensions(SDG); moderate satisfaction group(MS); quite satisfied group(QS); the highly satisfied group(HS) by an analysis of PCA (Principle component analysis) and CA (cluster analysis). Multiple linear regression was adapted to estimate the association between satisfaction and the responsiveness of OHIP-7T (Oral Health Impact Profile). Results When compared to the cluster “NAS”, the greatest improvement of OHRQoL after treatment was found in the group “HS” (β = 7.31(6.26–8.36), followed by group “QS” (β = 4.71(3.54–5.87)), group “MS” (β = 4.33(2.92–5.74)) and group “SDG” (β = 3.25(2.10–4.41)). An increasing trend was detected in patient-rating satisfaction and OHRQoL. The satisfaction cluster group is an important factor of OHRQoL after adjusting for other confounders. Conclusion Psychological-related aspects is the greatest impacting dimension on OHRQoL among denture wearers in Taiwan elderly. Better communication from the dental professional team with denture patients would improve their OHRQoL.

Severe periodontitis is a risk factor for poor glycemic control. The appropriate medicaltreatment and plaque control of periodontitis positively affects blood-sugar control in diabetespatients. We aimed to identify the factors associated with glycemic control and examine theperiodontal treatment (PT) experience and oral health-related quality of life (OHQoL) for patientswith poor glycemic control in type 2 diabetes mellitus (T2DM). This multicenter case&ndash, control studyrecruited 242 patients with poor glycemic control and 198 patients with good glycemic control. Wecollected patients&rsquo, information through face-to-face interviews using a structured questionnaire.The Oral Health Impact Profile-14 (OHIP-14) was used to measure OHQoL. Based on PT status, thepatients were classified into three groups: a non-periodontal disease group, a PT group, and a non-PT (NPT) group. Regression models were used to analyze the data. No interdental cleaning(adjusted odds ratio (aOR) = 1.78) and positive attitudes toward periodontal health (aOR = 1.11)were significantly more likely to be associated with poor glycemic control in patients with T2DM.The PT group had a significantly lower OHIP-14 score than the NPT group (6.05 vs. 9.02, p &lt, 0.001),indicating a better OHQoL among patients with poorly controlled T2DM. However, the OHQoLdid not differ significantly in patients with well-controlled T2DM between the PT and NPT groups.This suggested that diabetic patients with poor glycemic control must improve periodontal carepractices and receive proper PT, if necessary, to improve their OHQoL.

Enterprise Application Integration (EAI) plays an important role in the enterprise ecosystem. The systems in the enterprise usually communicate with each other through EAI. The way reduces the complexity of system integration because EAI provides uniform interface and central endpoint to the systems. Because EAI stays in the core of the systems, it must be stable enough and can be extensible easily to serve a large amount of requests every day, especially for IoT today. Moreover, we also need a low-cost architecture for supporting the operation of the company, especially for large-scale environment. In order to achieve these goals, we built an flexible EAI based on several open sources to support the services in the telecom, which faces ever-changing requirements today, with several features. First, it can provide SLA based on the importance of the service. Second, the request can be redirected to different backend processes at runtime without interrupting service operation. It supports quick switch between different implementations and the feature increases the availability of the ecosystem. Third, the capacity of the service can be extended easily at every level when the service becomes more important based on a low-cost architecture. Finally, it also can add new machine to the system when the capacity of the whole system is not enough.

Backgroud: The objectives were to evaluate the association between edentate patients’ self-ratings satisfaction and OHRQoL and to identify the determinants of denture satisfaction that best predict OHRQoL. Methods: This prospective study was conducted in subjects aged 65 years and over. All subjects completed questionnaires before and approximately 6 months after receiving complete denture. Information obtained by questionnaire included demographic characteristics, patients’ satisfaction and OHRQoL. The six satisfaction dimensions were classified as five cluster groups by an analysis of PCA and CA. Multiple linear regression was adapted to estimate the association between satisfaction and the responsiveness of OHIP7T. Results: The satisfaction cluster group is an important factor of OHRQoL after adjusting for other confounders. When compared to the cluster “HDS”, the greatest improvement of OHRQoL after treatment was found in the group “HS” (β=7.31(6.26-8.36), followed by group “QS” (β=4.71(3.54-5.87)), group “AS”(β=4.33(2.92-5.74)) and group “SDG” (β=3.25(2.10-4.41)). A statistically significant trend was detected in patient-rating satisfaction and OHRQoL. Conclusion: Psychological value is the greatest impacting dimension on OHRQoL among denture wearers in Taiwan elderly.

This paper presents a design and experimental study of 3D robotic vision for bin picking and obstacle avoidance. Through the 3D vision algorithm, the robotic picking system is able to analyze the imagery of cluttered objects, classify the objects and estimate the pose of identified objects for grasping. In order to facilitate the robot to work with a human nearby, obstacle avoidance during task execution is developed based on 3D vision. In this design, a RealSense SR300 RGB-D camera is utilized to acquire RGB images and depth images of clustered workpieces. A deep neural network (DNN) approach to object recognition is designed and combined with point cloud segmentation to enhance 3D object-pose estimation for grasping The robot avoids obstacles to assure safe operation during execution of the bin picking task. Practical experiments using a Techman TM5 6-DOF robot arm show that the proposed method effectively accomplishes obstacle avoidance in pick-and-place operations.

Background The X-linked tumor suppressor gene LDOC1 is reported to be involved in oral cancer. The detection of biomarkers in salivary RNA is a non-invasive strategy for diagnosing many diseases. The aim of the present study was to investigate the potential of salivary LDOC1 as a biomarker of oral cancer. Methods We determined the expression levels of LDOC1 in the saliva of oral squamous cell carcinoma (OSCC) subjects, and investigated its correlation with various clinicopathological characteristics. The expression levels of salivary LDOC1 were detected in 53 OSCC subjects and 43 healthy controls using quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis. We used Fisher’s exact test to analyze the correlations between expression levels and clinicopathological characteristics. Results Salivary LDOC1 was significantly upregulated in females with OSCC (p = 0.0072), and significantly downregulated in males with OSCC (p = 0.0206). Eighty-nine percent of male OSCC subjects who smoked expressed low levels of LDOC1. OSCC cell lines derived from male OSCC subjects expressed low levels of LDOC1. Conclusions A high level of salivary LDOC1 expression is a biomarker of OSCC in females. A high percentage of male OSCC subjects who smoke express low levels of salivary LDOC1. A low level of salivary LDOC1 expression is a biomarker of OSCC in males.

Laparoscopic surgery has become increasingly popular in the management of gastric gastrointestinal stromal tumors (GISTs) in recent years. One hundred and forty-five patients underwent curative resections of primary gastric stromal tumors between September 2002 and March 2012 were assigned to either an open surgery group (n = 99) or a laparoscopic surgery group (n = 46). In the open surgery group, there was a significantly higher number of samples with a mitotic index ≥ 10 (16.1% vs. 0%), more tumors located in the gastric cardia (13.1% vs. 6.5%), greater operative blood loss (80 mL vs. 50 mL) and a longer postoperative hospital stay (10 days vs. 6 days) than in the laparoscopic group. The surgical morbidity and mortality were 6.1% and 0% in the open group, whereas no complication or mortality in the laparoscopic group. Ten patients in the open group had tumor recurrences and no recurrence in the laparoscopic group. Multivariate analysis showed that tumor size and mitotic index were two independent risk factors associated with tumor recurrence. The 3-year disease-free survival rates and 5-year overall survival rates were similar between the two groups. The laparoscopic approach is a safe alternative procedure for gastric GISTs.

Objectives This study examined significant caries (SiC) and the interactive effects of maternal-related oral hygiene factors in urban preschool children. Methods A cross-sectional study was designed to collect data from a cluster of randomly selected samples in 2011. A total of 495 child-mother pairs from the San-Ming District of Kaohsiung City, Taiwan, participated in the study. Children aged 4-6 years received dental examinations, and their mothers completed a self-administered questionnaire. The SiC Index indicated the highest caries values in participants. The association between 3 groups – dmft (decayed, missing, and filled teeth)-free, non-SiC, and SiC – and the mothers’ and their children's factors were examined using polytomous logistic regression analysis. Results Among the SiC children, caries experience was most frequent in the mandibular molars (64.5-84.9 percent), and almost 50 percent of these children had central incisor caries. The significant factors associated with the SiC children were lower maternal self-efficacy in oral hygiene [adjusted odds ratio (aOR) = 2.04], child's intake of sugar-sweetened beverages (SSBs) more than once per day (aOR = 2.27), and irregular child dental checkups (aOR = 2.32). Significant interaction effects were detected among children who received irregular dental checkups and whose SSBs intake was more than once per day and whose mothers had lower self-efficacy in oral hygiene (P for interaction term = 0.034 and 0.004, respectively). Conclusions Caries prevention programs should prioritize enhancing maternal self-efficacy in oral hygiene and emphasize childhood SSBs intake management and regular dental checkups to mothers to prevent severe caries in preschool-aged children.

This study assessed the differences between immigrants and natives in terms of combined effects of sugar-sweetened beverage (SSB) or snack consumption and preventive behaviors for severe early childhood caries (SECC) through a large-scale survey of 31,565 native and 1046 immigrant child&ndash, parent pairs in Taiwan. Children aged 3&ndash, 5 years underwent dental examinations, and parents completed structured questionnaires. Immigrants had a significantly higher SECC prevalence than native children (32.3% vs. 19.4%). A combined effect of SECC was observed in native children who did not receive assistance when brushing teeth at night before sleep and those who consumed SSBs more than four times weekly (adjusted odds ratio (aOR) = 4.8). Moreover, native children who did not use dental floss and who consumed snacks more than four times weekly had an aOR of 4.1 for SECC. The combined effects of children with immigrant parents who did not receive assistance when brushing their teeth at night before sleep and those who consumed snacks more than four times weekly had an aOR of 8.2 for SECC. The results suggest the necessity of cross-cultural caries prevention programs for immigrants. Parents must limit children&rsquo, s SSB and snack intake, and implement preventive measures to reduce SECC development.

This paper presents a real-time motion planning and control design of a robotic arm for human-robot collaborative safety. A novel collision-free motion planning method is proposed not only to keep robot body from colliding with objects but also preserve the execution of robot's original task under the Cartesian constraint of the environment. Multiple KinectV2 depth cameras are utilized to model and track dynamic obstacles (e.g. Humans and objects) inside the robot workspace. Depth images are applied to generate point cloud of segmented objects in the environment. A K-nearest neighbor (KNN) searching algorithm is used to cluster and find the closest point from the obstacle to the robot. Then a Kalman filter is applied to estimate the obstacle position and velocity. For the collision avoidance in collaborative operation, attractive and repulsive potential is generated for robot end effector based on the task specification and obstacle observation. Practical experiments show that the 6-DOF robot arm can effectively avoid an obstacle in a constrained environment and complete the original task.

Objectives To date, there has been no evidence about objectively measured sleep characteristics from a representative national probability sample of adults in the United States. We used actigraphy to measure the sleep characteristics of older Americans. Design Cross-sectional study. Setting Sleep substudy within Wave 2 (2010-2011) of the ongoing National Social Life, Health, and Aging Project. Participants Seven hundred and thirty-nine National Social Life, Health, and Aging Project participants aged 62-90 years. Intervention Not applicable. Measurements Study participants wore a wrist actigraph for 72 hours, and sleep properties were compared across demographic, socioeconomic, and health-behavior–related lines. Results Actigraph-estimated sleep time averaged 7.2 hours (SE, 0.06 hour) each night; the majority of the sample (80%) slept between 5.8 and 8.6 hours per night. Average time spent awake after sleep onset (WASO) was 39 minutes (SE, 1.2 minutes). Women had significantly more total sleep time and lower sleep fragmentation compared with men. Total sleep time increased significantly with age, although sleep percentage decreased with age. Compared with white participants, African American participants had significantly more WASO (9.2 minutes, P P Conclusions Both short sleepers and long sleepers —often conventionally defined as obtaining 9 hours per night, respectively—are relatively rare among older Americans when sleep is estimated by actigraphy. Sleep quality is significantly poorer among men, African Americans, and those with less education.

Background Population-based studies of older adults increasingly use wearable devices to measure activity and sleep. Whether cognitive impairment reduces consent and compliance has not been assessed. Methods In the context of a nationally representative cohort of community-dwelling adults aged 62-90, individuals were invited to participate in a sleep and activity substudy that required wearing a wrist actigraph for 72 consecutive hours. Cognitive function in the parent study was assessed with the survey adaptation of the Montreal Cognitive Assessment, and individuals were categorized as normal, mild cognitive impairment, or dementia. Participants were asked to press an event marker on the actigraph when they started trying to fall asleep and when they awoke each day. Logistic and negative binomial regressions were used to link cognitive status to nonconsent, returning usable data, wearing the actigraph three full days, ever taking the device off-wrist during the 3-day study period, and pushing the event markers, controlling for demographics. Results Cognitive status was not associated with nonconsent, returning usable data, off-wrist, or missing days. However, individuals classified with dementia were more likely to miss bedtime and wake-up event markers. Individuals classified as mild cognitive impairment were more likely to miss wake-up event markers. Conclusions Impaired cognition does not seem to be a barrier to compliance with simply wearing a device but may affect compliance with additional action such as pressing event markers.

Companies leverage plenty of monitoring tools collecting performance metrics of Telecom BSS to assure it is in good status. The influence of the system failure is variance, depending on the length of time to finish the system reparation. The metrics collected by monitoring tools may have the indication of the system failure, and the maintainers have chances to foresee a system failure from those metrics. However, the metrics collected by the monitoring tools are too much, and some hints may hide in combinations of multiple metrics. We leverage machine learning approaches to address this problem. We used several machine learning tools and algorithms to explore the configuration of the machine learning models to obtain the model performing the best to our dataset. We compared many algorithms like linear SVM, SVM with RBF kernel, random forest and fully connected neural network. We also introduced an anomaly detection learning technique to see if better performance can be achieved. We found SVM with RBF kernel can achieve the best performance to our dataset, and we conducted a comprehensive grid search of the hyperparameters of the RBF SVM to found the best configuration to our dataset. We achieve F-score 21 in the final explored result and the model can predict 15% of the system failure 60 minutes in advance.

This paper will research the article be posted by headhunting consultant company on LinkedIn effective. This study focuses on the global Top 10 hunting consultant companies. This research follows those company's activities on LinkedIn in five months, during September 2016 to January 2017, collecting more than thousand messages and data which of including articles, posts, and member response, Like times, comments. And then entire collected data are classified into several main categories, analyzed by using social network analysis. Finally, this study could find out which articles would attract member interested effective.

BACKGROUND: Reports of insomnia symptoms are common among the elderly. However, little is known about the relationship between insomnia symptoms and objective assessments of sleep in the general population of older adults. We assessed concordance between insomnia symptoms and actigraphic sleep characteristics in a nationally representative sample of older Americans. METHODS: In a national probability sample of 727 adults aged 62-91 years in 2010-2011 from the National Social Life, Health, and Aging Project, respondents were asked how often they (a) feel rested when they wake up, (b) have trouble falling asleep, (c) have trouble with waking up during the night, and (d) have trouble waking up too early and not being able to fall asleep again. Responses to these questions were compared to sleep characteristics estimated from three nights of actigraphy for the same individuals. Statistical analyses were adjusted for age, gender, race and ethnicity, income, assets, and education. RESULTS: Feeling rested (Question (a), above) was not correlated with any actigraphy-estimated sleep characteristics. Questions (b)-(d) each had several significant correlations with the actigraphy metrics, but generally not with the specific objective sleep characteristics that each question intended to reference. In some cases, the associations were not in the expected direction. CONCLUSIONS: Although three of four questions about insomnia symptoms were significantly associated with objectively estimated sleep characteristics, responses seem to be general indicators of sleep quality rather than reports of specific sleep characteristics. Language: en

We propose an intuitive and computationally simple algorithm for clustering the probability density functions (pdfs). A data-driven learning mechanism is incorporated in the algorithm in order to determine the suitable widths of the clusters. The clustering results prove that the proposed algorithm is able to automatically group the pdfs and provide the optimal cluster number without any a priori information. The performance study also shows that the proposed algorithm is more efficient than existing ones. In addition, the clustering can serve as the intermediate compression tool in content-based multimedia retrieval that we apply the proposed algorithm to categorize a subset of COREL image database. And the clustering results indicate that the proposed algorithm performs well in colour image categorization.

Background/purpose: Improper assessment of the maxillary buccal vestibular space can contribute to the fabrication of maxillary dentures with inadequate buccal flange extensions. The purpose of this study was to determine whether a significant difference existed between the anatomic dimensions of the buccal vestibules and the corresponding buccal flanges of maxillary complete dentures in an edentulous population. Materials and methods: The anterior, middle, and posterior depth and width of the maxillary buccal vestibules in 100 randomly selected subjects were measured with a periodontal probe. Corresponding measurements of the buccal flanges of the subjects' existing dentures were recorded. The differences between buccal vestibule widths and depths and denture flange widths and lengths were statistically compared according to site. Results: The difference in the mean depth between the vestibules and the flanges in the posterior area (6.4 mm and 10.3 mm, respectively) was approximately 38% (P

Simulation is a common approach for assisting system design and optimization. For system-wide optimization, energy and computational resources are often the two most critical issues. Monitoring the energy state of each hardware component and measuring the time spent in each state is needed for accurate energy and performance prediction. For software optimization, it is important to profile the energy and the time consumed by each software construct in a realistic operating environment with a proper workload. However, the conventional approaches of simulation often fail to produce satisfying data. First, building a cycle-accurate simulation environment for a complex system, such as an Android smartphone, is difficult and can take a long time. Second, a slow simulation can significantly alter the behavior of multithreaded, I/O-intensive applications and can affect the accuracy of profiles. Third, existing software-based profilers generally do not work on simulators, which makes it difficult for performance analysis of complicated software, for example, Java applications executed by the Dalvik VM in an Android system. To address these aforementioned problems, we proposed and prototyped a framework, called virtual performance analyzer (VPA). VPA takes advantage of an existing emulator or virtual machine monitor to reduce the complexity of building a simulator. VPA allows the user to selectively and incrementally integrate timing models and power models into the emulator with our carefully designed performance/power monitors, tracing facility, and profiling tools to evaluate and analyze the emulated system. The emulated system can perform at different levels of speed to help verify if the profile data are impacted by the emulation speed. Finally, VPA supports existing software-based profiles and enables non-intrusive tracing/profiling by minimizing the probe effect. Our experimental results show that the VPA framework allows users to quickly establish a performance/power evaluation environment and gather useful information to support system design and software optimization for Android smartphones.

Purpose Variation in sleep duration has been linked with mortality risk. The purpose of this review is to provide an updated evaluation of the literature on sleep duration and mortality, including a critical examination of sleep duration measurement and an examination of correlates of self-reported sleep duration. Methods We conducted a systematic search of studies reporting associations between sleep duration and all-cause mortality and extracted the sleep duration measure and the measure(s) of association. Results We identified 42 prospective studies of sleep duration and mortality drawing on 35 distinct study populations worldwide. Unlike previous reviews, we find that the published literature does not support a consistent finding of an association between self-reported sleep duration and mortality. Most studies have employed survey measures of sleep duration, which are not highly correlated with estimates based on physiologic measures. Conclusions Despite a large body of literature, it is premature to conclude, as previous reviews have, that a robust, U-shaped association between sleep duration and mortality risk exists across populations. Careful attention must be paid to measurement, response bias, confounding, and reverse causation in the interpretation of associations between sleep duration and mortality.

The impact of body mass index (BMI) on the outcome of advanced gastric cancer surgery is controversial. Between December 1987 and December 2006, a total of 947 advanced gastric cancer patients receiving curative resection with retrieved lymph node number15 were studied and divided into three groups according to BMI (25, 25-30, and30 kg/m(2)).With regard to comorbidities present prior to surgery, higher BMI patients were more likely to have heart disease, type 2 diabetes, and hypertension than lower BMI patients. Compared with BMI25 kg/m(2), higher BMI patients had longer operative time and more surgery-related morbidity. Multivariate Cox proportional-hazard analysis showed that age, pathological T and N categories, and lymphovascular invasion were independent prognostic factors. The initial recurrence patterns, 5-year overall survival, and cancer-specific survival were similar among the three groups.Only in stage III gastric cancer with BMI less than 25 kg/m(2) patients receiving total gastrectomy had a more advanced pathological N category and a worse prognosis compared to those receiving subtotal gastrectomy. Higher BMI was associated with longer operative time and more surgery-related morbidity than lower BMI. BMI alone is not an independent prognostic factor.

When Business support systems (BSS) suffer poor performance, the system administrator has to spot the problem of BSS as soon as possible. The monitoring system is a great help to quickly gain insight of the system from all sides. By the monitoring system, the administrator can evaluate various metrics on the different fields in one single arranged page and understands the whole picture of current system status from brief reports. Although this kind of problem solving flow does well in certain circumstance, it may still be too late for some critical BSS. To further improve the speed of trouble-shooting, administrator sets the thresholds to each performance metric. Those thresholds are set based on knowledge and experience of administrator. If the performance metric collected from the system is over the set threshold, monitoring system will send alerts to administrator to inform current BSS status, and he can check the system status in advance before the situation get worse. This kind of traditional approach finds the problem about ten minutes before the emergency break out. In our work, we leverage a machine learning approach to determine emergency earlier. The machine learning model we developed can predict the healthy status of the system before the emergency an hour with average 14 points error.

Background/purpose The objective of this study was to assess the relationship between the essential functional qualities of complete dentures and participants' oral health-related well-being among an elderly edentulous population. Materials and methods Four hundred elderly participants from Taiwan, aged ≥ 65 years, with diverse levels of formal education, received intraoral examinations in accordance with the 10 criteria embedded in the Functional Assessment of Dentures (FAD) and personal interviews in accordance with the Oral Health Impact Profile (OHIP)-14. The mean OHIP-14 scores were compared among categories using a t test or ANOVA. A multiple-regression analysis was used to identify significant FAD criteria related to specific OHIP-14 domains, while adjusting for gender, age, and educational level. Results Maxillary stability and retention, denture articulation, and occlusion demonstrated significant relationships with the mean OHIP-14 scores and individual mean OHIP-14 domain scores. Maxillary denture stability and denture articulation were the two most significant denture-related variables. Conclusion A stable and retentive maxillary denture with adequate articulation provided the optimal environment for oral function with the highest level of patient oral health-related well-being in this elderly population.

This study aimed to evaluate the tongue’s role in supporting maxillary denture retention (MDR), in providing additional stabilization for the mandibular denture, and the tongue’s relationship with the oral health-related well being in elderly complete denture patients. Four hundred elderly individuals, 263 males and 137 females, were enrolled in this study. All were older than 65 years, and wore complete dentures. Intraoral examinations were performed in accordance with the 10 criteria embedded in the Functional Assessment of Dentures (FAD). Participants also received personal interviews and completed the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The associations between MDR (tongue support) with the mean OHIP-14 sum scores and FAD categories were analyzed using the t test or analysis of variance (ANOVA). Combinations of MDR (tongue support), MDR (resistance to vertical pull), and mandibular denture stability (anterior–posterior movement) were also assessed with the remaining FAD criteria and OHIP-14 domain scores. Individuals with adequate MDR (tongue support) were significantly associated with denture articulation, denture occlusion, MDR (resistance to vertical pull), maxillary denture stability (pronounced rocking), and mandibular denture stability (anterior–posterior movement). When individuals with adequate MDR (tongue support) were analyzed in conjunction with adequate MDR (resistance to vertical pull) and adequate mandibular denture stability (anterior–posterior movement), significant associations were observed with the mean OHIP-14 sum score and three individual OHIP-14 domains: functional limitation, physical pain, and physical disability (p ＜ 0.05). The mean OHIP-14 sum score was lower among individuals with both adequate MDR (tongue support) and inadequate MDR (resistance to vertical pull) than among participants with both inadequate MDR (tongue support) and inadequate MDR (resistance to vertical pull). MDR (tongue support) demonstrated significant differences from denture occlusion, denture articulation, MDR (resistance to vertical pull), maxillary denture stability (pronounced rocking), and mandibular denture stability (anterior–posterior movement). MDR (tongue support), in conjunction with both adequate MDR (resistance to vertical pull) and adequate mandibular stability (anterior–posterior movement), were significantly associated with the individuals’ oral health-related well being.

Robotic gastrectomy has become more popular in the treatment of gastric cancer, especially in Asian countries. Until now, few studies have compared robotic surgery with open or laparoscopic surgery for gastric cancer patients.Data were prospectively collected between January 2006 and February 2012. A total of 689 patients underwent curative resection of adenocarcinoma of the stomach. Patients were separated into three groups according to the different surgical approaches used (586 open, 64 laparoscopic, and 39 robotic). The clinicopathological characteristics and surgical outcomes of the three groups were compared.The open group was associated with a larger tumor size, more D2 dissection, more advanced tumor stage, and more blood loss than the groups treated with laparoscopic and robotic methods. Robotic gastrectomy was associated with female predominance, less blood loss, shorter hospital stay, and longer operative time than open and laparoscopic gastrectomy. The retrieved lymph node numbers were similar between the open and robotic groups. Postoperative morbidity rates were similar among the three groups. In terms of the learning curve of robotic gastrectomy, operative time and docking time were significantly reduced in the recent robotic group (n=14) compared to the initial robotic group (n=25).Robotic gastrectomy could achieve extended lymph node dissection similar to open surgery. Our results showed a significant learning curve effect in the initial 25 cases of the robotic group.

The benefit of resection of gastric cancer with locoregional invasion is still under debate. This study aimed to investigate the impact of surgery on patients with gastric cancer with locoregional invasion. From January 1988 to December 2009, a total of 2,678 patients with gastric cancer underwent surgery at the Department of Surgery, Taipei Veterans General Hospital. Among these patients, 569 and 295 were diagnosed as T4a (serosa invasion without penetration of visceral peritoneum) and T4b (serosa exposure with invasion of adjacent structure), respectively. Invasion type and prognosis were analyzed in patients with gastric cancer who had either curative or palliative resection. Our results showed that patients with T4a gastric cancer had a better 5-year overall survival than patients with T4b (22.5% vs. 11.5%, P

BACKGROUND/AIMS The rate of recurrence increases in proportion to the degree of tumor depth, even after curative resection for gastric adenocarcinoma. Serosal exposure is considered as an important risk factor of peritoneal recurrence. However, some patients with serosa-negative cancer were found to have peritoneal recurrence. There are few reports concerning risk factors of peritoneal recurrence in serosa-negative gastric adenocarcinoma. The aim of this study is to evaluate the incidence and risk factors of peritoneal recurrence in serosa-negative gastric adenocarcinoma after curative resection. METHODOLOGY Total 1128 serosa-negative gastric cancer patients (574 pT1, 251 pT2, 303 pT3) diagnosed as gastric adenocarcinoma that underwent R0 resection from 1988 to 2005 were enrolled. RESULTS Peritoneal recurrence was observed in 50 (4.4%) patients, including 3 pT1, 3 pT2 and 44 pT3 patients. The incidence of peritoneal recurrence increased significantly with tumor invading subserosa (pT3). Multivariate analysis showed that the independent risk factor of peritoneal recurrence was tumor depth. CONCLUSIONS The incidence of peritoneal recurrence in serosa-negative cancer is low, and tumor depth is a significant risk factor. We should be aware of peritoneal recurrence during follow-up, especially for patients with subserosal tumor invasion.

To validate the Chinese (Taiwan) version of the Oral Health Impact Profile (OHIP-49T) and develop a short form of the OHIP (OHIP-14T) for the elderly. A total of 1402 subjects, aged 65 and above, received a personal interview and oral examination. Internal consistency, measured by Cronbach’s alpha, and test–retest reliability were assessed by intra-class correlation coefficient (ICC) during a 2-week interval. The criterion-related validity of OHIP-49T was evaluated through associations between the OHIP-49 score with prosthetic need and prosthetic status. A subset (OHIP-14T) questionnaire, derived through a controlled regression procedure, was compared with the original OHIP-14 by Slade (OHIP-14S). The Cronbach’s alpha and ICC values were 0.97 and 0.98 for OHIP-49T and 0.90 and 0.93 for OHIP-14T. Mean scores of the OHIP-49T were significantly associated with prosthetic status (P = 0.0013) and prosthetic need (P = 0.0004), which were examined by dentists. The OHIP-14T score had stronger discriminatory ability than OHIP-14S. The OHIP-49T showed satisfactory reliability and validity for this Taiwanese elderly population. The OHIP-14T is more effective to measure OHRQoL than OHIP-14S.

The paper discusses a kitchen that intelligently senses cooking activities and provides realtime nutritional information helps facilitate healthy cooking by letting family cooks make informed decisions. It creates opportunities to embed pervasive computing in a smart kitchen to facilitate healthy cooking.

Background and Aim: Prognostic factors of lymph node-negative gastric adenocarcinoma after curative resection have been discussed. Recurrent pattern of advanced lymph node-negative gastric cancer after curative resection has rarely been described. Methods: Recurrent sites and correlated clinicopathological factors of 372 patients with lymph node-negative advanced gastric adenocarcinoma that underwent R0 resection from 1988 to 2005 were analyzed. Results: Recurrence was noted in 51 (13.7%) patients. Recurrent rates according to site of recurrence were 26 peritoneal seeding (51.0%), 26 locoregional (51.0%), 17 hematogenous (33.3%), and 4 lymph node metastasis (7.8%). Clinicopathological factors to predict peritoneal seeding were serosal exposure, lymphovascular invasion, Lauren's diffuse type differentiation and scirrhous stromal reaction. Serosal exposure, tumor size, microscopic infiltrating growth type predicts locoregional recurrence. Tumor had only lymphovascular invasion predict hematogenous spreading. Conclusion: Node-negative advanced gastric cancer has more peritoneal seeding and locoregional recurrence. Aggressive cell behavior predicted the route of tumor cell spreading.

Background Patients who wear mandibular dentures and hold their tongues in retracted positions alter the dimensions of the sublingual space and disrupt the peripheral seal that is needed for optimal denture retention. The authors studied whether retention could be improved if patients moved their tongues from a retracted resting position to an ideal resting position. Methods The authors observed and classified the mandibular residual ridge morphologies of 85 participants who wore complete dentures. The authors recorded and compared the retention of the mandibular denture before and after repositioning the tongue to the ideal resting position. Results When the participants’ tongues were in a retracted resting position, the average retention of the mandibular denture was 75.38 gram weight (± 81.83 standard deviation [SD]). After participants repositioned their tongues to the ideal resting position, the average retention of the mandibular denture was 118.89 gw (± 93.00 SD), an increase of 57.73 percent. Conclusions In all morphological classes, when participants held their tongues in the ideal resting position, the average mandibular denture retention increased by 57.73 percent, a statistically significant improvement compared with when participants held their tongues in a retracted resting position. Clinical Implications Clinicians are encouraged to evaluate carefully the tongue resting position in all patients who wear dentures, help create reasonable therapeutic expectations by informing patients about the significant effect that tongue position will have on future denture retention and provide helpful neuromuscular training for patients with retracted-tongue habits.

A soft palate defect may result from surgical resection, and its consequences could include hypernasal speech and nasal regurgitation of food and liquids. A speech aid prosthesis fabricated for patients can improve nasal emission during speech, and assist in preventing nasal regurgitation of food. This article presents a case of the reconstruction of a soft palate defect by prosthetic obturation.

Background: Presence or absence of nodal metastasis influences outcome of gastric cancer patients. This study gives insight into survival predictors and clinicopathological features of node-negative gastric adenocarcinoma. Methods: Between 1988 and 1999, 689 gastric cancer patients without other cancer or gastrectomy for benign disease who underwent curative resection were enrolled in this study. Clinicopathological data in patients with node metastasis were compared with those without. Results: The survival rate at 5 and 10 years for node-negative cases was 91.7% and 89.7%, respectively. On univariate analysis, node-negative patients were characterized by frequent location in the lower two-thirds of the stomach (84.9%), tumor size less than 4 cm (63.5%), grossly superficial type (71.6%), more medullary stromal reaction (50.5%) and intestinal type (67.7%), tumor invasion confined to serosa (78.4%), less poorly differentiated cell type (43.2%), and less lymphovascular invasion (33.4%). Multivariate analysis demonstrated that lymphovascular invasion (relative risk: 5.036) and depth of cancer invasion (relative risk: 4.404) were independent poor prognostic factors. However, lymphovascular invasion and serosal invasion were also correlated (P

Background Cohort studies have found that short and long sleep are both associated with worse outcomes, compared with intermediate sleep times. While demonstrated biological mechanisms could explain health effects for short sleep, long-sleep risk is puzzling. Most studies reporting the U shape use a single question about sleep duration, a measurement method that does not correlate highly with objectively measured sleep. We hypothesised that the U shape, especially the poor outcomes for long sleepers, may be an artefact of how sleep is measured. Methods We examined the cross-sectional prevalence of fair/poor health by sleep hour categories (≤6, ≤7, ≤8, ≤9, >9 h) in a national US sample of adults aged 62–90 that included several types of sleep measures (n=727). Survey measures were: a single question; usual bedtimes and waking times; and a 3-day sleep log. Actigraphy measures were the sleep interval and total sleep time. Fair/poor health was regressed on sleep hour categories adjusted for demographics, with tests for both linear trend and U shape. Results Adjusted OR of fair/poor health across sleep hour categories from the single question were 4.6, 2.2, referent (8 h), 1.8 and 6.9. There was high prevalence of fair/poor health for ≤6 h for all sleep measures, but the long-sleep effect was absent for sleep logs and actigraphy measures. Conclusions Associations between long sleep and poor health may be specific to studies measuring sleep with survey questions. As cohorts with actigraphy mature, our understanding of how sleep affects health may change.

Purpose: The aim of this study was to explore individual (ie, sociodemographic characteristics, patient personality) and clinical factors (ie, dentist-patient communication, denture quality) associated with complete denture satisfaction among the Taiwanese elderly population. Materials and Methods: A multistage sampling and cross-sectional design was used to collect data. A total of 387 fully edentulous citizens, aged 65 years and older and who had received new sets of complete dentures, were selected. The participants completed clinical dental examinations and questionnaires by personal interview to collect information on denture satisfaction and associated variables. The relationship among three groups of these participants (satisfied, neutral, and dissatisfied) and potential factors were simultaneously examined using polytomous logistic regression analysis. Results: Overall, 36.7% of the participants were dissatisfied with their dentures. Living status (crude odds ratio [COR] = 2.04), personality (COR = 4.86), dentist-patient communication (COR = 7.46), and denture quality (COR = 5.02) were associated with complete denture satisfaction. The multivariate regression model showed that dentist-patient communication (adjusted odds ratio [AOR] = 6.41) and denture quality (AOR = 4.40) were significant complete denture satisfaction factors that diluted the effect of living status and personality. Conclusions: Inadequate dentistpatient communication and low denture quality were associated with the dissatisfaction of patients with dentures. To increase complete denture satisfaction, the importance of training programs aimed at enhancing dentist-patient communication and denture quality cannot be overemphasized.

Sleep is a restorative behavior essential for health. Poor sleep has been linked to adverse health outcomes among older adults; however, we know little about the social processes that affect sleep. Using innovative actigraphy data from the National Social Life, Health, and Aging Project ( N = 727), we considered the role of marriage, positive marital relationship support, and negative marital relationship strain on older adults’ (ages 62–90) self-reported and actigraph-measured sleep characteristics. We found that married older adults had better actigraph-estimated but not self-reported sleep characteristics than the unmarried. However, among the married, those who reported more negative aspects of their marital relationship reported more insomnia symptoms, with the association reduced when psychosocial characteristics were added to the model. The married who reported more positive aspects of their marital relationship showed better actigraph-estimated sleep characteristics; taking characteristics of the physical and mental health and home environment into account reduced this association.

Recurrence after curative resection for gastric cancer remains high. We examined its incidence and factors related to recurrence pattern, while trying to avoid the interaction of various factors. A total of 611 gastric cancer patients after resection for curative intent (1988-1995) were analyzed. The result showed that 245 patients had recurrence (40.1%). Cumulative recurrence rates were 53.5%, 80%, 89.0%, 94.7%, 96.3%, 98%, and 99.5% at 1, 2, 3, 4, 5, 6, and 7 years, respectively. Over half of patients with recurrence (123; 50.2%) had an initial single recurrence. Taking single and multiple recurrence together, most recurrences (213; 86.9%) were distant metastases, 110 recurrences (44.9%) were local relapses, and 78 recurrences (49.8%) were both local and distant. Among the distant metastases, 131 patients (53.5%) had peritoneal dissemination, 106 patients (43.3%) had hematogenous metastases, and 70 patients (28.6%) had distant lymphatic spread. Scirrhous-type stromal reaction, serosa invasion, and female gender were factors negatively related to peritoneal recurrence. Medullary-type stromal reaction and male gender showed a preference for locoregional recurrence, and expanding growth tumor commonly led to hematogenous metastasis. Patients who had paraaortic lymph node metastasis were at high risk of developing distant lymphatic recurrence. It is conceivable that the patterns of recurrence and the times to recurrence provide a biological basis for clinical monitoring of patients with the aim of modifying therapeutic modalities.

Background Minimally invasive surgery, including laparoscopic and robotic gastrectomy, has become more popular in the treatment of gastric cancer. However, few studies have compared the learning curves between laparoscopic and robotic gastrectomy for gastric cancer. Methods Data were prospectively collected between July 2008 and Aug 2014. A total of 145 patients underwent minimally invasive gastrectomy for gastric cancer by a single surgeon, including 73 laparoscopic and 72 robotic gastrectomies. The clinicopathologic characteristics, operative outcomes and learning curves were compared between the two groups. Results Compared with the laparoscopic group, the robotic group was associated with less blood loss and longer operative time. After the surgeon learning curves were overcome for each technique, the operative outcomes became similar between the two groups except longer operative time in the robotic group. After accumulating more cases of robotic gastrectomy, the operative time in the laparoscopic group decreased dramatically. Conclusions After overcoming the learning curves, the operative outcomes became similar between laparoscopic and robotic gastrectomy. The experience of robotic gastrectomy could affect the learning process of laparoscopic gastrectomy.

Designing a smartphone system can be a challenging task since it contains complex hardware and software components. The design space of an Android smartphone is very large as it spans over many hardware parameters such as the processor pipeline, cache configurations, memory capacity, as well as software configurations and tunables in the operating system, middleware, and applications. It is desirable to have a set of design space exploration (DSE) tools which can be used to find good design points in such a large space. However, traditional architectural simulation tools are too slow to explore the design space in a timely fashion. To facilitate DSE for Android smartphones, we proposed a framework, called ADSET, which adopt a fast full-system modeling technique and a parallel DSE method to concurrently evaluate multiple design points. In this paper, we explain the framework in details and evaluate the effectiveness of ADSET in finding good designs in a large design space.

Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.