Objectives: The goal of this study was to assess the relations of electrocardiographic QRS duration to left ventricular(LV)measurements in individuals without heart failure(HF) or prior myocardial infarction(MI). Back...Objectives: The goal of this study was to assess the relations of electrocardiographic QRS duration to left ventricular(LV)measurements in individuals without heart failure(HF) or prior myocardial infarction(MI). Background: Increased electrocardiographic QRS duration(< 120 ms) is a marker of ventricular dyssynchrony. Methods: We evaluated the relations of maximal electrocardiographic QRS duration to echocardiographic LV dimensions in 4,534 Framingham Heart study participants(mean age 54 years, 57% women) without prior HF or MI. QRS duration was analyzed as a continuous variable and as categories(< 100, 100 to 119, and< 120 ms). Results: In linear regression models, LV mass, end- diastolic dimension, and septal and posterior wall thicknesses were positively related to log- QRS duration, whereas fractional shortening(FS) was inversely related(p< 0.001). There was a significant trend for increasing LV mass and dimensions, and decreasing FS across categories of QRS duration(p< 0.001). Left bundle branch block was associated with higher LV mass and lower FS compared with a normal QRS duration(p< 0.001). Conclusions: In our community- based sample of individuals free of HF and MI, increasing electrocardiographic QRS duration was positively related to LV mass and dimensions, and inversely associated with LV FS. Additional investigations are warranted to elucidate the mechanisms underlying the observed associations.展开更多
AIM To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease(NAFLD) in United States population.METHODS Using the National Health and Nutrition Examination Survey(NHANES...AIM To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease(NAFLD) in United States population.METHODS Using the National Health and Nutrition Examination Survey(NHANES) 1988-1994, NAFLD participants aged 20 or greater without any other liver diseases were included in this study. Excessive alcohol intake is defined as > 2 drinks per day for males and > 1 drink per day for females. C-peptide and 27 other factors known to be associated with NAFLD(e.g., age, gender, body mass index, waist circumference, race/ethnicity, liver chemistries, and other diabetes tests) were tested in both univariate and multivariate level using logistic regression with a P-value 0.05.RESULTS Of 18825 participants aged ≥ 20, 3235 participants(n = 3235) met inclusion criteria. There were 23 factors associated with NAFLD by univariate analysis. 9 factors, ranked by the highest change in pseudo R2, were found to be significant predictors of NAFLD in multivariate model: waist circumference, fasting C-peptide, natural log of alanine aminotransferase(ALT), total protein, beingMexican American, natural log of glycated hemoglobin, triglyceride level, being non-Hispanic white, and ferritin level. CONCLUSION Together with waist circumference and ALT, fasting C-peptide is among three most important predictors of NAFLD in United States population in the NHANES data set. Further study is needed to validate the clinical utility of fasting C-peptide in diagnosis or monitoring insulin resistance in NAFLD patients.展开更多
Android applications are associated with a large amount of sensitive data,therefore application developers use encryption algorithms to provide user data encryption,authentication and data integrity protection.However...Android applications are associated with a large amount of sensitive data,therefore application developers use encryption algorithms to provide user data encryption,authentication and data integrity protection.However,application developers do not have the knowledge of cryptography,thus the cryptographic algorithm may not be used correctly.As a result,security vulnerabilities are generated.Based on the previous studies,this paper summarizes the characteristics of password misuse vulnerability of Android application software,establishes an evaluation model to rate the security level of the risk of password misuse vulnerability and develops a repair strategy for password misuse vulnerability.And on this basis,this paper designs and implements a secure container for Android application software password misuse vulnerability:CM-Droid.展开更多
Detecting double Joint Photographic Experts Group (JPEG) compressionfor color images is vital in the field of image forensics. In previousresearches, there have been various approaches to detecting double JPEGcompress...Detecting double Joint Photographic Experts Group (JPEG) compressionfor color images is vital in the field of image forensics. In previousresearches, there have been various approaches to detecting double JPEGcompression with different quantization matrices. However, the detectionof double JPEG color images with the same quantization matrix is stilla challenging task. An effective detection approach to extract features isproposed in this paper by combining traditional analysis with ConvolutionalNeural Networks (CNN). On the one hand, the number of nonzero pixels andthe sum of pixel values of color space conversion error are provided with 12-dimensional features through experiments. On the other hand, the roundingerror, the truncation error and the quantization coefficient matrix are used togenerate a total of 128-dimensional features via a specially designed CNN. Insuch aCNN, convolutional layers with fixed kernel of 1×1 and Dropout layersare adopted to prevent overfitting of the model, and an average pooling layeris used to extract local characteristics. In this approach, the Support VectorMachine (SVM) classifier is applied to distinguishwhether a given color imageis primarily or secondarily compressed. The approach is also suitable for thecase when customized needs are considered. The experimental results showthat the proposed approach is more effective than some existing ones whenthe compression quality factors are low.展开更多
Content aware image resizing(CAIR)is an excellent technology used widely for image retarget.It can also be used to tamper with images and bring the trust crisis of image content to the public.Once an image is processe...Content aware image resizing(CAIR)is an excellent technology used widely for image retarget.It can also be used to tamper with images and bring the trust crisis of image content to the public.Once an image is processed by CAIR,the correlation of local neighborhood pixels will be destructive.Although local binary patterns(LBP)can effectively describe the local texture,it however cannot describe the magnitude information of local neighborhood pixels and is also vulnerable to noise.Therefore,to deal with the detection of CAIR,a novel forensic method based on improved local ternary patterns(ILTP)feature and gradient energy feature(GEF)is proposed in this paper.Firstly,the adaptive threshold of the original local ternary patterns(LTP)operator is improved,and the ILTP operator is used to describe the change of correlation among local neighborhood pixels caused by CAIR.Secondly,the histogram features of ILTP and the gradient energy features are extracted from the candidate image for CAIR forgery detection.Then,the ILTP features and the gradient energy features are concatenated into the combined features,and the combined features are used to train classifier.Finally support vector machine(SVM)is exploited as a classifier to be trained and tested by the above features in order to distinguish whether an image is subjected to CAIR or not.The candidate images are extracted from uncompressed color image database(UCID),then the training and testing sets are created.The experimental results with many test images show that the proposed method can detect CAIR tampering effectively,and that its performance is improved compared with other methods.It can achieve a better performance than the state-of-the-art approaches.展开更多
BACKGROUND Older men are more vulnerable to fatal falls than women,and gait disturbances contribute to the risk of falls.Studies have assessed the association between arterial stiffness and gait dysfunction,but the re...BACKGROUND Older men are more vulnerable to fatal falls than women,and gait disturbances contribute to the risk of falls.Studies have assessed the association between arterial stiffness and gait dysfunction,but the results have been inconclusive.This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial–ankle pulse wave velocity(baPWV)and gait assessment in older men.METHODS Data from the 2014–2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis.The inclusion criteria were men aged>65 years with gait assessment[the 30-s chair stand test(30s-CST),the timed up and go(TUG)test,the figure-of-8 walk(F8W)test,the 2-min step test(2MST),and the 6-min walk test(6MWT)]and baPWV measurement data.Generalized linear regression analysis was conducted with multiple confounding factor adjustments,including lower extremity isometric strength.RESULTS A total of 291 participants were included in the analysis.The mean age was 71.38±4.40 years.The mean values were as follows:(1)30s-CST,17.48±5.00;(2)TUG test,6.01±1.10 s;(3)F8W test,25.65±4.71 s;(4)2MST,102.40±18.83 per 2 min;and(5)6MWT,500.02±85.65 m.After multivariable adjustment,baPWV was associated with the 6MWT(β=−0.037,95%CI:−0.072–−0.002),TUG test(β=0,95%CI:0.000–0.001),and F8W test(β=0.002,95%CI:0.000–0.004).baPWV was not associated with the 30s-CST and 2MST.CONCLUSIONS The current study showed a statistically significant association between gait assessments and arterial stiffness,independent of lower extremity strength.However,this association was modest.Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.展开更多
Background: The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based ...Background: The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based setting. Methods: We examined the cross-sectional association of heart failure in parents with the prevalence of left ventricular systolic dysfunction, as well as left ventricular mass, internal dimensions, and wall thickness, in 1497 participants of the Framingham Offspring Study(mean age, 57 years; 819 women) who underwent routine echocardiography. We also investigated prospectively whether heart failure in parents increased the risk of heart failure in 2214 offspring(mean age, 44 years; 1150 women). Results: As compared with the 1039 participants whose parents did not have heart failure, the 458 participants in the cross-sectional cohort who had at least one parent with heart failure were more likely to have increased left ventricular mass(17.0 percent vs. 26.9 percent), left ventricular internal dimensions(18.6 percent vs. 23.4 percent), and left ventricular systolic dysfunction(3.1 percent vs. 5.7 percent); the multivariable-adjusted odds ratios were 1.35(95 percent confidence interval, 0.99 to 1.84), 1.29(95 percent confidence interval, 0.96 to 1.72), and 2.37(95 percent confidence interval, 1.22 to 4.61), respectively. In the longitudinal cohort, heart failure developed in 90 offspring during follow-up(mean length of follow-up, 20 years). The age-and sex-adjusted 10-year incidence rates of heart failure were 2.72 percent among offspring with a parent with heart failure, as compared with 1.62 percent among those without a parent with heart failure. This increase in risk persisted after multivariable adjustment(hazard ratio, 1.70; 95 percent confidence interval, 1.11 to 2.60). Conclusions: Heart failure in parents is associated with an increased prevalence of left ventricular systolic dysfunction cross-sectionally and an elevated risk of heart failure longitudinally. Our data emphasize the contribution of familial factors to the heart-failure burden in the community.展开更多
Background: Clinical trials indicate that a sizable proportion of adults have multiple borderline coronary risk factors and may benefit from treatment. Objective: To estimate the relative and absolute contributions of...Background: Clinical trials indicate that a sizable proportion of adults have multiple borderline coronary risk factors and may benefit from treatment. Objective: To estimate the relative and absolute contributions of borderline and elevated risk factors to the population burden of coronary heart disease(CHD) events. Design: A prospective cohort study and a national cross- sectional survey. Setting: The Framingham Study and the Third National Health and Nutrition Examination Survey(NHANES III). Participants: White non- Hispanic persons in the Framingham Study and in NHANES III who were between 35 to 74 years of age and had no CHD. Measurements: Occurrence of first CHD events according to 5 major CHD risk factors: blood pressure, low- density lipoprotein and high- density lipoprotein cholesterol levels, glucose intolerance, and smoking. Three categories- optimal, borderline, and elevated- were defined for each risk factor per national guidelines. Sex- specific 10- year CHD event rates from the Framingham Study were applied to numbers of at- risk individuals estimated from NHANES III and the 2000 U.S. Census. Results: Twenty- six percent of men and 41% of women had at least 1 borderline risk factor in NHANES III. According to estimates, more than 90% of CHD events will occur in individuals with at least 1 elevated risk factor, and approximately 8% will occur in people with only borderline levels of multiple risk factors. Absolute 10- year CHD risk exceeded 10% in men older than age 45 years who had 1 elevated risk factor and 4 or more borderline risk factors and in those who had at least 2 elevated risk factors. In women, absolute CHD risk exceeded 10% only in those older than age 55 years who had at least 3 elevated risk factors. Limitations: The generalizability of the findings to persons of other ethnic backgrounds is unknown. Conclusions: Borderline CHD risk factors alone account for a small proportion of CHD events.展开更多
Investigators have suggested that inflammation may play a role in the pathogenesis of valve calcium. Participants in the Framingham Heart Study’s offspring cohort had systemic levels of C-reactive protein, intercellu...Investigators have suggested that inflammation may play a role in the pathogenesis of valve calcium. Participants in the Framingham Heart Study’s offspring cohort had systemic levels of C-reactive protein, intercellular adhesion molecule-1, interleukin-6, and monocyte chemoattractant protein-1 measured at examination cycle 7. Mitral annular calcium, aortic annular calcium, aortic sclerosis, and aortic stenosis were assessed by echocardiography at examination cycle 6. Logistic regression was used to examine the odds of valvular calcium per 1 unit increase in inflammation(ISUM), a summary statistic of all normalized deviates of the individual markers. Two thousand six hundred eighty-three participants(mean age 61±10 years; 52%women) were analyzed: 8.2%(n=216) had ≥1 calcified valve or annulus; 89 had mitral annular calcium, 78 had aortic annular calcium, 135 had aortic sclerosis, and 33 had aortic stenosis. Participants with valvular calcium were older and were more likely to have hypertension and diabetes mellitus. Participants with valve calcium had higher median levels of all markers. For each log unit increase in ISUM, after adjustment for age and gender, there was an associated 1.1-fold increased odds of ≥1 calcified valve(p=0.02); the odds ratios were no longer significant after adjustment for cardiovascular disease risk factors(odds ratio 1.0, 95%confidence interval 0.9 to 1.1). Similar results were obtained for the individual markers and the odds of ≥1 calcified valve. In conclusion, inflammatory markers were elevated in patients with valvular calcium. Our findings suggest that much of the observed association between systemic inflammatory markers and valvular calcium may be due to shared risk factors.展开更多
As has been observed by Morse [1], any generic vector field v on a compact smooth manifold X with boundary gives rise to a stratification of the boundary by compact submanifolds , where . Our main observation is that ...As has been observed by Morse [1], any generic vector field v on a compact smooth manifold X with boundary gives rise to a stratification of the boundary by compact submanifolds , where . Our main observation is that this stratification re-flects the stratified convexity/concavity of the boundary ?with respect to the ?v-flow. We study the behavior of this stratification under deformations of the vector field v. We also investigate the restrictions that the existence of a convex/concave traversing ?v-flow imposes on the topology of X. Let be the orthogonal projection of on the tangent bundle of . We link the dynamics of theon the boundary with the property of in X being convex/concave. This linkage is an instance of more general phenomenon that we call “holography of traversing fields”—a subject of a different paper to follow.展开更多
Context: Obesity is associated with atrial enlargement and ventricular diastol ic dysfunction, both known predictors of atrial fibrillation(AF). However, it is unclear whether obesity is a risk factor for AF. Objectiv...Context: Obesity is associated with atrial enlargement and ventricular diastol ic dysfunction, both known predictors of atrial fibrillation(AF). However, it is unclear whether obesity is a risk factor for AF. Objective: To examine the asso ciation between body mass index(BMI) and the risk of developing AF. Design, Sett ing, and Participants: Prospective, communitybased observational cohort in Fra mingham, Mass. We studied 5282 participants(mean age, 57[SD, 13] years; 2898 wom en[55%]) without baseline AF(electrocardiographic AF or arterial flutter). Body mass index(calculated as weight in kilograms divided by square of height in met ers) was evaluated as both a continuous and a categorical variable(normal define d as < 25.0; overweight, 25.0 to < 30.0; and obese, ≥30.0). In addition to adju sting for clinical confounders by multivariable techniques, we also examined mod els including echocardiographic left atrial diameter to examine whether the infl uence of obesity was mediated by changes in left atrial dimensions. Main Outcome Measure: Association between BMI or BMI category and risk of developing newon set AF. Results: During a mean followup of 13.7 years, 526 participants(234 wo men) developed AF. Age adjusted incidence rates for AF increased across the 3 BM I categories in men(9.7, 10.7, and 14.3 per 1000 personyears) and women(5.1, 8 .6, and 9.9 per 1000 personyears). In multivariable models adjusted for cardio vascular risk factors and interim myocardial infarction or heart failure, a 4%i ncrease in AF risk per 1-unit increase in BMI was observed in men(95%confidenc e interval[CI], 1%-7%; P=.02) and in women(95%CI, 1%-7%; P=.009). Adjuste d hazard ratios for AF associated with obesity were 1.52(95%CI, 1.09-2.13; P=. 02) and 1.46(95%CI, 1.03-2.07; P=.03) for men and women, respectively, compare d with individuals with normal BMI. After adjustment for echocardiographic left atrial diameter in addition to clinical risk factors, BMI was no longer associat ed with AF risk(adjusted hazard ratios per 1-unit increase in BMI, 1.00[95%CI, 0.97-1.04], P=.84 in men; 0.99 [95%CI, 0.96-1.02], P=.56 in women). Conclusi ons: Obesity is an important, potentially modifiable risk factor for AF. The exc ess risk of AF associated with obesity appears to be mediated by left atrial dil atation. These prospective data raise the possibility that interventions to prom ote normal weight may reduce the population burden of AF.展开更多
The anti-incretin theory involving the abolishment of diabetes type(DT)II by some of methods used in bariatric surgery,first appeared during the early years of the XXI century and considers the existence of anti-incre...The anti-incretin theory involving the abolishment of diabetes type(DT)II by some of methods used in bariatric surgery,first appeared during the early years of the XXI century and considers the existence of anti-incretin substances.However,to date no exogenous or endogenous anti-incretins have been found.Our concept of the acini-islet-acinar axis assumes that insulin intra-pancreatically stimulates alpha-amylase synthesis(“halo phenomenon”)and in turn,alphaamylase reciprocally inhibits insulin production,thus making alpha-amylase a candidate for being an anti-incretin.Additionally,gut as well as plasma alphaamylase,of pancreatic and other origins,inhibits the appearance of dietary glucose in the blood,lowering the glucose peak after iv or oral glucose loading.This effect of alpha-amylase can be interpreted as an insulin down regulatory mechanism,possibly limiting the depletion of pancreatic beta cells and preventing their failure.Clinical observations agree with the above statements,where patients with high blood alpha-amylase concentrations are seldom obese and seldom develop DT2.Obese-DT2,as well as DT1 patients,usually develop exocrine pancreatic insufficiency(EPI)and vice versa.Ultimately,DT2 patients develop DT1,when the pancreatic beta cells are exhausted and insulin production ceases.Studies on biliopancreatic diversion(BPD)and on BPD with duodenal switch,a type of bariatric surgery,as well as studies on EPI pigs,allow us to observe and investigate the above-mentioned phenomena of intra-pancreatic interactions.展开更多
Context: Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have e xperienced similar declines in CVD risk. Objective: To det...Context: Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have e xperienced similar declines in CVD risk. Objective: To determine whether adults with and without diabetes experienced similar declines in incident CVD in 1950- 1995. Design, Setting, and Participants: Participants aged 4564 years from the F ramingham Heart Study original and offspring cohorts who attended examinations i n 19501966 ("earlier"time period; 4118 participants, 113 with diabetes) and 1977-1995 ("later"time period; 4063 participants, 317 with diabetes). Incid ence rates of CVD among those with and without diabetes were compared between th e earlier and later periods. Main Outcome Measures: Myocardial infarction, coron ary heart disease death, and stroke. Results: Among participants with diabetes, the age-and sex-adjusted CVD incidence rate was 286.4 per 10000 person-years in the earlier period and 146.9 per 10000 in the later period, a 49.3%(95%conf idence interval [Cl], 16.7%-69.4%) decline. Among participants without diabet es, the age-and sex-adjusted incidence rate was 84.6 per 10000 person-years i n the earlier period and 54.3 per 10000 person-yearsin the later period, a 35.4 %(95%Cl, 25.3%-45.4%) decline. Hazard ratios for diabetes as a predictor of incident CVD were not different in the earlier vs later periods. Conclusions: W e report a 50%reduction in the rate of incident CVD events among adults with di abetes, although the absolute risk of CVD is 2-fold greater than among persons without diabetes. Adults with and without diabetes have benefited similarly duri ng the decline in CVD rates over the last several decades. More aggressive treat ment of CVD risk factors and further research on diabetes-specific factors cont ributing to CVD risk are needed to further reduce the high absolute risk of CVD still experienced by persons with diabetes.展开更多
Background: The high power output necessary for insect flight has driven the evolution of muscles with large myofibrils (primary energy consumers) and abundant mitochondria (primary energy suppliers). The intricate fu...Background: The high power output necessary for insect flight has driven the evolution of muscles with large myofibrils (primary energy consumers) and abundant mitochondria (primary energy suppliers). The intricate functional interrelationship between these two organelles remains largely unknown despite its fundamental importance in understanding insect flight bioenergetics. Unlike vertebrate muscle that relies on a phosphagen (creatine phosphate/creatine kinase) system to regulate high energy phosphate flux, insect flight muscle has been reported to lack mitochondrial arginine kinase (analogous to creatine kinase), a key enzyme that enables intracellular energy transport. Creatine kinase is known to interact with mitochondrial adenine nucleotide translocase (ANT) in the transfer of ADP and ATP into and out of the mitochondria. Results: Here, we use quantitative immunogold transmission electron microscopy to show that in Drosophila melanogaster indirect flight muscles (IFM), ANT is present in the mitochondria as well as throughout the myofibril. To confirm this unexpected result, we created a transgenic line that expresses a chimeric GFP-ANT protein and used an anti-GFP antibody to determine the intracellular distribution of the fusion protein in the IFM. Similar to results obtained with anti-ANT, the fusion GFP-ANT protein is detected in myofibrils and mitochondria. We confirmed the absence of arginine kinase from IFM mitochondria and show that its sarcomeric (i.e., intramyofibrillar) distribution is similar to that of ANT. Conclusions: These results raise the possibility that direct channeling of nucleotides between mitochondria and myofibrils is assisted by an ANT protein thereby circumventing the need for a phosphagen shuttle in the IFM. The myofibrillar ANT may represent a unique adaptation in the muscles that require efficient exchange of nucleotides between mitochondria and myofibrils.展开更多
Purpose:The article examines the role of digital and,in particular,social media in business-to-business marketing in the international software industry.The authors responded to calls for empirical research on how the...Purpose:The article examines the role of digital and,in particular,social media in business-to-business marketing in the international software industry.The authors responded to calls for empirical research on how these media impact buyer-vendor relationships and the conjunction of the marketing and sales processes,particularly the distribution of complex software solutions.This paper develops a digital framework and discusses the managerial consequences.Design/methodology/approach:The model arises by merging themes derived from literature,experts,and job descriptions.Mixed Methods included conducting semi-structured interviews across marketing,business development,and sales executives from buyers,vendors,and third parties of various industries,supplemented by a survey of 530+executives.Findings:Multinational companies secure competitive advantage through agile business processes to improve buyer-vendor relationships in the digital era.Digital media enable vendors to interact continuously with buyers,gather intelligence,and foster mutually beneficial,trustworthy,long-term relationships.The objective is to prompt transactions and secure revenue streams.Research limitations/implications:The outcomes of this research center on North America,Western Europe(including the UK),and DACH(Germany-Austria-Switzerland),affecting the generalizability.Originality/value:The research is novel and bridges several gaps concerning industrial relationships in digitalization:it merges buyer,vendor,and third-party’s perspectives on an international scale.It provides deeper insights into existing and new relationships by identifying relevant digital/social media platforms,the underlying usage motivation,and fundamental B2B processes.Finally,it equips practitioners with metrics to improve performance.展开更多
文摘Objectives: The goal of this study was to assess the relations of electrocardiographic QRS duration to left ventricular(LV)measurements in individuals without heart failure(HF) or prior myocardial infarction(MI). Background: Increased electrocardiographic QRS duration(< 120 ms) is a marker of ventricular dyssynchrony. Methods: We evaluated the relations of maximal electrocardiographic QRS duration to echocardiographic LV dimensions in 4,534 Framingham Heart study participants(mean age 54 years, 57% women) without prior HF or MI. QRS duration was analyzed as a continuous variable and as categories(< 100, 100 to 119, and< 120 ms). Results: In linear regression models, LV mass, end- diastolic dimension, and septal and posterior wall thicknesses were positively related to log- QRS duration, whereas fractional shortening(FS) was inversely related(p< 0.001). There was a significant trend for increasing LV mass and dimensions, and decreasing FS across categories of QRS duration(p< 0.001). Left bundle branch block was associated with higher LV mass and lower FS compared with a normal QRS duration(p< 0.001). Conclusions: In our community- based sample of individuals free of HF and MI, increasing electrocardiographic QRS duration was positively related to LV mass and dimensions, and inversely associated with LV FS. Additional investigations are warranted to elucidate the mechanisms underlying the observed associations.
文摘AIM To determine whether fasting C-peptide is an independent predictor for non-alcoholic fatty liver disease(NAFLD) in United States population.METHODS Using the National Health and Nutrition Examination Survey(NHANES) 1988-1994, NAFLD participants aged 20 or greater without any other liver diseases were included in this study. Excessive alcohol intake is defined as > 2 drinks per day for males and > 1 drink per day for females. C-peptide and 27 other factors known to be associated with NAFLD(e.g., age, gender, body mass index, waist circumference, race/ethnicity, liver chemistries, and other diabetes tests) were tested in both univariate and multivariate level using logistic regression with a P-value 0.05.RESULTS Of 18825 participants aged ≥ 20, 3235 participants(n = 3235) met inclusion criteria. There were 23 factors associated with NAFLD by univariate analysis. 9 factors, ranked by the highest change in pseudo R2, were found to be significant predictors of NAFLD in multivariate model: waist circumference, fasting C-peptide, natural log of alanine aminotransferase(ALT), total protein, beingMexican American, natural log of glycated hemoglobin, triglyceride level, being non-Hispanic white, and ferritin level. CONCLUSION Together with waist circumference and ALT, fasting C-peptide is among three most important predictors of NAFLD in United States population in the NHANES data set. Further study is needed to validate the clinical utility of fasting C-peptide in diagnosis or monitoring insulin resistance in NAFLD patients.
基金This work is supported by The National Natural Science Foundation of China (Nos.U1536121,61370195).
文摘Android applications are associated with a large amount of sensitive data,therefore application developers use encryption algorithms to provide user data encryption,authentication and data integrity protection.However,application developers do not have the knowledge of cryptography,thus the cryptographic algorithm may not be used correctly.As a result,security vulnerabilities are generated.Based on the previous studies,this paper summarizes the characteristics of password misuse vulnerability of Android application software,establishes an evaluation model to rate the security level of the risk of password misuse vulnerability and develops a repair strategy for password misuse vulnerability.And on this basis,this paper designs and implements a secure container for Android application software password misuse vulnerability:CM-Droid.
基金Supported by the Fundamental Research Funds for the Central Universities (No.500421126)。
文摘Detecting double Joint Photographic Experts Group (JPEG) compressionfor color images is vital in the field of image forensics. In previousresearches, there have been various approaches to detecting double JPEGcompression with different quantization matrices. However, the detectionof double JPEG color images with the same quantization matrix is stilla challenging task. An effective detection approach to extract features isproposed in this paper by combining traditional analysis with ConvolutionalNeural Networks (CNN). On the one hand, the number of nonzero pixels andthe sum of pixel values of color space conversion error are provided with 12-dimensional features through experiments. On the other hand, the roundingerror, the truncation error and the quantization coefficient matrix are used togenerate a total of 128-dimensional features via a specially designed CNN. Insuch aCNN, convolutional layers with fixed kernel of 1×1 and Dropout layersare adopted to prevent overfitting of the model, and an average pooling layeris used to extract local characteristics. In this approach, the Support VectorMachine (SVM) classifier is applied to distinguishwhether a given color imageis primarily or secondarily compressed. The approach is also suitable for thecase when customized needs are considered. The experimental results showthat the proposed approach is more effective than some existing ones whenthe compression quality factors are low.
文摘Content aware image resizing(CAIR)is an excellent technology used widely for image retarget.It can also be used to tamper with images and bring the trust crisis of image content to the public.Once an image is processed by CAIR,the correlation of local neighborhood pixels will be destructive.Although local binary patterns(LBP)can effectively describe the local texture,it however cannot describe the magnitude information of local neighborhood pixels and is also vulnerable to noise.Therefore,to deal with the detection of CAIR,a novel forensic method based on improved local ternary patterns(ILTP)feature and gradient energy feature(GEF)is proposed in this paper.Firstly,the adaptive threshold of the original local ternary patterns(LTP)operator is improved,and the ILTP operator is used to describe the change of correlation among local neighborhood pixels caused by CAIR.Secondly,the histogram features of ILTP and the gradient energy features are extracted from the candidate image for CAIR forgery detection.Then,the ILTP features and the gradient energy features are concatenated into the combined features,and the combined features are used to train classifier.Finally support vector machine(SVM)is exploited as a classifier to be trained and tested by the above features in order to distinguish whether an image is subjected to CAIR or not.The candidate images are extracted from uncompressed color image database(UCID),then the training and testing sets are created.The experimental results with many test images show that the proposed method can detect CAIR tampering effectively,and that its performance is improved compared with other methods.It can achieve a better performance than the state-of-the-art approaches.
基金supported by the Korea Sport Promotion Foundation。
文摘BACKGROUND Older men are more vulnerable to fatal falls than women,and gait disturbances contribute to the risk of falls.Studies have assessed the association between arterial stiffness and gait dysfunction,but the results have been inconclusive.This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial–ankle pulse wave velocity(baPWV)and gait assessment in older men.METHODS Data from the 2014–2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis.The inclusion criteria were men aged>65 years with gait assessment[the 30-s chair stand test(30s-CST),the timed up and go(TUG)test,the figure-of-8 walk(F8W)test,the 2-min step test(2MST),and the 6-min walk test(6MWT)]and baPWV measurement data.Generalized linear regression analysis was conducted with multiple confounding factor adjustments,including lower extremity isometric strength.RESULTS A total of 291 participants were included in the analysis.The mean age was 71.38±4.40 years.The mean values were as follows:(1)30s-CST,17.48±5.00;(2)TUG test,6.01±1.10 s;(3)F8W test,25.65±4.71 s;(4)2MST,102.40±18.83 per 2 min;and(5)6MWT,500.02±85.65 m.After multivariable adjustment,baPWV was associated with the 6MWT(β=−0.037,95%CI:−0.072–−0.002),TUG test(β=0,95%CI:0.000–0.001),and F8W test(β=0.002,95%CI:0.000–0.004).baPWV was not associated with the 30s-CST and 2MST.CONCLUSIONS The current study showed a statistically significant association between gait assessments and arterial stiffness,independent of lower extremity strength.However,this association was modest.Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.
文摘Background: The association between heart failure in parents and the prevalence of left ventricular systolic dysfunction and the risk of heart failure in their offspring has not been investigated in a community-based setting. Methods: We examined the cross-sectional association of heart failure in parents with the prevalence of left ventricular systolic dysfunction, as well as left ventricular mass, internal dimensions, and wall thickness, in 1497 participants of the Framingham Offspring Study(mean age, 57 years; 819 women) who underwent routine echocardiography. We also investigated prospectively whether heart failure in parents increased the risk of heart failure in 2214 offspring(mean age, 44 years; 1150 women). Results: As compared with the 1039 participants whose parents did not have heart failure, the 458 participants in the cross-sectional cohort who had at least one parent with heart failure were more likely to have increased left ventricular mass(17.0 percent vs. 26.9 percent), left ventricular internal dimensions(18.6 percent vs. 23.4 percent), and left ventricular systolic dysfunction(3.1 percent vs. 5.7 percent); the multivariable-adjusted odds ratios were 1.35(95 percent confidence interval, 0.99 to 1.84), 1.29(95 percent confidence interval, 0.96 to 1.72), and 2.37(95 percent confidence interval, 1.22 to 4.61), respectively. In the longitudinal cohort, heart failure developed in 90 offspring during follow-up(mean length of follow-up, 20 years). The age-and sex-adjusted 10-year incidence rates of heart failure were 2.72 percent among offspring with a parent with heart failure, as compared with 1.62 percent among those without a parent with heart failure. This increase in risk persisted after multivariable adjustment(hazard ratio, 1.70; 95 percent confidence interval, 1.11 to 2.60). Conclusions: Heart failure in parents is associated with an increased prevalence of left ventricular systolic dysfunction cross-sectionally and an elevated risk of heart failure longitudinally. Our data emphasize the contribution of familial factors to the heart-failure burden in the community.
文摘Background: Clinical trials indicate that a sizable proportion of adults have multiple borderline coronary risk factors and may benefit from treatment. Objective: To estimate the relative and absolute contributions of borderline and elevated risk factors to the population burden of coronary heart disease(CHD) events. Design: A prospective cohort study and a national cross- sectional survey. Setting: The Framingham Study and the Third National Health and Nutrition Examination Survey(NHANES III). Participants: White non- Hispanic persons in the Framingham Study and in NHANES III who were between 35 to 74 years of age and had no CHD. Measurements: Occurrence of first CHD events according to 5 major CHD risk factors: blood pressure, low- density lipoprotein and high- density lipoprotein cholesterol levels, glucose intolerance, and smoking. Three categories- optimal, borderline, and elevated- were defined for each risk factor per national guidelines. Sex- specific 10- year CHD event rates from the Framingham Study were applied to numbers of at- risk individuals estimated from NHANES III and the 2000 U.S. Census. Results: Twenty- six percent of men and 41% of women had at least 1 borderline risk factor in NHANES III. According to estimates, more than 90% of CHD events will occur in individuals with at least 1 elevated risk factor, and approximately 8% will occur in people with only borderline levels of multiple risk factors. Absolute 10- year CHD risk exceeded 10% in men older than age 45 years who had 1 elevated risk factor and 4 or more borderline risk factors and in those who had at least 2 elevated risk factors. In women, absolute CHD risk exceeded 10% only in those older than age 55 years who had at least 3 elevated risk factors. Limitations: The generalizability of the findings to persons of other ethnic backgrounds is unknown. Conclusions: Borderline CHD risk factors alone account for a small proportion of CHD events.
文摘Investigators have suggested that inflammation may play a role in the pathogenesis of valve calcium. Participants in the Framingham Heart Study’s offspring cohort had systemic levels of C-reactive protein, intercellular adhesion molecule-1, interleukin-6, and monocyte chemoattractant protein-1 measured at examination cycle 7. Mitral annular calcium, aortic annular calcium, aortic sclerosis, and aortic stenosis were assessed by echocardiography at examination cycle 6. Logistic regression was used to examine the odds of valvular calcium per 1 unit increase in inflammation(ISUM), a summary statistic of all normalized deviates of the individual markers. Two thousand six hundred eighty-three participants(mean age 61±10 years; 52%women) were analyzed: 8.2%(n=216) had ≥1 calcified valve or annulus; 89 had mitral annular calcium, 78 had aortic annular calcium, 135 had aortic sclerosis, and 33 had aortic stenosis. Participants with valvular calcium were older and were more likely to have hypertension and diabetes mellitus. Participants with valve calcium had higher median levels of all markers. For each log unit increase in ISUM, after adjustment for age and gender, there was an associated 1.1-fold increased odds of ≥1 calcified valve(p=0.02); the odds ratios were no longer significant after adjustment for cardiovascular disease risk factors(odds ratio 1.0, 95%confidence interval 0.9 to 1.1). Similar results were obtained for the individual markers and the odds of ≥1 calcified valve. In conclusion, inflammatory markers were elevated in patients with valvular calcium. Our findings suggest that much of the observed association between systemic inflammatory markers and valvular calcium may be due to shared risk factors.
文摘As has been observed by Morse [1], any generic vector field v on a compact smooth manifold X with boundary gives rise to a stratification of the boundary by compact submanifolds , where . Our main observation is that this stratification re-flects the stratified convexity/concavity of the boundary ?with respect to the ?v-flow. We study the behavior of this stratification under deformations of the vector field v. We also investigate the restrictions that the existence of a convex/concave traversing ?v-flow imposes on the topology of X. Let be the orthogonal projection of on the tangent bundle of . We link the dynamics of theon the boundary with the property of in X being convex/concave. This linkage is an instance of more general phenomenon that we call “holography of traversing fields”—a subject of a different paper to follow.
文摘Context: Obesity is associated with atrial enlargement and ventricular diastol ic dysfunction, both known predictors of atrial fibrillation(AF). However, it is unclear whether obesity is a risk factor for AF. Objective: To examine the asso ciation between body mass index(BMI) and the risk of developing AF. Design, Sett ing, and Participants: Prospective, communitybased observational cohort in Fra mingham, Mass. We studied 5282 participants(mean age, 57[SD, 13] years; 2898 wom en[55%]) without baseline AF(electrocardiographic AF or arterial flutter). Body mass index(calculated as weight in kilograms divided by square of height in met ers) was evaluated as both a continuous and a categorical variable(normal define d as < 25.0; overweight, 25.0 to < 30.0; and obese, ≥30.0). In addition to adju sting for clinical confounders by multivariable techniques, we also examined mod els including echocardiographic left atrial diameter to examine whether the infl uence of obesity was mediated by changes in left atrial dimensions. Main Outcome Measure: Association between BMI or BMI category and risk of developing newon set AF. Results: During a mean followup of 13.7 years, 526 participants(234 wo men) developed AF. Age adjusted incidence rates for AF increased across the 3 BM I categories in men(9.7, 10.7, and 14.3 per 1000 personyears) and women(5.1, 8 .6, and 9.9 per 1000 personyears). In multivariable models adjusted for cardio vascular risk factors and interim myocardial infarction or heart failure, a 4%i ncrease in AF risk per 1-unit increase in BMI was observed in men(95%confidenc e interval[CI], 1%-7%; P=.02) and in women(95%CI, 1%-7%; P=.009). Adjuste d hazard ratios for AF associated with obesity were 1.52(95%CI, 1.09-2.13; P=. 02) and 1.46(95%CI, 1.03-2.07; P=.03) for men and women, respectively, compare d with individuals with normal BMI. After adjustment for echocardiographic left atrial diameter in addition to clinical risk factors, BMI was no longer associat ed with AF risk(adjusted hazard ratios per 1-unit increase in BMI, 1.00[95%CI, 0.97-1.04], P=.84 in men; 0.99 [95%CI, 0.96-1.02], P=.56 in women). Conclusi ons: Obesity is an important, potentially modifiable risk factor for AF. The exc ess risk of AF associated with obesity appears to be mediated by left atrial dil atation. These prospective data raise the possibility that interventions to prom ote normal weight may reduce the population burden of AF.
文摘The anti-incretin theory involving the abolishment of diabetes type(DT)II by some of methods used in bariatric surgery,first appeared during the early years of the XXI century and considers the existence of anti-incretin substances.However,to date no exogenous or endogenous anti-incretins have been found.Our concept of the acini-islet-acinar axis assumes that insulin intra-pancreatically stimulates alpha-amylase synthesis(“halo phenomenon”)and in turn,alphaamylase reciprocally inhibits insulin production,thus making alpha-amylase a candidate for being an anti-incretin.Additionally,gut as well as plasma alphaamylase,of pancreatic and other origins,inhibits the appearance of dietary glucose in the blood,lowering the glucose peak after iv or oral glucose loading.This effect of alpha-amylase can be interpreted as an insulin down regulatory mechanism,possibly limiting the depletion of pancreatic beta cells and preventing their failure.Clinical observations agree with the above statements,where patients with high blood alpha-amylase concentrations are seldom obese and seldom develop DT2.Obese-DT2,as well as DT1 patients,usually develop exocrine pancreatic insufficiency(EPI)and vice versa.Ultimately,DT2 patients develop DT1,when the pancreatic beta cells are exhausted and insulin production ceases.Studies on biliopancreatic diversion(BPD)and on BPD with duodenal switch,a type of bariatric surgery,as well as studies on EPI pigs,allow us to observe and investigate the above-mentioned phenomena of intra-pancreatic interactions.
文摘Context: Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have e xperienced similar declines in CVD risk. Objective: To determine whether adults with and without diabetes experienced similar declines in incident CVD in 1950- 1995. Design, Setting, and Participants: Participants aged 4564 years from the F ramingham Heart Study original and offspring cohorts who attended examinations i n 19501966 ("earlier"time period; 4118 participants, 113 with diabetes) and 1977-1995 ("later"time period; 4063 participants, 317 with diabetes). Incid ence rates of CVD among those with and without diabetes were compared between th e earlier and later periods. Main Outcome Measures: Myocardial infarction, coron ary heart disease death, and stroke. Results: Among participants with diabetes, the age-and sex-adjusted CVD incidence rate was 286.4 per 10000 person-years in the earlier period and 146.9 per 10000 in the later period, a 49.3%(95%conf idence interval [Cl], 16.7%-69.4%) decline. Among participants without diabet es, the age-and sex-adjusted incidence rate was 84.6 per 10000 person-years i n the earlier period and 54.3 per 10000 person-yearsin the later period, a 35.4 %(95%Cl, 25.3%-45.4%) decline. Hazard ratios for diabetes as a predictor of incident CVD were not different in the earlier vs later periods. Conclusions: W e report a 50%reduction in the rate of incident CVD events among adults with di abetes, although the absolute risk of CVD is 2-fold greater than among persons without diabetes. Adults with and without diabetes have benefited similarly duri ng the decline in CVD rates over the last several decades. More aggressive treat ment of CVD risk factors and further research on diabetes-specific factors cont ributing to CVD risk are needed to further reduce the high absolute risk of CVD still experienced by persons with diabetes.
文摘Background: The high power output necessary for insect flight has driven the evolution of muscles with large myofibrils (primary energy consumers) and abundant mitochondria (primary energy suppliers). The intricate functional interrelationship between these two organelles remains largely unknown despite its fundamental importance in understanding insect flight bioenergetics. Unlike vertebrate muscle that relies on a phosphagen (creatine phosphate/creatine kinase) system to regulate high energy phosphate flux, insect flight muscle has been reported to lack mitochondrial arginine kinase (analogous to creatine kinase), a key enzyme that enables intracellular energy transport. Creatine kinase is known to interact with mitochondrial adenine nucleotide translocase (ANT) in the transfer of ADP and ATP into and out of the mitochondria. Results: Here, we use quantitative immunogold transmission electron microscopy to show that in Drosophila melanogaster indirect flight muscles (IFM), ANT is present in the mitochondria as well as throughout the myofibril. To confirm this unexpected result, we created a transgenic line that expresses a chimeric GFP-ANT protein and used an anti-GFP antibody to determine the intracellular distribution of the fusion protein in the IFM. Similar to results obtained with anti-ANT, the fusion GFP-ANT protein is detected in myofibrils and mitochondria. We confirmed the absence of arginine kinase from IFM mitochondria and show that its sarcomeric (i.e., intramyofibrillar) distribution is similar to that of ANT. Conclusions: These results raise the possibility that direct channeling of nucleotides between mitochondria and myofibrils is assisted by an ANT protein thereby circumventing the need for a phosphagen shuttle in the IFM. The myofibrillar ANT may represent a unique adaptation in the muscles that require efficient exchange of nucleotides between mitochondria and myofibrils.
文摘Purpose:The article examines the role of digital and,in particular,social media in business-to-business marketing in the international software industry.The authors responded to calls for empirical research on how these media impact buyer-vendor relationships and the conjunction of the marketing and sales processes,particularly the distribution of complex software solutions.This paper develops a digital framework and discusses the managerial consequences.Design/methodology/approach:The model arises by merging themes derived from literature,experts,and job descriptions.Mixed Methods included conducting semi-structured interviews across marketing,business development,and sales executives from buyers,vendors,and third parties of various industries,supplemented by a survey of 530+executives.Findings:Multinational companies secure competitive advantage through agile business processes to improve buyer-vendor relationships in the digital era.Digital media enable vendors to interact continuously with buyers,gather intelligence,and foster mutually beneficial,trustworthy,long-term relationships.The objective is to prompt transactions and secure revenue streams.Research limitations/implications:The outcomes of this research center on North America,Western Europe(including the UK),and DACH(Germany-Austria-Switzerland),affecting the generalizability.Originality/value:The research is novel and bridges several gaps concerning industrial relationships in digitalization:it merges buyer,vendor,and third-party’s perspectives on an international scale.It provides deeper insights into existing and new relationships by identifying relevant digital/social media platforms,the underlying usage motivation,and fundamental B2B processes.Finally,it equips practitioners with metrics to improve performance.
