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1.
Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature
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Lin Li Mark Fisher Wei‐Ling Lau Hamid Moradi Alexander Cheung Gaby Thai Jason Handwerker Kamyar Kalantar‐Zadeh 《Hemodialysis international. International Symposium on Home Hemodialysis》2015,19(3):E1-E7
Cerebral microbleeds (CMBs) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMBs are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease (CKD) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB, raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease (ESRD) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients. 相似文献
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A Distributed Virtual Environment (DVE) system offers a computer-generated virtual world in which individuals located at different
places in the physical world can interact with one another. In order to achieve real-time response for a large user base,
DVE systems need to have a scalable architecture. In this paper, we present the design of a grid-enabled service oriented
framework for facilitating the construction of scalable DVE systems on computing grids. A service component called “gamelet”
is proposed, whose distinctive mark is its high mobility for supporting dynamic load sharing. We propose a gamelet migration
protocol which can ensure the transparency and efficiency of gamelet migration, and an adaptive gamelet load-balancing (AGLB)
algorithm for making gamelet redistribution decisions at runtime. The algorithm considers both the synchronization costs of
the DVE system and network latencies inherent in the grid nodes. The activities of the users and the heterogeneity of grid
resources are also considered in order to carry out load sharing more effectively. We evaluate the performance of the proposed
mechanisms through a multiplayer online game prototype implemented using the Globus toolkit. The results show that our approach
can achieve faster response times and higher throughputs than some existing approaches.
This research is supported in part by the China National Grid project (863 program) and the HKU Foundation Seed Grant 28506002. 相似文献
3.
The current Internet and wireless networks are harsh environments for transporting high-bandwidth multimedia data. We examine the technical issues involved, and describe an end-to-end solution to support a Web-based learn-on-demand system that operates in a wireless campus environment. 相似文献
4.
BACKGROUND: To determine the best cutoff values of aspartate aminotransferase (AST) and alanine amino-transferase (ALT) in detecting viral hepatitis C infection among patients of continuous ambulatory peritoneal dialysis (CAPD). METHODS: 90 (44 male and 46 female) CAPD patients and 526 adult controls (266 male, 260 female) were enrolled. Serum AST and ALT were measured by an auto-analyser monthly. Serum HBsAg was examined using a RIA method and anti-HCV by an second-generation EIA method. The best cutoff values of AST and ALT for detecting viral hepatitis were obtained from the ROC (receiver-operating characteristic) curve. RESULTS: The prevalence of anti-HCV(+) was significantly higher in CAPD patients (16.7%) than in normal controls (4.9%), while that of HBsAg(+) was similar in both groups. CAPD patients had significantly lower levels of serum aminotransferases compared to normal controls. Mean AST were 23.8 IU/l in normal control and 18.8 IU/l in the CAPD patients (P < 0.001). Mean ALT were 21.9 IU/l in normal controls and 15.3 IU/l in the CAPD patients (P < 0.001). CAPD patients with HCV infection had higher serum AST and ALT levels than those without. However, HBV infection did not cause significant serum aminotransferase elevation in patients. The conventional cutoff values of AST (40 IU/l) and ALT (40 IU/l) for detecting viral hepatitis yielded only a sensitivity of 27.3 and 18.2% respectively; on the contrary, our revised cutoff values of AST (24 IU/l) and ALT (17 IU/l) had better sensitivities (AST, 72.7%; ALT, 63.6%). For serial aminotransferase values, the sensitivity of AST and ALT for detecting HCV were 36.4 and 27.3% by conventional criteria, and were both 81.8%, by our newly revised criteria. CONCLUSIONS: Serum aminotransferase cutoff values should be modified for screening viral hepatitis in a CAPD population. Our new cutoff criteria had important clinical implications in providing benefits of earlier detection and possible prevention from chronic hepatic deteriorations. 相似文献
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On the macroscopic optimization of multicell wireless systems with multiuser detection and multiple antennas - uplink analysis 总被引:1,自引:0,他引:1
In this paper, we consider a system with K single-antenna client users, n/sub B/ base stations (each base station has n/sub R/ antennas), as well as a centralized controller. A client user could be associated with a single base station at any time. All the base stations operate at the same frequency and have optimal multiuser detection per base station which cancels intracell interference only. We consider a general problem of uplink macroscopic resource management where the centralized controller dynamically determines an appropriate association mapping of the K users with respect to the n/sub B/ base stations over a macroscopic time scale. We propose a novel analytical framework for the above macroscopic scheduling problems. A simple rule is to associate a user with the strongest base station (camp-on-the-strongest-cell), and this has been widely employed in conventional cellular systems. However, based on the optimization framework, we found that this conventional approach is in fact not optimal when multiuser detection is employed at the base station. We show that the optimal macroscopic scheduling algorithm is of exponential complexity, and we propose a simple greedy algorithm as a feasible solution. 相似文献
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In order to clarify the roles of three cysteines in ketosteroid isomerase (KSI) from Pseudomonas putida biotype B, each of the cysteine residues has been changed to a serine residue (C69S, C81S, and C97S) by site-directed mutagenesis. All cysteine mutations caused only a slight decrease in the k(cat) value, with no significant change of Km for the substrate. Even modification of the sulfhydryl group with 5,5'-dithiobis(2-nitrobenzoic acid) has almost no effect on enzyme activity. These results demonstrate that none of the cysteines in the KSI from P. putida is critical for catalytic activity, contrary to the previous identification of a cysteine in an active-site-directed photoinactivation study of KSI. Based on the three-dimensional structures of KSIs with and without dienolate intermediate analog equilenin, as determined by X-ray crystallography at high resolution, Asp-103 was found to be located within the range of the hydrogen bond to the equilenin. To assess the role of Asp-103 in catalysis, Asp-103 has been replaced with either asparagine (D103N) or alanine (D103A) by site-directed mutagenesis. For D103A mutant KSI there was a significant decrease in the k(cat) value: the k(cat) of the mutant was 85-fold lower than that of the wild-type enzyme; however, for the D103N mutant, which retained some hydrogen bonding capability, there was a minor decrease in the k(cat) value. These findings support the idea that aspartic acid 103 in the active site is an essential catalytic residue involved in catalysis by hydrogen bonding to the dienolate intermediate. 相似文献
10.
A 78-year-old Chinese woman presented with recurrent postprandial abdominal pain. Computerised tomography revealed a small bowel tumour causing volvulus of a segment of the small bowel. Laparotomy confirmed an extraluminal ileal tumour with partial volvulus of the involved small bowel segment. Small bowel resection was done. Histological and ultrastructural studies confirmed a gastrointestinal autonomic nerve tumour. We review the medical literature on this rare tumour. 相似文献