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Urban noise is a common environmental exposure that may increase the burden of hypertension in communities, yet it is largely unstudied in the United States, and it has not been studied in relation to blood pressure (BP) control. We investigated associations of urban noise with BP levels and control in the United States. We used repeated BP and medication data from Chicago-based participants of the Chicago Health and Aging Project (≥65 years) and MESA (Multi-Ethnic Study of Atherosclerosis; ≥45 years). Using a spatial prediction model with project-specific measurements, we estimated noise at participant homes. We imputed BP levels for those on medication and used mixed-effects models to evaluate associations with noise. Logistic regression was used for uncontrolled and apparent treatment-resistant hypertension. Models were run separately by cohort and altogether, all with adjustment for age, sex, sociodemographic factors, and other plausible sources of confounding. We evaluated 16 462 BP measurements from 6764 participants (6073 Chicago Health and Aging Project and 691 MESA) over an average of 4 years. For both cohorts, we found that greater levels of noise were associated with higher BP levels and greater risk of apparent treatment-resistant hypertension. In our pooled models, 10-dBA higher residential noise levels corresponded to 1.2 (95% CI, 0.1–2.2) and 1.1 mm Hg greater (95% CI, 0.6–1.7) systolic and diastolic BPs as well as a 20% increased odds of apparent treatment-resistant hypertension (odds ratio per 10 dBA: 1.2 [95% CI, 1.0–1.4], P =0.04). Urban noise may increase BP levels and complicate hypertension treatment in the United States.

Purpose: The aim of this work is to normalize the NLPCONTRIBUTIONS scheme (henceforward, NLPCONTRIBUTIONGRAPH) to structure, directly from article sentences, the contributions information in Natural Language Processing (NLP) scholarly articles via a two-stage annotation methodology: 1) pilot stage - to define the scheme (described in prior work); and 2) adjudication stage - to normalize the graphing model (the focus of this paper). Design/methodology/approach: We re-annotate, a second time, the contributions-pertinent information across 50 prior-annotated NLP scholarly articles in terms of a data pipeline comprising: contribution-centered sentences, phrases, and triple statements. To this end, specifically, care was taken in the adjudication annotation stage to reduce annotation noise while formulating the guidelines for our proposed novel NLP contributions structuring and graphing scheme. Findings: The application of NLPCONTRIBUTIONGRAPH on the 50 articles resulted finally in a dataset of 900 contribution-focused sentences, 4,702 contribution-information-centered phrases, and 2,980 surface-structured triples. The intra-annotation agreement between the first and second stages, in terms of F1, was 67.92% for sentences, 41.82% for phrases, and 22.31% for triple statements indicating that with increased granularity of the information, the annotation decision variance is greater. Practical Implications: We demonstrate NLPCONTRIBUTIONGRAPH data integrated into the Open Research Knowledge Graph (ORKG), a next-generation KG-based digital library with intelligent computations enabled over structured scholarly knowledge, as a viable aid to assist researchers in their day-to-day tasks., Comment: 22 pages, 9 figures, 4 tables

Purpose The objective of this scoping review was to get an overview of barriers emerging across the globe from the pandemic that are likely to increase the level of pre-existing disability status of neurologically challenged populations. Methods Database searches (PubMed/MEDLINE, CINAHL, ProQuest, Ovid, Scopus, and Web of Science) updated to December 2020 were conducted. Articles that identified challenges or barriers to neuro-rehabilitation, impact on disability status and health care services were included. Full-text articles limited to the English language with no restrictions on study design were included. Data was synthesized based on recurrent themes that were identified. Results Thirty-seven studies were included in this review. Neurological populations considered: stroke, multiple sclerosis, amyotrophic lateral sclerosis, parkinson's disease, autism, developmental disabilities, and those who required neurosurgical care. Barriers were grouped into categories as increased disease risk and complications, delayed or restricted access to neuro-rehabilitation, limited hospital access, telerehabilitation limitations, and shutdown of special centers of aid. Conclusions COVID-19 pandemic has given rise to barriers that affect almost every aspect of healthcare and rehabilitation in neurologically challenged populations prompting an increase in their disability level. This can assist policymakers in designing mitigation strategies to minimize the detrimental effects on this vulnerable population.Implications for rehabilitationPandemic has led to the worsening of existing motor and non-motor symptoms, which need to be monitored, assessed and managed medically, and through rehabilitation in neurologically challenged populations.Notable decline of cognition and physical activity in neurologically challenged populations needs to be assessed and efforts to reverse these outcomes should be attempted.Rehabilitation services, hospital care and centers of aid need to be made more accessible for neurologically challenged populations with COVID-19 precautionary measures.Telemedicine and telerehabilitation need to be upgraded to enhance further face to face like interactions and for tracking of progressive disease.

With the rapid growth of research publications, empowering scientists to keep an oversight over scientific progress is of paramount importance. In this regard, the leaderboards facet of information organization provides an overview on the state-of-the-art by aggregating empirical results from various studies addressing the same research challenge. Crowdsourcing efforts like PapersWithCode among others are devoted to the construction of leaderboards predominantly for various subdomains in Artificial Intelligence. Leaderboards provide machine-readable scholarly knowledge that has proven to be directly useful for scientists to keep track of research progress – their construction could be greatly expedited with automated text mining.

There is currently a gap between the natural language expression of scholarly publications and their structured semantic content modeling to enable intelligent content search. With the volume of research growing exponentially every year, a search feature operating over semantically structured content is compelling. The SemEval-2021 Shared Task NLPContributionGraph (a.k.a. 'the NCG task') tasks participants to develop automated systems that structure contributions from NLP scholarly articles in the English language. Being the first-of-its-kind in the SemEval series, the task released structured data from NLP scholarly articles at three levels of information granularity, i.e. at sentence-level, phrase-level, and phrases organized as triples toward Knowledge Graph (KG) building. The sentence-level annotations comprised the few sentences about the article's contribution. The phrase-level annotations were scientific term and predicate phrases from the contribution sentences. Finally, the triples constituted the research overview KG. For the Shared Task, participating systems were then expected to automatically classify contribution sentences, extract scientific terms and relations from the sentences, and organize them as KG triples. Overall, the task drew a strong participation demographic of seven teams and 27 participants. The best end-to-end task system classified contribution sentences at 57.27% F1, phrases at 46.41% F1, and triples at 22.28% F1. While the absolute performance to generate triples remains low, in the conclusion of this article, the difficulty of producing such data and as a consequence of modeling it is highlighted., Comment: 13 pages, 5 figures, 8 tables

The transfer of knowledge has not changed fundamentally for many hundreds of years: It is usually document-based - formerly printed on paper as a classic essay and nowadays as PDF. With around 2.5 million new research contributions every year, researchers drown in a flood of pseudo-digitized PDF publications. As a result research is seriously weakened. In this article, we argue for representing scholarly contributions in a structured and semantic way as a knowledge graph. The advantage is that information represented in a knowledge graph is readable by machines and humans. As an example, we give an overview on the Open Research Knowledge Graph (ORKG), a service implementing this approach. For creating the knowledge graph representation, we rely on a mixture of manual (crowd/expert sourcing) and (semi-)automated techniques. Only with such a combination of human and machine intelligence, we can achieve the required quality of the representation to allow for novel exploration and assistance services for researchers. As a result, a scholarly knowledge graph such as the ORKG can be used to give a condensed overview on the state-of-the-art addressing a particular research quest, for example as a tabular comparison of contributions according to various characteristics of the approaches. Further possible intuitive access interfaces to such scholarly knowledge graphs include domain-specific (chart) visualizations or answering of natural language questions. Der Verbreitung wissenschaftlicher Erkenntnisse hat sich seit vielen hundert Jahren nicht grundlegend verändert: Er erfolgt in der Regel dokumentenbasiert - früher als klassischer Aufsatz auf Papier gedruckt und heute online als PDF. Mit rund 2,5 Millionen neuen Forschungsbeiträgen pro Jahr ertrinken Forscher in einer Flut von pseudo-digitalisierten PDF-Publikationen. Als Folge davon wird die Forschung stark geschwächt. In diesem Artikel plädieren wir dafür, wissenschaftliche Beiträge in strukturierter und semantischer Form als Wissensgraph zu repräsentieren. Der Vorteil ist, dass die in einem Wissensgraph dargestellten Informationen für Maschinen und Menschen lesbar sind. Als Beispiel geben wir einen Überblick über den Open Research Knowledge Graph (ORKG), einen Dienst, der diesen Ansatz umsetzt. Für die Erstellung des Wissensgraph setzen wir eine Mischung aus manuellen (crowd/expert sourcing) und (halb-)automatisierten Techniken ein. Nur mit einer solchen Kombination aus menschlicher und maschineller Intelligenz können wir die erforderliche Qualität der Darstellung erreichen, um neuartige Explorations- und Unterstützungsdienste für Forscher zu ermöglichen. Im Ergebnis kann ein Wissensgraph wie der ORKG verwendet werden, um einen komprimierten Überblick über den Stand der Technik in Bezug auf eine bestimmte Forschungsaufgabe zu geben, z.B. als tabellarischer Vergleich der Beiträge nach verschiedenen Merkmalen der Ansätze. Weitere mögliche intuitive Nutzungsschnittstellen zu solchen wissenschaftlichen Wissensgraphen sind domänenspezifische Visualisierungen oder die Beantwortung natürlichsprachlicher Fragen mittels Question Answering.

There has been a trending impacting application in different sectors such as hospitals, banking, defense, retail and social networks, the rate at which information needs to be kept safe has been a major concern. The security being compromised at a rapid rate which is shown through the increasing rise in frauds has caused a serious impact. Anomaly detection has affected huge sectors and made its way in various applications including detect of fraudulence records, patterns, behaviors, third-party attack or intruder detection in networks and cyber-security. A great deal of research is being carried out in these areas, which uses various approaches such as statistical, data analytics, machine learning and so forth from which anomalies could be extracted. The interdependencies between data can be depicted and represented using graphs in an effective way. However, few works have focused on detecting anomalous behaviors, patterns, links and points in data represented as graphs with multi-dimension especially for detecting outliers in unstructured data. Indeed, data represented as graphs show interdependencies and should be taken into account while detecting anomalies. In this paper, a survey is carried out on the static, dynamic and machine learning approaches for detecting anomalies in the graph data structures. In addition, more focus is toward efficient graph-based techniques that can help in anomaly detection in big data transactions which are presented. Along the way, few open issues and research directions are also mentioned.

Anomaly is referred to as an object that does not follow the footprints of usual data object or the data that contains pattern that does not fit to a well-defined normal behavior. Cybercrime is a pervasive threat for today’s Internet-dependent society. Machine learning is becoming increasingly important for fraud detection. This means machine learning can analyze a large amount of data to identify the pattern associated with the fraud. Machine learning provides speed, scale and efficiency. In this paper, we are giving a machine learning model that will detect the fraud and give a known difference between fraud and genuine transactions. We use machine learning algorithms for efficient fraud detection in online transaction and represent those using graphs. Graph exhibits interdependencies between data in an effective way.

Introduction Exposure to noise might influence risk of Alzheimer's disease (AD) dementia. Methods Participants of the Chicago Health and Aging Project (≥65 years) underwent triennial cognitive assessments. For the 5 years preceding each assessment, we estimated 5227 participants' residential level of noise from the community using a spatial prediction model, and estimated associations of noise level with prevalent mild cognitive impairment (MCI) and AD, cognitive performance, and rate of cognitive decline. Results Among these participants, an increment of 10 A-weighted decibels (dBA) in noise corresponded to 36% and 29% higher odds of prevalent MCI (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.15 to 1.62) and AD (OR = 1.29, 95% CI, 1.08 to 1.55). Noise level was associated with worse global cognitive performance, principally in perceptual speed (-0.09 standard deviation per 10 dBA, 95% CI: -0.16 to -0.03), but not consistently associated with cognitive decline. Discussion These results join emerging evidence suggesting that noise may influence late-life cognition and risk of dementia.

Stroke survivors often face difficulty in community ambulation though they attain steady-state walking in clinical setups. Compliance and unpredictability of the environment may alter the muscle activity and challenge the individual's gait. Successful reintegration into the community requires gait assessment and training in a real-life challenging environment. Little is known about the assessment and training of gait in the community environment under challenging mobility dimensions. Hence, we aimed to study the changes that real-life environmental dimensions have on the activity of selected muscles in hemiparetic lower limb and gait velocity in stroke survivors.An observational cross-sectional study was conducted on 16 ambulatory stroke survivors to assess the hemiparetic lower limb muscle activity during walking in real-life environmental dimensions. Participants were made to walk in the community on a walkway consisting of even surface, ramp, stairs, uneven terrain and obstacles. They were also made to manoeuvre through traffic and pick a load while walking for a distance in the walkway. Muscle activity of Rectus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior of the paretic lower limb were continuously recorded while walking using wireless surface electromyography. Gait velocity for the entire walkway and level of perceived difficulty while walking in different dimensions were also measured. Paired t-test was used to compare the percentage Maximum Voluntary Contraction (%MVC) of lower limb muscles between even surface and real-life environment dimensions while walking. One sample t-test was used to compare the gait velocity in real-life dimensions versus gait velocity in even surface measured in an earlier study.There was a significant reduction (p 0.01) in the activity of all four hemiparetic lower limb muscles while walking under the influence of real-life environmental dimensions compared to even surface. Gait velocity (0.33 ± 0.17 m/s) was significantly lower than that is essential to be a community ambulator. The level of perceived difficulty across all dimensions was reported qualitatively with the highest difficulty reported during stair and obstacle clearance.Real-life environmental dimensions lead to the reduction of paretic lower limb muscle activities and gait velocity during walking in community-dwelling stroke survivors. Stroke survivors perceived more difficulty while walking in real-life environment dimensions particularly while negotiating stairs and obstacles.Knowledge about the influence of real-life environmental dimensions will help the clinicians to target rehabilitation methods to improve walking adaptability.

Objectives To systematically identify, define, and classify emerging knowledge synthesis methods through a scoping review. Study Design and Setting MEDLINE, CINAHL, EMBASE, PsycINFO, the Cochrane Methodology Register, the Cochrane Database of Systematic Reviews, Social Sciences Abstracts, Library and Information Science Abstracts, Philosopher's Index, and Education Resources Information Center were searched to identify articles reporting emerging knowledge synthesis methods across the disciplines of health, education, sociology, and philosophy. Two reviewers independently selected studies and abstracted data for each article. Results In total, 409 articles reporting on 25 knowledge synthesis methods were included after screening of 17,962 titles and abstracts and 1,010 potentially relevant full-text articles. Most of the included articles were an application of the method (83.9%); only 3.7% were seminal articles that fully described the method (i.e., operationalized the steps). Most of the included articles were published after 2005. The methods were most commonly used across the fields of nursing, health care science and services, and health policy. Conclusion We found a lack of guidance on how to select a knowledge synthesis method. We propose convening an international group of leaders in the knowledge synthesis field to help clarify emerging approaches to knowledge synthesis.

We propose a multilayered secure scheme to transfer sensitive text over an unreliable network. The secret text is first encrypted using the AES algorithm. The cipher text produced is hidden in an audio file. The audio file is in turn encrypted in parallel using the concept of Shamir's technique based on CRT to maximize resource utilization. These, audio shares are sent over different channels in the network for security. Experimental results show that, even if certain shares got lost over network, audio files could be recovered at the receiver with the remaining shares without sender needing to resend the file.

Air pollution exposures are hypothesized to impact blood pressure, yet few longitudinal studies exist, their findings are inconsistent, and different adjustments have been made for potentially distinct confounding by calendar time and age.We aimed to investigate the associations of long- and short-term [Formula: see text] and [Formula: see text] concentrations with systolic and diastolic blood pressures and incident hypertension while also accounting for potential confounding by age and time.Between 2000 and 2012, Multi-Ethnic Study of Atherosclerosis participants were measured for systolic and diastolic blood pressure at five exams. We estimated annual average and daily [Formula: see text] and [Formula: see text] concentrations for 6,569 participants using spatiotemporal models and measurements, respectively. Associations of exposures with blood pressure corrected for medication were studied using mixed-effects models. Incident hypertension was examined with Cox regression. We adjusted all models for sex, race/ethnicity, socioeconomic status, smoking, physical activity, diet, season, and site. We compared associations from models adjusting for time-varying age with those that adjusted for both time-varying age and calendar time.We observed decreases in pollution and blood pressures (adjusted for age and medication) over time. Strong, positive associations of long- and short-term exposures with blood pressure were found only in models with adjustment for time-varying age but not adjustment for both time-varying age and calendar time. For example, [Formula: see text] higher annual average [Formula: see text] concentrations were associated with 2.7 (95% CI: 1.5, 4.0) and [Formula: see text] (95% CI: [Formula: see text] 1.0) mmHg in systolic blood pressure with and without additional adjustment for time, respectively. Associations with incident hypertension were similarly weakened by additional adjustment for time. Sensitivity analyses indicated that air pollution did not likely cause the temporal trends in blood pressure.In contrast to experimental evidence, we found no associations between long- or short-term exposures to air pollution and blood pressure after accounting for both time-varying age and calendar time. This research suggests that careful consideration of both age and time is needed in longitudinal studies with trending exposures. https://doi.org/10.1289/EHP2966.

Background: Accruing evidence suggests that a relation of noise exposure to dementia is biologically plausible. Yet the association of long-term exposure to community noise with dementia has not be...

Importance Fine particulate matter (smaller than 2.5 μm) (PM2.5) air pollution is a major global risk factor for cardiovascular (CV) morbidity and mortality. Few studies have tested the benefits of portable air filtration systems in urban settings in the United States. Objective To investigate the effectiveness of air filtration at reducing personal exposures to PM2.5and mitigating related CV health effects among older adults in a typical US urban location. Design, Setting, and Participants This randomized, double-blind crossover intervention study was conducted from October 21, 2014, through November 4, 2016, in a low-income senior residential building in Detroit, Michigan. Forty nonsmoking older adults were enrolled, with daily CV health outcome and PM2.5exposure measurements. Interventions Participants were exposed to the following three 3-day scenarios separated by 1-week washout periods: unfiltered air (sham filtration), low-efficiency (LE) high-efficiency particulate arrestance (HEPA)–type filtered air, and high-efficiency (HE) true-HEPA filtered air using filtration systems in their bedroom and living room. Main Outcomes and Measures The primary outcome was brachial blood pressure (BP). Secondary outcomes included aortic hemodynamics, pulse-wave velocity, and heart rate variability. Exposures to PM2.5were measured in the participants’ residences and by personal monitoring. Results The 40 participants had a mean (SD) age of 67 (8) years (62% men). Personal PM2.5exposures were significantly reduced by air filtration from a mean (SD) of 15.5 (10.9) μg/m3with sham filtration to 10.9 (7.4) μg/m3with LE fitration and 7.4 (3.3) μg/m3with HE filtration. Compared with sham filtration, any filtration for 3 days decreased brachial systolic and diastolic BP by 3.2 mm Hg (95% CI, −6.1 to −0.2 mm Hg) and 1.5 mm Hg (95% CI, −3.3 to 0.2 mm Hg), respectively. A continuous decrease occurred in systolic and diastolic BP during the 3-day period of LE filtration, with a mean of 3.4 mm Hg (95% CI, −6.8 to −0.1 mm Hg) and 2.2 mm Hg (95% CI, −4.2 to −0.3 mm Hg), respectively. For HE filtration, systolic and diastolic BP decreased by 2.9 mm Hg (95% CI, −6.2 to 0.5 mm Hg) and 0.8 mm Hg (95% CI, −2.8 to 1.2 mm Hg), respectively. Most secondary outcomes were not significantly improved. Conclusions and Relevance Results of this study showed that short-term use of portable air filtration systems reduced personal PM2.5exposures and systolic BP among older adults living in a typical US urban location. The use of these relatively inexpensive systems is potentially cardioprotective against PM2.5exposures and warrants further research. Trial Registration ClinicalTrials.gov identifier:NCT03334565

Objectives: Over half the US population experiences noise levels above WHO recommendations yet little research within the US has examined the health effects of these exposures. Our objective is to investigate the associations between community noise and blood pressure in residents of Chicago. Methods: Participants were from two prospective cohort studies: the Multi Ethnic Study of Atherosclerosis (MESA) and the Chicago Health and Aging Project (CHAP). MESA is a multi-site study of persons aged 45-84 years and free of clinical cardiovascular disease. CHAP is an open cohort initiated to study chronic conditions of aging among persons aged ≥65 years. This analysis focuses on the 5,167 participants of these cohorts living in Chicago with an average of 2.5 (CHAP) and 4.5 (MESA) assessments per participant, for systolic (SBP) and diastolic (DBP) blood pressure between 1999-2011. In both cohorts, hypertension was defined as taking antihypertensive medication, SBP ≥140 or DBP ≥ 90 mmHg. We estimated noise at participant addresses using land use regression models weighted according to participants’ 5-year residential history before each exam. Among those taking antihypertensive medication, blood pressure was adjusted using multiple imputation. Associations between noise and blood were estimated using linear mixed models. A Cox proportional hazards model was used to estimate relative risk (RR) of incident hypertension. All models included calendar time, age, sex, race, income, education, neighborhood socioeconomic score, smoking, cohort, interaction between cohort and age, race, and gender, and NO x (a traffic-related air pollutant). Findings : At baseline, MESA participants were younger (63 vs 73 years) and more educated (36 vs. 3% with ≥graduate degree) than CHAP participants. MESA participants had higher noise levels (60 vs 56 dB) and lower blood pressures (e.g. SBP: 124 vs 135 mmHg) than CHAP participants. After adjusting for cohort and other confounders, we found that 10 dB higher residential noise levels were associated with 0.9 (95% CI: -0.2, 0.2; p=0.1) and 0.5 mmHg greater (95% CI: -0.1, 0.11; p=0.08) SBP and DBP, respectively. Similar associations were found within each cohort. Noise was not associated with incident hypertension overall (RR: 1.00; 95% CI: 0.8, 1.3, p=0.98) or within cohort. Conclusions: We found a suggestive association between noise and blood pressure levels, but no association with hypertension. This could be due to the lack of nighttime noise information, which has been shown to be more strongly associated with blood pressure outcomes than daytime levels or with the selection of healthy older participants.

Background/Aim: Noise has been associated with cardiovascular disease, a known risk factor for Alzheimer’s disease dementia (AD) and cognitive decline. Little, however, is known about the impacts o...

Background: Air pollution is linked to low lung function and to respiratory events, yet little is known of associations with lung structure. Objectives: We examined associations of particulate matter (PM2.5, PM10) and nitrogen oxides (NOx) with percent emphysema-like lung on computed tomography (CT). Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) recruited participants (45–84 years of age) in six U.S. states. Percent emphysema was defined as lung regions < –910 Hounsfield Units on cardiac CT scans acquired following a highly standardized protocol. Spirometry was also conducted on a subset. Individual-level 1- and 20-year average air pollution exposures were estimated using spatiotemporal models that included cohort-specific measurements. Multivariable regression was conducted to adjust for traditional risk factors and study location. Results: Among 6,515 participants, we found evidence of an association between percent emphysema and long-term pollution concentrations in an analysis leveraging between-city exposure contrasts. Higher concentrations of PM2.5 (5 μg/m3) and NOx (25 ppb) over the previous year were associated with 0.6 (95% CI: 0.1, 1.2%) and 0.5 (95% CI: 0.1, 0.9%) higher average percent emphysema, respectively. However, after adjustment for study site the associations were –0.6% (95% CI: –1.5, 0.3%) for PM2.5 and –0.5% (95% CI: –1.1, 0.02%) for NOx. Lower lung function measures (FEV1 and FVC) were associated with higher PM2.5 and NOx levels in 3,791 participants before and after adjustment for study site, though most associations were not statistically significant. Conclusions: Associations between ambient air pollution and percentage of emphysema-like lung were inconclusive in this cross-sectional study, thus longitudinal analyses may better clarify these associations with percent emphysema. Citation: Adar SD, Kaufman JD, Diez-Roux AV, Hoffman EA, D’Souza J, Stukovsky KH, Rich SS, Rotter JI, Guo X, Raffel LJ, Sampson PD, Oron AP, Raghunathan T, Barr RG. 2015. Air pollution and percent emphysema identified by computed tomography in the Multi-Ethnic Study of Atherosclerosis. Environ Health Perspect 123:144–151; http://dx.doi.org/10.1289/ehp.1307951

Internet security is getting worse day by day and it has become a major area of concern, as many types of hacking methods are practiced increasingly and new hacking techniques are being introduced. Hence cyber security is prioritized the most in many of the organizations. Hacking is illegal use of computer and network resources which enables to manipulate the normal behavior of systems connected to the network. Basically, a hacker is a skilled programmer who is clever enough to break into someone else's device and access the confidential data. The main purpose of this survey is to throw light on the concept of frequently occurring hacking techniques and its prevention for the betterment of the cyber security.

Objectives Compare the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding. Design and setting Systematic review and Bayesian random-effects network meta-analysis (NMA). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched until 27 April 2017. Screening, data abstraction and quality appraisal were completed in duplicate by independent reviewers. Participants 29 cohort studies including 5100 infants/children. Interventions Monotherapy and polytherapy AEDs including first-generation (carbamazepine, clobazam, clonazepam, ethosuximide, phenobarbital, phenytoin, primidone, valproate) and newer-generation (gabapentin, lamotrigine, levetiracetam, oxcarbazepine, topiramate, vigabatrin) AEDs. Epileptic women who did not receive AEDs during pregnancy or breast feeding served as the control group. Primary and secondary outcome measures Cognitive developmental delay and autism/dyspraxia were primary outcomes. Attention-deficit hyperactivity disorder, language delay, neonatal seizures, psychomotor developmental delay and social impairment were secondary outcomes. Results The NMA on cognitive developmental delay (11 cohort studies, 933 children, 18 treatments) suggested that among all AEDs only valproate was statistically significantly associated with more children experiencing cognitive developmental delay compared with control (OR=7.40, 95% credible interval (CrI) 3.00 to 18.46). The NMA on autism (5 cohort studies, 2551 children, 12 treatments) suggested that oxcarbazepine (OR 13.51, CrI 1.28 to 221.40), valproate (OR 17.29, 95% CrI 2.40 to 217.60), lamotrigine (OR 8.88, CrI 1.28 to 112.00) and lamotrigine+valproate (OR 132.70, CrI 7.41 to 3851.00) were associated with significantly greater odds of developing autism compared with control. The NMA on psychomotor developmental delay (11 cohort studies, 1145 children, 18 treatments) found that valproate (OR 4.16, CrI 2.04 to 8.75) and carbamazepine+phenobarbital+valproate (OR 19.12, CrI 1.49 to 337.50) were associated with significantly greater odds of psychomotor delay compared with control. Conclusions Valproate alone or combined with another AED is associated with the greatest odds of adverse neurodevelopmental outcomes compared with control. Oxcarbazepine and lamotrigine were associated with increased occurrence of autism. Counselling is advised for women considering pregnancy to tailor the safest regimen. Trial registration number PROSPERO database (CRD42014008925).

Background Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed anti-epileptic drugs (AEDs) to manage their symptoms. However, less is known about the comparative safety of AED exposure in utero. We aimed to compare the risk of congenital malformations (CMs) and prenatal outcomes of AEDs in infants/children who were exposed to AEDs in utero through a systematic review and Bayesian random-effects network meta-analysis. Methods MEDLINE, EMBASE, and Cochrane CENTRAL were searched from inception to December 15, 2015. Two reviewers independently screened titles/abstracts and full-text papers for experimental and observational studies comparing mono- or poly-therapy AEDs versus control (no AED exposure) or other AEDs, then abstracted data and appraised the risk of bias. The primary outcome was incidence of major CMs, overall and by specific type (cardiac malformations, hypospadias, cleft lip and/or palate, club foot, inguinal hernia, and undescended testes). Results After screening 5305 titles and abstracts, 642 potentially relevant full-text articles, and 17 studies from scanning reference lists, 96 studies were eligible (n = 58,461 patients). Across all major CMs, many AEDs were associated with higher risk compared to control. For major CMs, ethosuximide (OR, 3.04; 95% CrI, 1.23–7.07), valproate (OR, 2.93; 95% CrI, 2.36–3.69), topiramate (OR, 1.90; 95% CrI, 1.17–2.97), phenobarbital (OR, 1.83; 95% CrI, 1.35–2.47), phenytoin (OR, 1.67; 95% CrI, 1.30–2.17), carbamazepine (OR, 1.37; 95% CrI, 1.10–1.71), and 11 polytherapies were significantly more harmful than control, but lamotrigine (OR, 0.96; 95% CrI, 0.72–1.25) and levetiracetam (OR, 0.72; 95% CrI, 0.43–1.16) were not. Conclusion The newer generation AEDs, lamotrigine and levetiracetam, were not associated with significant increased risks of CMs compared to control, and were significantly less likely to be associated with children experiencing cardiac malformations than control. However, this does not mean that these agents are not harmful to infants/children exposed in utero. Counselling is advised concerning teratogenic risks when the prescription is written for a woman of childbearing age and before women continue with these agents when considering pregnancy, such as switching from polytherapy to monotherapy with evidence of lower risk and avoiding AEDs, such as valproate, that are consistently associated with CMs. These decisions must be balanced against the need for seizure control. Systematic Review Registration PROSPERO CRD42014008925 Electronic supplementary material The online version of this article (doi:10.1186/s12916-017-0845-1) contains supplementary material, which is available to authorized users.

Objectives: Hypertension is the most insidious ailment in primary care with its management being a daily affair. The avail of antihypertensive medications has affirmed their efficacy in blood pressure alleviation. Yet, the methodical choice of medication with which treatment ought to commence at the precise blood pressure threshold and maintained at a target level was undiscerned. Consequently, the Eighth Joint National Committee grants an evidence-based tool, which was employed in the appraisal of professional’s adherence to joint national committee 8 guidelines.Methods: A prospective, observational study was governed. Aggregate patients with hypertension with/without diabetes mellitus (DM) and/ or chronic kidney failure admitted in general medicine and the dialysis unit of the tertiary health care hospital, for 4 months were enrolled. The rationality of antihypertensive medications and target blood pressure was noted.Results: Patients matriculated to 125, 90 males and 35 females. Average age perceived was between 51 and 60 years, with the length of stay 14.39 (standard deviation [SD]±1.52) and 9.3 (SD±0.46) days in the respective unit. The gross medication endorsed represents 1085 medications, incorporating 337 antihypertensive medications. The optimal choice of an antihypertensive medicine was clonidine and amlodipine. Adherence in the populace with lone hypertension was cent percent, trailed by hypertension with DM 82.35% and minimal in hypertension with chronic kidney disease.Conclusion: 86-medication compiled adherence to the guidelines (25.52%). Rationality of medication depicts 25.6% were rational and 73.6% distinguish as non-rational, amid a demise of a sole victim. A significant high-grade defiance of health-care practitioners to the Eighth Joint National Committee guidelines was evidenced from our study.

Background Reduced heart rate variability, a marker of impaired cardiac autonomic function, has been linked to short-term exposure to airborne particles. This research adds to the literature by examining associations with long-term exposures to coarse particles (PM10-2.5). Methods Using electrocardiogram recordings from 2,780 participants (45-84 years) from three Multi-ethnic Study of Atherosclerosis sites, we assessed the standard deviation of normal to normal intervals and root-mean square differences of successive normal to normal intervals at a baseline (2000-2002) and follow-up (2010-2012) examination (mean visits/person = 1.5). Annual average concentrations of PM10-2.5 mass, copper, zinc, phosphorus, silicon, and endotoxin were estimated using site-specific spatial prediction models. We assessed associations for baseline heart rate variability and rate of change in heart rate variability over time using multivariable mixed models adjusted for time, sociodemographic, lifestyle, health, and neighborhood confounders, including copollutants. Results In our primary models adjusted for demographic and lifestyle factors and site, PM10-2.5 mass was associated with 1.0% (95% confidence interval [CI]: -4.1, 2.1%) lower standard deviation of normal to normal interval levels per interquartile range of 2 μg/m. Stronger associations, however, were observed before site adjustment and with increasing residential stability. Similar patterns were found for root-mean square differences of successive normal to normal intervals. We found little evidence for associations with other chemical species and with the rate of change in heart rate variability, though endotoxin was associated with increasing heart rate variability over time. Conclusion We found only weak evidence that long-term PM10-2.5 exposures are associated with lowered heart rate variability. Stronger associations among residentially stable individuals suggest that confirmatory studies are needed.

Purpose: When government funding for long-term care is reduced, participant outcomes may be adversely affected. We investigated the effect of program resources on individuals enrolled in the Michigan Home- and Community-Based Services (HCBS) waiver program for elderly and disabled adults. Design and Methods: Using dates of major policy and budget changes, we defi ned 4 distinct time periods between October 2001 and December 2005. Minimum Data Set for Home Care assessment records for HCBS participants ( n = 112,182) were used to examine temporal trends in formal care hours and 6 outcomes: emergency room (ER) use, hospitalization, caregiver burden, death, nursing facility (NF) use, and permanent NF placement. Controlling for demographics, functional status, and cognitive status, adjusted odds of outcomes were obtained using discrete-time survival analysis. Results: As resources diminished, mean formal care hours decreased, declining most for persons with moderate functional or cognitive impairment, for up to an approximately 30% decrease. In the most fi nancially restricted period, 3 adverse outcomes increased relative to baseline: hospitalization (odds ratio [OR] = 1.10; 95% confi dence interval [CI] = 1.03 – 1.18), ER use (OR = 1.13; 95% CI = 1.03 – 1.24), and permanent NF placement (OR = 1.20; 95% CI = 1.00 – 1.42). Implications: Reductions in resources for home care were associated with increased probability of adverse outcomes. Cutting funds to home care programs can increase utilization of other more costly services, thus offsetting potential health care savings. Policymakers must consider all ways in which budget reductions and policy changes can affect participants.

Background A method of occupational physical exposure assessment is needed to improve analyses using large data sets (e.g., national surveys) that provide only job title/category information as a proxy for exposure. Methods Five ergonomic experts rated and arrived at consensus ratings for job categories used in the Third National Health and Nutrition Examination Survey. Interrater agreement was examined for initial (pre-consensus) ratings. Correlation between consensus ratings and an independent source of ratings (US Department of Labor (DOL)) was used as a basis of comparison. Results Interrater agreements for the initial ratings were weak. Highest interrater agreement was for sitting (weighted kappa (κw) = 0.56). Lowest agreement was for standing (κw = 0.07). Consensus ratings were well correlated with DOL ratings (correlation coefficients ≥0.6). Conclusions The correlation between consensus ratings and DOL ratings support the use of expert consensus to assess physical exposures in national data sets. However, validation of expert consensus ratings is required. Am. J. Ind. Med. 50:608–616, 2007. © 2007 Wiley-Liss, Inc.

Objective To compare the safety and effectiveness of long-acting β-antagonists (LABA), long-acting antimuscarinic agents (LAMA) and inhaled corticosteroids (ICS) for managing chronic obstructive pulmonary disease (COPD). Setting Systematic review and network meta-analysis (NMA). Participants 208 randomised clinical trials (RCTs) including 134 692 adults with COPD. Interventions LABA, LAMA and/or ICS, alone or in combination, versus each other or placebo. Primary and secondary outcomes The proportion of patients with moderate-to-severe exacerbations. The number of patients experiencing mortality, pneumonia, serious arrhythmia and cardiovascular-related mortality (CVM) were secondary outcomes. Results NMA was conducted including 20 RCTs for moderate-to-severe exacerbations for 26 141 patients with an exacerbation in the past year. 32 treatments were effective versus placebo including: tiotropium, budesonide/formoterol, salmeterol, indacaterol, fluticasone/salmeterol, indacaterol/glycopyrronium, tiotropium/fluticasone/salmeterol and tiotropium/budesonide/formoterol. Tiotropium/budesonide/formoterol was most effective (99.2% probability of being the most effective according to the Surface Under the Cumulative RAnking (SUCRA) curve). NMA was conducted on mortality (88 RCTs, 97 526 patients); fluticasone/salmeterol was more effective in reducing mortality than placebo, formoterol and fluticasone alone, and was the most effective (SUCRA=71%). NMA was conducted on CVM (37 RCTs, 55 156 patients) and the following were safest: salmeterol versus each OF placebo, tiotropium and tiotropium (Soft Mist Inhaler (SMR)); fluticasone versus tiotropium (SMR); and salmeterol/fluticasone versus tiotropium and tiotropium (SMR). Triamcinolone acetonide was the most harmful (SUCRA=81%). NMA was conducted on pneumonia occurrence (54 RCTs, 61 551 patients). 24 treatments were more harmful, including 2 that increased risk of pneumonia versus placebo; fluticasone and fluticasone/salmeterol. The most harmful agent was fluticasone/salmeterol (SUCRA=89%). NMA was conducted for arrhythmia; no statistically significant differences between agents were identified. Conclusions Many inhaled agents are available for COPD, some are safer and more effective than others. Our results can be used by patients and physicians to tailor administration of these agents. Protocol registration number PROSPERO # CRD42013006725.

Introduction: Exposures to coarse particulate matter (PM10-2.5) have been associated with adverse pulmonary health. Although chronic pulmonary disease can result in right ventricular hypertrophy, n...

More than 25 million American children breathe polluted air on diesel school buses. Emission reduction policies exist, but the health impacts to individual children have not been evaluated.Using a natural experiment, we characterized the exposures and health of 275 school bus riders before, during, and after the adoption of clean technologies and fuels between 2005 and 2009. Air pollution was measured during 597 trips on 188 school buses. Repeated measures of exhaled nitric oxide (FeNO), lung function (FEV1, FVC), and absenteeism were also collected monthly (1,768 visits). Mixed-effects models longitudinally related the adoption of diesel oxidation catalysts (DOCs), closed crankcase ventilation systems (CCVs), ultralow-sulfur diesel (ULSD), or biodiesel with exposures and health.Fine and ultrafine particle concentrations were 10-50% lower on buses using ULSD, DOCs, and/or CCVs. ULSD adoption was also associated with reduced FeNO (-16% [95% confidence interval (CI), -21 to -10%]), greater changes in FVC and FEV1 (0.02 [95% CI, 0.003 to 0.05] and 0.01 [95% CI, -0.006 to 0.03] L/yr, respectively), and lower absenteeism (-8% [95% CI, -16.0 to -0.7%]), with stronger associations among patients with asthma. DOCs, and to a lesser extent CCVs, also were associated with improved FeNO, FVC growth, and absenteeism, but these findings were primarily restricted to patients with persistent asthma and were often sensitive to control for ULSD. No health benefits were noted for biodiesel. Extrapolating to the U.S. population, changed fuel/technologies likely reduced absenteeism by more than 14 million/yr.National and local diesel policies appear to have reduced children's exposures and improved health.

We examine a key task in biomedical text processing, normalization of disorder mentions. We present a multi-pass sieve approach to this task, which has the advantage of simplicity and modularity. Our approach is evaluated on two datasets, one comprising clinical reports and the other comprising biomedical abstracts, achieving state-of-the-art results.

We examine the task of temporal relation classification for the clinical domain. Our approach to this task departs from existing ones in that it is (1) knowledge-rich, employing sophisticated knowledge derived from semantic and discourse relations, and (2) hybrid, combining the strengths of rule-based and learning-based approaches. Evaluation results on the i2b2 Clinical Temporal Relations Challenge corpus show that our approach yields a 15--21% and 6--13% relative reduction in error over a state-of-the-art learning-based baseline system when gold-standard and automatically identified temporal relations are used, respectively.

We address the TLINK track of the 2012 i2b2 challenge on temporal relations. Unlike other approaches to this task, we (1) employ sophisticated linguistic knowledge derived from semantic and discourse relations, rather than focus on morpho-syntactic knowledge; and (2) leverage a novel combination of rule-based and learning-based approaches, rather than rely solely on one or the other. Experiments show that our knowledge-rich, hybrid approach yields an F-score of 69.3, which is the best result reported to date on this dataset.

Aim: The aim of the study was to evaluate the combined efficacy of foot care education and recombinant human platelet-derived growth factor (rhPDGF) on the wound healing in foot ulcers among adults with type 2 diabetes (T2D). Subjects and Methods: A randomized control trial and a factorial design were used in this study in a 500-bedded private teaching hospital with four major surgical units in 2013. A sample size of 50 adults with T2D was selected in each of the three groups; the combined intervention (foot education and rhPDGF), the medication intervention (rhPDGF), and the control group (CG) (Betadine gel). A standard clinical practice guideline was adopted for the three groups at baseline, 15 th day, and 30 th day. A modified Bates-Jensen wound assessment tool was used to assess the wound healing. Results: Combined efficacy of foot care education and rhPDGF resulted in complete closure of wound with a mean time of 15.91 days compared to the medication intervention (rhPDGF) and the CG in foot ulcers. There was better wound healing characteristics among adults with T2D exposed to the foot care education and rhPDGF compared to the use of rhPDGF and Betadine. Conclusion: Combined efficacy of foot care education with PDGF improved the total wound healing and ensured better wound characteristics in lower extremity foot ulcers among adults with T2D.

While traditional work on anaphora resolution has focused on resolving anaphors in newspaper and newswire articles, the surge of interest in biomedical natural language processing in recent years has stimulated work on anaphora resolution in biomedical texts. Existing anaphora resolvers, whether applied to the biomedical domain or not, have adopted either a learning-based or a rule-based approach. We hypothesize that both approaches have their unique strengths, and propose in this paper a hybrid approach to anaphora resolution in biomedical texts that aims to combine their strengths. Our hybrid approach achieves an F-score of 60.9 on the BioNLP-2011 coreference dataset, which to our knowledge is the best result reported to date on this dataset.

Background Few epidemiologic studies have addressed the exposure–response relationships between work activities and symptomatic knee osteoarthritis (OA). This analysis used data from a national survey and ergonomists’ ratings to address this issue. Methods Interview and knee X-ray data were obtained from the Third National Health and Nutrition Examination Survey. Occupational ratings were obtained using ergonomists. A weighted logistic regression was used. Results Among men, a significant exposure–response relationship was found between symptomatic knee OA and kneeling. In both genders, there was a significant trend in heavy lifting and severe symptomatic knee OA. Approximately 20.7% of knee OA can be attributed to kneeling >14% of the workday among men. Conclusions The significant exposure–response relationships suggest that modest reductions in certain occupational activities can reduce the burden of knee OA. The study was limited by unvalidated expert ratings. Research is needed to identify hazardous characteristics of work activities and to clarify exposure–response relationships. Am. J. Ind. Med. 51:37–46, 2008. 2007 Wiley-Liss, Inc.

The epidemiologic literature on lower extremity musculoskeletal disorders (MSDs), vascular disorders, and occupational mechanical factors is relatively sparse, compared to the low back and upper extremities. The present literature review aims to summarize and evaluate the current literature on lower extremity vascular disorders, MSDs, and symptoms, and to update previous literature reviews. A search was conducted in PubMed. Articles were included if they had a lower extremity musculoskeletal outcome, and a workplace factor(s). They were evaluated based upon their generalizability, exposure, and outcome assessments, study design, and controlling of confounders. Most of the literature has focused on osteoarthritis of the hip and knee, whereas not much research has been done examining the feet/ankles and lower legs. Overall, better exposure assessment is needed to examine the causal pathway between occupational factors and MSDs.

Motivation: We examine the task of temporal relation classification for the clinical domain. Our approach to this task departs from existing ones in that it is (i) ‘knowledge-rich’, employing sophisticated knowledge derived from discourse relations as well as both domain-independent and domain-dependent semantic relations, and (ii) ‘hybrid’, combining the strengths of rule-based and learning-based approaches. Evaluation results on the i2b2 Clinical Temporal Relations Challenge corpus show that our approach yields a 17–24% and 8–14% relative reduction in error over a state-of-the-art learning-based baseline system when gold-standard and automatically identified temporal relations are used, respectively. Database URL: http://www.hlt.utdallas.edu/~jld082000/temporal-relations/

We examine the novel task of domain-independent scientific concept extraction from abstracts of scholarly articles and present two contributions. First, we suggest a set of generic scientific concepts that have been identified in a systematic annotation process. This set of concepts is utilised to annotate a corpus of scientific abstracts from 10 domains of Science, Technology and Medicine at the phrasal level in a joint effort with domain experts. The resulting dataset is used in a set of benchmark experiments to (a) provide baseline performance for this task, (b) examine the transferability of concepts between domains. Second, we present two deep learning systems as baselines. In particular, we propose active learning to deal with different domains in our task. The experimental results show that (1) a substantial agreement is achievable by non-experts after consultation with domain experts, (2) the baseline system achieves a fairly high F1 score, (3) active learning enables us to nearly halve the amount of required training data.

Background As evidence-informed implementation interventions spread, they need to be tailored to address the unique needs of each setting, and this process should be well documented to facilitate replication. To facilitate the spread of the Mobilization of Vulnerable Elders in Ontario (MOVE ON) intervention, the aim of the current study is to develop a mapping guide that links identified barriers and intervention activities to behaviour change theory. Methods Focus groups were conducted with front line health-care professionals to identify perceived barriers to implementation of an early mobilization intervention targeted to hospitalized older adults. Participating units then used or adapted intervention activities from an existing menu or developed new activities to facilitate early mobilization. A thematic analysis was performed on the focus group data, emphasizing concepts related to barriers to behaviour change. A behaviour change theory, the ‘capability, opportunity, motivation-behaviour (COM-B) system’, was used as a taxonomy to map the identified barriers to their root causes. We also mapped the behaviour constructs and intervention activities to overcome these. Results A total of 46 focus groups were conducted across 26 hospital inpatient units in Ontario, Canada, with 261 participants. The barriers were conceptualized at three levels: health-care provider (HCP), patient, and unit. Commonly mentioned barriers were time constraints and workload (HCP), patient clinical acuity and their perceived ‘sick role’ (patient), and lack of proper equipment and human resources (unit level). Thirty intervention activities to facilitate early mobilization of older adults were implemented across hospitals; examples of unit-developed intervention activities include the ‘mobility clock’ communication tool and the use of staff champions. A mapping guide was created with barriers and intervention activities matched though the lens of the COM-B system. Conclusions We used a systematic approach to develop a guide, which maps barriers, intervention activities, and behaviour change constructs in order to tailor an implementation intervention to the local context. This approach allows implementers to identify potential strategies to overcome local-level barriers and to document adaptations. Electronic supplementary material The online version of this article (doi:10.1186/s13012-014-0160-6) contains supplementary material, which is available to authorized users.