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Objective: C-reactive protein to lymphocyte ratio (CLR) has been identified as a novel inflammatory biomarker. However, the role of CLR in myocardial infarction is unclear. Thus, this study designs to investigate the association of CLR with the prevalence of myocardial infarction in a large multiracial population in the United States. Methods: Participants from the National Health and Nutrition Examination Survey (NHANES) 2017–March 2020 Pre-pandemic were included in this cross-sectional study. Multivariable regression and subgroup analyses, controlling for demographic variables, were performed to examine the association between CLR and its quintiles and myocardial infarction. A smooth curve fitting was used to model the non-linear relationship between them. Results: A total of 12,615 participants aged ≥18 years were recruited, of whom 609 (4.83%) self-reported a history of myocardial infarction. Compared to those in the lowest quartile of ln-transformed CLR (Q1), the myocardial infarction risks for subjects in Q2, Q3, and Q4 were 1.64, 1.71, and 1.79 times, respectively. Obvious upward trends were observed when ln-transformed CLR increased (P for trend

Abstract The Matuyama‐Gauss (M‐G) magnetic polarity reversal is regarded as a fundamental time marker in the stratigraphic division of the Quaternary‐Neogene. However, previous paleomagnetic studies have shown that the M‐G is mainly recorded in the Chinese loess unit L33—a glacial stage (corresponding to marine isotope stage 104, i.e., MIS 104)—which is asynchronous with the timing recorded in marine sediments. Here, we solve this long‐standing debate by exploiting a method to extract reproducible records of paleomagnetic field intensity from Xifeng and Lantian loess profiles with meteoric 10Be. The results showed that for both loess profiles, the 10Be‐derived M‐G boundary is located in paleosol S32 ca. 2,589 ± 3 ka, which corresponds to MIS 103. This is synchronous with that seen in marine sediments, though it is, on average, ∼19 ka younger than the boundary inferred from paleomagnetic measurements from the two profiles, which demonstrates that magnetic overprinting has occurred.

Recent development on 3D flash memories largely promotes the wide application of Solid-State Drives (SSDs) by providing larger capacity from vertically-stacked layers. However, there exist speed variations across different layers because of manufacturing process variations or physical designs, which induces new challenges to fully explore the advantages of existing SSDs, e.g. the parallel structure. This paper investigates the effect of speed variation on the parallel performance of SSDs. To balance chips’ workloads, traditional method selects chips in a round-robin way. As chip queue time can be estimated by some main factors, the chip also can be chosen in a greedy way. However, because of the layer speed variation, queue time estimation model should be modified. This paper first establishes a new queue time estimation model with the awareness of the flash layer information. Then the model is used to estimate the chip queue time and to direct write requests into the chip with the least queue time. The key idea is to largely reduce queue time of each write, thus reducing the average SSD response time. Finally, this new request redirection method is evaluated on SSDsim with real world workloads. Experimental results show that our model can estimate the queue time more accurately and our new request redirection method can improve 8.3% of write queue time on average under the situation of 4 times speed variation among 16 layers.

Abstract Higher mortality in asthmatics has been shown previously. However, evidence on different asthma phenotypes on long-term mortality risk is limited. The aim was to evaluate the impact of asthma phenotypes on mortality in general population. Data from the National Health and Nutrition Examination Survey from 2001–2002 to 2013–2014 linked mortality files through December 31, 2015, were used (N = 37,015). Cox proportional hazards regression was used to estimate the risk of all-cause and cause-specific mortality adjusting for sociodemographic characteristics, smoking, body mass index, and chronic conditions. During the mean follow-up time of 7.5 years, 4326 participants died from a variety of causes. Current asthma, but not former asthma was associated with increased all-cause mortality (current asthma: HR = 1.37; 95% CI 1.20–1.58; Former asthma: HR = 0.93; 95% CI 0.73–1.18); as well as mortality from cardiovascular disease (HRCurrent = 1.41; 95% CI 1.08–1.85) and chronic lower respiratory diseases (HRCurrent = 3.17; 95% CI 1.96–5.14). In addition, we found that the HR for cardiovascular disease (CVD) mortality was slightly greater in people with childhood-onset asthma than those with adult-onset asthma. The HR for chronic lower respiratory diseases (CLRD) mortality was greater in people with adult-onset asthma than those with childhood-onset asthma. However, the differences were not statistically significant. Our study suggested that current asthma but not former asthma was associated with increased all-cause, CLRD and CVD mortality. Future well-designed studies with larger sample are required to demonstrate the association and clarify the potential mechanisms involved.

ObjectiveTraditional metal alloy occluders for the closure of patent foramen ovale (PFO) may be associated with some potential complications, and may restrict the trans-septal access to the left atrium for future treatment of left-sided heart disease. Increasing attention has been paid to novel biodegradable occluders (NBOs) to achieve PFO closure. We aimed to evaluate the role of transesophageal echocardiography (TEE) in the diagnostic and anatomical evaluation of PFO, as well as in the Post-procedural assessment after transcatheter closure with a NBO.MethodsWe conducted a prospective, single-center clinical study of 44 patients who were diagnosed with PFO by contrast transthoracic echocardiography (c-TTE) and TEE from June 2019 to June 2020. All patients underwent PFO occlusion with NBO under TTE guidance. Follow-up was performed at 2 days and 3 months after the procedure with TTE, and at 6 months and 1 year after the procedure with c-TTE, TTE, and TEE.ResultsInterventional treatment was successfully performed in all patients. The left and right sides of the occluder device disc were significantly reduced at 3, 6, and 12 months compared to 2 days after the procedure (all P < 0.01), and decreased gradually. The thickness was significantly reduced at 12 months compared to the first three time points (all P < 0.01). Thrombus was found on the surface of the occluder device in three patients (6.4%) at 3 and 6 months after occlusion. At 6 months after procedure, there were 3 (6.8%) cases of extensive residual right-to-left shunt (RLS), 2 (4.5%) cases of moderate shunt, and 7 (15.9%) cases of small shunts. One year after procedure, 2 (4.5%) cases had a extensive residual shunt, 6 (13.6%) cases of small shunts were confirmed to originate from pulmonary veins by TEE, and the PFO-RLS occlusion rate reached 95.5%.ConclusionThis study demonstrates the feasibility, safety, and effectiveness of NBO for the closure of PFO in humans, with a high rate of complete shunt closure. Accurate TEE assessment of the PFO anatomy before closure with NBO is important to ensure that the procedure remains safe and effective. Furthermore, TEE plays a crucial role in the Post-procedure follow-up.

Abstract Background There is growing evidence that pseudogenes may serve as prognostic biomarkers in several cancers. The present study was designed to develop and validate an accurate and robust pseudogene pairs-based signature for the prognosis of hepatocellular carcinoma (HCC). Methods RNA-sequencing data from 374 HCC patients with clinical follow-up information were obtained from the Cancer Genome Atlas (TCGA) database and used in this study. Survival-related pseudogene pairs were identified, and a signature model was constructed by Cox regression analysis (univariate and least absolute shrinkage and selection operator). All individuals were classified into high- and low-risk groups based on the optimal cutoff. Subgroups analysis of the novel signature was conducted and validated in an independent cohort. Pearson correlation analyses were carried out between the included pseudogenes and the protein-coding genes based on their expression levels. Enrichment analysis was performed to predict the possible role of the pseudogenes identified in the signature. Results A 19-pseudogene pair signature, which included 21 pseudogenes, was established. Patients in high-risk group demonstrated an increased the risk of adverse prognosis in the TCGA cohort and the external cohort (all P

Objective. The Amplatzer patent foramen ovale (PFO) occluder is the most commonly used device for percutaneous closure of a large PFO. However, its use may predispose the patient to postoperative residual shunting. To reduce the incidence of residual shunting, we investigated the safety and effectiveness of the Amplatzer atrial septal defect (ASD) occluder for percutaneous closure of a large PFO measured by transesophageal echocardiography (TEE) and evaluated the value of TEE in this procedure. Methods. Overall, 118 patients who were diagnosed with a large PFO (all with a≥2 mm left atrial side height after the Valsalva maneuver (VM) excluding those with a small ASD) using contrast transthoracic echocardiography (c-TTE) and TEE underwent closure under TEE guidance at The First Affiliated Hospital of Xi’an Jiaotong University. An ASD device was used in 48 patients (group I) and a PFO device in 70 (group II). After the procedure, we verified the safety and efficacy of different devices using c-TTE, TTE, and TEE. Results. In both groups, the preoperative TEE results showed a significantly increased left height of the PFO after VM compared with that at rest (all P

Due to its non-volatility and large capacity, NVM devices gradually take place at various levels of memories. However, their limited endurance is still a big concern for large-scale data centres. Compression algorithms have been used to save NVM space and enhance the efficiency of those lifetime extension methods. However, their own influence on the NVM lifetime is not clear. In order to fully investigate the impact of compression on NVM, this paper first studies bit flips involved in several typical compression algorithms. It is found that more bit flips would happen in the shrunken area of a memory block. This induces the phenomenon of intra-block wear unevenness, which sacrifices NVM lifetime. We propose a new metric called local bit flips to describe this phenomenon. In order to relieve the intra-block wear unevenness caused by compression, this paper proposes a sliding write method named SlidW to distribute the compressed data across the whole memory block. We first divide the memory block into several areas, and then consider five cases about the relationship between new data size and left space. Then, we place the new data according to the case. Comprehensive experimental results show that SlidW can efficiently balance wear and enhance NVM lifetime.

Address space layout randomization (ASLR) is now widely adopted in modern operating systems to thwart code reuse attacks. However, an adversary can still bypass fine-grained ASLR by exploiting memory corruption vulnerabilities and performing memory disclosure attacks. Although Execute-no-Read schemes have been proven to be an efficient solution against read-based memory disclosures, existing solutions need modifications to kernel or hypervisor. Besides, the defense of execution-based memory disclosures has been ignored. In this paper, we propose BoundShield, a self-protection scheme that provides comprehensive protection against memory disclosure attacks, especially against those based on executing arbitrary code by leveraging Intel Memory Protection Extension. BoundShield protects code memory by defending not only read-based memory disclosure attacks but also execution-based memory disclosure attacks. On one hand, read-based memory disclosures can be eliminated by hiding all code sections and code pointers in a secret region separated from the user address space. On the other hand, BoundShield prevents return addresses from being corrupted and ensures that all function pointers point to the legitimate entries whenever they are dereferenced, which significantly reduces the attack surface for execution-based memory disclosures. We have implemented a prototype of BoundShield based on a set of modifications to compiler toolchain and the standard C library. Our evaluation results show that the BoundShield can provide strong defenses against memory disclosure attacks while incurring a small performance overhead.

3D-multi-level cell (MLC) NAND flash memory adopts 3D stack technology and stores two bits per cell, leading to improved storage capacities, but sacrificing data reliability. Low-density parity-check (LDPC) codes showing strong error correction capability benefit from their soft decision decoding, which is widely exploited to guarantee data reliability. Nevertheless, adopting LDPC codes can introduce a concern about read performance, because their iterative soft-decision decoding requires LogLikelihood Ratio (LLR) information, called soft decision information, by applying multi-sensing voltages. This process of obtaining LLR information leads to high sensing and transferring latencies, lowering down 3D-MLC read performance. In particular, when raw bit error rates (RBER) are much higher due to the long retention periods and program/erase (P/E) cycles, this problem becomes more serious. In this paper, we propose a RBER-aware multi-sensing scheme for reducing sensing and transferring latencies, and thus improving read performance. This proposed scheme exploits the variations of RBER in flash pages with the increase of retention time and P/E cycles to dynamically apply sensing voltages. Simulation results show that this scheme significantly decreases the number of required sensing voltages while maintaining LDPC error correction capability, enhancing 3D-MLC read performance.

With the advantage of faster data access than traditional disks, in-memory database systems, such as Redis and Memcached, have been widely applied in data centers and embedded systems. The performance of in-memory database greatly depends on the access speed of memory. With the requirement of high bandwidth and low energy, die-stacked memory (e.g., High Bandwidth Memory (HBM)) has been developed to extend the channel number and width. However, the capacity of die-stacked memory is limited due to the interposer challenge. Thus, hybrid memory system with traditional Dynamic Random Access Memory (DRAM) and die-stacked memory emerges. Existing works have proposed to place and manage data on hybrid memory architecture in the view of hardware. This paper considers to manage in-memory database data in hybrid memory in the view of application. We first perform a preliminary study on the hotness distribution of client requests on Redis. From the results, we observe that most requests happen on a small portion of data objects in in-memory database. Then, we propose the Application-oriented Data Migration called ADM to accelerate in-memory database on hybrid memory. We design a hotness management method and two migration policies to migrate data into or out of HBM. We take Redis under comprehensive benchmarks as a case study for the proposed method. Through the experimental results, it is verified that our proposed method can effectively gain performance improvement and reduce energy consumption compared with existing Redis database.

The recent development of 3D flash memories has promoted the widespread application of SSDs in modern storage systems by providing large storage capacity and low cost. Garbage collection (GC) as a time-consuming but necessary operation in flash memories largely affects the performance. In this paper, we perform a comprehensive experimental study on how garbage collection impacts the performance of flash-based SSDs, in the view of performance cliff that closely relates to Quality of Service (QoS). According to the study results using real-world workloads, we first observe that GC occasionally causes response time spikes, which we call the performance cliff problem. Then, we find that 3D SSDs exacerbate the situation by inducing a much higher number of page migrations during GC. To relieve the performance cliff problem, we propose PreGC to assist normal GC. The key idea is to distribute the page migrations into the period before normal GC, thus leading to a reduction in page migrations during the GC period. Comprehensive experiments with real-world workloads have been performed on the SSDsim simulator. Experimental results show that PreGC can efficiently relieve the performance cliff by reducing the tail latency from the 90th to 99.99th percentiles while inducing a little extra write amplification.