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Background Real-world data on eosinophilic chronic obstructive pulmonary disease (COPD)'s clinical burden, in exacerbating/stable states, and the stability of blood eosinophil count (BEC) measurements are limited. We described measured BEC distributions among general practice COPD patients in New Zealand (NZ). Methods This retrospective cohort study utilized the NZ-HealthStat primary care database. Participants were aged ≥40 years, with ≥1 BEC 6 months following a COPD diagnosis code during 2011–2012. Descriptive analyses included examinations of BEC stability and association with COPD exacerbations/treatments/comorbidities. Results The most frequent COPD comorbidity was asthma (n = 1180/2909, 40.56%). Among COPD patients: 65% had BECs >150 cells/μL; 35% had BECs >300 cells/μL (non-mutually exclusive threshold categories). Treatment patterns were similar, except for more frequent inhaled corticosteroid (ICS)/long-acting beta2-agonist use in COPD patients with asthma history (51%) than those without (31%). Factors associated with BECs >150 cells/μL in participants without ICS treatment included Māori/Pacific ethnicity, obesity, oral corticosteroid (OCS) use, and exacerbation history. When stratified by asthma history, ICS treatment, and neutrophil count above/below 5000 cells/μL, geometric mean BECs ranged from 136.70 to 398.52 cells/μL. Exploratory analyses showed a fair–good COPD/BEC measurement stability over 12 months. Conclusions Asthma was a common COPD comorbidity in NZ, particularly in Māori/Pacific patients. No overall relationship was observed between BEC/COPD exacerbations, which may reflect background ICS confounding. However, analyses in non-ICS treated participants suggested that Māori/Pacific patients with obesity and COPD, OCS treatment, exacerbation history, and/or elevated BECs are at the highest risk of COPD exacerbations. One BEC measurement appears a good indicator of a patient's BECs over time.

Despite a growing prevalence of respiratory diseases in recent decades in China, limited evidence is available on the health and economic burden of chronic obstructive pulmonary disease (COPD). We estimated the 20-year health and economic burden of COPD in China from 2020 to 2039.We created a probabilistic dynamic open-cohort Markov model of COPD for the Chinese population aged ≥40 years. Projections of population growth and urbanization rates were obtained from the United Nations Population Division. Other parameter inputs including smoking prevalence, COPD prevalence and severity distributions, disease-related costs, and utility weights were obtained from the most recent published literature. We modeled number of COPD patients, excess mortality due to COPD, exacerbations, COPD-attributable losses of quality-adjusted life-years, and direct and indirect COPD costs over the 20 years.The number of COPD patients was projected to increase from 88.3 million in 2020 to 103.3 million in 2039. The projected total losses of quality-adjusted life-years and the excess mortality due to COPD were, respectively, estimated to be 253.6 million and 3.9 million over the 20 years. The projected 20-year total discounted direct and indirect costs of COPD were, respectively, $3.1 trillion and $360.5 billion. The projected health and economic burden was higher in males and urban areas.COPD is projected to inflict a substantial burden to the society and the health care system in China. Effective strategies for prevention and early management of COPD are needed to mitigate the forthcoming disease burden.

Budgetary constraints force healthcare authorities to set priorities for optimal vaccine interventions. A comprehensive decision-making tool would help inform the best combination and sequence of introduction of vaccines within constrained budgets.Looking at available vaccines against pneumococcal infections in Taiwan (10/13-valent pneumococcal conjugate vaccines [PCV10, PCV13] and 23-valent pneumococcal polysaccharide vaccine [PPV23]), a constrained optimization (CO) model was used to assess the optimal combination of vaccines in children and older adults that would maximize the quality-adjusted life years under predefined budget constraints. Scenario analyses were carried out to evaluate the impact of vaccine efficacy (VE) on the optimized solution.The CO model demonstrated that the optimal sequence of vaccine introduction was PPV23 in older adults and PCV10 in children. The optimal solution was mostly driven by the potential to reduce disease burden in the older adult population. The VE of PPV23 in older adults and the VE of PCV vaccines against serotype 19A invasive pneumococcal disease had little impact on the optimal solution.The CO approach can be used to set priorities for introducing new vaccines while maximizing health gains per age group within the constrained National Vaccine Fund for the prevention of pneumococcal disease in Taiwan.

Burden of severe eosinophilic asthma (SEA) data in Asia are limited.This retrospective, observational study characterized SEA epidemiology, healthcare resource use (HCRU) and costs for adult patients in Taiwan.Data from Taichung Veterans General Hospital electronic medical record database, between 2013 to 2016, were extracted. Eligible general asthma patients were ≥ 18 years at index date, with ≥ 1 medical claim with an asthma diagnosis after the index date. Patients with SEA (meeting additional criteria: Global Initiative for Asthma Step 4/5 treatment guidelines [within 3 months preceding index date], ≥ 2 clinically significant exacerbations, and eosinophil counts ≥ 300 cells/μL [within 12 months preceding index date] or ≥ 150 cells/μL [on index date]) and SEA patients using high-dose inhaled corticosteroids (HD ICS) were also identified. Twelve months' pre-index data were used to evaluate exacerbation frequency, treatment patterns, HCRU, and costs (2016 US Dollars).Of 2,601 eligible general asthmatic patients, 162 (6.2%) met predefined criteria for SEA; of SEA patients, 72/162 (44.4%) had used HD ICS. SEA and HD ICS SEA patients experienced more clinically significant exacerbations than general asthma patients (1.6 ± 3.3 and 1.5 ± 2.6 vs 0.6 ± 2.0, p0.01). HD ICS SEA and SEA patients incurred at least 2-2.5-fold higher total asthma-related and all-cause costs than general asthma patients and had significantly greater HCRU.Of eligible Taiwanese general asthma patients, 6.2% met predefined SEA criteria. Compared with general asthma patients, SEA and HD ICS SEA patients used more respiratory medications, experienced more exacerbations, and incurred greater HCRU and higher costs.

Background: This retrospective cohort study aimed to characterize epidemiology, medication use and healthcare resource utilization (HCRU) of patients diagnosed with severe eosinophilic asthma (SEA) compared to other patients with asthma in New Zealand.Methods: Adult patients with asthma with no concurrent diagnosis of Chronic Obstructive Lung Disease (COPD) were identified from the HealthStat primary care database and the National Minimum Dataset using asthma diagnosis, hospital codes and prescriptions. Patients with SEA were identified using a 1-year baseline period (2011) and were those with: inhaled corticosteroid prescription above medium dose (including high dose) plus controller medication, ≥2 exacerbations, and eosinophils ≥300 cells/µl (or ≥150 in 6 weeks prior to index date); patients were followed for 1 year (2012).Results: 160/3276 (4.9%) asthmatics with available eosinophil counts met SEA criteria. Patients with SEA were more likely to be Māori, former smokers, have more comorbidities, higher mean BMI and higher neutrophil counts compared with other patients with asthma. In the follow-up period, SEA patients had over 4 times as many exacerbations; incidence of exacerbations of the same frequency were highest in Māori patients.Conclusions: Compared with other patients with asthma, SEA patients had over 1.5 times as many respiratory treatment prescriptions and higher all-cause HCRU and total healthcare costs; asthma-related healthcare costs were 3.6 times greater.

Dutasteride improves hair growth compared with finasteride in male androgenic alopecia (AGA) and is well tolerated. However, real-world evidence for long-term dutasteride use in AGA is lacking.To describe baseline characteristics, treatment patterns and long-term safety and effectiveness of dutasteride versus finasteride.This was a multicentre, retrospective medical chart review study conducted in South Korea. The index date was the first prescription of dutasteride or finasteride. Baseline characteristics were assessed 6 months prior to index. Safety and effectiveness (improvements in basic and specific [BASP] classification) data were collected from index throughout the observation period.Overall, 600 male adult patients were included (dutasteride, n=295; finasteride, n=305). Dutasteride-treated patients were older (Dutasteride showed greater effectiveness than finasteride in improving BASP classification in treating male AGA and had a similar or possibly lower occurrence of overall AEs. Dutasteride may provide an effective and safe treatment option for male patients with AGA.

In this paper, we propose a cyber-physical signage interacting framework for the interaction between digital signage and mobile users using smart handheld devices, such as smartphones and tablets. The proposed framework can provide diverse multimedia/feedback services to mobile users interacting with digital signage through face detection, classification, and recognition techniques based on mobile cloud computing. Mobile users only need to click and drag the interested service over the face of advertising celebrities/endorsers displayed on digital signage and can obtain supplementary multimedia information or feedback related comments. Using the intuitive way of gesture-based operations, mobile users can directly interact with digital signage through their handheld devices. Our framework reveals an innovative human–machine interface for signage interacting between digital signage and mobile users. In addition, we integrate our framework with a face cache mechanism that can make the interaction delay as small as possible for popular signage. Furthermore, an Android-based signage interacting system is implemented to verify the feasibility and superiority of our framework. Experimental results show that our approach outperforms the existing methods and can significantly reduce the average consumption time of obtaining interested multimedia contents from digital signage.

Background: Severe eosinophilic asthma (SEA) is an important asthma phenotype that is poorly described in clinical practice in Asia. Aim and objectives: To characterize the epidemiology, medication dispensation and healthcare resource utilization (HRU) of adult SEA patients in Taiwan. Methods: This retrospective cohort study was carried out within Taichung Veterans General Hospital’s electronic medical record database. Asthma patients aged ≥18 years were identified from 1Jul13-30Jun16. Patients were classified as having SEA if the following criteria were met at baseline: Prescription per GINA Step 4/5 treatment guidelines, 2+ exacerbations, and a blood eosinophil (EOS) count of ≥300 cells/µL or ≥150 cells/µL at baseline. Patients were followed for 1 year post index to examine medication use, HRU and related costs. Results: Of 2,601 eligible asthma patients, 162 (6.2%) patients met the eligibility criteria for SEA. Higher prevalence of SEA was found in current or past smokers (23.5% vs. 16.0%, P=0.0305). The median blood EOS count for SEA patients was higher compared with those without SEA (467.5 cells/µl vs. 167.3 cells/µl, p Conclusions: Although the overall prevalence of SEA was low in this cohort, these patients accounted for higher health care resources than general asthma patients. Funding: GSK (PRJ2409)

Background: Patients with severe eosinophilic asthma (SEA) remain poorly described. Aim and objectives: This study aimed to characterize the epidemiology, medication use and healthcare resource utilization (HRU) of SEA patients compared to non-SEA asthma patients in New Zealand (NZ). Methods: A retrospective case-only cohort study was conducted to investigate adults (age 18+) enrolled in the HealthStat primary care database in NZ. Asthma patients were identified using diagnostic codes and prescriptions for inhaled corticosteroids (ICS). SEA was defined using the following criteria during a 1-year baseline period (2011): ICS prescription above the medium dose plus a controller medication, 2+ exacerbations, and an eosinophil cell count ≥300 cells/µL (or ≥150 in 6 weeks prior to index). SEA and non-SEA patients identified during baseline were followed for 1-year (2012) to evaluate HRU and related costs. Results: Among 3737 asthma patients, 6.2% (n=230) met the criteria for SEA. SEA prevalence was highest for individuals with Maori ethnicity (9.4%), age 60-69 years (9.3%), and former smokers (8.0%). Compared to the non-SEA group, SEA patients were more likely to have diabetes (23% v 15%) or heart failure (10% vs 5%) and a higher mean for BMI (33 vs 31 kg/m2) and neutrophil counts (5.2 vs 4.6 109/L). During baseline, SEA patients had six times as many exacerbations and twice as many respiratory treatment prescriptions than the non-SEA group. SEA patients had 70% more HRU and 3.4 times higher annual HRU costs compared to non-SEA patients. Conclusions: SEA patients had more comorbidities and medication usage and higher HRU and associated costs compared to non-SEA asthma patients in NZ. Funding: GSK (208970)

Experience ecotourism particularly could encourage active ageing groups with sensory experience, and easily help them reciprocally interact. This study invited four active aging persons and two professional tour-guiding staff to conduct "walk aloud" and "walk through" interviews in an ecological tourism destination "Taiwan Nantou Sun Link Sea Forest Recreation Area" suitable for the elderly's tourism according to the results of the first phase so as to further extract the problems and demands that the elderly face in ecotourism. The results show that: The factors forming the active aging groups' eco-tourism travel experience, including the external environment, physiological and psychological factors. However, to enhance the positive experience of the active aging groups' ecotourism when both physiological and environmental factors meet the conditions, external situation involvement is an important medium to enhance the elderly's satisfaction, including both emotion and story. The emotion part contains the experience of five senses, accompanying emotion and nostalgia experience; while the story part includes daily life stories, new knowledge obtaining and sharing mechanism. This study suggests that the results obtained from the above can be applied to shape the scenario design of future ecotourism field to help develop services and related technology products in order to enhance the elderly's joy and experience in ecotourism.

In this paper, we design and implement a face-based signage interacting system, called AdYou, for mobile users using smartphones. By using the AdYou system, mobile users only need to drag the service icon on the face of a particular target in a digital signage. AdYou is able to provide diverse services to mobile users through face detection and recognition techniques. Using the intuitive way of gesture-based operations, mobile users can directly interact with digital signage. We further integrate the AdYou server with a face cache mechanism that can make the system response time as small as possible for popular signage. AdYou reveals an innovative user interface for signage interacting between mobile users and digital signage. We have implemented an Android-based AdYou system that can be interacted by mobile users as fast as possible.

Mobile communication and handheld devices are currently extremely popular, and provide people with convenient and instant platforms for social networking. However, existing social networking services cannot offer efficient human-machine interfaces or intuitive user experiences. Mobile users must manually input account information and find targets from search results when attempting to add someone to their friend list on social networking sites, such as Facebook and Twitter. Additionally, mobile users may not be able to identify correct targets because some usernames are identical. Typos may occur during the input process due to unfamiliar identifiers, further increasing the total operation time. To encourage social initiation between mobile users, we design an instant social networking framework, called SocialYou, to minimize the startup time based on mobile cloud computing. SocialYou proposes an efficient architecture and innovative human-machine interfaces to alleviate the complexity and difficulty for mobile users using handheld devices. In particular, we implement an Android-based prototype to verify the feasibility and superiority of SocialYou. The experimental results show that SocialYou outperforms the existing methods and saves substantial amounts of operation time for mobile social networking.

In this paper, we design an augmented reality based social networking system, called SocialYou, for mobile users using smartphones. The SocialYou system only needs a single-finger action that drags the icon of social networking websites to the target face on the screen of a smartphone. The target user webpage in a specific social networking website can be immediately displayed in the social media App or built-in web browser. Through SocialYou, mobile users do not need to know the target identifier in advance. In addition, mobile users do not need to input identifier information by themselves. Furthermore, mobile users can select a specific target among multiple candidates from the camera of a smartphone. SocialYou reveals an innovative user interface for social networking between mobile users. We have implemented an Android-based SocialYou system that outperforms existing methods in experimental results.

In this paper, we propose a video-based metropolitan positioning system (V-MPS) for providing centimeter-grade localization in vehicular networks. The V-MPS system integrates vehicular networks with installed roadside/intersection cameras to provide positioning information to vehicles on the road. V-MPS can estimate the precise position of a vehicle and detect the located lane for each vehicle. To the best of our knowledge, V-MPS is the first positioning system which provides the following features: 1) it achieves the centimeter-grade positioning accuracy for vehicular networks that can detect the located lanes of vehicles, 2) it employs existing roadside/intersection cameras that can keep additional construction cost low, and 3) it establishes an innovative infrastructure for applications of next-generation Intelligent Transportation System (ITS) that can make lane-level traffic control, collision avoidance, and vehicle navigation possible. With vehicular networks, the estimated positions can be broadcast to nearby vehicles. With roadside/intersection cameras, the lane positions of vehicles can be detected even if GPS is not accurate enough to provide lane-level localization. In addition, the traffic condition can be continually monitored to optimize driving efficiency for next-generation ITS. This paper demonstrates our current prototype.

In this paper, we design an augmented reality based file transfer system called ShareAR. The ShareAR system only needs a single-finger action that drags the file icon to the target face on the screen of a mobile device. The dragged file can be transmitted to the target receiver who gets the file immediately as her/his mobile device is on-line or receives the file later after connecting to the Internet. Through ShareAR, users do not need to know the target account in advance. In addition, users do not need to input account information by themselves. Furthermore, users can select a specific target among multiple candidates from the camera of a mobile device. ShareAR reveals an innovative user interface to transfer files between mobile devices. We have implemented an Android-based ShareAR system that outperforms existing schemes in experimental results.

Molecular dynamic simulations of salt-free polyelectrolyte brushes subject to external fields applied normal to the grafting substrate reveal the three-dimensional monomer and counterion distributions. It is found that below a critical electric field, local electroneutrality holds for densely grafted brushes and the brush height remains independent of field intensity. Above this critical field (which scales as 1/3 with grafting density) brush height increases smoothly, and the fraction of condensed counterions decreases. The brush bifurcates into two subpopulations of stretched and collapsed chains when the grafting density is not low. At intermediate grafting densities, the majority of chains are stretched and the minority are nonstretched. At high grafting densities bifurcation and brush height growth occur consecutively. The majority of the chains are nonstretched at high grafting densities. Although not observed prior to overstretching of the chain model, it is predicted that the two subpopulations will re-merge to a single highly stretched phase when field intensity reaches a third critical value. The ability to control subpopulations of chains suggests that utilizing electric fields normal to polyelectrolyte brushes holds potential as controllable gates in microfluidic devices.

Consolidation of virtual machines is essential to achieve energy optimization in cloud computing environments. As virtual machines dynamically enter and leave a cloud system, it becomes necessary to relocate virtual machines among servers. However, relocation of virtual machines introduces run-time overheads and consumes extra energy, thus an careful planning for relocation is necessary. We model the relocation problem as a modified bin packing problem and propose a new server consolidation algorithm that guarantees server consolidation with {\em bounded} relocation costs. We also conduct a detailed analysis on the complexity of the server consolidation problem, and give a upper bound on the cost of relocation. Finally, we conduct simulations and compare our server consolidation algorithm with other relocation methods, like First Fit and Best Fit method. The experiment results suggest an interesting trade-off between server consolidation quality and relocation cost. Our algorithm is able to trade about 1\% in server consolidation quality for a reduction about 50\% in relocation cost, when compared with other well known bin packing algorithms. We also note that the relocation cost incurred in our method is much less than the theoretical bound we provided. The reason is that we overestimate the amount of relocation from theoretical analysis, and the actual amount of relocation found from experiments is much less than the worst-case bound from theoretical analysis.

MapReduce is a very popular parallel programming model for processing large data sets. This paper discusses strategies in implementing a MapReduce runtime system using Message Passing Interface (MPI) library. The implementation uses blocking communication function in MPI, e.g. MPI_Send and MPI_Recv, to transfer intermediate data, so as to make the communication between mappers and reducers in MapReduce model much more efficient. Experiment results indicate that our MPI implementation performs better than Hadoop when the data volume is below 60MB, and perform five times better then native Hadoop when the input size is below 5MB.

Summary Most methods of file transfer between mobile devices have to take considerable time to obtain and input target identifiers. To speed up file sharing of mobile devices, an intelligent file transfer framework is designed based on mobile cloud computing. Only single-finger action is performed in the proposed framework, which just drags the file to the target face on the touchscreen of a mobile device. The dragged file can be transmitted to the target receiver who can either get the file immediately as her/his mobile device is online or receive the file later after connecting to the Internet. Our framework provides the following features: (i) users do not need to know the target identifier in advance; (ii) users do not need to input identity information by themselves; and (iii) users can select a specific target among multiple candidates from the camera of a mobile device. The intelligent file transfer framework reveals an efficient architecture and innovative user interfaces to transfer files between mobile devices, which can significantly reduce the complexity and difficulty of file sharing. An Android-based prototype is implemented to verify the feasibility and superiority of our framework. Experimental results show that our approach outperforms existing schemes and can save large amounts of time in file sharing for mobile users. Copyright © 2015 John Wiley & Sons, Ltd.

This paper proposes scheduling algorithms for assigning jobs with different release time and execution time to machines with heterogeneous processor cardinality. We show that this scheduling problem is NP-complete, and propose dynamic programming to find the optimal schedules. Since the dynamic programming is time-consuming, we propose techniques that improve the efficiency of the dynamic programming. We also propose heuristic algorithms for this scheduling problem. Experimental results demonstrate that some of the heuristics not only compute the answer efficiently but also provide good solutions.