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An integrated approach for dynamic traffic routing and ramp metering using sliding mode control

Journal of Traffic and Transportation Engineering(English Edition) 2018年第2期5卷 116-128页

作者： hirsh majid Chao Lu Hardy Karim Department of Civil Engineering College of Engineering University of Sulaimani School of Mechanical Engineering Beijing Institute of Technology

The problem of designing integrated traffic control strategies for highway networks with the use of route guidance, ramp metering is considered. The highway network is simulated using a first order macroscopic model called LWR model which is a mathematical traffic flow model that formulates the relationships among traffic flow characteristics in terms of density, flow, and mean speed of the traffic stream. An integrated control algorithm is designed to solve the proposed problem, based on the inverse control technique and variable structure control（super twisting sliding mode）. Three case studies have been tested in the presence of an on-ramp at each alternate route and where there is a capacity constraint in the network. In the first case study, there is no capacity constraint at either upstream or downstream of the alternate routes and the function of the proposed algorithm is only to balance the traffic flow on the alternate routes. In the second case study, there is capacity constraint at downstream of alternate routes. The proposed algorithm aims to avoid congestion on the main road and balance the traffic flow on the alternate routes. In the last case study, there is capacity constraint at upstream of alternate routes. The objective of proposed algorithm is to avoid congestion on the main road and to balance the traffic flow on the alternate routes. The obtained results show that the proposed algorithms can establish user equilibrium between two alternate routes even when the on-ramps, located at alternate routes, have different traffic demands.

关键词： Highway traffic simulation Macroscopic model Sliding mode control Dynamic traffic routing On-ramp metering Integrated control

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Interventions to improve physical function and prevent adverse events in cirrhosis

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Gastroenterology Report 2018年第1期6卷 13-20,I0001页

作者： hirsh D.Trivedi Elliot B.Tapper Liver Center Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Department of Hepatology University of MichiganAnn ArborMIUSA

Cirrhosis is associated with debilitating complications that significantly impact on a patient’s physical function and reduce quality of *** to highly prevalent sarcopenia,malnutrition and hepatic encephalopathy,functional impairment or frailty is a common complication of *** in turn increases the patient’s risk of hospitalization,accidental falls and fractures,and *** management of frailty and its associated adverse effects is imperative in improving the overall prognosis of patients with advanced liver *** cornerstone of therapy revolves around optimizing physical function with appropriate nutrition and *** therapy with protein supplementation has shown significant benefit,while studies on exercise have been ***,newly emerging studies trend towards a beneficial effect of physical exercise with improvement in quality of *** implementation of technology in liver disease management shows future *** and other wearable devices can be used to help monitor a patient’s personal progress in physical exercise and nutritional ***,the progressive development of new smartphone applications to help aid in the diagnosis and monitoring of complications of cirrhosis provides a sophisticated avenue for improving care of patients with cirrhosis.

关键词： Hepatic encephalopathy frailty sarcopenia malnutrition liver disease

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Dilemmas in end-stage heart failure

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Journal of Geriatric Cardiology 2015年第1期12卷 57-65页

作者： Carol Chen-Scarabelli Louis Saravolatz Benjamin hirsh Pratik Agrawal Tiziano M. Scarabelli Veterans Affairs Healthcare System Ann Arbor 2215 Fuller Rd. Ann Arbor M148105 USA St. John Hospital and Medical Center~Wayne State University 22101 Moross Rd. Detroit M148236 USA Zena and Michael A. Wiener Cardiovascular Institute Mount Sinai Medical Center One Gustave L. Levy Place Box 1030 New York NY 10029-6574 USA

Heart failure （HF）, a complex clinical syndrome due to structural or functional disorder of the heart, is a major global health issue, with a prevalence of over 5.8 million in the USA alone, and over 23 million worldwide. As a leading cause of hospitalizations among patients aged 65 years or older, HF is a major consumer of healthcare resources, creating a substantial strain on the healthcare system. This paper discusses the epidemiology of HF, financial impact, and multifaceted predicaments in end-stage HF care. A search was conducted on the U.S National Library of Medicine website （***） using keywords such as end-stage heart failure, palliative care, ethical dilemmas. Despite the poor prognosis of HF （worse than that for many cancers）, many HF patients, caregivers, and clinicians are unaware of the poor prognosis. In addition, the unpredictable clinical trajectory of HF complicates the planning of end-of-life care, such as palliative care and hospice, leading to underutilization of such resources. In conclusion, ethical dilemmas in end-stage HF are numerous, embroiling not only the patient, but also the caregiver, healthcare team, and society.

关键词： Ethical dilemmas Heart failure Palliative care

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Rise of sodium-glucose cotransporter 2 inhibitors in the management of nonalcoholic fatty liver disease

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World Journal of Hepatology 2019年第7期11卷 562-573页

作者： Amr Dokmak Mohammad Almeqdadi hirsh Trivedi Sandeep Krishnan Division of Medicine St. Elizabeth’s Medical CenterBrightonMA 02135United States Tufts University School of Medicine BostonMA 02111United States Division of Gastroenterology Beth Israel Deaconess Medical CenterBostonMA 02215United States Division of Gastroenterology St. Elizabeth’s Medical CenterBrightonMA 02135United States

Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the Western world. It is more prevalent in male gender, and with increasing age, obesity, and insulin resistance. Besides weight loss, there are limited treatment options. The use of anti-diabetic medications has been studied with mixed results. In this review, we discuss the use of anti-diabetic medications in the management of NAFLD with a specific focus on sodium-glucose cotransporter 2 inhibitors. We shed light on the evidence supporting their use in detail and discuss limitations and future directions.

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Sodiumglucose cotransporter 2 inhibitors Liver cirrhosis Diabetes

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Identifying Scale-location Specific Control on Vegetation Distribution in Mountain-hill Region

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Journal of Mountain Science 2013年第4期10卷 541-552页

作者： QIU Bing-wen ZENG Can-ying TANG Zheng-hong LI Wei-jiao Aaron hirsh Key Laboratory of Spatial Data Mining&Information Sharing of Ministry of Education Spatial Information Research Centre of Fujian Province Fuzhou University Community and Regional Planning Program University of Nebraska-Lincoln Department of Civil Engineering University of Nebraska-Lincoln

vegetation continuous The scale-location specific control on distribution was investigated through wavelet transforms approaches in subtropical mountain-hill region, Fujian, China. The Normalized Difference Vegetation Index （NDVI） was calculated as an indicator of vegetation greenness using Chinese Environmental Disaster Reduction Satellite images along latitudinal and longitudinal transects. Four scales of variations were identified from the local wavelet spectrum of NDVI, with much stronger wavelet variances observed at larger scales. The characteristic scale of vegetation distribution within mountainous and hilly regions in Southeast China was around 20 km. Significantly strong wavelet coherency was generally examined in regions with very diverse topography, typically characterized as small mountains and hills fractured by rivers and residents. The continuous wavelet based approaches provided valuable insight on the hierarchical structure and its corresponding characteristic scales of ecosystems, which might be applied in defining proper levels in multilevel models and optimal bandwidths in Geographically Weighted Regression.

关键词： NDVI Continuous wavelet transform Characteristic scale Mountain-hill region Scale-location specific

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Osteoporosis in primary biliary cholangitis

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World Journal of Gastroenterology 2018年第31期24卷 3513-3520页

作者： Christopher J Danford hirsh D Trivedi Konstantinos Papamichael Elliot B Tapper Alan Bonder Division of Gastroenterology and Hepatology Beth Israel Deaconess Medical CenterHarvard Medical School Department of Hepatology University of Michigan

Primary biliary cholangitis(PBC) is an autoimmune cholestatic liver disease with multiple debilitating complications. Osteoporosis is a common complication of PBC resulting in frequent fractures and leading to significant morbidity in this population, yet evidence for effective therapy is lacking. We sought to summarize our current understanding of the pathophysiology of osteoporosis in PBC, as well as current and emerging therapies in order to guide future research directions. A complete search with a comprehensive literature review was performed with studies from Pub Med, EMBASE, Web of Science, Cochrane database, and the Countway Library. Osteoporosis in PBC is driven primarily by decreased bone formation, which differs from the increased bone resorption seen in postmenopausal osteoporosis. Despite this fundamental difference, current treatment recommendations are based primarily on experience with postmenopausal osteoporosis. Trials specific to PBC-related osteoporosis are small and have not consistently demonstrated a benefit in this population. As it stands, prevention of osteoporosis in PBC relies on the mitigation of risk factors such as smoking and alcohol use, as well as encouraging a healthy diet and weight-bearing exercise. The primary medical intervention for the treatment of osteoporosis in PBC remains bisphosphonates though a benefit in terms of fracture reduction has never been shown. This review outlines what is known regarding the pathogenesis of bone disease in PBC and summarizes current and emerging therapies.

关键词： Biliary cirrhosis Cholestatic liver disease Osteopenia Hepatic osteodystrophy Bisphosphonates Hormone replacement therapy

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Review of the treatment of metastatic non small cell lung carcinoma:A practical approach

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World Journal of Clinical Oncology 2011年第6期2卷 262-271页

作者： Vera hirsh Department of Medical Oncology McGill University Health CentreRoyal Victoria HospitalMontrealQC H3A 1A1Canada

In recent years,as we have a better knowledge and understanding of the biology of non small cell lung carcinoma(NSCLC),which leads us to targeting biomarkers driving the NSCLC carcinogenesis and metastatic potential,we now have an increased number of options to offer our patients with *** also realize the importance of distinguishing squamous and non squamous histology to guide our treatment decisions of *** palliative care concomitant with therapies from the very start of the treatment also showed an impact on *** review examines the treatment options in all lines of therapy for metastatic NSCLC that have been approved in Canada,the United States,or Europe.

关键词： Metastatic Non small cell lung carcinoma 1st Line 2nd Line 3rd Line Treatment

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Are the data on quality of life and patient reported outcomes from clinical trials of metastatic non-small-cell lung cancer important?

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World Journal of Clinical Oncology 2013年第4期4卷 82-84页

作者： Vera hirsh Division of Medical Oncology Mc Gill University Health Center

Majority of the patients with advanced non-small-cell lung cancer(NSCLC)experience two or more disease related symptoms,which may have a negative impact on their health-related quality of life(HR QOL).These patients prefer a therapy that would improve disease related symptoms,as opposed or treatment that slightly prolongs their survival without improving *** improvements of the symptoms augment the significance of improved response rates or progression free *** choice of the questionnaires to evaluate patients-reported outcomes(PROs)and HRQOL benefits and methods of collecting the data and their interpretations are very important and are discussed in this *** and HR QOL outcomes are important in patients with advanced NSCLC only when the data are collected and analyzed *** they can be viewed as components of the total value of a treatment,providing a comprehensive picture of the benefits and risks of anticancer *** the patients to feel during the last months of their lives more comfortable and not be dependent on their loved ones is a very important task in the treatment of advanced NSCLC.

关键词： Quality of life Clinical trials Non-small cell lung cancer Patient reported outcomes

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Kaempferia parviflora ethanol extract improves self-assessed sexual health in men:a pilot study

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Journal of Integrative Medicine 2018年第4期16卷 249-254页

作者： Richard A.Stein Kira Schmid Jowell Bolivar Andrew G.Swick Steven V.Joyal Steven P.hirsh Life Extension 3600 West Commercial BlvdFort tauderdaleFL 33309USA Life Extension Clinical Research Inc.5990 North Federal HighwayFort LauderdaleFL 33308USA

Background： Sexual health positively correlates with overall wellbeing. Existing therapeutics to enhance male sexual health are limited by factors that include responsiveness, adherence and adverse effects. As the population ages, safe and effective interventions that preserve male sexual function are needed. Published research suggests that various preparations of Kaempferia parviflora, a plant in the Zingiberaceae （ginger） family, support cardiovascular health and may ameliorate erectile function. Objective： The aim of this study was to examine the effects of KaempMaxTM, an ethanol extract of the K. parvi]lora rhizome, on erectile function in healthy middle-aged and older men. Design, setting, participants and interventions： We conducted an open-label, one-arm study on 14 generally healthy males aged 50-68 years with self-reported mild erectile dysfunction, who were not using pre- scription treatments. Participants took 100 mg KaempMaxTM daily for 30 days. Main outcome measures： Evaluations were conducted at baseline and on the final study assessment. Primary efficacy analyses included the International Index of Erectile Function （IIEF）; secondary efficacy analyses included the Global Assessment Question about erectile function. Results： Thirteen participants completed the 30-day study. Supplementation with KaempMaxTM resulted in statistically significant improvements in erectile function, intercourse satisfaction and total scores on the IIEF questionnaire. KaempMaxTM was well tolerated and exhibited an excellent safety profile. Conclusion： Our results suggest that KaempMaxTM may improve erectile function in healthy middle-aged and older men. While the effects were not as pronounced as what might be seen with prescription med- ication, most participants found them satisfactory. Additional, longer and placebo-controlled clinical tri- als will be needed. Trial registration： *** identifier Ncr03389867.

关键词： Sexual health Kaempferia parviflom Complementary therapies KaempMax^TM Global Assessment QuestionInternational Index of Erectile Function

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药物疗法——肝素

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国外医学（创伤与外科基本问题分册） 1991年第4期12卷 200-202页

作者： hirsh J 侯虹鲁

肝素除具有抗凝作用外,还可抑制血小板功能,增加血管壁的通透性,抑制血管平滑肌细胞增生以及延迟过敏反应。本文从临床应用等方面综合论述肝素治疗的有效性和安全性。

关键词：药物疗法肝素

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