PurposeThe purpose of this retrospective study was to identify the impact of oral anticoagulants on epistaxis with the focus on new oral anticoagulants.MethodsThe study was conducted at the Department  for Ear- Nose- and Throat (ENT), Head and Neck Surgery, Technical University Munich, Germany. All patients presenting in 2014 with the diagnosis of epistaxis to a specialized ENT accident and emergency department were identified and analyzed in clinical data and medication.Results600 adult cases, with a median age of 66.6 years were identified with active bleeding. 66.8% of all cases were anticoagulated. Classic oral anticoagulants (COAC) were three times more common in patients than new-generation oral anticoagulants (NOAC). Recurrent bleeding was significantly associated with oral anticoagulants (OAC) (p = 0.014) and bleeding location was most often anterior (p = 0.006). In contrast, severe cases, which required surgery or embolization were significantly more likely in non-anticoagulated middle-aged patients with posterior bleedings (p < 0.05). In our epistaxis cohort, OAC were highly overrepresented (40%) when compared to the general German population (1%) but COAC as well as NOAC played only a minor role in severe courses of epistaxis.ConclusionOral anticoagulation, especially with new-generation drugs, is not associated with more complicated and severe courses of epistaxis, but rather with recurrent bleeding. One should keep this information in mind when triaging the patient in the emergency room and when planning further procedures.

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Over the last years, web browsing has been steadily shifting from desktop computers to mobile devices like smartphones and tablets. However, mobile browsers available today have mainly focused on performance rather than power consumption, although the battery life of a mobile device is one of the most important usability metrics. This is because many of these browsers have originated in the desktop domain and have been ported to the mobile domain. Such browsers have multiple power hungry components such as the rendering engine, and the JavaScript engine, and generate high workload without considering the capabilities and the power consumption characteristics of the underlying hardware platform. Also, the lack of coordination between a browser application and the power manager in the operating system (such as Android) results in poor power savings. In this paper, we propose a power manager that takes into account the internal state of a browser -that we refer to as a phase -and show with Google's Chrome running on Android that up to 57.4% more energy can be saved over Android's default power managers. We implemented and evaluated our technique on a heterogeneous multi-processing (HMP) ARM big.LITTLE platform such as the ones found in most modern smartphones.

The volume of mobile web browsing traffic has significantly increased as well as the complexity of the mobile websites mandating high-performance web page rendering engines to be used on mobile devices. Although there has been a significant improvement in performance of web page rendering on mobile phones in recent years, the power consumption reduction has not been addressed much. A main contribution of this work is a thread level analysis of the workload generated by Google's Chrome browser on a heterogeneous multi-processing (HMP) platform found in many smartphones. We analyze the detailed traces of the thread workload generated by the web browser, especially the rendering engine, and discuss the power saving potentials in relation to power management policies in Android. Moreover, we propose power management strategies based on the results. All trace data and measurement results have been collected on a real HMP platform integrating the Samsung Exynos5422 SoC, also used in the Samsung Galaxy S5 smartphone. Our work shows that there is a considerable scope for power savings and outlines directions for future research. We believe that it will lead to development of practical power management techniques considering thread allocation, dynamic voltage and frequency scaling (DVFS) and power gating.