Miracle-dz/UniFAR-FTUs huggingface dataset:
HbA1c Identifies Subjects With Prediabetes and Subclinical Left Ventricular Diastolic Dysfunction

Context Prediabetes is associated with subclinical cardiac changes associated with heart failure development. Objective We investigated diastolic function and its association with markers of glycation and inflammation related to cardiovascular disease in patients with prediabetes. We focused on individuals with prediabetes identified only by glycated hemoglobin A1c [HbA1c; 5.7% to 6.4% and normal fasting glucose (NFG) and normal glucose tolerance (NGT) after an oral glucose tolerance test (OGTT)]. Design Cross-sectional study. Setting Departments of Clinical and Experimental Medicine and Cardiology, University of Catania, Catania, Italy. Main Outcome Measures HbA1c, OGTT, Doppler echocardiography, soluble receptor for advanced glycation end products (sRAGEs), and endogenous secretory RAGE (esRAGE) were evaluated. Patients We recruited 167 subjects with NFG/NGT who were stratified according to HbA1c level: controls (HbA1c <5.7%) and HbA1c prediabetes (HbA1c 5.7% to 6.4%). Results Patients with HbA1c prediabetes (n = 106) showed a lower peak mitral inflow in early diastole (E wave) to late diastolic atrial filling velocity (A wave) ratio (E/A ratio) than controls (n = 61) (1.10 ± 0.24 vs 1.18 ± 0.23; P < 0.05). They showed a higher left atrium volume (LAV) (28.4 ± 5 vs 22.1 ± 3; P < 0.05) and sphericity index (SI) (0.6 ± 0.06 vs 0.5 ± 0.05; P < 0.05). After multiple regression analyses, HbA1c, sRAGE, and esRAGE were the major determinants of E/A ratio, LAV, and SI. Conclusions Subjects with HbA1c prediabetes exhibited subclinical cardiac alterations associated with sRAGE, esRAGE, and HbA1c. These subjects would not have been classified as having prediabetes on the basis of fasting glycemia or post-OGTT values.
Circulating microRNAs in arrhythmogenic right ventricular cardiomyopathy with ventricular arrhythmia.

Aims MicroRNAs (miRNAs) have been implicated in cardiac diseases. This study aimed to characterize the circulating miRNAs in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and correlate the miRNAs with the clinical outcomes of ARVC. Methods and results This study included 62 patients with ventricular arrhythmia (VA): 28 patients (45%) had definite ARVC, 11 (18%) had borderline or possible ARVC, and 23 (37%) had idiopathic ventricular tachycardia (VT). In addition, 33 age- and sex-matched healthy subjects were enrolled as normal control subjects. The expression of selected miRNAs was analysed in all study subjects. The clinical outcomes of patients with definite ARVC after catheter ablation were further investigated. On the basis of the miRNA polymerase chain reaction array, we selected 11 miRNAs for analysis of their expression in the plasma of all subjects. Definite ARVC patients had significantly higher expression of circulating miR-144-3p, 145-5p, 185-5p, and 494 than the three other groups. Out of 25 definite ARVC patients who underwent radiofrequency catheter ablation, recurrent VA occurred in 8 patients (32%) during the follow-up period (45 ± 20 months). Definite ARVC patients with recurrent VA had a higher level of circulating miR-494 than did those without recurrence. Receiver operating characteristic analysis showed miR-494 to be a predictive factor of recurrent VA (area under the curve: 0.832). Conclusion Plasma levels of miR-144-3p, 145-5p, 185-5p, and 494 were significantly elevated in definite ARVC patients with VA. An increased plasma level of miR-494 was associated with the recurrence of VA after ablation in definite ARVC patients.
A New Interleaved Coupled-Inductor Nonisolated Soft-Switching Bidirectional DC–DC Converter With High Voltage Gain Ratio

This paper presents a new interleaved coupled-inductor nonisolated bidirectional dc–dc converter that provides high voltage gain ratio (VGR), low ripple current at the low-voltage side (LVS), and soft switching. The high VGR is obtained by connecting in series the outputs of an interleaved bidirectional buck–boost converter and a dual-active half-bridge converter, using the turns ratio of a coupled inductor. Since the voltage of the high-voltage side is shared between the converters outputs, the voltage stress across the active switches decrease. The active switches turn ON under zero-voltage switching condition in both directions. Moreover, the low current ripple at the LVS is achieved due to the applied interleaved technique. By employing the phase-shift angle modulation, the output voltage is regulated. The proposed converter is analyzed in details and a 900-W experimental prototype with 48-V input voltage and 400-V output voltage under 100-kHz switching frequency is implemented to verify the theoretical results.
Medical surveillance for occupational asthma-how are cases detected?

Background In Finland, medical surveillance, including spirometry, is periodically performed for workers who are exposed to agents capable of causing occupational asthma (OA). Although it has been shown that surveillance can detect OA at an early stage, few studies have assessed its benefits or the role of surveillance spirometry. Aims To assess the role of surveillance and spirometry in detecting OA and to evaluate the quality of spirometry. Methods We retrospectively reviewed the medical files of patients in health surveillance programmes who were diagnosed with sensitizer-induced OA at the Finnish Institute of Occupational Health in 2012‒14. We collected information on work exposure, respiratory symptoms, healthcare visits that initiated the diagnostic process, first spirometry and other diagnostic tests. Results Sixty files were reviewed. Medical surveillance detected 11 cases (18%) and 49 cases (82%) were detected at doctors' appointments that were not related to surveillance. The median delay from the onset of asthma symptoms to diagnosis was 2.2 years. Delay did not differ between these groups. No cases were detected on the basis of abnormal spirometry without respiratory symptoms. However, five patients (8%) initially reported solely work-related rhinitis symptoms. Spirometry was normal in half of the cases and quality criteria were fulfilled in 86% of the tests. Conclusions Fewer than one in five OA cases were detected through medical surveillance. Investigations were initiated by respiratory symptoms. No asymptomatic worker was referred because of abnormal spirometry. Our results highlight the importance of work-related nasal symptoms in detecting OA.
Is fibre-optic bronchoscopy necessary to confirm the position of rigid-angled endobronchial blockers before thoracic surgery? A randomized controlled trial†

OBJECTIVES To determine the success rate of blind insertion and the usefulness of fibre-optic bronchoscopy for directing rigid-angled endobronchial blockers (EBs) to the correct side and achieving satisfactory surgical fields. METHODS A randomized trial was designed to determine the extent to which the Coopdech Endobronchial Blocker Tube (Daiken Medical Co., Ltd) could successfully be placed through either auscultation (n = 57) or fibre-optic bronchoscopy (n = 55) in patients scheduled for thoracic surgery. The placement time was recorded and quality of the thoracoscopic operation field was determined by the thoracic surgeon. Anaesthesiologists with varying thoracic experience levels were enrolled. RESULTS The success rates of insertion through auscultation were 100% (32 of 32) for the right side and 88% (22 of 25) for the left side. Placement through auscultation was faster than that through bronchoscopy (mean 89.6 vs 141.1 s, P = 0.008) in the right-sided procedure but non-significant in the left-sided procedure (mean 138.5 vs 130 s, P = 0.795). Surgical grading of the operation field was not significantly different between both techniques (P = 0.502). Experienced anaesthesiologists took less time to position EBs (mean 91.0 vs 138.0 s, P = 0.015). Surgical grading was comparable between specialists and residents (P = 0.058). CONCLUSIONS Once an EB was correctly inserted and confirmed through auscultation, the corresponding surgical satisfaction was comparable to that through bronchoscopy. In the majority of cases, bronchoscopy is unnecessary for correct and efficient EB positioning. However, bronchoscopy is still mandatory in left-sided EB insertion and in patients with deviated tracheobronchial anatomy. Clinical registration number NCT02133235, registered at ClinicalTrials.gov [https://clinicaltrials.gov/ct2/show/NCT02133235 (8 July 2017, date last accessed)].
Thermodynamic approach to enhance the dispersion of graphene in epoxy matrix and its effect on mechanical and thermal properties of epoxy nanocomposites

Abstract Graphene-reinforced polymer nanocomposites are under intense investigation in recent years. In this work, graphene nanosheets have been prepared using chemical reduction method of graphene oxide. Graphene-reinforced epoxy nanocomposites show an enhancement in mechanical and thermal properties at 0.05 wt. % of graphene in epoxy matrix. Modification of graphene with polyvinylpyrrolidone (PVP) shows the significant enhancement in mechanical and thermal properties of epoxy nanocomposites. PVP-modified graphene nanosheets reduces the gap of enthalpic and entropic penalties and facilitates improved dispersion of graphene in epoxy matrix. In addition, enhanced dispersion of PVP-modified graphene in epoxy matrix results in better load transfer across graphene–epoxy interface. Glass transition temperature (Tg) of PVP-modified graphene epoxy nanocomposites increases as compared to pure epoxy because there exist an interaction between epoxy and PVP. Fractography study reveals the localized ductile fracture.
An Integrated Analysis of Molecular Acclimation to High Light in the Marine Diatom Phaeodactylum tricornutum

Photosynthetic diatoms are exposed to rapid and unpredictable changes in irradiance and spectral quality, and must be able to acclimate their light harvesting systems to varying light conditions. Molecular mechanisms behind light acclimation in diatoms are largely unknown. We set out to investigate the mechanisms of high light acclimation in Phaeodactylum tricornutum using an integrated approach involving global transcriptional profiling, metabolite profiling and variable fluorescence technique. Algae cultures were acclimated to low light (LL), after which the cultures were transferred to high light (HL). Molecular, metabolic and physiological responses were studied at time points 0.5 h, 3 h, 6 h, 12 h, 24 h and 48 h after transfer to HL conditions. The integrated results indicate that the acclimation mechanisms in diatoms can be divided into an initial response phase (0–0.5 h), an intermediate acclimation phase (3–12 h) and a late acclimation phase (12–48 h). The initial phase is recognized by strong and rapid regulation of genes encoding proteins involved in photosynthesis, pigment metabolism and reactive oxygen species (ROS) scavenging systems. A significant increase in light protecting metabolites occur together with the induction of transcriptional processes involved in protection of cellular structures at this early phase. During the following phases, the metabolite profiling display a pronounced decrease in light harvesting pigments, whereas the variable fluorescence measurements show that the photosynthetic capacity increases strongly during the late acclimation phase. We show that P. tricornutum is capable of swift and efficient execution of photoprotective mechanisms, followed by changes in the composition of the photosynthetic machinery that enable the diatoms to utilize the excess energy available in HL. Central molecular players in light protection and acclimation to high irradiance have been identified.
Why patients use alternative medicine: results of a national study.

CONTEXT Research both in the United States and abroad suggests that significant numbers of people are involved with various forms of alternative medicine. However, the reasons for such use are, at present, poorly understood. OBJECTIVE To investigate possible predictors of alternative health care use. METHODS Three primary hypotheses were tested. People seek out these alternatives because (1) they are dissatisfied in some way with conventional treatment; (2) they see alternative treatments as offering more personal autonomy and control over health care decisions; and (3) the alternatives are seen as more compatible with the patients' values, worldview, or beliefs regarding the nature and meaning of health and illness. Additional predictor variables explored included demographics and health status. DESIGN A written survey examining use of alternative health care, health status, values, and attitudes toward conventional medicine. Multiple logistic regression analyses were used in an effort to identify predictors of alternative health care use. SETTING AND PARTICIPANTS A total of 1035 individuals randomly selected from a panel who had agreed to participate in mail surveys and who live throughout the United States. MAIN OUTCOME MEASURE Use of alternative medicine within the previous year. RESULTS The response rate was 69%. The following variables emerged as predictors of alternative health care use: more education (odds ratio [OR], 1.2; 95% confidence interval [CI], 1.1-1.3); poorer health status (OR, 1.3; 95% CI, 1.1-1.5); a holistic orientation to health (OR, 1.4; 95% CI, 1.1-1.9); having had a transformational experience that changed the person's worldview (OR, 1 .8; 95% CI, 1 .3-2.5); any of the following health problems: anxiety (OR, 3.1; 95% CI, 1.6-6.0); back problems (OR, 2.3; 95% CI, 1 .7-3.2); chronic pain (OR, 2.0; 95% CI, 1.1 -3.5); urinarytract problems (OR, 2.2; 95% CI, 1.3-3.5); and classification in a cultural group identifiable by their commitment to environmentalism, commitment to feminism, and interest in spirituality and personal growth psychology (OR, 2.0; 95% CI, 1.4-2.7). Dissatisfaction with conventional medicine did not predict use of alternative medicine. Only 4.4% of those surveyed reported relying primarily on alternative therapies. CONCLUSION Along with being more educated and reporting poorer health status, the majority of alternative medicine users appear to be doing so not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.
Effects of Single Compared to Dual Task Practice on Learning a Dynamic Balance Task in Young Adults

Background: In everyday life, people engage in situations involving the concurrent processing of motor (balance) and cognitive tasks (i.e., “dual task situations”) that result in performance declines in at least one of the given tasks. The concurrent practice of both the motor and cognitive task may counteract these performance decrements. The purpose of this study was to examine the effects of single task (ST) compared to dual task (DT) practice on learning a dynamic balance task. Methods: Forty-eight young adults were randomly assigned to either a ST (i.e., motor or cognitive task training only) or a DT (i.e., motor-cognitive training) practice condition. The motor task required participants to stand on a platform and keeping the platform as close to horizontal as possible. In the cognitive task, participants were asked to recite serial subtractions of three. For 2 days, participants of the ST groups practiced the motor or cognitive task only, while the participants of the DT group concurrently performed both. Root-mean-square error (RMSE) for the motor and total number of correct calculations for the cognitive task were computed. Results: During practice, all groups improved their respective balance and/or cognitive task performance. With regard to the assessment of learning on day 3, we found significantly smaller RMSE values for the ST motor (d = 1.31) and the DT motor-cognitive (d = 0.76) practice group compared to the ST cognitive practice group but not between the ST motor and the DT motor-cognitive practice group under DT test condition. Further, we detected significantly larger total numbers of correct calculations under DT test condition for the ST cognitive (d = 2.19) and the DT motor-cognitive (d = 1.55) practice group compared to the ST motor practice group but not between the ST cognitive and the DT motor-cognitive practice group. Conclusion: We conclude that ST practice resulted in an effective modulation of the trained domain (i.e., motor or cognitive) while only DT practice resulted in an effective modulation of both domains (i.e., motor and cognitive). Thus, particularly DT practice frees up central resources that were used for an effective modulation of motor and cognitive processing mechanisms.
Isotherm and Kinetic Studies on Adsorption of Pb, Zn and Cu by Kaolinite

The feasibility of kaolinite used as a low-cost adsorbent for the removal of Pb(II), Zn(II) and Cu(II) from aqueous solutions was investigated. During the removal process, batch technique was used, and the effects of heavy metal concentration and contact time on adsorption efficiency at pH of 4.5, under a constant temperature of 20±1 °C were studied. The experimental results were analyzed using four adsorption isotherm models; Freundlich, Langmuir, Temkin and Redlich-Peterson. Evaluating the correlation coefficients showed that the Redlich-Peterson isotherm described the data appropriable than others. The adsorption capacities (qm) from the Langmuir isotherm for Pb(II), Zn(II) and Cu(II) are found as 7.75 mg/g, 4.95 mg/g and 4.42 mg/g respectively. The effectiveness of kaolinite in the sorption of the three metals from aqueous system was Pb(II) > Zn(II) > Cu(II). Kinetic studies showed that a pseudosecond order model was more suitable than the pseudo first order model. It is concluded that kaolinite can be used as an effective adsorbent for removing Pb(II), Zn(II) and Cu(II) from aqueous solutions.
Secular trends in the timing of skeletal maturation as assessed by the cervical vertebrae maturation method

Objective To investigate the presence of secular trends in skeletal maturation of girls and boys as assessed by the use of cervical vertebrae bones. Materials and methods The study compared two main groups: the first included data collected from the Denver growth study (1930s to 1960s) and the second included data collected from recent pretreatment records (1980s to 2010s) of patients from the orthodontic clinic of a North American University. The records from the two groups were all for Caucasian subjects. The sample for each group included 78 lateral cephalographs for girls and the same number for boys. The age of the subjects ranged from 7 to 18 years. Cervical vertebrae maturation (CVM) stages were directly assessed from the radiographs according to the method described by Hassel and Farman in which six CVM stages were designated from cervical vertebrae 2, 3, and 4. Results The mean age of girls from the Denver growth study and girls from the university clinic in each of the six CVM stages was not different at P ≤0.05. However, the mean age of boys from the two groups was not different only in stage 3 (P = 0.139) and stage 4 (P = 0.211). Conclusions The results showed no evidence to indicate a tendency for earlier skeletal maturation of girls or boys. Boys in the university group started their skeletal maturation later than boys in the Denver group and completed their maturation earlier. Gender was a significant factor affecting skeletal maturation stages in both Denver and university groups.
Novel arch fenestrated stent graft for acute Stanford Type A aortic dissection with open antegrade implantation.

OBJECTIVES The best surgical strategy for acute Stanford Type A aortic dissection (aTAAD) involving the arch remains controversial. Here, we report on the satisfactory results following aTAAD repair using a novel arch fenestrated stent graft. METHODS From December 2014 to December 2015, 42 aTAAD patients (27 male and 15 female) underwent ascending aorta replacement and fenestrated stent graft implantation. The fenestrated stent graft was implanted into the true lumen of the aortic arch and proximal descending aorta, with the fenestration opening located at the ostia of 3 head vessels in the arch. The proximal end of the stent graft was anastomosed to the distal end of the Dacron tube graft that replaced the proximal ascending aorta. All patients underwent contrast-enhanced computed tomography angiography prior to discharge and during follow-up. RESULTS The average cardiopulmonary bypass duration was 213 ± 49 min, aortic cross-clamp duration was 133 ± 39 min and unilateral cerebral perfusion and lower body arrest duration was 27 ± 8 min. There were 2 in-hospital deaths due to circulation failure (mortality 4.8%). During a mean follow-up period of 7.4 ± 3.2 months, 1 patient with Behçet's disease died of aortic root pseudoaneurysm. The 39 surviving patients underwent contrast-enhanced computed tomography scans at 3, 6 and 12 months, which indicated increasing false-lumen thrombosis. CONCLUSIONS In aTAAD patients, the use of the novel arch fenestrated stent graft achieved excellent aortic remodelling of the aortic arch and descending aorta without any increase in the morbidity and mortality.
New iterative algorithm for algebraic Riccati equation related to H ∞ control problem of singularly perturbed systems

We present the solution to the algebraic Riccati equation (ARE) with indefinite sign quadratic term related to the H/sub /spl infin// control problem for singularly perturbed systems by means of a Kleinman type algorithm. The resulting algorithm is very efficient from the numerical point of view because the ARE is solvable even if the quadratic term has an indefinite sign. Moreover, the resulting iterative algorithm is quadratically convergent. We also present an algorithm for solving the generalized algebraic Lyapunov equation on the basis of the fixed point algorithm.
Decreased Skeletal Muscle Mass and Risk Factors of Sarcopenic Dysphagia: A Prospective Observational Cohort Study

Background Dysphagia is a known risk factor for malnutrition and pneumonia. Although sarcopenia is hypothesized to cause dysphagia, its causality remains unclear. Thus, this study aimed to investigate causality and the risk factors for sarcopenic dysphagia. Methods We enrolled 95 hospitalized patients aged 65 years or older who had restricted oral intake without dysphagia. The skeletal muscle index and Functional Oral Intake Scale were used to evaluate muscle mass and swallowing ability, respectively. Nutritional status, assessed by body mass index, the Mini Nutritional Assessment-Short Form, and energy intake; activity of daily living, assessed by the Barthel Index; hand-grip strength; duration of oral intake restriction; and cognitive status were measured. Dysphagia (Functional Oral Intake Scale ≤ 5) was determined after 2 months. Results The participants' mean age was 83.2 ± 8.0 years; 63% were women. Of the surviving 82 patients, 63 (77%) had sarcopenia and 21 (26%) developed dysphagia, all of whom had sarcopenia (p = .002). Most variables were risk factors for dysphagia on univariate analysis. Decreased skeletal muscle index (odds ratio [OR] 24.0, 95% confidence interval [CI] 3.6-159.0, p = .001), Barthel Index (OR 12.9, 95% CI 2.1-78.4, p = .005), and body mass index (OR 11.4, 95% CI 1.8-70.5, p = .009) were independent predictors of dysphagia in the multivariate analysis. Conclusion This study provides evidence for sarcopenic dysphagia and its risk factors. Preventive and therapeutic interventions require further study.