Miracle-dz/UniFAR-FTUs huggingface dataset:
Validity of Different Activity Monitors to Count Steps in an Inpatient Rehabilitation Setting

Background Commonly used activity monitors have been shown to be accurate in counting steps in active people; however, further validation is needed in slower walking populations. Objectives To determine the validity of activity monitors for measuring step counts in rehabilitation inpatients compared with visually observed step counts. To explore the influence of gait parameters, activity monitor position, and use of walkers on activity monitor accuracy. Methods One hundred and sixty-six inpatients admitted to a rehabilitation unit with an average walking speed of 0.4 m/s (SD 0.2) wore 16 activity monitors (7 different devices in different positions) simultaneously during 6-minute and 6-m walks. The number of steps taken during the tests was also counted by a physical therapist. Gait parameters were assessed using the GAITRite system. To analyze the influence of different gait parameters, the percentage accuracy for each monitor was graphed against various gait parameters for each activity monitor. Results The StepWatch, Fitbit One worn on the ankle and the ActivPAL showed excellent agreement with observed step count (ICC 2,1 0.98; 0.92; 0.78 respectively). Other devices (Fitbit Charge, Fitbit One worn on hip, G-Sensor, Garmin Vivofit, Actigraph) showed poor agreement with the observed step count (ICC 2,1 0.12-0.40). Percentage agreement with observed step count was highest for the StepWatch (mean 98%). The StepWatch and the Fitbit One worn on the ankle maintained accuracy in individuals who walked more slowly and with shorter strides but other devices were less accurate in these individuals. Limitations There were small numbers of participants for some gait parameters. Conclusions The StepWatch showed the highest accuracy and closest agreement with observed step count. This device can be confidently used by researchers for accurate measurement of step counts in inpatient rehabilitation in individuals who walk slowly. If immediate feedback is desired, the Fitbit One when worn on the ankle would be the best choice for this population.
Profile of Maternal Smokers Who Quit During Pregnancy: A Population-Based Cohort Study of Tasmanian Women, 2011–2013

Introduction Smoking remains the single-most significant preventable cause of poor pregnancy outcomes, yet around 12% of Australian women smoke during pregnancy. Many women are motivated to quit when they find out they are pregnant, yet few are successful. While previous studies have examined the profile of the maternal smoker compared to her nonsmoking counterpart (Aim 1), little is known about what differentiates women who quit during pregnancy to those who do not (Aim 2). Here, we present results from a study investigating the characteristics of women who were able to quit during pregnancy. Methods Data were drawn from the Tasmanian Population Health database of women who had received antenatal care between 2011 and 2013 (n = 14300). Data collected included age, relationship status and ethnicity of expectant mothers, antenatal details, mental health conditions, and drug use. Independent samples t tests were used to compare differences between women who had, and those who had not, quit during pregnancy. The 19.4% of women who self-reported as smoking in the first half (first 20 weeks) of their pregnancy were further grouped and analyzed comparing those who reported still smoking in the second half of their pregnancy (smokers: n = 2570, 92.4%) to those who quit (quitters: n = 211, 7.6%). Results Quitters (57.8%) were more likely to be in a relationship than their non-quitting counterparts (49.6%, p = .022) and were less likely to suffer from postnatal depression (2.4% vs. 6.0%, p = .029). No other differences between quitters and smokers were observed. Conclusions Determining the profile of women who are able to quit during pregnancy may be important to improve the relatively poor cessation rates among maternal smokers and may assist in more effectively targeting at-risk women. Implications Smoking cessation interventions have traditionally targeted socially disadvantaged women, for good reason: the majority of smoking pregnant women fall into this category. However, despite the significant attention and resources dedicated to antenatal smoking cessation interventions, most are ineffective with only 7.6% of the present sample quitting smoking during pregnancy. This paper may assist in developing more effective antenatal smoking cessation interventions by more clearly describing the profile of maternal smokers who successfully quit during pregnancy. Specifically, this paper highlights the need to acknowledge and address women's relationship status and mental health in order to promote smoking cessation in pregnancy.
Proteomic analysis of gingival crevicular fluid for novel biomarkers of pubertal growth peak

Background Detection of pubertal growth peak is vital in orthodontic treatment timing and planning. Gingival crevicular fluid (GCF) contains abundant proteins from different sources and is an ideal source of biomarkers. The aim of this research is to detect candidate GCF biomarkers of pubertal growth by tandem mass tags (TMT) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) to help diagnosis and treatment planning of functional treatment. Methods Forty subjects were recruited and were divided into pubertal and post-pubertal groups according to cervical vertebral maturation method. GCF samples were collected by paper points. GCF proteome of pubertal and post-pubertal subjects was compared by TMT labelling coupled with LC-MS/MS. Results A total of 537 proteins were detected in GCF samples, with 183 proteins detected in GCF for the first time. These proteins were involved in processes of immune response, ion transport, and signal transduction. The GCF concentration of vitamin D binding protein (DBP) and seroserotransferrin (Tf) was significantly higher in pubertal than that in post-pubertal subjects. DBP and Tf, therefore, were considered to be candidate biomarkers of pubertal growth. This result was validated using GCF samples from new subjects (P < 0.05). Conclusion Our results indicate that TMT labelling coupled with LC-MS/MS were proved to be a useful method for proteomic analysis of GCF with high accuracy. The expression of DBP and Tf was increased in children at circumpubertal stage and can be considered candidate biomarkers of pubertal growth.
Adjuvant chemotherapy in patients with stage I endometrioid or clear cell ovarian cancer in the platinum era: a Surveillance, Epidemiology, and End Results Cohort Study, 2000–2013

Background We sought to evaluate the impact of adjuvant chemotherapy on overall survival (OS) in patients with stage I endometrioid epithelial ovarian cancer (EEOC) or ovarian clear cell cancer (OCCC) using a national database. Patients and methods The Surveillance, Epidemiology, and End Results database was used to identify patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I EEOC or OCCC from 2000 to 2013. We sought to identify predictors of chemotherapy use and to assess the impact of chemotherapy on OS in these patients. OS was compared using the log-rank test and the Cox proportional hazards model. Results In all, 3552 patients with FIGO stage I EEOC and 1995 patients with stage I OCCC were identified. Of the 1600 patients (45%) with EEOC who underwent adjuvant chemotherapy, the 5-year OS rate was 90%, compared with 89% for those who did not undergo adjuvant chemotherapy (P = 0.807). Of the 1374 (69%) patients with OCCC who underwent adjuvant chemotherapy, the 5-year OS rate was 85%, compared with 83% (P = 0.439) for those who did not undergo adjuvant chemotherapy. Chemotherapy use was associated with younger age, higher substage, and more recent year of diagnosis for both the EEOC and OCCC groups. Only in the subgroup of patients with FIGO substage IC, grade 3 EEOC (n = 282) was chemotherapy associated with an improved 5-year OS-81% compared with 62% (P = 0.003) in untreated patients (HR: 0.583; 95% CI: 0.359-0.949; P = 0.030). In patients with OCCC, there was no significant effect of adjuvant chemotherapy on OS in any substage. Conclusions Adjuvant chemotherapy was associated with improved OS only in patients with substage IC, grade 3 EEOC. In stage I OCCC, adjuvant chemotherapy was not associated with improved OS.
Listening Effort and Speech Recognition with Frequency Compression Amplification for Children and Adults with Hearing Loss

Abstract Background: Nonlinear frequency compression (NFC) can improve the audibility of high-frequency sounds by lowering them to a frequency where audibility is better; however, this lowering results in spectral distortion. Consequently, performance is a combination of the effects of increased access to high-frequency sounds and the detrimental effects of spectral distortion. Previous work has demonstrated positive benefits of NFC on speech recognition when NFC is set to improve audibility while minimizing distortion. However, the extent to which NFC impacts listening effort is not well understood, especially for children with sensorineural hearing loss (SNHL). Purpose: To examine the impact of NFC on recognition and listening effort for speech in adults and children with SNHL. Research Design: Within-subject, quasi-experimental study. Participants listened to amplified nonsense words that were (1) frequency-lowered using NFC, (2) low-pass filtered at 5 kHz to simulate the restricted bandwidth (RBW) of conventional hearing aid processing, or (3) low-pass filtered at 10 kHz to simulate extended bandwidth (EBW) amplification. Study Sample: Fourteen children (8–16 yr) and 14 adults (19–65 yr) with mild-to-severe SNHL. Intervention: Participants listened to speech processed by a hearing aid simulator that amplified input signals to fit a prescriptive target fitting procedure. Data Collection and Analysis: Participants were blinded to the type of processing. Participants' responses to each nonsense word were analyzed for accuracy and verbal-response time (VRT; listening effort). A multivariate analysis of variance and linear mixed model were used to determine the effect of hearing-aid signal processing on nonsense word recognition and VRT. Results: Both children and adults identified the nonsense words and initial consonants better with EBW and NFC than with RBW. The type of processing did not affect the identification of the vowels or final consonants. There was no effect of age on recognition of the nonsense words, initial consonants, medial vowels, or final consonants. VRT did not change significantly with the type of processing or age. Conclusion: Both adults and children demonstrated improved speech recognition with access to the high-frequency sounds in speech. Listening effort as measured by VRT was not affected by access to high-frequency sounds.
Synchronization of Liénard-type oscillators in heterogenous electrical networks

Motivated by potential applications for power-electronic converters in microgrids, we study the problem of global asymptotic synchronization of Liénard-type nonlinear oscillators in heterogenous LTI electrical networks with series R-L circuits modeling interconnections. By heterogeneous, we mean that the resistance-to-inductance ratios of the lines are not all the same. Building on our previous work, we derive sufficient conditions for global asymptotic synchronization by using a first-order filter on the outputs of the oscillators. Our approach leverages a coordinate transformation to a system that emphasizes signal differences and the use of passivity based arguments to establish synchronization of the network of oscillators asymptotically. The analysis subsumes and generalizes previous conditions that have been derived for Liénard oscillators in homogeneous electrical networks. Numerical simulations are provided to validate the results.
Metastasis inside‐out: dissemination of cancer cell clusters with inverted polarity

Zajac et al ( ) utilize patient tissue to discover a novel cellular mechanism for metastasis in colorectal cancer. They isolated cancer cell clusters from patient peritoneal fluid and demonstrated that these clusters invaded collectively into collagen gels, patient‐derived tissues, and through the peritoneum of mice. During invasion the clusters retained an inverted epithelial architecture, functioning as multicellular metastatic seeds with inverted polarity.
Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men.

BACKGROUND Obesity is a strong risk factor for type 2 diabetes. However, few studies have compared the predictive power of overall obesity with that of central obesity. The cutoffs for waist circumference (WC) and waist-to-hip ratio (WHR) as measures of abdominal adiposity remain controversial. OBJECTIVE The objective was to compare body mass index (BMI), WC, and WHR in predicting type 2 diabetes. DESIGN A prospective cohort study (Health Professionals Follow-Up Study) of 27 270 men was conducted. WC, WHR, and BMI were assessed at baseline. Covariates and potential confounders were assessed repeatedly during the follow-up. RESULTS During 13 y of follow-up, we documented 884 incident type 2 diabetes cases. Age-adjusted relative risks (RRs) across quintiles of WC were 1.0, 2.0, 2.7, 5.0, and 12.0; those of WHR were 1.0, 2.1, 2.7, 3.6, and 6.9; and those of BMI were 1.0, 1.1, 1.8, 2.9, and 7.9 (P for trend < 0.0001 for all). Multivariate adjustment for diabetes risk factors only slightly attenuated these RRs. Adjustment for BMI substantially attenuated RRs for both WC and WHR. The receiver operator characteristic curve analysis indicated that WC and BMI were similar and were better than WHR in predicting type 2 diabetes. The cumulative proportions of type 2 diabetes cases identified according to medians of BMI (>/=24.8), WC (>/=94 cm), and WHR (>/=0.94) were 82.5%, 83.6%, and 74.1%, respectively. The corresponding proportions were 78.9%, 50.5%, and 65.7% according to the recommended cutoffs. CONCLUSIONS Both overall and abdominal adiposity strongly and independently predict risk of type 2 diabetes. WC is a better predictor than is WHR. The currently recommended cutoff for WC of 102 cm for men may need to be reevaluated; a lower cutoff may be more appropriate.
Clinical associations of total kidney volume: the Framingham Heart Study

Background Total kidney volume (TKV) is an imaging biomarker that may have diagnostic and prognostic utility. The relationships between kidney volume, renal function and cardiovascular disease (CVD) have not been characterized in a large community-dwelling population. This information is needed to advance the clinical application of TKV. Methods We measured TKV in 1852 Framingham Heart Study participants (mean age 64.1 ± 9.2 years, 53% women) using magnetic resonance imaging. A healthy sample was used to define reference values. The associations between TKV, renal function and CVD risk factors were determined using multivariable logistic regression analysis. Results Overall, mean TKV was 278 ± 54 cm3 for women and 365 ± 66 cm3 for men. Risk factors for high TKV (>90% healthy referent size) were body surface area (BSA), diabetes, smoking and albuminuria, while age, female and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 were protective. Participants with high TKV had higher odds of diabetes [odds ratio (OR) 2.15, P < 0.001] and lower odds of eGFR <60 mL/min/1.73 m2 (OR 0.32, P = 0.007). Risk factors for low TKV (<10% healthy referent size) were age, female and eGFR <60 mL/min/1.73 m2, while BSA and diabetes were protective. Participants with low TKV had higher odds of eGFR <60 mL/min/1.73 m2 (OR 6.12, P < 0.001) and albuminuria (OR 1.56, P = 0.03). Conclusions Low TKV is associated with markers of kidney damage including albuminuria and eGFR <60 mL/min/1.73 m2, while high TKV is associated with diabetes and decreased odds of eGFR <60 mL/min/1.73 m2. Prospective studies are needed to characterize the natural progression and clinical consequences of TKV.
Formulation and evaluation of meloxicam orally dispersible capsules

Purpose: Meloxicam is a non-steroidal anti-inflammatory drug with highly variable bioavailability due to its poor aqueous solubility and dissolution. This work aimed to improve meloxicam bioavailability by formulating it in orodispersible capsules containing a soluble complex of the drug with beta-cyclodextrin. Methods: Complexes were prepared by different methods and characterized by differential scanning calorimetry, X-ray diffraction, infrared spectroscopy and dissolution efficiency studies. Orodispersible capsule shells were prepared from conventional hard gelatin capsule shells by freeze-drying and evaluated by image analysis microscopy and moisture content estimation. Formulae containing the freeze-dried complex and different fillers were prepared and characterized for their flowability, moisture content and moisture absorption behavior. The orodispersible capsules were evaluated in-vitro and in-vivo in comparison with meloxicam commercial tablets (Mobic TM). Results: Inclusion complexes between meloxicam and beta-cyclodextrin were formed and the dissolution efficiency was greatly enhanced by the freeze-dried product. The formulations containing mannitol or anhydrous lactose as fillers were superior and disintegrated within 23 s. The dissolution efficiency after 60 min exceeded 98% for the orodispersible capsules while its value was only 79% for Mobic TM. In comparison with Mobic TM, the tested orodispersible capsules showed a 1.7-fold increase in the average Cmax, a 0.5-fold decrease in the average tmax and a 1.4-fold increase in the average AUC0-4� of meloxicam. Conclusion: Orodispersible capsules containing meloxicam/beta-cyclodextrin freeze-dried complex markedly improve meloxicam bioavailability.
Neural responses to negative outcomes predict success in community‐based substance use treatment

Background and aims Patterns of brain activation have demonstrated promise as prognostic indicators in substance dependent individuals (SDIs) but have not yet been explored in SDIs typical of community‐based treatment settings. Design Prospective clinical outcome design, evaluating baseline functional magnetic resonance imaging data from the Balloon Analogue Risk Task (BART) as a predictor of 3‐month substance use treatment outcomes. Setting Community‐based substance use programs in Bloomington, Indiana, USA. Participants Twenty‐three SDIs (17 male, aged 18–43 years) in an intensive outpatient or residential treatment program; abstinent 1–4 weeks at baseline. Measurements Event‐related brain response, BART performance and self‐report scores at treatment onset, substance use outcome measure (based on days of use). Findings Using voxel‐level predictive modeling and leave‐one‐out cross‐validation, an elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) at baseline successfully predicted greater substance use during the 3‐month study interval (P ≤ 0.006, cluster‐corrected). This effect was robust to inclusion of significant non‐brain‐based covariates. A larger response to negative feedback in bilateral Amyg/aHipp was also associated with faster reward‐seeking responses after negative feedback (r(23) = −0.544, P = 0.007; r(23) = −0.588, P = 0.003). A model including Amyg/aHipp activation, faster reward‐seeking after negative feedback and significant self‐report scores accounted for 45% of the variance in substance use outcomes in our sample. Conclusions An elevated response to unexpected negative feedback in bilateral amygdala and anterior hippocampus (Amyg/aHipp) appears to predict relapse to substance use in people attending community‐based treatment.
Multi-objective optimal scheduling of a micro-grid consisted of renewable energies using multi-objective Ant Lion Optimizer

This paper proposes a sustainable simulation method for managing energy resources from the point of view of virtual power players (VPP) operating in a smart grid. The proposed energy resource management schedule in a micro-grid, including fuel cells, micro turbines, solar panels, wind turbines, and batteries, intelligently meets the needs of the grid. Apart from using the aforementioned resources, VPP can also purchase additional energy from upper utility to respond to the load. In addition, the proposed method plans suitably a micro-grid using a multi-objective framework, which minimizes the total operation cost and emission caused by the generating units simultaneously. To achieve this goal, the multi-objective Ant Lion Optimizer (MOALO) has been used to solve the multi-objective optimization problem and to produce Pareto optimal solutions. The fuzzy technique has been used for the decision making process. Finally, to demonstrate the effectiveness of the proposed method, the results have been compared with multi-objective Particle Swarm Optimization (MOPSO) and Non-dominated Sorting Genetic Algorithm-II (NSGA-II), which shows that the use of the MOALO method in the presence of fuzzy technique attain the superior solutions on the operation cost and the emission of pollutant.
Late Presentation With HIV in Africa: Phenotypes, Risk, and Risk Stratification in the REALITY Trial

Abstract Background Severely immunocompromised human immunodeficiency virus (HIV)–infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and “late presenter” phenotypes. Methods The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts <100 cells/µL initiating ART in Uganda, Zimbabwe, Malawi, and Kenya. Baseline predictors of mortality through 48 weeks were identified using Cox regression with backwards elimination (exit P > .1). Results Among 1711 included participants, 203 (12%) died. Mortality was independently higher with older age; lower CD4 count, albumin, hemoglobin, and grip strength; presence of World Health Organization stage 3/4 weight loss, fever, or vomiting; and problems with mobility or self-care at baseline (all P < .04). Receiving enhanced antimicrobial prophylaxis independently reduced mortality (P = .02). Of five late-presenter phenotypes, Group 1 (n = 355) had highest mortality (25%; median CD4 count, 28 cells/µL), with high symptom burden, weight loss, poor mobility, and low albumin and hemoglobin. Group 2 (n = 394; 11% mortality; 43 cells/µL) also had weight loss, with high white cell, platelet, and neutrophil counts suggesting underlying inflammation/infection. Group 3 (n = 218; 10% mortality) had low CD4 counts (27 cells/µL), but low symptom burden and maintained fat mass. The remaining groups had 4%–6% mortality. Conclusions Clinical and laboratory features identified groups with highest mortality following ART initiation. A screening tool could identify patients with low CD4 counts for prioritizing same-day ART initiation, enhanced prophylaxis, and intensive follow-up. Clinical Trials Registration ISRCTN43622374.