Miracle-dz/UniFAR-FTUs huggingface dataset:
Maintaining the Outcomes of a Successful Weight Gain Prevention Intervention in Mid-Age Women: Two Year Results from the 40-Something Randomized Control Trial

Despite the life stage of menopause being identified as a high risk for weight gain, there are few obesity prevention interventions for this target group, and no evidence on maintenance of intervention effects after intervention support is withdrawn. In the 40-Something Randomized Controlled Trial (RCT) (ACTRN12611000064909), a five-consultation health professional (dietitian and exercise physiologist) obesity prevention intervention, using motivational interviewing principles (MI) over 12 months, achieved significantly greater weight loss than a self-directed intervention (SDI) (tailored written material) in 54 non-obese (body mass index (BMI): 18.5–29.9 kg/m2), premenopausal women (44–50 years). The aim of the current paper is to report on whether the intervention effects were maintained at two years. Anthropometric, biochemical and health behavior data were collected at baseline, 12 months (end of intervention) and 24 months (end of maintenance period). Forty participants (22 = MI, 18 = SDI) who completed all measures to 12 months were invited to participate in the monitoring phase and 30 (MI = 16, SDI = 14) consented. The primary outcome of weight at 24 months was assessed using intention to treat principles (n = 54), adjusting for baseline weight. The MI group had a significantly lower weight at 24 months (64.6 kg, 95% CI: 63.2, 66.6, p = 0.015) compared with the SDI group (67.3 kg, 95% CI: 65.7, 68.8), and the secondary outcomes of percentage body fat and waist circumference were also significantly lower in the MI group. The low-intensity, health professional weight control intervention utilizing MI principles was more efficacious in maintaining a significant weight loss compared to a self-directed intervention, and both were successful in preventing obesity.
A small-scale randomised controlled trial of home telemonitoring in patients with severe chronic obstructive pulmonary disease

Introduction This was a pilot study to examine the effects of home telemonitoring (TM) of patients with severe chronic obstructive pulmonary disease (COPD). Methods A randomised controlled 12-month trial of 42 patients with severe COPD was conducted. Home TM of oximetry, temperature, pulse, electrocardiogram, blood pressure, spirometry, and weight with telephone support and home visits was tested against a control group receiving only identical telephone support and home visits. Results The results suggest that TM had a reduction in COPD-related admissions, emergency department presentations, and hospital bed days. TM also seemed to increase the interval between COPD-related exacerbations requiring a hospital visit and prolonged the time to the first admission. The interval between hospital visits was significantly different between the study arms, while the other findings did not reach significance and only suggest a trend. There was a reduction in hospital admission costs. TM was adopted well by most patients and eventually, also by the nursing staff, though it did not seem to change patients’ psychological well-being. Discussion Ability to draw firm conclusions is limited due to the small sample size. However the trends of reducing hospital visits warrant a larger study of a similar design. When designing such a trial, one should consider the potential impact of the high quality of care already made available to this patient cohort.
Supraspinal Control of Recurrent Inhibition during Anisometric Contractions.

PURPOSE Increase in recurrent inhibition was observed during eccentric compared with isometric and concentric maximal voluntary contractions but the neural mechanisms involved in this specific control of the Renshaw cell activity are unknown. This study was designed to investigate the supraspinal control of the recurrent inhibition during anisometric contractions of the plantar flexor muscles. METHODS To that purpose, the paired Hoffmann-reflex (H-reflex) technique permitted to assess changes in homonymous recurrent pathway by comparing the modulations of test and conditioning H-reflexes (H' and H1 respectively) in the soleus muscle (SOL) during maximal and submaximal isometric, concentric and eccentric contractions. Submaximal contraction intensity was set at 50% of the SOL electromyographic activity recorded during maximal isometric contraction. 14 volunteer subjects participated in an experimental session designed to assess the activity of the recurrent inhibition pathway. RESULTS The results indicate that the amplitude of H1 normalized to the maximal M-Wave were similar (p > 0.05) regardless of the muscle contraction type and intensity. Whatever the contraction intensity, the ratio between H' and H1 amplitudes was significantly decreased (p < 0.05) during eccentric compared with isometric and concentric contractions. Furthermore, this ratio was significantly smaller (p < 0.05) during submaximal compared with maximal contractions whatever the muscle contraction type. CONCLUSION Together, the current results confirm the supraspinal control of the Renshaw cell activity when muscle contraction intensity is modulated and show that this control remains similar for isometric, concentric and eccentric contractions. Data further suggest that recurrent inhibition pathway may serve as variable gain regulator at motoneuronal level to improve resolution in the control of motor output for the SOL during eccentric contractions.
Ice sheet contributions to future sea-level rise from structured expert judgment

Significance Future sea level rise (SLR) poses serious threats to the viability of coastal communities, but continues to be challenging to project using deterministic modeling approaches. Nonetheless, adaptation strategies urgently require quantification of future SLR uncertainties, particularly upper-end estimates. Structured expert judgement (SEJ) has proved a valuable approach for similar problems. Our findings, using SEJ, produce probability distributions with long upper tails that are influenced by interdependencies between processes and ice sheets. We find that a global total SLR exceeding 2 m by 2100 lies within the 90% uncertainty bounds for a high emission scenario. This is more than twice the upper value put forward by the Intergovernmental Panel on Climate Change in the Fifth Assessment Report. Despite considerable advances in process understanding, numerical modeling, and the observational record of ice sheet contributions to global mean sea-level rise (SLR) since the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change, severe limitations remain in the predictive capability of ice sheet models. As a consequence, the potential contributions of ice sheets remain the largest source of uncertainty in projecting future SLR. Here, we report the findings of a structured expert judgement study, using unique techniques for modeling correlations between inter- and intra-ice sheet processes and their tail dependences. We find that since the AR5, expert uncertainty has grown, in particular because of uncertain ice dynamic effects. For a +2 °C temperature scenario consistent with the Paris Agreement, we obtain a median estimate of a 26 cm SLR contribution by 2100, with a 95th percentile value of 81 cm. For a +5 °C temperature scenario more consistent with unchecked emissions growth, the corresponding values are 51 and 178 cm, respectively. Inclusion of thermal expansion and glacier contributions results in a global total SLR estimate that exceeds 2 m at the 95th percentile. Our findings support the use of scenarios of 21st century global total SLR exceeding 2 m for planning purposes. Beyond 2100, uncertainty and projected SLR increase rapidly. The 95th percentile ice sheet contribution by 2200, for the +5 °C scenario, is 7.5 m as a result of instabilities coming into play in both West and East Antarctica. Introducing process correlations and tail dependences increases estimates by roughly 15%.
Ultrasonographic confirmation of carotid artery atheromas diagnosed via panoramic radiography.

BACKGROUND Studies have shown that panoramic radiographs can capture images of calcified atheromas in the internal carotid artery (ICA) in some neurologically asymptomatic patients receiving routine dental care. However, the prevalence of these hemodynamically significant lesions--that is, those causing greater than 50 percent vessel lumen occlusion with the consequent heightened risk of stroke--has been evaluated rarely. The purpose of this study was to use Doppler ultrasonography (DUS) to determine the prevalence of large occlusive lesions detected initially via panoramic radiography. Aggressive medical and surgical interventions directed toward these large lesions have been shown to moderate the risk of stroke. STUDY DESIGN The authors analyzed the panoramic radiographs of 1,548 consecutively treated, neurologically asymptomatic dental patients who were 50 years or older. Those with presumptive atheromas underwent DUS for confirmation of the diagnosis and for determination of the degree of stenosis. RESULTS The radiographs of 65 patients (4.2 percent) showed at least one ICA atheroma. Thirty-eight patients had bilateral opacities and 27 had unilateral opacities. DUS evaluation of the 103 sides of the neck with a radiographically identified atheroma revealed that none of the ICAs were normal, 81 (79 percent) had less than 50 percent stenosis, 18 (17 percent) had 50 to 69 percent stenosis and four (4 percent) had 70 percent or greater stenosis. Four of the ICAs on the 27 sides without calcifications were deemed normal and 23 had less than 50 percent stenosis. CONCLUSIONS These results demonstrate that a subset of patients (15 [23 percent] of 65) with an occult atheroma discovered on panoramic radiography had significant (> 50 percent) levels of ICA stenosis. CLINICAL IMPLICATIONS Dentists should refer all patients with radiographically identified atheromas to a physician for confirmation of the diagnosis and a determination of the magnitude of disease, because antiatherogenic interventions have been shown to prevent a stroke.
Enhanced proliferation and differentiation of mesenchymal stem cells by astaxanthin-encapsulated polymeric micelles

Astaxanthin is a highly potent antioxidant which can be extracted from Haematococcus pluvialis when cultivated and induced at high stress conditions. Due to astaxanthin’s hydrophobicity, methoxypolyethylene glycol-polycaprolactone (mPEG-PCL) copolymer was synthesized to form polymeric micelles for the encapsulation of astaxanthin. Astaxanthin-loaded polymeric micelles were then used to examine the effects on the proliferation and differentiation of human mesenchymal stem cells (MSCs). Dynamic light scattering (DLS) and Fourier transform infrared spectroscopy (FT-IR) confirmed astaxanthin was encapsulated into mPEG-PCL micelles. Astaxanthin loading and encapsulation efficiency, determined by UV/Vis spectroscopy, were 3.27% and 96.67%, respectively. After 48 h, a total of 87.31% of astaxanthin was released from the polymeric micelles. The drug release profile was better fit by the Michaelis-Menten type model than the power law model. The MSC culture results showed that culture medium supplemented with 0.5 μg/mL astaxanthin-encapsulated polymeric micelles led to a 26.3% increase in MSC proliferation over an 8-day culture period. MSC differentiation results showed that 20 ng/mL astaxanthin-encapsulated polymeric micelles enhanced adipogenesis, chondrogenesis, and osteogenesis of MSCs by 52%, 106%, and 182%, respectively.
Prolactin as a marker of successful catheterization during IPSS in patients with ACTH-dependent Cushing's syndrome.

CONTEXT Anomalous venous drainage can lead to false-negative inferior petrosal sinus sampling (IPSS) results. Baseline inferior petrosal sinus to peripheral (IPS/P) prolactin ratio higher than 1.8 ipsilateral to the highest ACTH ratio has been proposed to verify successful catheterization. Prolactin-normalized ACTH IPS/P ratios may differentiate Cushing's disease (CD) from ectopic ACTH syndrome (EAS). OBJECTIVE Our objective was to examine the utility of prolactin measurement during IPSS. DESIGN, SETTING, AND PARTICIPANTS We conducted a retrospective analysis of prolactin levels in basal and CRH-stimulated IPSS samples in ACTH-dependent Cushing's syndrome (2007-2010). RESULTS Twenty-five of 29 patients had a pathologically proven diagnosis (17 CD and eight EAS). IPSS results were partitioned into true positive for CD (n = 16), true negative (n = 7), false negative (n = 1), and false positive (n = 1). Prolactin IPS/P ratio suggested successful IPSS in eight of 11 with abnormal venograms. Baseline prolactin IPS/P ratio was helpful in two patients with abnormal venograms and false-negative (catheterization unsuccessful) or true-negative (catheterization successful) IPSS results; the normalized ratio correctly diagnosed their disease. Normalized ACTH IPS/P ratio was at least 1.3 in all with CD, but prolactin IPS/P ratios were misleadingly low in two. One patient with cyclic EAS had a false-positive IPSS when eucortisolemic (baseline prolactin IPS/P = 1.7; normalized ratio = 5.6). All other EAS patients had normalized ratios no higher than 0.7. CONCLUSION Prolactin measurement and evaluation of the venogram can improve diagnostic accuracy when IPSS results suggest EAS but is not necessary with positive IPSS results. Confirmation of hypercortisolemia remains a prerequisite for IPSS. A normalized ratio of 0.7-1.3 was not diagnostic.
Factors Influencing Analysis of Complex Cognitive Tasks: A Framework and Example from Industrial Process Control

We propose that considering four categories of task factors can facilitate knowledge elicitation efforts in the analysis of complex cognitive tasks: materials, strategies, knowledge characteristics, and goals. A study was conducted to examine the effects of altering aspects of two of these task categories on problem solving behavior across skill levels: materials and goals. Two versions of an applied engineering problem were presented to expert, intermediate, and novice participants. Participants were to minimize the cost of running a steam generation facility by adjusting steam generation levels and flows. One version was cast in the form of a dynamic, computer-based simulation that provided immediate feedback on flows, costs, and constraint violations, thus incorporating key variable dynamics of the problem context. The other version was cast as a static computer-based model, with no dynamic components, cost feedback, or constraint checking. Experts performed better than the other groups across material conditions, and, when required, the presentation of the goal assisted the experts more than the other groups. The static group generated richer protocols than the dynamic group, but the dynamic group solved the problem in significantly less time. Little effect of feedback was found for intermediates, and none for novices. We conclude that demonstrating differences in performance in this task requires different materials than explicating underlying knowledge that leads to performance. We also conclude that substantial knowledge is required to exploit the information yielded by the dynamic form of the task or the explicit solution goal. This simple model can help to identify the contextual factors that influence elicitation and specification of knowledge, which is essential in the engineering of joint cognitive systems.
Determining residual reduction algorithm kinematic tracking weights for a sidestep cut via numerical optimization

Abstract Musculoskeletal modeling allows for the determination of various parameters during dynamic maneuvers by using in vivo kinematic and ground reaction force (GRF) data as inputs. Differences between experimental and model marker data and inconsistencies in the GRFs applied to these musculoskeletal models may not produce accurate simulations. Therefore, residual forces and moments are applied to these models in order to reduce these differences. Numerical optimization techniques can be used to determine optimal tracking weights of each degree of freedom of a musculoskeletal model in order to reduce differences between the experimental and model marker data as well as residual forces and moments. In this study, the particle swarm optimization (PSO) and simplex simulated annealing (SIMPSA) algorithms were used to determine optimal tracking weights for the simulation of a sidestep cut. The PSO and SIMPSA algorithms were able to produce model kinematics that were within 1.4° of experimental kinematics with residual forces and moments of less than 10 N and 18 Nm, respectively. The PSO algorithm was able to replicate the experimental kinematic data more closely and produce more dynamically consistent kinematic data for a sidestep cut compared to the SIMPSA algorithm. Future studies should use external optimization routines to determine dynamically consistent kinematic data and report the differences between experimental and model data for these musculoskeletal simulations.
Defining a Willingness-to-transplant Threshold in an Era of Organ Scarcity: Simultaneous Liver–kidney Transplant as a Case Example

Background. Organ scarcity continues in solid organ transplantation, such that the availability of organs limits the number of people able to benefit from transplantation. Medical advancements in managing end-stage organ disease have led to an increasing demand for multiorgan transplant, wherein a patient with multiorgan disease receives >1 organ from the same donor. Current allocation schemes give priority to multiorgan recipients compared with single-organ transplant recipients, which raise ethical questions regarding equity and utility. Methods. We use simultaneous liver and kidney (SLK) transplant, a type of multiorgan transplant, as a case study to examine the tension between equity and utility in multiorgan allocation. We adapt the health economics willingness-to-pay threshold to a solid organ transplant setting by coining a new metric: the willingness-to-transplant (WTT) threshold. Results. We demonstrate how the WTT threshold can be used to evaluate different SLK allocation strategies by synthesizing utility and equity perspectives. Conclusions. We submit that this new framework enables us to distill the question of SLK allocation down to: what is the minimum amount of benefit we require from a deceased donor kidney to allocate it for a particular indication? Addressing the above question will prove helpful to devising a rational system of SLK allocation and is applicable to other transplant settings.
National Dietary Guidelines of Greece for children and adolescents: a tool for promoting healthy eating habits

Abstract Objective: Dietary guidelines are an essential policy tool for facilitating optimal dietary patterns and healthy eating behaviours. We report: (i) the methodological approach adopted for developing the National Dietary Guidelines of Greece (NDGGr) for Infants, Children and Adolescents; and (ii) the guidelines for children aged 1–18 years. Design: An evidence-based approach was employed to develop food-based recommendations according to the methodologies of the WHO, FAO and European Food Safety Authority. Physical activity recommendations were also compiled. Food education, healthy eating tips and suggestions were also provided. Setting: The NDGGr encompass food-based nutritional and physical activity recommendations for promoting healthy dietary patterns and eating behaviours and secondarily to serve as a helpful tool for the prevention of childhood overweight and obesity. Results: The NDGGr include food-based recommendations, food education and health promotion messages regarding: (i) fruits; (ii) vegetables; (iii) milk and dairy products; (iv) cereals; (v) red and white meat; (vi) fish and seafood; (vii) eggs; (viii) legumes; (ix) added lipids, olives, and nuts; (x) added sugars and salt; (xi) water and beverages, and (xii) physical activity. A Nutrition Wheel, consisting of the ten most pivotal key messages, was developed to enhance the adoption of optimal dietary patterns and a healthy lifestyle. The NDGGr additionally provide recommendations regarding the optimal frequency and serving sizes of main meals, based on the traditional Greek diet. Conclusions: As a policy tool for promoting healthy eating, the NDGGr have been disseminated in public schools across Greece.
Synergy between serum amyloid A and secretory phospholipase A2

Serum amyloid A (SAA) is an evolutionally conserved enigmatic biomarker of inflammation. In acute inflammation, SAA plasma levels increase ~1,000 fold, suggesting that this protein family has a vital beneficial role. SAA increases simultaneously with secretory phospholipase A2 (sPLA2), compelling us to determine how SAA influences sPLA2 hydrolysis of lipoproteins. SAA solubilized phospholipid bilayers to form lipoproteins that provided substrates for sPLA2. Moreover, SAA sequestered free fatty acids and lysophospholipids to form stable proteolysis-resistant complexes. Unlike albumin, SAA effectively removed free fatty acids under acidic conditions, which characterize inflammation sites. Therefore, SAA solubilized lipid bilayers to generate substrates for sPLA2 and removed its bioactive products. Consequently, SAA and sPLA2 can act synergistically to remove cellular membrane debris from injured sites, which is a prerequisite for tissue healing. We postulate that the removal of lipids and their degradation products constitutes a vital primordial role of SAA in innate immunity; this role remains to be tested in vivo.
Cervical cancer case–control audit: Results from routine evaluation of a nationwide cervical screening program

Our study used a refined case–control cervical cancer Audit framework to investigate effectiveness of cervical screening, with measures of three screening failures: irregular‐participation, cervical cancer developed after cytological abnormalities and after normal screening results. The register‐based study included 4,254 cervical cancer cases diagnosed in Sweden during 2002–2011, and 30 population‐based controls per case. We used conditional logistic regression models to examine relative risks of cervical cancer in relation to screening participation and screening results in the past two screening rounds from 6 months before cancer diagnosis. We found that women unscreened in past two screening rounds showed four times increased risk of cervical cancer compared to women screened in time (OR = 4.1, 95% CI = 3.8–4.5), and women unscreened in the previous round but screened in the most recent round also showed a statistically significantly elevated risk (OR = 1.6, 95% CI = 1.5–1.8). Women having abnormality in previous two rounds exhibited higher risk of cervical cancer compared to women screened with normal results, while having normal results in the subsequent round after the abnormality also yielded an increased risk (OR = 4.0, 95% CI = 3.2–5.1). Being screened with only normal results was associated with 89% risk reduction for squamous cell cancer, compared to women unscreened, but only 60% reduction for adenocarcinoma. Our findings emphasize the importance of routine participation in cervical screening and suggest that management of abnormalities, as well as sensitivity of the test, warrants improvement especially for preventing cervical adenocarcinoma. The Audit framework serves as routine evaluation model and the findings benchmark for future evaluation of changes in screening practice.