Miracle-dz/UniFAR-FTUs huggingface dataset:
Cardiac function in newborns of obese women and the effect of exercise during pregnancy. A randomized controlled trial

Background The prevalence of maternal obesity is rising. Pre-pregnancy obesity is associated with later cardiovascular disease in the child and the underlying pathogenesis begins in early life. Therefore, pregnancy and infancy are key periods for potential intervention. The aim of this study was to study the cardiac function in newborns of obese women compared to newborns of normal-weight women, and to determine if exercise intervention during pregnancy could have an effect on cardiac function of newborns to obese women. Material and methods Fifty-five pregnant women, 51 obese (BMI ≥ 30 kg/m2) and four overweight (BMI 28–30 kg/m2), were randomized to an exercise training group (n = 27) or a control group (standard maternity care, n = 28). From gestational week 14 until delivery participants in the intervention group were offered supervised training sessions three times weekly. In addition, they were told to exercise at home once weekly. All newborns had an echocardiogram performed 1–3 days and 6–8 weeks after delivery. The results were compared with newborns of normal weight women (n = 20, standard maternity care). Results Newborns of obese women had an impaired systolic and diastolic cardiac function with reduced global strain, strain rate, tissue Doppler velocities and a thicker intraventricular septum at birth and after 6–8 weeks after delivery compared to newborns of normal weight women. Exercise had no statistically significant effect on either of the cardiac function parameters. The mean (± standard deviation) adherence to the exercise protocol was 1.3 ± 0.8 sessions per week for supervised training and 0.8 ± 0.7 sessions per week for home-based exercise training. Conclusions Newborns of obese women had reduced cardiac function and thicker intraventricular septum compared to newborns of normal weight women. Exercise training during pregnancy had no significant effect, potentially due to a low number of subjects and low adherence to the exercise protocol. Trial registration ClinicalTrials.gov NCT01243554.
Stress-Induced Acoustic Variation in L2 and L1 Spanish Vowels

Abstract Aim: We assessed the effect of lexical stress on the duration and quality of Spanish word-final vowels /a, e, o/ produced by American English late intermediate learners of L2 Spanish, as compared to those of native L1 Argentine Spanish speakers. Methods: Participants read 54 real words ending in /a, e, o/, with either final or penultimate lexical stress, embedded in a text and a word list. We measured vowel duration and both F1 and F2 frequencies at 3 temporal points. Results: stressed vowels were longer than unstressed vowels, in Spanish L1 and L2. L1 and L2 Spanish stressed /a/ and /e/ had higher F1 values than their unstressed counterparts. Only the L2 speakers showed evidence of rising offglides for /e/ and /o/. The L2 and L1 Spanish vowel space was compressed in the absence of stress. Conclusion: Lexical stress affected the vowel quality of L1 and L2 Spanish vowels. We provide an up-to-date account of the formant trajectories of Argentine River Plate Spanish word-final /a, e, o/ and offer experimental support to the claim that stress affects the quality of Spanish vowels in word-final contexts.
De novo mutations in FLNC leading to early‐onset restrictive cardiomyopathy and congenital myopathy

Mutations in FLNC for a long time are known in connection to neuromuscular disorders and only recently were described in association with various cardiomyopathies. Here, we report a new clinical phenotype of filaminopathy in four unrelated patients with early‐onset restrictive cardiomyopathy (RCM) in combination with congenital myopathy due to FLNC mutations (NM_001458.4:c.3557C>T, p.A1186V, rs1114167361 in three probands and c.[3547G>C; 3548C>T], p.A1183L, rs1131692185 in one proband). In all cases, concurrent myopathy was confirmed by neurological examination, electromyography, and morphological studies. Three of the patients also presented with arthrogryposis. The pathogenicity of the described missense variants was verified by cellular and morphological studies and by in vivo modeling in zebrafish. Combination of in silico and experimental approaches revealed that FLNC missense variants localized in Ig‐loop segments often lead to development of RCM. The described FLNC mutations associated with early‐onset RCMP extend cardiac spectrum of filaminopathies and facilitate the differential diagnosis of restrictive cardiac phenotype associated with neuromuscular involvement in children.
Macular dysfunction in patients with macula-on rhegmatogenous retinal detachments

Aims To assess macular function in patients with macula-on rhegmatogenous retinal detachments (RRDs) using focal macular electroretinography (FMERG). Methods This is a prospective, observational case series of 27 patients diagnosed with a macula-on RRD. Foveal attachment was confirmed on spectral-domain optical coherence tomography. Eyes with any macular disorder, cataract, vitreous opacity or vitreous haemorrhage were excluded. FMERG was recorded in the affected and fellow eyes using a round stimulus 15° in diameter. The status of four retinal factors in the affected eyes was examined, that is, the number of involved quadrants, number of quadrants with retinal breaks, presence of an RRD invading the vascular arcade, and presence of a giant retinal tear. The implicit time and amplitude of the a-wave, b-wave and oscillatory potentials (OPs) were compared between the affected and fellow eyes using Wilcoxon signed-rank test. The influence of the four retinal factors on each FMERG component of the affected eyes was also evaluated using Mann-Whitney U test and Kruskal-Wallis test. Results Significant reductions in the amplitudes of the a-waves (p=0.001), b-waves (p<0.001) and OPs (p=0.001) were observed in the affected eyes compared with the fellow eyes. There was no significant difference between the affected and fellow eyes in the implicit times of any components. None of the four retinal factors affected the parameters in the affected eyes. Conclusion Altered FMERG responses suggested the presence of macular dysfunction in eyes with macula-on RRDs.
Predictive Value of Circulating Progenitor Cells in Acute Coronary Syndrome: Implications for Treatment.

Acute coronary syndromes (ACS), and notably acute myocardial infarction (AMI), continue to be one of the leading causes of cardiovascular morbidity and mortality. Although significant progress has been achieved in the prevention, diagnosis, and management of patients with ACS, the burden of recurrent events, progression to heart failure, and sudden cardiac death remains high. The research and development of biomarkers that predict which patients are at high risk for events and therapies that prevent or improve the outcome of patients with ACS is, therefore, imperative.
Imbalanced data classification using MapReduce and relief

ABSTRACT Classification of imbalanced data has been reported to require modification of standard classification algorithms and lately has attracted a lot of attention due to practical applications in industry, banking and finance. The aim of the paper is to examine algorithms known from literature when two modifications are introduced: MapReduce to parallelize computations and Relief to select most valuable attributes. Both modifications are needed in Big Data area. Also two new algorithms are considered.
Conscious sedation or local anesthesia during endovascular treatment for acute ischemic stroke

Objective To investigate the effect of conscious sedation (CS) on functional outcome and complication rates after intra-arterial treatment (IAT) for acute ischemic stroke (AIS) compared to the use of local anesthesia (LA) at the puncture site only. Methods Patients undergoing IAT for AIS with CS or LA in the Erasmus University Medical Center from March 2014 to June 2016 were included for analysis. The primary outcome was the score on the ordinal modified Rankin Scale (mRS). We compared CS to LA by ordinal logistic regression with covariate adjustment using propensity scoring. Results In 146 AIS patients treated with IAT, use of CS was associated with a shift towards worse mRS scores (odds ratio [OR] 0.4 [95% confidence interval (CI) 0.2–0.7]) compared to LA. Mortality after 90 days was higher in the CS group compared to the LA group (OR 2.3 [95% CI 1.0–5.2]). No differences between groups were noted with regard to procedure duration (8 minutes, β = 6.3 [95% CI −7.4 to 20.0]) or occurrence of procedure-related complications (OR 1.3 [95% CI 0.6–2.7]). Conclusion CS was associated with poor functional outcome and increased mortality rates compared to LA. Furthermore, CS did not reduce duration of intervention or interventional complications. CS during IAT for AIS is of no benefit if LA is considered safe. Classification of evidence This study provides Class II evidence, because of nonrandom allocation, that for patients with AIS undergoing IAT, LA rather than CS improves functional outcome.
Risk of Hyperglycemia and Diabetes after Early-Life Famine Exposure: A Cross-Sectional Survey in Northeastern China

Previous studies suggested that malnutrition during early life may play an essential role in later outcomes and disease risk in adulthood. We aimed to investigate the risks of hyperglycemia and diabetes 50 years after early-life famine exposure in a Northeastern Chinese population. We used the data from 5690 adults born between 1956 and 1965 in selected communities from a 2012 cross-sectional study. The early-childhood exposure cohort showed an increased risk of hyperglycemia compared with the unexposed cohort in the female population (odds ratio (OR) 1.46; 95% confidence interval (CI) 1.04, 2.06). The increased risk of diabetes in the early-childhood and fetal exposure cohorts was 37.0% (95% CI 1.05–1.79) and 50% (95% CI 1.15–1.96), respectively. For women, the risk of diabetes was more pronounced in the fetal-exposed cohort (OR 1.82; 95% CI 1.26–2.63) than in the early-childhood cohort (OR 1.57; 95% CI 1.08–2.26). Early-life exposure to famine increased the risk of diabetes. Furthermore, early-childhood exposure to famine might increase the risk of hyperglycemia in women. A policy for preventing early life malnutrition should be drafted by the government to prevent hyperglycemia and diabetes in adulthood.
Correlations between clinical features and death in patients with severe fever with thrombocytopenia syndrome

Abstract Severe fever with thrombocytopenia syndrome (SFTS) is an emerging high-fatality infectious disease caused by a novel phlebovirus belonging to the Bunyaviridae family. Thus, the independent predictors of death in this disease must be identified to improve the survival of affected patients. A total of 25 hospitalized patients with SFTS virus infection were enrolled in our study, and their medical records and laboratory data were reviewed. The risk factors for death were examined by binary logistic regression. The patient age was significantly higher in the deceased cases than in those who recovered (P = .020). Moreover, the occurrence of shock, respiratory failure, hemorrhagic manifestations, kidney dysfunction, and arrhythmia was significantly more common in the deceased cases than in the recovered cases (P = .016, P = .004, P = .005, P = .002, P = .038). Univariate binary logistic regression showed that shock, arrhythmia, and hemorrhage, as well as PCT, serum creatinine (Scr), and blood urea nitrogen (BUN) elevations, were the risk factors for death (odds ratio, OR 28.5, P = .015; OR 13.5, P = .027; OR 36, P = .008; OR 28.5, P = .015; OR 36, P = .008; and OR 76.0, P = .004). However, the BUN increase was the only independent risk factor for death indicated by multivariate logistic regression (OR 76.0, P = .004). SFTS presents with a high fatality rate. When patients with SFTS manifest shock, arrhythmia, hemorrhage, PCT increase, and Scr and BUN elevations, especially BUN > 8.2 &mgr;mol/L, health care providers should be alerted and must administer early intervention to prevent the progress to death.
Glial βII Spectrin Contributes to Paranode Formation and Maintenance

Action potential conduction along myelinated axons depends on high densities of voltage-gated Na+ channels at the nodes of Ranvier. Flanking each node, paranodal junctions (paranodes) are formed between axons and Schwann cells in the peripheral nervous system (PNS) or oligodendrocytes in the CNS. Paranodal junctions contribute to both node assembly and maintenance. Despite their importance, the molecular mechanisms responsible for paranode assembly and maintenance remain poorly understood. βII spectrin is expressed in diverse cells and is an essential part of the submembranous cytoskeleton. Here, we show that Schwann cell βII spectrin is highly enriched at paranodes. To elucidate the roles of glial βII spectrin, we generated mutant mice lacking βII spectrin in myelinating glial cells by crossing mice with a floxed allele of Sptbn1 with Cnp-Cre mice, and analyzed both male and female mice. Juvenile (4 weeks) and middle-aged (60 weeks) mutant mice showed reduced grip strength and sciatic nerve conduction slowing, whereas no phenotype was observed between 8 and 24 weeks of age. Consistent with these findings, immunofluorescence microscopy revealed disorganized paranodes in the PNS and CNS of both postnatal day 13 and middle-aged mutant mice, but not in young adult mutant mice. Electron microscopy confirmed partial loss of transverse bands at the paranodal axoglial junction in the middle-aged mutant mice in both the PNS and CNS. These findings demonstrate that a spectrin-based cytoskeleton in myelinating glia contributes to formation and maintenance of paranodal junctions. SIGNIFICANCE STATEMENT Myelinating glia form paranodal axoglial junctions that flank both sides of the nodes of Ranvier. These junctions contribute to node formation and maintenance and are essential for proper nervous system function. We found that a submembranous spectrin cytoskeleton is highly enriched at paranodes in Schwann cells. Ablation of βII spectrin in myelinating glial cells disrupted the paranodal cell adhesion complex in both peripheral and CNSs, resulting in muscle weakness and sciatic nerve conduction slowing in juvenile and middle-aged mice. Our data show that a spectrin-based submembranous cytoskeleton in myelinating glia plays important roles in paranode formation and maintenance.
Left Ventricular Diastolic Dysfunction in the Community: Impact of Diagnostic Criteria on the Burden, Correlates, and Prognosis

Background Left ventricular diastolic dysfunction (DD) is common, particularly in women and older individuals, and it is associated with adverse cardiovascular outcomes. We evaluated the impact of age‐ and sex‐specific diagnostic criteria on the assessment of DD in the community‐based Framingham Heart Study. Methods and Results We estimated age‐ and sex‐specific reference limits for echocardiographic measures of DD in a healthy reference subsample (N=2355, mean age 44 years, 66% women). The prevalence, correlates, and association with future cardiovascular disease were compared for DD using age‐ and sex‐specific versus single cut point reference limits in a broad sample (N=6102, mean age 50 years, 56% women). Using age‐ and sex‐specific criteria, DD was present in ≈25% to 30% of individuals across age groups, and it was directly associated with a number of modifiable risk factors. In contrast, with single cut point criteria, age was the primary determinant of DD. During follow‐up (mean 7.9±2.2 years), incident cardiovascular disease occurred in 213 of 5770 individuals. Using age‐ and sex‐specific criteria, mild and moderate‐severe DD were associated with 50% (95% confidence interval, 1.09–2.05) and 65% (95% confidence interval, 1.14–2.38) higher incidences of cardiovascular disease, respectively, in age‐ and sex‐adjusted analyses. With single cut point criteria, moderate‐severe DD (hazard ratio, 1.66; 95% confidence interval, 1.05–2.61), but not mild DD (hazard ratio, 0.94; 95% confidence interval, 0.63–1.40), was associated with incident cardiovascular disease. Conclusions Age‐ and sex‐specific reference limits may result in DD assessments that are less dependent on age, more robustly related to modifiable risk factors, and are more closely associated with incident cardiovascular disease.
Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.
RESEARCH Integrative Cardiovascular Physiology and Pathophysiology High-intensity resistance exercise with low repetitions maintains endothelial function

High-intensity resistance exercise with low repetitions maintains endothelial function. Physiol Physiol doi:10.1152/ajpheart.00281. 2018. —Resis-tance exercise impairs endothelial function, and this impairment is thought to be mediated by sustained elevation in blood pressure. Herein, we tested the hypothesis that resistance exercise-induced endothelial dysfunction would be prevented by high-intensity resistance exercise with low repetitions. This type of resistance exercise is known to induce temporal elevation in blood pressure due to low repetitions and a long resting period between sets. Thirteen young healthy subjects completed three randomized experimental trials as follows: 1 ) moderate-intensity exercise with moderate repetitions (moderate-moderate trial), 2 ) low-intensity exercise with high repetitions (low-high trial), and 3 ) high-intensity exercise with low repetitions (high-low trial). After baseline brachial artery ﬂow-mediated dilation (FMD) and blood pressure measurements, subjects performed resistance exercise according to the different types of trials. Thereaf-ter, brachial artery FMD and blood pressure measurements were repeated 10, 30, and 60 min after the exercise. Exercise-induced increases in blood ﬂow and shear rate were signiﬁcantly lower in the high-low trial than in the other two trials ( P (cid:2) 0.05). Although systolic blood pressures were signiﬁcantly elevated after exercise in all trials ( P (cid:2) 0.05), the magnitudes of rise in blood pressure increase were signiﬁcantly lower in the high-low trial than in the moderate-moderate and low-high trials ( P (cid:2) 0.05). Moderate-moderate and low-high trials caused a signiﬁcant impairment in brachial artery FMD ( P (cid:2) 0.05), which could be prevented through high-intensity resistance exercise with low repetitions ( (cid:3) 0.05). In conclusion, endothelial function was maintained by conducting high-intensity resistance exercise with low repetitions. NEW & NOTEWORTHY Data from the present study reveal that high-intensity resistance exercise with low repetitions can maintain endothelial function. Thus, this study provides the ﬁrst evidence that the detrimental vascular effects of resistance exercise are preventable when resistance exercise is performed in high intensity with low repetitions.Listento
Hypoxia inducible factor 2α (HIF2α/EPAS1) is associated with development of pulmonary hypertension in severe congenital diaphragmatic hernia patients

We show that hypoxia inducible factor 2α (HIF2α) is highly expressed in patients with pulmonary hypertension (PH). HIF2α is expressed in every patient with congenital diaphragmatic hernia, while only half of the controls express HIF2α. Our data suggest that HIF2α is a link between hypoxia and the development of PH.
Cancer phase I trial design using drug combinations when a fraction of dose limiting toxicities is attributable to one or more agents

Drug combination trials are increasingly common nowadays in clinical research. However, very few methods have been developed to consider toxicity attributions in the dose escalation process. We are motivated by a trial in which the clinician is able to identify certain toxicities that can be attributed to one of the agents. We present a Bayesian adaptive design in which toxicity attributions are modeled via copula regression and the maximum tolerated dose (MTD) curve is estimated as a function of model parameters. The dose escalation algorithm uses cohorts of two patients, following the continual reassessment method (CRM) scheme, where at each stage of the trial, we search for the dose of one agent given the current dose of the other agent. The performance of the design is studied by evaluating its operating characteristics when the underlying model is either correctly specified or misspecified. We show that this method can be extended to accommodate discrete dose combinations.
Unexpectedly decreased plasma cytokines in patients with chronic back pain

Introduction Chronic back pain is one of the most important socioeconomic problems that affects the global population. Elevated levels of inflammatory mediators, such as cytokines, have been correlated with pain, but their role in chronic back pain remains unclear. The effectiveness of anti-inflammatory drugs seems to be limited for chronic back pain. The authors wanted to investigate the levels of inflammatory mediators in long-term medically treated patients with persistent chronic back pain. Methods Cytokine plasma levels of patients with chronic back pain (n=23), compared to pain-free healthy controls (n=30), were investigated by immunoassay. Patients with chronic back pain were exposed to long-term conservative medical therapy with physiotherapy and anti-inflammatories, also combined with antidepressants and/or muscle-relaxants. Results The patients with chronic back pain expressed lower levels of the chemokines MCP1, CCL5, and CXCL6 compared to pain-free healthy controls. Significantly lower concentrations of the anti-inflammatory cytokines, interleukin (IL)-4 and granulocyte-colony stimulating factor were also found. Interestingly, levels of proinflammatory cytokines (IL-2, IL-6, IL-1β, tumor necrosis factor alpha), IL-10, granulocyte-macrophage colony-stimulating factor, and stromal cell-derived factor 1 alpha showed no significant differences between both groups. Conclusion This decrease of inflammatory mediators in medically treated patients with chronic back pain is of unclear origin and might be either a long-term side effect of medical therapy or related to chronic pain. Further longitudinal research is necessary to elucidate the underlying cause of these findings.