Miracle-dz/UniFAR-FTUs huggingface dataset:
THERAPEUTIC EFFECTS OF LOW-LEVEL LASER AND REFLEXOLOGY ON ADHESIVE CAPSULITIS IN ELDERLY TYPE 2 DIABETIC PATIENTS

Objective: Adhesive capsulitis is common in Type 2 diabetic patients. The painful nature of adhesive capsulitis and the lack of effective therapy for improving motion and diminishing pain demonstrate the demand for a new effective therapeutic intervention. The current study aimed to determine the efficacies of low-level laser therapy (LLLT) and reflexology for improving range of motion (ROM) in diabetic patients with adhesive capsulitis. Methods: Forty volunteer patients of both sexes with proven Type 2 diabetes and adhesive capsulitis were included in the current study. The patients were divided into two groups each comprising 20 patients as follows; Group I (LLLT): Patients received LLLT for 15 minutes and Group II (Reflexology): Patients received reflexology in the form of thumb walk for 15 minutes. Therapy was applied 3 times/week for 8 weeks with concurrent 15 minutes exercise. Results: Patients received LLLT showed a significant increase in ROM of abduction, internal rotation, flexion, and external rotation at the end of 4 and 8 weeks. Reflexology induced a significant improvement in shoulder ROM at 8 weeks posttreatment, however, its effect on internal rotation ROM was non-significant at the end of 4 weeks period. Conclusion: LLLT and reflexology significantly improved ROM and reduced pain severity in diabetic patients with adhesive capsulitis; LLLT seemed to be more effective. Thus, both therapies may be recommended in the treatment of frozen shoulder, pending further investigations to trace out their exact efficacies. Keywords: Adhesive capsulitis, Diabetes complications, Laser, Reflexology.
Five-Year Outcomes of a Randomized Trial of Gastric Band Surgery in Overweight but Not Obese People With Type 2 Diabetes

The incremental benefit of bariatric surgery in people who receive good diabetes care is uncertain. So far only one randomized trial of surgery for obese people with type 2 diabetes (T2D) has reported 5-year outcomes. Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD) reduced the burden of glucose-lowering medication and delivered diabetes remission in 50% of surgical-arm participants (1). We previously reported 2-year outcomes of a randomized trial of laparoscopic adjustable gastric band (GB) surgery in overweight but not obese Australians with T2D of less than 5 years’ duration (2). Diabetes remission, defined as fasting glucose <7.0 and 2-h glucose <11.1 mmol/L after a 75-g oral challenge, was observed in 52% of GB participants. The protocol, methods, and extended data are available in the Supplementary Data online. We now report 5-year outcomes. Of 51 participants who enrolled in the study between 2009 and 2011, 45 (22 randomized to receive GB combined with medical care and 23 to medical care alone [MED]) were followed to 5 years. The mean ± SD weight loss (WL) at the end of the study was 11.2 ± 7.6% and 2.6 ± 6.9% of baseline in GB and MED participants, respectively (difference 8.6%, 95% CI 4.2–13.0). The average WL over the 5 years of the study was 12.2% in GB and 1.8% in MED participants (difference 10.4%, 95% CI 6.9–13.8) (Fig. 1 A ). This degree of incremental WL was lower than that seen in the prior surgical study in obese people …
The relationship between depression and cognitive function in adults with cardiovascular risk: Evidence from a randomised attention-controlled trial

Background and aim This study assessed the association between depressive symptom severity and cognition in middle-to-older aged adults with mild-to-moderate depression and cardiovascular risk factors using an online test battery (CogState) and whether changes in depressive symptoms over 3 months were associated with changes in cognition. Methods Participants (mean age = 57.8) with cardiovascular risk and mild–to-moderate depressive symptoms completed measures of psychomotor speed, learning, and executive function prior to (n = 445)_and after (n = 334) online depression or attention control interventions. The symptom severity-cognition relationship was examined both cross-sectionally and prospectively. Results Participants exhibited significantly reduced psychomotor speed and variable impairments on measures of learning and executive functioning relative to normative data. However, there was no association of depression severity with cognition at baseline or of change in depressive symptoms with change in cognitive performance. Limitations Participants were well-educated, which may have protected against cognitive decline. Attrition may limit generalisability, though is unlikely to explain the lack of association between depression symptoms and cognition. Conclusions Adults with comorbid mild-to-moderate depressive symptoms and cardiovascular risks performed less well than age-matched normative data on three online cognitive tests; however, we were unable to show any symptom-cognition association cross-sectionally or longitudinally, despite significant improvements in depressive symptoms. This challenges the generalisability of such associations found in more severely unwell clinical samples to those with a broader depressive symptom profile, or suggests that underlying cardiovascular disease may account for the association seen in some clinical studies. This has implications for scaling up selective prevention of cognitive decline.
Management of carotid artery disease in the elderly

Stroke is one of the leading causes of death in western countries and puts a large burden on healthcare budgets. Many studies have confirmed the increased incidence of stroke with increasing age. There is no evidence of a significant difference in the risk factors for atherosclerosis among different age groups. However, there are some ADDitional risk factors that can contribute to carotid artery disease in the elderly. There is good evidence that elderly patients, aged 80 years or above with transient ischemic attack or ischemic stroke, are generally underinvestigated in routine clinical practice. Several treatment modalities exist for stroke in elderly patients, including medical treatment, thrombolysis and/or endarterectomy. We have herein analyzed the results of treatment modalities as applied to this age group. We have also compared the results of different age group and analyzed the outcome of each modality as appropriate.
5. Glycemic Targets

Recommendations c When prescribed as part of a broader educational context, self-monitoring of blood glucose (SMBG) results may help to guide treatment decisions and/or self-management for patients using less frequent insulin injections B or noninsulin therapies. E c When prescribing SMBG, ensure that patients receive ongoing instruction and regular evaluation of SMBG technique, SMBG results, and their ability to use SMBG data to adjust therapy. E c Most patients on intensive insulin regimens (multiple-dose insulin or insulin pump therapy) should consider SMBG prior to meals and snacks, occasionally postprandially, at bedtime, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are normoglycemic, and prior to critical tasks such as driving. B c When used properly, continuous glucose monitoring (CGM) in conjunction with intensive insulin regimens is a useful tool to lower A1C in selected adults (aged $25 years) with type 1 diabetes. A c Although the evidence for A1C lowering is less strong in children, teens, and younger adults, CGM may be helpful in these groups. Success correlates with adherence to ongoing use of the device. B c CGM may be a supplemental tool to SMBG in those with hypoglycemia unawareness and/or frequent hypoglycemic episodes. C c Given variable adherence to CGM, assess individual readiness for continuing CGM use prior to prescribing. E c When prescribing CGM, robust diabetes education, training, and support are required for optimal CGM implementation and ongoing use. E c People who have been successfully using CGM should have continued access after they turn 65 years of age. E
A Novel Small-Molecule Inhibitor of Transforming Growth Factor β Type I Receptor Kinase (SM16) Inhibits Murine Mesothelioma Tumor Growth In vivo and Prevents Tumor Recurrence after Surgical Resection

Malignant mesothelioma is an aggressive and lethal pleural cancer that overexpresses transforming growth factor beta (TGFbeta). We investigated the efficacy of a novel small-molecule TGFbeta type I receptor (ALK5) kinase inhibitor, SM16, in the AB12 syngeneic model of malignant mesothelioma. SM16 inhibited TGFbeta signaling seen as decreased phosphorylated Smad2/3 levels in cultured AB12 cells (IC(50), approximately 200 nmol/L). SM16 penetrated tumor cells in vivo, suppressing tumor phosphorylated Smad2/3 levels for at least 3 h following treatment of tumor-bearing mice with a single i.p. bolus of 20 mg/kg SM16. The growth of established AB12 tumors was significantly inhibited by 5 mg/kg/d SM16 (P < 0.001) delivered via s.c. miniosmotic pumps over 28 days. The efficacy of SM16 was a result of a CD8+ antitumor response because (a) the antitumor effects were markedly diminished in severe combined immunodeficient mice and (b) CD8+ T cells isolated from spleens of mice treated with SM16 showed strong antitumor cytolytic effects whereas CD8+ T cells isolated from spleens of tumor-bearing mice treated with control vehicle showed minimal activity. Treatment of mice bearing large tumors with 5 mg/kg/d SM16 after debulking surgery reduced the extent of tumor recurrence from 80% to <20% (P < 0.05). SM16 was also highly effective in blocking and regressing tumors when given p.o. at doses of 0.45 or 0.65 g/kg in mouse chow. Thus, SM16 shows potent activity against established AB12 malignant mesothelioma tumors using an immune-mediated mechanism and can significantly prevent tumor recurrence after resection of bulky AB12 malignant mesothelioma tumors. These data suggest that ALK5 inhibitors, such as SM16, offer significant potential for the treatment of malignant mesothelioma and possibly other cancers.
Why should cardiologist care about peripheral arterial disease in their cardiac patients

Identification of patients with PAD provides valuable prognostic information and the importance of prompt diagnosis and timely intervention in patients at risk of PAD and those with undiagnosed PAD cannot be ignored. The 5-year mortality rate for patients with PAD is � 30%, with 75% of deaths from cardiovascular causes which is overwhelming due to myocardial infarction and stroke. 4 Furthermore, patients with symptomatic PAD often experience diminished quality of life (QoL) and physical limitation which is on a par with other cardiovascular diseases such as heart failure and ischaemic heart disease. 5 Peripheral arterial disease is common among patients with coronary artery disease (CAD). 6 Patients with concomitant CAD and PAD have worse prognosis, lower QoL, and physical function than patients with either disease alone. In the REACH registry, major cardiovascular events at 1 year were 13% in patients with CAD alone and 23% (P , 0.001) in combined CAD and PAD. Patients with PAD have more severe CAD manifested by higher frequency of left-main and multivessel CAD suggesting greater burden of atherosclerosis. 7 Therefore, early diagnosis of PAD in patients with CAD should prompt aggressive risk factor modification to slow progression of atherosclerosis and prevent premature deaths, heart attack, and stroke. The deleterious nature of PAD is compounded by being an under-diagnosed and under-treated disease. Less than half of PAD patients are diagnosed because majority are
Changes in children’s television and computer time according to parental education, parental income and ethnicity: A 6-year longitudinal EYHS study

Objectives To investigate changes in children’s television and computer time according to three socio-economic status (SES) indicators. Design Prospective cohort study. Methods Data were drawn from the European Youth Heart Study and included longitudinal data collected in 1997 and 2003 in Denmark. Television and computer time were self-reported by children. Parental education, income and ethnicity were parent-reported. Baseline data were available for 549 children (47.0% boys, 9.6 years). Generalized linear mixed models analyzed whether changes in television and computer time from baseline to follow-up differed according to the SES-indicators. Result TV viewing time increased with 25% over time (ExpB = 1.25, 95% CI = 1.04–1.50). At both time points, children with two higher educated parents viewed 25% less hours of television than children with no higher educated parents (ExpB = 0.75, 95% CI = 0.60–0.94) and one higher educated parent (ExpB = 0.75, 95%CI = 0.59–0.97). Among children with no higher educated parents the odds of being in a higher category of computer time increased with 80% over time (OR = 1.80, 95% CI = 1.24–2.60). Among children with two higher educated parents the odds of being in a higher category of computer time decreased with 45% over time (OR = 0.55, 95% CI = 0.32–0.94). The association with ethnicity showed that white children had 42% lower odds (OR = 0.58; 95% CI = 0.34–1.00) of being in a higher category of computer time than non-white children. No significant associations were found for parental income. Conclusions The most important SES measure of screen-based behaviors in children was parental education. Ethnicity was only associated with computer time. Financial resources were less relevant for changes in television viewing and computer use.
Plasma Concentrations of Afamin Are Associated With Prevalent and Incident Type 2 Diabetes: A Pooled Analysis in More Than 20,000 Individuals

OBJECTIVE The human vitamin E–binding glycoprotein afamin is primarily expressed in the liver and has been associated with prevalent and incident metabolic syndrome. These data were in line with observations in transgenic mice. We thus investigated whether afamin concentrations are associated with prediabetes, type 2 diabetes, and insulin resistance (IR). RESEARCH DESIGN AND METHODS Individual-level baseline (n = 20,136) and follow-up data (n = 14,017) of eight prospective cohort studies were investigated. Study-level data were combined using random-effects meta-analyses. Main outcomes were prevalent and incident type 2 diabetes, prediabetes, and IR. Discrimination and reclassification of participants was analyzed for incident type 2 diabetes. RESULTS Mean afamin concentrations between studies ranged from 61 to 73 mg/L. The eight studies included 1,398 prevalent and 585 incident cases of type 2 diabetes. Each increase of afamin by 10 mg/L was associated with prevalent type 2 diabetes (odds ratio [OR] 1.19 [95% CI 1.12–1.26], P = 5.96 × 10−8). Afamin was positively associated with IR assessed by HOMA-IR (β 0.110 [95% CI 0.089–0.132], P = 1.37 × 10−23). Most importantly, afamin measured at baseline was an independent predictor for 585 incident cases of type 2 diabetes (OR 1.30 [95% CI 1.23–1.38], P = 3.53 × 10−19) and showed a significant and valuable gain in risk classification accuracy when added to this extended adjustment model. CONCLUSIONS This pooled analysis in >20,000 individuals showed that afamin is strongly associated with IR, prevalence, and incidence of type 2 diabetes independent of major metabolic risk factors or parameters. Afamin might be a promising novel marker for the identification of individuals at high risk for the development of type 2 diabetes.
Eye tracking cognitive load using pupil diameter and microsaccades with fixed gaze

Pupil diameter and microsaccades are captured by an eye tracker and compared for their suitability as indicators of cognitive load (as beset by task difficulty). Specifically, two metrics are tested in response to task difficulty: (1) the change in pupil diameter with respect to inter- or intra-trial baseline, and (2) the rate and magnitude of microsaccades. Participants performed easy and difficult mental arithmetic tasks while fixating a central target. Inter-trial change in pupil diameter and microsaccade magnitude appear to adequately discriminate task difficulty, and hence cognitive load, if the implied causality can be assumed. This paper’s contribution corroborates previous work concerning microsaccade magnitude and extends this work by directly comparing microsaccade metrics to pupillometric measures. To our knowledge this is the first study to compare the reliability and sensitivity of task-evoked pupillary and microsaccadic measures of cognitive load.
Social inequalities in health and mental health in France. The results of a 2010 population-based survey in Paris Metropolitan Area

The present study aimed to assess socioeconomic inequalities in general and mental health, depression and substance use disorders (daily tobacco use, hazardous alcohol use). Data from the 2010 SIRS (French acronym for Health, Inequalities, and Social Ruptures) study, which is deemed to be representative of the French-speaking adult population living in the Paris Metropolitan Area, were analysed. Different socioeconomic position indicators were selected: education, income and perceived financial status. Absolute measures (the slope index of inequality (SII)) and relative measures (the odds ratio (OR) and relative index of inequality (RII)) of health inequalities were used. The OR, RII and SII were adjusted for age, household type and migration characteristics and all analyses were performed separately for men and women. The study included 3,006 adults. The results showed significant relative and absolute socioeconomic inequalities in general, mental health and depression for all socioeconomic position indicators considered (education, income, and perceived financial status). The absolute inequalities were greater for women than for men. Strongest inequalities were observed by perceived financial status for men and women. Education seemed to play a stronger role in inequalities for women, whereas, for men, income seemed to play a stronger role. Only few socioeconomic inequalities were found in daily tobacco use, while a reversed gradient was observed for hazardous alcohol use. We hope that these results will be regularly re-evaluated and compared across time in order to monitor socioeconomic inequalities in health.
Application of Zone Model Predictive Control Artificial Pancreas During Extended Use of Infusion Set and Sensor: A Randomized Crossover-Controlled Home-Use Trial

OBJECTIVE As artificial pancreas (AP) becomes standard of care, consideration of extended use of insulin infusion sets (IIS) and continuous glucose monitors (CGMs) becomes vital. We conducted an outpatient randomized crossover study to test the safety and efficacy of a zone model predictive control (zone-MPC)–based AP system versus sensor augmented pump (SAP) therapy in which IIS and CGM failures were provoked via extended wear to 7 and 21 days, respectively. RESEARCH DESIGN AND METHODS A smartphone-based AP system was used by 19 adults (median age 23 years [IQR 10], mean 8.0 ± 1.7% HbA1c) over 2 weeks and compared with SAP therapy for 2 weeks in a crossover, unblinded outpatient study with remote monitoring in both study arms. RESULTS AP improved percent time 70–140 mg/dL (48.1 vs. 39.2%; P = 0.016) and time 70–180 mg/dL (71.6 vs. 65.2%; P = 0.008) and decreased median glucose (141 vs. 153 mg/dL; P = 0.036) and glycemic variability (SD 52 vs. 55 mg/dL; P = 0.044) while decreasing percent time <70 mg/dL (1.3 vs. 2.7%; P = 0.001). AP also improved overnight control, as measured by mean glucose at 0600 h (140 vs. 158 mg/dL; P = 0.02). IIS failures (1.26 ± 1.44 vs. 0.78 ± 0.78 events; P = 0.13) and sensor failures (0.84 ± 0.6 vs. 1.1 ± 0.73 events; P = 0.25) were similar between AP and SAP arms. Higher percent time in closed loop was associated with better glycemic outcomes. CONCLUSIONS Zone-MPC significantly and safely improved glycemic control in a home-use environment despite prolonged CGM and IIS wear. This project represents the first home-use AP study attempting to provoke and detect component failure while successfully maintaining safety and effective glucose control.
Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias

Purpose Multiple clinical and epidemiological studies have provided estimates of fibromyalgia prevalence and sex ratio, but different criteria sets and methodology, as well as bias, have led to widely varying (0.4%->11%) estimates of prevalence and female predominance (>90% to <61%). In general, studies have failed to distinguish Criteria based fibromyalgia (CritFM) from Clinical fibromyalgia (ClinFM). In the current study we compare CritFM with ClinFM to investigate gender and other biases in the diagnosis of fibromyalgia. Methods We used a rheumatic disease databank and 2016 fibromyalgia criteria to study prevalence and sex ratios in a selection biased sample of 1761 referred and diagnosed fibromyalgia patients and in an unbiased sample of 4342 patients with no diagnosis with respect to fibromyalgia. We compared diagnostic and clinical variables according to gender, and we reanalyzed a German population study (GPS) (n = 2435) using revised 2016 criteria for fibromyalgia. Results In the selection-biased sample of referred patients with fibromyalgia, more than 90% were women. However, when an unselected sample of rheumatoid arthritis (RA) patients was studied for the presence of fibromyalgia, women represented 58.7% of fibromyalgia cases. Women had slightly more symptoms than men, including generalized pain (36.8% vs. 32.4%), count of 37 symptoms (4.7 vs. 3.7) and mean polysymptomatic distress scores (10.2 vs. 8.2). We also found a linear relation between the probability of being females and fibromyalgia and fibromyalgia severity. Women in the GPS represented 59.2% of cases. Discussion The perception of fibromyalgia as almost exclusively (≥90%) a women’s disorder is not supported by data in unbiased studies. Using validated self-report criteria and unbiased selection, the female proportion of fibromyalgia cases was ≤60% in the unbiased studies, and the observed CritFM prevalence of fibromyalgia in the GPS was ~2%. ClinFM is the public face of fibromyalgia, but is severely affected by selection and confirmation bias in the clinic and publications, underestimating men with fibromyalgia and overestimating women. We recommend the use of 2016 fibromyalgia criteria for clinical diagnosis and epidemiology because of its updated scoring and generalized pain requirement. Fibromyalgia and generalized pain positivity, widespread pain (WPI), symptom severity scale (SSS) and polysymptomatic distress (PSD) scale should always be reported.
Chitosan biopolymer promotes yield and stimulates accumulation of antioxidants in strawberry fruit

Strawberry is a well-known source of natural antioxidants with excellent free radical scavenging capacity. This study determined the effects of chitosan application in field condition on plant growth, fruit yield and antioxidant activities in strawberry fruit. Foliar applications of chitosan on strawberry significantly increased plant growth and fruit yield (up to 42% higher) compared to untreated control. Increased fruit yield was attributed to higher plant growth, individual fruit weight and total fruit weight/plant due to the chitosan application. Surprisingly, the fruit from plants sprayed with chitosan also had significantly higher contents (up to 2.6-fold) of carotenoids, anthocyanins, flavonoids and phenolics compared to untreated control. Total antioxidant activities in fruit of chitosan treated plants were also significantly higher (ca. 2-fold) (p< 0.05) than untreated control. To the best of our knowledge, this is the first report of chitosan applied on field plants providing significant improvement of both yield and health benefiting biochemical contents in strawberry fruit. Further study on the elucidation of mechanisms involved with enhancement of growth, yield and biochemical contents by chitosan is needed to promote sustainable production of strawberry.