Miracle-dz/UniFAR-FTUs huggingface dataset:
Can smartphone wireless ECGs be used to accurately assess ECG intervals in pediatrics? A comparison of mobile health monitoring to standard 12-lead ECG

Background Arrhythmias in children are often paroxysmal, complicating the ability to capture the abnormal rhythm on routine ECG during an outpatient visit. The Alivecor Kardia Mobile (KM) device is a wireless mobile health (mHealth) device that generates a single lead ECG tracing with a FDA-approved algorithm for detection of atrial fibrillation in adults. Objective The goal of this study is to assess the accuracy of interval measurements on KM tracings by directly comparing to standard 12-lead ECGs in pediatric patients. Methods This single center, prospective study enrolled pediatric outpatients, age <18 years presenting for cardiology clinic visits, into 3 groups based on age: 0–5 years, 6–10 years, and 11–18 years. Patients were excluded if 12-lead ECG was not ordered during the visit. Each enrolled subject underwent standard 12-lead ECG followed by 30-second KM tracing. ECG parameters were batch read by 2 blinded pediatric electrophysiologists. Results Thirty patients were recruited with 10 patients/group. Structural heart disease and/or conduction abnormality was present in 20 patients (67%). Majority of tracings (27/30, 90%) were of diagnostic quality on first attempt. Overall, the ΔPR was 15.2±10.8ms (r = 0.86), ΔQRS was 9.6±8ms (r = 0.86), and ΔQTc was 15.6±12.7ms (r = 0.83). There were 9 patients with ΔQTc measurements >20ms with 4/9 (44%) having a conduction disorder and 2/9 (22%) having marked sinus arrhythmia. Bland-Altman method of agreement demonstrated strong agreement for QRSd and QTc. The AF algorithm reported 4/30 (13%) false positive "possible AF" diagnoses (rhythm over-read on KM demonstrated n = 3 marked sinus arrhythmia, n = 1 sinus rhythm with aberrated PACs) resulting in a specificity of 87%. Conclusion The Alivecor Kardia device produces accurate single lead ECG tracings in both healthy children and children with cardiac disease or rhythm abnormalities across the pediatric spectrum. This mHealth application provides an accurate, non-invasive, real-time approach for ambulatory ECG monitoring in children and adolescents.
5 G-based Wideband Cognitive Radio System Design with Cooperative Spectrum Sensing

Since the 5G bandwidth is very large, there are a large number of non-continuous idle spectrum in 5G communication. In this paper, we have designed transmitter and receiver of a 5G-based wideband cognitive radio (CR) system with cooperative spectrum sensing, in order to improve transmission performance and avoid interference signals. Each CR user marks the spectrum availability for getting the sub-basis function through doing Inverse Fast Fourier Transform (IFFT) with the product of spectrum marker vector and random phase vector. The cooperative spectrum sensing can be realized by cascading the sub-basis functions of all the users. Multiple access of the CR system is also proposed to access much non-continuous idle spectrum. The simulation results have shown that the proposed CR system can avoid the interference effectively and outperform the spread spectrum system obviously.
Association of Serum Markers of Oxidative Stress With Incident Major Cardiovascular Events, Cancer Incidence, and All-Cause Mortality in Type 2 Diabetes Patients: Pooled Results From Two Cohort Studies

OBJECTIVE Oxidative stress plays an important role in the pathophysiology of type 2 diabetes mellitus (T2DM). However, associations of biomarkers of oxidative stress with diabetes complications have not yet been addressed in large cohort studies. RESEARCH DESIGN AND METHODS Derivatives of reactive oxygen metabolites (d-ROMs) levels, a proxy for the reactive oxygen species burden, and total thiol levels (TTLs), a proxy for the reductive capacity, were measured in 2,125 patients with T2DM from two German cohort studies of almost equal size at baseline and 3–4 years later. Multivariable adjusted Cox proportional hazards models with time-dependent modeled d-ROMs levels and TTLs were used to assess the associations with incident major cardiovascular events (MCE), cancer incidence, and all-cause mortality. RESULTS In total, 205, 179, and 394 MCE, cancer, and all-cause mortality cases were observed during 6–7 years of follow-up, respectively. Both oxidative stress biomarkers and the d-ROMs-to-TTL ratio were statistically significantly associated with all-cause mortality in both cohorts, and the pooled hazard ratios (HRs) and 95% CIs for top versus bottom tertiles were 2.10 (95% CI 1.43, 3.09) for d-ROMs levels, 0.59 (0.40, 0.87) for TTLs, and 2.50 (1.86, 3.36) for d-ROMs-to-TTL ratio. The d-ROMs-to-TTL ratio was also statistically significantly associated with incident MCE for top versus bottom tertile (1.65 [1.07, 2.54]), but this association did not persist after additional adjustment for chronic diseases. No associations with cancer were detected. CONCLUSIONS The observed strong associations of both biomarkers with mortality suggest an important contribution of an imbalanced redox system to the premature mortality of patients with diabetes.
Molecular dynamics study of tensile properties of graphene/GaN heterostructures

Graphene/GaN nanocomposites have been widely used in high-power and high-frequency optoelectronic devices. At present, the thermal transport characteristics of graphene/gallium nitride heterostructures have been investigated by many scholars, but their mechanical properties have not been systematically studied. In this paper, the effects of graphene layer number, temperature and interfacial structure on the mechanical properties of graphene/GaN heterostructures were investigated by molecular dynamics method. The mechanical properties of materials were analyzed by failure stress, failure strain and Young’s modulus. The simulation results show that the heterogeneous structure is very sensitive to temperature. When the temperature is set at 2000K, the Young’s modulus of the heterostructure decreases by 25.11% compared with that at 300K, which indicates that the increase of temperature will reduce the mechanical properties of graphene composites, However, when the number of graphene layers increases, the mechanical properties of the heterostructures also improved. With the number of graphene layers is set from 1 layer to 5 layers, the performance of the heterostructure is improved, and its Young’s modulus increases by 48.46%. In addition, the effect of interface structure on the young’s modulus of the heterostructure structure is not obvious, but it will affect the maximum failure stress and maximum failure strain of the material. The mechanical properties of graphene in cross section contact with gallium atom are better than those of nitrogen atom. It is beneficial to improve the reliability of microelectronic devices to control and design heterogeneous structures based on the research results.
A National Study of Amyotrophic Lateral Sclerosis Multidisciplinary Clinic Utilization

There is no cure for the fatal progression of Amyotrophic Lateral Sclerosis (ALS). Optimization of quality of life is the primary ALS treatment goal (Simmons, 2005). Consolidating multiple appointments into one visit is advantageous due to the severity of muscular deterioration and mobility problems associated with the disease. Multidisciplinary Clinics (MDC) provide improved care coordination, accessibility to health care professionals skilled in treating ALS, and improvements in symptom control for patients with ALS. The purpose of this study is to discuss the differences in quality of life, physical health status, and coping skills for individuals with ALS attending multidisciplinary clinics versus those receiving traditional, practitioner driven care. The investigation is part of a larger program of research designed to identify and address the psychosocial needs of individuals with ALS. The literature is void regarding factors connected to the reasons why individuals choose to attend an MDC, compared with receiving traditional practitioner driven care. Grounded theory was utilized to analyze and compare data by coding categories related to patient choice to utilize a multidisciplinary clinic or to utilize traditional care. This approach is specifically designed to provide supporting evidence that multidisciplinary clinics optimize quality of life for patients with ALS. This study was conducted through an online survey; 403 people initiated the survey, and 329 met inclusion criteria. Individuals who attend ALS clinics perceive Quality Of Life (QOL) as being higher in physical function and bulbar function, although those patients have lower levels of physical function, as measured by the ALSFRS-R. Thus, individuals attending a MDC differ in this survey from those who do not attend. MULTIDISCIPLINARY CLINIC UTILIZATION v
X-ray dark-field imaging of the human lung—A feasibility study on a deceased body

Disorders of the lungs such as chronic obstructive pulmonary disease (COPD) are a major cause of chronic morbidity and mortality and the third leading cause of death in the world. The absence of sensitive diagnostic tests for early disease stages of COPD results in under-diagnosis of this treatable disease in an estimated 60–85% of the patients. In recent years a grating-based approach to X-ray dark-field contrast imaging has shown to be very sensitive for the detection and quantification of pulmonary emphysema in small animal models. However, translation of this technique to imaging systems suitable for humans remains challenging and has not yet been reported. In this manuscript, we present the first X-ray dark-field images of in-situ human lungs in a deceased body, demonstrating the feasibility of X-ray dark-field chest radiography on a human scale. Results were correlated with findings of computed tomography imaging and autopsy. The performance of the experimental radiography setup allows acquisition of multi-contrast chest X-ray images within clinical boundary conditions, including radiation dose. Upcoming clinical studies will have to demonstrate that this technology has the potential to improve early diagnosis of COPD and pulmonary diseases in general.
Dog ownership satisfaction determinants in the owner-dog relationship and the dog's behaviour

Dog ownership satisfaction relates to the quality of life of both owner and dog, and when seriously compromised may even lead to dog abandonment. Knowledge on determinants of dog ownership satisfaction is limited, obstructing solutions for promoting satisfaction, and here we quantified causes making dog owners less than very satisfied with their dog. We focused on the owner perceived relationship with the dog, unwanted dog behaviour, and dog obedience class attendance. The study population included only few seriously dissatisfied dog owners, preventing discrimination of multiple levels below ‘very satisfied’. Consequently, existing relationships in the entire population may have been missed or underestimated and the findings apply specifically to dog owners that are relatively contented with dog ownership. Nine hundred seventy-seven Dutch dog owners completed an online questionnaire and we found the probability of being very satisfied to associate with all three subscales of the Monash Dog Owner Relationship Scale. Most strongly with perceived costs of ownership and less so with shared activities between owner and dog, and perceived emotional closeness to the dog. Aggression and/or disobedience related directly to high perceived ownership costs and to an increased probability of being less than very satisfied. Interaction effects indicated that dog disobedience was less influential on ownership satisfaction at high levels of aggression. Surprisingly, dog ownership satisfaction was unrelated to dog obedience class attendance, raising questions about the effectiveness of these classes in establishing satisfying dog-owner relationships. Training aids used during classes could play a role here, as choke chain use associated with high perceived costs and increased probabilities of being less then very satisfied with dog ownership. Ownership satisfaction in relatively contented dog owners, seems more influenced by unwanted dog behaviour and perceived costs of ownership, than by perceived emotional closeness to the dog, shared activities and dog obedience class attendance.
Primum Non Nocere: Refocusing Our Attention on Severe Hypoglycemia Prevention

Severe hypoglycemia, defined as low blood glucose requiring assistance for recovery, is arguably the most dangerous complication of type 1 diabetes as it can result in permanent cognitive impairment, seizure, coma, accidents, and death (1,2). Since the Diabetes Control and Complications Trial (DCCT) demonstrated that intensive intervention to normalize glucose prevents long-term complications but at the price of a threefold increase in the rate of severe hypoglycemia (3), hypoglycemia has been recognized as the major limitation to achieving tight glycemic control. Severe hypoglycemia remains prevalent among adults with type 1 diabetes, ranging from ∼1.4% per year in the DCCT/EDIC (Epidemiology of Diabetes Interventions and Complications) follow-up cohort (4) to ∼8% in the T1D Exchange clinic registry (5). One the greatest risk factors for severe hypoglycemia is impaired awareness of hypoglycemia (6), which increases risk up to sixfold (7,8). Hypoglycemia unawareness results from deficient counterregulation (9), where falling glucose fails to activate the autonomic nervous system to produce neuroglycopenic symptoms that normally help patients identify and respond to episodes (i.e., sweating, palpitations, hunger) (2). An estimated 20–25% of adults with type 1 diabetes have impaired hypoglycemia awareness (8), which increases to more than 50% after 25 years of disease duration (10). Screening for hypoglycemia unawareness to identify patients at increased risk of severe hypoglycemic events should be part of routine diabetes care. Self-identified impairment in awareness tends to agree with clinical evaluation (11). Therefore, hypoglycemia unawareness can be easily and effectively screened using multiple, self-administered methods (11). These range from single questions (i.e., “Do you know when your hypos are coming? ” [7] and “Can you feel when you are low? ” [12]) to longer assessments characterizing hypoglycemia exposure and the glycemic threshold for symptomatic response, as in the 8-item Clarke questionnaire (11 …
Suicide and all-cause mortality following routine hospital management of self-harm: Propensity score analysis using multicentre cohort data

Background Observational studies are suited to examining links between the routine hospital management of self-harm and future suicide and all-cause mortality due to their large scale. However, care must be taken when attempting to infer causal associations in non-experimental settings. Methods Data from the Multicentre Study of Self-Harm in England were used to examine associations between four types of hospital management (specialist psychosocial assessment, general hospital admission, psychiatric outpatient referral and psychiatric admission) following self-harm and risks of suicide and all-cause mortality in the subsequent 12 months. Missing data were handled by multiple imputation and propensity score (PS) methods were used to address observed differences between patients at baseline. Unadjusted, PS stratified and PS matched risk ratios (RRs) were calculated. Results The PSs balanced the majority of baseline differences between treatment groups. Unadjusted RRs showed that all four treatment types were associated with either increased risks or no change in risks of suicide and all-cause mortality within a year. None of the four types of hospital management were associated with lowered risks of suicide or all-cause mortality following propensity score stratification (psychosocial assessment and medical admission) and propensity score matching (psychiatric outpatient referral and psychiatric admission), though there was no longer an increased risk among people admitted to a psychiatric bed. Individuals who self-cut were at an increased risk of death from any cause following psychosocial assessment and medical admission. Medical admission appeared to be associated with reduced risk of suicide in individuals already receiving outpatient or GP treatment for a psychiatric disorder. Conclusions More intensive forms of hospital management following self-harm appeared to be appropriately allocated to individuals with highest risks of suicide and all-cause mortality. PS adjustment appeared to attenuate only some of the observed increased risks, suggesting that either differences between treatment groups remained, or that some treatments had little impact on reducing subsequent suicide or all-cause mortality risk. These findings are in contrast to some previous studies that have suggested psychosocial assessment by a mental health specialist reduces risk of repeat self-harm. Future observational self-harm studies should consider increasing the number of potential confounding variables collected.
Identifying Diabetic Patients at High Risk for Lower-Extremity Amputation in a Primary Health Care Setting: A prospective evaluation of simple screening criteria

OBJECTIVE To evaluate prospectively a risk categorization scheme for lower-extremity problems that incorporates the Semmes-Weinstein 5.07 monofilament and a simple exam to stratify patients who were followed in a primary-care setting into risk groups for plantar ulceration and lower-extremity amputation. RESEARCH DESIGN AND METHODS Patients with diabetes in a well-defined American-Indian population were stratified into four risk categories based on sensation status to the 5.07 monofilament, the presence of foot deformity, and a history of lower-extremity events (amputation or ulceration): category 0, sensate; category 1, insensate; category 2, insensate with deformity; and category 3, history of lower extremity events. Patients were followed prospectively for lower extremity events and changes in sensation status. RESULTS We gave screening exams to 358 (88%) of 406 individuals with diabetes in the community. The distribution of patients for risk categories 0, 1, 2, and 3 was 74.3, 8.4, 4.5, and 13%, respectively. Over a 32-mo follow-up period, 41 patients developed ulcerations, and incidence rates correlated positively with increasing risk category (P < 0.00001). All 14 amputations occurred in risk groups 2 and 3. CONCLUSIONS These data suggest that the risk categorization described here may have a role in identifying patients at risk for lower extremity events who are followed in a primary-care setting.
High Prevalence of NIDDM and IGT in an Elderly South Indian Population With Low Rates of Obesity

OBJECTIVE To assess the prevalence of diabetes and impaired glucose tolerance (IGT) in the urban and rural elderly population in south India. RESEARCH DESIGN AND METHODS Urban and rural populations ≥60 years of age and representative of the areas (873 urban and 588 rural subjects) were screened for diabetes and IGT using fasting and 2-h postglucose capillary blood glucose measurements. RESULTS In the urban area, 211 (23.7%) had diabetes, and 101 (12.4%) had IGT. In the rural area, 56 (9.9%) had diabetes, and 82 (14.9%) had IGT. The ratio of newly diagnosed to known diabetes was 1:3 in the urban and 1:1 in the rural areas. Positive family history of diabetes, body mass index (BMI), subscapular-to-triceps ratio, and waist-to-hip ratio were significantly associated with diabetes in the urban population. Only age and BMI showed significant association with diabetes in the elderly rural population. None of the tested parameters, except age in the urban subjects, showed association with IGT. CONCLUSIONS This study highlights the high prevalence of glucose intolerance in elderly south Indians having low mean BMI (mean ± SD; urban 21.7 ± 4.6, rural 17.9 ±3.3 kg/m2). Although there was a twofold higher prevalence of diabetes in the urban area, the occurrence of IGT was similar in urban and rural populations.
Elements of Successful Inclusion for Children with Significant Disabilities

This study focused on the practices used by specialists and early childhood education personnel that contributed to the successful inclusion of 7 young children with significant disabilities who were served in typical community settings, such as preschools and childcare centers. Analysis identified 4 elements common to each of the research sites: attitudes, parent—provider relationships, therapeutic interventions, and adaptations. These were examined in depth to identify essential practices that contributed to the children's successful inclusion in the community childcare or preschool programs.
Administration of CORM-2 inhibits diabetic neuropathy but does not reduce dyslipidemia in diabetic mice

The antinociceptive effects of the carbon monoxide-releasing molecule tricarbonyldichlororuthenium (II) dimer (CORM-2) during chronic pain are well documented, but most of its possible side-effects remain poorly understood. In this work, we examine the impact of CORM-2 treatment on the lipoprotein profile and two main atheroprotective functions attributed to high-density lipoprotein (HDL) in a mouse model of type 1 diabetes while analyzing the effect of this drug on diabetic neuropathy. Streptozotocin (Stz)-induced diabetic mice treated with CORM-2 (Stz-CORM-2) or vehicle (Stz-vehicle) were used to evaluate the effect of this drug on the modulation of painful diabetic neuropathy using nociceptive behavioral tests. Plasma and tissue samples were used for chemical and functional analyses, as appropriate. Two main antiatherogenic properties of HDL, i.e., the ability of HDL to protect low-density lipoprotein (LDL) from oxidation and to promote reverse cholesterol transport from macrophages to the liver and feces in vivo (m-RCT), were also assessed. Stz-induced diabetic mice displayed hyperglycemia, dyslipidemia and pain hypersensitivity. The administration of 10 mg/kg CORM-2 during five consecutive days inhibited allodynia and hyperalgesia and significantly ameliorated spinal cord markers (Cybb and Bdkrb1expression) of neuropathic pain in Stz mice, but it did not reduce the combined dyslipidemia shown in Stz-treated mice. Its administration to Stz-treated mice led to a significant increase in the plasma levels of cholesterol (∼ 1.4-fold vs. Ctrl, ∼ 1.3- fold vs. Stz-vehicle; p < 0.05) and was attributed to significant elevations in both non-HDL (∼ 1.8-fold vs. Ctrl; ∼ 1.6-fold vs. Stz-vehicle; p < 0.05) and HDL cholesterol (∼ 1.3-fold vs. Ctrl, ∼ 1.2-fold vs. Stz-vehicle; p < 0.05). The increased HDL in plasma was not accompanied by a commensurate elevation in m-RCT in Stz-CORM-2 compared to Stz-vehicle mice; instead, it was worsened as revealed by decreased [3H]-tracer trafficking into the feces in vivo. Furthermore, the HDL-mediated protection against LDL oxidation ex vivo shown by the HDL isolated from Stz-CORM-2 mice did not differ from that obtained in Stz-vehicle mice. In conclusion, the antinociceptive effects produced by a high dose of CORM-2 were accompanied by antioxidative effects but were without favorable effects on the dyslipidemia manifested in diabetic mice.