Miracle-dz/UniFAR-FTUs huggingface dataset:
Collaboration between stakeholders involved in augmentative and alternative communication (AAC) care of people without natural speech

ABSTRACT Collaboration among health care providers is intended to dissolve boundaries between the sectors of health care systems. The implementation of adequate augmentative and alternative communication (AAC) care of people without natural speech depends highly on collaboration among multiple stakeholders such as speech and language pathologists, teachers, or physicians. This paper examines existing barriers to and facilitators of collaboration from a stakeholder perspective. Five heterogeneous focus group interviews were conducted with N= 32 stakeholders including speech and language pathologists, AAC consultants, teachers, employees of sheltered workshops, parents, and relatives of AAC users, and other educational professionals (e.g., employees of homes for persons with disabilities) at three AAC counseling centers in Germany. Interview data were analyzed by structured qualitative content analysis. The results show very different experiences of collaboration in AAC care. Factors were identified that can have both positive and negative effects on the collaboration between all stakeholders (e.g., openness toward AAC, knowledge about AAC, communication between stakeholders). In addition, stakeholder-specific influencing factors, such as working conditions or commitment to AAC implementation, were identified. The results also reveal that these factors may have an impact on the quality of AAC care. Overall, the results indicate that good collaboration can contribute to better AAC care and that adequate conditions such as personnel, and time-related resources, or financial conditions need to be established to facilitate collaboration.
Evidence for interhemispheric imbalance in stroke patients as revealed by combining transcranial magnetic stimulation and electroencephalography

Interhemispheric interactions in stroke patients are frequently characterized by abnormalities, in terms of balance and inhibition. Previous results showed an impressive variability, mostly given to the instability of motor‐evoked potentials when evoked from the affected hemisphere. We aim to find reliable interhemispheric measures in stroke patients with a not‐evocable motor‐evoked potential from the affected hemisphere, by combining transcranial magnetic stimulation (TMS) and electroencephalography. Ninteen stroke patients (seven females; 61.26 ± 9.8 years) were studied for 6 months after a first‐ever stroke in the middle cerebral artery territory. Patients underwent four evaluations: clinical, cortical, corticospinal, and structural. To test the reliability of our measures, the evaluations were repeated after 3 weeks. To test the sensitivity, 14 age‐matched healthy controls were compared to stroke patients. In stroke patients, stimulation of the affected hemisphere did not result in any inhibition onto the unaffected. The stimulation of the unaffected hemisphere revealed a preservation of the inhibition mechanism onto the affected. This resulted in a remarkable interhemispheric imbalance, whereas this mechanism was steadily symmetric in healthy controls. This result was stable when cortical evaluation was repeated after 3 weeks. Importantly, patients with a better recovery of the affected hand strength were the ones with a more stable interhemispheric balance. Finally, we found an association between microstructural integrity of callosal fibers, suppression of interhemispheric TMS‐evoked activity and interhemispheric connectivity. We provide direct and sensitive cortical measures of interhemispheric imbalance in stroke patients. These measures offer a reliable means of distinguishing healthy and pathological interhemispheric dynamics.
Walking in Your Culture: A Study of Culturally Sensitive Outdoor Walking Space for Chinese Elderly Immigrants

Objectives: This was a study conducted in Atlanta, GA, in the United States with Chinese elderly immigrants, examining the relationship between visual preference and motivation to walk in a particular outdoor space. Backgrounds: Outdoor walking promotes the well-being of older adults. However, their declined body functions impact their motivation to walk outside. For elderly immigrants living in a country with different cultural backgrounds from their homelands, it is important to find the ways to enhance their motivation of outdoor walking. Method: Visual preference survey was conducted to assess preferences of first-generation Chinese elderly immigrants attending a care facility setting. Preferences included Chinese classical walking spaces or American modern walking spaces. The data were interpreted using descriptive statistics and factorial experiment analysis. Results: A total of 95 Chinese elderly immigrants gave valid responses to the visual preference survey. Survey results revealed that respondents had a high preference for Chinese classical walking spaces even though they had an average time of 26 years as a U.S. resident. Although the functions and purposes of the walking spaces caused safety and comfort concerns, the interaction effects of design style, design function, and design purpose illustrated that Chinese classical style had high effectiveness to promote outdoor walking of Chinese elderly immigrants. Conclusions: These results support the significance of culturally sensitive care environments in promoting outdoor walking for elderly Chinese immigrants. It also indicates that spaces designed with an assigned cultural style had higher attractiveness to older adults from the same assigned cultural background.
Early Effects of Abaloparatide on Bone Formation and Resorption Indices in Postmenopausal Women With Osteoporosis

Anabolic osteoporosis drugs improve bone mineral density by increasing bone formation. The objective of this study was to evaluate the early effects of abaloparatide on indices of bone formation and to assess the effect of abaloparatide on modeling‐based formation (MBF), remodeling‐based formation (RBF), and overflow MBF (oMBF) in transiliac bone biopsies. In this open‐label, single‐arm study, 23 postmenopausal women with osteoporosis were treated with 80 μg abaloparatide daily. Subjects received double fluorochrome labels before treatment and before biopsy collection at 3 months. Change in dynamic histomorphometry indices in four bone envelopes were assessed. Median mineralizing surface per unit of bone surface (MS/BS) increased to 24.7%, 48.7%, 21.4%, and 16.3% of total surface after 3 months of abaloparatide treatment, representing 5.5‐, 5.2‐, 2.8‐, and 12.9‐fold changes, on cancellous, endocortical, intracortical, and periosteal surfaces (p < .001 versus baseline for all). Mineral apposition rate (MAR) was significantly increased only on intracortical surfaces. Bone formation rate (BFR/BS) was significantly increased on all four bone envelopes. Significant increases versus baseline were observed in MBF on cancellous, endocortical, and periosteal surfaces, for oMBF on cancellous and endocortical surfaces, and for RBF on cancellous, endocortical, and intracortical surfaces. Overall, modeling‐based formation (MBF + oMBF) accounted for 37% and 23% of the increase in bone‐forming surface on the endocortical and cancellous surfaces, respectively. Changes from baseline in serum biomarkers of bone turnover at either month 1 or month 3 were generally good surrogates for changes in histomorphometric endpoints. In conclusion, treatment with abaloparatide for 3 months stimulated bone formation on cancellous, endocortical, intracortical, and periosteal envelopes in transiliac bone biopsies obtained from postmenopausal women with osteoporosis. These increases reflected stimulation of both remodeling‐ and modeling‐based bone formation, further elucidating the mechanisms by which abaloparatide improves bone mass and lowers fracture risk. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes

Abstract Aims There is inconsistent evidence on the relation of alcohol intake with incident atrial fibrillation (AF), in particular at lower doses. We assessed the association between alcohol consumption, biomarkers, and incident AF across the spectrum of alcohol intake in European cohorts. Methods and results In a community-based pooled cohort, we followed 107 845 individuals for the association between alcohol consumption, including types of alcohol and drinking patterns, and incident AF. We collected information on classical cardiovascular risk factors and incident heart failure (HF) and measured the biomarkers N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin I. The median age of individuals was 47.8 years, 48.3% were men. The median alcohol consumption was 3 g/day. N = 5854 individuals developed AF (median follow-up time: 13.9 years). In a sex- and cohort-stratified Cox regression analysis alcohol consumption was non-linearly and positively associated with incident AF. The hazard ratio for one drink (12 g) per day was 1.16, 95% CI 1.11–1.22, P < 0.001. Associations were similar across types of alcohol. In contrast, alcohol consumption at lower doses was associated with reduced risk of incident HF. The association between alcohol consumption and incident AF was neither fully explained by cardiac biomarker concentrations nor by the occurrence of HF. Conclusions In contrast to other cardiovascular diseases such as HF, even modest habitual alcohol intake of 1.2 drinks/day was associated with an increased risk of AF, which needs to be considered in AF prevention.
Analysis of the Choroid and Its Relationship with the Outer Retina in Patients with Diabetes Mellitus Using Binarization Techniques Based on Spectral-Domain Optical Coherence Tomography

(1) Background: We aimed to reveal the relationship between the choroid and the outer retina with optical coherence tomography (OCT) in patients with diabetes mellitus (DM) with mild or no diabetic retinopathy (DR) in order to find early biomarkers for progressing retinopathy. (2) Methods: We performed a prospective study including 61 eyes of patients with type 1 or type 2 DM and 36 eyes of healthy controls. All subjects were imaged with Spectralis OCT. The choroid was assesseed using enhanced depth imaging OCT (EDI-OCT). Binarization of subfoveal choroidal images was done with public domain software, ImageJ (version 1.53a; National Institutes of Health, Bethesda, Maryland, USA). (3) Results: Luminal area, stromal area and total choroidal area were significantly decreased in diabetic patients compared to control: 0.23 ± 0.07 vs. 0.28 ± 0.08, p = 0.012; 0.08 ± 0.03 vs. 0.10 ± 0.04, p = 0.026; 0.31 ± 0.09 vs. 0.38 ± 0.11, p = 0.008. The thickness of retinal pigment epithelium (RPE) correlated positively with the choroidal vascularity index (CVI). The correlations between outer nuclear layer (ONL), photoreceptors (PR) and foveal choroidal thickness (FChT) were moderately negative. (4) Conclusion: Thicker RPE and a thinner PR layer may be assigned the role of early biomarkers signaling the conversion time to progressing retinopathy.
Perinatal photoperiod associations with diabetes and chronotype prevalence in a cross-sectional study of the UK Biobank

ABSTRACT Experimental studies indicate that perinatal light may imprint the circadian timing system, subsequently affect later life physiology, and possibly disease risk. We combined individual time-of-year of birth and corresponding latitude to determine perinatal photoperiod characteristics for UK Biobank participants (n = 460,761) and tested for associations with diabetes mellitus (DM, the pathophysiology of which is often linked with circadian disruption) and chronotype (a trait co-governed by the circadian timing system) prevalence in a cross-sectional investigation. The UK Biobank is a population-based cohort with a 5.5% participation rate (~9.2 million individuals were invited into the study between 2006 and 2010). We defined three groups based on photoperiods experienced in the 3rd trimester of pregnancy and first 3 months post-birth time windows: (1) those who exclusively experienced non-extreme photoperiods (NEP, 8–16 hours), (2) those who experienced at least one extreme short photoperiod (ESP, <8 hours), and those who experienced at least one extreme long photoperiod (ELP, >16 hours). For individuals in each group and time window, mean daily photoperiod and relative photoperiod range (relative = relative to the mean) were calculated. Inclusion of relative photoperiod range adds dispersion information (relative change of photoperiods) to statistical models. Multivariable and multinomial logistic regression analyses were used to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Increased 3rd trimester relative range was associated with decreased odds of DM (OR 0.63 95%CI 0.49–0.81) in the NEP group, but increased odds of DM were detected for the ESP (OR 1.34, 95%CI 0.96–1.86) and ELP groups (OR 1.32, 95%CI 0.78–2.22). Increased 3rd trimester relative range was associated with increased odds of being a “Morning” (OR 1.20, 95%CI 1.02–1.41) or “Evening” (OR 1.43, 95%CI 1.21–1.69) chronotype in the NEP group, but this was not observed in other groups. Additionally, different effect sizes and directions of association with DM were observed in different strata of ethnicity and chronotype and statistically significant odds ratio modifications were detected. In conclusion, perinatal photoperiod associations with DM and chronotype prevalence are detected in the UK Biobank. NEP, ESP, and ELP differences are speculated to be caused by a non-linear dose-response to photoperiods from 0–24 hours or by confounding due to artificial light playing a dominant role in ESP individuals and seeking darkness in ELP individuals. Ethnicity and chronotype may be important effect modifiers of perinatal photoperiod associations with DM. Potential for selection biases due to low UK Biobank participation rate disallows stating conclusions too strongly. Overall, further studies are needed to confirm different perinatal photoperiod associations with DM and chronotype. Further investigations into the hypothesized imprinting mechanism are also warranted.
Low-Latency In Situ Image Analytics With FPGA-Based Quantized Convolutional Neural Network

Real-time in situ image analytics impose stringent latency requirements on intelligent neural network inference operations. While conventional software-based implementations on the graphic processing unit (GPU)-accelerated platforms are flexible and have achieved very high inference throughput, they are not suitable for latency-sensitive applications where real-time feedback is needed. Here, we demonstrate that high-performance reconfigurable computing platforms based on field-programmable gate array (FPGA) processing can successfully bridge the gap between low-level hardware processing and high-level intelligent image analytics algorithm deployment within a unified system. The proposed design performs inference operations on a stream of individual images as they are produced and has a deeply pipelined hardware design that allows all layers of a quantized convolutional neural network (QCNN) to compute concurrently with partial image inputs. Using the case of label-free classification of human peripheral blood mononuclear cell (PBMC) subtypes as a proof-of-concept illustration, our system achieves an ultralow classification latency of 34.2 $\mu \text{s}$ with over 95% end-to-end accuracy by using a QCNN, while the cells are imaged at throughput exceeding 29 200 cells/s. Our QCNN design is modular and is readily adaptable to other QCNNs with different latency and resource requirements.
Evaluating the Safety and Tolerability of Azilsartan Medoxomil alone or in combination with Chlorthalidone in the Management of Hypertension: A Systematic Review.

BACKGROUND AND AIM Azilsartan medoxomil (AZM) is the newest representative in the class of angiotensin receptor blockers. Azilsartan medoxomil in combination with the older diuretic chlorthalidone (CLD) in fixed-doses of AZM/CLD 40/12.5 mg and 40/25 mg has been approved by the FDA for use in patients with essential hypertension. We sought to evaluate the safety and tolerability of AZL-M alone and in combination with CLD. METHODS We conducted a search of pubmed using the keywords 'azilsartan', 'azilsartan medoxomil', 'chlorthalidone, 'safety', 'tolerability' in order to find scientific studies evaluating the safety of these drugs. We included studies report ing side effects of these drugs, alone or in combination, in comparison to placebo or other antihypertensive medications. For our systematic review we followed the PRISMA guidelines. RESULTS Azilsartan medoxomil is a potent antihypertensive medicine with an acceptable safety profile. Most commonly reported adverse events are dizziness, headache, fatigue, upper respiratory tract infection and urinary tract infection. Chlorthalidone is more potent and has a considerably longer duration of action than the most commonly prescribed diuretic hydrochlorothiazide. Safety and tolerability between these two drugs is similar with the exception of higher serum uric acid and lower potassium levels with chlorthalidone. CONCLUSIONS The combination of azilsartan medoxomil with chlorthalidone has been shown to be effective in lowering blood pressure with an acceptable safety and tolerability profile. This fixed-dose combination is an attractive treatment option for hypertension management.
Factors Affecting Thanatosis in the Braconid Parasitoid Wasp Heterospilus prosopidis

Simple Summary Thanatosis is an antipredator behavior widely recognized in insects, but our knowledge of this behavior in Hymenoptera is insufficient. We examined the effects of sex, age, temperature, and background color on thanatosis in the parasitoid wasp Heterospilus prosopidis under laboratory conditions, and found that some of these factors have significant effects on thanatosis of this species. Abstract Thanatosis, also called death feigning, is often an antipredator behavior. In insects, it has been reported from species of various orders, but knowledge of this behavior in Hymenoptera is insufficient. This study examined the effects of sex, age (0 or 2 days old), temperature (18 or 25 °C), and background color (white, green, or brown) on thanatosis in the braconid parasitoid wasp Heterospilus prosopidis. Thanatosis was more frequent in 0-d-old individuals and in females at 18 °C. The duration of thanatosis was longer in females, but this effect of sex was weaker at 18 °C and in 0-d-old individuals. The background color affected neither the frequency nor duration. These results were compared with reports for other insects and predictions based on the life history of this species, and are discussed from an ecological perspective.
Proposing a mobile apps acceptance model for users in the health area: A systematic literature review and meta-analysis

Due to rapid advancements in the field of information and communication technologies, mobile health (mHealth) has become a significant topic in the delivery of healthcare. Despite the perceived advantages and the large number of mHealth initiatives, the success of mHealth ultimately relies on whether these initiatives are used; their benefits will be diminished should people not use them. Previous literature has found that the adoption of mHealth by users is not yet widespread, and little research has been conducted on this problem. Therefore, this study identifies the antecedents of the intention to use mHealth and proposes a general model that might prove beneficial in explaining the acceptance of mHealth. The authors performed a quantitative meta-analysis of 49 journal papers published over the past 10 years and systematically reviewed the evidence regarding the most commonly identified factors that may affect the acceptance of mHealth. The findings indicate that the proposed model includes the seven most commonly used relationships in the selected articles. More specifically, the model assumes that perceived usefulness positively affects perceived ease of use and user behavioral intention to use mHealth is commonly influenced by five factors: perceived usefulness, perceived ease of use, attitude toward behavior, subjective norms, and facilitating conditions. The results of this work provide important insights into the predictors of mHealth acceptance for future researchers and practitioners.
Dietary Protein Intake in Older Adults from Ethnic Minorities in the Netherlands, a Mixed Methods Approach

Optimizing protein intake is a novel strategy to prevent age associated loss of muscle mass and strength in older adults. Such a strategy is still missing for older adults from ethnic minority populations. Protein intake in these populations is expected to be different in comparison to the majority of the population due to several socio-cultural factors. Therefore, the present study examined the dietary protein intake and underlying behavioral and environmental factors affecting protein intake among older adults from ethnic minorities in the Netherlands. We analyzed frequency questionnaire (FFQ) data from the Healthy Life in an Urban Setting (HELIUS) cohort using ANCOVA to describe dietary protein intake in older adults from ethnic minorities in the Netherlands (N = 1415, aged >55 years, African Surinamese, South Asian Surinamese, Moroccan, and Turkish). Additionally, we performed focus groups among older adults from the same ethnic minority populations (N = 69) to discover behavioral and environmental factors affecting protein intake; 40–60% of the subjects did not reach minimal dietary protein recommendations needed to maintain muscle mass (1.0 g/kg bodyweight per day (BW/day)), except for Turkish men (where it was 91%). The major sources of protein originated from animal products and were ethnic specific. Participants in the focus groups showed little knowledge and awareness about protein and its role in aging. The amount of dietary protein and irregular eating patterns seemed to be the major concern in these populations. Optimizing protein intake in these groups requires a culturally sensitive approach, which accounts for specific protein product types and sociocultural factors.