Miracle-dz/UniFAR-FTUs huggingface dataset:
A pilot study into reaching performance after severe to moderate stroke using upper arm support

Stroke effects millions of people each year and can have a significant impact on the ability to use the impaired arm and hand. One of the results of stroke is the development of an abnormal shoulder-elbow flexion synergy, where lifting the arm can cause the elbow, wrist, and finger flexors to involuntarily contract, reducing the ability to reach with the arm and hand opening. This study explored the effect of using support at the upper arm to improve hand and arm reaching performance. Nine participants were studied while performing a virtual reaching task under three conditions: while the weight of their impaired arm was supported by a robot arm, while unsupported, and while using their non-impaired arm. Most subjects exhibited faster and more accurate reaching while supported compared to unsupported. For the subjects who could voluntarily open their hand, most were able to more swiftly open their hand when using upper arm support. In many cases, performance with support was not statistically different than the unaffected arm and hand. Muscle activity of the impaired limb with upper arm support showed decreased effort to lift the arm and reduced biceps activity in most subjects, pointing to a reduction in the abnormal flexion synergy while using upper arm support. While arm support can help to reduce the activation of abnormal synergies, weakness resulting from hemiparesis remains an issue impacting performance. Future systems will need to address both of these causes of disability to more fully restore function after stroke.
The Relationship of Reduced Peripheral Nerve Function and Diabetes With Physical Performance in Older White and Black Adults

OBJECTIVE—Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance. RESEARCH DESIGN AND METHODS—Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73–82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk. RESULTS—Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed. CONCLUSIONS—Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults.
ATLANTIC DIP: The Impact of Obesity on Pregnancy Outcome in Glucose-Tolerant Women

OBJECTIVE A prospective study of the impact of obesity on pregnancy outcome in glucose-tolerant women. RESEARCH DESIGN AND METHODS The Irish Atlantic Diabetes in Pregnancy network advocates universal screening for gestational diabetes. Women with normoglycemia and a recorded booking BMI were included. Maternal and infant outcomes correlated with booking BMI are reported. RESULTS A total of 2,329 women fulfilled the criteria. Caesarean deliveries increased in overweight (OW) (odds ratio 1.57 [95% CI 1.24–1.98]) and obese (OB) (2.65 [2.03–3.46]) women. Hypertensive disorders increased in OW (2.30 [1.55–3.40]) and OB (3.29 [2.14–5.05]) women. Reported miscarriages increased in OB (1.4 [1.11–1.77]) women. Mean birth weight was 3.46 kg in normal BMI (NBMI), 3.54 kg in OW, and 3.62 kg in OB (P < 0.01) mothers. Macrosomia occurred in 15.5, 21.4, and 27.8% of babies of NBMI, OW, and OB mothers, respectively (P < 0.01). Shoulder dystocia occur in 4% (>4 kg) compared with 0.2% (<4 kg) babies (P < 0.01). Congenital malformation risk increased for OB (2.47 [1.09–5.60]) women. CONCLUSIONS OW and OB glucose-tolerant women have greater adverse pregnancy outcomes.
Risk of breast cancer in the UK biobank female cohort and its relationship to anthropometric and reproductive factors

Background Anthropometric and reproductive factors have been reported as being established risk factors for breast cancer (BC). This study explores the contribution of anthropometric and reproductive factors in UK females developing BC in a large longitudinal cohort. Methods Data from the UK Biobank prospective study of 273,467 UK females were analyzed. Relative risks (RRs) and 95% confidence intervals (CIs) for each factor were adjusted for age, family history of BC and deprivation score. The analyses were stratified by the menopausal status. Results Over the 9 years of follow up the total number of BC cases were 14,231 with 3,378 (23.7%) incident cases with an incidence rate of 2.09 per 1000 person-years. In pre-menopausal, increase in age, height, having low BMI, low waist to hip ratio, first degree family history of BC, early menarche age, nulliparous, late age at first live birth, high reproductive interval index, and long contraceptive use duration were all significantly associated with an increased BC risk. In post-menopausal, getting older, being taller, having high BMI, first degree BC family history, nulliparous, late age at first live birth, and high reproductive interval index were all significantly associated with an increased risk of BC. The population attributable fraction (PAF) suggested that an early first live birth, lower reproductive interval index and increased number of children can contribute to BC risk reduction up to 50%. Conclusions This study utilizes the UK Biobank study to confirm associations between anthropometric and reproductive factors and the risk of breast cancer development. Result of attributable fraction of risk contributed by each risk factor suggested that lifetime risk of BC can be reduced by controlling weight, reassessing individual approaches to the timing of childbirth and options for contraception and considering early screening for women with family history in the first degree relative.
Depression and Insulin Resistance

OBJECTIVE To examine the association between depressive disorder and insulin resistance in a sample of young adults using the Composite International Diagnostic Interview to ascertain depression status. RESEARCH DESIGN AND METHODS Cross-sectional data were collected from 1,732 participants aged between 26 and 36 years. Insulin resistance was derived from blood chemistry measures of fasting insulin and glucose using the homeostasis model assessment method. Those identified with mild, moderate, or severe depression were classified as having depressive disorder. RESULTS The 12-month prevalence of depressive disorder was 5.4% among men and 11.7% among women. In unadjusted models mean insulin resistance was 17.2% (95% CI 0.7–36.0%, P = 0.04) higher in men and 11.4% (1.5–22.0%, P = 0.02) higher in women with depressive disorder. After adjustment for behavioral and dietary factors, the increased level of insulin resistance associated with depressive disorder was 13.2% (−3.1 to 32.3%, P = 0.12) in men and 6.1% (−4.1 to 17.4%, P = 0.25) in women. Waist circumference was identified as a mediator in the relationship between depression and insulin resistance, reducing the β coefficient in the fully adjusted models in men by 38% and in women by 42%. CONCLUSIONS A positive association was found between depressive disorder and insulin resistance in this population-based sample of young adult men and women. The association seemed to be mediated partially by waist circumference.
The next HDL (panel session): if C++ is ;the answer, what was the question?

The focus of this panel is on issues surrounding the use of C++ in modeling, integration of silicon IP and system-on-chip designs. In the last two years there have been several announcements promoting C++ based solutions and of multiple consortia (SystemC, Cynapps, Accellera, SpecC) that represent increasing commercial interest both from tool vendors as well as perhaps expression of genuine needs from the design houses. There are, however, serious questions about what value proposition does a C++ based design methodology bring to the IC or system designer? What has changed in the modeling technology (and/or available tools) that gives a new capability? Is synthesis the right target? or VAlidation? Tester modeling or testbench generation? This panel brings together advocates and opponents from the user community to highlight the achievements and the challenges that remain in use C++ for use in microelectronic circuits and systems.
Gender-specific associations between perceived and objective neighbourhood crime and metabolic syndrome

Much research has considered the relationship between neighbourhood crime and physical activity, but few studies have assessed clinical outcomes consequent to behaviour, such as cardiometabolic risk. Fewer still have simultaneously assessed perceived and objective measures of crime. Perceptions of crime and actual victimisation vary according to gender; thus, this study sought to assess: 1) correspondence between perceived and objective neighbourhood crime; and 2) gender-specific associations between perceived and reported crime and metabolic syndrome, representing cardiometabolic risk. The indirect effect of neighbourhood crime on metabolic syndrome via walking was additionally evaluated. An Australian population-based biomedical cohort study (2004–2007) collected biomedical, socio-demographic, and neighbourhood perceptions data from n = 1,172 urban-dwelling, adults. Area-level reported crime rates were standardised and linked to individual data based on participants' residential location. Correspondence between actual and perceived crime measures was assessed using Pearson correlation coefficients. Cross-sectional associations between crime and metabolic syndrome were analysed using generalised estimating equations regression models accounting for socio-demographic factors and area-level income. Correspondence between perceived and objective crime was small to medium among men and women (r = 0.17 to 0.33). Among men, metabolic syndrome was related to rates of violent (OR = 1.21, 95% CI 1.08–1.35) and total crime (OR = 1.17, 95% CI 1.04–1.32), after accounting for perceived crime. Among women, metabolic syndrome was related to perceived crime (OR = 1.35, 95% CI 1.14–1.60) after accounting for total reported crime. Among women, there were indirect effects of perceived crime and property crime on metabolic syndrome through walking. Results indicate that crime, an adverse social exposure, is linked to clinical health status. Crime rates, and perceptions of crime and safety, differentially impact upon cardiometabolic health according to gender. Social policy and public health strategies targeting crime reduction, as well as strategies to increase perceptions of safety, have potential to contribute to improved cardiometabolic outcomes.
The Diabeo Software Enabling Individualized Insulin Dose Adjustments Combined With Telemedicine Support Improves HbA1c in Poorly Controlled Type 1 Diabetic Patients

OBJECTIVE To demonstrate that Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support significantly improves HbA1c in poorly controlled type 1 diabetic patients. RESEARCH DESIGN AND METHODS In a six-month open-label parallel-group, multicenter study, adult patients (n = 180) with type 1 diabetes (>1 year), on a basal-bolus insulin regimen (>6 months), with HbA1c ≥8%, were randomized to usual quarterly follow-up (G1), home use of a smartphone recommending insulin doses with quarterly visits (G2), or use of the smartphone with short teleconsultations every 2 weeks but no visit until point end (G3). RESULTS Six-month mean HbA1c in G3 (8.41 ± 1.04%) was lower than in G1 (9.10 ± 1.16%; P = 0.0019). G2 displayed intermediate results (8.63 ± 1.07%). The Diabeo system gave a 0.91% (0.60; 1.21) improvement in HbA1c over controls and a 0.67% (0.35; 0.99) reduction when used without teleconsultation. There was no difference in the frequency of hypoglycemic episodes or in medical time spent for hospital or telephone consultations. However, patients in G1 and G2 spent nearly 5 h more than G3 patients attending hospital visits. CONCLUSIONS The Diabeo system gives a substantial improvement to metabolic control in chronic, poorly controlled type 1 diabetic patients without requiring more medical time and at a lower overall cost for the patient than usual care.
The Relationship Between β-Cell Function and Glycated Hemoglobin

OBJECTIVE The study objective was to assess the relationship between β-cell function and HbA1c. RESEARCH DESIGN AND METHODS A total of 522 Mexican American subjects participated in this study. Each subject received a 75-g oral glucose tolerance test (OGTT) after a 10- to 12-h overnight fast. Insulin sensitivity was assessed with the Matsuda index. Insulin secretory rate was quantitated from deconvolution of the plasma C-peptide concentration. β-Cell function was assessed with the insulin secretion/insulin resistance (IS/IR) (disposition) index and was related to the level of HbA1c. RESULTS At HbA1c levels <5.5%, both the Matsuda index of insulin sensitivity and IS/IR index were constant. However, as the HbA1c increased >5.5%, there was a precipitous decrease in both the Matsuda index and the IS/IR index. Subjects with HbA1c = 6.0–6.4% had a 44 and 74% decrease in the Matsuda index and the IS/IR index, respectively, compared with subjects with HbA1c <5.5% (P < 0.01 for both indices). Subjects with normal glucose tolerance and HbA1c <5.7% had β-cell function comparable to that of subjects with normal glucose tolerance with HbA1c = 5.7–6.4%. However, subjects with impaired fasting glucose or impaired glucose tolerance had a marked decrease in β-cell function independent of their HbA1c level. CONCLUSIONS The results of the current study demonstrate that in Mexican Americans, as HbA1c increases >6.0%, both insulin sensitivity and β-cell function decrease markedly. Performing an OGTT is pivotal for accurate identification of subjects with impaired β-cell function.
Evaluation of vitamin B6 status of adult Saudis in Al-Qassim region-Saudi Arabia.

The aim of this study was to evaluate vitamin B status of adult Saudis in Al-Qassim region-Saudi 6 Arabia. A sample of 239 (127 males and 112 females) healthy Saudi adults was recruited. Vitamin B status 6 was evaluated by dietary intake and biochemical measurements. Results of dietary intake measurements showed that means of vitamin B intake and intake of vitamin B to protein ratio for males and females were 6 6 1.97±0.58 mg/day, 0.021±0.003 and 1.89±0.61 mg/day, 0.020±0.04, respectively. Results of biochemica l measurements showed that means of plasma pyridoxal phosphate (PLP) concentration and average urinary 4-Pyridoxic Acid (4-PA) excretion for males and females were 29.6±9.6 nmol L and 7.0±2.4 µmol day and -1 -1 31.7±10.4 nmol L and 6.8±2.5 µmol day , respectively. The study also investigated and discussed other -1 -1 health indicators that are related to vitamin B status including Body Mass Index (BMI), plasma albumin 6 concentration and alkaline phosphatase activity. Results of dietary intakes and biochemical measurements indicated an adequate status of vitamin B. There were no significant differences between males and 6 females in any of the previous measurements. This study indicated an adequate status of vitamin B among 6 healthy adult Saudis in Al-Qassim region, however due to the numerous functions and the importance of the vitamin, the study suggested a further evaluation in various groups of the Saudi population in other regions of the country.
Diabetes Care for Emerging Adults: Recommendations for Transition From Pediatric to Adult Diabetes Care Systems

During childhood and adolescence, there is a gradual shift from diabetes care supervised by parents and other adults to self-care management. The actual change from pediatric to adult health care providers signals a more abrupt change that requires preparation by patients, their families, and their health care providers. A number of publications from the U.S. and other countries have highlighted substantial gaps in care during this transition period between pediatric and adult care that often arise in later adolescence and the subsequent developmental stage of life termed “emerging adulthood. ” This is a critical time when patients not only assume responsibility for their diabetes self-care and interactions with the health care system but when they become more independent, potentially moving out of their parents’ home to attend college or to join the workforce (1). In the context of these transitions and the developmental issues of this age-group, gaps in diabetes care can result in suboptimal health care utilization, deteriorating glycemic control, increased occurrence of acute complications, emergence of chronic complications of diabetes that may go undetected or untreated, and psychosocial, behavioral, and emotional challenges. With the increasing incidence of both type 1 and type 2 diabetes in childhood, adolescence, and young adulthood, there is an increase in the absolute numbers of youth with diabetes in this transition period, highlighting the need for a framework of care and education for this population and a call for additional research in this area. Substantial challenges relating to the transitional period include the following:
Gene Expression Profiling in Human Acute Ischemic Stroke

Background: Gene expression profiling of human acute ischemic stroke (AIS) has the potential to identify a diagnostic panel for differential diagnosis of AIS early in the treatment phase. Purpose: The objective of this dissertation was to identify peripheral blood biomarkers that could be further explored for use in differential diagnosis of AIS and the design of stroke therapeutics.Methods: A prospective gene expression profiling study of 39 patients and 25 healthy controls was conducted. Peripheral blood samples were collected in Paxgene Blood RNA tubes from patients who were ≥18 years of age with MRI diagnosed AIS after differential diagnosis and controls who were Non-stroke neurologically healthy. In stroke patients, blood was redrawn 24 hours following onset of symptoms to determine changes in gene expression profiles over time. RNA was hybridized to Illumina humanRef-8v2 bead chips. Validation was performed using Taqman Gene expression polymerase chain reaction on significant targets. Results: A nine gene profile has been identified for AIS. Five of these nine genes were identified in the previously published whole blood gene expression profiling study of stroke and therefore play a likely role in the response to AIS in humans. One of these nine genes (s100A12) was significantly associated with increasing age and therefore may be non-specific for stroke. Three genes were identified as the whole blood expression profile change over time (LY96, IL8, and SDPR). Pathway analysis revealed a robust innate immune response, with toll like receptor (TLR) signaling as a highly significant pathway present in the peripheral whole blood of AIS patients.Conclusion: The findings of this study support the claim that gene expression profiling of peripheral whole blood can be used to identify diagnostic markers of AIS. A plausible case for innate immunity through the activation of TLR4 as a mediator of response to AIS has been made from the results of this study. This study and those conducted by Moore et al (2005) and Tang et al (2006) provide the foundation of data that support the use of peripheral whole blood for future blood profiling studies of neurological disease; which significantly opens the door of opportunity.
The Health and Retirement Study: A Public Data Resource for Research on Aging

The Health and Retirement Study (HRS) is a nationally representative longitudinal survey of more than 37,000 individuals in 23,000 households over age 50 in the United States. Fielded biennially since 1992, it was established to provide a national resource for data on the changing health and economic circumstances associated with aging. HRS covers four broad topic areas—income and wealth; health, cognition, and use of health care services; work and retirement; and family connections. HRS data are also linked at the individual level to administrative records from Social Security and Medicare, Veteran’s Administration, the National Death Index, and employer-provided pension plan information. In 2006, data collection expanded to include biomarkers and genetics and greater depth in psychosocial well-being and social context. This blend of economic, health, and psychosocial information provides unprecedented potential to study increasingly complex questions about aging and retirement. HRS prioritizes rapid release of data while simultaneously protecting the confidentiality of respondents. Three categories of data—public, sensitive, and restricted—can be accessed through procedures described on the HRS website (hrsonline.isr.umich.edu).
Determinants and Prognostic Value of Cardiovascular Autonomic Function in Coronary Artery Disease Patients With and Without Type 2 Diabetes

OBJECTIVE Cardiovascular autonomic dysfunction is a common finding among patients with coronary artery disease (CAD) and type 2 diabetes (T2D). The reasons and prognostic value of autonomic dysfunction in CAD patients with T2D are not well known. RESEARCH DESIGN AND METHODS We examined the association between heart rate recovery (HRR), 24-h heart rate (HR) variability (SD of normal R-R interval [SDNN]), and HR turbulence (HRT), and echocardiographic parameters, metabolic, inflammatory, and coronary risk variables, exercise capacity, and the presence of T2D among 1,060 patients with CAD (mean age 67 ± 8 years; 69% males; 50% patients with T2D). Second, we investigated how autonomic function predicts a composite end point of cardiovascular death, acute coronary event, stroke, and hospitalization for heart failure during a 2-year follow-up. RESULTS In multiple linear regression model, exercise capacity was a strong predictor of HRR (R = 0.34, P < 0.001), SDNN (R = 0.33, P < 0.001), and HRT (R = 0.13, P = 0.001). In univariate analyses, a composite end point was predicted by reduced HRR (hazard ratio 1.7 [95% CI 1.1–2.6]; P = 0.020), reduced SDNN (2.0 [95% CI 1.2–3.1]; P = 0.005), and blunted HRT (2.1 [1.3–3.4]; P = 0.003) only in patients with T2D. After multivariate adjustment, none of the autonomic markers predicted the end point, but high-sensitivity C-reactive protein (hs-CRP) remained an independent predictor. CONCLUSIONS Cardiovascular autonomic function in CAD patients is associated with several variables, including exercise capacity. Autonomic dysfunction predicts short-term cardiovascular events among CAD patients with T2D, but it is not as strong an independent predictor as hs-CRP.