Miracle-dz/UniFAR-FTUs huggingface dataset:
Route of Delivery Modulates the Efficacy of Mesenchymal Stem Cell Therapy for Myocardial Infarction: A Meta-Analysis of Preclinical Studies and Clinical Trials

Rationale: Accumulating data support a therapeutic role for mesenchymal stem cell (MSC) therapy; however, there is no consensus on the optimal route of delivery. Objective: We tested the hypothesis that the route of MSC delivery influences the reduction in infarct size and improvement in left ventricular ejection fraction (LVEF). Methods and Results: We performed a meta-analysis investigating the effect of MSC therapy in acute myocardial infarction (AMI) and chronic ischemic cardiomyopathy preclinical studies (58 studies; n=1165 mouse, rat, swine) which revealed a reduction in infarct size and improvement of LVEF in all animal models. Route of delivery was analyzed in AMI swine studies and clinical trials (6 clinical trials; n=334 patients). In AMI swine studies, transendocardial stem cell injection reduced infarct size (n=49, 9.4% reduction; 95% confidence interval, −15.9 to −3.0), whereas direct intramyocardial injection, intravenous infusion, and intracoronary infusion indicated no improvement. Similarly, transendocardial stem cell injection improved LVEF (n=65, 9.1% increase; 95% confidence interval, 3.7 to 14.5), as did direct intramyocardial injection and intravenous infusion, whereas intracoronary infusion demonstrated no improvement. In humans, changes of LVEF paralleled these results, with transendocardial stem cell injection improving LVEF (n=46, 7.0% increase; 95% confidence interval, 2.7 to 11.3), as did intravenous infusion, but again intracoronary infusion demonstrating no improvement. Conclusions: MSC therapy improves cardiac function in animal models of both AMI and chronic ischemic cardiomyopathy. The route of delivery seems to play a role in modulating the efficacy of MSC therapy in AMI swine studies and clinical trials, suggesting the superiority of transendocardial stem cell injection because of its reduction in infarct size and improvement of LVEF, which has important implications for the design of future studies.
Risk of cardiovascular events in survivors of severe sepsis.

RATIONALE The risk of cardiovascular events after severe sepsis is not known, and these events may explain increased long-term mortality in survivors of severe sepsis. OBJECTIVES To determine whether survivors of severe sepsis hospitalization have high long-term risk of cardiovascular events. We examined whether higher risk is due to severe sepsis hospitalization or poor prehospitalization health status, and if the higher risk is also observed in patients hospitalized for infectious and noninfectious reasons, and in other critically ill patients. METHODS Unmatched and matched-cohort analyses of Medicare beneficiaries. For unmatched analysis, we compared patients with severe sepsis admitted to the intensive care unit (ICU) and survived hospitalization (n = 4,179) to unmatched population control subjects (n = 819,283). For matched analysis, we propensity-score-matched each patient with severe sepsis to four control subjects (population, hospitalized, non-severe sepsis ICU control subjects, and infection hospitalization). Primary outcome was 1-year incidence rate of hospitalization for cardiovascular events. MEASUREMENTS AND MAIN RESULTS Cardiovascular events were common among patients discharged alive after severe sepsis hospitalization (29.5%; 498.2 events/1,000 person-years). Survivors of severe sepsis had a 13-fold higher risk of cardiovascular events compared with unmatched control subjects (498.2 vs. 36 events/1,000 person-years; P < 0.0001), and a 1.9-fold higher risk compared with matched-population control subjects (P < 0.0001). Survivors of severe sepsis had 1.1-fold higher risk compared with matched hospitalized patients and infection hospitalizations (P = 0.002 and 0.001) and similar risk compared with matched-ICU control subjects. CONCLUSIONS Survivors of severe sepsis have high risk of cardiovascular events. The higher risk is mainly due to poor prehospitalization health status, and is also seen in a broader population of acutely ill patients.
Computer-assisted identification of proliferative diabetic retinopathy in color retinal images

Advanced (proliferative) stage of diabetic retinopathy (DR) is indicated by the growth of thin, fragile and highly unregulated vessels, neovascularization (NV). In order to identify proliferative diabetic retinopathy (PDR), our approach models the micro-pattern of local variations using texture based analysis and quantifies the structural changes in vessel patterns in localized patches, to map them to the confidence score of being neovascular using supervised learning framework. Rule-based criteria on patch-level neovascularity scores in an image is used for the decision of absence or presence of PDR. Evaluated using 3 datasets, our method achieves 96% sensitivity and 92.6% specificity for localizing NV. Image-level identification of PDR achieves high sensitivity of 96.72% at 79.6% specificity and high specificity of 96.50% at 73.22% sensitivity. Our approach could have potential application in DR grading where it can localize NVE regions and identify PDR images for immediate intervention.
Four Distinct Health Profiles in Older Patients With Cancer: Latent Class Analysis of the Prospective ELCAPA Cohort.

BACKGROUND Several studies have evaluated the independent prognostic value of impairments in single geriatric-assessment (GA) components in elderly cancer patients. None identified homogeneous subgroups. Our aims were to identify such subgroups based on combinations of GA components and to assess their associations with treatment decisions, admission, and death. METHODS We prospectively included 1,021 patients aged ≥70 years who had solid or hematologic malignancies and who underwent a GA in one of two French teaching hospitals. Two geriatricians independently selected candidate GA parameters for latent class analysis, which was then performed on the 821 cases without missing data. Age, gender, tumor site, metastatic status, and inpatient versus outpatient status were used as active covariates and predictors of class membership. Outcomes were cancer treatment decisions, overall 1-year mortality, and 6-month unscheduled admissions. Sensitivity analyses were performed on the overall population of 1,021 patients and on 375 newly enrolled patients. RESULTS We identified four classes: relatively healthy (LC1, 28%), malnourished (LC2, 36%), cognitive and mood impaired (LC3, 15%), and globally impaired (LC4, 21%). Tumor site, metastatic status, age, and in/outpatient status independently predicted class membership (p < .001). In adjusted pairwise comparisons, compared to LC1, the three other LCs were associated with higher risks of palliative treatment, death, and unscheduled admission (p ≤ .05). LC4 was associated with 1-year mortality and palliative treatment compared to LC2 and LC3 (p ≤ .05). CONCLUSION We identified four health profiles that may help physicians select cancer treatments and geriatric interventions. Researchers may find these profiles useful for stratifying patients in clinical trials.
Flow-diverting stents for intracranial bifurcation aneurysm treatment.

BACKGROUND Although initially considered safe when covering bifurcation sites, flow-diverting stents may provoke thrombosis of side branches that are covered during aneurysm treatment. OBJECTIVE To understand the occurrence and clinical expression of side-branch remodeling in distal intracranial arterial sites after flow diverter deployment by means of correlation of imaging and clinical data. METHODS We analyzed our prospectively collected data on a series of patients treated with flow diverters for intracranial aneurysms at bifurcation sites. From February 2011 to May 2013, 32 patients with 37 aneurysms (anterior communicating artery, 9 [24.3%]; anterior cerebral artery, 5 [13.5%]; middle cerebral artery, 19 (51.4%); terminal internal carotid artery, 4 [10.8%]) were treated. We divided aneurysms into 2 groups based on the side branches covered by the stent during treatment. Group A consisted of cases with side branches that supplied brain territories also receiving a direct collateral supply. Group B consisted of cases in which side branches supplied territories without direct collateral supply. The 2 groups were compared statistically. RESULTS Total exclusion occurred in 97.3% of aneurysms at follow-up. Initial modified Rankin Scale (mRS) score was 0 to 1 for 29 patients (90.6%) and 2 for 3 patients (9.4%). New permanent neurological deficit was reported in 3 patients (9.4%). At the 6-month follow-up, the mRS score was 0 to 1 for 31 patients (96.8%) and 3 for 1 patient (3.2%). Although 78.5% of side branches in group A underwent narrowing or occlusion after 6 months, no new stroke was found on magnetic resonance imaging. CONCLUSION Symptomatic modifications of side branches after flow diverter treatment depend on the extent and type of collateral supply.
High cardiorespiratory fitness in early to late middle age preserves the cortical circuitry associated with brain-heart integration during volitional exercise.

This study tested the hypothesis that high cardiorespiratory fitness (peak oxygen uptake) preserves the cortical circuitry associated with cardiac arousal during exercise in middle- to older-aged individuals. Observations of changes in heart rate (HR) and in cortical blood oxygenation level-dependent (BOLD) images were made in 52 healthy, active individuals (45-73 yr; 16 women, 36 men) across a range of fitness (26-66 ml·kg-1·min-1). Seven repeated bouts of isometric handgrip (IHG) at 40% maximal voluntary contraction force were performed with functional magnetic resonance imaging at 3 T, with each contraction lasting 20 s and separated by 40 s of rest. HR responses to IHG showed high variability across individuals. Linear regression revealed that cardiorespiratory fitness was not a strong predictor of the HR response (r2 = 0.09). In a region-of-interest analysis both the IHG task and the HR time course correlated with increased cortical activation in the bilateral insula and decreased activation relative to baseline in the anterior and posterior cingulate and medial prefrontal cortex (MPFC). t-Test results revealed greater deactivation at the MPFC with higher fitness levels beyond that of guideline-based activity. Therefore, whereas high cardiorespiratory fitness failed to affect absolute HR responses to IHG in this age range, a select effect was observed in cortical regions known to be associated with cardiovascular arousal.NEW & NOTEWORTHY Our first observation suggests that fitness does not strongly predict the heart rate (HR) response to a volitional handgrip task in middle- to older-aged adults. Second, the BOLD response associated with the handgrip task, and with the HR time course, was associated with response patterns in the cortical autonomic network. Finally, whereas high cardiorespiratory fitness failed to affect absolute HR responses to isometric handgrip in this age range, a select effect was observed in cortical regions known to be associated with cardiovascular arousal, beyond that achieved through healthy active living.
Biochemical and Molecular Actions of Nutrients Proteins of White Lupin Seed, a Naturally Isoﬂavone-Poor Legume, Reduce Cholesterolemia in Rats and Increase LDL Receptor Activity in HepG2 Cells 1

White lupin ( Lupinus albus , L.), a widely cultivated crop that has been consumed for many years in Western Europe, may provide a useful alternative for individuals wishing to substitute animal with plant proteins for cardiovascular disease prevention. Lupin seeds have a very low content of isoﬂavones, and lupin protein isolates are essentially isoﬂavone free. In rats fed a casein-based cholesterol (cid:1) cholic acid diet, a relatively low daily intake (50 mg/d by gavage for 2 wk) of total lupin protein extract reduced plasma total and VLDL (cid:1) LDL cholesterol concentrations by 21 and 30%, respectively (both P (cid:2) 0.001). In an attempt to elucidate the lipid-lowering mechanism, LDL receptor activity was evaluated in a human hepatoma cell line (HepG2). In this model, the lupin total protein extract was essentially inactive, whereas one puriﬁed minor protein component, conglutin (cid:1) , had a remarkable upregulatory effect, with maximal increases of 53 and 21% (both P (cid:2) 0.05) for LDL uptake and degradation, respectively. This initial study indicates that lupin, although isoﬂavone free, has hypocholesterolemic activity similar to that of other leguminous proteins in an established animal model. Further, the cholesterol reduction appears to be associated with stimulation of LDL receptors by a well-deﬁned protein component of the lupin seeds as demonstrated by in vitro studies.
Experimental study on obtaining hydraulic concrete strength by use of concrete piezoelectric ceramic smart module pairs

The concrete strength has the strong influence on service safety of mass hydraulic concrete structures. The real-time identification of concrete strength is very important to ensure the pouring quality during the construction and find timely the hidden troubles in service. Based on the analysis for the mapping relationship between concrete strength and stress wave amplitude, the method is proposed to obtain indirectly the concrete strength with self-made concrete piezoelectric ceramic smart module pairs. First, according to the service condition of hydraulic concrete structure, the concrete piezoelectric ceramic smart module is designed and the process manufacturing concrete piezoelectric ceramic smart module is presented. The protecting measures of piezoelectric ceramic piece, the peripheral material constituent, and the pouring links are introduced. Second, an integrated system, which is composed of self-made concrete piezoelectric ceramic smart modules in pair as sensor and actuator, fuzzy inference system, and other auxiliary equipments, is developed to monitor indirectly concrete strength. Its working principle is studied. Finally, an experiment of hydraulic concrete strength is implemented to demonstrate the feasibility and validity of the proposed method and developed system. The concrete piezoelectric ceramic smart modules in pair are taken as sensor and actuator embedded in hydraulic concrete specimens. The wave-based analysis method is adopted to collect the stress wave amplitude data during the pouring process of concrete specimens. The fuzzy inference approach is utilized to build the mathematical model describing the relationship between concrete strength and stress wave amplitude. Based on the above mathematical model, the concrete strength can be identified indirectly.
An Event-Driven Service Provisioning Mechanism for IoT (Internet of Things) System Interaction

The heterogeneity, large scale, and resource constraint of IoT environment raise some issues which hinder its development. We focus on two issues among them: 1) most of the existing IoT applications are “silos”, that is, wireless sensor and actuator network resources and applications are tightly coupled, applications cannot share and reuse resources and interact with each other and 2) how to efficiently disseminate the sensing information among the information providers and consumers, and rapidly respond to changes in the physical world. This paper proposes a multilevel and multidimensional model-based service provisioning platform, which can access large-scale heterogeneous resources and expose their capabilities as light-weighted services. Moreover, it presents a unified message space to facilitate the on-demand dissemination and sharing of sensing information in distributed IoT environment. The platform supports applications to share and reuse resources and provides the basic infrastructure for the IoT application pattern: inner-domain autonomy and inter-domain coordination.
Association of Co-Morbidity and Treatment with the Complications of Acute Coronary Syndrome in Young Patients Less Than 45 Years.

Background Approximately 5%-10% of acute coronary syndrome (ACS) cases occur in people younger than 45 years of age. This study aimed to identify complications of ACS and the associated factors in young patients. Methods In this cross-sectional study, data from 147 ACS patients aged less than 45 years were analysed. Results The mean age was 39.1 (4.9) years, the male to female ratio was 3:1; 21.2% of patients presented with unstable angina, 58.5% had non-ST elevation myocardial infarction and 20.4% had ST elevation myocardial infarction. The most frequent risk factor of ACS was dyslipidaemia (65.3%), followed by hypertension (43.5%). In total, 49.7% of patients had inpatient complication(s), with the most common being heart failure (35.4%), followed by arrhythmia (20.4%). The significant factors associated with ACS complications were current smoking [adjusted odds ratio (AOR) 4.03; 95% confidence interval (CI): 1.33, 12.23; P-value = 0.014], diabetic mellitus [AOR 3.03; 95% CI: 1.19, 7.71; P-value = 0.020], treatments of fondaparinux [AOR 0.18; 95% CI: 0.08, 0.39; P-value < 0.001] and oral nitrates [AOR 0.18; 95% CI: 0.08, 0.42; P-value < 0.001]. Conclusions Smoking status and diabetes mellitus were modifiable risk factors while pharmacological treatment was an important protective factor for ACS complications in young patients.
High prepregnant body mass index is associated with early termination of full and any breastfeeding in Danish women.

BACKGROUND An association between high prepregnant body mass index (BMI) and early termination of breastfeeding has been observed, but this finding may have depended on the sociocultural context. OBJECTIVE The objective was to determine whether this association was stronger with increasing maternal obesity, was modified by gestational weight gain, and still existed when there was greater social support for breastfeeding. DESIGN Study participants (37 459 women) were drawn from the Danish National Birth Cohort. The association of prepregnant BMI and gestational weight gain with the termination of full or any breastfeeding by 1, 16, or 20 wk postpartum was assessed with logistic regression analyses, and the risk of early termination of full and any breastfeeding during the first 18 mo postpartum was assessed with Poisson regression analyses. RESULTS The risk of early termination of any (with similar results for full) breastfeeding rose progressively with increasing prepregnant BMI values (in kg/m(2)), from 1.12 (95% CI: 1.09, 1.16) for overweight (BMI = 25.0-29.9) women to 1.39 (95% CI: 1.19, 1.63) for obese class III women (BMI >or= 40) compared with normal-BMI women. Gestational weight gain did not add to or modify the association between prepregnant BMI and breastfeeding. CONCLUSIONS These findings extend the observation to a broader range of BMIs that the greater the prepregnant BMI, the earlier the termination of breastfeeding. Together with the fact that this association was evident in a more supportive social context for breastfeeding, these findings suggest a biological basis for the association.
General Cognitive Impairment as a Risk Factor for Motor Vehicle Collision Involvement: A Prospective Population-Based Study

This study examined whether cognitive impairment and decline as assessed by a brief mental status screening test is associated with future crash risk in a cohort of older drivers. A three-year prospective study was conducted in a population-based sample of 2000 licensed drivers, aged 70 years and older. At the baseline visit, cognitive impairment was defined as <24 on the Mini Mental State Exam (MMSE). Decline was defined as those with a one-year change in MMSE scores in the lowest quartile (largest decrease). Motor vehicle collision involvement was obtained from the Alabama Department of Public Safety. Poisson regression was used to calculate crude and adjusted rate ratios (RR). There were 278 crashes during the follow-up period. Rates of crash involvement were higher for those with cognitive impairment (crude RR = 2.33) compared to those without impairment at baseline; adjustment for potential confounders namely age and visual processing speed attenuated this relationship (adjusted RR = 1.26, 95% confidence interval (CI) 0.65–2.44). Drivers who experienced a pronounced decline in estimated MMSE scores in one year were 1.64 (95% CI 1.04–2.57) times more likely to have a future at-fault crash, as compared to those whose scores did not decline. Evaluation of MMSE over time may provide important insight in an older driver’s future risk of at-fault crash involvement.
Preliminary Evidence That Excitatory Transcranial Direct Current Stimulation Extends Time to Task Failure of a Sustained, Submaximal Muscular Contraction in Older Adults.

BACKGROUND Decreased cortical excitability has been proposed as a potential mechanism underlying task failure during sustained muscular contractions, and cortical excitability may decrease with old age. We tested the hypothesis that transcranial direct current stimulation, which has been reported to raise cortical excitability, would prolong the time to task failure during a sustained muscular contraction in older adults. METHODS Thirteen older adults (68.3±2.0 years; eight women and five men) performed isometric, elbow flexions to failure while receiving sham or anodal transcranial direct current stimulation. Order of stimulation was randomized, and the subjects and investigators were blinded to condition. Time to task failure was measured alongside selected psychological indices of perceived exertion and affect. RESULTS Anodal transcranial direct current stimulation prolonged mean time to task failure by approximately 15% (16.9±2.2 vs 14.7±1.8 minutes) and slowed the rate of increase in rating of perceived exertion (0.29±0.03 vs 0.31±0.03) relative to the sham condition. CONCLUSIONS These preliminary findings suggest that anodal transcranial direct current stimulation enhances time to task failure of a sustained, submaximal contraction in older adults by potentially increasing cortical excitability and/or influencing the perception of exertion. These results raise the question of whether interventions that acutely increase cortical excitability could enhance physical function and/or exercise-induced adaptations in older adults.
Preparation of Sandwich-Like TiO2/Graphene/TiO2 Films and its Application in Photocatalysis

Anatase nano-TiO2 film was prepared by sol-gel method and graphene oxide nanosheets synthesized by Hummers method were deposited on this TiO2 thin film. Another nano-TiO2 film was then deposited on the graphene film forming sandwich-like to avoid graphene layer peeled off. Scanning electron microscope shows that TiO2 particles layer with a diameter of about 20 nm were densely and uniformly deposited on both surfaces of the graphene layer to form a sandwich-like composite structure. The composite films exhibit excellent photocatalytic degradation to methyl orange and remains chemically stable in the whole process without anything exfoliation.