Miracle-dz/UniFAR-FTUs huggingface dataset:
Is children’s listening effort in background noise influenced by the speaker’s voice quality?

Abstract The present study aims at exploring the influence of voice quality on listening effort in children performing a language comprehension test with sentences of increasing difficulty. Listening effort is explored in relation to gender ( = cisgender). The study has a between-groups design. Ninety-three mainstreamed children aged 8;2 to 9;3 with typical language development participated. The children were randomly assigned to two groups (n = 46/47) with equal allocation of boys and girls and for the analysis to four groups depending of gender and voice condition. Working memory capacity and executive functions were tested in quiet. A digital version of a language comprehension test (the TROG-2) was used to measure the effect of voice quality on listening effort, measured as response time in a forced-choice paradigm. The groups listened to sentences through recordings of the same female voice, one group with a typical voice and one with a dysphonic voice, both in competing multi-talker babble noise. Response times were logged after a time buffer between the sentence-ending and indication of response. There was a significant increase in response times with increased task difficulty and response times between the two voice conditions differed significantly. The girls in the dysphonic condition were slower with increasing task difficulty. A dysphonic voice clearly adds to the noise burden and listening effort is greater in girls than in boys when the teacher speaks with dysphonic voice in a noisy background. These findings might mirror gender differences as for coping strategies in challenging contexts and have important implications for education.
Identifying Specific Combinations of Multimorbidity that Contribute to Health Care Resource Utilization: An Analytic Approach

Background: Multimorbidity affects the majority of elderly adults and is associated with higher health costs and utilization, but how specific patterns of morbidity influence resource use is less understood. Objective: The objective was to identify specific combinations of chronic conditions, functional limitations, and geriatric syndromes associated with direct medical costs and inpatient utilization. Design: Retrospective cohort study using the Health and Retirement Study (2008–2010) linked to Medicare claims. Analysis used machine-learning techniques: classification and regression trees and random forest. Subjects: A population-based sample of 5771 Medicare-enrolled adults aged 65 and older in the United States. Measures: Main covariates: self-reported chronic conditions (measured as none, mild, or severe), geriatric syndromes, and functional limitations. Secondary covariates: demographic, social, economic, behavioral, and health status measures. Outcomes: Medicare expenditures in the top quartile and inpatient utilization. Results: Median annual expenditures were $4354, and 41% were hospitalized within 2 years. The tree model shows some notable combinations: 64% of those with self-rated poor health plus activities of daily living and instrumental activities of daily living disabilities had expenditures in the top quartile. Inpatient utilization was highest (70%) in those aged 77–83 with mild to severe heart disease plus mild to severe diabetes. Functional limitations were more important than many chronic diseases in explaining resource use. Conclusions: The multimorbid population is heterogeneous and there is considerable variation in how specific combinations of morbidity influence resource use. Modeling the conjoint effects of chronic conditions, functional limitations, and geriatric syndromes can advance understanding of groups at greatest risk and inform targeted tailored interventions aimed at cost containment.
Aerobic interval training improves VO2peak in coronary artery disease patients; no additional effect from hyperoxia

Objectives. To investigate whether hyperoxic aerobic interval training improves training quality in coronary artery disease patients. Design. Twenty-one stable coronary artery disease patients were recruited to hyperoxic (n=10) and normoxic (n=11) groups (age: 62.4±6.8 years). Patients underwent 30 supervised 4×4 minutes interval training sessions using treadmill walking, at 85–95% of peak heart rate. Results. Arterial saturation was significantly increased by 3% at pretest from normoxic to hyperoxic testing conditions. Peak oxygen uptake and stroke volume increased significantly by 16% and 17% (p<0.05) and by 16% and 18% (p<0.05) in the hyperoxic and normoxic training groups respectively. No difference was revealed between groups for peak oxygen uptake and stroke volume. Blood volumes were unchanged from pre to post training. Peak oxygen uptake measured in normoxia and hyperoxia in the hyperoxia training group revealed no difference. Conclusion. The present study shows that breathing 100% oxygen enriched air during aerobic interval training in stable coronary artery disease patients does not improve peak oxygen uptake above the level attained with normoxic training.
Differences in Hospital Risk-standardized Mortality Rates for Acute Myocardial Infarction When Assessed Using Transferred and Nontransferred Patients

Background: One in 5 patients with acute myocardial infarction (AMI) are transferred between hospitals. However, current hospital performance measures based on AMI mortality exclude these patients from the evaluation of referral hospitals. Objective: To determine the relationship between risk-standardized mortality for transferred and nontransferred patients at referral hospitals. Research Design: This is a retrospective cohort study. Subjects: Fee-for-service Medicare claims from 2011 for patients hospitalized with a primary diagnosis of AMI, at hospitals admitting at least 15 patients in transfer. Measures: Hospital-specific risk-standardized 30-day mortality rates (RSMRs) for 2 groups of patients: those admitted through transfer from another hospital, and those natively admitted without a preceding or subsequent interhospital transfer. Results: There were 304 hospitals admitting at least 15 patients in transfer. These hospitals cared for 77,711 natively admitted patients (median, 254; interquartile range, 162–321), and 11,829 patients admitted in transfer (median, 26; interquartile range, 19–46). Risk-standardized mortality rates were higher for natively admitted patients than for those admitted in transfer (mean, 11.5%±1.2% vs. 7.2%±1.1%). There was weak correlation between hospital performance as assessed by RSMR for patients natively admitted versus those admitted in transfer (Pearson r=0.24, P<0.001); when performance was arrayed by quartile, 102 hospitals (33.6%) differed at least 2 quartiles of performance across the 2 patient groups. Conclusions: For Medicare patients with AMI, hospital-specific RSMRs for natively admitted patients are only weakly associated with RSMRs for patients transferred in from another hospital. Current AMI performance metrics may fail to provide guidance about hospital quality for transferred patients.
Coronary angiography of patients with a previous coronary artery by-pass operation is associated with a three times increased risk for neurological complications. A report from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)

Objectives. This study aimed to determine the incidence of complications of diagnostic coronary angiography that was not followed by percutaneous coronary interventions and to compare differences in complication rates between patients with or without previous coronary artery by-pass surgery. Design. We evaluated major complications due to diagnostic coronary angiography by merging the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), the Swedish Hospital Discharge Registry and the National Population Registry. Results. A total of 1 115 complications were recorded (2.2%). There was a higher incidence of any complications in patients with a previous coronary by-pass surgery in uni-variable analysis (2.7% vs. 2.1%, p=0.003) but not in multi-variable analysis after adjustment for differences in background and procedural factors. Neurological complications were not common (0.20%) but after adjustment for differences in background and procedural factors, the risk of neurological complications was nearly three times higher in patients with a previous CABG compared to patients without previous CABG, odds ratio 2.89 (95% CI 1.68–4.97). Conclusion. Neurological complications are significantly more common in patients with previous by-pass surgery. Considering the risk for neurological complications the risk-benefit ratio may be higher when compared with patients without previous by-pass surgery.
Angiogenic and inflammatory biomarkers in the differentiation of pulmonary hypertension

Abstract Objectives. Pulmonary hypertension (PH) is a serious condition where diagnosis often is delayed due to unspecific symptoms. New methods to diagnose and differentiate PH earlier would therefore be of great value. The aim of this study was therefore to evaluate the relationship between circulating angiogenic and inflammatory biomarkers and various hemodynamic variables in relation to different causes of PH. Design. Plasma samples from 63 patients at diagnosis were extracted from Lund Cardio Pulmonary Register, separated into pulmonary arterial hypertension (PAH, n = 22), chronic thromboembolic pulmonary hypertension (CTEPH, n = 15) and left heart disease (LHD) with (n = 21) and without (n = 5) PH. Blood samples from eight control subjects devoid of PH were additionally evaluated. Plasma concentrations of angiogenic (PlGF, Tie2, VEGF-A, VEGF-D, bFGF, sFlt-1) and inflammatory (IL-6, IL-8, TNF-α) biomarkers were analysed and related to hemodynamic variables. Results. SFlt-1 (p < .004) and VEGF-A (p < .035) were higher in all PH groups compared to controls. TNF-α (p < .030) were elevated in PAH patients in relation to the other PH groups as well as controls. Likewise, plasma VEGF-D (p < .008) were elevated in LHD with PH compared to the other groups with PH and controls. In PAH, higher sFlt-1 concentrations correlated to a worse state of hemodynamics. Conclusions. Our findings indicate that sFlt-1 and VEGF-A may be future tools when discriminating PH from non-PH. Moreover, TNF-α may differentiate PAH and VEGF- D may differentiate LHD with PH, from the other groups with PH, as well as controls. SFlt-1 may furthermore play a role as a future marker of disease severity.
In-hospital outcomes after rotational atherectomy in patients with low ejection fraction

Abstract Objectives. This study evaluated angiographic success and in-hospital outcomes of percutaneous coronary intervention (PCI) with rotational atherectomy (RA) in patients with low left ventricular ejection fraction (LVEF). Design. Between January 2010 and March 2014, 272 consecutive patients with heavily calcified lesions underwent elective PCI with RA. Of these, 33 patients had LVEF ≤35% (low LVEF group), whereas 237 patients had LVEF >35% (preserved LVEF group). The primary endpoint was angiographic success and in-hospital major adverse cardiac events (MACE). MACE included death from any cause, postprocedure onset MI, emergency coronary artery bypass grafting, and target vessel revascularization. The secondary endpoints were MACE and the components within 30days after PCI. The components of MACE were evaluated. Results. Angiographic success, defined as <30% residual stenosis with thrombolysis in myocardial infarction flow 3 at final angiography, was achieved in all patients without fatal complications. Intra-aortic ballon pumping (IABP) was used significantly more frequently in the low LVEF group compared with the preserved LVEF group (15.2% vs. 2.1%, p = .003). There were no significant differences between groups regarding in-hospital and clinical outcomes within 30 days following PCI. Conclusion. If medications and mechanical support were appropriately performed, the angiographic success rate and in-hospital MACE rate of PCI with RA in patients with low LVEF could be expected to have good outcomes similar to those for patients with preserved LVEF.
The Association of Patient-centered Medical Home Designation With Quality of Care of HRSA-funded Health Centers: A Longitudinal Analysis of 2012–2015

Objectives: (1) To evaluate the relationship between Patient-centered Medical Home (PCMH) recognition and quality of clinical care among health centers, and (2) to determine whether the duration of recognition is positively associated with cumulative quality improvement over time. Methods: Data came from the 2012 to 2015 Uniform Data System, health centers’ PCMH recognition status, and the Area Resource File. Health center was the unit of observation. The outcome variables included 11 measures of clinical quality. We pooled all years of data and modeled longitudinal data with generalized estimating equations to examine the degree of improvement in health care quality in health centers with and without PCMH recognition over the years 2012–2015. Results: Health centers with PCMH recognition generally performed better on clinical quality measures than health centers that did not have PCMH recognition for all years studied. After accounting for health center and county-level potential confounders, health centers with longer periods of PCMH recognition were more likely to have improved their clinical quality on 9 of 11 measures, than health centers with fewer years of PCMH recognition. Conclusions: Health centers’ length of time with PCMH recognition was positively associated with additive quality improvement. Adoption of the PCMH model of care may serve as a strategy to enhance quality of primary care services.
Particle‐specific sorption/desorption properties determine test compound fate and bioavailability in toxicity tests with Chironomus riparius—high‐resolution studies with lindane

We studied the sorption (batch equilibrium experiments) and desorption (consecutively harsher supercritical fluid extractions) of lindane to different types of sediment and food particles, as well as larval uptake in standardized peat‐based artificial sediment toxicity tests with the midge Chironomus riparius. Lindane sorption to organic particles was fast and efficient, reaching 98 ± 0.1 and 97 ± 0.1% of added compound in 48 h for peat and Tetraphyll®, respectively, and 77 ± 0.2% in whole sediment. Sorption to inorganic particles, that is, sand and kaolin clay, was much lower, 9.6 ± 1.3% and 8.3 ± 0.8%, respectively. Supercritical fluid extractions showed that most of the lindane sorbed to organic particles and sediment was loosely bound, as only 9 to 14% remained associated with particles after weak and intermediate extractions strengths. Larval uptake of dissolved lindane was 4.9 ± 0.71 and 10.8 ± 1.2 µg/g wet weight in 22 and 68 µg/L treatments, respectively, and four to five times higher than that of particle‐associated lindane, ranging 1.0 ± 0.15 to 2.7 ± 0.21 µg/g in the above treatments. Surprisingly, larval uptake of lindane was similar from refractory peat and the more labile Tetraphyll particles. Despite an efficient larval uptake of dissolved lindane, sorption/desorption of lindane to/from Tetraphyll particles will facilitate digestive uptake in toxicity tests, particularly in spiked‐water scenarios where food particles may act as vectors. Our results show that the exposure scenario is an important determinant for the behavior and bioavailability of test compounds in standardized toxicity tests. Environ. Toxicol. Chem. 2010;29:1520–1528. © 2010 SETAC
Racial Disparities in Mortality Among Adults Hospitalized After Injury

Background:Injury is a major cause of death in adults. Although racial disparities in healthcare access and health outcomes are well documented for medical conditions, the influence of race on access to emergent care after injury has received little scrutiny. Objectives:We sought to determine whether race was associated with risk of in-hospital death after injury. Research Design:Data from the Healthcare Cost and Utilization Project (1998–2002) were used to estimate multivariate models of in-hospital mortality, controlling for age, race, gender, comorbid conditions, injury severity, primary payer, median income of zip code of residence, and hospital type. Additional multivariate models were estimated among stratified subsets of patients, including injury severity and hospital type. Subjects:Patients age 18–64 with a primary diagnosis of injury. Results:Relative to injured white patients, black and Asian patients had a higher risk of death [1.5% vs. 2.1% and 2.0%, multivariate odds ratios (OR) = 1.14 and 1.39]. Other racial/ethnic groups showed no significant mortality difference from white patients. In stratified analyses, we found large black-white mortality disparities among mild to moderately injured patients (OR = 1.40, 95% confidence interval: 1.18–1.66), whereas Asian-white disparities were concentrated among more severely injured patients (OR = 1.37, 95% confidence interval: 1.03–1.80). Conclusions:Black and Asian patients have a higher risk of death after injury than white patients. These data raise important questions about access to quality trauma care for racial minority patients.
PETROTOX: An aquatic toxicity model for petroleum substances

A spreadsheet model (PETROTOX) is described that predicts the aquatic toxicity of complex petroleum substances from petroleum substance composition. Substance composition is characterized by specifying mass fractions in constituent hydrocarbon blocks (HBs) based on available analytical information. The HBs are defined by their mass fractions within a defined carbon number range or boiling point interval. Physicochemical properties of the HBs are approximated by assigning representative hydrocarbons from a database of individual hydrocarbons with associated physicochemical properties. A three‐phase fate model is used to simulate the distribution of each structure among the water‐, air‐, and oil‐phase liquid in the laboratory test system. Toxicity is then computed based on the predicted aqueous concentrations and aquatic toxicity of each structure and the target lipid model. The toxicity of the complex substance is computed assuming additivity of the contribution of the individual assigned hydrocarbons. Model performance was evaluated by using direct comparisons with measured toxicity data for petroleum substances with sufficient analytical characterization to run the model. Indirect evaluations were made by comparing predicted toxicity distributions using analytical data on petroleum substances from different product categories with independent, empirical distributions of toxicity data available for the same categories. Predictions compared favorably with measured aquatic toxicity data across different petroleum substance categories. These findings demonstrate the utility of PETROTOX for assessing environmental hazards of petroleum substances given knowledge of substance composition. Environ. Toxicol. Chem. 2012; 31: 2498–2506. © 2012 SETAC
A disintegrin and metalloproteinase (ADAM)-10 as a predictive factor for tocilizumab effectiveness in rheumatoid arthritis

Abstract Objectives: A disintegrin and metalloproteinase (ADAM)-10 is expressed in rheumatoid arthritis (RA). In this study, we focused on ADAM-10 as a predictive factor for the treatment with biologics in RA. Methods: The levels of ADAM-10 and fractalkine/CX3CL1 in RA and healthy controls serum were measured using enzyme-linked immunosorbent assays. Fifteen patients were treated with adalimumab (ADA), and 20 patients were treated with tocilizumab (TCZ). Results: ADAM-10 positively correlated with fractalkine/CX3CL1 in the sera of RA patients and was presented at a significantly higher level compared to that in normal serum (487 ± 80 pg/ml and 85 ± 33 pg/ml, respectively, p < 0.05). ADAM-10 highly correlates with fractalkine/CX3CL1 in the sera of RA patients. The level of ADAM-10 decreased after the treatment with TCZ but not with ADA. In addition, we found that the level of ADAM-10 in TCZ responders was significantly higher than that of the TCZ nonresponders at 24 weeks (619 ± 134 pg/ml and 109 ± 25 pg/ml, respectively). Multiple regression analysis showed that ADAM-10 was only identified as independent predictive variable for the improvement of DAS28 (ESR) at 24 weeks. Conclusions: ADAM-10 may be a predictor of the effectiveness of TCZ in treating RA.
Yoga: An Ancient Occupational Therapy?

Yoga is a complete system of occupational regulation, based on complex theories that address occupational risk factors while relating occupation directly to health and wellbeing. Although aspects of yoga have been used in Western occupational therapy settings, some of its underlying theories may have been overlooked. If validated by research, these theories may enrich occupational therapy philosophy. Yogic techniques of potential clinical use include pulse diagnosis, meditation and breath control. These are not described in detail in this opinion piece, but should be the subject of thorough literature reviews and, perhaps, further research.
Avoidance of contaminated sediments by an amphipod (Melita plumulosa), A harpacticoid copepod (Nitocra spinipes), and a snail (Phallomedusa solida)

The distribution of contaminants is seldom homogeneous in aquatic systems. In the present study, the avoidance response of Melita plumulosa, Nitocra spinipes, and Phallomedusa solida when exposed to contaminated sediments was investigated. Test vessels were designed to allow the congruent placement of two sediments and assessment of the movement of organisms between the sediments. When exposed to reference sediment, each species dispersed evenly between test chambers regardless of differences in sediment particle size. In the presence of contaminated sediment, the magnitude and rate of avoidance varied. Avoidance assays showed that test species avoided contaminated sediment as early as 6, 6, and 24 h following exposure for N. spinipes, P. solida, and M. plumulosa, respectively. The 48‐h avoidance response of M. plumulosa for nine contaminated sediments of varying toxicity showed that avoidance was generally greater for sediments which elicited greater 10‐d lethality to this species. The study demonstrated that each of these species has the ability to respond to chemical cues in the environment to inhabit sediment that provides the best opportunity for survival. The avoidance response for each species indicates the potential for developing rapid screening methods to assess sediment quality. Evidence suggests that avoidance was related to sediment toxicity and that static 10‐d toxicity methods are likely to overestimate toxicity for species, which would avoid contamination in heterogeneous field settings. Environ. Toxicol. Chem. 2013;32:644–652. © 2012 SETAC
The study of maternal and fetal plasma catecholamines levels during pregnancy and delivery

Abstract Background: To study maternal and fetal plasma levels of catecholamines (CA) during pregnancy and delivery, especially changes in CA levels during fetal distress and conditions of different modes of delivery. Methods: Maternal and fetal plasma NE, E and DA levels were determined by high performance liquid chromatography (HPLC) for 16 non-pregnant women, 19 cases of early pregnancy, 17 cases of mid pregnancy, late pregnancy, spontaneous vaginal delivery and 53 cases of cesarean section. Results: Plasma NE and DA levels decreased gradually with the advance of gestational weeks, and levels of plasma NE were significantly lower than those of non-pregnant women (P < 0.05). The levels of plasma CA in patients who had elective cesarean section were significantly lower than those who had vaginal delivery and emergency cesarean section (P < 0.01). However, CA levels of the cord artery in the vaginal delivery group were significantly higher than those in the cesarean section group (P < 0.01). Conclusion: Vaginal delivery is better than cesarean section for the newborn. If cesarean section is necessary, it is best for the newborn after onset of labor.