Miracle-dz/UniFAR-FTUs huggingface dataset:
Association of body position with severity of apneic events in patients with severe nonpositional obstructive sleep apnea.

STUDY OBJECTIVE To compare the severity of sleep apneic events occurring in the supine posture vs the severity of sleep apneic events occurring in the lateral posture in patients with severe obstructive sleep apnea (OSA). DESIGN A retrospective analysis of apneic event variables in a group of 30 OSA patients who underwent a complete polysomnographic evaluation in our sleep disorders unit. PATIENTS Thirty patients with severe OSA (respiratory disturbance index [RDI] = 70.1+/-18.2) who were nonpositional patients (NPP), ie, in whom the ratio of the supine RDI to the lateral RDI is < 2 (supine RDI = 85.7+/-11.7, lateral RDI = 64.8+/-17.3), and who had > or =30 apneic events in the lateral position and 30 apneic events in the supine position during sleep stage 2 were included in the study. MEASUREMENTS For the 30 apneic events in each body position, the following variables were evaluated: apnea duration (ApDur), minimum desaturation (MinDes), Delta desaturation (Delta-Des), duration of arousal (DurArous), maximum snoring loudness (MaxSL), and Delta heart rate (Delta-HR). In addition, three other variables assessed as a ratio of ApDur (Rate-D = Delta-Des/ApDur, R-HR =Delta-HR/ApDur, and R-Arous = DurArous/ApDur) were also calculated. RESULTS For all variables evaluated, apneic events occurring in the supine posture were significantly more severe than those apneic events occurring in the lateral posture during sleep stage 2. ApDur of both body postures correlated significantly with DurArous, Delta-HR, and MaxSL, but not with Delta-Des and MinDes. ApDur correlated linearly with DurArous for both postures. The slopes of the two regression lines were similar (p = 0.578) but the regression line intercept for the supine apneas was significantly higher than that of lateral apneas (p<0.0001). In addition, the average number of supine apneic events that did not end with an arousal was smaller than the average number of lateral apneic events not ending with an arousal (4.4+/-6.0 vs. 10.5+/-6.7, respectively; p< 0.0001). Also, only 4 of 900 (0.44%) apneic events analyzed in the lateral posture ended with an awakening (> 15 s), whereas in the supine posture, there were 37 (4.1%) such events (p<0.001). CONCLUSIONS These results show that even in patients with severe OSA who have a high number of apneic events in the supine and lateral posture, the apneic events occurring in the supine position are more severe than those occurring while sleeping in the lateral position. Thus, it is not only the number of apneic events that worsen in the supine sleep position but, probably no less important, the nature of the apneic events themselves.
IS AUDITOR INDEPENDENCE ENDOGENOUS? EVIDENCE AND IMPLICATIONS FOR PUBLIC POLICY

This paper examines the extent to which firm-specific levels of auditor-independence are codetermined with alternative inputs to governance production. We identify a number of governance-producing mechanisms that are causally or simultaneously related to auditor independence. These results are shown to be robust to omitted variable bias. Consequently, prescriptive regulation of auditor independence will be at least partly offset by firm adjustments on alternative governance-producing margins. ; Original title: Optimization in production of corporate governance - evidence from auditor independence and implications for public policy
Redes optimas con costos acumulativos y comunicación bidireccional

Este trabajo es una extensión al enfoque de Larrosa y Tohmé (2003) en el cual se modifica la función de pagos al permitir que la información fluya en ambos sentidos. Los costos siguen siendo pagados por quién inicia la conexión por lo que esta asimetría revela cambios en la topología final de equilibrio. Encontramos que diversas topologías óptimas persisten como redes de Nash pero que una red estricta de Nash se corresponde con la red de línea secuencial con nodos activos intermedios, es decir, los agentes se colocan en una línea y, agente de por medio, se van conectando con el agente predecesor y con el agente posterior. De ese modo se interrumpe la acumulación de costos y los beneficios son maximizados.
Sex Differences in the Response of Rat Heart Ventricle to Calcium

Calcium (Ca 2+ ) is a key mediator of myocardial function. Calcium regulates contraction, and disruption of myocellular Ca 2+ handling plays a role in cardiac pathologies such as arrhythmias and heart failure. This investigation examines sex differences in sensitivity of the contractile proteins to Ca 2+ and myofibrillar Ca 2+ delivery in the ventricular myocardium. Sensitivity of contractile proteins to Ca 2+ was measured in weight-matched male and female Sprague-Dawley rats using the skinned ventricular papillary muscle fiber and Ca 2+ -stimulated Mg 2+ -dependent adenosine triphosphatase (ATPase) activity methodologies. Calcium delivery was examined by measuring the contractile response to a range of extracellular Ca 2+ concentrations in isolated ventricular myocytes, papillary muscle, and the isolated perfused whole heart. Findings from studies in the whole heart suggest that at a fixed preload, the male left ventricle generates more pressure than a female ventricle over a range of extracellular Ca 2+ concentrations. In contrast, results from myocyte and papillary muscle studies suggest that females require less extracellular Ca 2+ to elicit a similar contractile response. Results obtained from the 2 methods used to determine sex differences in Ca 2+ sensitivity were equivocal. Further studies are required to elucidate sex differences in myocardial Ca 2+ handling and the reasons for disparate results in different heart muscle preparations. The results of these studies will lead to the design of sex-optimized therapeutic interventions for cardiac disease.
Direct Graduate Medical Education Payments to Teaching Hospitals by Medicare: Unexplained Variation and Public Policy Contradictions

Purpose To comprehensively examine both inter- and intrastate variations in Medicare's cost-rate structure for teaching hospitals and to assess the Medicare payment system for graduate medical education (GME), as presently configured, as an instrument to promote physician workforce reform, specifically sufficient public access to primary care physician services. Method Using Public Use Files of hospital cost reports from the Health Care Financing Administration for fiscal year 1997, 648 hospitals that met inclusion criteria for moderate GME volume were identified. The average and range of direct costs of resident training were computed for these teaching hospitals to illustrate differences within and between the 45 states that had at least two teaching hospitals that qualified for comparison. The cost rate upon which direct medical education (DME) payments are based was then correlated with the percentage of a state's counties that were wholly designated primary care health personnel shortage areas (PCHPSAs) in 1997 and with its primary care physician-to-population ratio, as determined from the Area Resource File. Results Variations in inter- and intrastate DME costs exist. In some states, the range in DME rates substantially exceeded the mean cost. DME funding policies are more generous toward teaching hospitals in states with greater primary care physician-to-population ratios and smaller proportions of counties wholly designated PCHPSAs. Conclusion Inherent inequities in DME funding seriously undermine the current Medicare GME payment system's capacity to contribute to U.S. physician workforce reform and to improve access to care. There is actually a financial incentive to train residents in areas in which there is relatively less need for their services.
A novel approach for enhancing the catalytic efficiency of a protease at low temperature: Reduction in substrate inhibition by chemical modification

The alkaline protease, savinase was chemically modified to enhance the productivity of the enzyme at low temperatures on a complex polymeric protein (azocasein) substrate. At 5 and 15°C, savinase modified with ficol or dextran hydrolyzed fivefold more azocasein than the unmodified savinase. Kinetic studies showed that the catalytic improvements are associated with changes in uncompetitive substrate inhibition with Ki values of modified savinases sixfold higher than the unmodified savinase. Modeling of small‐angle scattering data indicates that two substrate molecules bind on opposing sides of the enzyme. The combined kinetic and structural data indicate that the polysaccharide modifier sterically blocks the allosteric site and reduces substrate inhibition. In contrast to the properties of cold‐active enzymes that generally manifest as low activation enthalpy and high flexibility, this study shows that increased activity and productivity at low temperature can be achieved by reducing uncompetitive substrate inhibition, and that this can be achieved using chemical modification with an enzyme in a commercial enzyme‐formulation. Biotechnol. Bioeng. 2009;103: 676–686. © 2009 Wiley Periodicals, Inc.
Distribution of neurons expressing neurokinin B in the rat brain: Immunohistochemistry and in situ hybridization

Neurokinin B (NKB) belongs to the family of neuropeptides named tachykinins. Members of this family such as substance P or neurokinin A have been proposed to function as neurotransmitters or neuromodulators. Searching for possible sites of action of NKB in the central nervous system, we have now investigated its distribution within the rat brain by immunohistochemical techniques and in situ hybridization. For immunohistology two different antisera directed against amino acid sequences within preprotachykinin B were used. One antiserum had been raised against a synthetic derivative of NKB; the other one was directed towards the amino acids 50–79 of preprotachykinin B, which are referred to as peptide 2.
The Role of Late-Onset Autoimmune Diabetes in White Familial NIDDM Pedigrees

OBJECTIVE To determine whether autoimmunity is a prominent feature of NIDDM among diabetic members in families with a strong history of NIDDM or in families with a mixture of NIDDM and IDDM. RESEARCH DESIGN AND METHODS We determined GAD and islet cell (ICA512) autoantibodies from 215 NIDDM individuals and from 14 individuals with impaired glucose tolerance (IGT) of 68 families, including 1 family with maturity-onset diabetes of the young (MODY) and 3 families ascertained specifically for a mixture of NIDDM and IDDM. We tested 2 control populations: 50 unrelated spouses form Utah families, including 29 spouses with either IGT or NIDDM and 198 random nondiabetic white individuals from Colorado. RESULTS We detected either GAD or ICA512 autoantibodies in 11 members of seven families and in one spouse used as a control subject. In two families, two affected individuals showed evidence of autoimmunity, but NIDDM individuals in each of the seven families showed no evidence of autoimmunity. Among the five families with both IDDM and NIDDM individuals (three families ascertained for a mixture and two families ascertained with an incidental IDDM child), antibodies were detected in members of only one family. Antibody-positive individuals were significantly younger at diabetes onset and had low waist-to-hip ratios, but were not more likely to be insulin treated. CONCLUSIONS Autoimmunity is an important cause of apparent NIDDM, even among families with a strong history of NIDDM. However, autoimmunity among affected family members appeared to be a chance event and not the manifestation of a different genetic cause of diabetes.
The effect of tibiofemoral loading on proximal tibiofibular joint motion *

The human proximal tibiofibular joint (PTFJ) and its relationship to overall knee joint mechanics have been largely unexplored. This study describes force/displacement data from experiments done on four human cadaveric knee specimens and general conclusions obtained with the help of a statistical modeling technique. Specimens were rigidly affixed at the tibia to a force plate and the femur was attached to a custom made device allowing for manual load application. Motion of the fibular head was tracked relative to the tibial plateau by means of reflective markers and a high speed digital camera synchronized with the force plate data stream. Each specimen was subjected to a range of loading conditions and a quadratic regression model was created and then used to predict the specimen's response to standardized loading conditions and compare these across specimens. Statistical analysis was performed with a three‐factor analysis of variance with repeated measures.
Serum Leptin, Resistin, and Lipid Levels in Patients with End Stage Renal Failure with Regard to Dialysis Modality

Little information is available on the relationship between serum resistin levels and other adipokines with serum lipid levels and insulin resistance in uremic patients under different dialysis modalities. Methods. This study investigated the effects of dialysis modality on serum leptin, adiponectin, resistin, interleukin 6 (IL-6), and tumor necrosis factor (TNF) α levels in age, sex, and total adipose tissue mass (TATM); matched 30 hemodialysis (HD) patients, 30 continuous peritoneal dialysis (CAPD) patients, and 30 healthy controls; and evaluated the relationship between these adipokines and dyslipidemia and insulin resistance. Results. Serum resistin, adiponectin, IL-6, TNF-α, and high sensitive C reactive protein (hsCRP) levels were significantly increased in dialysis patients compared to controls (p < 0.05). In CAPD patients, serum leptin, resistin, triglycerides, and total cholesterol levels were higher than those in HD patients (p < 0.05). Leptin levels were positively correlated with TATM, serum triglycerides, total cholesterol, and low density lipoprotein (LDLc) levels in both dialysis groups. Resistin levels were found to positively correlate with TATM and triglycerides in CAPD patients. No relationship was found between the homeostasis model assessment-insulin resistance index (HOMA-IR) and adipokines studied. Conclusion. Serum leptin, resistin, triglycerides, and total cholesterol levels were higher in CAPD patients. Leptin levels were positively correlated with TATM, serum triglycerides, total cholesterol, and LDLc levels in dialysis patients. Resistin levels were positively correlated with TATM and triglycerides in CAPD patients. Glucose load during CAPD may be an important factor in increased in leptin, resistin, triglycerides, and total cholesterol levels in CAPD patients. These results highlight the importance of leptin and resistin as determinants of dyslipidemia, especially in CAPD patients.
Additional genetic high-risk features such as 11q deletion, 17p deletion, and V3-21 usage characterize discordance of ZAP-70 and VH mutation status in chronic lymphocytic leukemia.

PURPOSE Immunoglobulin heavy chain variable-region (VH) gene mutation status and zeta-associated protein 70 (ZAP-70) expression are correlated in chronic lymphocytic leukemia (CLL), but their concordance is variable. The goal of this study was to elucidate additional factors potentially characterizing their discordance. PATIENTS AND METHODS We evaluated ZAP-70 expression by flow cytometry, VH status by DNA sequencing, and genomic aberrations by fluorescence in situ hybridization in 148 CLL patients. The parameters were analyzed for their associations and their individual prognostic impact. RESULTS ZAP-70 expression and VH mutation status were strongly associated in CLL without additional genetic high-risk-features as defined by the absence of 11q or 17p deletion and V3-21 usage (concordance 84%). In contrast, the proportion of discordant cases was significantly higher (39%), if such additional genetic high-risk features were present. Discordant cases with V3-21 usage were almost exclusively ZAP-70 positive and VH mutated (89%), whereas all but one of the discordant cases with high-risk aberrations were ZAP-70 negative and VH unmutated (92%). By multivariate regression analysis, two models were developed, which both include high-risk genomic aberrations and, alternatively, VH mutation status and V3-21 usage or ZAP-70 expression as independent outcome predictors. CONCLUSION There were characteristic modes of discordance between ZAP-70 and VH mutation status depending on the presence or absence of additional genetic high-risk features such as 11q and 17p deletion or V3-21 usage. Although the biologic background for these findings is yet to be determined, these data have biologic and clinical implications regarding ZAP-70 as a pathogenic factor and outcome predictor, respectively.
Moderation by Extremes: Biases in Reward Perceptions Drive Compromise Effects in Financial Bundles

Considerable research demonstrates a “compromise effect” showing preference for “middle” options. Yet, in the context of bundles, the “middle” option in a choice set can be composed in multiple ways. First, a bundle may include only purely moderate options (e.g., individual stocks moderate in both risk and reward). Alternately, a bundle may include equal numbers of both extreme alternatives (e.g., half high-risk/high-reward and half low-risk/low reward stocks), such that moderate attribute levels exist in the aggregate, but not for any single item. Using stock and lottery portfolios, we find that compromise effects are stronger when consumers are offered middle options that bundle extremes together. This occurs because the bundle-of-extremes is erroneously viewed as more potentially rewarding, but not more risky than a bundle-of-pure-moderation. Importantly, exposing people to simulated information about potential outcomes, such that consumers can better recognize potential downsides of the bundle-of-extremes option, mitigates this preference.
Screening of calpain-3 autolytic activity in LGMD muscle: a functional map of CAPN3 gene mutations

Background: The diagnosis of calpainopathy is obtained by identifying calpain-3 protein deficiency or CAPN3 gene mutations. However, in many patients with limb girdle muscular dystrophy type 2A (LGMD2A), the calpain-3 protein quantity is normal because loss-of-function mutations cause its enzymatic inactivation. The identification of such patients is difficult unless a functional test suggests pursuing a search for mutations. Materials and methods: A functional in vitro assay, which was able to test calpain-3 autolytic function, was used to screen a large series of muscle biopsy specimens from patients with unclassified LGMD/hyperCKaemia who have previously shown normal calpain-3 protein quantity. Results: Of 148 muscle biopsy specimens tested,17 samples (11%) had lost normal autolytic function. CAPN3 gene mutations were identified in 15 of 17 patients (88%), who account for about 20% of the total patients with LGMD2A diagnosed in our series. Conclusions: The loss of calpain-3 autolytic activity is highly predictive of primary calpainopathy, and the use of this test as part of calpainopathy diagnosis would improve the rate of disease detection markedly. This study provides the first evidence of the pathogenetic effect of specific CAPN3 gene mutations on the corresponding protein function in LGMD2A muscle and offers new insights into the structural–functional relationship of the gene and protein regions that are crucial for the autolytic activity of calpain-3.
A Neural Network-Based Intelligent Image Target Identification Method And Its Performance Analysis

Abstract The image sensor-based target identification is one of the important for vehicle identification and intelligent transportation applications. Based on neural network classification algorithms, one vehicle identification method is proposed. The main work includes: (1) designing the parameter extraction of vehicle shape based on Sobel operator and mathematical morphology; (2) introducing a vehicle feature extraction method based on “i”-shape model; (3) designing a momentum back-propagation algorithm with the smallest error and a variable learning rate of an exponential fimction, verify the algorithm by simulation experiments. The proposed algorithm combines the advantages of the algorithm with additional momentum and variable learning rate while the convergence speed is accelerated and jumps out of local minimum points. The results of simulation experiments show that the proposed algorithm can quickly and effectively identify the various types of vehicle models.
Doppler compensation for mobile OFDM systems with multiple receive antennas

In OFDM systems, mobility induced Doppler spreading distorts the orthogonality among the subcarriers, and results in intercarrier interference (ICI) which degrades the reception quality. In this paper, we investigate how ICI can be mitigated by using multiple receive antennas. In this context, by using Taylor series approximation of the time-varying channels, we derive minimum mean-squared error (MMSE) linear combining scheme for Doppler compensation. Motivated by lower complexity, we develop new combining schemes, i.e., Simple Doppler Compensating Combiner (SDCC) and approximated Zero Forcing (aZF) combiner, based on approximation of MMSE combining. We show that by new combining schemes, the Doppler tolerance of mobile OFDM systems can be increased significantly with respect to conventional maximum ratio combining (MRC) with a moderate increase in computational complexity. Furthermore, we show that the proposed linear combining schemes can be combined with existing single-antenna ICI mitigation methods, forming a Hybrid Doppler compensation method that obtains higher mobility tolerance.
Occurrence of transcranial Doppler high-intensity transient signals in patients with potential cardiac sources of embolism. A prospective study.

BACKGROUND AND PURPOSE Cerebral emboli can be recognized by typical "high-intensity transient signals" (HITS) in the transcranial Doppler (TCD) spectral curves. Patients with potential cardiac sources of embolism are at higher risk for stroke. METHODS We examined the frequency of HITS in the left middle cerebral artery (MCA) with TCD over periods of 30 minutes in 100 patients having potential cardiac sources of embolism, as indicated by transthoracic or transesophageal echocardiography. RESULTS Thirty-six (36%) of the patients presented with HITS. Sex, age, sufficient anticoagulation level, antiplatelet therapy, neurological symptoms, and a history of thrombosis had no influence on the prevalence and number of HITS. The patients with a single echocardiographic diagnosis were separated into eight echocardiographically defined groups: patients with (1) atrial fibrillation, (2) coronary artery disease plus ejection fraction of more than 30% including at least three wall segments of hypokinesia/akinesia, (3) coronary artery disease with less than 30% ejection fraction, (4) dilated cardiomyopathy, (5) infectious endocarditis, (6) aortic stenosis, (7) mitral stenosis, and (8) patent foramen ovale. A significant difference in HITS occurrence could not be found in any of the defined groups. Only patients with infectious endocarditis showed a tendency for a higher HITS prevalence. CONCLUSIONS HITS are common phenomena in patients with potential cardiac sources of embolism. The clinical relevance of these HITS remains unclear.