Aims/Introduction
Clinical studies show that either heart rate variability (HRV) or electrochemical skin conductance (ESC) alone can serve as a simple and objective method for screening ...cardiovascular autonomic neuropathy (CAN). We tested the hypothesis that combining these two quantitative approaches can not only reinforce accuracy in CAN screening but also provide a better estimate of CAN severity in patients with type 2 diabetes (T2DM) who had already had CAN in outpatient clinics.
Materials and Methods
Each patient received a complete battery of cardiovascular autonomic reflex tests (CARTs), with ESC measured by SUDOSCAN, time domain of HRV measured by standard deviation of all normal RR intervals (SDNN) and frequency domain of HRV (low frequency LF, high frequency HF, and LF/HF ratio), and peripheral blood studies for vascular risk factors. Severity of CAN was measured by CAN score.
Results
The 90 T2DM patients included 50 males and 40 females. Those with more severe CAN had lower values in feet ESC (P = 0.023) and SDNN (P < 0.0001). Multiple linear regression analysis also showed that feet ESC and SDNN value (P = 0.003 and P < 0.0001) were significantly associated with CAN score. Combining SDNN and feet ESC also can increase the diagnostic accuracy of CAN with respective to sensitivity and specificity by using receiver operating characteristic analysis.
Conclusions
Combining the results of SDNN and feet ESC can not only assess, but also quantitatively reflect the progress or improvement of autonomic nerve function (including sympathetic and parasympathetic activity) in patients with T2DM.
Testosterone deficiency is associated with poor prognosis among patients with chronic heart failure (HF). Physiological testosterone improves the exercise capacity of patients with HF. In this study, ...we evaluated whether treatment with physiological testosterone contributes to anti-fibrogenesis by modifying calcium homeostasis in cardiac fibroblasts and we studied the underlying mechanisms. Nitric oxide (NO) analyses, calcium (Ca2+) fluorescence, and Western blotting were performed in primary isolated rat cardiac fibroblasts with or without (control cells) testosterone (10, 100, 1,000 nmol/L) treatment for 48 hours. Physiological testosterone (10 nmol/L) increased NO production and phosphorylation at the inhibitory site of the inositol trisphosphate (IP3) receptor, thereby reducing Ca2+ entry, phosphorylated Ca2+/calmodulin-dependent protein kinase II (CaMKII) expression, type I and type III pro-collagen production. Non-physiological testosterone-treated fibroblasts exhibited similar NO and collagen production capabilities as compared to control (testosterone deficient) fibroblasts. These effects were blocked by co-treatment with NO inhibitor (L-NG-nitro arginine methyl ester L-NAME, 100 μmol/L). In the presence of the IP3 receptor inhibitor (2-aminoethyl diphenylborinate 2-APB, 50 μmol/L), testosterone-deficient and physiological testosterone-treated fibroblasts exhibited similar phosphorylated CaMKII expression. When treated with 2-APB or CaMKII inhibitor (KN93, 10 μmol/L), testosterone-deficient and physiological testosterone-treated fibroblasts exhibited similar type I, and type III collagen production. In conclusion, physiological testosterone activates NO production, and attenuates the IP3 receptor/Ca2+ entry/CaMKII signaling pathway, thereby inhibiting the collagen production capability of cardiac fibroblasts.
Abstract
Background
Insulin is highly recommended for diabetes management in persons with liver cirrhosis. However, few studies have evaluated its long-term effects in these persons. We conducted ...this study to compare the risks of mortality, liver-related complications, and cardiovascular events in persons with type 2 diabetes mellitus (T2DM) and compensated liver cirrhosis.
Methods
From January 1, 2000, to December 31, 2012, we selected 2047 insulin users and 4094 propensity score-matched nonusers from Taiwan’s National Health Insurance Research Database. Cox proportional hazard models were used to assess the risks of outcomes.
Results
The mean follow-up time was 5.84 years. The death rate during the follow-up period was 5.28 and 4.07 per 100 person-years for insulin users and nonusers, respectively. In insulin users, the hazard ratios and 95% confidence intervals (CIs) of all-cause mortality, hepatocellular carcinoma, decompensated cirrhosis, hepatic failure, major cardiovascular events, and hypoglycemia were 1.31 (1.18–1.45), 1.18 (1.05–1.34), 1.53 (1.35–1.72), 1.26 (1.42–1.86), 1.41 (1.23–1.62), and 3.33 (2.45–4.53), respectively.
Conclusions
This retrospective cohort study indicated that among persons with T2DM and compensated liver cirrhosis, insulin users were associated with higher risks of death, liver-related complications, cardiovascular events, and hypoglycemia compared with insulin nonusers.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this paper, we demonstrate a rotational actuator using a thermomagnetic-induced magnetic force interaction. The actuator consists of a magnetic rotary beam, stainless-steel bearing, mechanical ...frame, thermomagnetic Gadolinium sheets, and thermoelectric generators (TEGs). Experimental results show that applying a sequence of currents to the TEGs successfully produces sequential magnetic forces. Consequently, these sequential magnetic forces rotate the beam for revolutions. When applying a sequence set of currents of -0.5 and 1.3 A, the maximum rotation speed and maximum stall torque of the actuator is 3.81 rpm and 136.2~\mu Nm, respectively. Most importantly, the operating temperatures of other thermomagnetic (and electrothermal) actuators are usually high, but the operating temperature of our actuator is approximately room temperature (13 °C-27 °C). Therefore, our actuators have more practical applications. According to the above-mentioned features, we believe our actuator is an important alternative approach to developing future rotational actuators and motors.
As the growing demand on artificial intelligence (AI) Internet-of-Things (IoT) devices, smart vision sensors with energy-efficient computing capability are required. This article presents a low-power ...and low-voltage dual mode 0.5-V computational CMOS image sensor (C 2 IS) with array-parallel computing capability for feature extraction using convolution. In the feature extraction mode, by applying the pulsewidth modulation (PWM) pixel and switch-current integration (SCI) circuit, the in-sensor eight-directional matrix-parallel multiply-accumulate (MAC) operation is realized. Furthermore, the analog-domain convolution-on-readout (COR) operation, the programmable <inline-formula> <tex-math notation="LaTeX">3\times3 </tex-math></inline-formula> kernel with ±3-bit weights, and the tunable-resolution column-parallel analog-to-digital converter (ADC) (1-8 bit) are implemented to achieve the real-time feature extraction without using additional memory and sacrificing frame rate. In the image capturing mode, the sensor provides the linear-response 8-bit raw image data. The C 2 IS prototype has been fabricated in the TSMC 0.18-<inline-formula> <tex-math notation="LaTeX">\mu \text{m} </tex-math></inline-formula> standard process technology and verified to demonstrate the raw and feature images at 480 frames/s with a power consumption of 77/<inline-formula> <tex-math notation="LaTeX">117~\mu \text{W} </tex-math></inline-formula> and the resultant FoM of 9.8/14.8 pJ/pixel/frame, respectively. The prototype sensor is used as a real-time edge feature detection frond-end camera and accompanied with a simplified convolutional neural network (CNN) architecture to demonstrate the hand gesture recognition. The prototype system achieves more than 95% validation accuracy.
We report the magnetic-field-assisted electric-field-controlled domain switching of a magnetic single domain in a multiferroic/magnetoelectric Ni nanochevrons/Pb(Mg
Nb
)O
-PbTiO
(PMN-PT) layered ...structure. Initially, a magnetic field was applied in the transverse direction across single-domain Ni nanochevrons to transform each of them into a two-domain state. Subsequently, an electric field was applied to the layered structure, exerting the converse magnetoelectric effect to transform/release the two-domain Ni nanochevrons into one of two possible single-domain states. Finally, the experimental results showed that approximately 50% of the single-domain Ni nanochevrons were switched permanently after applying our approach (i.e., the magnetization direction was permanently rotated by 180 degrees). These results mark important advancements for future nanoelectromagnetic systems.
The current investigation examined the psychometric properties of the Internalized Stigma of Mental Illness (ISMI) scale in a sample of patients with mental illness. In addition to the internal ...consistency, test-retest reliability, and concurrent validity that previous studies have tested for the ISMI, we extended the evaluation to its construct validity and measurement invariance using confirmatory factor analysis (CFA).
Three hundred forty-seven participants completed two questionnaires (i.e., the ISMI and the Depression and Somatic Symptoms Scale DSSS), and 162 filled out the ISMI again after 50.23±31.18 days.
The results of this study confirmed the frame structure of the ISMI; however, the Stigma Resistance subscale in the ISMI seemed weak. In addition, internal consistency, test-retest reliability, and concurrent validity were all satisfactory for all subscales and the total score of the ISMI, except for Stigma Resistance (α = 0.66; ICC = 0.52, and r = 0.02 to 0.06 with DSSS). Therefore, we hypothesize that Stigma Resistance is a new concept rather than a concept in internalized stigma. The acceptable fit indices supported the measurement invariance of the ISMI across time, and suggested that people with mental illness interpret the ISMI items the same at different times.
The clinical implication of our finding is that clinicians, when they design interventions, may want to use the valid and reliable ISMI without the Stigma Resistance subscale to evaluate the internalized stigma of people with mental illness.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Spinal microglia are crucial to neuronal hyper-excitability and pain hypersensitivity. The local anesthetic bupivacaine is commonly used for both peripheral and spinal anesthesia. The pain-relief ...effects resulting from the peripheral and systemic administration of bupivacaine have been previously reported. In this study, the preventive effects of intrathecal bupivacaine administration against neuropathic pain were revealed in a rat model of sciatic nerve chronic constriction injury (CCI). Using a CCI rat model, pain hypersensitivity, characterized by mechanical allodynia and thermal hyperalgesia, correlated well with microglia M1 polarization, activation and pro-inflammatory cytokine expression in both spinal cord dorsal horns and sciatic nerves. Bupivacaine attenuated pain behaviors and inflammatory alternations. We further identified that the Interferon Regulatory Factor 5 (IRF5)/P2X Purinoceptor 4 (P2X4R) and High Mobility Group Box 1 (HMGB1)/Toll-Like Receptor 4 (TLR4)/NF-κB inflammatory axes may each play pivotal roles in the acquisition of microglia M1 polarization and pro-inflammatory cytokine expression under CCI insult. The relief of pain paralleled with the suppression of microglia M1 polarization, elevation of microglia M2 polarization, and inhibition of IRF5/P2X4R and HMGB1/TLR4/NF-κB in both the spinal cord dorsal horns and sciatic nerve. Our findings provide molecular and biochemical evidence for the anti-neuropathic effect of preventive bupivacaine.
Following the rapidly increasing number of multisystem inflammatory syndromes in children (MIS‐C), a similar clinical scenario has been observed in adult patients. Although its prevalence is low and ...probably related to underdiagnosis, its development can be associated with high mortality. Multisystem inflammatory syndrome in adults (MIS‐A) can develop following both asymptomatic and symptomatic severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and in previously healthy people. Like MIS‐C, MIS‐A is a multisystem disease that can involve the cardiovascular, respiratory, gastrointestinal, dermatologic, hematologic, and neurologic systems. In addition to the clinical manifestations, the diagnosis of MIS‐A requires laboratory evidence of inflammation and SARS‐CoV‐2 infection. The appropriate treatment for MIS‐A remains unclear; anti‐inflammatory agents, including intravenous immunoglobulin and corticosteroids, are commonly used. However, there are still many unknowns regarding MIS‐A. Further studies are needed to determine the true prevalence, pathogenesis, and effective treatment for MIS‐A.
Bubble tea beverages (
= 105) purchased from vendors in Taiwan were tested to determine their microbiological and chemical quality. Nearly half of the tested samples (48.6%, 51 of 105) had aerobic ...plate counts (APCs) higher than the Taiwan Food and Drug Administration guideline of 4.0 log CFU/mL, and 55 (52.4%) had coliform counts (most probable number MPN) higher than the 10 MPN/mL guideline.
sweeteners, preservatives, maleic acid, and coumarin were not detected in any sample. However, catechins were not detected to 188 mg/mL, and caffeine was 10.1 to 457.6 mg/mL. Bubble tea samples obtained from vendors in southern Taiwan had a mean APC of 2.6 log CFU/mL and a mean coliform count of 61.7 MPN/mL; these values were significantly lower (
< 0.05) than those from samples collected from vendors in northern, eastern, or central Taiwan. Samples obtained from southern Taiwan had the highest mean catechin concentrations of 21.3 mg/mL (
< 0.05). About 60% (63 of 105) of the bubble tea samples were not labeled with the origin of the tea leaves, which is in violation of Taiwanese food labeling regulations. In general, the bubble tea beverages tested had satisfactory microbial and chemical qualities.
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