Does Diabetes Accelerate the Progression of Aortic Stenosis through Enhanced Inflammatory Response within Aortic valves?

Diabetes predisposes to aortic stenosis (AS). We aimed to investigate if diabetes affects the expression of selected coagulation proteins and inflammatory markers in AS valves. Twenty patients with severe AS and concomitant type 2 diabetes mellitus (DM) and 40 well-matched patients without DM scheduled for valve replacement were recruited. Valvular tissue factor (TF), TF pathway inhibitor (TFPI), prothrombin, C-reactive protein (CRP) expression were evaluated by immunostaining and TF, prothrombin, and CRP transcripts were analyzed by real-time PCR. DM patients had elevated plasma CRP (9.2 [0.74–51.9] mg/l vs. 4.7 [0.59–23.14] mg/l, p = 0.009) and TF (293.06 [192.32–386.12] pg/ml vs. 140 [104.17–177.76] pg/ml, p = 0.003) compared to non-DM patients. In DM group, TF−, TFPI−, and prothrombin expression within valves was not related to demographics, body mass index, and concomitant diseases, whereas increased expression related to DM was found for CRP on both protein (2.87 [0.5–9]% vs. 0.94 [0–4]%, p = 0.01) and transcript levels (1.3 ± 0.61 vs. 0.22 ± 0.43, p = 0.009). CRP-positive areas were positively correlated with mRNA TF (r = 0.84, p = 0.036). Diabetes mellitus is associated with enhanced inflammation within AS valves, measured by CRP expression, which may contribute to faster AS progression

Assessment of long-term renal complications in extremely low birth weight children

We assessed the long-term renal complications in a regional cohort of extremely low birth weight (ELBW) children born in 2002–2004. The study group, comprising 78 children born as ELBW infants (88% of the available cohort), was evaluated with measurement of serum cystatin C, urinary albumin excretion, renal ultrasound, and 24-h ambulatory blood pressure measurements. The control group included 38 children born full-term selected from one general practice in the district. Study patients were evaluated at a mean age of 6.7 years, and had a median birthweight of 890 g (25th–75th percentile: 760–950 g) and a median gestational age of 27 weeks (25th–75th percentile: 26–29 weeks). Mean serum cystatin C levels were significantly higher (0.64 vs. 0.59 mg/l; p = 0.01) in the ELBW group. Hypertension was diagnosed in 8/78 ELBW and 2/38 of the control children (p = 0.5). Microalbuminuria (>20 mg/g of creatinine) was detected only in five ELBW children (p = 0.17). The mean renal volume was significantly lower in the ELBW group (absolute kidney volume 81 ml vs. 113 ml; p < 0.001, relative kidney volume 85 vs. 97%; p < 0.001). Abnormally small kidneys (<2/3 of predicted size) were detected in 19 ELBW and four control children (p = 0.08). Multivariate logistic regression revealed that the only independent risk factor for renal complications was weight gained during neonatal hospitalization (odds ratio: 0.67; 95% confidence interval: 0.39–0.94). Serum cystatin C and kidney volume are significantly lower in school-age ELBW children. It is important to include systematic renal evaluation in the follow-up programs of ELBW infants

Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study.

BACKGROUND: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. METHODS: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient's age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. RESULTS: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81-87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). CONCLUSION: Knowledge about a patient's frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)

Pervaporation applied for dewatering of reaction mixture during esterification

In this work the esterification of diethyl tartrate was studied. The research was focused on the enhancement of reversible reaction yield, which is accomplished by dewatering of the reaction mixture. The removal of water shifts the equilibrium towards the main product. Pervaporation was applied for this purpose, and results were compared to distillation. The advantages and limitations of both processes are discussed. The experimental part consists of dewatering of mixture after the reaction had reached the equilibrium, and was subsequently fed to the test rig equipped with a single zeolite membrane purchased from Pervatech B.V. Results show a significant conversion increase as a result of water removal by pervaporation. Compared to distillation no addition of organics is necessary to efficiently remove water above the azeotrope. Nevertheless, some limitations and issues which call for optimisation are pointed out. A simple numerical model is proposed to support design and sizing of the pervaporation system. Various modes of integrated system operation are also briefly discussed

Considering Wake Gestures for Smart Assistant Use

Smart speakers have become an almost ubiquitous technology as they enable users to access conversational agents easily. Yet, the agents can only be activated using specific voice commands, i.e. a wake word. This, in turn, requires the device to constantly listen to and process sound, which represents a privacy issue for some users. Further, using the trigger word for the agent in a conversation with another human may lead to accidental triggers. Here, we propose using gestural triggers for conversational agents. We conducted gesture elicitation to identify five candidate gestures. We then conducted a user study to investigate the acceptability and effort required to perform the gestures. Initial results indicate that the snap gesture shows the most potential. Our work contributes initial insights on using smart speakers with ubiquitous sensing

Considering Wake Gestures for Smart Assistant Use

10.1145/3334480.3383089CHI '20: CHI Conference on Human Factors in Computing System

Subtletee:Augmenting Posture Awareness for Beginner Golfers

While the sport of golf offers unique opportunities for people of all ages to be active, it also requires mastering complex movements before it can be fully enjoyed. Extensive training is required to begin achieving any success, which may demotivate prospective players away from the sport. To aid beginner golfers and enable them to practice without supervision, we designed Subtletee-a system that enhances the bodily awareness of golfers by providing feedback on the position of their feet and elbows. We first identified key problems golf beginners face through expert interviews. We then evaluated different feedback modalities for Subtletee-visual, tactile and auditory in an experiment with 20 beginner golfers. We found that providing proprioception feedback increased the users' performance on the driving range, with tactile feedback providing the most benefits. Our work provides insights on delivering feedback during physical activity that requires high precision movements

Goodness-of-fit tests via characterizations. General approach

K.W. Morris and D. Szyna