Decorrelation of Lung and Heart Sound

Abstract— Signal separation is very useful where several signals have been mixed together to form combined signal and our objective is to recover individual original component signals from that combined signal. One of the major problem in neural network and research in other disciplines is finding a suitable representation of multivariate data, i.e. random vectors. For concept and computational simplicity representation is in terms of linear transformation of the original data. This means that each component of the representation is a linear combination of the original variables. There are linear transformation methods such as principal component analysis and Independent Component Analysis (ICA). ICA is a recently developed method in which the goal is to find a linear representation of non-gaussian data so that the components are statistically independent or as independent as possible. DOI: 10.17762/ijritcc2321-8169.150615

An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract

Background: Ashwagandha (Withania somnifera (L.) Dunal) is a herb traditionally used to reduce stress and enhance wellbeing. The aim of this study was to investigate its anxiolytic effects on adults with self-reported high stress and to examine potential mechanisms associated with its therapeutic effects. Methods: In this 60-day, randomized, double-blind, placebo-controlled study the stress-relieving and pharmacological activity of an ashwagandha extract was investigated in stressed, healthy adults. Sixty adults were randomly allocated to take either a placebo or 240 mg of a standardized ashwagandha extract (Shoden) once daily. Outcomes were measured using the Hamilton Anxiety Rating Scale (HAM-A), Depression, Anxiety, and Stress Scale -21 (DASS-21), and hormonal changes in cortisol, dehydroepiandrosterone-sulphate (DHEA-S), and testosterone. Results: All participants completed the trial with no adverse events reported. In comparison with the placebo, ashwagandha supplementation was associated with a statistically significant reduction in the HAM-A (P = .040) and a near-significant reduction in the DASS-21 (P = .096). Ashwagandha intake was also associated with greater reductions in morning cortisol (P < .001), and DHEA-S (P = .004) compared with the placebo. Testosterone levels increased in males (P = .038) but not females (P = .989) over time, although this change was not statistically significant compared with the placebo (P = .158). Conclusions: These findings suggest that ashwagandha's stress-relieving effects may occur via its moderating effect on the hypothalamus-pituitary-adrenal axis. However, further investigation utilizing larger sample sizes, diverse clinical and cultural populations, and varying treatment dosages are needed to substantiate these findings

Is exposure to biomass smoke really associated with COPD?

Vandana Das, Vanjare Nitin, Sundeep Salvi, Rahul Kodgule Department of Pulmonary Function Laboratory, Chest Research Foundation, Pune, Maharashtra, IndiaWe read the article by Balcan et al1 with great interest. The authors have reported a case&ndash;control study that included 115 females and looked at the association between exposure to biomass smoke and detection of COPD. Although the authors concluded a positive association, we are concerned about the issues related to the conduct of the study and discrepancies in the data reported. COPD cases in this study were defined based on pre-bronchodilator forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio &lt;0.70. However, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines define COPD based on post-bronchodilator FEV1/FVC ratio &lt;0.70. Hence, many subjects detected to have COPD in this study may actually have had asthma, in which case, the findings of the study would not apply to the COPD population. Also the overall population included in the study was relatively younger (18&ndash;48 years). Use of a fixed ratio of FEV1/FVC is likely to lead to underdiagnosis of airflow limitation in this age group.2 Use of lower limits of normal would have been a better approach. Also, COPD is more common in age groups above 40 years. Therefore, we are not convinced about the selection of population with younger age. (Open PDF to read the full Letter)Authors&rsquo; replyBaran Balcan1Selcuk Akan2Aylin Ozsancak Ugurlu1Bahar Ozcelik Handemir3Berrin Bagcı Ceyhan4Sevket Ozkaya5&nbsp;1Department of Pulmonary Medicine, Baskent University Faculty of Medicine, Istanbul, 2Department of Internal Medicine, Ankara Education and Teaching Hospital, Ankara, 3Department of Pulmonary Medicine, Irmet Hospital, Tekirdag˘, 4Department of Pulmonary Medicine, Marmara University Faculty of Medicine, 5Department of Pulmonary Medicine, Faculty of Medicine, Bah&ccedil;eşehir University, Istanbul, Turkey&nbsp;According to GOLD guidelines, post-bronchodilator pulmonary function test results are taken into account to diagnose COPD. As this is a standard criterion according to GOLD, we did not mention it in the methodology section, though we used post-bronchodilator results. Moreover, it is known that in a standard spirometry test, the best of three attempts should be taken into consideration; therefore, we did not mention that the best of three attempts was taken. (Open PDF to read full Response)&nbsp;View original paper by Balcan and colleagues.&nbsp

A randomized, double-blind study comparing the efficacy and safety of a combination of formoterol and ciclesonide with ciclesonide alone in asthma subjects with moderate-to-severe airflow limitation

Context: The combination of inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) is widely used in the treatment of moderate-to-severe asthma uncontrolled by ICS alone. Aims: To evaluate the efficacy and safety of a new ICS-LABA combination inhaler containing Formoterol (F) and Ciclesonide (C). Settings and Design: A double-blind, double-dummy, parallel group fashion, multi-centric study. Subjects and Methods: A total of 169 asthma patients received Ciclesonide 80 μg once daily during a 4-week run-in period, after which, they were randomized to receive either C (80 μg) or a combination of F (4.5 μg) and C (80 μg) (FC) both delivered through a hydro-fluro-alkane pressurized-metered-dose inhaler as 1 puff twice daily, for 6 weeks. Statistical Analysis Used: Inter-group differences were compared using t-test for independent samples at a significance level of 5%. Results: From baseline, the improvements in forced expiratory volume in 1 s at 1, 3, and 6 weeks was significantly higher in the FC group compared to Group C (110 ml vs. 40 ml, 140 ml vs. 20 ml, and 110 ml vs. 40 ml, respectively, all P < 0.05). From baseline, the improvements in mean morning peak expiratory flow at 1, 3, and 6 weeks was significantly higher in the FC group compared to Group C (17 L/min vs.−3 L/min, 22 L/min vs. 3 L/min, and 30 ml vs. 8 L/min respectively, all P < 0.05). The changes in symptom scores were similar in both the groups. The adverse events in the FC group were not significantly different from those in the C group. Conclusions: FC provides better improvement than C alone in terms of lung function and symptoms without increased risk of adverse events in asthma patients

Reference values for peak expiratory flow in Indian adult population using a European Union scale peak flow meter

Background: Reference values of peak expiratory flow (PEF) in Indian adults have to date been derived locally, using an old (Wright) scale peak flow meter. There are thus no reliable reference values for PEF for Indians and this formed the aim of the study. Materials and Methods: A European Union (EU) scale peak flow meter (PFM) was used for the study. A respiratory health and demographic questionnaire was administered to 1000 male and female adults from randomly selected locations in the country in this multi centric study. The locations represented different geographic, ethnic, and socioeconomic backgrounds. Patients were stratified according to height and age. The PEF values were measured using the Breathometer™ (Cipla Ltd., India) with EU scale. Reference equations were derived from multiple regression analysis. Results: A total of 3608 participants were excluded. In 80% of the remaining 6138 healthy adults (M: 3720; F: 2418), the predicted regression equations were derived. Gender, age, and height were the significant determinants of PEF. The equations in L/minute are: Females: PEF = -1.454 (Age) + 2.368 (Height) Males: PEF = -1.807 (Age) + 3.206 (Height). The derived equation was validated by comparing the predicted PEF values with the measured values in the remaining sample of 20% (Mean ΔPEF: M = 1.85 L/minute, CI = -2.76, 6.47; F = 1.64, CI = -2.89, 6.18). An Indian adult with average height and age was found to have approximately 30% lower PEF compared to the corresponding European adult using the Nunn and Gregg equation. Conclusion: We derived reference values of PEF for Indian adults using a validated EU scale peak flow meter

ETV6 Deficiency Unlocks ERG-Dependent Microsatellite Enhancers to Drive Aberrant Gene Activation in B-Lymphoblastic Leukemia.

Distal enhancers play critical roles in sustaining oncogenic gene-expression programs. We identify aberrant enhancer-like activation of GGAA tandem repeats as a characteristic feature of B-cell acute lymphoblastic leukemia (B-ALL) with genetic defects of the ETV6 transcriptional repressor, including ETV6-RUNX1+ and ETV6-null B-ALL. We show that GGAA repeat enhancers are direct activators of previously identified ETV6-RUNX1+/- like B-ALL "signature" genes, including the likely leukemogenic driver EPOR. When restored to ETV6-deficient B-ALL cells, ETV6 directly binds to GGAA repeat enhancers, represses their acetylation, downregulates adjacent genes, and inhibits B-ALL growth. In ETV6-deficient B-ALL cells, we find that the ETS transcription factor ERG directly binds to GGAA microsatellite enhancers and is required for sustained activation of repeat enhancer-activated genes. Together, our findings reveal an epigenetic gatekeeper function of the ETV6 tumor suppressor gene and establish microsatellite enhancers as a key mechanism underlying the unique gene-expression program of ETV6-RUNX1+/- like B-ALL. SIGNIFICANCE: We find a unifying mechanism underlying a leukemia subtype-defining gene-expression signature that relies on repetitive elements with poor conservation between humans and rodents. The ability of ETV6 to antagonize promiscuous, nonphysiologic ERG activity may shed light on other roles of these key regulators in hematolymphoid development and human disease. See related commentary by Mercher, p. 2. This article is highlighted in the In This Issue feature, p. 1.http://deepblue.lib.umich.edu/bitstream/2027.42/175557/2/ETV6_deficiency_Blood_Cancer_Discovery_2023.pdfPublished versionDescription of ETV6_deficiency_Blood_Cancer_Discovery_2023.pdf : Published versio