Effects of Repeat Exercise Under Different Prandial States and Diet Composition on Glucoregulation and Appetite.

Glycemic responses to meal ingestion and exercise are important due to their relevance to type 2 diabetes. Studying the impact of a single exposure of exercise or meal on glucoregulation could not reveal the real life situation that meals are eaten, and exercise if necessary, more than once in a day. It requires a better understanding how exercise and meal interactions on glycemia through different prandial states from fasting, to early- then late-postprandial periods. Additional complexity is a circadian decline in glucose tolerance and insulin secretion in the afternoon/evening. This dissertation employs a repeat-event design, using two isocaloric meals and two bouts of moderate-intensity exercise to examine the effects of exercise performed in different prandial states on glucoregulation (Study 1), the influence of dietary composition in this process (Study 2), and the impact of satiating gut peptides, glucagon-like peptide-1 and peptide tyrosine tyrosine, associated with different prandial stages on exercise anorexia (Study 3). In Study 1, exercise significantly lowered blood glucose only when it was performed during late postprandial period, but not during early postprandial or fasting period. In Study 2, reducing carbohydrate content from 60% to 30% of energy intake reduced afternoon postprandial insulin response by 39% in parallel with a 48% reduction in glucose-dependent insulinotropic peptide. In Study 3, appetite suppression was associated with the late postprandial period regardless of the presence or absence of exercise. No consistent and specific association was seen between the two measured satiating gut peptides and exercise anorexia. This dissertation provides scientific knowledge about the interactions between exercise and meals, including: (1) exercise performed during late postprandial period, but not other prandial states, leads to substantial declines in blood glucose concentration which could have negative impact on exercise performance but a positive impact in hyperglycemic insulin-resistant states; (2) reducing carbohydrate content of the meal to a half can reduce insulin response by 39% within a day, which could reduce the diabetogenic risk of postprandial insulin over-secretion; and (3) the repeat-event design of exercise and diet rather than the exclusive single-event design reveals the complexities of glucoregulation in the real life condition.PHDKinesiologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111600/1/pjlin_1.pd

Use of Oral Anticoagulant for Secondary Prevention of Stroke in Very Elderly Patients With Atrial Fibrillation: An Observational Study

SummaryBackgroundOral anticoagulant (OAC) is proven to be more effective than antiplatelet therapy in the secondary prevention of ischemic stroke in patients with atrial fibrillation (AF). The objective of this study was to determine the effect of age on the prescription of OAC and its actual use by neurologists for secondary prevention among the very elderly patients with AF hospitalized for ischemic stroke.MethodsIn this prospective observational study, data from patients with first-ever ischemic stroke and AF were included. We reviewed the use of antithrombotic agents before stroke onset and at discharge in patients with AF who were aged 80 years or older. We analyzed the trends of oral anticoagulation as secondary prevention in very elderly patients and identify the reasons why anticoagulant was not prescribed at discharge.ResultsA total of 152 patients with AF experienced first-ever ischemic stroke. Of these, 51 patients (33.6%) were ≥80 years of age, and 101 were <80 years of age. Thirteen patients died during the acute stroke and thus were excluded from the analysis. Of 139 ischemic stroke survivors at discharge, 45 were ≥80 years of age and 94 were <80 years of age. For those aged ≥80 years, 62.2% received neither antiplatelet nor anticoagulant agents before stroke onset. Surprisingly, only one patient (2.2%) was treated with OAC. At discharge, only 12 patients (26.7%) aged ≥80 years were treated with OAC compared with those aged <80 years (48/94 [51.1%]).ConclusionThis study suggests that OAC is underused in most of the very elderly patients despite its proven efficacy. A history of stroke did alter the trend of use of antithrombotic agents in this age group

Rhythm-Flexible Voice Conversion without Parallel Data Using Cycle-GAN over Phoneme Posteriorgram Sequences

Speaking rate refers to the average number of phonemes within some unit time, while the rhythmic patterns refer to duration distributions for realizations of different phonemes within different phonetic structures. Both are key components of prosody in speech, which is different for different speakers. Models like cycle-consistent adversarial network (Cycle-GAN) and variational auto-encoder (VAE) have been successfully applied to voice conversion tasks without parallel data. However, due to the neural network architectures and feature vectors chosen for these approaches, the length of the predicted utterance has to be fixed to that of the input utterance, which limits the flexibility in mimicking the speaking rates and rhythmic patterns for the target speaker. On the other hand, sequence-to-sequence learning model was used to remove the above length constraint, but parallel training data are needed. In this paper, we propose an approach utilizing sequence-to-sequence model trained with unsupervised Cycle-GAN to perform the transformation between the phoneme posteriorgram sequences for different speakers. In this way, the length constraint mentioned above is removed to offer rhythm-flexible voice conversion without requiring parallel data. Preliminary evaluation on two datasets showed very encouraging results.Comment: 8 pages, 6 figures, Submitted to SLT 201

{μ-6,6′-Dimeth­oxy-2,2′-[ethane-1,2-diyl­bis(nitrilo­methanylyl­idene)]diphenolato-1κ4 O 6,O 1,O 1′,O 6′;2κ4 O 1,N,N′,O 1′}(methanol-1κO)(tetra­fluoridoborato-1κ2 F,F′)-2-copper(II)-1-sodium

In the dinuclear salen-type title complex, [CuNa(BF4)(C18H18N2O4)(CH3OH)], the CuII atom is chelated by two O atoms and two N atoms of the deprotonated Schiff base in a square-planar geometry. The Na atom is seven-coordinate as it is linked to four O atoms of the same Schiff base ligand, one O atom of the methanol and two tetra­fluorido­borate F atoms. The remaining two F atoms of the anion are disordered over two sites in a 0.598 (18):0.402 (18) ratio

Carbon monoxide may enhance bile secretion by increasing glutathione excretion and Mrp2 expression in rats

AbstractBackgroundNitric oxide (NO) donors have been reported to induce choleresis via an increased excretion of glutathione. The effects of another gas molecule, carbon monoxide (CO), on bile formation are, however, inconsistent among previous reports. We investigated the sequential changes of bile output and the biliary contents in rats with or without CO supplementation to elucidate the mechanism of CO on bile excretion.MethodsDichloromethane (DCM) was gastrically fed to male Sprague–Dawley rats to yield CO by liver biotransformation. The rats were divided into DCM-treated (n = 7), DCM plus L-NAME-treated (n = 6), and corn oil-treated-(n = 8) groups. Bile samples were collected hourly to examine the flow rate and bile content. Serum levels of nitrite and nitrate 4 hours after DCM supplementation with or without NO synthase (NOS) inhibition were measured by capillary electrophoresis. The expression of hepatic inducible NOS was evaluated by Western blotting 6 hours after DCM administration.ResultsLevels of carboxyhemoglobin rose to around 10% at 4 hours after DCM supplementation and were maintained until the end of the experiments. Bile flow increased after DCM supplementation and was associated with a concomitant increase of biliary glutathione and higher hepatic multidrug resistance-associated protein 2 (Mrp2) expression. Hepatic inducible NOS expression and serum nitrate/nitrite levels were also increased. Treatment with an NOS inhibitor (L-NAME) abolished the CO-induced glutathione excretion and choleresis, but not Mrp2 expression.ConclusionThe present study demonstrated that CO enhanced biliary output in conjunction with NO by increasing the biliary excretion of glutathione. The increment in biliary glutathione was associated with an increased expression of hepatic Mrp2

The effects of rear-wheel camber on the kinematics of upper extremity during wheelchair propulsion

BACKGROUND: The rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns. METHODS: Twelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s. RESULTS: The results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p < 0.01). A single loop pattern (SLOP) was adopted by most of the subjects. CONCLUSIONS: The rear-wheel camber affects propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration

Dementia Assessment Using Mandarin Speech with an Attention-based Speech Recognition Encoder

Dementia diagnosis requires a series of different testing methods, which is complex and time-consuming. Early detection of dementia is crucial as it can prevent further deterioration of the condition. This paper utilizes a speech recognition model to construct a dementia assessment system tailored for Mandarin speakers during the picture description task. By training an attention-based speech recognition model on voice data closely resembling real-world scenarios, we have significantly enhanced the model's recognition capabilities. Subsequently, we extracted the encoder from the speech recognition model and added a linear layer for dementia assessment. We collected Mandarin speech data from 99 subjects and acquired their clinical assessments from a local hospital. We achieved an accuracy of 92.04% in Alzheimer's disease detection and a mean absolute error of 9% in clinical dementia rating score prediction.Comment: submitted to IEEE ICASSP 202

catena-Poly[copper(II)-bis­(μ-2-formyl-6-meth­oxy­phenolato-κ4 O 2,O 1:O 1,O 6)-[(methanol-κO)sodium]-μ-perchlorato-κ2 O:O′]

In the title heterodinuclear complex, [CuNa(C8H7O3)2(ClO4)(CH3OH)]n, the CuII ion is five-coordinated by four O atoms from two 2-formyl-6-meth­oxy­phenolate anions and one O atom from a perchlorate anion in a distorted square-pyramidal geometry. The Na+ ion is six-coordinated by four O atoms from two 2-formyl-6-meth­oxy­phenolate ligands, one O atom of a methanol mol­ecule and one O atom of a perchlorate anion. The perchlorate anions link the Na+ and CuII ions, forming a chain along [010]. O—H⋯O hydrogen bonds connect the chains. π–π inter­actions are present between the benzene rings [centroid–centroid distances = 3.566 (2) and 3.702 (2) Å]. The O atoms of the perchlorate anion are disordered over two sets of sites, with an occupancy ratio of 0.481 (8):0.519 (8)