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Background: There is limited available data regarding the impact of cycle length (CL) prolongation when converting atrial fibrillation (AF) to organized atrial tachycardia (AT) and its effect on clinical outcomes. Methods and Method: We retrospectively screened and included a cohort of 132 patients with persistent or long‐standing persistent AF who underwent circumferential pulmonary vein isolation (CPVI) and left atrial substrate modification (LASM) between January 2015 and October 2019. In all 132 consecutive patients, persistent AF was successfully converted into organized AT. For cases with recurrence after a 3‐month blanking period, a repeat procedure was conducted. Results: We observed a notable prolongation in CL after ablation (average increase of 56.6 ± 30 ms). Following a median follow‐up duration of 9.5 ± 5.1 months, 27 patients experienced recurrence. Through receiver operating curve (ROC) analysis, a prolonged CL cut‐off of 42.5 ms was identified, with a specificity of 71% and a sensitivity of 59.4%. Patients were categorized into two groups: those with CL less than 42.5 ms (group A, n = 48) and those with CL more than 42.5 ms (group B, n = 84). The Kaplan–Meier survival curves demonstrated a significantly higher recurrence‐free rate after catheter ablation in group B compared to group A (p = 0.002). Conclusions: Upon termination of persistent AF into AT during ablation, it was found that CL prolongation beyond 42.5 ms was associated with improved freedom from arrhythmia. [ABSTRACT FROM AUTHOR]

Background: A novel method to measure atrial fibrillation cycle length (AF-CL) was recently described, based on the average of 10 consecutive signals (FARS10). FARS10 accurately identified pulmonary vein isolation (PVI)-responders among patients with persistent AF. Whether this method is applicable to patients with paroxysmal AF is unknown. Objective: The aim of this study is to evaluate the prognostic value of FARS10 measurements in patients with paroxysmal AF. Methods and results: We enrolled paroxysmal AF patients undergoing PVI in a prospective multicenter study. After AF induction with a standardized protocol, the AF-CL was measured using FARS-10 method. The primary endpoint was AF/AT-recurrence. One-hundred and four patients were included (61 ± 14 years, 25% females). After a mean follow-up of 12 ± 4 months, AF/AT recurrence rate was 20%. The fastest PV CL (fPV-CL) was independently associated with the primary endpoint at multivariate analysis (HR 1.02, p < 0.001). Every 10 ms increase in fPV-CL, AF recurrences increased by 20%. The value of 160 ms was found to be the optimal cut-off (specificity 81%, sensitivity 76%). Patients with fPV-CL < 160 ms experienced lower AF recurrences as compared to patients with fPV-CL > 160 ms (8% vs. 32% at 1 year; HR = 0.17, p < 0.001). Progression to persistent AF was observed in 13% of patients with fPV-CL > 160 ms. Conclusion: fPV-CL measured with the FARS-10 method accurately predicts PVI success in paroxysmal AF patients undergoing PVI. Patients with slow PV activity (fPV-CL > 160 ms) experience higher AF recurrence rate after PVI and more frequent progression to persistent AF. In 104 patients with paroxysmal atrial fibrillation (AF) undergoing AF ablation, AF was induced at the beginning of the procedure. Pulmonary vein activity was measured using FARS10 measurement (10 consecutive fastest atrial repetitive similar morphology signals). The value of 160 ms was found to be the best cut-off to discriminate outcomes. At 1-year follow-up, patients with fast veins (< 160 ms) experienced significantly fewer AF recurrences as compared to patients with slow veins (> 160 ms). PV activity measured with FARS10 method accurately discriminates pulmonary vein isolation responders, in patients with paroxysmal AF. Abbreviations: AF atrial fibrillation, AT atrial tachycardia, CL cycle length, FARS10: 10 consecutive fastest atrial repetitive similar morphology signal, fPV fastest pulmonary vein, HR hazard ratio, ms milliseconds. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the estrous cycle length of the Algerian Arbia goat in Northern Algeria. For this, eighteen (18) Arbia goats, aged between 2 and 6 years, were used in our work that took place in the experimental farm of the Saad Dahlab University (Blida, Algeria). Blood samples were taken from each goat twice a week (at a 2 or 3-day interval) for 3 months. The serum progesterone concentration was determined by Radio-Immuno-Assay. Smears of the vaginal mucosa were taken at the same time as the blood samples. The predominance of superficial cells on the smear of the vaginal mucosa as well as a serum progesterone level less than 1 ng/mL expressed the return to estrous which was considered the beginning of a new cycle. A negative correlation was observed between the percentage of superficial cells (SC) and serum progesterone (P4) levels in all goats. Our results showed a significant difference (P<0.05) between the means of different cycle lengths obtained among the females. In addition, normal cycles had an average of 20.11±1.85 days (17-25 days) representing 59.6% of cycles. Besides, a large number of short cycles (<17 days) with an average of 14.41±1.51 days were found representing 25.5% of recorded cycles. The number of long cycles (>25 days; with an average of 32.14±5.58 days), represented 14.9% of recorded cycles. Following these results, it can be concluded that the local goat in Northern Algeria had different types of cycles (normal, short, and long) with a large percentage of normal cycles. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the estrous cycle length of the Algerian Arbia goat in Northern Algeria. For this, eighteen (18) Arbia goats, aged between 2 and 6 years, were used in our work that took place in the experimental farm of the Saad Dahlab University (Blida, Algeria). Blood samples were taken from each goat twice a week (at a 2 or 3-day interval) for 3 months. The serum progesterone concentration was determined by Radio-Immuno-Assay. Smears of the vaginal mucosa were taken at the same time as the blood samples. The predominance of superficial cells on the smear of the vaginal mucosa as well as a serum progesterone level less than 1 ng/mL expressed the return to estrous which was considered the beginning of a new cycle. A negative correlation was observed between the percentage of superficial cells (SC) and serum progesterone (P4) levels in all goats. Our results showed a significant difference (P25 days; with an average of 32.14±5.58 days), represented 14.9% of recorded cycles. Following these results, it can be concluded that the local goat in Northern Algeria had different types of cycles (normal, short, and long) with a large percentage of normal cycles.

Introduction: Multiple analysis techniques evaluate electrograms during atrial fibrillation (AF), but none have been established to guide catheter ablation. This study compares electrogram properties recorded from multiple right (RA) and left atrial (LA) sites. Methods: Multisite LA/RA mapping (281 ± 176/239 ± 166 sites/patient) was performed in 42 patients (30 males, age 63 ± 9 years) undergoing first (n = 32) or redo‐AF ablation (n = 10). All electrogram recordings were visually reviewed and artifactual signals were excluded leaving a total of 21 846 for analysis. Electrogram characteristics evaluated were cycle length (CL), amplitude, Shannon's entropy (ShEn), fractionation interval, dominant frequency, organizational index, and cycle length of most recurrent morphology (CLR) from morphology recurrence plot analysis. Results: Electrogram characteristics were correlated to each other. All pairwise comparisons were significant (p <.001) except for dominant frequency and CLR (p =.59), and amplitude and dominant frequency (p =.38). Only ShEn and fractionation interval demonstrated a strong negative correlation (r = −.94). All other pairwise comparisons were poor to moderately correlated. The relationships are highly conserved among patients, in the RA versus LA, and in those undergoing initial versus redo ablations. Antiarrhythmic drug therapy did not have a significant effect on electrogram characteristics, except minimum ShEn. Electrogram characteristics associated with ablation outcome were shorter minimum CLR, lower minimum ShEn, and longer mimimum CL. There was minimal overlap between the top 10 sites identified by one electrogram characteristic and the top 10 sites identified by the other 10 characteristics. Conclusion: Multiple techniques can be employed for electrogram analysis in AF. In this analysis of eight different electrogram characteristics, seven were poorly to moderately correlated and do not identify similar locations. Only some characteristics were predictive of ablation outcome. Further studies to consider electrogram properties, perhaps in combination, for categorizing and/or mapping AF are warranted. [ABSTRACT FROM AUTHOR]

Background: Phthalates have been shown to disrupt the estrous cycle in animal studies. However, epidemiological research investigating their associations with menstrual cycle characteristics is limited. Objective: To explore the relationships between phthalate exposure and menstrual cycle characteristics among women seeking fertility assistance. Methods: We determined the levels of eight phthalate metabolites in both follicular fluid (FF) and urine specimens collected from 441 women in the Tongji Reproductive and Environmental (TREE) cohort, using high-performance liquid chromatography and tandem mass spectrometry. Information about menstrual cycle parameters was obtained through a questionnaire. The impacts of individual and joint exposure to phthalates on menstrual cycle characteristics were assessed using multivariable linear regression, Poisson regression, and quantile g-computation approaches. Results: After adjusting for relevant covariates, we found that per log10-unit increase in mono(2-ethylhexyl) phthalate (MEHP) level in urine specimens was associated with a decrease of 0.20 days (95 % CI: −0.37, −0.03) in bleeding duration. We also observed that mono(2-ethyl-5-carboxypentyl) phthalate (MECPP) and the sum of di(2-ethylhexyl) phthalate (DEHP) metabolites (∑DEHP) concentrations in FF samples were inversely related to cycle length [β = −1.92 (95 % CI: −3.10, −0.75) and −1.87 (95 % CI: −3.56, −0.19), respectively]. However, we generally observed null associations between phthalate metabolites and irregular cycle, dysmenorrhea, hypomenorrhea, or cycle length variation. Furthermore, we also found that phthalate metabolite mixtures in FF and urine were generally unrelated to menstrual cycle characteristics. Conclusion: Our findings suggest that some DEHP metabolites in FF and urine are inversely associated with menstrual cycle length and menstrual bleeding duration in women attending a fertility center.

Aims Although the mechanism of an atrial tachycardia (AT) can usually be elucidated using modern high-resolution mapping systems, it would be helpful if the AT mechanism and circuit could be predicted before initiating mapping. Objective We examined if the information gathered from the cycle length (CL) of the tachycardia can help predict the AT-mechanism and its localization. Methods One hundred and thirty-eight activation maps of ATs including eight focal-ATs, 94 macroreentrant-ATs, and 36 localized-ATs in 95 patients were retrospectively reviewed. Maximal CL (MCL) and minimal CL (mCL) over a minute period were measured via a decapolar catheter in the coronary sinus. CL-variation and beat-by-beat CL-alternation were examined. Additionally, the CL-respiration correlation was analysed by the RhythmiaTM system. : Both MCL and mCL were significantly shorter in macroreentrant-ATs [MCL = 288 (253–348) ms, P = 0.0001; mCL = 283 (243–341) ms, P = 0.0012], and also shorter in localized-ATs [MCL = 314 (261–349) ms, P = 0.0016; mCL = 295 (248–340) ms, P = 0.0047] compared to focal-ATs [MCL = 506 (421–555) ms, mCL = 427 (347–508) ms]. An absolute CL-variation (MCL-mCL) < 24 ms significantly differentiated re-entrant ATs from focal-ATs with a sensitivity = 96.9%, specificity = 100%, positive predictive value (PPV) = 100%, and negative predictive value (NPV) = 66.7%. The beat-by-beat CL-alternation was observed in 10/138 (7.2%), all of which showed the re-entrant mechanism, meaning that beat-by-beat CL-alternation was the strong sign of re-entrant mechanism (PPV = 100%). Although the CL-respiration correlation was observed in 28/138 (20.3%) of ATs, this was predominantly in right-atrium (RA)-ATs (24/41, 85.7%), rather than left atrium (LA)-ATs (4/97, 4.1%). A positive CL-respiration correlation highly predicted RA-ATs (PPV = 85.7%), and negative CL-respiration correlation probably suggested LA-ATs (NPV = 84.5%). Conclusion Detailed analysis of the tachycardia CL helps predict the AT-mechanism and the active AT chamber before an initial mapping. [ABSTRACT FROM AUTHOR]

Performance-determining variables are usually measured from a rested state and not after prolonged exercise, specific to when athletes compete for the win in long-distance events. Purpose: (1) To compare cross-country skiing double-poling (DP) performance and the associated physiological and biomechanical performance-determining variables between a rested state and after prolonged exercise and (2) to investigate whether the relationship between the main performance-determining variables and DP performance is different after prolonged submaximal DP than when tested from a rested state. Methods: Male cross-country skiers (N = 26) performed a blood lactate profile test and an incremental test to exhaustion from a rested state on day 1 (D1; all using DP) and after 90-minute submaximal DP on day 2 (D2). Results: The DP performance decreased following prolonged submaximal DP (D1: peak speed = 15.33–20.75 km·h−1, median = 18.1 km·h−1; D2: peak speed = 13.68–19.77 km·h−1, median = 17.8 km·h−1; z = −3.96, P <.001, effect size r = −.77), which coincided with a reduced submaximal gross efficiency and submaximal and peak cycle length, with no significant change in peak oxygen uptake (P =.26, r =.23). The correlation coefficient between D1 cycle length at 12 km·h−1 and D2 performance is significantly smaller than the correlation coefficient between D2 cycle length at 12 km·h−1 and D2 performance (P =.033), with the same result being found for peak cycle length (P <.001). Conclusions: The reduced DP performance after prolonged submaximal DP coincided with a reduced submaximal gross efficiency and shorter peak cycle length. The results indicate that performance-determining variables could be determined after prolonged exercise to gain more valid insight into long-distance DP performance. [ABSTRACT FROM AUTHOR]

This research work presents a depleted demand inventory model with constant deterioration. The rate of change of demand is assumed to be a time-dependent function. Initial non-zero demand occurs due to advertisements. Advertisement cost is assumed to be constant. Two types of models are considered for two replenishment strategies viz., without shortages and with shortages. This study aims to obtain a suitable policy for replenishment for minimizing the total inventory cost. Four examples about the alterations made in the optimal solutions due to different values of independent parameters used in the models are considered and discussed. Sensitivity analysis is done and numerical illustrations are provided for validating the approach presented.

Abstract To determine the influence of the phases of the menstrual cycle on swimming performance, analyzing the variation of performance in the variables time, frequency and duration of the swimming cycle in crawl style, efficiency index and average speed developed. Eleven regional high-performance swimmers were recruited. The intervention was carried out in 3 phases of the menstrual cycle (menstrual phase (FM); follicular phase (FF) and luteal phase (FL) which consisted of a 2 x 50 m test with 5 minutes of recovery in crawl style. The 50-metre time (T50), cycle frequency (CF), cycle length (CL), mean velocity (MV) and efficiency index (EI) were analyzed. For comparisons between menstrual cycle times, a T-Student for related samples was applied. Effect size was calculated using Cohen's d. There are significant differences in performance as a function of menstrual cycle phase. MP vs FP: T50 [30.41 (1.47) sec] vs [29.86 (1.56) sec] 1.91% (D=0.36); CL [46.01 (3.92) cycles/min] vs [47.15 (4.03) cycles/min] 2.5% (D=0.28); MP vs LP: CL [1.99 (0.13) cycles/min] vs [2.01 (0.14) cycles/min] 1.01% (D=0.13) FP vs LP: CL [1.97 (0.15) m/cycle] vs [2.01 (0.14) m/cycle] 2.03% (D=0.27%) IE p<0.05). The different phases of the menstrual cycle influence crawl performance in young high performance female swimmers. The FF was the most optimal phase due to a decrease in the total time of the test and an increase in the length of the swim cycle. It is unclear whether there is a direct influence on performance as a function of menstrual phase, which is attributed to possible inter-individual differences. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the complexity of a number of computational problems defined on a synchronous boolean finite dynamical system, where update functions are chosen from a template set of exclusive-or and its negation. We first show that the reachability and path-intersection problems are solvable in logarithmic space-uniform AC1 if the objects execute permutations, while the reachability problem is known to be in P and the path-intersection problem to be in UP in general. We also explore the case where the reachability or intersection are tested on a subset of objects, and show that this hardens complexity of the problems: both problems become NP-complete, and even π 2 p -complete if we further require universality of the intersection. We next consider the exact cycle length problem, that is, determining whether there exists an initial configuration that yields a cycle in the configuration space having exactly a given length, and show that this problem is NP-complete. Lastly, we consider the t-predecessor and t-Garden of Eden problem, and prove that these are solvable in polynomial time even if the value of t is also given in binary as part of instance, and the two problems are in logarithmic space-uniform NC2 if the value of t is given in unary as part of instance. [ABSTRACT FROM AUTHOR]

Gao, Huo, Liu, and Ma proved a result on the existence of paths connecting specified two vertices whose lengths differ by one or two. By using this result, they settled two famous conjectures due to Thomassen. In this paper, we improve their result, and obtain a generalization of a result of Bondy and Vince. [ABSTRACT FROM AUTHOR]

Abstract Background Metformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects. Objective Inositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS. Methods The present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs). Results Twenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85). Conclusion Inositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin. Trial registration PROSPERO registration number: CRD42021283275.

The discrete logarithm problem (DLP) in semigroups has attracted some interests and serves as the foundation of many cryptographic schemes. In this work, we study algorithms and lower bounds for DLP in semigroups. First, we propose a variant of the deterministic algorithm for solving the cycle length of torsion elements and show the lower bound of computing the DLP in a semigroup. Then, we propose an algorithm for solving the multiple discrete logarithm (MDL) problem in the semigroup and give the lower bound for solving the MDL problem by considering the MDL problem in the generic semigroup model. Besides, we solve the multidimensional DLP and product DLP in the semigroup.

The high capture cross-section (σc) of Gadolinium (Gd-155 and Gd-157) causes reactivity penalty and swing at the initial stage of fuel burnup in Pressurized Water Reactor (PWR). The present study is concerned with the feasibility of the combination of mixed burnable poison with both low and high σc as an approach to minimize these effects. Two considered reference designs are fuel assemblies with 24 IBA rods of Gd2O3 and Er2O3 respectively. Models comprise nuclear fuel with a homogeneous mixture of Er2O3, AmO2, SmO2, and HfO2 with Gd2O3 as well as the coating of PaO2 and ZrB2 on the Gd2O3 pellet's outer surface. The infinite multiplication factor was determined and reactivity was calculated considering 3% neutron leakage rate. All models except Er2O3 and SmO2 showed expected results namely higher values of these parameters than the reference design of Gd2O3 at the early burnup period. The highest value was found for the model of PaO2 and Gd2O3 followed by ZrB2 and HfO2. The cycle burnup, discharge burnup, and cycle length for three batch refueling were calculated using Linear Reactivity Model (LRM). The pin power distribution, energy-dependent neutron flux and Fuel Temperature Coefficient (FTC) were also studied. An optimization of model 1 was carried out to investigate effects of different isotopic compositions of Gd2O3 and absorber coating thickness.

Simple Summary: The mechanism which ensures a mare recognises the presence of a pregnancy and receives an embryonic signal to prevent her returning to oestrus is known as maternal recognition of pregnancy (MRP) and occurs approximately 12 days after ovulation. We do not fully understand the MRP signal in the mare or the mechanisms involved in how it prevents lysis of the corpus luteum, the progesterone secreting structure on the maternal ovaries. This experiment aimed to determine if the timing of the MRP signal was specific to individual mares by examining when luteostasis (maintenance) of the corpus luteum reliably occurred in individuals following embryo reduction. Singleton (n = 150) and synchronous twin pregnancies (n = 9) were reduced in 10 individuals (5–29 reductions/mare) at pre-determined time points within days 10–14 of pregnancy. Individual mares showed a significant variation in when they consistently entered a period of luteostasis following embryo reduction (272–344 h post-ovulation). The presence of twins, the size of the embryonic vesicle, the interovulatory period and mare age did not factor into the timing of MRP in the individuals. The factors and mechanisms underlying the individuality in the timing of MRP were not determined and warrant further study. The present experiment aimed at determining whether the timing of the maternal recognition of pregnancy (MRP) was specific to individual mares by determining when luteostasis, a failure to return to oestrus, reliably occurred in individuals following embryo reduction. Singleton (n = 150) and synchronous twin pregnancies (n = 9) were reduced in 10 individuals (5–29 reductions/mare) at pre-determined time points within days 10 (n = 20), 11 (n = 65), 12 (n = 47), 13 (n = 12) or 14 (n = 15) of pregnancy. Prior to embryo reduction, the vesicle diameter was measured in 71% (106/150) of the singleton pregnancies. The interovulatory interval (IOI) was recorded on 78 occasions in seven of the mares in either non-pregnant cycles (n = 37) or those in which luteolysis followed embryo reduction (n = 41). The earliest time post-ovulation at which the embryo reduction resulted in luteostasis in an individual was 252 h (mid-Day 10). Consistency in luteostasis following embryo reduction showed individual variation between mares (272–344 h). Binary logistic regression analysis showed an individual mare effect (p < 0.001) and an effect of the interval post-ovulation at which embryo reduction was undertaken (p < 0.001). However, there was no significant effect of vesicle diameter at the time of embryo reduction (p = 0.099), nor a singleton or twin pregnancy (p = 0.993), on the dependent of luteolysis or luteostasis. The median IOI between individual mares varied significantly (p < 0.05) but was not correlated to the timing of MRP. The timing of MRP varied between the mares but was repeatable in each individual. The factors and mechanisms underlying the individuality in the timing of MRP were not determined and warrant further study. [ABSTRACT FROM AUTHOR]

Background: Metformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects. Objective: Inositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS. Methods: The present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs). Results: Twenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85). Conclusion: Inositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin. Trial registration: PROSPERO registration number: CRD42021283275. [ABSTRACT FROM AUTHOR]

From a safety point of view, the fuel-cladding of the current design of the KLT-40S reactor still carries a potential risk in the event of a loss-of-coolant accident (LOCA) allowing the formation of hydrogen gas. The concept of accident tolerant fuels (ATF) offers a variety of new safer fuel-cladding materials, one of which is U3Si2-FeCrAl, a potential fuel-cladding combination according to various research sources. In this research, a study of neutronic parameters (1) cycle length, (2) reactivity feedback coefficient, and (3) reactor proliferation resistance was performed with ATF material U3Si2-FeCrAl as fuel-cladding in the KLT-40S reactor core. Modeling and simulation of the ATF-fueled KLT-40S reactor core were performed using KENO-VI and TRITON modules from SCALE code. The results showed that replacement of the fuel-cladding material with the ATF material in the KLT-40S reactor resulted in a shorter cycle length, and the enrichment required to reproduce the original cycle length was above the safeguard limit. The fuel temperature, moderator temperature, and void reactivity coefficient were negative, although not as negative as the original ones. The spent fuel produced at the end of the cycle had good proliferation resistance, although not as good as the original one. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is associated with insulin resistance. Few randomized controlled trials (RCT) compared myoinositol (MI) with metformin (MET) regarding insulin resistance in PCOS. This was an open-label six-month RCT in women with PCOS (n = 45) with interventions MI 4 g/day or MET 2 g/day. Primary outcome was the homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes were fasting glucose, weight, cycle length, lipids, testosterone, adverse effects, quality of life, and depression scores. Median age was 26 years. Body mass was index was 34.4 kg/m2. HOMA-IR was unchanged during MI (p = 0.31) and MET (p = 0.11) (MI vs. MET, p = 0.09). Median fasting glucose changed +0.2 mmol/L during MI (p < 0.001) and −0.1 mmol/L during MET (p = 0.04) (MI vs. MET p < 0.001). Median weight changed −2.3 kg during MI (p = 0.98) and −6.1 kg during MET (p < 0.001) (MI vs. MET, p = 0.02). Median cycle length decreased nine days during MI (p = 0.03) and 13 days during MET (p = 0.03) (MI vs. MET, p = 0.93). High-density lipoprotein (HDL) changed +0.1 mmol/L during MET (p = 0.04) (MI vs. MET, p = 0.07). All other blood parameters and scores of quality of life and depression remained unchanged during MI and MET (all p > 0.06) (MI vs. MET, all p > 0.27). Adverse effects appeared in four women during MI and 16 women during MET (MI vs. MET, p = 0.001). In conclusion, there was no effect on the metabolic outcomes during MI, but positive effects on fasting blood glucose, weight, and HDL during MET. The effect on cycle length was comparable during MI and MET. Adverse effects were less frequent during MI. [ABSTRACT FROM AUTHOR]

Road transportation is the main factor affecting high greenhouse gas (GHG) emissions and poor air quality in the atmosphere. One cause is traffic congestion on urban streets due to plenty of travel demand over road network capacity and inefficient traffic management at signalized intersections. Moreover, typical vehicles consume much fuel affecting the problems mentioned above, and there is still little use of environmentally friendly vehicles, such as the hybrid car (HV). This research investigated how efficient traffic signal management could reduce vehicle fuel consumption approaching a signalized intersection in traffic congestion. In addition, the fuel consumption of HV was compared with that of conventional gasoline cars regarding how it could reduce fuel consumption in a condition of the adjustment of traffic signal management. Then, estimating fuel consumption at the intersection was assembled by traffic simulation to identify driving patterns/modes of each vehicle. The results indicated that an adjustment of traffic signal management at the intersection by optimizing cycle length calculation based on Webster’s method could reduce vehicle fuel consumption by decreasing vehicle delay and stop time. If HVs replaced conventional gasoline cars by at least 5%, fuel consumption would be significantly reduced when HVs stop and run at a fluctuated speed between 1-20 km/hr (crawling) near the intersection. Therefore, this research could well detect a reduction in fuel consumption of environmentally friendly vehicles, even for vehicles traveling at a crawl.

Atrial cycle length (CL) is an important feature for the analysis of electrogram (EGM) characteristics acquired during catheter ablation (CA) of atrial fibrillation (AF), the commonest cardiac arrhythmia. Nevertheless, a robust ACL estimator requires the precise detection of local activation waves (LAWs), which still remains a challenge. This work aims to compare the performance in (CL) estimation, especially under fractionated EGMs, of three different LAW detection methods relying on different operation strategies. The methods are based on the hyperbolic tangent (HT) function, an adaptive amplitude threshold (AAT) and a (CL) iteration (ACLI), respectively. For each method, LAW detection has been assessed with respect to manual annotations made by two experts and performance has been estimated by confusion matrix and mean and individual (CL) error calculation by EGM types of fractionation. The influence of EGM length on the individual (CL) error has been additionally considered. For the HT method, accuracy, sensitivity and precision were 92.77–100%, while for the AAT and ACLI methods they were 78.89–99.91% for all EGM types. The CL error on the HT method was lower than AAT and ACLI methods (up to 12 ms versus up to 20 ms), with the difference being more prominent in complex EGMs. The HT method also showed the lowest dependency on EGM length, presenting the lowest and least variable error values. Therefore, the HT method achieves higher performance in (CL) estimation in comparison with previous LAW detection techniques. The high robustness and precision demonstrated by this method suggest its implementation on CA mapping devices for a more successful location of ablation targets and improved results during CA procedures. [ABSTRACT FROM AUTHOR]

The economic production quantity (EPQ) model for delayed deteriorating items considering two-phase production periods, exponential demand rate and linearly increasing function of time holding cost is proposed to solve a production problem similar to the one caused by the Covid-19 pandemic. Without shortages, the necessary and sufficient conditions for optimality of this model are characterized through a theorem and lemmas while a solution methodology based on differential calculus is adopted. This paper determines the best replenishment cycle length corresponding to the optimal total variable cost and production quantity of imperfect production industry. To illustrate this model, a numerical experiment is conducted. The results demonstrate that a higher carrying charge decreases the production quantity and a longer demanding period decreases the total variable cost of an industry with a distracted production period. Finally, managerial insights are discussed using sensitivity analysis and future research directions are exposed. [ABSTRACT FROM AUTHOR]

Purpose: Several studies have emphasised the significance of high dominant frequency (HDF) and rotors in the perpetuation of AF. However, the colocalisation relationship between both attributes is not completely understood yet. In this study, we aim to evaluate the spatial distributions of HDF regions and rotor sites within the left atrium (LA) pre and post HDF-guided ablation in PersAF. Methods: This study involved 10 PersAF patients undergoing catheter ablation targeting HDF regions in the LA. 2048-channels of atrial electrograms (AEG) were collected pre-and post-ablation using a non-contact array (EnSite, Abbott). The dominant frequency (DF, 4-10 Hz) areas with DF within 0.25 Hz of the maximum out of the 2048 points were defined as "high" DF (HDF). Rotors were defined as PSs that last more than 100 ms and at a similar location through subsequent phase frames over time. Results: The results indicated an extremely poor spatial correlation between the HDF regions and sites of the rotors in pre-versus post-ablation cases for the non-terminated (pre: CORR; 0.05 ± 0.17. vs. post: CORR; -0.030 ± 0.19, and with terminated patients (pre: CORR; -0.016 ± 0.03. post: CORR; -0.022 ± 0.04). Rotors associated with AF terminations had a long-lasting life-span postablation (non-terminated vs. terminated 120.7 ± 6.5 ms vs. 139.9 ± 39.8 ms), high core velocity (1.35 ± 1.3 mm/ms vs. 1.32 ± 0.9 mm/ms), and were less meandering (3.4 ± 3.04mmvs. 1.5 ± 1.2 mm). Although the results suggest a poor spatial overlapping between rotors' sites and sites of AFCL changes in terminated and non-terminated patients, a higher correlation was determined in terminated patients (spatial overlapping percentage pre: 25 ± 4.2% vs. 17 ± 3.8% vs. post: 8 ± 4.2% vs. 3.7 ± 1.7% p < 0.05, respectively). Conclusion: Using non-contact AEG, it was noted that the correlation is poor between the spatial distribution of HDF regions and sites of rotors. Rotors were longer-lasting, faster and more stationary in patients with AF termination postablation. Rotors sites demonstrated poor spatial overlapping with sites of AFCL changes that lead to AF termination. [ABSTRACT FROM AUTHOR]

Traffic delay is a very common phenomenon in urban intersections where the traffic volume on the approach roads is high. Coordinated traffic signals based on real-time traffic can be very useful for minimizing intersection traffic delays. Therefore, this study is aimed to investigate the prospect of a coordinated signal system for the busiest and closely spaced intersections (Ambarkhana, Chowhatta and Zindabazar) in the Sylhet city of Bangladesh. This signal system will allow a continuous flow of traffic for through moving vehicles between successive coordinated intersections so that the vehicles that running at the design speed can pass through the coordinated intersections without a significant halt. Isolated signal is designed for three intersections and linked up them based on offset values (time to travel from one intersection to another). Phase splits were adjusted using the Time-Space diagram. [ABSTRACT FROM AUTHOR]

• This study implements a fuel reload-reshuffle scheme for a PWR-based SMR, using hybrid in-out and out-in refueling strategies. • A poison-free ACP-100 core with 57 fuel assemblies and enrichments of 3.0%, 4.0%, and 4.45% was modeled in SERPENT. • Four burnup cycles were simulated, with refueling patterns set by assembly discharge burnup and core power profiles. • The core remained critical for four cycles. After 2160 EFPDs, high discharge burnups of 41.18 MWD/kg were achieved. • FTC and MTC stayed negative across cycles. The refueling schemes can be iterated based on plant operational needs. This study aims to implement a coupled fuel reload-reshuffle scheme for a PWR-based SMR. Considering 540 EFPD as the cycle length, a heterogenous poison-free core based on the design of ACP-100 with 57 fuel assemblies (FAs) utilizing three different enrichments (3.0 wt.%, 4.0 wt.%, and 4.45 wt.%) was modeled in SERPENT. Initially, the core achieved a k eff of 1.31492 and a radial PPF of 1.77, which decreased to 1.10914 and 1.19 respectively at the end of the first cycle. Reloading 12 fresh FAs and shuffling 32 irradiated FAs within the core at this point increased the k eff to 1.1584, sustaining criticality for an additional 540 EFPDs (the second cycle). Two more burnup cycles were simulated with the refueling patterns being established by evaluating the assembly discharge burnup and core power profile. Through a hybrid combination of in-out and out-in loading approaches, a high cumulative average discharge burnup exceeding 30 MWD/kg (over 40 MWD/kg for some assemblies) was achieved at the end of the fourth cycle (2160 EFPDs). Although the employed refueling patterns raised the power peaking factors (PPFs) at the beginning of each cycle, the core power distribution in general became more uniform and the PPF decreased as burnup progressed. Other than the beginning of the fourth cycle, the obtained PPF values were less than or around 2.00 even without the use of any control systems. Both the fuel and moderator temperature coefficients remained sufficiently negative throughout the burnup cycles. Further iterations of the implemented refueling schemes can be carried out depending on plant operational requirements. [ABSTRACT FROM AUTHOR]

Purpose: Several studies have emphasised the significance of high dominant frequency (HDF) and rotors in the perpetuation of AF. However, the co-localisation relationship between both attributes is not completely understood yet. In this study, we aim to evaluate the spatial distributions of HDF regions and rotor sites within the left atrium (LA) pre and post HDF-guided ablation in PersAF.Methods: This study involved 10 PersAF patients undergoing catheter ablation targeting HDF regions in the LA. 2048-channels of atrial electrograms (AEG) were collected pre- and post-ablation using a non-contact array (EnSite, Abbott). The dominant frequency (DF, 4–10 Hz) areas with DF within 0.25 Hz of the maximum out of the 2048 points were defined as “high” DF (HDF). Rotors were defined as PSs that last more than 100 ms and at a similar location through subsequent phase frames over time.Results: The results indicated an extremely poor spatial correlation between the HDF regions and sites of the rotors in pre-versus post-ablation cases for the non-terminated (pre: CORR; 0.05 ± 0.17. vs. post: CORR; −0.030 ± 0.19, and with terminated patients (pre: CORR; −0.016 ± 0.03. post: CORR; −0.022 ± 0.04). Rotors associated with AF terminations had a long-lasting life-span post-ablation (non-terminated vs. terminated 120.7 ± 6.5 ms vs. 139.9 ± 39.8 ms), high core velocity (1.35 ± 1.3 mm/ms vs. 1.32 ± 0.9 mm/ms), and were less meandering (3.4 ± 3.04 mm vs. 1.5 ± 1.2 mm). Although the results suggest a poor spatial overlapping between rotors’ sites and sites of AFCL changes in terminated and non-terminated patients, a higher correlation was determined in terminated patients (spatial overlapping percentage pre: 25 ± 4.2% vs. 17 ± 3.8% vs. post: 8 ± 4.2% vs. 3.7 ± 1.7% p < 0.05, respectively).Conclusion: Using non-contact AEG, it was noted that the correlation is poor between the spatial distribution of HDF regions and sites of rotors. Rotors were longer-lasting, faster and more stationary in patients with AF termination post-ablation. Rotors sites demonstrated poor spatial overlapping with sites of AFCL changes that lead to AF termination.

The present experiment aimed at determining whether the timing of the maternal recognition of pregnancy (MRP) was specific to individual mares by determining when luteostasis, a failure to return to oestrus, reliably occurred in individuals following embryo reduction. Singleton (n = 150) and synchronous twin pregnancies (n = 9) were reduced in 10 individuals (5–29 reductions/mare) at pre-determined time points within days 10 (n = 20), 11 (n = 65), 12 (n = 47), 13 (n = 12) or 14 (n = 15) of pregnancy. Prior to embryo reduction, the vesicle diameter was measured in 71% (106/150) of the singleton pregnancies. The interovulatory interval (IOI) was recorded on 78 occasions in seven of the mares in either non-pregnant cycles (n = 37) or those in which luteolysis followed embryo reduction (n = 41). The earliest time post-ovulation at which the embryo reduction resulted in luteostasis in an individual was 252 h (mid-Day 10). Consistency in luteostasis following embryo reduction showed individual variation between mares (272–344 h). Binary logistic regression analysis showed an individual mare effect (p < 0.001) and an effect of the interval post-ovulation at which embryo reduction was undertaken (p < 0.001). However, there was no significant effect of vesicle diameter at the time of embryo reduction (p = 0.099), nor a singleton or twin pregnancy (p = 0.993), on the dependent of luteolysis or luteostasis. The median IOI between individual mares varied significantly (p < 0.05) but was not correlated to the timing of MRP. The timing of MRP varied between the mares but was repeatable in each individual. The factors and mechanisms underlying the individuality in the timing of MRP were not determined and warrant further study.

• Mixed oxide (MOX) fuels have been utilized to increase the conversion ratio (CR) of conventional LWRs. • Five assembly models were prepared using a combination of different MOX fuels. • Burnup-dependent infinite multiplication factor and reactivity were determined. • Cycle burnup, discharge burnup, and cycle length of the assembly models were calculated. • Conversion ratio and fissile inventory ratio were evaluated in each case. • The burnup dependent concentrations of minor actinides and fission product poison were also investigated for each model. The prospect of adopting various mixed oxide fuels to increase the conversion ratio (CR) of conventional LWRs has been explored in this study. The Westinghouse AP1000 fuel assembly (FA) was taken as the reference design. While the geometry of the FA was kept the same, five assembly models were constructed utilizing different MOX fuels in the fuel rods. Depleted UO 2 was mixed with PuO 2 for the first model, the next two models featured a combination of UO 2 with ThO 2 , the fourth one utilized a mixture of PuO 2 and ThO 2 , and the final model employed a combination of UO 2 , PuO 2 , and ThO 2. Depletion analysis of these fuel assembly models was then carried out using the lattice physics code Dragon 5. The burnup-dependent infinite multiplication factor and reactivity were determined and a significant improvement in cycle length was observed at the end of the burnup period because of fertile to fissile conversion. A higher fast fission rate was obtained for plutonium-based fuel models compared to the reference, whereas the thorium-based fuel models demonstrated higher thermal fission rates. The linear reactivity model (LRM) was utilized to calculate fuel cycle performance for a three-batch refueling scheme. The three fuel models utilizing PuO 2 achieved improved discharge burnup and cycle length, and required lower charge fuel mass to obtain the same thermal power. All of the five proposed models attained higher conversion ratios compared to the reference, while the highest increment in CR was obtained for the last model utilizing all three oxides. The CR of conventional UO 2 fuel in AP1000 was 0.64, whereas it was calculated to be 0.73 for Model 5. Key safety parameters including the fuel and moderator temperature coefficients of reactivity and the effective delayed neutron fraction of the models were also determined. Finally, the isotopic evolution of minor actinides and fission product poisons of the models were analyzed as a function of burnup and compared with the reference. [ABSTRACT FROM AUTHOR]

• The feasibility of five different fuel configurations (6.11 wt.% enriched UO 2 , thorium, TRU, reactor and weapons grade MOX fuel) for the SCWR core was studied. • All fuels except thorium exhibited a cycle length exceeding 1000 EFPDs and a discharge burnup greater than 30 MWD/kg. • MOX fuel with 16 wt.% RG plutonium demonstrated the best performance with over 1700 EFPD cycle length and a 53.8 MWD/kg discharge burnup. • Negative reactivity coefficients were obtained for all of the fuels during their respective critical states with little differences in the radial power peaking factors. This study aims to investigate the feasibility of five different fuel configurations for the supercritical water reactor (SCWR) core. Thorium, MOX and transuranic (TRU) fuels were considered alongside conventional UO 2 , and burnup simulations were conducted using the Monte Carlo code SERPENT for an extended period of 1800 EFPDs. All of the fuels, except thorium, successfully demonstrate cycle lengths greater than 1000 EFPDs and discharge burnups exceeding 30 MWD/kg. The reactivity coefficients of the cores also remain negative for the entire operational period. MOX fuel with 16 wt.% reactor-grade plutonium exhibits the best fuel cycle performance with over 1700 EFPD cycle length, a staggering 53.8 MWD/kg discharge burnup, the greatest conversion ratio of 0.5725, as well as the most negative fuel, moderator and coolant temperature coefficients. However, it has a reduced effective delayed neutron fraction and a slightly higher xenon and samarium content. Despite the shortest cycle length and lowest burnup, thorium fuel exhibits a high conversion ratio of 0.5585, indicating its potential for 233U breeding with modifications to fuel composition and assembly design. MOX fuel using weapons-grade plutonium and TRU fuel demonstrate cycle lengths less than conventional UO 2 (6.11 wt.% enriched), with TRU fuel having the least β eff , but they offer the opportunity to reduce the plutonium stockpile generated from currently operational reactors. [ABSTRACT FROM AUTHOR]

• This paper investigates the core characteristics of a reactor loaded with ATF. • Cr-coated and LAS doped fuel pellet ATF were considered. • The overall impact on core performance is not significant exculding cycle length. Following the Fukushima Daiichi accident, efforts have been made in a variety of disciplines to respond to nuclear accidents. From the perspective of nuclear fuel, various approaches have been attempted, and development has been made as an Accident Tolerant Fuel (ATF). Advanced fuel technology, often known as advanced fuel concepts, is ATF. The ATF is a type of fuel designed to be more resistant to damage in the event of a loss-of-coolant accident (LOCA) or other type of incident. Some ATF designs make use of materials that can better withstand high temperatures and pressures, which can help prevent fuel melting and release of radioactive materials. Currently, we are in the stage of developing a method to apply Cr coating on zircaloy cladding or a new cladding made of SiC. Additionally, some minerals like Cr, Mn, or La 2 O 3 -Al 2 O 3 -SiO 2 (LAS) are doped into pellet materials to alter their characteristics in order to create ATF fuel. In this paper, the characteristics of a core loaded with Cr-coated clad, and LAS doped fuel pellet ATF was investigated. The multiplication factor, power distribution, peaking factor, moderator temperature coefficient, and cycle length of the ATF-loaded core were calculated and compared to the results of the ATF-free core. The neutron absorption increases when the ATF is loaded due to the Cr coating and LAS doped fuel pellet, resulting in a difference when compared to the reference case. However, this study confirmed that the difference attributable to ATF was not significant except for the cycle length. To compensate for the reduced cycle length due to ATF, the cycle length and peaking factor were evaluated for the core with increased fuel enrichment and compared with the results of the conventional core. [ABSTRACT FROM AUTHOR]

We study the following Steinberg‐type problem on circular coloring: for an odd integer k≥3, what is the smallest number f(k) such that every planar graph of girth k without cycles of length from k+1 to f(k) admits a homomorphism to the odd cycle Ck (or equivalently, is circular (k,k−12)‐colorable). Known results and counterexamples on Steinberg's Conjecture indicate that f(3)∈{6,7}. In this paper, we show that f(k) exists if and only if k is an odd prime. Moreover, we prove that for any prime p≥5, p2−52p+32≤f(p)≤2p2+2p−5.We conjecture that f(p)≤p2−2p, and observe that the truth of this conjecture implies Jaeger's conjecture that every planar graph of girth 2p−2 has a homomorphism to Cp for any prime p≥5. Supporting this conjecture, we prove a related fractional coloring result that every planar graph of girth k without cycles of length from k+1 to ⌊22k3⌋ is fractional (k:k−12)‐colorable for any odd integer k≥5. [ABSTRACT FROM AUTHOR]

Study Question: Are menstrual cycle characteristics throughout the reproductive lifespan associated with cancer risk?Summary Answer: Irregular and long menstrual cycles throughout the reproductive lifespan were associated with increased risk of total invasive cancer, especially obesity-related cancers.What Is Known Already: Long and irregular menstrual cycles have been associated with lower risk of pre-menopausal breast cancer and higher risk of endometrial cancer, but associations with other malignancies are less clear.Study Design, Size, Duration: Prospective cohort study. Prospective follow-up of 78 943 women participating in the Nurses' Health Study II between 1989 and 2015.Participants/materials, Setting, Methods: We followed 78 943 pre-menopausal women without cancer history who reported the usual length and regularity of their menstrual cycles at different ages (14-17, 18-22 and 29-46 years). Cancer diagnosis was confirmed through medical record review and classified as obesity-related (colorectal, gallbladder, kidney, multiple myeloma, thyroid, pancreatic, esophageal, gastric, liver, endometrial, ovarian and post-menopausal breast) or non-obesity-related. We fitted Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs of the association between menstrual cycle characteristics and cancer incidence.Main Results and the Role Of Chance: We documented 5794 incident cancer cases during 1 646 789 person-years of follow-up. After adjusting for BMI and other potential confounders, women reporting irregular cycles at age 29-46 years had an 11% (95% CI: 2-21%) higher risk of total invasive cancer than women reporting very regular cycles at the same age. This association was limited to obesity-related cancers, with a 23% (95% CI: 9-39%) higher risk and was strongest for endometrial cancer (HR = 1.39; 95% CI: 1.09-1.77). Findings were comparable for cycle characteristics earlier in life and for menstrual cycle length. Very irregular cycles at age 14-17 years were associated with significant increase in risk of colorectal cancer (HR = 1.36; 95% CI: 1.02-1.81).Limitations, Reasons For Caution: Our study might be subject to recall bias for findings pertaining to cycle characteristics in adolescence and early adulthood, as these were retrospectively reported. Generalizability to non-White women may be limited, as 96% of participants were White.Wider Implications Of the Findings: Women with irregular or long menstrual cycles in mid-adulthood had a statistically significantly higher risk of developing cancer, especially obesity-related cancers. This association was not limited to gynecological cancers. Obesity-related cancers may need to be added to the spectrum of long-term health consequences of long or irregular cycles, possibly warranting targeted screening among women who experience long or irregular cycles in mid-adulthood.Study Funding/competing Interest: This work was supported by grants U01 CA176726, U01 HL145386 and R01 HD096033 from the National Institutes of Health. The authors have no conflicts of interest to declare.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Fourier analysis can provide policymakers useful information for analysing the pandemic behaviours. This paper proposes a Fourier analysis approach for examining the cycle length and the power spectrum of the pandemic by converting the number of deaths due to coronavirus disease 2019 in the US to the frequency domain. Policymakers can control the pandemic by using observed cycle length whether they should strengthen their policy or not. The proposed Fourier method is useful for analysing waves in other medical applications. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is associated with insulin resistance. Few randomized controlled trials (RCT) compared myoinositol (MI) with metformin (MET) regarding insulin resistance in PCOS. This was an open-label six-month RCT in women with PCOS (n = 45) with interventions MI 4 g/day or MET 2 g/day. Primary outcome was the homeostasis model assessment of insulin resistance (HOMA-IR). Secondary outcomes were fasting glucose, weight, cycle length, lipids, testosterone, adverse effects, quality of life, and depression scores. Median age was 26 years. Body mass was index was 34.4 kg/m2. HOMA-IR was unchanged during MI (p = 0.31) and MET (p = 0.11) (MI vs. MET, p = 0.09). Median fasting glucose changed +0.2 mmol/L during MI (p < 0.001) and −0.1 mmol/L during MET (p = 0.04) (MI vs. MET p < 0.001). Median weight changed −2.3 kg during MI (p = 0.98) and −6.1 kg during MET (p < 0.001) (MI vs. MET, p = 0.02). Median cycle length decreased nine days during MI (p = 0.03) and 13 days during MET (p = 0.03) (MI vs. MET, p = 0.93). High-density lipoprotein (HDL) changed +0.1 mmol/L during MET (p = 0.04) (MI vs. MET, p = 0.07). All other blood parameters and scores of quality of life and depression remained unchanged during MI and MET (all p > 0.06) (MI vs. MET, all p > 0.27). Adverse effects appeared in four women during MI and 16 women during MET (MI vs. MET, p = 0.001). In conclusion, there was no effect on the metabolic outcomes during MI, but positive effects on fasting blood glucose, weight, and HDL during MET. The effect on cycle length was comparable during MI and MET. Adverse effects were less frequent during MI.

Purpose: This study aimed to compare physiological factors and cycle characteristics during cross-country (XC) roller-skiing at matched inclines and speeds using the double-poling (DP) and diagonal-stride (DS) sub-techniques in junior female and male XC skiers. Methods: Twenty-three well-trained junior XC skiers (11 women, 12 men; age 18.2 ± 1.2 yr.) completed two treadmill roller-skiing tests in a randomized order using either DP or DS. The exercise protocols were identical and included a 5 min warm-up, 4 × 5 min submaximal stages, and an incremental test to exhaustion, all performed at a 5° incline. Results: No significant three-way interactions were observed between sex, submaximal exercise intensity, and sub-technique. For the pooled sample, higher values were observed for DP versus DS during submaximal exercise for the mean oxygen uptake kinetics response time (33%), energy cost (18%), heart rate (HR) (9%), blood lactate concentration (5.1 versus 2.1 mmol·L−1), rating of perceived exertion (12%), and cycle rate (25%), while cycle length was lower (19%) (all P < 0.001). During the time-to-exhaustion (TTE) test, peak oxygen uptake ( V ˙ O2peak), peak HR, and peak oxygen pulse were 8%, 2%, and 6% lower, respectively, for DP than DS, with a 29% shorter TTE during DP (pooled data, all P < 0.001). Conclusion: In well-trained junior XC skiers, DP was found to exert a greater physiological load than DS during uphill XC roller-skiing at submaximal intensities. During the TTE test, both female and male athletes were able to ski for longer and reached markedly higher V ˙ O2peak values when using DS compared to DP. [ABSTRACT FROM AUTHOR]

Background: Catheter ablation is highly effective for atrioventricular nodal re‐entrant tachycardia (AVNRT). Generally junctional rhythm (JR) is an accepted requirement for successful ablation however there is a lack of detailed prospective studies to determine the characteristics of JR and the impact on slow pathway conduction. Methods: Multicentre prospective observational study evaluating the impact of individual radiofrequency (RF) applications in typical AVNRT (slow/fast). Characteristics of JR during ablation were documented and detailed testing was performed after every RF application to determine outcome. Procedural success was defined as ≤1 AV nodal echo. Results: Sixty‐seven patients were included (mean age 53 ± 18years, 57% female and a history of SVT 2.9 ± 4.7 years). RF (50w, 60°) ablation for AVNRT was applied in 301 locations with JR in 178 (59%). Successful slow pathway modification was achieved in 66 (99%) patients with slow pathway block in 30 (46%). Success was associated with JR in all patients. Success was achieved in six patients with RF < 10 s. There was no significant difference in the CL of JR during RF between effective (587 ± 150 ms) versus ineffective (611 ± 193 ms, p =.4) applications. Inadvertent junctional beat‐atrial (JA) block with immediate termination of RF was observed in 19 (28%) patients with AVNRT no longer inducible in 14 (74%). Freedom from SVT was achieved in 66 (99%) patients at a mean follow up of 15 ± 6 months. Conclusion: In this prospective study, JR was required during RF for acute success in AVNRT. Cycle length of JR during RF was not predictive of success. Although unintended JA block during faster JR was associated with slow pathway block, this is a precursor to fast pathway block and should not be intentionally targeted. [ABSTRACT FROM AUTHOR]

It is known that the installation of edge rate lines can help reduce driving speed. Theoretically, higher edge rate density leads to higher perception speed, so as the effect of speed reduction. However, there has not been a successful evaluation of appropriate design cycle length requirements. A series of experiments were taken on the straight sections on Hangrui highway in China. The cycle length was separately set in different values of 16, 8, 4, 2 and 1 m. The results showed that cycle length had significantly influence on the speed reduction effect. When the length of spatial edge rate line in each cycle λ equalled to the value of 16, 8, 4, 2 m, the effect of speed reduction was significantly enhanced as λ decreased. Percent of average speed reduction was 0.8, 3.0, 5.8 and 7.4%, respectively. However, when λ = 1 m, speed reduction effect was weaker than λ = 2 m, reduction percent of average speed was 5.2%. Then, relations between acceleration and average edge rate was analysed. When temporal frequency of edge rate lines fell in (10 Hz, 19 Hz], the braking deceleration of drivers increased as the temporal frequency increased, which conformed to the relation between temporal frequency and perception speed; when temporal frequency was lower than 10 Hz, some drivers will speed up. It may be related to the threshold of perception speed difference; when temporal frequency was higher than 19 Hz, some drivers will speed up. It may be related to flicker fusion phenomenon. According to the experiments results, edge rate lines cycle length for future implementations should be determined by the speed distribution of the target road. First published online 19 August 2020

It is well known that a graph is bipartite if and only if it contains no odd cycles. Gallai characterized edge colorings of complete graphs containing no properly colored triangles in recursive sense. In this paper, we completely characterize edge-colored complete graphs containing no properly colored odd cycles and give an efficient algorithm with complexity O (n 3) for deciding the existence of properly colored odd cycles in an edge-colored complete graph of order n. Moreover, we show that for two integers k, m with m ⩾ k ⩾ 3 , where k - 1 and m are relatively prime, an edge-colored complete graph contains a properly colored cycle of length ℓ ≡ k (mod m) if and only if it contains a properly cycle of length ℓ ′ ≡ k (mod m) , where ℓ ′ < 2 m 2 (k - 1) + 3 m . [ABSTRACT FROM AUTHOR]

Background: Menstrual dysfunctions are often found in athletic women. This study evaluated the association between leisure time physical activity (LTPA) and menstrual function in healthy nonathletic women. Methods: During 1984-1986, a population-based health survey (HUNT 1) was conducted in Nord-Trøndelag, Norway, with follow-up (HUNT 2) in 1995-1997. Women < 45 years old in HUNT 2 were included in the current study. LTPA was assessed by questionnaire in HUNT 1 and HUNT 2, and menstrual function by questionnaire in HUNT 2. Results: Adjusted odds ratios (OR's) for long cycles were increased in women who reported < 1 hour of light LTPA (OR = 1.4, 95% CI = 1.0-2.0) and 1-2 hours (OR = 1.3, 95% CI = 1.0-1.8) per week compared with women with ≥ 3 hours/week. Adjusted OR for irregular cycles was decreased in women constantly in the lowest tertile of LTPA index in HUNT 1 and HUNT 2 (OR = 0.4, 95% CI = 0.2-0.9). Adjusted OR for prolonged bleeding was 2.6 (95% CI = 1.3-5.4) for women with < 1 hour/week of light LTPA and 2.3 (95% CI = 1.3-4.3) for women with 1-2 hours, compared with ≥ 3 hours/week. Conclusions: Very low physical activity may increase the risk of menstrual cycle disruptions. Moderate PA should be encouraged for optimum reproductive health. [ABSTRACT FROM AUTHOR]

Purpose: To investigate performance and the associated physiological and biomechanical responses during upper-body repeated-sprint work. Methods: Twelve male ice sledge hockey players from the Norwegian national team performed eight 30-m sprints with start every 30 s and an active recovery between sprints. Time was captured every 10 m by photocells, cycle length and rate were determined by video analyses, and heart rate and blood lactate concentration were measured by conventional methods. Results: The percentage sprint decrement was 7% over the 8 trials, with significant reductions in performance from the previous trial already on the second trial (all P < .05). Furthermore, cycle rate was reduced by 9% over the 8 trials (P < .05). Similar changes in performance and kinematic patterns were evident for all 10-m phases of the sprints. Heart rate gradually increased to 94% of maximal (178 ± 10 beats/min) over the 8 trials, and the mean reduction in heart rate was 7 + 2 beats/min during the 22-24 s of active recovery for all trials (all P < .05). The blood lactate concentration increased to the athletes' maximal levels over the 8 sprints (P < .05). Conclusions: This is the first study to investigate performance, physiological, and biomechanical aspects of self-propelled upper- body repeated-sprint work. The observed sprint decrement over the 8 trials was associated with reductions in cycle rates and high physiological demands. However, no kinematic and physiological characteristics were significantly correlated to repeated-sprint ability or the sprint decrement. [ABSTRACT FROM AUTHOR]

Facial blood flow, which typically exhibits distinctive oscillation at a frequency of around 0.1 Hz, has been extensively studied. Although this oscillation may include important information about blood flow regulation, its origin remains unknown. The spatial phase distribution of the oscillation is thus desirable. Therefore, we visualized facial blood volume oscillation at a frequency of around 0.1 Hz using a digital camera imaging method with an improved approximation equation, which enabled precise analysis over a large area. We observed a slow spatial movement of the 0.1-Hz oscillation. The oscillation phase was not synchronized, but instead moved slowly. The phase velocity varies with person, measurement location, and time. An average phase velocity of 3.8 mm/s was obtained for several subjects. The results are consistent with previous studies; however, the conventional explanation that the blood flow at a certain point oscillates independently of adjacent areas should be corrected. If the primary origin of the movement is myogenic activity, the movement may ascend along a blood vessel toward the upstream. Otherwise, the oscillation and its propagation can be considered to be related to Mayer waves. By determining the mechanism, some questions regarding Mayer waves can be answered. The direction of the wave (upstream or downstream) provides important information.

Facial blood flow, which typically exhibits distinctive oscillation at a frequency of around 0.1 Hz, has been extensively studied. Although this oscillation may include important information about blood flow regulation, its origin remains unknown. The spatial phase distribution of the oscillation is thus desirable. Therefore, we visualized facial blood volume oscillation at a frequency of around 0.1 Hz using a digital camera imaging method with an improved approximation equation, which enabled precise analysis over a large area. We observed a slow spatial movement of the 0.1-Hz oscillation. The oscillation phase was not synchronized, but instead moved slowly. The phase velocity varies with person, measurement location, and time. An average phase velocity of 3.8 mm/s was obtained for several subjects. The results are consistent with previous studies; however, the conventional explanation that the blood flow at a certain point oscillates independently of adjacent areas should be corrected. If the primary origin of the movement is myogenic activity, the movement may ascend along a blood vessel toward the upstream. Otherwise, the oscillation and its propagation can be considered to be related to Mayer waves. By determining the mechanism, some questions regarding Mayer waves can be answered. The direction of the wave (upstream or downstream) provides important information. [ABSTRACT FROM AUTHOR]

Background: Fast ventricular tachycardias (VTs) have historically been attributed to shorter path lengths with smaller reentrant circuit dimensions in animal models. The relationship between the dimensions of the reentrant VT circuit and tachycardia cycle length (TCL) has not been examined in humans. This study aimed to analyze the determinants of the rate of human VT with comparison of circuit dimensions and conduction velocity (CV) across a wide range of both stable and unstable VTs delineated by high-resolution mapping.Methods: Fifty-four VTs with complete circuit delineation (>90% TCL) by high-resolution multielectrode mapping were analyzed in 49 patients (men, 88%; age, 65 years [58-71 years]; nonischemic, 47%). Fast VT was defined as TCL <333 milliseconds (rate >180 bpm). Unstable VT was defined by hemodynamic deterioration with an intrinsic mean arterial pressure <60 mm Hg during a sustained episode.Results: The median TCL of VT was 365 milliseconds (306-443 milliseconds), and 24 fast VTs were characterized. A wide range of CVs was observed within the entrance (0.03-0.55 m/s), common pathway (0.03-0.77 m/s), exit (0.03-0.53 m/s), and outer loop (0.17-1.13 m/s). There were no significant differences in the median dimensions of the isthmus and path length between fast and slow VTs and between unstable and stable VTs. The outer loop CV was the only circuit component that correlated with TCL in both ischemic cardiomyopathy (r=-0.5, P=0.006) and nonischemic cardiomyopathy (r=-0.45, P=0.028). The duration of the longest diastolic electrogram was inversely correlated with the dimensions of common pathway (length: r=-0.46, P=0.001, width: r=-0.3, P=0.047) and predictive of rapid VT termination by a single radiofrequency application (r=-0.41, P=0.023).Conclusions: Because of a wide spectrum of CV observed within the reentrant path during human VT, the dimensions of the circuit were not predictive of VT cycle length. For the first time, we demonstrate that the CV of the outer loop, rather than isthmus, is the principal determinant of the rate of VT. The size of the circuit was similar between fast and slow VTs and between unstable and stable VTs. Long, continuous electrograms were indicative of spatially confined isthmus dimensions, confirmed by rapid termination of VT during radiofrequency delivery. [ABSTRACT FROM AUTHOR]

Aims: To establish a simple criterion for determining a failed His-bundle pacing (HBP). This criterion states that if stimulus to QRS end interval is longer than His-bundle potential to QRS end interval ('S-QRSend > H-QRSend') then a failed HBP can be determined.Methods and Results: We performed retrospective analysis on 737 pacing tests around His-bundle in 241 patients and prospective analysis on 400 tests in 123 patients. A successful HBP is defined as that whole His-bundle is captured with or without capture of adjacent ventricular myocardium, otherwise, a failed HBP was considered. The output criteria and effective refractory period criteria were used as the gold standards for determining a successful HBP. The gold standards are that if decreasing the pacing output or pacing cycle length to a certain level results in duration or morphology changes of QRS, then a successful HBP is ascertained. In retrospective analysis of patients with normal His-Purkinje conduction, a failed HBP was determined in 31% (154/492) of pacing tests according to 'S-QRSend > H-QRSend'; all of them were validated by the gold standards (specificity = 100%). In prospective study, a failed HBP was confirmed according to the simple criterion with 100% accuracy in 33% (79/241) pacing tests. This simple criterion was also suitable for patients with His-Purkinje conduction disease although cases with 'S-QRSend > H-QRSend' rarely occurred.Conclusion: A failed HBP can be easily and reliably determined solely by 'S-QRSend > H-QRSend' in more than 30% pacing tests. [ABSTRACT FROM AUTHOR]

Purpose: To examine the development of performance, physiological and technical capacities as well as the effect of sport background among runners, kayakers and rowers when transferred to cross-country (XC) skiing over a 6-month training period.Methods: Twenty-four endurance athletes (15 runners and 9 rowers/kayakers; 15 men and 9 women) were tested for performance, physiological and technical capacities during treadmill running and roller-ski skating, double-poling ergometry, as well as upper-body, one-repetition maximum-strength (1 RM) at baseline (pre) after three (mid) and 6-months (post) of XC ski-specific training.Results: Peak treadmill speed when roller-ski skating improved significantly (13%, P < 0.01) from pre-post, with a larger improvement in runners than in kayakers/rowers (16 vs. 9%, P < 0.05), whereas peak speed in running was unchanged. Average power output during 5-min and 30-s ergometer double-poling tests improved by 8% and 5% (both P < 0.01), with improvement found only in runners on the 30-s test (8 vs. −2% in kayakers/rowers, P < 0.01). Peak oxygen uptake (VO2peak) in running and double-poling ergometry did not improve, whereas VO2peak in roller-ski skating improved by 5% in runners (P < 0.05). Submaximal gross efficiency increased by 0.6%-point and cycle length by 13%, whereas 1 RM in seated pull-down and triceps press increased by 12 and 11%, respectively (all P < 0.05).Conclusion: Six-months of XC ski-specific training induced large improvements in sport-specific performance which were associated with better skiing efficiency, longer cycle length, and greater 1RM upper-body strength in a group of endurance athletes transferring to XC skiing. Furthermore, larger sport-specific development was found in runners compared to kayakers/rowers.