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Abstract Background Post-exertional malaise (PEM), the hallmark symptom of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), represents a constellation of abnormal responses to physical, cognitive, and/or emotional exertion including profound fatigue, cognitive dysfunction, and exertion intolerance, among numerous other maladies. Two sequential cardiopulmonary exercise tests (2-d CPET) provide objective evidence of abnormal responses to exertion in ME/CFS but validated only in studies with small sample sizes. Further, translation of results to impairment status and approaches to symptom reduction are lacking. Methods Participants with ME/CFS (Canadian Criteria; n = 84) and sedentary controls (CTL; n = 71) completed two CPETs on a cycle ergometer separated by 24 h. Two-way repeated measures ANOVA compared CPET measures at rest, ventilatory/anaerobic threshold (VAT), and peak effort between phenotypes and CPETs. Intraclass correlations described stability of CPET measures across tests, and relevant objective CPET data indicated impairment status. A subset of case–control pairs (n = 55) matched for aerobic capacity, age, and sex, were also analyzed. Results Unlike CTL, ME/CFS failed to reproduce CPET-1 measures during CPET-2 with significant declines at peak exertion in work, exercise time, $$\dot{\text{V}}$$ V ˙ e, $$\dot{\text{V}}$$ V ˙ O2, $$\dot{\text{V}}$$ V ˙ CO2, $$\dot{\text{V}}$$ V ˙ T, HR, O2pulse, DBP, and RPP. Likewise, CPET-2 declines were observed at VAT for $$\dot{\text{V}}$$ V ˙ e/ $$\dot{\text{V}}$$ V ˙ CO2, PetCO2, O2pulse, work, $$\dot{\text{V}}$$ V ˙ O2 and SBP. Perception of effort (RPE) exceeded maximum effort criteria for ME/CFS and CTL on both CPETs. Results were similar in matched pairs. Intraclass correlations revealed greater stability in CPET variables across test days in CTL compared to ME/CFS owing to CPET-2 declines in ME/CFS. Lastly, CPET-2 data signaled more severe impairment status for ME/CFS compared to CPET-1. Conclusions Presently, this is the largest 2-d CPET study of ME/CFS to substantiate impaired recovery in ME/CFS following an exertional stressor. Abnormal post-exertional CPET responses persisted compared to CTL matched for aerobic capacity, indicating that fitness level does not predispose to exertion intolerance in ME/CFS. Moreover, contributions to exertion intolerance in ME/CFS by disrupted cardiac, pulmonary, and metabolic factors implicates autonomic nervous system dysregulation of blood flow and oxygen delivery for energy metabolism. The observable declines in post-exertional energy metabolism translate notably to a worsening of impairment status. Treatment considerations to address tangible reductions in physiological function are proffered. Trial registration number: ClinicalTrials.gov, retrospectively registered, ID# NCT04026425, date of registration: 2019-07-17.

Background: Multilingual outcome measures are used so that research studies are more generalizable across language contexts. Objective: To determine the score equivalence of the English and Chinese versions of Brief Assessment Scale for Caregivers (BASC) in Singapore. Method: Caregivers of patients with advanced cancer completed the BASC in either English or Chinese. Multivariable linear regression analysis was used to compare the mean BASC total and factor scores between the 2 language versions, with adjustment for possible confounding variables. Equivalence was declared if the 90% confidence interval of the mean scores fell entirely within an equivalence zone of ±0.5 standard deviation. Results: There were 521 ethnic Chinese participants, of whom 214 answered the English version and 307 answered the Chinese version. The BASC total and factor scores met the criteria for equivalence. Cronbach α coefficients were similar and exploratory factor analysis showed similar 2-factor structures for both language versions. Conclusion: The English and Chinese versions of the BASC were found to be equivalent in terms of similar adjusted mean scores, Cronbach α, and factor structures.

BACKGROUND:Evidence is growing that low-dose aspirin used as an adjuvant treatment of cancer is associated with an increased survival and a reduction in metastatic spread. We therefore extended up to August 2017 an earlier systematic search and meta-analyses of published studies of low-dose aspirin taken by patients with a diagnosis of cancer. METHODS:Searches were completed in Medline and Embase to August 2017 using a pre-defined search strategy to identify reports of relevant studies. References in all the selected papers were scanned. Two reviewers independently applied pre-determined eligibility criteria and extracted data on cause-specific cancer deaths, overall mortality and the occurrence of metastatic spread. Meta-analyses were then conducted for different cancers and heterogeneity and publication bias assessed. Sensitivity analyses and attempts to reduce heterogeneity were conducted. RESULTS:Analyses of 29 studies reported since an earlier review up to April 2015 are presented in this report, and these are then pooled with the 42 studies in our earlier publication. Overall meta-analyses of the 71 studies are presented, based on a total of over 120 thousand patients taking aspirin. Ten of the studies also give evidence on the incidence of metastatic cancer spread. There are now twenty-nine observational studies describing colorectal cancer (CRC) and post-diagnostic aspirin. Pooling the estimates of reduction by aspirin which are reported as hazard ratios (HR), gives an overall HR for aspirin and CRC mortality 0.72 (95% CI 0.64-0.80). Fourteen observational studies have reported on aspirin and breast cancer mortality and pooling those that report the association with aspirin as a hazard ratio gives HR 0.69 (0.53-0.90). Sixteen studies report on aspirin and prostate cancer mortality and a pooled estimate yields an HR of 0.87 (95% CI 0.73-1.05). Data from 12 reports relating to other cancers are also listed. Ten studies give evidence of a reduction in metastatic spread; four give a pooled HR 0.31 (95% CI 0.18, 0.54) and five studies which reported odds ratio of metastatic spread give OR 0.79 (0.66 to 0.95). CONCLUSION:Being almost entirely from observational studies, the evidence of benefit from aspirin is limited. There is heterogeneity between studies and the results are subject to important biases, only some of which can be identified. Nevertheless, the evidence would seem to merit wide discussion regarding whether or not it is adequate to justify the recommendation of low-dose therapeutic aspirin, and if it is, for which cancers?

Over the past decade, significant progress in quantum technologies has been made, and hence, engineering of these systems has become an important research area. Many researchers have become interested in studying ways in which classical integrated circuits can be used to complement quantum mechanical systems, enabling more compact, performant, and/or extensible systems than would be otherwise feasible. In this article—written by a consortium of early contributors to the field—we provide a review of some of the early integrated circuits for the quantum information sciences. Complementary metal--oxide semiconductor (CMOS) and bipolar CMOS (BiCMOS) integrated circuits for nuclear magnetic resonance, nitrogen-vacancy-based magnetometry, trapped-ion-based quantum computing, superconductor-based quantum computing, and quantum-dot-based quantum computing are described. In each case, the basic technological requirements are presented before describing proof-of-concept integrated circuits. We conclude by summarizing some of the many open research areas in the quantum information sciences for CMOS designers.

The resistance to staining of two low-fusing porcelains (Procera and Duceratin) for use with titanium and one conventional feldspathic porcelain (Vita VMK 68) were examined visually according to a protocol similar to the ADA Specification No. 69. The color deviation was also quantified using a colorimeter. Forty samples of each product were prepared using manufacturers instructions and the samples divided into two groups of 20. The samples of one group were immersed in methylene blue, and the control group in distilled water. Of the twenty samples from each group, ten were ground to remove the glaze. The color values for each sample were recorded prior to and after immersion in the staining medium. The color deviation value, ∆E. for each sample was calculated. Visually discernible stain was present on the unglazed samples of all three porcelain products immersed in methylene blue. No stain was visually detectable on the glazed samples or the unglazed samples immersed in distilled water (or all three porcelain products. The objective evaluation confirmed that the unglazed porcelain of all three porcelain products had statistically higher color deviation after immersion in niethylene blue. [ABSTRACT FROM AUTHOR]

Abstract Background Retinal dystrophies constitute a group of diseases characterized by clinical variability and pronounced genetic heterogeneity. Retinitis pigmentosa is the most common subtype of hereditary retinal dystrophy and is characterized by a progressive loss of peripheral field vision (Tunnel Vision), eventual loss of central vision, and progressive night blindness. The characteristics of the fundus changes include bone-spicule formations, attenuated blood vessels, reduced and/or abnormal electroretinograms, changes in structure imaged by optical coherence tomography, and subjective changes in visual function. The different syndromic and nonsyndromic forms of retinal dystrophies can be attributed to mutations in more than 250 genes. Molecular diagnosis for patients with retinitis pigmentosa has been hampered by extreme genetic and clinical heterogeneity between retinitis pigmentosa and other forms of retinal dystrophies. Next generation sequencing (NGS) technologies are among the most promising techniques to identify pathogenic variations in retinal dystrophies. Purpose The purpose of this study was to discover the molecular diagnosis for Brazilian patients clinically diagnosed with a retinitis pigmentosa pattern of inheritance by using NGS technologies. Materials and methods Sixteen patients with the clinical diagnosis of retinitis pigmentosa were included in the study. Their DNA was sequenced in a panel with 132 genes related to retinal dystrophies using the Illumina® platform. Sequence analysis and variation calling was performed using Soft Genetics®, NextGene, and Geneticist Assistant software. The criteria for pathogenicity analysis were established according to the results of prediction programs (Polyphen 2, Mutation taster and MetaCore™) and comparison of pathogenic variations found with databases. Results The identified potentially pathogenic variations were all confirmed by Sanger sequencing. There were 89 variations predicted as pathogenic, but only 10 of them supported the conclusion of the molecular diagnosis. Five of the nine patients were autosomal dominant RP (56%), two (22%) were autosomal recessive RP, and two (22%) were X-linked RP. Nine of the 16 patients (56%) had probably positive or positive results. Conclusion The Next Generation Sequencing used in this study allowed the molecular diagnosis to be confirmed in 56% of the patients and clarified the inheritance pattern of the patient’s retinal dystrophies.

Background. The use of long-lasting insecticide-treated nets (LLITNs) is one of the effective strategies for the prevention of malaria, especially among pregnant women. Aim. This study is aimed at assessing the awareness and utilization of LLITNs during pregnancy among antenatal clinic attendees at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods. This was a cross-sectional study among antenatal attendees at the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State. A semistructured questionnaire was used to obtain relevant information from the participants. Data analysis was done using SPSS version 20. Results. The mean age of the women was 26.05 ± 5.76 years. About one-third (30%) of the respondents were nulliparous. Most of the respondents had at least a secondary education. More than ninety percent of the respondents had a good knowledge of malaria with 95.8% being aware of LLITNs. The main source of information was from hospitals (54.5%). The rate of utilization of LLITNs was 37.5%; however, consistent use was only reported by about a third of this proportion. The major reasons for not utilizing the nets include discomfort/heat and fear of the chemical content. Women with tertiary education were more likely to utilize mosquito nets during pregnancy compared with women with secondary or primary education. Women who live in rural areas (OR = 0.393 95% CI 0.602–0.073) were less likely to use LLITNs during pregnancy, while those who are aware of the aetiology of malaria (OR = 4.38 95% CI 0.983–19.591) were more likely to utilize LLITNs in pregnancy. Conclusion. The level of awareness of LLITNs is high; however, its utilization was discouragingly low. Rural dwellers and those without appropriate knowledge of the aetiology of malaria were less likely to use LLITNs in pregnancy.

Two-dimensional arrays of trapped ion qubits are attractive platforms for quantum information processing, but rapid reloading remains a challenge. Here the authors use a continuous flux of pre-cooled neutral atoms to achieve fast loading of single ions without affecting the coherence of adjacent qubits.

Purpose: There is only one prior report associating mutations in BEST1 with a diagnosis of retinitis pigmentosa (RP). The imaging studies presented in that report were more atypical of RP and shared features of autosomal recessive bestrophinopathy and autosomal dominant vitreoretinochoroidopathy. Here, we present a patient with a clinical phenotype consistent with classic features of RP. Observations: The patient in this report was diagnosed with simplex RP based on clinically-evident bone spicules with characteristic ERG and EOG findings. The patient had associated massive cystoid macular edema which resolved following a short course of oral acetazolamide. Genetic testing revealed that the patient carries a novel heterozygous deletion mutation in BEST1 which is not carried by either parent. While this suggests BEST1 is causative, the patient also inherited heterozygous copies of several mutations in other genes known to cause recessive retinal degenerative disease. Conclusions and Importance: How some mutations in BEST1 associate with peripheral retinal degeneration phenotypes, while others manifest as macular degeneration phenotypes is currently unknown. We speculate that RP due to BEST1 mutation requires mutations in other modifier genes.

We present a low-loss integrated photonics platform in the visible and near ultraviolet (UV) regime. Fully etched waveguides based on atomic layer deposition (ALD) of aluminum oxide operate in a single transverse mode with

Enteroviruses commonly infect the gastrointestinal tract, and replication of enteroviruses has been well documented in the Peyer patches of the small bowel. Chronic enterovirus infection has been found in the stomach and terminal ileum of patients with myalgic encephalomyelitis/chronic fatigue syndrome. The authors report the unexpected finding of enterovirus VP1 protein, by immunoperoxidase staining, in carcinoid tumours found in one patient with myalgic encephalomyelitis/ chronic fatigue syndrome and another patient with chronic lower quadrant abdominal pain, and suggest a possible association between enteroviruses and tumorigenesis. [ABSTRACT FROM AUTHOR]

Abstract The steady rise of online shopping goes hand in hand with the development of increasingly complex ML and NLP models. While most use cases are cast as specialized supervised learning problems, we argue that practitioners would greatly benefit from general and transferable representations of products. In this work, we build on recent developments in contrastive learning to train FashionCLIP, a CLIP-like model adapted for the fashion industry. We demonstrate the effectiveness of the representations learned by FashionCLIP with extensive tests across a variety of tasks, datasets and generalization probes. We argue that adaptations of large pre-trained models such as CLIP offer new perspectives in terms of scalability and sustainability for certain types of players in the industry. Finally, we detail the costs and environmental impact of training, and release the model weights and code as open source contribution to the community.