Enhanced recovery in patients with gestational diabetes mellitus and MTHFR 677 TT genotype after taking high-dose folic acid supplements during mid-late pregnancy: an open-label interventional study.

Objective: To explore the relationship between folic acid supplementation and the recovery rate of gestational diabetes mellitus (GDM) in women with methylenetetrahydrofolate (MTHFR) 677 TT genotypes in mid-late pregnancy. Methods: 9, 096 pregnant women were recruited with their MTHFR gene genotyped. 5,111 women underwent a 75-g oral glucose tolerance test (OGTT) and 2,097 were confirmed with GDM. The association between MTHFR genotypes and GDM risk was estimated using logistic and log-binomial regression, with age and parity set as the covariates to control their confounding effects. Further assessment of GDM risk on glucose levels was done using the ANCOVA model. As an open-label intervention study, 53 GDM patients with TT genotype were prescribed 800µg/day of folic acid as the high-dose group, while 201 GDM patients were given 400µg/day as the standard-dose group at their 24-28 weeks of pregnancy. A rate ratio (RR) of GDM recovery was estimated at each available time point for both groups. The time-to-GDM persistence events were analyzed with the Kaplan-Meier method and Cox-regression model. The trend of glucose levels over time was estimated using the linear model. Results: MTHFR 677 TT genotype has no significant association with the glucose levels and GDM risk, with an adjusted OR of 1.105 (95% CI 0.853, 1.431; p=0.452) and an adjusted PR of 1.050 (95% CI 0.906, 1.216; p=0.518) compared to the wildtype CC group. Patients in the high-dose group (n=38; 15 drop-outs; 40.69 days (95% CI 33.22, 48.15)) recovered from GDM approximately 27 days faster than those in the standard-dose group (n=133; 68 drop-outs; 68.09 days (95% CI 63.08, 73.11)). Concomitantly, the RR of GDM recovery rose and reached 1.247 (95% CI 1.026, 1.515) at 100 days of treatment with the standard-dose group as reference. Conclusion: High-dose folic acid supplement intake in mid-late pregnancy is associated with faster GDM relief in patients with MTHFR 677 TT genotype compared to the standard dose, which would be served as a novel and low-cost alternative therapy for the treatment of GDM.

Relative Fuzzy Rough Approximations for Feature Selection and Classification.

Fuzzy rough set (FRS) theory is generally used to measure the uncertainty of data. However, this theory cannot work well when the class density of a data distribution differs greatly. In this work, a relative distance measure is first proposed to fit the mentioned data distribution. Based on the measure, a relative FRS model is introduced to remedy the mentioned imperfection of classical FRSs. Then, the positive region, negative region, and boundary region are defined to measure the uncertainty of data with the relative FRSs. Besides, a relative fuzzy dependency is defined to evaluate the importance of features to decision. With the proposed feature evaluation, we propose a feature selection algorithm and design a classifier based on the maximal positive region. The classification principle is that an unlabeled sample will be classified into the class corresponding to the maximal degree of the positive region. Experimental results show the relative fuzzy dependency is an effective and efficient measure for evaluating features, and the proposed feature selection algorithm presents better performance than some classical algorithms. Besides, it also shows the proposed classifier can achieve slightly better performance than the KNN classifier, which demonstrates that the maximal positive region-based classifier is effective and feasible.

Heat Transfer of Hybrid Nanomaterials Base Maxwell Micropolar Fluid Flow over an Exponentially Stretching Surface.

A numerical investigation of three-dimensional hybrid nanomaterial micropolar fluid flow across an exponentially stretched sheet is performed. Recognized similarity transformations are adopted to convert governing equations from PDEs into the set ODEs. The dimensionless system is settled by the operating numerical approach bvp4c. The impacts of the nanoparticle volume fraction, dimensionless viscosity ratio, stretching ratio parameter, and dimensionless constant on fluid velocity, micropolar angular velocity, fluid temperature, and skin friction coefficient in both x-direction and y-direction are inspected. Graphical outcomes are shown to predict the features of the concerned parameters into the current problem. These results are vital in the future in the branches of technology and industry. The micropolar function Rη increases for higher values of the micropolar parameter and nanoparticle concentration. Micropolar function Rη declines for higher values of the micropolar parameter and nanoparticle concentration. Temperature function is enhanced for higher values of solid nanoparticle concentration. Temperature function declines for higher values of the micropolar parameter. The range of the physical parameters are presented as: 0.005<ϕ2<0.09, Pr=6.2, 0

Targeted galectin-7 inhibition with ultrasound microbubble targeted gene therapy as a sole therapy to prevent acute rejection following heart transplantation in a Rodent model.

BACKGROUND: Despite significant advances in transplantation, acute cellular rejection (AR) remains a major obstacle that is most prevalent in the first months post heart transplantation (HT). Current treatments require high doses of immunosuppressive drugs followed by maintenance therapies that have systemic side effects including early infection. In this study, we attempted to prevent AR with a myocardial-targeted galectin-7-siRNA delivery method using cationic microbubbles (CMBs) combined with ultrasound targeted microbubble destruction (UTMD) to create local immunosuppression in a rat abdominal heterotopic heart transplantation acute rejection model. METHODS AND RESULTS: Galectin-7-siRNA (siGal-7) bound to CMBs were synthesized and effective ultrasound-targeted delivery of siGal-7 into target cells confirmed in vitro. Based on these observations, three transplant rat models were tested：①isograft (ISO); ② Allograft (ALLO) +UTMD; and ③ALLO + PBS. UTMD treatments were administered at 1, 3, 5, 7 days after HT. Galectin 7 expression was reduced by 50% compared to ALLO + PBS (p < 0.005), and this was associated with significant reductions in both galectin 7 and Interleukin-2 protein levels (p < 0.001). The ALLO + UTMD group had Grade II or less inflammatory infiltration and myocyte damage in 11/12 rats using International Society For Heart and Lung Transplantation grading, compared to 0/12 rats with this grading in the ALLO + PBS group at 10 days post HT (p < 0.001). CONCLUSIONS: Ultrasound-targeted galectin-7-siRNA knockdown with UTMD can prevent acute cellular rejection in the early period after allograft heart transplantation without the need for systemic immunosuppression. KEY WORDS: Microbubble, Acute Rejection, Heart Transplantation, Galectin-7, RNA.

[Using ecological systems theory in community health assessment].

The health of urban community residents is an issue of growing concern due to ecological degredation, increasingly extreme changes in weather, the growing prevalence of economic downturns, and chronic population structure imbalances (e.g., rising elderly and unmarried populations, low birth rates, and rising immigrant populations) around the globe. Although the theory of ecology is commonly used by domestic and international researchers to explore health promotion issues in modern society, it has not been applied in assessing the problems of community health in Taiwan or elsewhere. This paper focused on one community in Taipei City's Xinyi District to investigate the feasibility of applying the ecological system theory to urban community health assessments in Taiwan and analyzed the influence of external environments on residents' health. Researchers used observation, in-depth interviews, a questionnaire survey and literature review to frame research and collect data. Community health assessment results show one of the main health problems in the target community resulted from inadequate resident abilities and actions related to health promotion. Some residents also maintained only distant interpersonal relationships with people in their immediate neighborhood. Findings suggest the need for implementing concrete schemes based on four ecological systems to resolve identified health problems that included inadequate community human resource integration and community consensus building.