Mechanism of liver X receptor α and ATP binding cassette transporter A1 involved in preeclampsia using an optimized deep learning model.

OBJECTIVE: Preeclampsia (PE) is a complex disease-causing multisystem damage. Many genes, environmental factors, and their interactions are involved in the development and progression of PE. The pathogenesis of PE is not fully understood, limiting the prevention and treatment of PE. The aim of this study was to investigate the effect of 4,4'-diisothiocyanato-stilbene-2,2'-disulfonic acid (DIDS), an ATP-binding cassette transporter A1 (ABCA1) blocker, on apoM mRNA and protein levels. PATIENTS AND METHODS: The role of liver X receptor α (LXRα) and ABCA1 in the pathogenesis of PE was investigated by optimizing the design of DIDS inhibition based on a deep learning model. RESULTS: The proportion of primipara in the research group, EOPE group, LOPE group, and controls was 59.82%, 65.85%, 56.34%, and 21.43%, respectively. The difference between the research group and the controls was statistically significant (p<0.01). In the clinical data, serum-free triiodothyronine (FT3), gestational age at delivery, high-density lipoprotein cholesterol (HDL-C), hemoglobin (HGB), albumin, and platelet (PLT) in the research group were lower than those in the controls (p<0.05). CONCLUSIONS: ABCA1 is considered to affect apoM mRNA expression, G/HDL-C may increase the risk of LOPE, and overweight or obesity, abnormal glycemic regulation, and hypothyroidism are independent risk factors closely related to the pathogenesis of PE and its subgroups.

[Bimatoprost promotes hair growth of reconstructed hair follicles in mice through activation of the Wnt/ß-catenin signaling pathway].

Objective: To investigate effect of Bimatoprost (BimP) on growth of reconstructed hair follicles in recipient nude mice. Methods: Primary epidermal and dermal cells were isolated from newborn C57BL/6J mice (1-day-old) skins, and the reconstructed hair follicles was implanted in the dorsal skin of Balb/c-nu nude mice using a silicon chamber protocol, then, the 18 nude mice were randomly divided into control group, BimP group and minoxidil group, with 6 mice in each group. After 2 weeks, topical treatment was applied to the grafted area of the nude mice by 2% minoxidil 100 µl, 0.03% BimP 100 µl and saline 100 µl, respectively, once daily for 2 weeks. At day 14 after treatment, the mice were euthanized to measure the length of dorsal hair, and the number and hair cycle of the reconstructed follicles was observed histologically. The total mRNA and proteins expression of Wnt3a, LEF1, ß-catenin and Frizzled7 were determined by qPCR and Western Blotting. The distribution and expression of ß-catenin in the reconstructed follicles was detected by immunofluorescence staining. Results: As compared to the control group, the BimP group had thicker and longer hair [(0.57±0.07) vs (0.36±0.05) cm, P<0.01], no significant difference was seen between the BimP and minoxidil group. The mRNA expression levels of Wnt3a (2.73±0.17 vs 1.00±0.14, P<0.01)、LEF1(1.71±0.12 vs 1.00±0.19, P<0.01)、ß-catenin (2.37±0.21vs 1.00±0.11, P<0.01) and Frizzled7 (2.62±0.15vs 1.00±0.18, P<0.01) were significantly increased in BimP group compared with the control group. Western Blotting showed the same results, the protein expression levels of Wnt3a (1.44±0.21vs 1.00±0.13, P<0.05)、LEF1 (1.36±0.15 vs 1.00±0.09, P<0.05)、ß-catenin (1.60±0.13 vs 1.00±0.16, P<0.01) and Frizzled7 (1.52±0.15 vs 1.00±0.21, P<0.05) in BimP group were higher than those in control group, and the difference was statistically significant. Immunofluorescence staining showed that ß-catenin was strongly expressed in hair bulb cells and sebaceous gland cells of reconstructed hair follicles in BimP group and minoxidil group, whereas barely seen in the control group. Conclusion: BimP directly promotes growth of reconstructed hair follicles in mice by activating canonical Wnt/ß-catenin signaling pathway.

Analysis of Characteristics and Relevant Factors of 1 340 Cases of Intentional Injury Cases in Southwest China.

ABSTRACT: Objective To investigate the characteristics and patterns of factors such as victims' information, injury tools and time of occurrence of intentional injury cases in southwest China. Methods One thousand three hundred and forty intentional injury cases from several places in southwest China from 2014 to 2016 assessed as minor injury level Ⅱ and above had been randomly selected. Data on victims' information, motives, injury tools, sites of occurrence, time of occurrence, injured parts and degrees of injury were classified and gathered, and then association analyses of motives and types of injury tools as well as degrees of injury and injury tools were made. Results Most of the victims were young adults between 20-50 years （65.2%）, male （82.3%）, rural household registration （62.8%）; the motives were mainly dispute （45.8%）. Injury tools were mostly blunt （54.6%） or sharp （36.0%）. Specifically, injuries were mostly made bare-handed （36.9%） and by cutting tools （33.2%）; the cases mainly occurred in public areas （59.0%）. Cases occurred more frequently in January （11.3%）, February （13.1%）, March （11.6%） and from 22：00 to 01：00 every night. Injuries mainly involved the craniofacial region. The wounds were mainly assessed as minor injury level Ⅱ （61.6%）. There was statistical significance in the difference of types of injury tools among cases with different motives （P<0.05）. There was statistical significance in the difference of the distribution of injury tools among cases with different degrees of injury （P<0.05）. Conclusion The occurrence of intentional injury cases in southwest China has potential patterns and relevant influencing factors. Prevention and analysis of such cases need to be comprehensively considered from the aspects such as victims' information, injury tools and time of occurrence.

A smartphone oximeter with a fingertip probe for use during exercise training: usability, validity and reliability in individuals with chronic lung disease and healthy controls.

BACKGROUND AND AIM: Telehealth is a strategy to expand the reach of pulmonary rehabilitation (PR). Smartphones can monitor and transmit oxygen saturation (SpO2) and heart rate (HR) data to ensure patient safety during home-based or other exercise. The purpose of this study was to evaluate the usability, validity and reliability of a Kenek O2 pulse oximeter and custom prototype smartphone application (smartphone oximeter) during rest and exercise in healthy participants and those with chronic lung disease. METHODS: Fifteen individuals with chronic lung disease and 15 healthy controls were recruited. SpO2 and HR were evaluated at rest and during cycling and walking. SpO2 was valid if the mean bias was within +±2%, the level of agreement (LoA) was within ±4%; HR was valid if the mean bias was within ±5 beats per min (bpm), LoA was within ±10bpm. Usability was assessed with a questionnaire and direct observation. RESULTS: The smartphone oximeter was deemed easy to use. At rest, SpO2 measures were valid in both groups (bias <2%, lower bound LoA -2 to 3%). During exercise, SpO2 measurement did not meet validity and reliability thresholds in the patients with chronic lung disease, but was accurate for the healthy controls. HR recording during exercise or rest was not valid (LoA>10bpm) in either group. CONCLUSIONS: The smartphone oximeter did not record HR or SpO2 accurately in patients with chronic lung disease during exercise, although SpO2 was valid at rest. During exercise, patients with chronic lung disease should pause to ensure greatest accuracy of SpO2 and HR measurement.

Syncope caused by complete heart block and ventricular arrhythmia as early manifestation of systemic lupus erythematosus in a pregnant patient: a case report.

Systemic lupus erythematosus (SLE) can affect all heart structures including the conduction system, with either reversible or permanent derangement. However, only a few cases of adult SLE and complete atrioventricular (AV) block have been reported. We describe a young pregnant woman who initially presented with complete AV block on electrocardiography before the diagnosis of SLE. Syncope subsequently developed during the postpartum period due to frequent nonsustained polymorphic ventricular tachycardia, suggesting lupus myocarditis. The ventricular arrhythmia was successfully treated by intravenous corticosteroids, lidocaine and implantation of a permanent pacemaker. This may represent the first report of complete AV block with polymorphic ventricular tachycardia, which was identified before the other clinical features of SLE fully manifested. SLE should be considered if a patient presents with complete AV block without other clinical features. It may warn for early diagnosis and appropriate treatment of SLE including lupus-related heart disease.

Cross-cultural adaptation and implementation of Good Life with osteoarthritis in Denmark (GLA:D™): group education and exercise for hip and knee osteoarthritis is feasible in Canada.

OBJECTIVE: Adapt and evaluate the feasibility of implementing Good Life with osteoArthritis in Denmark (GLA:DTM) in Canada for people with mild to severe hip/knee osteoarthritis. METHODS: Patients triaged to non-surgical management participated in two education sessions and 12 supervised, neuromuscular exercise classes. We used the RE-AIM implementation framework evaluating outcomes of Reach, Effectiveness/Efficacy, Adoption, Implementation and Maintenance. Patients completed surveys pre-program and at 3 months follow-up. Program fidelity was evaluated at four observations against a priori criteria. We conducted semi-structured interviews with therapists post-program. RESULTS: 72 patients consented to participate, 59 started the program and one withdrew on physician advice. The remaining 58 provided follow-up data. Mean age was 67 years; 78% were female and 52% had body mass index (BMI) >25. The effect of the program was demonstrated: 40% improvement in pain with 59% achieving a clinically important improvement of ≥2 points on the Numeric Pain Rating scale. Statistically significant improvement also occurred in the Hip disability/Knee injury and Osteoarthritis Outcome Score subscales. 24% reported increased physical activity. Program fidelity was demonstrated with all criteria met. Therapists emphasized that rolling recruitment allowed appropriate supervision and resulted in participants encouraging each other. 99% of participants indicated they benefitted from and were satisfied with the program and 90% reported using the knowledge daily. 52% were willing to pay >$250 Cdn for the program. CONCLUSION: GLA:DTM implementation was feasible in the Canadian context with results similar to those of >7,000 participants in Denmark. Implementation and evaluation of GLA:DTM Canada is now occurring nationally.

Patient and health care professional perspectives on using telehealth to deliver pulmonary rehabilitation.

The objective of this study was to identify the necessary features of pulmonary telerehabilitation (P-TR) from the perspectives of individuals living with chronic lung disease and health care professionals (HCPs) who deliver pulmonary rehabilitation (PR). Focus groups were carried out with patients ( n = 26) and HCPs ( n = 26) to elicit and explore their opinions about the critical elements of in-person PR and ideas for how these elements could be supported using technology. A questionnaire was used to assess technology use, PR experience, and general health status. Four key elements of PR were identified as critical to P-TR: the social aspect of PR; communicating with HCPs for education and support; using biosensors for monitoring and promoting self-knowledge; and the evolution of support with progress over time. A range of technology-enabled devices and programs were suggested as means to recreate aspects of these integral elements. Consultations with patients and HCPs suggest that users are interested in technology and want to ensure it recreates the important aspects of PR. Patients and HCPs identified similar key elements for P-TR. The opinions and suggestions of patients and HCPs should be the driving force of innovation if P-TR is to succeed in improving health outcomes.

Long non-coding RNA CCAT2 promotes the breast cancer growth and metastasis by regulating TGF-ß signaling pathway.

OBJECTIVE: Long non-coding RNA (LncRNA) CCAT2 plays an important role in tumorigenesis, tumor growth and metastasis. In this study, we reported that long noncoding RNA CCAT2 (LncRNA CCAT2) could regulate TGF-ß signaling pathway in breast cancer. PATIENTS AND METHODS: The relative mRNA expression level of CCAT2 in adjacent non-cancerous and breast cancer tissues without or with metastasis were analyzed by quantitative Real-time polymerase chain reaction (qRT-PCR). The mRNA expression levels of CCAT2 in breast cancer cell lines were analyzed by qRT-PCR. Proliferation, invasion and migration of breast cancer cells were detected after infected with si-NC or si-CCAT2. Flow cytometry analysis was used to detect the cell cycle distribution and apoptosis rate in breast cancer cells after infected with si-NC or si-CCAT2. The relative protein expression level of TGF-ß, Smad2 and α-SMA in breast cancer cells after infected with si-NC or si-CCAT2 were analyzed by Western blot. RESULTS: The relative mRNA expression level of CCAT2 in breast cancer tissues was significantly increased compared with adjacent non-cancerous tissues. The expression level of CCAT2 in breast cancer without metastasis was decreased compared with breast cancer metastasis. Meanwhile, down-regulation of CCAT2 inhibited the proliferation, invasion and migration in breast cancer cells. Furthermore, down-regulation of CCAT2 caused breast cancer cells cycle arrested in G0/G1 phase and promoted cell apoptosis. Down-regulation of CCAT2 significantly down-regulated the protein expression levels of TGF-ß, Smad2 and α-SMA in breast cancer cells. CONCLUSIONS: CCAT2 was highly expressed in breast cancer. Down-regulation of CCAT2 inhibited the proliferation, invasion and migration and promoted cell apoptosis in breast cancer cells by regulating TGF-ß signaling pathway.

Relationship between physical activity and hip pain in persons with and without cam or pincer morphology: a population-based case-control study.

OBJECTIVES: The purpose of the study was to determine if physical activity (PA) is a risk factor for persistent or recurrent hip pain in young and middle-aged persons with and without radiographic findings of cam or pincer morphology (CPM). METHODS: A population sample of persons aged 20-49 with (cases) and without (controls) hip pain in Metro Vancouver, Canada, was selected through random digit dialing (RDD). Self-reported PA was expressed as average energy expenditure (MET-hours) per year, over lifetime. CPM was defined as alpha angle >55°, lateral centre edge angle (LCE) >40°, or positive cross-over sign. RESULTS: Data were obtained for 500 subjects, 269 cases and 231 controls. Prevalence of radiographic CPM was 49% in the cases and 44% in the controls. In a logistic regression model adjusted for age, gender and CPM, total lifetime PA, including occupational, domestic and recreational activities, was significantly associated with hip pain (Odds ratio (OR) 1.30 per 1000 MET-hours, 95% CI 1.15-1.38). The effect of total PA was observed in those with CPM (1.44, 1.17-1.78) and without CPM (1.23, 1.04-1.45). For domestic activities, the association was seen only in those with CPM (significant interaction). When PA was categorized into quartiles, higher levels of PA were associated with a greater risk of pain. CONCLUSIONS: PA, as measured by average energy expenditure over lifetime is a risk factor for hip pain in young and middle-aged persons. For some activities, the risk is likely increased in persons with radiographic evidence of CPM.

The validity of a non-radiologist reader in identifying cam and pincer femoroacetabular impingement (FAI) using plain radiography.

The purpose of this study was to evaluate the validity and reliability of a radiographic diagnosis of femoroacetabular impingement (FAI) by a non-radiologist. Symptomatic FAI is prevalent and thought to be a cause of hip osteoarthritis. However, the diagnosis is often delayed by 1-2 years, in large part because radiographic findings are often subtle and clinicians have been unaware of their significance. The purpose of this study was to evaluate the validity of a radiographic diagnosis of FAI by a non-radiologist. A population-based sample of 701 subjects was recruited in Vancouver, Canada. For the current study, 50 subjects were selected-40 randomly from the population sample and 10 from an orthopedic practice with confirmed FAI. An anterior-posterior pelvis and bilateral Dunn radiographs were acquired and read by a fellowship-trained musculoskeletal radiologist and a third-year medical student who received basic training in radiographic signs of FAI. Three radiographic signs were evaluated: the lateral center edge angle, alpha angle and crossover sign. Validity was assessed using sensitivity and specificity, Bland-Altman limits of agreement and kappa. The sample contained 65% women (n = 31), was 62% Caucasian and 38% Chinese and had a mean age of 38.3 years. For correctly diagnosing FAI, the non-radiologist reader had a sensitivity of 0.83 and specificity of 0.87. Intra-rater κ value was 0.72, and prevalence-adjusted bias-adjusted κ was 0.76. This study provides evidence that a non-radiologist can accurately and reliably identify FAI on plain films.

Role of Nrf2 signal pathway in rats with deep hypothermia ischemia/reperfusion injury undergoing remote postconditioning.

We investigated the protective effects of remote postconditioning (RPC) in the lungs of rats with deep hypothermia ischemia/reperfusion (I/R) injury and the role of nuclear factor E2-related factor 2 (Nrf2) signaling in this process. Forty-nine rats were randomly divided into a sham control group, deep hypothermia I/R group, RPC group, I/R+all-trans retinoic acid (ATRA) group, I/R+RPC+ATRA group, I/R+tert-butylhydroquinone (tBHQ) group, and I/R+RPC+tBHQ group. Real-time polymerase chain reaction and Western blot analysis were used to examine Nrf2 mRNA and protein expression, respectively. Compared with the sham control group, Nrf2 expression, malondialdehyde (MDA) content, and the wet/dry weight (W/D) ratio were significantly increased in the I/R group, while superoxide dismutase (SOD) activity was significantly decreased. Pulmonary Nrf2 expression and SOD activity was significantly increased, and MDA content and the W/D ratio were significantly decreased in the RPC group compared with the I/R group. Compared with the I/R group, MDA and W/D ratio significantly decreased and SOD activity remarkably increased in I/R+tBHQ group. After ATRA intervention in the I/R+ATRA group, MDA content and W/D ratio increased and SOD activity decreased compared to the I/R group. MDA content and W/D ratio in the RPC+tBHQ group significantly decreased and SOD activity increased compared with in the RPC group (P < 0.01). In the RPC+ATRA group, MDA content and W/D ratio decreased while SOD activity increased compared with the RPC group (P < 0.01). RPC alleviated deep hypothermia I/R injury; the Nrf2 signaling pathway may be involved in the protective effects induced by RPC.

Genetic expression and functional characterization of the RUNX2 gene in human adult bone marrow mesenchymal stem cells.

Past studies have revealed the critical role of runt-related transcription factor 2 (RUNX2) in the proliferation and differentiation of mesenchymal stem cells (MSCs). This study therefore aimed to investigate the expression profile of the RUNX2 gene in human bone marrow MSCs and its biological characteristics. Bone marrow MSCs were separated from 12 patients who had received hip joint replacement surgery. After purification and culture, the MSCs were subjected to the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, flow cytometry, the alkaline phosphatase assay, reverse transcription polymerase chain reaction, and RUNX2 protein quantification. The cell growth curve, staining images, and information on the membrane antigens and the levels of RUNX2 mRNA and protein were obtained based on the results. The growth curve showed, after a 2-day lag period, cultured MSCs entered into the log phase between d3 (Day 3) and d6, when they reached a plateau. Flow cytometry data suggested 94.38% of MSCs were CD90-positive, while only 3.99 and 1.71% of total cells were positive for CD35 and CD45, respectively. With the elongated induction period, cultured MSCs were polygonal in shape. After a 14-day induction, cell fusion occurred in the center of the cell nodule accompanied by the disappearance of cellular structure to form the calcium nodule, which was stained red. There was also a statistically significant increase in the level of RUNX2 protein at d7 and d14. An osteogenic medium is required for the differentiation of adult MSCs, which is also under RUNX2 regulation. These findings are potentially valuable for clinical practice.

Exercise prescription after fragility fracture in older adults: a scoping review.

The purpose of this study is to identify and chart research literature on safety, efficacy, or effectiveness of exercise prescription following fracture in older adults. We conducted a systematic, research-user-informed, scoping review. The population of interest was adults aged ≥45 years with any fracture. "Exercise prescription" included post-fracture therapeutic exercise, physical activity, or rehabilitation interventions. Eligible designs included knowledge synthesis studies, primary interventional studies, and observational studies. Trained reviewers independently evaluated citations for inclusion. A total of 9,415 citations were reviewed with 134 citations (119 unique studies) identified: 13 knowledge syntheses, 95 randomized or controlled clinical trials, and 11 "other" designs, representing 74 articles on lower extremity fractures, 34 on upper extremity, eight on vertebral, and three on mixed body region fractures. Exercise prescription characteristics were often missing or poorly described. Six general categories emerged describing exercise prescription characteristics: timing post-fracture, person prescribing, program design, functional focus, exercise script parameters, and co-interventions. Upper extremity and ankle fracture studies focused on fracture healing or structural impairment outcomes, whereas hip fracture studies focused more on activity limitation outcomes. The variety of different outcome measures used made pooling or comparison of outcomes difficult. There was insufficient information to identify evidence-informed parameters for safe and effective exercise prescription for older adults following fracture. Key gaps in the literature include limited numbers of studies on exercise prescription following vertebral fracture, poor delineation of effectiveness of different strategies for early post-fracture mobilization following upper extremity fracture, and inconsistent details of exercise prescription characteristics after lower extremity fracture.

Everyday ethics and help-seeking in early rheumatoid arthritis.

BACKGROUND: Sociological understandings of chronic illness have revealed tensions and complexities around help-seeking. Although ethics underpins healthcare, its application in the area of chronic illness is limited. Here we apply an ethical framework to interview accounts and identify ethical challenges in the early rheumatoid arthritis (RA) experience. METHODS: In-depth interviews were conducted with eight participants who had been diagnosed with RA in the 12 months prior to recruitment. Applying the concepts of autonomous decision-making and procedural justice highlighted ethical concerns which arose throughout the help-seeking process. Analysis was based on the constant-comparison approach. RESULTS: Individuals described decision-making, illness actions and the medical encounter. The process was complicated by inadequate knowledge about symptoms, common-sense understandings about the GP appointment, difficulties concerning access to specialists, and patient-practitioner interactions. Autonomous decision-making and procedural justice were compromised. The accounts revealed contradictions between the policy ideals of active self-management, patient-centred care and shared decision-making, and the everyday experiences of individuals. CONCLUSIONS: For ethical healthcare there is a need for: public knowledge about early RA symptoms; more effective patient-practitioner communication; and increased support during the wait between primary and secondary care. Healthcare facilities and the government may consider different models to deliver services to people requiring rheumatology consults.

Strontium borate glass: potential biomaterial for bone regeneration.

Boron plays important roles in many life processes including embryogenesis, bone growth and maintenance, immune function and psychomotor skills. Thus, the delivery of boron by the degradation of borate glass is of special interest in biomedical applications. However, the cytotoxicity of borate glass which arises with the rapid release of boron has to be carefully considered. In this study, it was found that the incorporation of strontium into borate glass can not only moderate the rapid release of boron, but also induce the adhesion of osteoblast-like cells, SaOS-2, thus significantly increasing the cyto-compatibility of borate glass. The formation of multilayers of apatite with porous structure indicates that complete degradation is optimistic, and the spread of SaOS-2 covered by apatite to form a sandwich structure may induce bone-like tissue formation at earlier stages. Therefore, such novel strontium-incorporated borosilicate may act as a new generation of biomaterial for bone regeneration, which not only renders boron as a nutritious element for bone health, but also delivers strontium to stimulate formation of new bones.

ß-induced Alfvén eigenmodes destabilized by energetic electrons in a Tokamak plasma.

The ß-induced Alfvén eigenmode (BAE) excited by energetic electrons has been identified for the first time both in the Ohmic and electron cyclotron resonance heating plasma in HL-2A. The features of the instability, including its frequency, mode number, and propagation direction, can be observed by magnetic pickup probes. The mode frequency is comparable to that of the continuum accumulation point of the lowest frequency gap induced by the shear Alfvén continuous spectrum due to finite ß effect, and it is proportional to Alfvén velocity at thermal ion ß held constant. The experimental results show that the BAE is related not only with the population of the energetic electrons, but also their energy and pitch angles. The results indicate that the barely circulating and deeply trapped electrons play an important role in the mode excitation.

Rehabilitation in rheumatoid arthritis and ankylosing spondylitis: differences and similarities.

The aim of the paper is to summarize and compare the best available evidence concerning the effectiveness of rehabilitative interventions and provide an overview of recommendations or international guidelines on non-pharmacological treatments in rheumatoid arthritis (RA) and ankylosing spondylitis (AS).It was found that, compared to RA, there are relatively fewer non-pharmacological intervention studies in AS. Overall, the literature on the effectiveness of non-pharmacological treatment modalities in RA and AS supports the use of exercise and educational interventions with a cognitive behavioural component. The evidence on electro-physical modalities, balneotherapy, and dietary interventions and alternative or complementary interventions for managing RA and AS is generally weak or inconclusive.International practice guidelines on RA and AS management recommend non-pharmacological interventions as adjunctive interventions to medications.Areas for future research include non-pharmacological interventions in AS, studies on the effectiveness and costs of various health care delivery models, and the usage of alternative or complementary treatments.

Correlated electric fluctuations in GaN nanowire devices.

We report an experimental study on the correlation spectrums between different sections of a multi-contact GaN nanowire device. Our results indicate that there exists a negative correlation between the voltage fluctuations of adjacent sections of the nanowire separated by a metal contact in the transition region between the low-frequency 1/f noise and the high-frequency white thermal noise. We suggest that this correlation is caused by the voltage fluctuation under the contact area.