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1.
Talanta ; 206: 120194, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31514904

RESUMO

Phthalate esters (PAEs), a category of widely used plasticizers, are tend to migrate from plastic packaging to drinks. In this paper, we develop a simple and rapid coprecipitation method for synthesis of a magnetic covalent organic framework (COF) adsorbent. The fabricated COF-(TpBD)/Fe3O4 was applied to magnetic solid phase extraction (MSPE) of 15 phthalate esters (PAEs) for subsequent GC-MS/MS determination in beverage samples. The as-synthesized magnetic adsorbent exhibited great potential in PAEs analysis with a limit of detection of 15 PAEs ranged from 0.005 to 2.748 µg L-1 (S/N = 3). The intra-day and inter-day relative standard deviations (RSD) value of the PAEs were less than 8.8% and 9.9%, respectively. The adsorbent can be reused after washing with methanol. The developed method was successfully applied for the determination of trace PAEs in eight beverages with recoveries ranging from 79.3% to 121.8% and RSDs were less than 11.9%. This work provides a simple magnetization process, which facilitates the application of COFs for enrichment and separation of PAEs in beverages with different matrices.

2.
Biomolecules ; 9(11)2019 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-31684108

RESUMO

Human high-mobility group A2 (HMGA2) encodes for a non-histone chromatin protein which influences a variety of biological processes, including the cell cycle process, apoptosis, the DNA damage repair process, and epithelial-mesenchymal transition. The accumulated evidence suggests that high expression of HMGA2 is related to tumor progression, poor prognosis, and a poor response to therapy. Thus, HMGA2 is an important molecular target for many types of malignancies. Our recent studies revealed the positive connections between heat shock protein 90 (Hsp90) and HMGA2 and that the Hsp90 inhibitor has therapeutic potential to inhibit HMGA2-triggered tumorigenesis. However, 43% of patients suffered visual disturbances in a phase I trial of the second-generation Hsp90 inhibitor, NVP-AUY922. To identify a specific inhibitor to target HMGA2, the Gene Expression Omnibus (GEO) database and the Library of Integrated Network-based Cellular Signatures (LINCS) L1000platform were both analyzed. We identified the approved small-molecule antifungal agent ciclopirox (CPX) as a novel potential inhibitor of HMGA2. In addition, CPX induces cytotoxicity of colorectal cancer (CRC) cells by induction of cell cycle arrest and apoptosis in vitro and in vivo through direct interaction with the AT-hook motif (a small DNA-binding protein motif) of HMGA2. In conclusion, this study is the first to report that CPX is a novel potential inhibitor of HMGA2 using a drug-repurposing approach, which can provide a potential therapeutic intervention in CRC patients.

3.
Eur Radiol ; 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31712961

RESUMO

OBJECTIVE: To develop and evaluate the performance of U-Net for fully automated localization and segmentation of cervical tumors in magnetic resonance (MR) images and the robustness of extracting apparent diffusion coefficient (ADC) radiomics features. METHODS: This retrospective study involved analysis of MR images from 169 patients with cervical cancer stage IB-IVA captured; among them, diffusion-weighted (DW) images from 144 patients were used for training, and another 25 patients were recruited for testing. A U-Net convolutional network was developed to perform automated tumor segmentation. The manually delineated tumor region was used as the ground truth for comparison. Segmentation performance was assessed for various combinations of input sources for training. ADC radiomics were extracted and assessed using Pearson correlation. The reproducibility of the training was also assessed. RESULTS: Combining b0, b1000, and ADC images as a triple-channel input exhibited the highest learning efficacy in the training phase and had the highest accuracy in the testing dataset, with a dice coefficient of 0.82, sensitivity 0.89, and a positive predicted value 0.92. The first-order ADC radiomics parameters were significantly correlated between the manually contoured and fully automated segmentation methods (p < 0.05). Reproducibility between the first and second training iterations was high for the first-order radiomics parameters (intraclass correlation coefficient = 0.70-0.99). CONCLUSION: U-Net-based deep learning can perform accurate localization and segmentation of cervical cancer in DW MR images. First-order radiomics features extracted from whole tumor volume demonstrate the potential robustness for longitudinal monitoring of tumor responses in broad clinical settings. U-Net-based deep learning can perform accurate localization and segmentation of cervical cancer in DW MR images. KEY POINTS: • U-Net-based deep learning can perform accurate fully automated localization and segmentation of cervical cancer in diffusion-weighted MR images. • Combining b0, b1000, and apparent diffusion coefficient (ADC) images exhibited the highest accuracy in fully automated localization. • First-order radiomics feature extraction from whole tumor volume was robust and could thus potentially be used for longitudinal monitoring of treatment responses.

4.
Sci Total Environ ; 699: 134380, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31678878

RESUMO

The oral health of preschool children in an electronic waste (e-waste) area is susceptible to lead (Pb) exposure increasing the risk of dental caries and causing periodontitis and other oral diseases. The aim of the present study is to investigate the relationship between chronic exposure to Pb and oral anti-inflammatory potential of preschool children. For this analysis, 574 preschool children from 2.5 to 6 years of age were recruited between November and December 2017, in which 357 preschool children were from Guiyu (n = 357), an e-waste-contaminated town, and 217 from Haojiang Shantou. We measured the levels of child blood Pb, salivary sialic acid, serum interleukin-6 (IL-6) and serum tumor necrosis factor-α (TNF-α), and investigated the prevalence of dental caries in deciduous teeth. The medians of blood Pb levels, serum IL-6 and TNF-α were significantly higher in the Guiyu children than in Haojiang children. Concomitantly, salivary sialic acids were lower in the Guiyu children [9.58 (3.97, 18.42) mg/dL] than in Haojiang [17.57 (5.95, 24.23) mg/dL]. Additionally, the prevalence of dental caries in deciduous teeth was significantly higher in the Guiyu children than in Haojiang (62.5% vs. 53.9%). Blood Pb levels were negatively correlated with salivary sialic acids, in which IL-6 played as a mediator of the association between blood Pb levels and saliva sialic acid concentrations according to the mediation model. To our knowledge, this is the first report on the potential association between chronic Pb exposure and the anti-inflammatory ability of oral sialic acids among preschool children. These results suggest that the chronic Pb exposure can reduce salivary sialic acid levels, attenuate oral anti-inflammatory potential and increase the potential risk of dental caries in deciduous teeth among preschool children in an e-waste site.

5.
J Neural Eng ; 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31689695

RESUMO

OBJECTIVE: Understanding how current reaches the brain during transcranial Electrical Stimulation (tES) underpins efforts to rationalize outcomes and optimize interventions. To this end, computational models of current flow relate applied dose to brain electric field. Conventional tES modeling considers distinct tissues like scalp, skull, cerebrospinal fluid (CSF), gray matter and white matter. The properties of highly conductive CSF are especially important. However, modeling the space between skull and brain as entirely CSF is not an accurate representation of anatomy. The space conventionally modeled as CSF is approximately half meninges (dura, arachnoid, and pia) with lower conductivity. However, the resolution required to describe individual meningeal layers is computationally restrictive in an MRI-derived head model. Emulating the effect of meninges through CSF conductivity modification could improve accuracy with minimal cost. APPROACH: Models with meningeal layers were developed in a concentric sphere head model. Then, in a model with only CSF between skull and brain, CSF conductivity was optimized to emulate the effect of meningeal layers on cortical electric field for multiple electrode positions. This emulated conductivity was applied to MRI-derived models. MAIN RESULTS: Compared to a model with conventional CSF conductivity (1.65 S/m), emulated CSF conductivity (0.85 S/m) produced voltage fields better correlated with intracranial recordings from epilepsy patients. SIGNIFICANCE: Conventional tES models have been validated using intracranial recording. Residual errors may nonetheless impact model utility. Because CSF is so conductive to current flow, misrepresentation of the skull-brain interface as entirely CSF is not realistic for tES modeling. Updating the conventional model with a CSF conductivity emulating the effect of the meninges enhances modeling accuracy without increasing model complexity. This allows existing modeling pipelines to be leveraged with a simple conductivity change. Using 0.85 S/m emulated CSF conductivity is recommended as the new standard in non-invasive brain stimulation modeling.

6.
Math Biosci Eng ; 16(6): 7829-7838, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31698642

RESUMO

Adjacent segment disease (ASD) is one of the potential risks after lumbar spine surgery with instrumentation. Revision surgery needs to be performed on patients suffered from ASD. The traditional open surgery takes severe injury to the body. We investigated the clinical outcome of using full-endoscopic transforaminal procedure to treat the single-level adjacent segment diseases after posterior lumbar fusion. 33 patients (average 71 years, ranged 65-84 years old) underwent full-endoscopic transforaminal procedure were involved. The Oswestry Disability Index (ODI), Modified Japanese Orthopedic Association (mJOA) score and visual analogue scale (VAS) score were used to evaluate the clinical effect. The complication, hospital stay, hospitalization costs and blood loss were investigated according to the patient's records. The mean VAS score was 1.8 and mJOA score was 5.4 postoperatively. Improvement rate was 78%. The mean ODI was 14.6 postoperatively. The mean length of hospital stay, hospitalization costs and blood loss was 2.5 days, $3500 and 15 mL, respectively. No complication or recurrence was observed in any of the patients at the final follow-up. Full-endoscopic transforaminal procedure is a safe and effective technique. It is economical, acceptable and mini-invasive. Of course, it also can shorten the length of hospital stay and decrease bleeding. For revision surgery to treat ASD, this technique can achieve good clinical effects.

7.
Arthroscopy ; 35(11): 3117-3131.e2, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31699265

RESUMO

PURPOSE: To investigate the functional improvement and pain reduction of different nonsurgical treatments for patellar tendinopathy (PT), a systematic review with network meta-analysis was performed. METHODS: Studies were comprehensively searched for without language restrictions in the CENTRAL, MEDLINE, EMBASE, Web of Science, Physiotherapy Evidence Database, and SPORTDiscus databases from inception to May 2018. Randomized controlled trials about nonsurgical treatments for PT were included. The outcome measurements were the Victorian Institute of Sports Assessment (VISA) scale and pain scores (such as the visual analog scale or Numerical Rating Scale). Study quality was evaluated using the Physiotherapy Evidence Database score. Direct comparisons were performed using pairwise meta-analysis, whereas network meta-analysis was performed using a frequentist method in a multivariate random-effects model. RESULTS: Eleven studies with 430 affected patellar tendons were included in the systematic review. The summary mean difference of improvement in the VISA scale versus the control group for corticosteroid injection was -23.00 (95% confidence interval [CI] -36.73 to -9.27), for leukocyte-rich platelet-rich plasma (LR-PRP) was 13.22 (95% CI 2.37-24.07), for focused extracorporeal shockwave therapy (ESWT) was -1.28 (95% CI -6.25 to 3.68), for radial ESWT was -6.68 (95% CI -20.20 to 6.84), for ultrasound was -0.70 (95% CI -11.23 to 9.83), for autologous blood injection was -0.60 (95% CI -9.30 to 8.10), for dry needling was 17.51 (95% CI -2.57 to 37.60), for topical glyceryl trinitrate was -0.90 (95% CI -13.07 to 11.27), and for skin-derived tendon-like cells was 10.40 (95% CI -1.59 to 22.39). LR-PRP (Surface Under the Cumulative Ranking curve [SUCRA] = 87.5%) or dry needling (SUCRA = 90.5%) was most likely to be ranked the best in terms of improvement on the VISA scale. Compared with the control group, the summary mean difference of the change in pain score for corticosteroid injection was 0.80 (95% CI -3.48 to 5.08), for LR-PRP was -1.87 (95% CI -3.28 to -0.46), for focused ESWT was 0.13 (95% CI -0.68 to 0.93), for radial ESWT was 0.03 (95% CI -1.92 to 1.98), for ultrasound was -0.20 (95% CI -1.49 to 1.09), for autologous blood injection was 0.60 (95% CI -0.73 to 1.93), for dry needling was -0.37 (95% CI -2.71 to 1.97), and for topical glyceryl trinitrate was -0.50 (95% CI -2.55 to 1.55). The treatment most likely to be ranked the best in terms of change in pain score was LR-PRP (SUCRA = 94.9%). CONCLUSIONS: The network meta-analysis demonstrated that LR-PRP has the greatest functional improvement and pain reduction for PT compared with other treatment options. However, the treatment effect estimates can be biased by the possible intransitivity and should not be overestimated. LEVEL OF EVIDENCE: Level I, meta-analysis of Level I studies.

8.
Health Policy ; 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31699446

RESUMO

Reducing low-value care is a top priority in health care. However, how prospective payment methods such as diagnosis-related group (DRG) payment scheme reduce the use of low-value services is unclear. This study aimed to assess frequency of low-value preoperative testing services among surgical inpatients over time and to investigate whether the 2010 Tw-DRG policy has reduced utilization of these services under the National Health Insurance program in Taiwan. The nationwide National Health Insurance claims data in Taiwan from 2008 to 2013 were used. The difference-in-differences (DID) method was adopted. Utilization of three low-value preoperative testing services (chest x-ray, echocardiogram, and stress testing) were assessed. The prevalence of the three preoperative tests ranged from 0.13 per 100 admissions (preoperative stress testing) to 78.12 per 100 admissions (preoperative chest x-ray). Following the implementation of the Tw-DRG policy, the predicted probability of low-value care use was significantly reduced from 67.91% to 64.93% in the DRG group but remained relatively stable in the comparison group (from 69.44% to 68.43%) in 2010. The use of three selected preoperative tests had only a minor temporary reduction in 2010, but later increased over time. The 2010 Tw-DRG policy did not significantly moderate the growth of low-value preoperative use. Hospital financial incentives alone may be insufficient for reducing the provision of low-value care.

9.
J Acoust Soc Am ; 146(4): 2619, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31671976

RESUMO

This study modeled the circular diaphragm of push-pull electrostatic speakers using electro-mechano-acoustical equivalent circuits to determine the frequency responses related to the average displacement and sound pressure of the diaphragm with respect to acoustic impedance effects. A laser vibrometer system was used to measure the displacement in the center of the circular diaphragms (60 mm and 65 mm in diameter) in optically transparent indium tin oxide (ITO) electrostatic speakers. The sound pressure levels (SPLs) were predicted using the average displacement of the diaphragm without resorting to sound field measurements or finite element analysis. The predicted SPL results were then compared to acoustic measurements. The results demonstrate that ITO plates are a practical tool for the measurement of displacement and the prediction of SPLs. When the proposed electrostatic speaker (65-mm-diameter diaphragm) design was applied to the over-ear electrostatic headphone, the SPL curve obtained from artificial ear measurements was similar to the preferred target curve of Harman International (Stamford, CT). This resulted in outstanding sound quality comparable to that of high-end commercial dynamic headphones.

10.
ISA Trans ; 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31733891

RESUMO

In quasi-static or static environments, generating secret key from wireless channels is bad randomness and vulnerable to active attacks. To improve randomness of the generated secret key, singular value decomposition (SVD) techniques are used to construct equivalent wireless channels in multiple-input multiple-output (MIMO) systems. SVD techniques and private pilot are used to detect active attacks by authenticating sender based on wireless channels. To defend passive eavesdropping and active attacks, the concept of one time pad is used to encrypt wireless channels with private pilot. The proposed SKG scheme based on private pilot and SVD techniques can not only detect whether SKG suffers active attacks, but also defend man-in-the-middle attack, impersonation attack, signal injection attack, passive eavesdropping. What is more, the SKG scheme can obtain higher SKG rate and randomness than the approach via random beam-forming. Theoretical analysis and simulation results prove the above results again.

11.
Ann Hematol ; 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31758262

RESUMO

Primary central nervous system lymphoma (PCNSL) is a rare form of extranodal non-Hodgkin's lymphoma and a limited number of cases have been reported from China. This study aimed to investigate the clinicopathological features of newly diagnosed PCNSLs from a single center in eastern China and to identify the potential prognostic factors for overall survival (OS) and progression-free survival (PFS). All consecutive patients with histopathologically diagnosed PCNSLs at our center between January 2003 and October 2017 were recruited. Demographic and clinicopathological data were collected and reviewed retrospectively. The potential risk factors for OS and PFS were identified using the log-rank test and Cox regression analysis. A total of 167 immunocompetent cases were enrolled. The median age was 58 years (range 17-96 years), and the male:female ratio was 3:2. Headache (n = 65; 39%) and cerebral hemisphere (n = 96; 57%) were the most common presenting complaint and location, respectively. Out of 167 cases, 150 cases were diffuse large B cell lymphomas. With a median follow-up of 25 months (range 1-152 ), the median OS and PFS were 37 months (95% CI, 25-49) and 17 months (95% CI, 13-20), respectively. Residual tumor after operation, chemotherapy without HD-MTX and palliative treatment was revealed as independent prognostic markers. Moreover, ECOG > 3, multifocal lesions, and palliative treatment were revealed as unfavorable independent prognostic markers for PFS. In conclusion, Chinese patients with PCNSL have distinct characteristics. Further studies are warranted to confirm the prognostic value of these factors and to optimize treatments for these patients.

12.
Chin Med J (Engl) ; 132(22): 2684-2689, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31725446

RESUMO

BACKGROUND: Due to the different treatments for low-volume metastatic prostate cancer (PCa) as well as high-volume ones, evaluation of bone metastatic status is clinically significant. In this study, we evaluated the correlation between pre-treatment plasma fibrinogen and the burden of bone metastasis in newly diagnosed PCa patients. METHODS: A single-center retrospective analysis, focusing on prostate biopsies of newly diagnosed PCa patients, was performed. A total of 261 patients were enrolled in this study in a 4-year period. All subjects were submitted to single-photon emission computerized tomography-computed tomography to confirm the status of bone metastasis and, if present, the number of metastatic lesions would then be calculated. Clinical information such as age, prostate-specific antigen (PSA), fibrinogen, clinical T stage, and Gleason score were collected. Patients were divided into three groups: (i) a non-metastatic group, (ii) a high volume disease (HVD) group (>3 metastases with at least one lesion outside the spine), and (iii) a low volume disease (LVD) group (metastatic patients excluding HVD ones). The main statistical methods included non-parametric Mann-Whitney test, Spearman correlation, receiver operating characteristic (ROC) curves, and logistic regression. RESULTS: Fibrinogen positively correlated with Gleason score (r = 0.180, P = 0.003), PSA levels (r = 0.216, P < 0.001), and number of metastatic lesions (r = 0.296, P < 0.001). Compared with the non-metastatic and LVD groups, the HVD group showed the highest PSA (104.98 ng/mL, median) and fibrinogen levels (3.39 g/L, median), as well as the largest proportion of Gleason score >7 (86.8%). Both univariate (odds ratio [OR] = 2.16, 95% confidential interval [CI]: 1.536-3.038, P < 0.001) and multivariate (OR = 1.726, 95% CI: 1.206-2.472, P = 0.003) logistic regressions showed that fibrinogen was independently associated with HVD. The ROC curve suggested that fibrinogen acts as a predictor of HVD patients, yielding a cut-off of 3.08 g/L, with a sensitivity of 0.684 and a specificity of 0.760 (area under the curve = 0.739, 95% CI: 0.644-0.833, P < 0.001). CONCLUSIONS: Pre-treatment plasma fibrinogen is positively associated with bone metastatic burden in PCa patients. Our results indicate that fibrinogen might be a potential predictor of HVD.

13.
Artigo em Inglês | MEDLINE | ID: mdl-31708481

RESUMO

BACKGROUND/PURPOSE: This multicenter study aimed to evaluate the seroprevalence of hepatitis B virus (HBV) and the use of combination antiretroviral therapy (cART) among patients receiving HIV care in Taiwan. METHODS: We retrospectively reviewed the medical records of HIV-infected adult patients who initiated cART at 11 designated hospitals in Taiwan between 2012 and 2016. The clinical information collected included serological profiles on HBV, hepatitis C virus (HCV), and syphilis, plasma HIV RNA load, nadir CD4 cell count, and antiretrovirals with activity against both HBV and HIV (tenofovir disoproxil fumarate [TDF], lamivudine [LAM], and emtricitabine [FTC]). RESULTS: We analyzed 1800 HIV-infected patients; 1742 (96.8%) were male and 794 (44.1%) were born after July, 1986, when nationwide universal neonatal HBV vaccination was implemented. HBsAg positive results were 11.6% (209/1800), which decreased significantly from 18.1% (182/1006) in those born before July 1986 to 3.4% (27/794) in those born after. In multivariable analysis, HBsAg positivity was significantly associated with age (adjusted odds ratio [aOR] 1.06, 95% confidence interval [CI] 1.05-1.08), CD4≧200 cells/µL (aOR 0.73, 95% CI 0.53-0.99), and HCV seropositivity (aOR 1.62, 95% CI 1.06-2.50). Of 209 HBV/HIV-coinfected patients, 31.1% started cART containing only LAM with anti-HBV activity, while 68.9% started cART containing TDF plus LAM or coformulated TDF/FTC. CONCLUSIONS: The overall prevalence of HBV/HIV coinfection remained high among HIV-infected patients in Taiwan. Despite recommendations of the HIV treatment guidelines for the management of HBV infection, a substantial proportion of HIV/HBV-coinfected patients received cART containing only LAM for HBV infection.

14.
iScience ; 21: 490-498, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31707261

RESUMO

The direct functionalization of C(sp3)-H bonds has led to the development of methods to access molecules or intermediates from basic chemicals in an atom- and step-economic fashion. Nevertheless, achieving high levels of chemo-, regio-, and enantioselectivity in these reactions remains challenging due to the ubiquity and low reactivity of C(sp3)-H bonds. Herein, we report an unprecedented protocol for enantioselective cyanation of remote C(sp3)-H bonds. With chiral Box-Cu complex as the catalyst, the reaction of N-fluorosulfonamide furnishes the corresponding products in excellent yields and high enantiomeric excess (ee) under mild reaction conditions. A radical relay pathway involving 1,5-hydrogen atom transfer (1,5-HAT) of N-center radicals followed by enantioselective cyanation of the in situ-formed benzyl radicals is proposed. This enantioselective copper-catalyzed cyanation thus offers insights into an efficient way for the synthesis of bioactive molecules for drug discovery.

15.
Water Sci Technol ; 80(5): 989-997, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31746806

RESUMO

As a kind of earth-abundant and cheap natural clay mineral, palygorskite (Pal) was facilely modified by grafting with graphene oxide (GO) to fabricate GO/Pal composites for rapid removal of Pb(II) from aqueous solutions. The results of characterization confirmed that the GO/Pal composites were successfully grafted between GO sheets and Pal nanorods. The effects of pH, adsorbent dosage, adsorption time, initial Pb(II) concentration and temperature on the adsorption of Pb(II) onto the GO/Pal composites as adsorbents were systematically investigated. The maximum adsorption capacity over 106.6 mg/g was obtained within a short adsorption time of less than 1 h even at 298.15 K. The adsorption of Pb(II) was a fast process that more accurately followed the pseudo-second-order kinetic equation. This process also could be described better with the Langmuir equation model than the Freundlich model. The negative values of ΔG° and the positive values of ΔH° and ΔS° indicated that it was a spontaneous, endothermic and entropy-increasing adsorption process. Compared with pristine Pal and GO powders, such the GO/Pal composites as a cost-efficient and eco-friendly adsorbents could significantly improve the adsorption properties of Pb(II) and would have potential application in the industrial wastewater treatment for rapid removal of Pb(II).


Assuntos
Grafite , Poluentes Químicos da Água , Purificação da Água , Adsorção , Concentração de Íons de Hidrogênio , Cinética , Chumbo , Compostos de Magnésio , Óxidos , Compostos de Silício , Soluções
16.
Nutrients ; 11(11)2019 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-31752391

RESUMO

The triglyceride-glucose (TyG) index has been correlated with insulin resistance. We aim to investigate the role of the TyG index on cardiovascular (CV) events in type 2 diabetes mellitus and compare the roles of fasting glucose, hemoglobin A1c, and the TyG index in predicting CV events. This retrospective study enrolled 3524 patients with type 2 diabetes from the Kaohsiung Medical University Research Database in 2009 in this longitudinal study and followed them until 2015. The TyG index was calculated as log (fasting triglyceride level (mg/dL) × fasting glucose level (mg/dL)/2). CV events included myocardial infarction, unstable angina, stroke, hospitalization for coronary artery disease, peripheral artery disease, and CV-related death. The association between variables and CV events was assessed using a multivariable stepwise Cox proportional hazard analysis. Two hundred and fifteen CV events (6.1%) were recorded during a follow-up period of 5.93 years. The multivariable stepwise analysis showed that high fasting glucose (HR, 1.007; p < 0.001) and a high TyG index (HR, 1.521; p = 0.004) but not hemoglobin A1c or triglycerides were associated with a higher rate of CV events. Adding fasting glucose and the TyG index to the basic model improved the predictive ability of progression to a CV event (p < 0.001 and p = 0.018, respectively), over that of hemoglobin A1c (p = 0.084) and triglyceride (p = 0.221). Fasting glucose and the TyG index are useful parameters and stronger predictive factors than hemoglobin A1c and triglyceride for CV events and may offer an additional prognostic benefit in patients with type 2 diabetes.

17.
Sci Rep ; 9(1): 16595, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31719551

RESUMO

Using two advanced sequencing approaches, Illumina and PacBio, we derive the entire Dscam gene from an M2 assembly of the complete Penaeus monodon genome. The P. monodon Dscam (PmDscam) gene is ~266 kbp, with a total of 44 exons, 5 of which are subject to alternative splicing. PmDscam has a conserved architectural structure consisting of an extracellular region with hypervariable Ig domains, a transmembrane domain, and a cytoplasmic tail. We show that, contrary to a previous report, there are in fact 26, 81 and 26 alternative exons in N-terminal Ig2, N-terminal Ig3 and the entirety of Ig7, respectively. We also identified two alternatively spliced exons in the cytoplasmic tail, with transmembrane domains in exon variants 32.1 and 32.2, and stop codons in exon variants 44.1 and 44.2. This means that alternative splicing is involved in the selection of the stop codon. There are also 7 non-constitutive cytoplasmic tail exons that can either be included or skipped. Alternative splicing and the non-constitutive exons together produce more than 21 million isoform combinations from one PmDscam locus in the P. monodon gene. A public-facing database that allows BLAST searches of all 175 exons in the PmDscam gene has been established at http://pmdscam.dbbs.ncku.edu.tw/ .

18.
Artigo em Inglês | MEDLINE | ID: mdl-31677603

RESUMO

CONTEXT: The impact of mild TSH elevation (2.5-4.08 mIU/L) on pregnancy outcomes is unclear. The treatment strategy for mild TSH elevation is dependent on TPOAb status according to the guidelines. OBJECTIVE: To assess the effects of mild thyroid dysfunction combined with TPOAb status in the 1st trimester on pregnancy outcomes and the impact of L-T4 treatment on pregnancy outcomes. DESIGN: The study retrospectively evaluated 3562 pregnant women. A total of 3296 untreated women were divided into four subgroups: Group A: 4.08

20.
J Foot Ankle Surg ; 58(6): 1273-1275, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31679680

RESUMO

Replantation of the lower leg has controversial indications, but it may be considered in carefully selected patients. Although the function of prosthetic lower legs has been improved in recent decades, leg salvage remains a laudable goal. We present the case of a 7-year-old child who sustained a traumatic amputation at the level of the middle tibia with loss of the middle portion of the lower leg. We performed successful replantation, and tibia lengthening was performed starting 10 days after replantation and lasted 6 months.

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