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NAFLD is common after liver transplantation (LT) and is associated with an increased metabolic burden. Currently, there is a paucity of investigations into the treatment of post-LT NAFLD. In the present study, we evaluated the safety and efficacy of saroglitazar, a novel dual peroxisome proliferator-associated receptor α/γ agonist, on the treatment of post-LT NAFLD and metabolic burden. This is a phase 2A, single-center, open-label, single-arm study in which patients with post-LT NAFLD received saroglitazar magnesium 4 mg daily for 24 weeks. NAFLD was defined by a controlled attenuation parameter ≥264 dB/m. The primary endpoint was the reduction in liver fat as measured by MRI proton density fat fraction (MRI-PDFF). Secondary MRI-based metabolic endpoints included visceral adipose tissue, abdominal subcutaneous adipose tissue volumes, muscle fat infiltration, and fat-free muscle volume. Saroglitazar treatment led to a reduction in MRI-PDFF from 10.3±10.5% at baseline to 8.1±7.6%. A relative 30% reduction from baseline MRI-PDFF value was noted in 47% of all patients and 63% of patients with baseline MRI-PDFF >5%. Reduction in serum alkaline phosphatase was an independent predictor of MRI-PDFF response. Saroglitazar did not decrease fat-free muscle volume nor increase muscle fat infiltration, but did lead to a mild increase in visceral adipose tissue and abdominal subcutaneous adipose tissue. The study drug was well tolerated and a mild nonsignificant increase in serum creatinine was noted. Saroglitazar did not affect the weight. The study provides preliminary data demonstrating the safety and metabolic benefits of saroglitazar in LT recipients and underscores the importance of future studies to establish its efficacy after LT.
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Transplante de Fígado , Hepatopatia Gordurosa não Alcoólica , Fenilpropionatos , Humanos , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Transplante de Fígado/efeitos adversos , Fígado/diagnóstico por imagem , Fenilpropionatos/uso terapêutico , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: The prevalence of overweight and obesity (OW/OB) has increased rapidly in Vietnam. This study aimed to elucidate the factors influencing OW/OB among secondary schoolchildren. METHOD: A survey was conducted in January 2014 in four randomly selected state schools in two Hanoi urban districts, and 821 students in grade six (11-12 years old) participated. Definitions of OW/OB followed the World Health Organization standard cut-offs. RESULTS: Overall, 4.1% of children were underweight, 59.7% were normal weight, 17.1% were overweight, and 19.1% were obese. The odds of OW/OB were lowest among children whose parents had college/university degrees [father (aOR =0.65, 95% CI: 0.42-1.00); mother (aOR =0.63, 95% CI: 0.41-0.97)] compared with those whose parents had only a primary education. Children with an OW/OB family history had an increased risk of OW/OB. Other associated factors include parental OW/OB and birth weight (BW). The odds of OW/OB were highest among children with parents with OW/OB [father (aOR =2.022, 95% CI: 1.34-3.04); mother (aOR =2.83, 95% CI: 1.51-5.30)] compared with those with normal-weight parents. Children with both parents having OW/OB [both parents (aOR =6.59, 95% CI: 1.28-33.87) had the highest risk, followed by one parent (aOR =2.22, 95% CI: 1.50-3.27)] and then neither parent having OW/OB. Moreover, high-birth-weight children [BW ≥ 3500 g (aOR =1.52, 95% CI: 1.07-2.15)] had greater odds than did normal-birth-weight children. Children who slept 11 h per day [8-11 h (aOR =0.57, 95% CI: 0.40-0.81) or more (aOR =0.44, 95% CI: 0.22-0.87)] had lower OW/OB odds than those who slept 8 h or less. Children with specific positive lifestyle behaviours had lower risk of OW/OB than those who did not engage in positive lifestyle behaviours. The odds were lower among children who exercised for weight reduction (OR = 0.16, 95% CI: 0.11-0.23), lowered food intake (aOR = 0.12, 95% CI: 0.09-0.17), and added vegetables to their diet (aOR = 0.26, 95% CI: 0.19-0.35). CONCLUSION: The results suggest that parents and children with OW/OB parents or a high BW should be educated to prevent OW/OB at an early stage. Positive lifestyle behaviours should be adopted by the students.
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Obesidade Infantil/epidemiologia , Estudantes/estatística & dados numéricos , Peso ao Nascer , Criança , Dieta/efeitos adversos , Dieta/estatística & dados numéricos , Feminino , Humanos , Estilo de Vida , Masculino , Pais , Obesidade Infantil/etiologia , Prevalência , Fatores de Risco , Instituições Acadêmicas , Sono , Inquéritos e Questionários , Vietnã/epidemiologiaRESUMO
This paper addresses the problem of mapping high-dimensional data to a low-dimensional space, in the presence of other known features. This problem is ubiquitous in science and engineering as there are often controllable/measurable features in most applications. To solve this problem, this paper proposes a broad class of methods, which is referred to as conditional multidimensional scaling (MDS). An algorithm for optimizing the objective function of conditional MDS is also developed. The convergence of this algorithm is proven under mild assumptions. Conditional MDS is illustrated with kinship terms, facial expressions, textile fabrics, car-brand perception, and cylinder machining examples. These examples demonstrate the advantages of conditional MDS over conventional dimension reduction in improving the estimation quality of the reduced-dimension space and simplifying visualization and knowledge discovery tasks. Computer codes for this work are available in the open-source cml R package.
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BACKGROUND: Loss of skeletal muscle can be accompanied by an increase in adipose tissue leading to sarcopenic obesity. There are limited data on how liver transplantation (LT) might impact adipose tissue compartments, particularly among patients with metabolically active disease, such as nonalcoholic steatohepatitis (NASH) and subsequent metabolic sequela. METHODS: Skeletal muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured using cross-sectional imaging performed in 190 patients pre-LT, 6 mo post-LT and 12 mo post-LT. Changes in adipose tissue and their impact on metabolic diseases were determined in patients transplanted for NASH versus non-NASH. RESULTS: Skeletal muscle, VAT, and SAT were similar in patients with NASH and non-NASH pre-LT despite a higher burden of metabolic diseases in patients with NASH. Following LT, no significant differences between skeletal muscle and SAT were observed in the entire cohort and among patients with NASH (versus non-NASH). LT recipients with the highest muscle mass pre-LT were at the greatest risk for muscle loss post-LT. A time-dependent increase in VAT was noted post-LT, which was more robust among patients with a history of NASH cirrhosis. In adjusted multivariate analysis, NASH versus non-NASH was a strong predictor of post-LT increase in VAT (ß-coefficient 3.00, P = 0.04). Pre-LT VAT was an independent predictor of post-LT serum triglycerides (ß-coefficient 5.49 ± 2.78, P = 0.05) and low-density lipoprotein cholesterol (ß-coefficient 1.80 ± 0.75, P = 0.02). A trend between pre-LT VAT and diabetes was noted but did not reach statistical significance. CONCLUSIONS: VAT but not SAT increases rapidly after LT, especially among patients transplanted for NASH cirrhosis and predicts future metabolic burden.
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Diabetes Mellitus , Transplante de Fígado , Hepatopatia Gordurosa não Alcoólica , Humanos , Transplante de Fígado/efeitos adversos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/cirurgia , Diabetes Mellitus/patologia , Tecido Adiposo , Cirrose Hepática/diagnóstico , Cirrose Hepática/cirurgia , Cirrose Hepática/complicações , Progressão da Doença , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/metabolismoRESUMO
Transforaminal lumbar interbody fusion (TLIF) is a commonly used technique for treating lumbar degenerative diseases. In this study, we developed a fully computer-supported pipeline to predict both the cage height and the degree of lumbar lordosis subtraction from the pelvic incidence (PI-LL) after TLIF surgery, utilizing preoperative X-ray images. The automated pipeline comprised two primary stages. First, the pretrained BiLuNet deep learning model was employed to extract essential features from X-ray images. Subsequently, five machine learning algorithms were trained using a five-fold cross-validation technique on a dataset of 311 patients to identify the optimal models to predict interbody cage height and postoperative PI-LL. LASSO regression and support vector regression demonstrated superior performance in predicting interbody cage height and postoperative PI-LL, respectively. For cage height prediction, the root mean square error (RMSE) was calculated as 1.01, and the model achieved the highest accuracy at a height of 12 mm, with exact prediction achieved in 54.43% (43/79) of cases. In most of the remaining cases, the prediction error of the model was within 1 mm. Additionally, the model demonstrated satisfactory performance in predicting PI-LL, with an RMSE of 5.19 and an accuracy of 0.81 for PI-LL stratification. In conclusion, our results indicate that machine learning models can reliably predict interbody cage height and postoperative PI-LL.
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OBJECTIVE: In this systematic review, we summarized the indications for and outcomes of three main unilateral biportal endoscopic (UBE) approaches for the decompression of degenerative lumbar spinal stenosis (DLSS). METHODS: A comprehensive search of the literature was performed using Ovid Embase, PubMed, Web of Science, and Ovid's Cochrane Library. The following information was collected: surgical data; patients' scores on the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Macnab criteria; and surgical complications. RESULTS: In total, 23 articles comprising 7 retrospective comparative studies, 2 prospective comparative studies, 12 retrospectives case series, and 2 randomized controlled trials were selected for quantitative analysis. The interlaminar approach for central and bilateral lateral recess stenoses, contralateral approach for isolated lateral recess stenosis, and paraspinal approach for foraminal stenosis were used in 16, 2, and 4 studies, respectively. In one study, both interlaminar and contralateral approaches were used. L4-5 was the most common level decompressed using the interlaminar and contralateral approaches, whereas L5-S1 was the most common level decompressed using the paraspinal approach. All three approaches provided favorable clinical outcomes at the final follow-up, with considerable improvements in patients' VAS scores for leg pain (63.6-73.5%) and ODI scores (67.2-71%). The overall complication rate was <6%. CONCLUSIONS: The three approaches of UBE surgery are effective and safe for the decompression of various types of DLSS. In the future, long-term prospective studies and randomized control trials are warranted to explore this new technique further and to compare it with conventional surgical techniques.
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We investigate the impact of financing and legal obstacles on firm growth across different firm sizes before and after the global financial crisis (GFC). Using two enterprise surveys in Vietnam, we find firms facing higher financing obstacles have lower sales and employment growth. The smallest firms are the most adversely affected by financing obstacles. The legal obstacles impede the employment growth of SMEs more than large enterprises, which is attributable to the tendency of firms to avoid tall poppy syndrome and the scrutiny of tax officials. Furthermore, we find that the negative effects of financing obstacles on small firms' sales and employment growth reduce in the post-GFC period. We attribute it to a higher proportion of small firms being able to borrow from commercial banks after the financial crisis, partly due to the introduction of new policies supporting SMEs from the Vietnamese Government. Overall, our findings recommend to policymakers that improvement in access to finance is imperative for productivity increases and job creation for small and medium firms.
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This article investigates the effect of academic majors on entrepreneurial intentions of engineering and business students. The research model was established based on the extension of the theory of planned behavior (TPB) through combining the TPB model, perceived risks, academic majors and personalities of students. A sample of 1844 students from the four largest universities in engineering and business in Vietnam were surveyed. The main findings indicated that (i) the relationship in the TPB model was accepted except the effect of subjective norms on entrepreneurial intentions; (ii) perceived risks have negative impacts on perceived behavioral control; (iii) male engineering students have a higher entrepreneurial intentions than female students, but this result was not found in business students; (iv) engineering students have a higher entrepreneurial intentions than business students; (vi) there are no differences between the entrepreneurial intention of students coming from rural and urban areas. The study also contributes to some policy discussion to extend the current debate about the role of academic majors that students take in university in the entrepreneurial process as well as the importance of entrepreneurial students to society.
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Economic research is vital for creating more suitable policies to facilitate economic growth. Employing a combination of descriptive and Bayesian analyses, this paper investigates the research landscape of the economics discipline in Vietnam, in particular, the leading affiliations in the field and how these institutions compare to each other in terms of productivity, the number of lead authors, new authors and publications' journal impact factor. We also examine the differences in the authors' productivity based on their age and gender. The dataset extracted from the SSHPA database includes 1,444 articles. The findings show that among top producers of economic research in Vietnam, seven are universities, leaving only one representative of research institutes. These top producers account for 52% of research output among 178 institutes recorded in the database. We also find a correlation between a researcher's affiliation, sex, and scientific productivity in Vietnam's economic discipline. Overall, publications by male researchers outnumber those by female ones in most of the top affiliations. The findings also indicate that 40-44 is the age group with the highest scientific productivity. Researchers' collaboration, which is observed through co-authorship, is on the rise in all of the top eight economic research affiliations. However, the quality of current Vietnam's scientific works in the discipline is questionable. Therefore, it is suggested that in order to sustain scientific productivity, economic researchers might need to balance the quantity and quality of their contributions.
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43 people in 30 days before and after oral use of BELAF were studied. Results: blood red cell superocid dismistase (SOD) activation increased (691.7106.46 versus 984.23102.98 U/g Hb), white blood red cell glutathion peroxidase (GPx) and glutathion reductase (GR) had not any change obviously. The plasma total antioxidant state enhanced, MDA level decreased, ChE activetion enhanced. The study showed that BELAF could help to improve the state of antioxidation in blood red cell and in plasma of workers of chemical production