bluuebunny/crossref_metadata_2025 huggingface dataset:
Charging wireless sensor network security technology based on encryption algorithms and dynamic model
Authors: Li Yuanming , Guo Wei , Meng Xuejun , Xia Wen
Published: February 2020

With the popularization of the Internet, the related information technology is developing faster and faster, and the scale and complexity of the network are also increasing. Wireless networks cover all aspects of life, along with it, network security issues have gradually emerged. In recent years, network security vulnerabilities have been exposed continuously, from WiFi to Bluetooth, people gradually realize the security of wireless networks. The purpose of this article is to solve the existing security problems and study the operation process of RC4 and Advanced Encryption Standard algorithms, and the improvement scheme is put forward. This article is based on the inherent media access control address filtering technology of wireless network card; a dynamic security model for wireless networks is proposed and constructed. Devices accessing the network use 802.1x authentication method and distribute and set security status values for each device, the authentication server uses Remote Authentication Dial in User Service. This article uses the method of virtual private network encryption network to provide an encryption layer for communication between devices and wireless networks, thus, the data in network transmission can be encrypted and protected. In this article, the structure and strategy of Remote Authentication Dial in User Service are changed, in order to ensure the high security of wireless network equipment in the connection process. In the testing phase of this article, we have tested the model in detail several times. Tests are divided into middleman and session interception tests. A large number of test results show that this model can improve the security of wireless network and has good performance.
Dynamic reputation–based consensus mechanism: Real-time transactions for energy blockchain
Authors: Cai Wenjun , Jiang Wei , Xie Ke , Zhu Yan , Liu Yingli , Shen Tao
Published: February 2020

The energy blockchain is a distributed Internet protocol for energy transactions between nodes in power systems. The consensus algorithm is the core component of the energy blockchain and has an essential impact on its application. At present, in the implementation of the energy blockchain, there are problems such as low transaction throughput (transactions per second) and high latency, which cannot meet the application requirements of real-time processing transactions in the energy field. To this end, according to the analysis of conventional blockchain consensus algorithm and traditional practical Byzantine fault tolerance algorithm, a dynamic-reputation practical Byzantine fault tolerance algorithm for the energy blockchain is proposed. The dynamic-reputation practical Byzantine fault tolerance algorithm adopts a credit-based consortium node consensus election method. The monitoring node divides the remaining nodes into two types of nodes according to the reputation value: the consensus node and the secondary node, which, respectively, participate in different stages of the block generation process, and dynamically update the consensus nodes with low reputation ratings. By constructing the experimental platform simulation, the test results verify the effectiveness of the dynamic-reputation practical Byzantine fault tolerance algorithm. Compared with the algorithm of the fabric platform, the dynamic-reputation practical Byzantine fault tolerance algorithm improves the transaction processing speed and is suitable for the blockchain application in the energy field.
Transverse deformation effect on sensitivity of strain-sensing patch antenna
Authors: Wan Chunfeng , Xie Liyu , Xu Kangqian , Xue Songtao , Jiang Can , Wan Guochun , Ding Tao
Published: February 2020

The strain sensor based on microwave patch antenna is proposed to monitor structural strain in structural health monitoring. When patch antenna experiences deformation, the resonant frequency of patch antenna will shift. With these characteristics, the patch antenna can operate as both the strain-sensing element and communication component. This article chooses an RT-5880 rectangular patch antenna for strain measurement, focusing on its sensing performance. For distinguishing the influence of deformation in the antenna’s length direction and width direction, the numerical simulation is implemented, and then two kinds of laboratory experiments are conducted. The first approach is to paste antennas in longitudinal and transverse ways and solve the equation set. The other approach is to design another patch antenna with narrow width and compare the test results with the wide one. All results show that the influence of deformation in wide direction on sensitivity can be neglected, and the resonant frequency shift has a good linear relationship with the strain of antenna in length direction.
Outcomes and Management of Peripheral Intravenous Infiltration Injuries
Authors: Gibian Joseph T. , Zakria Danny , March Cooper , Schaheen Basil , Drolet Brian C.
Published: February 2020

Background: Although intravenous (IV) infiltration is relatively common, data regarding complications and outcomes of this problem remain limited. In addition, there is wide variation in institutional protocols for the management of IV infiltrations. Through retrospective review, we aim to delineate complications and outcomes, and propose an algorithm for the management of these injuries. Methods: We performed a retrospective review of all patients who had an IV infiltration at a tertiary care center’s inpatient and outpatient facilities between January 1, 2016, and December 31, 2018. Results: In all, 479 patients with 495 infiltrations were included, with a mean age of 36.7 years. The upper extremity was involved in 89.6% of events. Of all the events, 8.6% led to a superficial soft tissue infection, 3.2% led to necrosis or eschar formation, and 1.9% led to ulceration or full-thickness wound formation. There were zero cases of compartment syndrome. Only 5.1% resulted in any long-term defects; none resulted in a functional defect of the extremity. Patients with vascular disease did not experience worse outcomes compared with healthy individuals. Plastic or orthopedic surgery was consulted in 25.3% of events. No emergent surgical intervention was required, 7 (1.4%) required bedside procedures, and 7 (1.4%) patients underwent nonacute operations. Conclusions: A specialist was consulted in about one-quarter of IV infiltrations, yet none were surgical emergencies. Instead, most complications could be monitored and managed by a primary team. Therefore, we propose algorithms involving nursing staff, wound care teams, and primary physicians with limited specialist consultation to manage these injuries.
Critical Consciousness of Food Systems as a Potential Lifestyle Intervention on Health Issues
Authors: Eng Sothy , Donoghue Carli , Khun Tricia , Szmodis Whitney
Published: February 2020

When examining food systems in contemporary, industrialized, and globalized nations such as the United States, there is a quantity over quality cultural mind-set driven by capitalism. This creates an environment in which consumer desires for convenient lifestyles run high, mainly focused on the production of food and individual financial gain rather than the food systems as a whole. This approach neglects the overall outcomes in health, wellness, health disparities, and the sustainability footprint associated with consumption. Food is more than just food. It involves a network of different levels and elements that creates a multidimensional framework in which food systems, and the choices produced within those systems, can either positively or negatively affect consumers’ lifestyles and health. This article discusses the importance of food systems and the ways in which they can be incorporated into a lifestyle intervention for general food consumers as well as those suffering from dietary-related diseases. With a critical understanding that structural barriers associated with current food systems are partly responsible for dietary-related diseases, individuals’ self-blame and guilt can be alleviated and liberated, thus enhancing overall emotional and physical health. Drawing on social cognitive theory, food systems are conceptualized into triadic, dynamic interaction of environment (eg, food production, processing, packaging, transporting, marketing, disposing), cognition (eg, learned experience, and knowledge of food, nutrition, and wellness), and behavior (eg, food purchasing, preparation, and consumption).
Estimated costs of pivotal trials for U.S. Food and Drug Administration–approved cancer drugs, 2015–2017
Authors: Hsiue Emily Han-Chung , Moore Thomas J , Alexander G Caleb
Published: February 2020

Background:

Pivotal clinical trials provide critical evidence to regulators regarding a product’s suitability for marketing approval. The objectives of this study are (1) to characterize select features of trials for oncology products approved by the U.S. Food and Drug Administration between 2015 and 2017; and (2) to quantify the costs of these trials and how such costs varied based on trial characteristics.

Methods:

We identified novel oncology therapeutic drugs, and their respective pivotal trials, approved between 2015 and 2017 using annual summary reports from the Food and Drug Administration. Cost estimates for each pivotal trial were calculated using IQVIA’s CostPro, a clinical trial cost estimating tool based on executed contracts between pharmaceutical manufacturers and contract research organizations. Measures of drug and trial characteristics included trial design, end point, patient enrollment, and regulatory pathway. We also performed sensitivity analyses that varied assumptions regarding how efficiently each trial was conducted.

Results:

A total of 39 pivotal clinical trials provided the basis for Food and Drug Administration approval of 30 new oncology drugs from 2015 to 2017. Among these trials, primary end points were objective response rate in 20 (51.3%), progression-free survival in 13 (33.3%), and overall survival in 6 (15.4%). Twenty trials (51.3%) were single-arm studies. The median estimated cost of oncology pivotal trials was $31.7 million (interquartile range = $17.0–$60.4 million). Trials with objective response rate as primary end point had a median estimate of $17.7 million (interquartile range = $11.9–$27.1 million), compared with trials examining progression-free survival ($42.3 million, interquartile range = $34.6–$101.2 million) or overall survival ($79.4 million, interquartile range = $56.9–$97.7 million) (p < 0.001). Estimated costs for single-arm trials ($17.7 million, interquartile range = $11.9–$23.7 million) were less than for trials with a placebo-controlled ($56.7 million, interquartile range = $40.9–$103.9 million) or active control arm ($67.6 million, IQR = $35.5–$93.5 million) (p < 0.001).

Conclusions:

Relative to the estimated costs of drug development, the costs of these oncology pivotal trials were modest, with trials that produced more valuable scientific information costing more than their counterparts.
A critical genre analysis of MD&A discourse in corporate annual reports
Authors: Qian Yubin
Published: February 2020

Based on the texts of ‘Management Discussion and Analysis on Financial Status and Business’ (MD&A) collected from 118 American corporate annual reports, this study investigated how the professional discourse is realized from the dimensions of text, genre, professional practice and professional culture, according to the framework of the Critical Genre Analysis (CGA) theory. It was found that (1) In the text dimension, lexicon features regarding vocabulary volume, vocabulary highlighting, readability and sentiment are unique to MD&As; (2) the genre of MD&As corresponds to a rhetorical structure of 3 moves and 10 steps; (3) the professional practice of MD&As is represented by three types of interdiscursivity, that is, shifting, mixing and embedding; (4) the professional culture of MD&As is embodied through identity enculturation, human-oriented value, cooperation awareness and self-serving manner. The results of this study help to better understand the realization of professional discourse and expand the application of CGA in professional practice. The findings presented herein are expected to enhance interdisciplinary research that relates language with corporate performance.
Contexto de procedencia, autopercepción y expectativas de los jóvenes en situación de encierro
Authors: Barnetche Maria Marcela , Cornejo Lila Susana
Published: February 2020

Es notable el incremento de delitos protagonizados por jóvenes, siendo difícil distinguir entre la actividad delictiva propiamente dicha y un comportamiento desviado de costumbres, tradiciones, condicionamientos socioeconómicos, o el medio habitual en el cual se desarrollan desde sus primeros años de vida. Para conocer las percepciones y significado del contexto de procedencia de jóvenes en situación de encierro, se desarrolló una investigación cualitativa considerando las normativas del Consejo de Organizaciones Internacionales de las Ciencias Médicas. Se realizaron entrevistas con marco pautado a 28 varones y 4 mujeres alojadas en los centros socioeducativos del Área Penal Juvenil de la Provincia de Córdoba, Argentina. El análisis de la información se realizó a través de la Teoría Fundamentada (muestreo teórico, método comparativo constante) y Triangulación de investigadores. Los jóvenes del estudio integran familias del tipo extendida, donde surge la figura del padrastro. Las actividades de la familia, se dividen entre la escuela para los pequeños y laborales para el jefe de familia. Refieren buena relación familiar; confianza con hermanos, no aceptan puesta de límites. No han cumplimentado la escolaridad, por mala conducta, y/o falta de interés. Referido a sus amigos, diferencian según procedencia (escuela y/o barrio) y clase social. “La esquina” aparece como lugar de encuentro en el barrio. Los deportes surgen para el tiempo libre. Presentan experiencia laboral, incluyendo actividades ilícitas, de diferente significación: renta para adquirir sus gustos y/o ayuda familiar y como espacio de aprendizaje. Se describen bondadosos y solidarios, contraponiéndose a su accionar. Para el egreso de la institución, tienen expectativas relacionadas al trabajo formal, escolaridad y cambio de conductas motivada por afecto materno. Si bien estos jóvenes provienen de contextos diversos, la situación de encierro revela la construcción de cambios conductuales y anhelos, que al egreso serán condicionados por su contexto.
Dose–time fractionation schedules of preoperative radiotherapy and timing to surgery for rectal cancer
Authors: Jin Fu , Luo Huanli , Zhou Juan , Wu Yongzhong , Sun Hao , Liu Hongliang , Zheng Xiaodong , Wang Ying
Published: February 2020

Chemoradiotherapy (CRT) is extensively used prior to surgery for rectal cancer to provide significantly better local control, but the radiotherapy (RT), as the other component of CRT, has been subject to less interest than the drug component in recent years. With considerable developments in RT, the use of advanced techniques, such as intensity-modulated radiotherapy (IMRT) in rectal cancer, is garnering more attention nowadays. The radiation dose can be better conformed to the target volumes with possibilities for synchronous integrated boost without increased complications in normal tissue. Hopefully, both local recurrence and toxicities can be further reduced. Although those seem to be of interest, many issues remain unresolved. There is no international consensus regarding the radiation schedule for preoperative RT for rectal cancer. Moreover, an enormous disparity exists regarding the RT delivery. With the advent of IMRT, variations will likely increase. Moreover, time to surgery is also quite variable, as it depends upon the indication for RT/CRT in the clinical practices. In this review, we discuss the options and problems related to both the dose–time fractionation schedule and time to surgery; furthermore, it addresses the research questions that need answering in the future.
Suboptimal Health, Dietary Supplementation, and Public Health Approaches to Regulatory Challenges in Dubai
Authors: Jairoun Ammar Abdulrahman , Al-Hemyari Sabaa Saleh , El-Dahiyat Faris , Hassali Mohamed Azmi , Shahwan Moyad , Al Ani Mina Rabea , Jabbar Hussein Ali
Published: February 2020

Objectives: Presently, limited data are available on dietary supplements (DSs) and their associated effects on health status although the consumption of DS continues to expand. This study is aimed to explore the possible relationship between DSs consumption and suboptimal health status (SHS) in Dubai, United Arab Emirates (UAE). Methods: This study was a cross-sectional research held among a sample of citizens and residents in the Emirate of Dubai in the UAE using a well-structured, self-administered, anonymous survey. Frequency tables, odds ratios, and confidence intervals were generated during the data analysis using SPSS version 23. Results: A total of 618 participants were enrolled in this study and fully completed the questionnaire. In this study, 317 participants (51.3%) (95% CI: 47.3%-55.3%) reported the use of DS products. A significant association between DS consumption and suboptimal health status was detected ( P < .001). DS consumers had a 1.5-fold increased odds of suboptimal health status when compared with non-DS consumers (95% CI 1.4-1.7). Conclusion: The findings of this study suggest a need to develop policies and programs that will help minimize the risk of possible adverse events that are associated with the utilization of DSs.
A Comparison of Interteaching and the Learning Pathway in a Community Health Undergraduate Course
Authors: Schulz Jonathan A. , Francisco Vincent T.
Published: February 2020

Health promotion undergraduate courses frequently use active learning strategies in an attempt to ensure that future health professionals are prepared to improve population health outcomes. One teaching method with limited research in health promotion courses at the undergraduate level is interteaching (IT). IT is based on behavior analytic techniques and uses paired discussion and student-informed clarifying lectures to teach course objectives. A number of studies suggest that IT is more effective than traditional teaching methods (i.e., lecture). However, research is needed to compare IT with other active learning strategies (i.e., strategies that foster critical thinking by engaging students in analysis, synthesis, and evaluation through discussion and active student responding) and in new subject areas. The present study compared IT with an active learning strategy known as the Learning Pathway (LP) in an undergraduate community health education/promotion planning course. The LP uses group work and guided self-instruction to help students address a societal issue of their choice. Results indicate that students performed slightly higher on multiple-choice quizzes during the IT condition and correctly answered more fill-in-the-blank midterm and final exam questions related to content covered in the IT condition. However, students indicated that they preferred the LP teaching method. Although further research is needed to investigate active learning strategies that are most effective on various outcomes in health promotion courses, this study suggests that IT may be more effective than the LP on teaching course objectives as measured by quiz scores.
Teaching Behavior Change Theory in Canada: Establishing Consensus on Behavior Change Theories That Are Recommended to Be Taught to Undergraduate Students in Courses Addressing Health Behavior Change
Authors: Gainforth Heather L. , Dineen Tineke E. , Giroux Emily E. , Forneris Tanya
Published: February 2020

There is little guidance on which behavior change theories should be taught in undergraduate courses addressing health behavior change. Delphi consensus methods provide a formal, systematic, and reproducible method for establishing consensus among experts. Objective. Use a Delphi methodology to establish consensus regarding behavior change theories that should be taught to undergraduate students enrolled in health behavior change courses. Method. An online Delphi consensus exercise was completed by instructors who were identified through a systematic search of 94 University course calendars to be teaching health behavior change content to undergraduate students in Canada. In Round 1, 22 participants generated a list of theories taught in undergraduate courses. In Rounds 2 and 3, participants indicated their level of agreement using an 11-point Likert-type scale as to which theories should be taught. Theories that reached predetermined consensus criteria were retained in each round. Results. In Round 1, participants listed over 50 different theories being taught in undergraduate courses. After Round 2, nine theories met consensus criteria which were refined to only six theories in Round 3 (i.e., behavior change wheel, self-determination theory, self-efficacy theory, social ecological model, social cognitive theory, theory of planned behavior). Conclusions. A wide range of theories are taught in undergraduate courses. However, only a minority of these theories reached consensus criteria as being theories that should be taught to undergraduate students enrolled in courses addressing health behavior change. Findings can be used to improve the consistency and quality of instruction of behavior change theories at the undergraduate level.
Adjuvant Chemotherapy with Chinese Herbal Medicine Formulas Versus Placebo in Patients with Lung Adenocarcinoma after Radical Surgery: a Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Authors: Wang Qin , Jiao Lijing , Wang Shengfei , Chen Peiqi , Bi Ling , Zhou Di , Yao Jialin , Li Jiaqi , Wang Liyu , Chen Zhiwei , Jia Yingjie , Zhang Ziwen , Shen Weisheng , Zhu Weirong , Xu Jianfang , Gao Yong , Xu Ling , Gong Yabin
Published: February 2020

Background

The toxicity and side effects caused by adjuvant chemotherapy (ACT) after radical surgery for lung adenocarcinoma (LAC) lead to early termination frequently. This study was conducted to provide an objective basis for the effect of Chinese herbal medicine formulas (CHMFs) combined with chemotherapy in reducing toxicity and enhancing efficacy of ACT.

Method

From February 17th, 2012 to March 20th, 2015, 233 patients from 7 hospitals diagnosed with LAC in IB~IIIA stage were randomly assigned into ACT + CHMF group (116 patients) and ACT + placebo group (117 patients). CHMF was taken orally until the end of chemotherapy. Chemotherapy-related toxic, side effects were investigated as the primary outcome. Disease-free survival (DFS) and overall survival (OS) were used as the secondary outcome.

Results

At one week following chemotherapy, the incidence of dry mouth, diarrhea and thrombocytopenia significantly decreased in CHMF group (P = 0.017, P = 0.033, P = 0.019, respectively). At two weeks following chemotherapy, fatigue and diarrhea were more obvious in the placebo group (P = 0.028, P = 0.025, respectively). In addition, patients in the CHMF group showed an increase in median DFS from 37.1 to 51.5 months compared with placebo group although there was no statistical significance (P = 0.16). In the stage IB subgroup, the CHMF group had a significantly better DFS (HR (95% CI) = 0.53 (0.28–0.99), P = 0.046). There was no significant difference in OS between the groups (P = 0.72).

Conclusion

For patients with LAC, ACT combined with CHMF after radical surgery can prolong the DFS time especially in the early stage, and reduces the chemotherapy-related toxic and side effects.

Trial Registration

NCT 01441752. Registered 14 July, 2011.
Taste disorder in facial onset sensory and motor neuronopathy: a case report
Authors: Ohashi Nobuhiko , Nonami Jin , Kodaira Minori , Yoshida Kunihiro , Sekijima Yoshiki
Published: February 2020

Background

Taste disorder is a common symptom in the general population. Several studies have shown that patients with neurological disorders, such as amyotrophic lateral sclerosis and Parkinson’s disease, develop taste disturbance. Facial onset sensory and motor neuronopathy (FOSMN) is a rare disease characterized by sensory disturbance and weakness spreading from the face to the limbs caudally. We describe a patient with FOSMN who showed taste disorder as the sole initial symptom.

Case presentation

A 49-year-old man who smoked cigarettes developed taste disturbance. Despite using zinc supplements, an herbal medication, and an ointment, his taste disorder worsened. 4 years later, a tingling feeling emerged at the tip of his tongue and gradually spread to his entire lips. At 55 years of age, he showed difficulty in swallowing, followed by facial paresthesia, muscle atrophy, and weakness in the face and upper limbs without apparent upper motor neuron sign. Cessation of smoking did not improve his taste disturbance, and he was unable to discriminate different tastes on the entire tongue. In an electrogustometric study, electrical stimulation did not induce any type of taste sensation. Blink reflex showed delayed or diminished R2 responses. Needle electromyography revealed severe chronic neurogenic changes in the tongue and masseter muscles. Mild chronic neurogenic changes were also observed in the limbs. In the thoracic paraspinal muscles, active neurogenic changes were detected. Findings of hematological and cerebrospinal fluid analyses, and magnetic resonance images of the brain and spinal cord were unremarkable. One cycle of intravenous immunoglobulin therapy did not improve his symptoms. We diagnosed him as having FOSMN with the sole initial symptom of taste disorder. Nine years after the onset of taste disorder, he developed impaired sensation of touch in the right upper limb and required tube feeding and ventilator support.

Conclusion

Taste disorder can be the initial manifestation of FOSMN and might involve the solitary nucleus.
A potential risk factor of total knee arthroplasty: an infected Baker’s cyst – a case report
Authors: Lee Byung-Ill , Seo Jong-Hyeon , Kim Yong-Beom , Seo Gi-Won
Published: February 2020

Background

In adults, Baker’s cyst development is attributable principally to secondary alterations after degenerative changes. The latter changes often accompany osteoarthritis, and we frequently encounter patients with Baker’s cysts seeking total knee arthroplasty (TKA). Baker’s cysts are not usually subject to extensive preoperative evaluation because the cysts often disappear naturally after surgery, unaccompanied by any adverse symptoms.

Case presentation

A 63-year-old woman presented with moderate pain in the left knee joint that had developed 1 year ago. Posterior knee pain was aggravated on maximum knee flexion. Three months previously, a popliteal mass had become palpable and the patient had undergone needle mass aspiration twice in a local orthopedic hospital, but the mass had recurred. We initially considered TKA for her severe degenerative osteoarthritis. However, we decided to perform only arthroscopic debridement and cyst excision because the patient was experienced severe pain only on maximal knee flexion, and did not want TKA. Pus gushed from the torn cyst during the operation. We diagnosed an infected Baker’s cyst. The patient was treated with a first-generation cephalosporin postoperatively.

Conclusions

A Baker’s cyst that was aspirated and still causes symptoms with altered blood tests needs to be evaluated accurately before TKA.
Differential effects of Chinese high-fat dietary habits on lipid metabolism: mechanisms and health implications
Authors: Yan Sisi , Zhou Huijuan , Liu Shuiping , Wang Ji , Zeng Yu , Matias Froilan Bernard , Wen Lixin
Published: February 2020

Background

The traditional Chinese diet blends lard with vegetable oil, keeping the fatty acid balance intake ratio of saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids at nearly 1:1:1. However, the effects of a mixture of lard and vegetable oil on lipid metabolism have never been researched. In the present study, by simulating Chinese high-fat dietary habits, we explored the effects of a mixture of lard and vegetable oil on lipid metabolism.

Methods

We randomly assigned 50 male C57BL/6 J mice to 5 groups (10 in each group) and fed them lard, sunflower oil (SFO), soybean oil (SBO), lard blended with sunflower oil (L-SFO), or lard blended with soybean oil (L-SBO) for 12 weeks.

Results

We found that the final body weights of mice in the lard group were significantly higher than those of mice in the SFO and SBO groups. Body fat rate and volume of fat cell of the lard group were significantly higher than those of the SFO, SBO, and L-SBO groups. Liver triglyceride level of the lard group increased significantly compared to the other groups. Although body fat rate and liver triglyceride level in the SBO and SFO groups decreased compared to those in the other groups, the high-density lipoprotein cholesterol/low-density lipoprotein cholesterol ratio were also significantly decreased in the SBO and SFO groups.

Conclusions

We found that a lard diet induced accumulation of body fat, liver and serum lipids, which can increase the risk of obesity, non-alcoholic fatty acid liver disease, and atherosclerosis. The vegetable oil diet resulted in cholesterol metabolism disorders even though it did not lead to obesity. The mixed oil diet induced body fat accumulation, but did not cause lipid accumulation in the liver and serum. Thus, differential oil/fat diets have an impact on differential aspects in mouse lipid metabolism.

Graphical abstract
The effectiveness of different down-regulating protocols on in vitro fertilization-embryo transfer in endometriosis: a meta-analysis
Authors: Cao Xue , Chang Hong-yang , Xu Jun-yan , Zheng Yi , Xiang Yun-gai , Xiao Bing , Geng Xu-jing , Ni Li-li , Chu Xi-ying , Tao Shi-bo , He Yan , Mao Gen-hong
Published: February 2020

Background

To investigate the effectiveness of the GnRH-a ultra-long protocol, GnRH-a long protocol, and GnRH-a short protocol used in in vitro fertilization-embryo transfer (IVF-ET) in infertile women with endometriosis.

Methods

We searched PubMed, Embase, Web of Science, Cochrane Library, Elsevier Science Direct, OA Library, Google Scholar, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, China Science and Technology Journal database, and the China Biology Medicine disc for randomized controlled trials (RCTs) and observational studies (non-RCTs) to evaluate the efficacy of the GnRH-a ultra-long protocol, GnRH-a long protocol, and GnRH-a short protocol in IVF-ET in infertile patients with endometriosis.

Results

A total of 21 studies in compliance with the standard literature were included, and RCT and non-RCT studies were analyzed separately. This meta-analysis showed that the GnRH-a ultra-long protocol could improve the clinical pregnancy rate of infertile patients in RCT studies, especially in patients with stages III–IV endometriosis (RR = 2.04, 95% CI: 1.37~3.04, P < 0.05). However, subgroup analysis found the different down-regulation protocols provided no significant difference in improving clinical outcomes in patients with endometriosis in the non-RCT studies.

Conclusion

This study suggests that the GnRH-a ultra-long protocol can improve the clinical pregnancy rate of the patients with stages III–IV endometriosis in RCT studies. Although it is generally believed that the results of RCT are more reliable, the conclusions of the non-RCT studies cannot be easily neglect, which let us draw conclusions more cautious.
Successful pregnancy after prenatal diagnosis by NGS for a carrier of complex chromosome rearrangements
Authors: Ou Jian , Yang Chuanchun , Cui Xiaoli , Chen Chuan , Ye Suyan , Zhang Cai , Wang Kai , Chen Jianguo , Zhang Qin , Qian Chunfeng , Fang Guangguang , Zhang Wenyong
Published: February 2020

Background

The study is aimed to provide prediction for fertility risk in the setting of assisted reproduction for a woman with complex chromosomal rearrangements (CCRs).

Methods

We implemented a robust approach, which combined whole-genome low-coverage mate-pair sequencing (WGL-MPS), junction-spanning PCR and preimplantation genetic testing for aneuploidy (PGT-A) method to provide accurate chromosome breakpoint junctional sequences in the embryo selection process in the setting of assisted reproduction for a couple with recurrent abortions due to CCRs.

Result

WGL-MPS was applied to a female carrying CCRs which consisted of 9 breakpoints and 1 cryptic deletion related to fertility risks. Sequencing data provided crucial information for designing junction-spanning PCR and PGT-A process, which was performed on the 11 embryos cultivated. One embryo was considered qualified for transplanting, which carried the exact same CCRs as the female carrier, whose phenotype was normal. The amniotic fluid was also investigated by WGL-MPS and karyotyping at 19 weeks’ gestation, which verified the results that the baby carried the same CCRs. A healthy baby was born at 39 weeks’ gestation by vaginal delivery.

Conclusion(s)

Our study illustrates the WGL-MPS approach combining with junction-spanning PCR and PGT-A is a powerful and practical method in the setting of assisted reproduction for couples with recurrent miscarriage due to chromosomal abnormalities, especially CCRs carriers.
Pharmacodynamic material basis of traditional Chinese medicine based on biomacromolecules: a review
Authors: Zhang Wen-Jin , Wang Sheng , Kang Chuan-zhi , Lv Chao-geng , Zhou Li , Huang Lu-Qi , Guo Lan-Ping
Published: February 2020

Biomacromolecules, the first components of bioactive substances in traditional Chinese medicines (TCM) have wide bioactivity-related efficacy but have not yet been fully appreciated compared to small molecule components. The present review brings a novel and systemic point of view to deepen the understanding of the pharmacodynamic material basis of TCM based on biomacromolecules (polysaccharides, proteins and nucleic acids). Biomacromolecules have been, are and will have considerable roles in the efficacy of Chinese medicine, as evidenced by the number of biological activities related to traditional clinical efficacy. The direct and indirect mechanisms of biomacromolecules are further accounted for in a variety of neurotransmitters, hormones, and immune substances to maintain immune function in both sensitive and stable equilibrium. The biological functions of biomacromolecules have been elaborated on in regard to their roles in the process of plant growth and development to the relationship between primary metabolism and secondary metabolism and to the indispensable role of polysaccharides, proteins, and nucleic acids in the quality formation of TCM. Understanding the functional properties and mechanisms of biological macromolecules will help to demystify the drug properties and health benefits of TCM.
Live birth rate comparison of three controlled ovarian stimulation protocols for in vitro fertilization-embryo transfer in patients with diminished ovarian reserve after endometrioma cystectomy: a retrospective study
Authors: Zhao Feiyan , Lan Yonglian , Chen Tong , Xin Zhimin , Liang Yu , Li Ying , Wang Shuyu , Zhang Jun , Yang Xiaokui
Published: February 2020

Background

Women with endometriosis and previous cystectomy may respond less well to gonadotropin stimulation, which results in fewer oocytes retrieved and poor pregnancy outcomes. Choosing an appropriate protocol for such populations is essential. This study involved an analysis of the effect of different controlled ovarian stimulation (COS) protocols on the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) in women with diminished ovarian reserve (DOR) who underwent ovarian endometrioma cystectomy.

Methods

A total of 342 patients that underwent IVF-ET treatment at the Beijing Obstetrics and Gynecology Hospital from January 1, 2013 to April 30, 2018 were included in this retrospective study. The patients were distributed into three groups according to the COS protocols, namely prolonged GnRH-agonist (Group A, n = 113), GnRH-antagonist (Group B, n = 121), and long GnRH-agonist (Group C, n = 108). The clinical and laboratory parameters of the three protocols were analyzed and a logistic regression of clinical pregnancy and live births was conducted.

Results

There were no significant differences in the age, infertility duration, basic follicle stimulation hormone (FSH), luteinizing hormone (LH), or estradiol (E2) levels as well as other baseline characteristics among groups (P > 0.05). The total gonadotrophin (Gn) dosage and duration tended to be less in the GnRH-antagonist group than in the others (P < 0.05). No significant differences were found in the implantation rate and clinical pregnancy rate among the groups, but the prolonged GnRH-agonist group showed the highest rates. In addition, no significant differences were present in the number of retrieved oocytes, oocyte fertilization rate, embryo utilization rate, live birth rate, abortion rate, ectopic pregnancy rate, or multiple pregnancy rate in the three groups (P > 0.05). Age had a significant effect on both clinical pregnancy and live birth.

Conclusion

For those DOR patients who had undergone ovarian endometriosis cystectomy, the prolonged GnRH-agonist protocol may achieve better clinical IVF-ET outcomes, but there were no significant differences from the other groups. The GnRH-antagonist protocol may reduce the cost and time of drug treatment. Age should be considered for its influence on pregnancy outcome. However, a larger sample size may be needed for further study.
Racial disparities in pre-operative pain, function and disease activity for patients with rheumatoid arthritis undergoing Total knee or Total hip Arthroplasty: a New York based study
Authors: Hirsch J. , Mehta B. , Finik J. , Navarro-Millan I. , Brantner C. , Mirza S. , Figgie M. , Parks M. , Russell L. , Orange D. , Goodman S.
Published: February 2020

Background

Black and Hispanic patients with osteoarthritis have more pain and worse function than Whites at the time of arthroplasty. Whether this is true for patients with rheumatoid arthritis (RA) is unknown.

Methods

This cross-sectional study used data on RA patients acquired between October 2013 and November 2018 prior to elective total knee (TKA) or hip arthroplasty (THA). Pain, function, and disease activity were assessed using the visual analogue scale (VAS), the Multidimensional Health Assessment Questionnaire (MDHAQ), and the Disease Activity Score (DAS28-ESR). We linked the cases to census tracts using geocoding to determine the community poverty level. Race, education, income, insurance and medications were collected via self-report. Using multivariable linear and logistic models we examined whether minority status predicted pain, function and RA disease activity at the time of arthroplasty.

Results

Thirty seven (23%) of the 164 patients were Black or Hispanic (minorities). The MDHAQ and DAS28-ESR were not significantly worse while VAS pain score was significantly worse in minority patients (p = 0.03). There was no significant difference in education between the groups. Insurance varied significantly; 29% of minority patients had Medicaid vs. 0% of Whites (p < 0.0001). In the multivariable analyses minority status was not significantly associated with DAS28-ESR [p = 0.66], MDHAQ [p = 0.26], or VAS pain [p = 0.18].

Conclusions

For Black and/or Hispanic patients with RA undergoing THA or TKA at a high-volume specialty hospital, unlike Black or Hispanic patients with osteoarthritis (OA), there was no association with worse pain, function, or RA disease activity at the time of elective arthroplasty.
Effect of Plasma Exchange in Thyroid Storm With Consideration of Its Distribution Into the Extravascular Space
Authors: Shinohara Mai , Uchida Toyoyoshi , Funayama Takashi , Watanabe Mika , Kusaoi Makio , Yamaji Ken , Tamura Naoto , Goto Hiromasa , Satoh Hiroaki , Watada Hirotaka
Published: February 2020

Plasma exchange (PE), which directly removes some plasma thyroid hormones, is a treatment option for thyroid storm. However, the effect of PE has not been accurately assessed yet. Here we assessed the effect of PE in a patient with thyroid storm while taking into consideration the distribution of thyroid hormones in the extravascular space. A 51-year-old woman with thyroid storm underwent 2 PE procedures at our hospital. By measuring changes in thyroid hormone levels in plasma, fresh frozen plasma (FFP) used, and waste fluid during each 2.5-hour PE procedure, we calculated the efficiency of thyroid hormone removal based on the hypothesis that total thyroid hormone content before and after PE is the same. During the patient’s first PE procedure, the estimated thyroxine (T4) balance in the extravascular space (ΔX) was −70 μg, which corresponds to approximately 19% of T4 in the waste fluid. During the second PE procedure, ΔX was −131 μg, which corresponds to approximately 52% of T4 in the waste fluid. These data indicated that the source of removed T4 during PE varies. The amount of T4 removed from the extravascular space should be taken into account during assessment of the effect of PE in thyroid storm.
Establishment of 5′–3′ interactions in mRNA independent of a continuous ribose-phosphate backbone
Authors: Kluge Florian , Götze Michael , Wahle Elmar
Published: February 2020

Functions of eukaryotic mRNAs are characterized by intramolecular interactions between their ends. We have addressed the question whether 5′ and 3′ ends meet by diffusion-controlled encounter “through solution” or by a mechanism involving the RNA backbone. For this purpose, we used a translation system derived from Drosophila embryos that displays two types of 5′–3′ interactions: Cap-dependent translation initiation is stimulated by the poly(A) tail and inhibited by Smaug recognition elements (SREs) in the 3′ UTR. Chimeric RNAs were made consisting of one RNA molecule carrying a luciferase coding sequence and a second molecule containing SREs and a poly(A) tail; the two were connected via a protein linker. The poly(A) tail stimulated translation of such chimeras even when disruption of the RNA backbone was combined with an inversion of the 5′–3′ polarity between the open reading frame and poly(A) segment. Stimulation by the poly(A) tail also decreased with increasing RNA length. Both observations suggest that contacts between the poly(A) tail and the 5′ end are established through solution, independently of the RNA backbone. In the same chimeric constructs, SRE-dependent inhibition of translation was also insensitive to disruption of the RNA backbone. Thus, tracking of the backbone is not involved in the repression of cap-dependent initiation. However, SRE-dependent repression was insensitive to mRNA length, suggesting that the contact between the SREs in the 3′ UTR and the 5′ end of the RNA might be established in a manner that differs from the contact between the poly(A) tail and the cap.
Correlations between radiological classification systems and confirmed cartilage loss in severe knee osteoarthritis
Authors: Keenan Oisin J. F. , Holland George , Maempel Julian F. , Keating John F. , Scott Chloe E. H.
Published: February 2020

Aims

Although knee osteoarthritis (OA) is diagnosed and monitored radiologically, actual full-thickness cartilage loss (FTCL) has rarely been correlated with radiological classification. This study aims to analyze which classification system correlates best with FTCL and to assess their reliability.

Methods

A prospective study of 300 consecutive patients undergoing unilateral total knee arthroplasty (TKA) for OA (mean age 69 years (44 to 91; standard deviation (SD) 9.5), 178 (59%) female). Two blinded examiners independently graded preoperative radiographs using five common systems: Kellgren-Lawrence (KL); International Knee Documentation Committee (IKDC); Fairbank; Brandt; and Ahlbäck. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Intraoperatively, anterior cruciate ligament (ACL) status and the presence of FTCL in 16 regions of interest were recorded. Radiological classification and FTCL were correlated using the Spearman correlation coefficient.

Results

Knees had a mean of 6.8 regions of FTCL (SD 3.1), most common medially. The commonest patterns of FTCL were medial ± patellofemoral (143/300, 48%) and tricompartmental (89/300, 30%). ACL status was associated with pattern of FTCL (p = 0.023). All radiological classification systems demonstrated moderate ICC, but this was highest for the IKDC: whole knee 0.68 (95% confidence interval (CI) 0.60 to 0.74); medial compartment 0.84 (95% CI 0.80 to 0.87); and lateral compartment 0.79 (95% CI 0.73 to 0.83). Correlation with actual FTCL was strongest for Ahlbäck (Spearman rho 0.27 to 0.39) and KL (0.30 to 0.33) systems, although all systems demonstrated medium correlation. The Ahlbäck score was the most discriminating in severe knee OA. Osteophyte presence in the medial compartment had high positive predictive value (PPV) for FTCL, but not in the lateral compartment.

Conclusion

The Ahlbäck and KL systems had the highest correlation with confirmed cartilage loss at TKA. However, the IKDC system displayed the best interobserver reliability, with favourable correlation with FTCL in medial and lateral compartments, although it was less discriminating in more severe disease. Cite this article: Bone Joint J 2020;102-B(3):301–309