Maternal circulating status of vitamin D, adiponectin and lipid ratios in gestational diabetes mellitus

Background. The present research was an attempt to assess maternal serum values of 25-hydroxy vitamin D3 [25(OH)D3], adiponectin and the lipid ratios and comparison of their associations with insulin resistance and insulin sensitivity in gestational diabetes mellitus (GDM). Methods. It was conducted on 100 participants including 49 women with GDM and 51 normal pregnant women at 24–28 weeks of gestation. Maternal fasting serum values of glucose, 25(OH)D3, lipid profile, adiponectin and insulin were assessed and the lipid ratios and biomarkers of resistance and sensitivity to insulin were calculated. Statistical significance was set at P < 0.05. Results. Current research revealed that levels of 25(OH) D3 were significantly lower in GDM than in normal pregnancy. Binary logistic regression analysis showed that GDM was associated negatively with 25(OH)D3, HDL-C and adiponectin and positively with the lipid ratios. Multiple linear regression analysis showed that only values of 25(OH)D3 were independently associated negatively with the insulin resistance (P = 0.012). Conclusions. Levels of 25(OH)D3 were significantly decreased in GDM compared with normal pregnancy. On the other hand, 25(OH)D3 had a significant negative correlation with insulin resistance which was stronger than the lipid ratios and adiponectin

Ericson: An Interactive Open-Domain Conversational Search Agent

Open-domain conversational search (ODCS) aims to provide valuable, up-to-date information, while maintaining natural conversations to help users refine and ultimately answer information needs. However, creating an effective and robust ODCS agent is challenging. In this paper, we present a fully functional ODCS system, Ericson, which includes state-of-the-art question answering and information retrieval components, as well as intent inference and dialogue management models for proactive question refinement and recommendations. Our system was stress-tested in the Amazon Alexa Prize, by engaging in live conversations with thousands of Alexa users, thus providing empirical basis for the analysis of the ODCS system in real settings. Our interaction data analysis revealed that accurate intent classification, encouraging user engagement, and careful proactive recommendations contribute most to the users satisfaction. Our study further identifies limitations of the existing search techniques, and can serve as a building block for the next generation of ODCS agents.Comment: pre-prin

The effect of epidural morphine sponge in postoperative pain control after Microdiscectomy

Opiates such as morphine are one of the most effective classes of medication prescribed to treat both acute and chronic pain.They act to suppress pain through mu-receptor activation on primary afferent nerve fibers, dorsal horn neurons and supraspinal pain center neorons. When morphine is administered epidurally, it diffuses to the cord substance, producing analgesia [1],The aim of this study was to check the efficacy of this method for controling postoperative lumbar pain after microdiscectomy. In a randomized clinical trial, numbers of 100 patients were included into two equal groups due to low back radicular pain and underwent microdiscectomy. In study group, an absorbable gelatin sponge (Gelfoam) is contoured to the epidural space, placed in methylprednisolone acetate (40-80 mg), and then injected with 2 mg/ml morphine and control group received an absorbable gelatin, placed in methylprednisolone acetate (40-80 mg) and were injected with normal saline (5mL) as a placebo. The main outcome to be compared between trial and placebo groups were: Patient comfort rate in recovery room and ward, amount of analgesics used, postoperative ambulation time, post operative hospitalization days. The restlessness and agitation during recovery in study group was lower than control group. Mean systolic blood pressure increment was lower in morphine group. Only 6% of patients in study group compared to 98% in placebo group had either moderate or severe pain six hours after operation. Mean morphine dose used for study group was 10.75 mg compared to 21.4 mg among control group patients (P < 0.0001). Mean ambulation time was 2 days among study group patients compared to 2.6 days in control group. Mean hospitalization length was 4.7 and 7 days in study and control group respectively. By means of the technique assigned to the patient (an epidural morphine sponge) during Lumbar microdiscectomy the results were: Better controlled postoperative pain, early ambulation of patients and decreased hospitalization length.

Magnesium Sulfate Effect on the Clinical Course and GCS of Patients with a Severe Diffuse Axonal Injury

Based on a number of studies, magnesium sulfate (MgSO4) given after a diffuse axonal injury has gained attention as a useful neuroprotective agent .The present study was conducted to examine if magnesium sulfate has a therapeutic efficacy and safety in patients with a severe diffuse axonal injury. Adult patients admitted within 1 hour of a closed Traumatic Brain Injury (TBI) with a severe diffuse axonal injury that met eligibility criteria were randomized into two groups. Our treatment guidelines consisted of an initial loading dose of 50 mg/kg magnesium sulfate and then 50 mg/kg QID up to 24 hours after the trauma. The outcome measures were mortality, GCS, and motor function scores which were assessed up to 2 months after the trauma. Magnesium showed a significant positive effect on GCS 2 months (P=0.03).  Among those in MgSO4 group, motor functioning score improved more than control group but this was not statistically significant (P = 0.51). At the end, we have demonstrated that administration of magnesium sulfate can have neuroprotective role following severe DAI.