Intra-articular injections of sodium hyaluronate (Hyalgan®) in osteoarthritis of the knee. a randomized, controlled, double-blind, multicenter trial in the asian population

<p>Abstract</p> <p>Background</p> <p>The efficacy and tolerability of 500-730 kDa sodium hyaluronate (Hyalgan^®) for treatment of osteoarthritis (OA) pain has been established in clinical trials, but few data are available in the Asian population. We conducted a randomized, double-blind, multicenter, placebo-controlled study to evaluate the efficacy and tolerability of this preparation in a Taiwanese population.</p> <p>Methods</p> <p>Two hundred patients with mild to moderate OA of the knee were randomized to receive five weekly intra-articular injections of sodium hyaluronate or placebo. The primary efficacy outcome was the change from baseline to Week 25 in patients' evaluation of pain using a 100-mm visual analog scale (VAS) during the 50-foot walking test. Additional outcomes included Western Ontario and McMaster Universities (WOMAC) scores, time on the 50-foot walking test, patient's and investigator's subjective assessment of effectiveness, acetaminophen consumption, and the amounts of synovial fluid.</p> <p>Results</p> <p>The Hyalgan^®treatment group showed a significantly greater improvement from baseline to Week 25 in VAS pain on the 50-foot walking test than the placebo group (p = 0.0020). The Hyalgan^®group revealed significant improvements from baseline to week 25 in WOMAC pain and function score than the placebo group (p = 0.005 and 0.0038, respectively) Other outcomes, such as time on the 50-foot walking test and subjective assessment of effectiveness, did not show any significant difference between groups. Both groups were safe and well tolerated.</p> <p>Conclusions</p> <p>The present study suggests that five weekly intra-articular injections of sodium hyaluronate are well tolerated, can provide sustained relief of pain, and can improve function in Asian patients with osteoarthritis of the knee.</p> <p>Level of Evidence</p> <p>Therapeutic study, Level I-1a (randomized controlled trial with a significant difference).</p> <p>Trial registration</p> <p>ClinicalTrials.gov Identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01319461">NCT01319461</a></p

Well-differentiated gall bladder hepatoid carcinoma producing alpha-fetoprotein: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gall bladder carcinoma is rare, and metastatic gall bladder carcinoma from hepatocellular carcinoma has been reported in only a few patients.</p> <p>Case presentation</p> <p>We present a 73-year-old man with a history of hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma. He received transcatheter arterial chemoembolization, and was diagnosed to have an alpha-fetoprotein producing gall bladder tumor with intraluminal growth. Open cholecystectomy was performed. Pathologic examination of the lesion revealed a well-differentiated hepatoid carcinoma. The lesion was thought most likely to be a metastatic lesion from previous hepatocellular carcinoma. His alpha-fetoprotein level dropped to normal levels five months after the surgery.</p> <p>Conclusion</p> <p>This unusual intraluminal growing tumor proved to be a well-differentiated hepatoid carcinoma, most likely a metastatic lesion from previous hepatocellular carcinoma. This case reminds clinicians that in looking for likely hepatocellular carcinoma recurrence, when no detectable hepatic lesion can account for an elevated alpha-fetoprotein level, the gall bladder should be included in the search for the site of metastasis.</p

Fisetin Protects Against Hepatic Steatosis Through Regulation of the Sirt1/AMPK and Fatty Acid β-Oxidation Signaling Pathway in High-Fat Diet-Induced Obese Mice

Background/Aims: Fisetin is a naturally abundant flavonoid isolated from various fruits and vegetables that was recently identified to have potential biological functions in improving allergic airway inflammation, as well as anti-oxidative and anti-tumor properties. Fisetin has also been demonstrated to have anti-obesity properties in mice. However, the effect of fisetin on nonalcoholic fatty liver disease (NAFLD) is still elusive. Thus, the present study evaluated whether fisetin improves hepatic steatosis in high-fat diet (HFD)-induced obese mice and regulates lipid metabolism of FL83B hepatocytes in vitro. Methods: NAFLD was induced by HFD in male C57BL/6 mice. The mice were then injected intraperitoneally with fisetin for 10 weeks. In another experiment, FL83B cells were challenged with oleic acid to induce lipid accumulation and treated with various concentrations of fisetin. Results: NAFLD mice treated with fisetin had decreased body weight and epididymal adipose tissue weight compared to NAFLD mice. Fisetin treatment also reduced liver lipid droplet and hepatocyte steatosis, alleviated serum free fatty acid, and leptin concentrations, significantly decreased fatty acid synthase, and significantly increased phosphorylation of AMPKα and the production of sirt-1 and carnitine palmitoyltransferase I in the liver tissue. In vitro, fisetin decreased lipid accumulation and increased lipolysis and β-oxidation in hepatocytes. Conclusion: This study suggests that fisetin is a potential novel treatment for alleviating hepatic lipid metabolism and improving NAFLD in mice via activation of the sirt1/AMPK and β-oxidation pathway

Exploring blockchain technology in international trade Business process re-engineering for letter of credit

Purpose The purpose of this paper is to explore the applicability of blockchain technology in international trade process from a perspective of letter of credit payment. Design/methodology/approach A blockchain-based re-engineering process is designed by employing the blockchain and its affiliated smart contract technology to harvest the benefits of distributed ledger and distributed business workflow automation. Findings Comparative analysis and feasibility study were conducted to identify and validate the prospects, in terms of facilitating process flow and enhancing overall trade performance, of the proposed blockchain-based international trade process model. Practical implications Traditional trade processes suffer from a great number of issues about intermediaries, information latency and trust, which, in turn, hinder overall process efficiency. The emerging blockchain technology may have potentials to mitigate those issues by revolutionizing business processes across enterprise borders in various industries. Originality/value This study contributes to the conceptual design of a blockchain- and smart-contract-based process along with a provision of practical case in business process re-engineering. Further endeavors devoted to blockchain research and application across different sectors are suggested to reach better performance of business process operations

Quantitative assessment at task-level for performance of robotic configurations and task plans

Given a robotic manipulation task, decision on which robotic configuration (robotic system and necessary peripherals, including assistant tools, sensor systems, and so on.) to use and evaluating performance of the solution remains as an open, challenging but a meaningful problem. This work attempts to address this problem by defining the concept of task-level performance and developing an approach for systematic assessment based on a proposed task representation for performance quantification of different task plans and robotic configurations. Starting from productivity which is one of the main concern for manufacturers, this work introduces a methodology for quantitative assessment of any given robotic configuration and task handling. Such a method is useful for comparing the productivity of different robotic configurations and evaluating the worthiness of updated solution of a sub-task through observing improvements in productivity. Implemented and tested on a peg-in-hole task with the different level of difficulty through single-arm and dual-arm manipulation on a dual-arm robot, the methodology has demonstrated encouraging results. Finally, the connection of performance assessment from task-level to economy-level is presented.Accepted versio

Historical data is useful for navigation planning : data driven route generation for autonomous ship

This work presents a method for automated generation of navigation plan for autonomous or robotic surface vessel. Historical Automatic Identification System (AIS) data is of significant value to this problem. The method joins AIS locations of a same vessel at different time and locations in a region into a route. Next, it automatically computes navigation plans using nearest neighbour based path retrieval relying on two representations, Ship Feature and Navigation Feature. Before starting service, existing AIS records in the form of ship properties and corresponding route are preprocessed and stored in the form of Ship and Navigation Feature. During online retrieval, given input constraints in vector form, nearest neighbour of this query vector in the same space is found and corresponding path of the neighbour is returned as recommended path. Analysis was done in four and two dimensional spaces for Ship and Navigation Feature respectively. Application of the method is demonstrated in two regions of Australian, covering Bass Strait and Great Australian Bight.Economic Development Board (EDB)Nanyang Technological UniversityThis project was carried out under funding from Economic Development Board of Singapore, Lloyd’s Register and Nanyang Technological University through Industrial Postgraduate Programm

Finding Approaches to Exploring the Environmental Factors That Influence Copepod-Induced Trophic Cascades in the East China Sea

Copepods have been known to be able to cause an increase in phytoplankton through trophic cascades, as copepods consume heterotrophic protists that feed on phytoplankton. However, how the intensity of copepod-induced trophic cascades varies with environmental conditions remains elusive. We hypothesized that a higher proportion of large phytoplankton in the phytoplankton size distribution, a higher stoichiometric quality of phytoplankton, and a higher temperature could mitigate the intensity of a trophic cascade through increasing direct grazing on phytoplankton by copepods. To explore this issue, we quantified the intensity of a trophic cascade as the difference in phytoplankton concentration reduction by grazing using in situ incubations with and without copepods in the East China Sea. We then investigated the relationship between the intensity of trophic cascades versus the slope of the normalized biomass size spectrum (NBSS) of the phytoplankton community, the C:N ratio of particulate organic matter (POM), and temperature. We found that the intensity of trophic cascades weakly decreased with the NBSS slope and increased with temperature; however, both relationships were not statistically significant. We did not find a clear relationship between the strength of the trophic cascades and the C:N ratio of POM. Our results do not support the hypothesis that the proportion of large phytoplankton, the stoichiometric quality of phytoplankton, and the temperature affect trophic cascades. Instead, we suggest that other critical factors, such as protist abundance, play a role in affecting trophic cascades in the plankton food web in the East China Sea. We further propose some issues which should be addressed when conducting in situ shipboard incubation

Study and fabrication of a flexible Zr-based metallic glass thin film strain gauge

Metallic glass is an amorphous structure and has excellent mechanical properties such as high strength, hardness and elastic strain limitation. In this study, a Zr-based metallic glass thin film was deposited on a polymer substrate using the sputter technique for strain gauge applications. A copper thin film strain gauge was fabricated to compare with the properties of the Zr-based strain gauge. Different thicknesses of the thin films were fabricated for comparison. The gauge factor of the Zr-based strain gauge is 2.4 times higher than that of the copper strain gauge. The temperature coefficient of resistance of the Zr-based metallic glass thin film is extremely low, 8 × 10-6 °C-1, which is essential to reduce thermal drift for strain gauge applications