Investigation Into the Predictive Potential of Three-Dimensional Ultrasonographic Placental Volume and Vascular Indices in Gestational Diabetes Mellitus

BackgroundThe use of ultrasonography in pregnancies complicated with gestational diabetes mellitus (GDM) can vary according to clinical practice. This study aims to compare the changes of placental volume (PV) and vascular indices measured by three-dimensional (3D) Power Doppler between pregnant women with and without GDM.Materials and MethodsThis was a prospective study of singleton pregnancies who took the early nuchal translucency examination from January 2018 to September 2019. Data on PV and vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI) between pregnant women with and without GDM were measured by 3D Power Doppler ultrasound machine. Univariate and multivariate logistic regression determined the association between risk factors and GDM. Receiver operating characteristic (ROC) and area under the ROC curve (AUC) were applied to evaluate the diagnostic value of different parameters for GDM.ResultsOf the 141 pregnant women enrolled, 35 developed GDM and 106 did not. The maternal age and gravida in the GDM group were significantly higher than that in the non-GDM group. The PV, VI, FI, and VFI in the GDM group were significantly lower than that in the non-GDM group. There were no significant differences in other clinical parameters between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in VI [odds ratio (OR) = 0.98, 95% confidence interval (CI) = 0.951–1.002], FI (OR = 0.93, 955 CI: 0.86–1.00), and VFI (OR = 0.67, 95% CI = 0.52–0.87). ROC analysis indicated that the combination of maternal age, gravida, PV, and VFI was more accurate as a marker for detecting GDM than the PV, VI, FI, or VFI alone.ConclusionsThe 3D ultrasonography results suggest that PV and vascular indices (VI, FI, and VFI) during the first trimester may serve as potential markers for GDM diagnosis. The combination of maternal age, gravida, and sonographic markers may have good diagnostic values for GDM, which should be confirmed by further investigations

A 64-week, multicenter, open-label study of aripiprazole effectiveness in the management of patients with schizophrenia or schizoaffective disorder in a general psychiatric outpatient setting

<p>Abstract</p> <p>Objective</p> <p>To evaluate the overall long-term effectiveness of aripiprazole in patients with schizophrenia in a general psychiatric practice setting in Taiwan.</p> <p>Methods</p> <p>This was a prospective, open-label, multicenter, post-market surveillance study in Taiwanese patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of schizophrenia or schizoaffective disorder requiring a switch in antipsychotic medication because current medication was not well tolerated and/or clinical symptoms were not well controlled. Eligible patients were titrated to aripiprazole (5-30 mg/day) over a 12-week switching phase, during which their previous medication was discontinued. Patients could then enter a 52-week, long-term treatment phase. Aripiprazole was flexibly dosed (5-30 mg/day) at the discretion of the treating physicians. Efficacy was assessed using the Clinical Global Impression scale Improvement (CGI-I) score, the Clinical Global Impression scale Severity (CGI-S) score, The Brief Psychiatry Rating Scale (BPRS), and the Quality of Life (QOL) scale, as well as Preference of Medicine (POM) ratings by patients and caregivers. Safety and tolerability were also assessed.</p> <p>Results</p> <p>A total of 245 patients were enrolled and switched from their prior antipsychotic medications, and 153 patients entered the 52-week extension phase. In all, 79 patients (32.2%) completed the study. At week 64, the mean CGI-I score was 3.10 and 64.6% of patients who showed response. Compared to baseline, scores of CGI-S, QOL, and BPRS after 64 weeks of treatment also showed significant improvements. At week 12, 65.4% of subjects and 58.9% of caregivers rated aripiprazole as better than the prestudy medication on the POM. The most frequently reported adverse events (AEs) were headache, auditory hallucinations and insomnia. A total of 13 patients (5.3%) discontinued treatment due to AEs. No statistically significant changes were noted with respect to fasting plasma glucose, lipid profile, body weight, and body mass index after long-term treatment with aripiprazole.</p> <p>Conclusions</p> <p>Although the discontinuation rate was high, aripiprazole was found to be effective, safe and well tolerated in the long-term treatment of Taiwanese patients with schizophrenia who continued to receive treatment for 64 weeks.</p

Clinical correlation of nonalcoholic fatty liver disease in a Chinese taxi drivers population in Taiwan: Experience at a teaching hospital

<p>Abstract</p> <p>Background</p> <p>To explore any gender-related differences in the prevalence of conditions-associated with non-alcoholic fatty liver disease (NAFLD) among Taiwanese taxi drivers in Taipei, Taiwan.</p> <p>Methods</p> <p>We studied 1635 healthy taxi drivers (1541 males and 94 females) who volunteered for physical check-ups in 2006. Blood samples and ultrasound fatty liver sonography results were collected.</p> <p>Results</p> <p>The prevalence of NAFLD was 66.4% and revealed no statistically significant decrease with increasing age (p = 0.58). Males exhibited a greater prevalence of NAFLD than did females (67.5% vs 47.9%, p < 0.0001). Gender-related differences for associated factors were found. For males, hypertension, hyperuricemia, higher AST, higher ALT, hypertriglyceridemia, and higher fasting plasma glucose were significantly related to NAFLD. These conditions were not sigfinicantly related to NAFLD in females.</p> <p>Conclusion</p> <p>Several gender-related differences were noted for NAFLD among Taiwanese taxi drivers.</p

The 3′-Terminal Hexamer Sequence of Classical swine fever virus RNA Plays a Role in Negatively Regulating the IRES-Mediated Translation

The 3′ untranslated region (UTR) is usually involved in the switch of the translation and replication for a positive-sense RNA virus. To understand the 3′ UTR involved in an internal ribosome entry site (IRES)-mediated translation in Classical swine fever virus (CSFV), we first confirmed the predicted secondary structure (designated as SLI, SLII, SLIII, and SLIV) by enzymatic probing. Using a reporter assay in which the luciferase expression is under the control of CSFV 5′ and 3′ UTRs, we found that the 3′ UTR harbors the positive and negative regulatory elements for translational control. Unlike other stem loops, SLI acts as a repressor for expression of the reporter gene. The negative cis-acting element in SLI is further mapped to the very 3′-end hexamer CGGCCC sequence. Further, the CSFV IRES-mediated translation can be enhanced by the heterologous 3′-ends such as the poly(A) or the 3′ UTR of Hepatitis C virus (HCV). Interestingly, such an enhancement was repressed by flanking this hexamer to the end of poly(A) or HCV 3′ UTR. After sequence comparison and alignment, we have found that this hexamer sequence could hypothetically base pair with the sequence in the IRES IIId1, the 40 S ribosomal subunit binding site for the translational initiation, located at the 5′ UTR. In conclusion, we have found that the 3′-end terminal sequence can play a role in regulating the translation of CSFV

Location and Level of Etk Expression in Neurons Are Associated with Varied Severity of Traumatic Brain Injury

Much recent research effort in traumatic brain injury (TBI) has been devoted to the discovery of a reliable biomarker correlating with severity of injury. Currently, no consensus has been reached regarding a representative marker for traumatic brain injury. In this study, we explored the potential of epithelial/endothelial tyrosine kinase (Etk) as a novel marker for TBI.TBI was induced in Sprague Dawley (SD) rats by controlled cortical impact. Brain tissue samples were analyzed by Western blot, Q-PCR, and immunofluorescence staining using various markers including glial fibrillary acidic protein, and epithelial/endothelial tyrosine kinase (Etk). Results show increased Etk expression with increased number and severity of impacts. Expression increased 2.36 to 7-fold relative to trauma severity. Significant upregulation of Etk appeared at 1 hour after injury. The expression level of Etk was inversely correlated with distance from injury site. Etk and trauma/inflammation related markers increased post-TBI, while other tyrosine kinases did not.The observed correlation between Etk level and the number of impacts, the severity of impact, and the time course after impact, as well as its inverse correlation with distance away from injury site, support the potential of Etk as a possible indicator of trauma severity

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Focused ultrasound-modulated glomerular ultrafiltration assessed by functional changes in renal arteries.

This study demonstrates the feasibility of using focused ultrasound (FUS) to modulate glomerular ultrafiltration by renal artery sonication and determine if protein-creatinine ratios are estimated through vascular parameters. All animal experiments were approved by our Animal Care and Use Committee. The renal arteries of Sprague-Dawley rats were surgically exposed and sonicated at various acoustic power levels using a FUS transducer with a resonant frequency of 1 MHz. The mean peak systolic velocity (PSV) of the blood flow was measured by Doppler ultrasound imaging. Urinary protein-creatinine ratios were calculated during the experiments. Histological examination of renal arteries and whole kidneys was performed. The PSV, pulsatility index, and resistance index of blood flow significantly increased in the arteries after FUS sonication without microbubbles (p<0.05). The change in normalized protein-creatinine ratios significantly increased with increasing acoustic power, but such was not observed when microbubbles were administered. Furthermore, no histological changes were observed in the hematoxylin- and eosin-stained sections. Glomerular ultrafiltration is regulated temporarily by renal artery sonication without microbubbles. Monitoring vascular parameters are useful in estimating the normalized change in protein-creatinine ratios

[[alternative]]The Effectiveness of Case management Style for the Twin Pregnancy Women

[[abstract]]本研究目的在探討實施個案管理模式於雙胞胎妊娠孕婦之成效。本研究採類實驗型雙組前後測研究設計之研究方法以立意取樣方式選取台北巿醫院婦產科門診妊娠20週～24週雙胞胎妊娠孕婦，並隨機分配至實驗組和對照組，共有95位孕婦全程參與本研究，其中實驗組48位孕婦，對照組47位孕婦。在妊娠20週～24週進行第一次收案填寫問卷量表，實驗組孕婦接受一對一之雙胞胎相關知識與早產相關知識的口頭衛教以及教導放鬆，往後至少每2週一次接受電話追蹤，而對照組婦女則不提供，以醫院的產後常規教育為主，兩組於28週～32週給予情境焦慮量表與孕期壓力量表後測，隨後追蹤至生產。研究結果發現：（一）實驗組孕婦的孕期壓力有顯著的降低（t=-3.47，p<.01）。（二）實驗組孕婦的焦慮有顯著的降低（t=-4.25，p<.001）。（三）實驗組孕婦有較低的早產發生率（χ2=7.69，p<.01）。（四）實驗組孕婦有較少的就醫次數（χ2=11.63，p<.01）。（五）實驗組孕婦有較少的住院次數（χ2=8.42，p<.05）。本研究證實透過個案管理模式照護來照護早產高風險孕婦是可行與有效的，且可以有效地減輕孕婦的焦慮與壓力，藉以減少非必要的醫療支出。研究結果作為相關人員在臨床實務、護理助產研究及護理助產教育方面的參考，以提昇臨床照護品質。關鍵字：雙胞胎妊娠、早產、個案管理、焦慮、孕期壓力。[[abstract]]ABSTRACTThe purpose of this study was to investigate the effectiveness of the case management style for the pregnant women of twins. The experiments of this study were used on 103 pregnant women of twins in Taipei hospitals. The average pregnancy is between 20 ~ 24 weeks. After losing 8 patients who were not qualified the circumstances during the mid-or-after the pregnancy, there were total of 95 pregnant women who participated the experiment throughout the study. The subjects were randomly picked and divided into two groups— 48 patient in the intervention group and 47 patient in the control group. During the pregnancy of 20 ~ 24 weeks, the pregnant women of twins in the intervention group received the first time of survey including the information of one-on-one hygiene education of prematurity and relaxation training. Besides, there was a follow-up tracking by phone every other week. On the other side, the pregnant women of twins in the control group were provided the regular education regarding the nursing care before and after childbirth instead of the previous information and education. At the same time, during the pregnancy of 28~32 weeks, two groups were provided the survey of State-Trait Anxiety Inventory and Stress Scale measure. The follow-up of this survey lasted and ended until the newborns giving birth. The measurement of this study included quality-emotion measure chart and stress-pregnancy measure chart. The data was theoretically analyzed by the average, percentage, Independent sample-T test and pair-T test. The results of this study indicated that: 1) The stress during the pregnancy on the women in the intervention group obviously decreased. 2) The anxiety during the pregnancy on the women in the intervention group obviously decreased. 3) There was a low rate of prematurity on the women in the intervention group. 4) There was a low rate of hospitalization on the women in the intervention group. The study proved the availability and effectiveness of the case management on the high-risk pregnant women. The possibility of prematurity reduced. Besides, the anxiety and stress on the pregnant women also significantly decreased. The outcome also cut off the unnecessary medical outgoings. The results of this study provided the positive effect on the related research such as nursing midwife research and on clinical care. It also provided the valuable quality on the clinical care.Key words: pregnant women of twins, preterm labor, management style, anxiety, stress

Changes in peak systolic velocity (PSV) of blood flow in the renal arteries of rats during FUS exposure.

<p>(A) The boxes extend from the 25^th to the 75^th percentile, with horizontal lines indicating the median. Bar lines indicate the 10^th and 90^th percentiles (* <i>p</i><.05). (B) Normalized change in PSV (mean ± SEM) of blood flow in the renal arteries of rats in response to various acoustic power levels immediately before and after FUS exposure. The normalized change in PSV was significantly greater in the high-power group (12 or 18 W) than in the low-power group (3 or 6 W) (mean ± SEM; standard <i>t</i>-test; ***, ### <i>p</i><.001).</p

Measurement by ultrasound image.

<p>(A) B-mode ultrasound images of the renal artery and kidney of a rat. The inner diameter of the renal artery is about 1.1 mm. (B) Doppler spectral waveforms of blood flow in the renal artery of a rat during pulsed FUS exposure; interference caused by sonication (<i>bright column</i>) and the waveforms of peak systolic velocity (PSV) immediately before and after sonication (<i>indicated by arrows</i>).</p