Efficacy and Tolerability of GCSB-5 for Hand Osteoarthritis: A Randomized, Controlled Trial

AbstractPurposeThe aim of this study was to investigate the efficacy and tolerability of GCSB-5, a mixture of 6 purified herbal extracts, in treating hand osteoarthritis (OA).MethodsA randomized, double-blind, placebo-controlled trial enrolled 220 patients with hand OA who had baseline a visual analog scale joint pain score of >30 of 100 mm at 3 hospitals between September 2013 and November 2014. After randomization, patients were allocated to receive oral GCSB-5 600 mg or placebo, bid for 12 weeks. The primary end point was the change in the Australian/Canadian OA Hand Index (AUSCAN)-defined pain score at 4 weeks relative to baseline. Secondary end points included the frequency Outcome Measures in Rheumatology–OA Research Society International (OMERACT-OARSI)-defined response at 4, 8, 12, and 16 weeks after randomization.FindingsThe allocated treatment was received by 109 and 106 patients in the GCSB-5 and placebo groups, respectively. At 4 weeks, the median (interquartile range) change in AUSCAN pain score relative to baseline was significantly greater in the GCSB-5 group than in the placebo group (–9.0 [–23.8 to –0.4] vs –2.2 [–16.7 to 6.0]; P = 0.014), with sustained improvement at 8, 12, and 16 weeks (P = 0.039). The GCSB-5 group also had a significantly greater OMERACT-OARSI–defined response rate than did the placebo group at 4 weeks (44.0% vs 30.2%), 8 weeks (51.4% vs 35.9%), 12 weeks (56.9% vs 40.6%), and 16 weeks (50.5% vs 37.7%) (P = 0.0074). The 2 treatments exhibited comparable safety profiles.ImplicationsGCSB-5 was associated with improved symptoms of hand OA, with good tolerability, in these patients. GCSB-5 may be a well-tolerated alternative of, or addition to, the treatment of hand OA. ClinicalTrials.gov identifier: NCT01910116

Successful management of heterotopic cornual pregnancy with laparoscopic cornual resection

AbstractObjectiveTo examine the feasibility of laparoscopic cornual resection for the treatment of heterotopic cornual pregnancy.Study designWomen who underwent laparoscopic cornual resection for heterotopic cornual pregnancy at our hospital between January 2003 and March 2015 were retrospectively analyzed. We evaluated significant parameters such as operative complications and postoperative pregnancy outcomes of concomitant pregnancy.ResultsThirteen patients with heterotopic cornual pregnancy were included in the study. All were pregnant through assisted reproductive technology, and the diagnosis was made at a median of 6+6 weeks (range 5+4–10+0). They were successfully treated with laparoscopic cornual resection and admitted for a median of 4 days (range, 2–7) postoperatively. The median operative time was 65min (range, 35–145min) and estimated blood loss was 200mL (range, 10–3000mL). There was a spontaneous abortion at 7+6 gestational weeks in a patient who received bilateral cornual resection. Seven patients delivered babies at term and 3 at preterm. All 10 women delivered without any maternal or neonatal complications. Two were lost to follow-up.ConclusionsLaparoscopic cornual resection is a feasible primary approach for the management of heterotopic cornual pregnancy

Tropical cyclone intensity estimation through convolutional neural network transfer learning using two geostationary satellite datasets

Accurate prediction and monitoring of tropical cyclone (TC) intensity are crucial for saving lives, mitigating damages, and improving disaster response measures. In this study, we used a convolutional neural network (CNN) model to estimate TC intensity in the western North Pacific using Geo-KOMPSAT-2A (GK2A) satellite data. Given that the GK2A data cover only the period since 2019, we applied transfer learning to the model using information learned from previous Communication, Ocean, and Meteorological Satellite (COMS) data, which cover a considerably longer period (2011–2019). Transfer learning is a powerful technique that can improve the performance of a model even if the target task is based on a small amount of data. Experiments with various transfer learning methods using the GK2A and COMS data showed that the frozen–fine-tuning method had the best performance due to the high similarity between the two datasets. The test results for 2021 showed that employing transfer learning led to a 20% reduction in the root mean square error (RMSE) compared to models using only GK2A data. For the operational model, which additionally used TC images and intensities from 6 h earlier, transfer learning reduced the RMSE by 5.5%. These results suggest that transfer learning may represent a new breakthrough in geostationary satellite image–based TC intensity estimation, for which continuous long-term data are not always available

Geographical Distribution of Vi-Phage Types of Salmonella typhi Isolated in East Asia; A Review Made Mainly on a Basis of Results in Korea

Typhoid fever is now a minor cause of death, but it remains at fairly high rate in some area of Asiatic countries. In Korea it is on the increase since several years, and in Japan, to be scarce now, the case rate is stagnant since 1960. The Vi-phage typi

miR-140-5p suppresses BMP2-mediated osteogenesis in undifferentiated human mesenchymal stem cells

AbstractHuman mesenchymal stem cells (hMSCs) have self-renewal and differentiation capabilities but the regulatory mechanisms of MSC fate determination remain poorly understood. Here, we aimed to identify microRNAs enriched in hMSCs that modulate differentiation commitments. Microarray analysis revealed that miR-140-5p is commonly enriched in undifferentiated hMSCs from various tissue sources. Moreover, bioinformatic analysis and luciferase reporter assay validated that miR-140-5p directly represses bone morphogenic protein 2 (BMP2). Furthermore, blocking miR-140-5p in hMSCs increased the expression of BMP signaling components and critical regulators of osteogenic differentiation. We propose that miR-140-5p functionally inhibits osteogenic lineage commitment in undifferentiated hMSCs

RaidEnv: Exploring New Challenges in Automated Content Balancing for Boss Raid Games

The balance of game content significantly impacts the gaming experience. Unbalanced game content diminishes engagement or increases frustration because of repetitive failure. Although game designers intend to adjust the difficulty of game content, this is a repetitive, labor-intensive, and challenging process, especially for commercial-level games with extensive content. To address this issue, the game research community has explored automated game balancing using artificial intelligence (AI) techniques. However, previous studies have focused on limited game content and did not consider the importance of the generalization ability of playtesting agents when encountering content changes. In this study, we propose RaidEnv, a new game simulator that includes diverse and customizable content for the boss raid scenario in MMORPG games. Additionally, we design two benchmarks for the boss raid scenario that can aid in the practical application of game AI. These benchmarks address two open problems in automatic content balancing, and we introduce two evaluation metrics to provide guidance for AI in automatic content balancing. This novel game research platform expands the frontiers of automatic game balancing problems and offers a framework within a realistic game production pipeline.Comment: 14 pages, 6 figures, 6 tables, 2 algorithm

Efficacy and safety of rapid intermittent correction compared with slow continuous correction with hypertonic saline in patients with moderately severe or severe symptomatic hyponatremia: study protocol for a randomized controlled trial (SALSA trial)

Abstract Background Hyponatremia is the most common electrolyte imbalance encountered in clinical practice, associated with increased mortality and length of hospital stay. However, no high-quality evidence regarding whether hypertonic saline is best administered as a continuous infusion or a bolus injection has been found to date. Therefore, in the current study, we will evaluate the efficacy and safety of rapid intermittent correction compared with slow continuous correction with hypertonic saline in patients with moderately severe or severe symptomatic hyponatremia. Methods/design This is a prospective, investigator-initiated, multicenter, open-label, randomized controlled study with two experimental therapy groups. A total of 178 patients with severe symptomatic hyponatremia will be enrolled and randomly assigned to receive either rapid intermittent bolus or slow continuous infusion management with hypertonic saline. The primary outcome is the incidence of overcorrection at any given period over 2 days. The secondary outcomes will include the efficacy and safety of two other approaches to the treatment of hyponatremia with 3% hypertonic saline. Discussion This is the first clinical trial to investigate the efficacy and safety of rapid intermittent correction compared with slow continuous correction with hypertonic saline in patients with moderately severe or severe hyponatremia. Trial registration ClinicalTrials.gov, identifier number: NCT02887469 . Registered on 1 August 2016

Inflammatory Polyarthritis in a Patient with Psoriasis: Is It Psoriatic Arthritis or Rheumatoid Arthrirtis?

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. There are no generally accepted diagnostic criteria for PsA. Indeed, the diagnosis of this inflammatory arthritis is made by exclusion of other possible diseases and based upon immunologic, radiologic, and clinical features which are consistent with the diagnosis. Inflammatory arthritis in a patient with psoriasis can be an important clue for the diagnosis of PsA, but the possibility for diagnosis of other inflammatory arthritides ever remains. Herein we report a case of a female patient who was not diagnosed with PsA, but with rheumatoid arthritis, even though she had psoriasis