Crystal structure of (E)-amino(2-(4-(dimethylamino)benzylidene)hydrazineyl)methaniminium nitrate, C10H16N6O3

C10H16N6O3, monoclinic, P 2 1 / c $P{2}_{1}/c$ (no. 14), a = 7.2312(1) Å, b = 17.7721(3) Å, c = 11.0146(2) Å, β = 104.557°, V = 1370.08(4) Å3, Z = 4, R gt (F) = 0.0532, wR ref (F 2) = 0.1537, T = 170.0 K.

Crystal structure of (E)-(2-((1H-pyrrol-2-yl)methylene)hydrazineyl)(amino)methaniminium nitrate monohydrate, C6H12N6O4

C6H12N6O4, monoclinic, P21/n (no. 14), a = 7.3652(3) Å, b = 16.8683(7) Å, c = 8.3779(3) Å, β = 101.525(4)°, V = 1019.87(7) Å3, Z = 4, R gt (F) = 0.0349, wR ref (F 2) = 0.1018, T = 170 K.

The Involvement of Aquaporin-4 in the Interstitial Fluid Drainage Impairment Following Subarachnoid Hemorrhage

The mechanism of brain injury following subarachnoid hemorrhage (SAH) has not yet been clarified. The glymphatic system (GS), a glia-dependent waste clearance pathway, drains away soluble waste proteins and metabolic products, even some toxic factors from the brain. Aquaporin-4 (Aqp4) is highly expressed on the astrocyte foot processes and facilitates the interstitial fluid (ISF) transportation in the GS system. In this study, the role of Aqp4 in the GS injury after SAH was explored using Aqp4 gene knockout (Aqp4^−/−) Sprague Dawley rats. The results of MRI, fluorescent imaging, and transmission electron microscopy (TEM) indicated that, after SAH, the inflow of cerebrospinal fluid (CSF) into the brain and the clearance of ISF from the brain were both significantly decreased. Meanwhile, the expression level of Aqp4 around the artery was markedly higher than that around the vein following SAH. Aqp4 knockout exacerbated the GS damage after SAH. In summary, after SAH, there was an apparent GS impairment, and Aqp4 played key roles in modulating the function of GS in the brain.

The use of 2-, 5-, and 10-year probabilities to characterize fracture risk after a recent sentinel fracture

The increase in fracture risk associated with a recent fragility fracture is more appropriately captured using a 10-year fracture probability than 2- or 5-year probabilities.

INTRODUCTION

The recency of prior fractures affects subsequent fracture risk. The aim of this study was to quantify the effect of a recent sentinel fracture, by site, on the 2-, 5-, and 10-year probability of fracture.

METHODS

The study used data from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture probabilities were determined after a sentinel fracture (humeral, clinical vertebral, forearm and hip fracture) occurring within the previous 2 years and probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios were used to adjust fracture probabilities over a 2-, 5-, and 10-year time horizon.

RESULTS

As expected, probabilities decreased with decreasing time horizon. Probability ratios varied according to age and the site of sentinel fracture. Probability ratios to adjust for a prior fracture within the previous 2 years were higher the shorter the time horizon, but the absolute increases in fracture probabilities were much reduced. Thus, fracture probabilities were substantially lower with time horizons less than 10 years.

CONCLUSION

The 10-year probability of fractures is the appropriate metric to capture the impact of the recency of sentinel fractures. The probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures, adjustments which can readily inform clinical decision-making.

Global impact of COVID-19 on non-communicable disease management: descriptive analysis of access to FRAX fracture risk online tool for prevention of osteoporotic fractures

The COVID-19 pandemic, and its management, is markedly impacting the management of osteoporosis as judged by access to online FRAX fracture risk assessments. Globally, access was 58% lower in April than in February 2020. Strategies to improve osteoporosis care, with greater use of fracture risk assessments, offer a partial solution.

INTRODUCTION

The COVID-19 pandemic is having a significant detrimental impact on the management of chronic diseases including osteoporosis. We have quantified the global impact by examining changes in the usage of online FRAX fracture risk assessments before and after the declaration of the pandemic (11 March 2020).

METHODS

The study comprised a retrospective analysis using GoogleAnalytics data on daily sessions on the FRAX® website ( www.sheffield.ac.uk/FRAX ) from November 2019 to April 2020 (main analysis period February-April 2020), and the geographical source of that activity.

RESULTS

Over February-April 2020, the FRAX website recorded 460,495 sessions from 184 countries, with 210,656 sessions in February alone. In March and April, the number of sessions fell by 23.1% and 58.3% respectively, a pattern not observed over the same period in 2019. There were smaller reductions in Asia than elsewhere, partly related to earlier and less-marked nadirs in some countries (China, Taiwan, Hong Kong, South Korea and Vietnam). In Europe, the majority of countries (24/31, 77.4%) reduced usage by at least 50% in April. Seven countries showed smaller reductions (range - 2.85 to - 44.1%) including Poland, Slovakia, Czech Republic, Germany, Norway, Sweden and Finland. There was no significant relationship between the reduction in FRAX usage and measures of disease burden such as COVID-attributed deaths per million of the population.

CONCLUSION

This study documents a marked global impact of the COVID-19 pandemic on the management of osteoporosis as reflected by FRAX online fracture risk assessments. The analysis suggests that impact may relate to the societal and healthcare measures taken to ameliorate the pandemic.

Combining fracture outcomes in phase 3 trials of osteoporosis: an analysis of the effects of denosumab in postmenopausal women

This paper explores use of metrics that combine fracture outcomes that add power to phase 3 studies and provide a surrogate outcome for regulatory agencies.

INTRODUCTION

The aim of this study was to develop an analytic framework that would combine information from all fracture outcomes (including radiographic vertebral fractures) in phase 3 studies to provide a metric for the assessment of treatment efficacy.

METHODS

Data from the phase 3 study of denosumab were used as an exemplar comparing the effects of active intervention with placebo on the risk of all fractures associated with osteoporosis. Fracture outcomes were assigned utility weights drawn from the published literature and applied to age-specific health state values of the general population. For each fracture outcome in each arm of the study, cumulative disutility was computed to serve as the principal end point. The hypothesis tested was that treatment with denosumab results in a significant reduction in mean fracture-related disutility.

RESULTS

Treatment with denosumab was associated with significantly lower utility loss compared with placebo. For patients treated with denosumab, mean utility loss was 42% less than with placebo (4.5 vs. 7.5 QALYs/1000 patient years, respectively, p < 0.001).

CONCLUSIONS

Denosumab significantly decreased utility loss. The use of metrics that combine fracture outcomes may provide added power to phase 3 studies and provide a surrogate outcome for regulatory agencies.

The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density

The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. In older women, TUG time predicts the risk of major osteoporotic fracture and hip fracture independently of clinical risk factors and bone mineral density, and has a substantial impact on fracture probabilities.

INTRODUCTION

The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. A slow TUG has been associated with an increased fracture risk, but it is unclear whether the association is independent of clinical risk factors and bone mineral density (BMD). The aim of this study was to investigate if TUG time was associated with fracture risk independently of clinical risk factors and BMD and to determine its impact on fracture probabilities in older women.

METHODS

A standardized questionnaire was used to assess information regarding clinical risk factors in the large population-based SUPERB study of 3028 older women (75-80 years). At baseline, the TUG test was performed and BMD measured with DXA. The association between TUG time and the risk of hip fracture and major osteoporotic fracture (MOF) was examined using an extension of Poisson regression.

RESULTS

Fracture incidence increased steeply with increasing TUG time up to 12 s and subsequently started to level off. A slow TUG time was therefore defined as TUG > 12 s, a cutoff level then used in Cox models to study the association between slow TUG and fracture risk. A slow TUG time was associated with an increased risk of fracture (MOF 2.39 [1.80-3.18] and hip fracture 2.96 [1.62-5.40]). These associations were slightly attenuated but remained significant after adjustment for clinical risk factors and femoral neck BMD. Depending on BMD, the 4-year fracture probability of MOF increased by a factor of 1.5-1.9 in a 75-year-old woman with slow TUG (> 12 s).

CONCLUSION

The TUG time predicts the risk of MOF and hip fracture independently of clinical risk factors and BMD and has a substantial impact on fracture probabilities, indicating that inclusion of the TUG test in patient evaluation should be considered in order to improve fracture prediction in older women.

Crystal structure of dichlorido-bis(1-hexyl-1H-benzotriazole-k1 N)zinc(II), C24H34N6Cl2Zn

C24H34N6Cl2Zn, monoclinic, P21/c (no. 14), a = 9.513(3) Å, b = 9.546(3) Å, c = 30.956(10) Å, β = 101.228(9)°, V = 2757.3(15) Å3, Z = 4, R gt (F) = 0.0452, wR ref (F 2) = 0.1299, T = 293 K.

Crystal structure of 1,3-bis(octyl)benzimidazolium perchlorate C23H39ClN2O4

C23H39ClN2O4, triclinic, P 1 ‾ $P&#x203e;{1}$ (no. 2), a = 9.0752(19) Å, b = 9.542(2) Å, c = 16.049(3) Å, α = 99.088(4)°, β = 94.422(4)°, γ = 107.146(4)°, V = 1300.0(5) Å3, Z = 2, R gt(F) = 0.0646, wR ref(F 2) = 0.2298, T = 293.0 K.

Low dietary protein resilience is an indicator of the relative protein efficiency of individual dairy cows

Our objectives were to determine (1) the sources of variation in cow responses to dietary protein reduction, and (2) the association of low dietary protein resilience (LPR) with protein efficiency. Lactating Holstein cows in peak lactation (n = 166; 92 primiparous, 77 multiparous) with initial milk yield 41 ± 9.8 kg/d were fed high-protein (HP) or low-protein (LP) diets in 4-wk periods in a crossover design with half the cows fed LP first and half fed HP first. The study was repeated for 69 of these cows (42 primiparous, 27 multiparous) in late lactation. Low-protein diets were 14% crude protein (CP) in peak lactation and 13% CP in late lactation and were formulated to contain adequate rumen-degradable protein to maintain rumen function but inadequate rumen-undegradable protein for cows with average production in this study to maintain their production. High-protein diets were 18% CP in peak lactation and 16% CP in late lactation and contained extra expeller soybean meal to meet metabolizable protein requirements. Protein efficiency was defined as the protein captured in milk or in both milk and body tissues per unit of consumed protein. Low dietary protein resilience was calculated for each cow in peak and late lactation based on actual intake, production, and body weight measures. The ability of a cow to maintain total protein captured in milk and body gain when fed less protein varied considerably and the variation was mostly explained by a cow's captured protein per kilogram of metabolic body weight when fed HP, her parity, treatment sequence, and experiment. Protein efficiency was moderately repeatable across diets within lactation stage. Milk urea nitrogen was not associated with protein efficiency in individual cows within a diet and lactation stage. Cows with greater dietary protein resiliency (higher LPR) had similar protein efficiency on the HP diet as cows with lower LPR, but higher protein efficiency on the LP diet. In conclusion, cows generally maintained their protein efficiency rankings when switching diets between sufficient or insufficient protein; however, some high-producing cows are better able to maintain high production when fed less protein. We define this ability as LPR and suggest it might be useful for identifying cows that use protein more efficiently to enhance dairy sustainability.

Examining the effect of land transfer on landlords' income in China: An application of the endogenous switching model

The paper looks at factors that influence landlords' decision to transfer their farmlands and how farmland transfer has impacted on landlords' income. The essence of farmland transfer policy is to promote efficiency in agricultural land use. Endogenous regression model was adopted for the study because of its ability to handle the transfer decisions and impact of transfer decision on outcome simultaneously. The data were obtained from selected communities in Yunnan province, China. A total of 260 landlords were randomly selected for the study. The result shows that out-migration, off-farm income, agesq, public infrastructure and skill training influence transfer decision positively. The results further show that famine experience, access to credit, education and age negatively influence farmland transfer decision. The results show that farmland transfer leads to a significant increase in landlords' income.

Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures

The risk of a recurrent fragility fracture is particularly high immediately following the fracture. This study provides adjustments to FRAX-based fracture probabilities accounting for the site of a recent fracture.

INTRODUCTION

The recency of prior fractures affects subsequent fracture risk. The aim of this study was to quantify the effect of a recent sentinel fracture, by site, on the 10-year probability of fracture determined with FRAX.

METHODS

The study used data from the Reykjavik Study fracture register that documented prospectively all fractures at all skeletal sites in a large sample of the population of Iceland. Fracture probabilities were determined after a sentinel fracture (humeral, clinical vertebral, forearm and hip fracture) from the hazards of death and fracture. Fracture probabilities were computed on the one hand for sentinel fractures occurring within the previous 2 years and on the other hand, probabilities for a prior osteoporotic fracture irrespective of recency. The probability ratios provided adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.

RESULTS

Probability ratios to adjust 10-year FRAX probabilities of a major osteoporotic fracture for recent sentinel fractures were age dependent, decreasing with age in both men and women. Probability ratios varied according to the site of sentinel fracture with higher ratios for hip and vertebral fracture than for humerus or forearm fracture. Probability ratios to adjust 10-year FRAX probabilities of a hip fracture for recent sentinel fractures were also age dependent, decreasing with age in both men and women with the exception of forearm fractures.

CONCLUSION

The probability ratios provide adjustments to conventional FRAX estimates of fracture probability for recent sentinel fractures.

How has formal institutions influenced opportunity and necessity entrepreneurship? The case of brics economies

Using a panel data of BRICS economies, this study looks at how formal institutions have influenced various types of entrepreneurship. The study concentrated mainly on the following formal institutional factors: fiscal freedom, business freedom, property rights, financial freedom, labour freedom, and investment freedom. For the opportunity entrepreneurship, the result is not statistically significant. With the exception of business freedom, the remaining institutional factors have negative relationship with opportunity entrepreneurship. Fiscal freedom and business freedom show negative significant relationship with necessity entrepreneurship. The result also shows that business freedom has a negative significant effect on female opportunity entrepreneurship. The study further reveals that fiscal freedom, business freedom and financial freedom have a negative significant effect on men necessity entrepreneurship. Population growth has a positive effect on all categories of entrepreneurship whiles unemployment contributes negatively to all categories of entrepreneurship.

Effects of supplementing Holstein cows with soybean oil compared with palmitic acid-enriched triglycerides on milk production and nutrient partitioning

Both insulin and trans-10,cis-12 C18:2 (t10c12CLA) can be increased by high-starch diets; thus, it is difficult to determine whether insulin or t10c12CLA mediates nutrient partitioning toward body tissues during milk fat depression. To minimize insulin secretion while manipulating t10c12CLA levels, diets supplemented with palmitic acid-enriched triglycerides and soybean oil were fed to cows. Thirty-two Holstein cows (93 ± 35 d in milk) were included in the crossover experiment with each treatment period being 28 d. Treatment diets contained 25% neutral detergent fiber, 32% starch, 18% crude protein, and 4.6% fatty acids (dry matter basis). Treatment diets contained either palmitic acid-enriched triglycerides (2.5% dry matter, BergaFat T-300, Berg + Schmidt America LLC, Libertyville, IL; PAT) or soybean oil (2.5% dry matter; SBO). Cows were blocked by milk yield, body weight, and parity, and then randomly assigned to 1 of 2 treatment sequences (PAT-SBO or SBO-PAT). Cows fed PAT produced milk with only 3.1% fat, indicating milk fat depression; SBO decreased fat content further to only 2.4%. No effect of treatment was observed on dry matter intake, apparent net energy intake, milk yield, body condition score, or fat thickness over the rump and rib. However, compared with PAT, SBO decreased fat-corrected milk yield, energy-corrected milk yield, milk fat yield, de novo fatty acids, and 16-carbon fatty acid yield, whereas SBO increased body weight gain. Neutral detergent fiber digestibility tended to be lower in SBO, whereas fatty acid digestibility was higher. Additionally, the concentration of plasma insulin, nonesterified fatty acids, and triglycerides, and milk metabolites (trans-10 C18:1 and t10c12CLA) were all higher in SBO. In conclusion, with similar dietary starch content, the diet containing palmitic acid-enriched triglycerides partitioned more energy toward milk synthesis, whereas the diet containing soybean oil partitioned more energy toward body tissue gain.

Acetic Acid Promoted Direct Iodination of Terminal Alkynes with N-Iodosuccinimide: Efficient Preparation of 1-Iodoalkynes

An efficient and highly chemoselective approach for the direct iodination of terminal alkynes using acetic acid as N-iodosuccinimide activated reagent under metal-free conditions has been developed. This facile process tolerates a variety of terminal alkynes and provides the desired products in good to excellent yields (up to 99%).

Crystal structure of 1,1′-bis(diphenylphosphino)ferrocene-(1,1′-bis(diphenylphosphino)ferrocene-κ2 P,P′)-(O-isobutyl sulfurodithioito-κ2 S,S′)copper(I), C39H37CuFeOP2S2

C39H37CuFeOP2S2, triclinic, P1̄ (no. 2), a = 9.6132(10) Å, b = 11.5667(12) Å, c = 16.8739(18) Å, α = 99.732(2)°, β = 96.342(2)°, γ = 93.446(2)°, V = 1832.0(3) Å3, Z = 2, R gt(F) = 0.0455, wR ref(F 2) = 0.1212, T = 293.0 K.

Crystal structure of bis(2,3-diphenyltetrazolidine-5-thione-κ1 S)-(nitrato-κ1 O)-(nitrato-κ2 O,O′)lead(II), C26H20N10O6S2Pb

C26H20N10O6S2Pb, triclinic, P1̄ (no. 2), a = 9.3480(19) Å, b = 12.985(3) Å, c = 14.278(3) Å, α = 113.14(3)°, β = 92.05(3)°, γ = 102.75(3)°, V = 1539.8(7) Å3, Z = 2, R gt(F) = 0.0336, wR ref(F 2) = 0.0874, T = 293.0 K.

Crystal structure of dichloro-bis-(1-butyl-1H-benzo[d]imidazole)-nickel(II), C22H28Cl2N4Ni

C22H28Cl2N4Ni, monoclinic, P21/c (no. 14), a = 9.7332(19) Å, b = 14.886(3) Å, c = 18.623(5) Å, β = 117.45(2)°, V = 2394.5(10) Å3, Z = 4, R gt(F) = 0.0450, wR ref(F 2) = 0.1466, T = 293.0 K.

Crystal structure of bis(N,2-bis(4-ethoxybenzylidene)hydrazine-1-carbohydrazonothioato-κ2 N,S)nickel(II) — N,N-dimethylformamide (1/2), C44H56N10S2O6Ni

C44H56N10S2O6Ni, triclinic, P1̄ (no. 2), a = 9.3077(14) Å, b = 9.9624(14) Å, c = 14.0449(19) Å, α = 70.889(3)°, β = 75.532(2)°, γ = 87.544(3)°, V = 1190.5(3) Å3, Z = 1, R gt(F) = 0.0528, wR ref(F 2) = 0.1279, T = 293 K.

Crystal structure of diisopropyl 2,5-dihydroxycyclohexa-1,4-diene-1,4-dicarboxylate, C14H20O6

C14H20O6, triclinic, P1̄ (no. 2), a = 6.4270(13) Å, b = 8.3458(17) Å, c = 8.4120(17) Å, α = 107.08(3)°, β = 106.43(3)°, γ = 107.37(3)°, V = 376.2(2) Å3, Z = 1, R gt(F) = 0.0521, wR ref(F 2) = 0.1541, T = 294.0 K.

Crystal structure of diisobutyl 2,5-dihydroxycyclohexa-1,4-diene-1,4-dicarboxylate, C16H24O6

C16H24O6, triclinic, P1̄ (no. 2), a = 6.3410(13) Å, b = 7.3430(15) Å, c = 10.241(2) Å, α = 94.06(3)°, β = 103.89(3)°, γ = 113.13(3)°, V = 418.3(8) Å3, Z = 1, R gt(F) = 0.0546, wR ref(F 2) = 0.1691, T = 295(3) K.

Relationship of residual feed intake and protein efficiency in lactating cows fed high- or low-protein diets

Our objectives were to determine the repeatability of residual feed intake (RFI) across dietary protein levels and to determine the association between RFI and protein efficiency in lactating cows. Holstein cows (n = 166; 92 primiparous, 74 multiparous) with initial milk yield 41.3 ± 9.8 kg/d were fed diets with high or low protein in peak lactation. Experiments were conducted as crossovers with 2 treatment periods of 28 to 35 d. Production of 69 of the 166 cows (42 primiparous, 27 multiparous) was also measured in late lactation. Low-protein diets were 14% crude protein (CP) in peak lactation and 13% CP in late lactation and were formulated to contain adequate rumen-degradable protein to maintain rumen function. High-protein diets were 18% CP in peak lactation and 16% CP in late lactation and contained extra expeller soybean meal to increase absorbed protein. Cows were milked twice daily; DMI and milk yield were recorded daily. Milk composition was measured over 4 consecutive milkings weekly, and body weight (BW) was measured 3 times weekly. Fixed effects of diet, parity, and treatment period, interaction of parity and diet, and random effects of experiment and cow nested within experiment were included in the model to compare intake and production performance between cows fed different levels of CP. The RFI value was calculated for each cow on each treatment based on the actual intake, milk energy output, metabolic BW, and body energy (calculated from BW change and body condition score over the treatment period) change. Ranking of cows for RFI was moderately repeatable across dietary protein in peak lactation (r = 0.59) but less repeatable in late lactation (r = 0.41). Negative correlation was observed between RFI and protein efficiency values (dietary protein captured in milk) for cows in both peak lactation (r = -0.42) and late lactation (r = -0.24), which suggested that cows with higher energy efficiency had greater protein efficiency. In conclusion, RFI was repeatable across dietary protein levels within lactation stage, and cows with lower RFI values utilized protein more efficiently.

Correction to: Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures

The article 'Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures',written by J. A. Kanis, was originally published Online First without Open Access. After publication in volume [#], issue [#] and page [#-#], the author decided to opt for Open Choice and to make the article an Open Access publication.

Crystal structure of dipentyl 2,5-dihydroxycyclohexa-1,4-diene-1,4-dicarboxylate, C18H28O6

C18H28O6, monoclinic, C2/c (no. 15), a = 15.061(3) Å, b = 13.791(3) Å, c = 10.106(2) Å, β = 118.60(3)°, V = 1843.0(8) Å3, Z = 4, R gt(F) = 0.0462, wR ref(F 2) = 0.1315, T = 294.3 K.

Efficient synthesis of 1-iodoalkynes via Al2O3 mediated reaction of terminal alkynes and N-iodosuccinimide

Iodination of terminal alkynes using N-iodosuccinimide (NIS) in the presence of γ-Al₂O₃ was developed to afford 1-iodoalkynes with good to excellent yields (up to 99%). This described approach featured excellent chemoselectivity, good functional group tolerance, and utilization of an inexpensive catalyst.

An efficient Al₂O₃-mediated direct iodination of terminal alkynes was developed to afford 1-iodoalkynes.

A surrogate FRAX model for the Kyrgyz Republic

The hip fracture rates from Kazakhstan were used to create a surrogate FRAX® model for the Kyrgyz Republic.

INTRODUCTION

The International Society for Clinical Densitometry and International Osteoporosis Foundation recommend utilizing a surrogate FRAX model, based on the country-specific risk of death, and fracture data based on a country where fracture rates are considered to be representative of the index country.

OBJECTIVE

This paper describes a surrogate FRAX model for the Kyrgyz Republic.

METHODS

The FRAX model used the incidence of hip fracture from the neighbouring country of Kazakhstan and the death risk for the Kyrgyz Republic.

RESULTS

Compared with the model for Kazakhstan, the surrogate model gave somewhat higher 10-year fracture probabilities for men between 60 and 80 years of age and lower probabilities for men above the age of 80. For women the probabilities were similar up to the age of 75-80 years and then lower. There were very close correlations in fracture probabilities between the surrogate and authentic models (1.00) so that the use of the Kyrgyz model had little impact on the rank order of risk. It was estimated that 2752 hip fractures arose in 2015 in individuals over the age of 50 years in the Kyrgyz Republic, with a predicted increase by 207% to 8435 in 2050.

CONCLUSION

The surrogate FRAX model for the Kyrgyz Republic provides the opportunity to determine fracture probability among the Kyrgyz population and help guide decisions about treatment.

Algorithm for the management of patients at low, high and very high risk of osteoporotic fractures

Guidance is provided in an international setting on the assessment and specific treatment of postmenopausal women at low, high and very high risk of fragility fractures.

INTRODUCTION

The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2019. This manuscript seeks to apply this in an international setting, taking additional account of further categorisation of increased risk of fracture, which may inform choice of therapeutic approach.

METHODS

Clinical perspective and updated literature search.

RESULTS

The following areas are reviewed: categorisation of fracture risk and general pharmacological management of osteoporosis.

CONCLUSIONS

A platform is provided on which specific guidelines can be developed for national use to characterise fracture risk and direct interventions.

Epidemiology of osteoporotic fracture in Kazakhstan and development of a country specific FRAX model

Retrospective and prospective population-based survey in a region of the Republic of Kazakhstan determined the incidence of fractures at the hip, proximal humerus and distal forearm. The hip fracture rates were used to create a FRAX® model to enhance fracture risk assessment in Kazakhstan.

OBJECTIVE

This paper describes the epidemiology of osteoporotic fractures in the Republic of Kazakhstan that was used to develop a country specific FRAX® tool for fracture prediction.

METHODS

We carried out a retrospective population-based survey in Taldykorgan in the Republic of Kazakhstan representing approximately 1% of the country's population. Hip, forearm and humerus fractures were identified retrospectively in 2015 and 2016 from hospital registers and the trauma centre. Hip fractures were prospectively identified in 2017 from the same sources and additionally from primary care data. Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for Kazakhstan. Fracture probabilities were compared with those from neighbouring countries having FRAX models.

RESULTS

The difference in hip fracture incidence between the retrospective and prospective survey indicated that approximately 25% of hip fracture cases did not come to hospital attention. The incidence of hip fracture applied nationally suggested that the estimated number of hip fractures nationwide in persons over the age of 50 years for 2015 was 11,690 and is predicted to increase by 140% to 28,000 in 2050. Hip fracture incidence was a good predictor of forearm and humeral fractures in men but not in women.

CONCLUSION

The FRAX model should enhance accuracy of determining fracture probability among the Kazakh population and help guide decisions about treatment.

Aquaporin4 Knockout Aggravates Early Brain Injury Following Subarachnoid Hemorrhage Through Impairment of the Glymphatic System in Rat Brain

BACKGROUND

It is reported that the expression of aquaporin4 (AQP4) in the brain is increased and leads to the brain edema after subarachnoid hemorrhage (SAH). In this study, by using AQP4 knockout rat model, the opposite role of AQP4 in early brain injury following SAH through modulation of interstitial fluid (ISF) transportation in the brain glymphatic system had been explored.

METHODS

The SAH model was established using endovascular perforation method, the AQP4 knockout rat model was generated using TALENs (transcription activator-like (TAL) effector nucleases) technique. The animals were randomly divided into four groups: sham (n = 16), AQP4^-/-sham (n = 16), SAH (n = 24), and AQP4^-/-SAH groups (n = 27). The roles of AQP4 in the brain water content and neurological function were detected. In addition, immunohistochemistry and Nissl staining were applied to observe the effects of AQP4 on the blood-brain barrier (BBB) integrity and the loss of neurons in the hippocampus. To explore the potential mechanism of these effects, the distribution of Gd-DTPA (interstitial fluid indicator) injected from cisterna magna was evaluated with MRI.

RESULTS

Following SAH, AQP4 knockout could significantly increase the water content in the whole brain and aggravate the neurological deficits. Furthermore, the loss of neuron and BBB disruption in hippocampus were also exacerbated. The MRI results indicated that the ISF transportation in the glymphatic system of AQP4 deficit rat was significantly injured.

CONCLUSION

AQP4 facilitates the ISF transportation in the brain to eliminate the toxic factors; AQP4 knockout will aggravate the early brain injury following SAH through impairment of the glymphatic system.

Crystal structure of Bis(acetato-κ2O,O′)-bis[4-(dimethylamino)pyridine-κN]nickel(II), C18H26N4NiO4

C18H26N4NiO4, triclinic, P1̄ (no. 2), a = 7.7547(16) Å, b = 7.8666(16) Å, c = 8.2798(17) Å, α = 90.46(3)°, β = 96.24(3)°, γ = 93.25(3)°, V = 501.24(18) Å3, Z = 1, Rgt(F) = 0.0294, wRref(F2) = 0.0873, T = 310 K.

Higher thyroid-stimulating hormone levels in the first trimester are associated with gestational diabetes in a Chinese population

AIM

To evaluate the relationship between maternal thyroid-stimulating hormone levels during the first trimester and gestational diabetes risk.

METHODS

In Tianjin, China, 7258 women underwent a thyroid-stimulating hormone screening test within 12 gestational weeks and then had a glucose challenge test at 24-28 weeks of gestational age. The women with a glucose challenge test ≥7.8 mmol/l underwent a 75 g oral glucose tolerance test. Gestational diabetes was diagnosed following International Association of Diabetes and Pregnancy Study Group criteria. Restricted cubic spline analysis was performed to explore full-range risk associations of thyroid-stimulating hormone levels with gestational diabetes. Logistic regression was performed to obtain odds ratios and 95% confidence intervals.

RESULTS

In all, 594 women (8.2%) had gestational diabetes. Among women with thyroid-stimulating hormone ≤3.2 mIU/l, a positive association between thyroid-stimulating hormone levels and gestational diabetes risk was found (adjusted OR: 1.13, 95% CI: 1.00-1.27). There was no relationship between thyroid-stimulating hormone levels and gestational diabetes risk in univariable and multivariable analyses among women with thyroid-stimulating hormone >3.2 mIU/l. In subgroup analyses, among women with thyroid-stimulating hormone ≤3.2 mIU/l and BMI ≥25 kg/m² , the adjusted odds ratio for thyroid-stimulating hormone levels with gestational diabetes was enhanced to 1.25 (95% CI: 1.02-1.53).

CONCLUSIONS

In pregnant Chinese women, thyroid-stimulating hormone levels even within normal range in the first trimester were positively related to gestational diabetes risk, especially for pre-pregnancy overweight/obese women.

Crystal structure of 1-(5-(4-chlorophenyl)-3-(2-fluorophenyl)-4,5-dihydro-1H-pyrazol-1-yl)ethan-1-one, C17H14N2OFCl

C17H14N2OFCl, triclinic, P1̄ (no. 2), a = 8.2387(19) Å, b = 9.764(2) Å, c = 10.644(3) Å, α = 72.023(4)°, β = 72.770(4)°, γ = 78.581(4)°, V = 772.5(3) Å3, Z = 2, Rgt(F) = 0.0444, wRref(F2) = 0.1099, T = 294.15 K.

Psychometric Evaluation of the Neuropsychological Test Battery in Individuals with Normal Cognition, Mild Cognitive Impairment, or Mild to Moderate Alzheimer's Disease: Results from a Longitudinal Study

BACKGROUND

The Neuropsychological Test Battery (NTB) is a combination of widely used clinical neuropsychological tests measuring memory and executive function and was designed to overcome some of the limitations of the traditionally used Alzheimer's disease Assessment Scale - Cognitive subscale (ADAS-Cog). A previously reported account indicated high levels of NTB reliability in patients with mild-to-moderate Alzheimer's disease (AD) and mild cognitive impairment (MCI).

OBJECTIVES

We examined capacity of the Neuropsychological Test Battery (NTB) and its component subtests to measure cognitive change over time. Correlations with other cognitive and functional assessments were also determined. Design, Settings, Participants: This was a multicentre, prospective, non-interventional, longitudinal cohort study involving patients with mild-to-moderate AD (n=196), MCI (n=70), or cognitively normal control participants (NC, n=75).

INTERVENTION

The NTB, as well as other Clinical Outcome Assessments including, ADAS-Cog, other cognitive measures, functional/behavioral questionnaires, health outcome questionnaires, and resource utilization tools were administered.

RESULTS

Mean change from baseline for the NTB composite score and the six individual NTB subtests showed greater reductions in performance over time in the AD and MCI groups, compared with NC group. The ADAS-Cog was found to be more sensitive to change than the NTB in all three populations.

CONCLUSIONS

The NTB showed high correlation with the ADAS-Cog and appears to be a sensitive and reliable assessment tool for measuring cognitive decline in patients with mild-to-moderate AD. However, the ADAS-Cog was found to be more sensitive to change over time in both the AD and MCI populations.

Crystal structure of 5-(4-chlorophenyl)-3-(4-fluorophenyl)-1-phenyl-4,5-dihydro-1H-pyrazole, C21H16ClFN2

C21H16ClFN2, monoclinic, P21/c (no. 14), a = 20.286(4) Å, b = 5.3827(11) Å, c = 16.254(3) Å, β = 104.95(3)°, Z = 4, V = 1714.7(7) Å3, R gt(F) = 0.0548, wR ref(F 2) = 0.1199, T = 293(2) K.

rSjp40 inhibits activated hepatic stellate cells by promoting nuclear translocation of YB1 and inducing BMP-7/Smad1/5/8 pathway

Background

Activation of hepatic stellate cells is the dominant pathogenic event during the process of liver fibrosis. Bone morphogenic protein (BMP)-7 has recently been identified as an anti-fibrotic factor and leads to phosphorylation of Smad1/5/8 in activated hepatic stellate cells. Its expression can be upregulated by the transcriptional activator, Y-Box protein-1 (YB1). Previous studies have found that the recombinant Schistosoma japonicum protein p40 (rSjp40) can inhibit the activation of hepatic stellate cells, and based on this evidence we attempted to investigate whether or not BMP-7 is involved in rSjp40’s inhibition.

Methods

A human hepatic stellate cell line, the LX-2 cell line, was cultured and treated with rSjp40. The role of BMP-7 was analyzed by Western blot.

Results

Our findings testified that knockdown of BMP-7 impaired rSjp40-induced downregulation of α-SMA and phosphorylation of Smad1/5/8 in LX-2 cells. Furthermore, rSjp40 upregulated expression of BMP-7 at both mRNA and protein levels depending on YB1. Interestingly, YB1 was translocated from the cytoplasm to the nucleus upon treatment of rSjp40.

Conclusions

These results suggest that rSjp40 inhibits the activation of hepatic stellate cells by promoting nuclear translocation of YB1 and inducing BMP-7/Smad1/5/8 pathway, which provide a new clue to guide ongoing research into the anti-fibrosis of rSjp40.

The olfactory stimulation slows down the substance clearance in the extracellular space of the hippocampus in rat brain

Accelerating the clearance of toxin in the brain extracellular space (ECS) has grown a promising strategy for treating some central nervous system diseases. As oldest sensory system, we know little about the influence of olfaction on the brain, but preclinical studies such as treatment of neurological diseases through it are in the ascendant. This makes it important to clarify the effects of olfaction on brain ECS and interstitial fluid (ISF) drainage. In this study, the effect of olfactory stimulation (eugenol, EUG) on ISF flow in hippocampus and its association with aquaporin 4 (Aqp4) had been investigated. The results show that eugenol can significantly increase the activity of hippocampal neurons, but reduce the clearance and diffusion rates of Gd-DTPA and A-594 in hippocampus. Similarly, eugenol inhalation slows down the rate of Gd-DTPA in CSF entering the hippocampus and its clearance. And knockout of Aqp4 gene aggravated these processes. In vitro results showed that after Aqp4 gene silencing, astrocytes grew slowly, with significantly decreased cells number, less nuclei, atrophied bodies and shorter processes. These results concluded that olfactory stimulation can change the ECS structure of the hippocampus, slow down the ISF drainage, and improve the function of neurons, while Aqp4 plays important roles.

The effects of dihydroxyphenyl lactic acid on alleviating blood-brain barrier injury following subarachnoid hemorrhage in rats

BACKGROUND

In this study, the protective effects of 3,4-dihydroxyphenyl lactic acid (DLA) on blood-brain barrier (BBB) injury following subarachnoid hemorrhage (SAH) has been explored.

METHODS

Male Sprague-Dawley rats (weight 300-350 g) were used to establish the SAH model using the endovascular perforation method. The animals were randomly divided into four groups: sham (n = 40), SAH (n = 46), SAH + vehicle (n = 44), and SAH + DLA (n = 40) treatment groups. At 1 h after SAH, either DLA (10 mg/kg) or normal saline (vehicle) was administered by femoral vein injection. The effects of DLA on mortality, neurological function, brain water content, and BBB were observed. Additionally, immunohistochemistry and western blot techniques were applied to investigate the mechanism of action of DLA.

RESULTS

We found that the administration of DLA (10 mg/kg) following SAH could improve neurological functions, reduce brain water content, and maintain BBB integrity. The expression of pro-inflammatory and pro-apoptotic factors such as toll-like receptor 4 (TLR4), NF-κB (p-p65), tumor necrosis factor-α, p-p38 MAPK, p-p53, and caspase-3 were significantly increased after SAH. These same factors were markedly attenuated following treatment with DLA.

CONCLUSIONS

These findings showed that DLA can alleviate BBB injury following SAH through its anti-inflammatory and anti-apoptotic effects via suppression of TLR4 and its downstream NF-κB and p38 MAPK pathways.