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Background: After isotretinoin's approval to treat patients with recalcitrant acne, there have been continued debates around its psychiatric safety profile. This study aimed to assess the risk of psychiatric disorders in patients with acne who are taking isotretinoin.Methods: We used de-identified information from Taiwan's National Health Insurance Research Database from 2000 to 2015 to examine the risk for psychiatric disorders among patients with acne who were taking isotretinoin. We performed subgroup analyses based on the dosage and duration of isotretinoin administration.Results: This study included 29,943 participants during a 16-year follow-up period. We found no significantly increased risk for psychiatric disorders among patients taking isotretinoin compared with patients who did not receive isotretinoin treatment (adjusted hazard ratio [aHR]: 1.009, 95% confidence interval [CI]: 0.422-1.696). Subgroup analyses showed no significantly increased risk for psychiatric disorders in patients taking different doses of isotretinoin (≤ 20 mg per day, aHR: 0.892, 95% CI: 0.371-1.501; > 20 mg per day, aHR: 1.068, 95% CI: 0.446-1.798). There was also no significant increase in risk for patients undergoing isotretinoin treatment over different periods (≤ 6 months, aHR: 0.924, 95% CI: 0.392-1.612; > 6 months, aHR: 1.196, 95% CI: 0.488-2.004).Limitations: We did not analyze the risk of suicidal ideation, and it could be underestimated in medical claims databases.Conclusions: We found no increased risk of psychiatric disorders among Taiwanese patients with acne who were taking isotretinoin. Higher dosage or longer duration of isotretinoin treatment did not increase the risk for developing a psychiatric disorder. [ABSTRACT FROM AUTHOR]

Objectives: Recent studies highlighted the link of schizophrenia risk with genetic variations in complement, which share the same pathogenesis with systemic lupus erythematosus (SLE). However, the coexistence of SLE and schizophrenia were rarely reported. We aimed to explore the autoantibody profiles, complement levels and prevalence of SLE in chronic schizophrenia patients.Methods: A prospective, cross-sectional study was conducted to recruit 481 long-term hospitalized schizophrenia spectrum disorder patients in Yuli hospital, Taiwan. Severity of schizophrenia was assessed by Positive and Negative Syndrome Scale (PANSS). Immunologic tests of autoantibodies and complement levels were measured. Genome-wide association analysis was conducted to compare genetic variants between schizophrenia with SLE and non-SLE schizophrenia.Results: In total, 47 (9.8%) and 31 (6.4%) participants had positive anti-nuclear antibody (ANA) and anti-double stranded DNA (anti-dsDNA) antibodies, respectively. After rheumatologic exams, 30 (6.2%) patients were diagnosed schizophrenia with SLE, while 32 (6.7%) subjects were classified as schizophrenia with autoimmune features. Schizophrenia patients with SLE had more arthritis, serositis, homogenous ANA pattern, conceptual disorganization in PANSS and increased salivation due to psychotropics compared with their counterparts. ANA titers and complement levels were significantly correlated with PANSS scores and side effect of psychotropics. No significant genetic variation between schizophrenia with SLE and non-SLE schizophrenia were identified.Conclusion: SLE may coexist in chronic hospitalized schizophrenia. Complement levels could be a potential biomarker in schizophrenia patients. Considering the possible reversibility of psychotic features and adverse effects of antipsychotics, SLE with psychosis should be identified in patients with chronic hospitalized schizophrenia. [ABSTRACT FROM AUTHOR]

Background: The association between abnormal gut microbiome composition and depression is well established. However, the composition and functional capacity of the gut microbiota regarding depressed women has been poorly addressed.Methods: Stool samples from 62 female patients with major depressive disorder (MDD) and 46 healthy controls (Con) were analyzed by 16S rRNA gene sequencing; Twenty fecal samples from the patient group and 21 fecal samples from the Con group were further analyzed by shotgun metagenomic sequencing. Psychiatric symptoms and psychological, social, and professional functioning was also assessed.Results: Phylum Bacteroidetes, proteobaeteria, and Fusobacteria were greatly enriched in patients with MDD, while the Firmicutes and Actinobacteria phyla were consistently higher in Con. Notably, 18 microbial markers were identified on a random forest model and achieve an area under the curve of 0.92 between patients with MDD and the Con group. Forty-five species and their associated function were identified with statistically significant differences between patients with MDD and the Con group.Limitations: The number of recruited samples, especially samples enrolled for shotgun metagenomic sequencing was relatively small, and the stool samples were collected only at baseline, making it difficult to establish a causal association between changes in gut microbiota compositions and disease remission.Conclusions: This study characterizes the gut microbiota and their related function in female MDD. The gut microbiota-based biomarkers may be helpful in diagnosis and the altered gut microbial metabolites may contribute to the pathogenesis of MDD in women, representing potential microbial targets. [ABSTRACT FROM AUTHOR]

Background: Mental distress patterns in first-time or experienced mothers and fathers during the transition to parenthood have been inadequately studied. This longitudinal study thus investigated changes in depression, anxiety, and health-related quality of life in both parents from early pregnancy until 1 year postpartum. Parity effects were specifically examined.Methods: In total, 531 pregnant women and their partners were recruited in Taiwan during early prenatal visits from 2011 to 2015, with five follow-ups from midpregnancy to 1 year postpartum. The participants' self-reported data were collected and analyzed using generalized estimating equation models.Results: Maternal mental distress levels were highest at 1 month postpartum. During postpartum periods, depression scores increased and social relations domain scores decreased in men. Although mental distress levels were higher in mothers than in fathers, parity evidently affected men. Experienced fathers were independently associated with a 70% higher risk of perinatal depression (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 1.2-2.3) and anxiety (OR = 1.7, 95% CI = 1.2-2.6). Experienced fathers also exhibited significantly lower perinatal scores than first-time fathers in the physical health and social relations domains.Limitations: Selection of both parents in metropolitan areas with higher socioeconomic status may restrict the generalizability of our findings.Conclusions: In addition to maternal mental distress during the transition to parenthood, we highlighted experienced fathers' psychological difficulties throughout perinatal periods. Such trends may indicate unsatisfied needs and could guide timely intervention to prevent adverse consequences. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the association between affiliate stigma and depression in caregivers of children with attention-deficit/hyperactivity disorder (ADHD) in Taiwan and evaluated the moderating effects of perceived family support, self-esteem, and children's behavioral problems on the association.Methods: The affiliate stigma and depressive symptoms of 400 caregivers of children with ADHD were assessed using the Affiliate Stigma Scale and Center for Epidemiological Studies Depression Scale, respectively. A general linear model (GLM) was used to examine the association between affiliate stigma and depression symptoms. The interaction models of the GLM and the Johnson-Neyman technique were used to examine the moderating effects of caregivers' family support and self-esteem and children's internalizing problems and ADHD symptoms on the association.Results: Affiliate stigma was positively associated with the depression level in caregivers of children with ADHD. The level of the association between affiliate stigma and depression symptoms was negatively associated with the levels of family support and self-esteem but positively associated with the levels of child's internalizing problems and ADHD symptoms.Limitations: The cross-sectional design limited the possibility of determining the causal relationships among the variables.Conclusions: Prevention and intervention strategies should aim to reduce affiliate stigma and depression symptoms, as well as to target the moderators of the association. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress could participate in the pathogenesis of Parkinson's disease (PD). However, the role of genetic variation of superoxide dismutase 2 (SOD2), an important regulator against oxidative stress, in PD remains to be elucidated.Methods: We screened SOD2 gene variation by sequencing cDNA from 72 patients with early onset PD. A cohort of PD (n = 609) and ethnically matched controls (n = 681) were further examined for the identified sequence variant by PCR and NaeI restriction analysis.Results: Only a reported c.47T>C polymorphism (rs4880, SOD2 p.V16A) was found by cDNA sequencing. Case-control study of c.47T>C revealed that genotype and allele frequencies were in Hardy-Weinberg equilibrium in both patients and healthy controls. In a recessive model, those with CC genotype had a 2.61-fold increased risk of PD (95% CI: 1.08-6.30, P = 0.03) compared to subjects with TT and TC genotypes. Significant association between CC genotype and PD in non-smokers was also observed after stratification according to the history of smoking (3.54-fold increased risk of PD, 95% CI: 1.17-10.72, P = 0.02). Meta-analysis by combining studies of Chinese in China, Singapore, and Taiwan (total 2302 cases and 2029 controls) consistently showed CC genotype with increased risk of PD (OR = 1.77, 95% CI: 1.15-2.71, P = 0.01).Conclusion: Our findings demonstrate that SOD2 p.V16A may play a role in the susceptibility of PD in Han Chinese. [ABSTRACT FROM AUTHOR]

Perceiving simultaneity is critical in integrating visual and auditory signals that give rise to a unified perception. We examined whether background color modulates people's perception of audiovisual simultaneity. Two hypotheses were proposed and examined: (1) the red-impairment hypothesis: visual processing speed deteriorates when viewing a red background because the magnocellular system is inhibited by red light; and (2) the blue-enhancement hypothesis: the detection of both visual and auditory signals is enhanced when viewing a blue background because it stimulates the blue-light sensitive intrinsically photosensitive retinal ganglion cells (ipRGCs), which trigger a higher alert state. Participants were exposed to different backgrounds while performing an audiovisual simultaneity judgment (SJ) task: a flash and a beep were presented at pre-designated stimulus onset asynchronies (SOAs) and participants judged whether or not the two stimuli were presented simultaneously. Experiment 1 demonstrated a shift of the point of subjective simultaneity (PSS) toward the visual-leading condition in the red compared to the blue background when the flash was presented in the periphery. In Experiment 2, the stimulation of ipRGCs was specifically manipulated to test the blue-enhancement hypothesis. The results showed no support for this hypothesis, perhaps due to top-down cortical modulations. Taken together, the shift of PSS toward the visual-leading condition in the red background was attributed to impaired visual processing speed with respect to auditory processing speed, caused by the inhibition of the magnocellular system under red light. [ABSTRACT FROM AUTHOR]

Despite Alzheimer's disease (AD) being the most common neurodegenerative disorder worldwide, no FDA-approved disease-modifying treatments have been approved for this condition since 2003. Neuronal-type alpha7 nicotinic acetylcholine receptors (α7nAChRs) play an essential role in cognitive functions, binding with extracellular β-amyloid (Aβ plaques) and inhibiting Aβ-induced neurotoxicity. α7nAChRs are impaired early in the course of AD; drugs targeting α7nAChRs are being hotly pursued as a treatment of AD. Encenicline, a partial selective agonist of α7nAChR and modulator of acetylcholine, failed in phase III trials because of gastrointestinal side effects. We, therefore, evaluated the efficacy of galantamine, a positive allosteric modulator at α7nAChRs and an acetylcholinesterase inhibitor, that has been used since 2000 as first-line treatment of mild-to-moderate dementia. This study highlights an important new benefit with galantamine. We found that galantamine inhibits Aβ1-42-induced apoptosis by activating the JNK signaling pathway, thus enhancing α7nAChR expression, and also inhibits the Akt pathway, which further increases autophagosome biogenesis and autophagy. These effects can be reproduced by α7nAChR overexpression in the absence of galantamine. Importantly, the α7 subunit protein sequence of α7nAChRs contains 3 LC3-interacting regions; our immunoprecipitation data show that α7 binds with the autophagosomal marker protein LC3. This is the first report to provide evidence showing that the cell surface receptor α7nAChR acts as a cargo carrier for LC3 binding for Aβ1-42 sequestration to autophagosomes, suggesting a novel mechanism for the neuroprotective efficacy of galantamine in AD. [ABSTRACT FROM AUTHOR]

Background: The efficacy and safety of adjuvant substrate modification (SM; either linear ablation [LA] or complex fractionated atrial electrogram [CFAE] ablation) in addition to pulmonary vein isolation (PVI) for the treatment of symptomatic, drug-refractory atrial fibrillation (AF), have still not been clarified and need further assessment.Method: We systematically searched the PubMed, MEDLINE, and Cochrane databases for studies comparing PVI with adjunctive SM versus PVI alone for treatment of drug-refractory AF.Results: Twenty-six (26) studies including 3,409 patients (1,975 PVI + SM; 1,434 PVI alone) were included for further analysis. Atrial fibrillation/atrial tachycardia-free survival of patients with PVI + SM was comparable with that of PVI alone (relative risk [RR], 1.06; 95% confidence interval [CI], 0.98-1.14; p = 0.143). In line with this, the primary clinical outcomes were robust, irrespective of additional LA (RR, 1.07; 95% CI, 0.97-1.18; p = 0.194) or CFAE ablation (RR, 1.04; 95% CI, 0.93-1.16; p = 0.534). Adjuvant SM is associated with longer procedural time (weighted mean difference, 20.72; 95% CI, 10.25-31.20; p = 0.0) and fluoroscopy time (weighted mean difference, 6.66; 95% CI, 1.74-11.58; p = 0.000); surprisingly, it presented similar procedure-related complications as PVI alone during AF catheter ablation (RR, 1.01; 95% CI, 0.68-1.50; p = 0.946).Conclusions: Adjuvant LA or CFAE ablation do not provide incremental benefit over PVI alone. Although substrate-based ablation markedly prolonged procedural and fluoroscopic duration, there was no evidence of increased risk of procedure-related complications. [ABSTRACT FROM AUTHOR]

Background/purpose: With globalization, transnational marriages become more and more common in the world. The mental health of the offspring of immigrants is a significant public health issue. The present study aimed to investigate whether children of immigrant mothers demonstrate more emotional and behavioral problems than those of native mothers in Taiwan.Methods: In a sample of 6242 children in grade 3, grade 5, and grade 7 from a national epidemiological study of child mental disorders, 617 (9.9%) children were born by immigrant mothers (Chinese, Vietnam, Indonesia, and other countries) and 5625 children by Taiwanese parents. The children reported on Achenbach Youth Self-report, and their parents reported about them on the Child Behavior Checklist, Parental Bonding Inventory, and Family APGAR for assessing emotional and behavioral problems, mother's parenting style, and perceived family support.Results: Compared with children of native mothers, children of immigrant mothers reported themselves and were reported by their parents to have more externalizing and internalizing problems. However, after considering the effects of sociodemographics, parenting style, and family function, only significant differences in externalizing problems between children with native or immigrant mothers were found.Conclusion: Our findings indicate that right parenting style and family support; may offset emotional and behavioral problems in children of immigrant mothers, and suggest that improving maternal parenting and family function is beneficial to child development, regardless of immigrant or native mothers. [ABSTRACT FROM AUTHOR]

Background/purpose: It is still challengeable to treat periodontal pockets refractory to mechanical debridement. This study is to evaluate the potential of indocyanine green (ICG)-diode laser-based photothermal therapy (PTT) for solving this dilemma.Methods: Bone marrow-derived mesenchymal stem cells (BMSCs) and periodontal ligament cells (PDLCs) were incubated with phosphate-buffered saline, chlorhexidine, or ICG, non-irradiated or irradiated with 810-nm diode lasers, and the cell viability was evaluated. Patients with teeth refractory to mechanical periodontal debridement on different quadrants were recruited. At baseline (T0), all examined teeth received scaling and root planing, and those on the test quadrant (PTT group) received ICG-diode laser treatment. The outcome was evaluated using clinical parameters and cytokines in the gingival crevicular fluids at 4-6 weeks (T1) and 6 months (T2).Results: In ICG-treated cultures, the viability of BMSCs and PDLCs was recovered on day 4, and laser irradiation inhibited the metabolic activities of BMSCs. 22 patients with 30 control teeth and 35 PTT-treated teeth were examined. All examined teeth showed modest reductions in probing pocket depth (PPD), clinical attachment loss (CAL), bleeding upon probing (BOP), and plaque score at T1 and T2 and significant reductions in IL-1β and MMP-8 at T2. Compared with controls, BOP was reduced more prominently, IL-1β and MMP-8 were significantly lower, and reductions in PPD and CAL were slightly greater in the PTT group at T1 (0.05-0.19 mm).Conclusion: ICG-diode laser-based PTT is compatible to periodontium and assists in faster resolution of gingival inflammation in periodontal pockets refractory to mechanical debridement. [ABSTRACT FROM AUTHOR]

The flicker electroretinogram (ERG) is typically analyzed in terms of peak-to-trough amplitude and implicit time. However, additional important information may be captured by spectral-domain analysis of the ERG harmonics (responses that occur at multiples of the stimulus frequency). This study describes an approach to analyze the harmonic components of the flicker ERG and its application to patients who have early-stage non-proliferative diabetic retinopathy (NPDR). Of particular interest were the sub-harmonic components occurring at 1.5x and 2.5x the stimulus frequency that produce cycle-to-cycle variation in amplitude termed "period doubling." Twenty visually-normal subjects, 20 diabetic subjects who have no clinically-apparent retinopathy (NDR), and 20 diabetic subjects who have mild NPDR participated. ERGs were recorded in response to sinusoidal flicker (27-63 Hz) and Fourier analysis was performed to extract fundamental and harmonic response amplitudes. Linear quantile mixed models (LQMMs) were used to compare the amplitude of the response components among the three subject groups. Results indicated that the maximum sub-harmonic amplitude occurred in the stimulus frequency range of 33-38 Hz for all subjects. The LQMMs showed a significant sub-harmonic amplitude reduction for the mild NPDR subjects compared to the controls; sub-harmonic amplitude for the NDR subjects did not differ significantly from the controls. In contrast, the fundamental response did not differ among the groups for stimulus frequencies between 33 and 38 Hz. Modeling these results indicated that subharmonic amplitude loss in mild NPDR subjects may be attributed to attenuated feedback occurring early in the retina, possibly at the synapse of cone photoreceptors and OFF bipolar cells. [ABSTRACT FROM AUTHOR]

Introduction: X-linked adrenoleukodystrophy (ALD) and Zellweger spectrum disorder (ZSD) are peroxisomal diseases characterized by accumulation of very long chain fatty acids (VLCFA) in plasma and tissues. Considering the wide variability of manifestation, patients of ALD and atypical ZSD are easily misdiagnosed as hereditary spastic paraplegia (HSP) on their clinical grounds. Here, we aimed to determine the frequency of peroxisome diseases and compare their phenotypic spectra with HSP.Methods: We first applied targeted sequencing in 120 pedigrees with spastic paraplegia, and subsequently confirmed 74 HSP families. We then performed whole exome sequencing for the probands of the 46 remaining pedigrees lacking known HSP-causal genes. Detailed clinical, radiological features, and VLCFA analyses are presented.Results: Seven ALD pedigrees with ABCD1 mutations and one ZSD family harboring bi-allelic mutations of PEX16 were identified. Clinically, in addition to spastic paraplegia, four ALD probands presented adrenocortical insufficiency, and the ZSD proband and her affected sister both developed thyroid problems. VLCFA analysis showed that ratios of C24/C22 and C26/C22 were specifically increased in ALD probands. Moreover, three ALD probands and the ZSD proband had abnormalities in brain or spinal imaging.Conclusions: Our study reports the first ZSD case in China that manifested spastic paraplegia, and emphasized the finding that peroxisomal diseases comprise a significant proportion (8/120) of spastic paraplegia entities. These findings extend our current understanding of the ALD and ZSD diseases. [ABSTRACT FROM AUTHOR]

Background: Prognostic factors for the outcomes in traumatic cardiac arrest (TCA) patients transported to hospitals without prehospital return of spontaneous circulation (ROSC) remain uncertain. The aim of this study is to investigate factors associated with outcomes in TCA patients without prehospital ROSC.Methods: We conducted a retrospective cohort study using a multi-institutional, 5-year database. Only TCA patients without prehospital ROSC were included. The primary outcome was ROSC in the emergency department (ED), and the secondary outcome was 30-day survival. Logistic regression analysis was performed to determine the factors associated with primary and secondary outcomes.Results: Among 463 TCA patients, 73 (16%) had ROSC during ED resuscitation, and among those with sustained ROSC, 10 (14%) survived for at least 30 days. Injury severity score ≧ 16 (OR, 0.06; 95% CI: 0.02-0.20), trauma center admission (OR, 2.69; 95% CI: 1.03-7.03), length of ED resuscitation (OR, 0.98; 95% CI: 0.96-0.99), and total resuscitation length > 20 min (OR, 0.21; 95% CI: 0.08-0.54) were associated with ROSC.Conclusions: In TCA patients transported to hospitals without prehospital ROSC, resuscitation attempts could be beneficial. We should aim to resuscitate patients as soon as possible with appropriate treatments for trauma patients, early activation of trauma team, and then, as a result, shorter resuscitation time will be achieved. [ABSTRACT FROM AUTHOR]

Objective: The main purpose of this study was to assess the empirical findings of compulsory admission for psychiatric disorders before and after the 2007 amendment to the Mental Health Act in Taiwan.Methods: A matched case-control study design was applied. Participants were selected using the National Health Insurance Research Database (NHIRD) in Taiwan. The control and case data were collected in 2006 and 2011, and the number of compulsory admission cases was recorded with a case-control ratio of 1:4, along with information on age (±3 years) and gender. In 2006, the number of patients recruited was 9265, including 1853 compulsorily admitted patients and 7412 voluntarily admitted patients. In 2011, the number of patients recruited was 4505, including 901 compulsorily admitted patients and 3604 voluntarily admitted patients.Results: The data collected for the patients who underwent compulsory admission before and after the amended Mental Health Act included gender, diagnosis, Charlson Comorbidity Index Score (CCIS), length of stay in an acute hospital ward (days), hospital accreditation level, ownership, teaching hospital status, psychiatrist gender and age, and hospital location. Although the number of compulsory admission cases (1853 vs. 901) markedly decreased and the length of stay in an acute hospital ward (30.7 ± 25.0 days vs. 39.0 ± 22.6 days) increased from 2006 to 2011, the readmission rate was reduced from 52.6% in 2006 to 42.5% in 2011.Conclusions: The average lengths of hospital stay and community survival time were greater for compulsorily admitted patients than those for voluntarily admitted patients. This result might be attributed to a number of changes implemented since the 2007 amendment of the Mental Health Act, including a strict review process for compulsory admissions and a new discharge planning process, which require further research for approval. [ABSTRACT FROM AUTHOR]

Obesity is a serious and costly issue to the medical welfare worldwide. Probiotics have been suggested as one of the candidates to resolve the obesity-associated problems, but how they combat obesity is not fully understood. Herein, we investigated the effects of Lactobacillus reuteri 263 (L. reuteri 263) on antiobesity using four groups of Sprague-Dawley rats (n=10/group), namely, C (normal diet with vehicle treatment), HE [high-energy diet (HED) with vehicle treatment], 1X (HED with 2.1×109 CFU/kg/day of L. reuteri 263) and 5X (HED with 1.05×1010 CFU/kg/day of L. reuteri 263), for 8 weeks. L. reuteri 263 improved the phenomenon of obesity, serum levels of proinflammatory factors and antioxidant enzymes. More importantly, L. reuteri 263 increased oxygen consumption in white adipose tissue (WAT). The mRNA expressions of thermogenesis genes uncoupling protein-1, uncoupling protein-3, carnitine palmitoyltransferase-1 and cell death-inducing DFFA-like effector-a were up-regulated in WAT of the 5X group. Moreover, L. reuteri 263 might induce browning of WAT due to the higher mRNA levels of browning-related genes peroxisome proliferator-activated receptor-γ, PR domain containing-16, Pparγ coactivator-1α, bone morphogenetic protein-7 and fibroblast growth factor-21 in the 1X and 5X groups compared to the HE group. Finally, L. reuteri 263 altered the expressions of genes involved in glucose and lipid metabolisms in WAT, including increasing the levels of glucose transporter type 4 and carbohydrate-responsive element-binding protein and decreasing the expression of Acetyl-CoA carboxylase-1. The results suggest that L. reuteri 263 may treat obesity through energy metabolism remodeling of WAT in the high-energy-diet-induced obese rats. [ABSTRACT FROM AUTHOR]

Introduction: Phospholipase A2-associated neurodegeneration (PLAN) is an autosomal recessive movement disorder with abnormal iron deposition in basal ganglia, substantial nigra and adjacent areas, and cerebellar atrophy. It is caused by PLA2G6 mutations and comprises three phenotypes. We aimed to investigate genetic mutations in patients with predominantly extrapyramidal symptoms.Methods: Eighteen Chinese patients with early onset of extrapyramidal symptoms were identified and underwent targeted next-generation sequencing, followed by Sanger sequencing. Detailed clinical and radiological features are presented. Prediction software was used to evaluate the pathogenicity of the identified variants.Results: We identified 7 PLA2G6 variants including five known variants (c.668C > T, c.991G > T, c.1117G > A, c.1982C > T, and c.2218G > A) and two novel variants (c.1511C > T, and c.1915G > A) in four index cases. Among them, three cases had initial symptoms of difficulty walking or gait disturbance around the age of 30, and one case and his sibling developed mental handicap at age 7. Two cases exhibited a phenotype of "early parkinsonism" and the other two cases mimicked a phenotype of "hereditary spastic paraplegia (HSP)". Iron deposition in globus pallidus and substantia nigra was seen in three cases. Cerebellar atrophy was present in all four cases.Conclusions: Our study expands the mutation spectrum of the PLA2G6 gene and further supports the hypothesis that PLA2G6 mutations are associated with a continuous clinical spectrum from PLAN to HSP. [ABSTRACT FROM AUTHOR]

Context: Dyspnea, fatigue, and pain are common in individuals with chronic obstructive pulmonary disease (COPD). However, questionnaires with a similar format are not available to assess their relative severity and interference.Objectives: To determine the reliability and validity of the Brief Fatigue Inventory (BFI) and Dyspnea Inventory (DI) in COPD patients who attend pulmonary rehabilitation programs.Methods: Participants were recruited from four pulmonary rehabilitation programs to complete a survey package containing: the Chronic Respiratory Questionnaire (CRQ), BFI, and DI; and one week later, to complete the BFI and DI. Retrospective data of the CRQ, BFI, and DI were retrieved from one of the programs.Results: For the prospective component, there was an 85% response rate (n = 91) for the first package and 83.5% response rate (n = 76) for the second package. Retrospectively, CRQ, BFI, and DI data were retrieved from 48 charts. The BFI and DI demonstrated excellent internal consistency (Cronbach alpha = 0.96 both), and high test-retest reliability (intraclass correlation3,1 = 0.86 and 0.91, respectively). By comparison to the fatigue and dyspnea domains of the CRQ, the BFI showed high concurrent validity (ρ = -0.83), whereas the DI showed moderate (ρ = -0.57) to high (ρ = -0.78) concurrent validity. Factor analysis provided evidence that the items in the BFI and DI measured the intended constructs.Conclusion: The BFI and DI are valid and reliable measures to evaluate fatigue and dyspnea in COPD patients and could be used concurrently with the Brief Pain Inventory to inform the relative severity and interference of these common symptoms in COPD. [ABSTRACT FROM AUTHOR]

To reduce the chiller energy consumption in a central air-conditioning system, a heat exchanger, acting as an air cooler, can be installed before an air handling unit to pre-cool the fresh air by recovering cooling capacity from exhaust air. However, studies on evaluating the performances of air cooler under condensation condition are limited. Therefore, an experimental study was conducted to evaluate the plate type air cooler performance under four operating modes (dry/wet mode, low/high air humidity). Under dry operating mode, the air cooler serves as a traditional air cooler; while under wet operating mode, it works as an indirect evaporative cooler (IEC). The cooler dynamic performances during different operating mode transition were investigated. The steady performances under different parameter influence were also comparatively studied. The results show that wet operating improves the sensible and latent cooling capacities of air cooler significantly. Condensation takes place under high humidity inlet air, results in decreasing of sensible efficiency but increasing of latent efficiency and total heat transfer rate. The coefficient of performance (COP) of IEC is higher than that of traditional air cooler under the same testing configuration. The highest COP can reach 9.0 and achieved under wet operating mode with condensation. [ABSTRACT FROM AUTHOR]

Background/purpose: In the past few years, many new subtypes in hepatitis C virus (HCV) genotype 6 have been identified. The aim of this study was to modify the multiplex real-time polymerase chain reaction (RT-PCR) protocol and use it to determine the HCV subtypes of a group of Taiwanese injection drug users (IDUs).Methods: We used 76 serum specimens collected in northern Taiwan in 2008. Multiplex RT-PCR was used for HCV subtyping among those serum samples having anti-HCV antibodies. Twenty cases were randomly selected for comparison with subtyping results from Inno-LiPa II tests and phylogenetic tree analysis using NS5B sequences.Results: Multiplex RT-PCR assays showed that 60.5% (46/76) of IDUs had single HCV infection. Three out of 76 (3.9%) had double HCV infection (1b/6a, 2a/2b and 2b/6a). Besides this, 27.6% (21/76) had no HCV signal. One IDU had subtype 6n and two had subtype 6w infection. Inno-LiPa II tests misclassified all 6n and 6w cases as 1b subtype.Conclusion: Our modified multiplex RT-PCR protocol can be used to support molecular epidemiological studies and laboratory diagnoses of different HCV subtypes including genotype 6. [ABSTRACT FROM AUTHOR]

In this study, we compared the detachment ratio of HaCaT and Hs68 cells from pH-responsive chitosan surface by raising medium pH from 7.20 to 7.65 for 60 min. The detachment ratio of elongated Hs68 cells was over 75%, but that of round-shaped HaCaT cells was less than 50%, even extending the incubation time to 6 h or enhancing the cytoskeletal contractile force with the Rho activator CN01. However, the addition of 2 m m of EDTA into the medium at pH 7.65 could effectively detach HaCaT cells (detachment ratio > 90%), indicating that the calcium ion played an important role in the detachment process. Therefore, the family of Ca +2 -dependent integrin receptors was examined by RT-PCR, real-time PCR and immunocytochemistry. It was found the expression of integrin β4 (ITGb4) was HaCaT cell-specific and the mRNA level of ITGb4 in undetached HaCaT cells was significantly higher than that in detached ones. By modulating ITGb4 activity with specific functional blocking antibody ASC-8, the detachment ratio of HaCaT cells could be increased to be greater than 85%. Conversely, the addition of the ligand of ITGb4 laminin into the culture system decreased the medium pH-induced detachment ratio for HaCaT cells, but not for Hs68 cells. Further addition of ASC-8 could rescue the effect of laminin on preventing the detachment of HaCaT cells from pH-sensitive chitosan surface. Therefore, this study demonstrated the interaction of ITGb4 and laminin played an important role in controlling the detachment of HaCaT cells on pH-responsive chitosan. [ABSTRACT FROM AUTHOR]

Highlights: [•] We estimate potential PV location on buildings by a street block scale. [•] We analyze PV electrical energy when shaded and unshaded in summer and winter. [•] The efficiency of PV on vertical facades is compared with that on rooftops. [Copyright &y& Elsevier]

Abstract: Comparisons of myeloablative conditioning versus reduced-intensity conditioning (RIC) have demonstrated a tradeoff between relapse and toxicity. Dose intensity across RIC regimens vary and may affect treatment outcomes. In this retrospective analysis, we investigated the effect of i.v. busulfan dosing (total dose 3.2 mg/kg versus 6.4 mg/kg) in RIC regimens that combined fludarabine and busulfan on outcomes in patients who were undergoing hematopoietic stem cell transplantation (HSCT) for myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). A total of 217 consecutive patients with MDS or AML underwent first busulfan and fludarabine RIC peripheral blood stem cell transplantation from well-matched related or unrelated donors at our institutions between 2004 and 2009. Of the 217 patients, 135 patients received Bu1 (3.2 mg/kg of busulfan) and 82 patients received Bu2 (6.4 mg/kg of busulfan), both with daily fludarabine (30 mg/m2/day for 4 days). The choice of RIC regimen was based on temporal institutional standard, enrollment on protocols, and physician choice. Patients had similar characteristics with a few notable differences: Patients who received Bu1 were younger (median age 61 versus 64 years, P < . 001), received more single-antigen mismatched unrelated grafts (14.1% versus 1.2%, P < . 001), received more sirolimus-based graft-versus-host disease (GVHD) prophylaxis regimens (63% versus 45%, P < .0001), received less antithymocyte globulin for GVHD prophylaxis (0% versus 22%, P < .001), and had less enrollment on a clinical trial that used prophylactic rituximab for the prevention of chronic GVHD (2.2% versus 11.0%, P = .011). Clinical disease status was similar between the groups. Median follow-up for survivors was 4.4 years for Bu1 and 3.2 years for Bu2. Because of the differences in characteristics, the 2 groups were compared with the adjustment of a propensity score that predicted Bu2 to account for measured differences. The day +200 cumulative incidence rates of grades II to IV acute GVHD (Bu1, 17%, versus Bu2, 8.5%; hazard ratio [HR], .56; 95% confidence interval [CI], .22 to 1.41; P = .22) or grades III to IV acute GVHD (Bu1, 6.7%, versus Bu2, 4.9%) were not different. The 2-year cumulative incidence of chronic GVHD was not significantly different between Bu1 and Bu2 (41.5% versus 28%, respectively; HR, .70; CI, .42 to 1.17; P = .09). Two-year nonrelapse mortality rates were similar for Bu1 and Bu2 (8.9% versus 9.8%, respectively; HR, .80; CI, .29 to 2.21; P = .67). Two-year progression-free survival and overall survival were also similar between Bu1 and Bu2 (progression-free survival: 40.6% versus 39.3%, respectively; HR, .82; CI, .57 to 1.30; P = .33; and overall survival: 47.4% versus 48.8%, respectively; HR, .96; CI, .64 to 1.44; P = .85). Subset analysis defined by clinical disease and cytogenetic risk with the propensity risk score applied suggest that in patients with high clinical disease risk and nonadverse cytogenetics, the higher dose busulfan RIC regimen may be of marginal benefit (2-year progression-free survival: HR, .54; CI, .29 to 1.03; P = .062). For the majority of patients with MDS or AML undergoing busulfan and fludarabine RIC peripheral blood stem cell transplantation, however, the dose of busulfan (3.2 mg/kg versus 6.4 mg/kg) is not associated with significant differences in overall outcomes. [Copyright &y& Elsevier]

The feasibility of biodiesel production from soapnut (Sapindus mukorossi) oil was investigated with respect to the fuel properties and its blending properties with diesel. Soapnut oil methyl esters (SNME) had satisfactory fuel properties, and the predominant components were methyl oleate at 55.2 wt.% and methyl eicosenoate at 23.9 wt.%. The SNME had the cetane number of 58, cold filter plugging point of 6 °C, flash point of 177 °C, iodine value of 83.6 g I2/100 g, and kinematic viscosity of 4.88 mm2/s at 40 °C. In addition, the oxidation stability of the SNME satisfied the requirements of the biodiesel specifications. Furthermore, the SNME was blended with diesel at various volumetric percentages and evaluated for fuel properties in comparison with the relevant specifications. The linear correlations were established to describe the variations of the properties of the SNME-diesel blends with the volumetric percentage of the SNME. [ABSTRACT FROM AUTHOR]

Abstract: This research focuses on one of the major challenges in a tele-operated crane system, namely the user interface (UI). This UI should provide rich information retrieved from the field and display it properly in order to enhance the operation and decision-making processes involved in crane activities. In this research, we have designed two UIs specifically for a tele-operated crane system. The first UI is a four view system (quad-view) with a top view, left-side view, right-side view, and global view. The second UI has four views but uses additional guidance from Augmented Reality (AR) technologies. To test the UIs, we used a robot arm (KUKA KR16) to simulate a tele-operated crane in a testing environment. We also compared the UIs we designed against a conventional operation interface (i.e. operator’s view with oral guidance from the ground). We conducted a user test with two groups of participants: 5 crane operators and 30 students. Students constitute a novice group, and their results are interpreted from a statistical perspective. Using the student group, the interface’s learning curve can be evaluated. Operators constitute an expert group, which provides evidences for evaluating if the developed UIs are realistic and fit the needs of the field. We found that use of the UIs we designed resulted in a shorter erection time (336 and 343s) than if the participants used the conventional operation interface (380s). A self-evaluated index showing the difficulty of the tasks, the NASA task loading index (TLX), was calculated for each of the UIs. The UIs resulted in a higher TLX (52.0 and 53.2) than the conventional operation interface (32.2). In summary, the two UIs developed in this research are able to assist operators in operating remote cranes more efficiently and with less mental load than by using the conventional operation interface. [Copyright &y& Elsevier]

Abstract: In order to investigate the influences of the city scale, usage, topography, and climate on surface heat balance, the authors compared the surface heat balance for three urban areas in Taiwan, namely, Kaohsiung City, Taichung City, and Tainan City, estimated using ASTER and Formosat-2 data. The net radiation was in a similar range in all three study areas because the cities are in close proximity to each other. Tainan City released 60–70% of the sensible heat flux of the other cities because of its smaller size. Taichung City, which is located in a basin, exhibited the largest sensible heat flux, due to the radiation cooling during the night before the observation. Anthropogenic heat discharge clearly decreased the storage heat flux in certain industrial areas in Kaohsiung City and Taichung City, while the small scale urban functions moderated the variation of storage heat flux in Tainan City. These results imply that the terrain around a given city as well as the scale of urban activity significantly affect the heat balance in the cities. [Copyright &y& Elsevier]

Background/purpose: Taiwan experienced a rapid surge in human immunodeficiency virus (HIV) among injection drug users (IDUs) from 2003 to 2005. The male-to-female ratio of HIV cases decreased from 20:1 in 2003 to 6:1 in 2006. This change is primarily due to increasing numbers of female injection drug users in Taiwan. Our primary objective was to identify the risk factors associated with HIV infection among incarcerated female drug users.Methods: A case-control design involved recruitment of all eligible HIV-infected female inmates from all 24 prisons in Taiwan from November to December, 2007. Eligible HIV seronegative controls were chosen within the same prison and matched to the cases by age (within 3 years) and by history of illicit drug use. A subsample of these matches was randomly selected since there were many more eligible controls than HIV-infected cases. An anonymous self-administered questionnaire was completed with assistance from trained research assistants.Results: A total of 114 cases and 149 control participants were recruited, with a response rate of 82% and 54%. Injectable heroin use was significantly greater (p = 0.02) among HIV-infected cases (93.0%) than un-infected controls (84.6%). Compared to seronegative controls, HIV-infected cases were more likely to share drug paraphernalia and have drug-using sexual partners. Multiple logistic regression analysis revealed that the number of imprisonments (between 2-5 times; OR = 5.23), sharing mainly dilutes (OR= 63.47), and sharing dilutes concurrently with needles (OR= 127.33) significantly predicted HIV seroconversion, after controlling for age and years of education.Conclusion: Sharing needles/dilutes and practicing unsafe intercourse with drug-using sexual partners places female drug users at considerable risk. [ABSTRACT FROM AUTHOR]

Abstract: This study investigates the influence of tab position and quantity as well as multi-segment electrodes in cell design for the performance of an 18650 power-oriented lithium-ion cell. The resistances of cells with traditional and center-tab designs are simulated by a simplified model. It shows that tab position significantly influences the cell resistance even when other components in the cell are fixed. The performances of both center-tab and traditional designs are compared by the cell direct-current resistance (DCR), body temperature, and 15A cycling test to demonstrate the impact of cell design. The multi-tab design also shows better performance than the single-tab design for power cells; however there are diminishing returns for cells with three or more tabs as the additional tabs do not significantly reduce the cell resistance. The two-tab design is concluded to be the best choice for an 18650 power cell considering the process ability and overall high-rate performance. The difference in the waste power between the center-tab and the traditional designs, which is transformed into heat, is the main reason for the poor high-rate cycling performance as expected. Such modeling provides a quick design reference for a power cell with new size to get the most suitable electrode design. [ABSTRACT FROM AUTHOR]

Background/purpose: Circulating retinol binding protein 4 (RBP4) is associated with a variety of obesity-related diseases. This study investigated whether there were aberrant concentrations of RBP4 in cholesterol gallstone disease.Methods: Serum RBP4 levels of 100 cholesterol gallstone patients and 147 healthy controls were measured by enzyme-linked immunosorbent assay and further correlated with clinical and biochemical characteristics, including insulin resistance and renal function. Gallstone specimens were obtained during laparoscopic cholecystectomy and analyzed for their chemical composition using Fourier transform infrared spectroscopyResults: Significantly lower serum RBP4 levels were found in patients with cholesterol gallstones in comparison with controls (30.57 +/- 13.64 mg/L vs. 41.52 +/- 20.25 mg/L, p<0.001). Lower serum RBP4 levels were also associated with gallstone occurrence (odds ratio = 0.93; 95% confidence interval = 0.88-0.96; p = 0.004). Serum RBP4 levels of all subjects were positively correlated with total cholesterol, triglyceride, creatinine, insulin resistance and albumin, and inversely correlated with aspartate aminotransferase and alanine aminotransferase. In multivariate analysis, cholesterol gallstone formation was significantly associated with a lower serum RBP4 level (odds ratio = 4.2; 95% confidence interval= 1.40-12.57; p = 0.010). RBP4 levels were significantly decreased regardless of renal function in patients with gallstones, but levels increased proportionate to renal dysfunction in people without gallstones.Conclusion: Circulating RBP4 decreases in cholesterol gallstone disease independent of renal function. Further studies are needed to investigate the relationship between liver function and RBP4 levels in these patients. [ABSTRACT FROM AUTHOR]

Background/purpose: The seroincidence of human immunodeficiency virus (HIV) in Taiwan has drastically increased since 2004, particularly among injection drug users and prisoners. The major purpose of this study was to explore the prevalence and correlates of psychiatric morbidity among HIV-infected male prisoners.Methods: In 2006, data were collected from all of HIV-infected male prisoners (n = 535) in seven prisons in Taiwan. This collection was performed using a self-administered, anonymous questionnaire in group settings directed by our interviewers. Psychiatric morbidity was measured using the five-item Brief Symptom Rating Scale in 535 participants, which represented an 85% response rate. After excluding incomplete data, 479 participants were included in the analysis.Results: Psychiatric morbidity was present in 46% of participants. Multivariate logistic regression revealed that correlates of the five-item Brief Symptom Rating Scale defined cases included the following: being a recidivist, having poor self-rated health status, and having experienced psychiatric symptoms in one's lifetime (e.g. significant physical pain or discomfort, depression for 2 weeks or longer, serious anxiety or tension, trouble understanding, concentrating, or remembering, and serious thoughts of suicide), with a Nagelkerke R(2) equal to 0.365.Conclusion: Psychiatric morbidity is prevalent among HIV-infected male prisoners. Tailored HIV/AIDS education related to mental health is therefore suggested for inclusion as part of a comprehensive HIV/AIDS training program among incarcerated populations. [ABSTRACT FROM AUTHOR]

Abstract: To compare the cytotoxicity of three nano-dentin bonding agents (nano-DBAs) and two non-nano-DBAs using Chinese hamster ovary (CHO-K1) cells. We found that nano fillers were not the major contributing factor in DBA cytotoxicity, as analyzed by colony forming assay and 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) assay. Exposure of CHO-K1 cells to all three tested total-etching DBAs led to G0/G1 cell cycle arrest, whereas exposure to higher concentrations of two tested nano-DBAs induced G2/M arrest. All five DBAs further induced apoptosis at the highest concentration, as analyzed by propidium iodide staining flow cytometry. The toxicity of all DBAs (1:4000v/v or higher) is related to increased reactive oxygen species (ROS) production, as analyzed by single cell DCF fluorescence flow cytometry. These results indicate that clinical application of DBAs may be potentially toxic to dental pulp tissues. Cytotoxicity of DBAs is associated with ROS production, cell cycle deregulation and apoptosis. Presence of methacrylate monomers such as PENTA and UDMA is possibly the major cytotoxic factor for DBAs. Further studies on other toxicological endpoints of nano-DBAs are necessary to highlight their safe use. [Copyright &y& Elsevier]

Background/purpose: Salmonella enterica serotype Enteritidis (SE) is the most frequent etiological agent of human salmonellosis. The molecular epidemiology and antimicrobial susceptibility of human and chicken isolates of SE were examined.Methods: A total of 27 human and 40 chicken isolates of SE were collected in 2005-2006. We examined these isolates by antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE), and plasmid analysis.Results: Most isolates were susceptible to the seven antibiotics tested, except chicken isolates in 2005, which showed 70% resistance to streptomycin and 75% to tetracycline. There were six plasmid profiles identified among these isolates. Almost all isolates (97%) harbored the 60-kb serotype-specific virulence plasmid. PFGE using XbaI digestion separated human isolates into eight subtypes (1a-1h) and chicken isolates into four subtypes (1a-1c and 1g). In 2005, 1a and 1c were predominant for human isolates and 1a for chicken isolates. However, in 2006, 1a and 1c remained predominant for human isolates and 1b and 1c for chicken isolates. Most 1b and 1c isolates belonged to plasmid type 2 or 4. Correlation between plasmid patterns and PFGE subtypes was obtained between a 36-kb plasmid and 1b and between another 3.6-kb plasmid and 1a.Conclusion: Plasmid profiling and PFGE were efficient for discriminating SE isolates from different sources. Our data support the notion that SE is transmitted from chickens to humans, presumably through the food chain, but it appears that chickens are not the sole reservoir for human infection with SE in Taiwan SE remained susceptible to most antimicrobial agents. [ABSTRACT FROM AUTHOR]

Background/Purpose: The electropharmacological effect of arsenic trioxide (As2O3) is unknown. The present study investigated the effects of As2O3 on spontaneous neuronal impulse activity. Methods: Intracellular recordings and the two-electrode voltage clamp method were used to study the effect of As2O3 on the RP4 neuron, the number 4 neuron in the right partial ganglion of the giant African snail (Achatina fulica Ferussac). Results: The RP4 neuron generated spontaneous action potentials, which were affected by As2O3 in a concentration-dependent manner. Extracellular application of 1 or 3 mM As2O3 decreased the frequency of spontaneously generated action potentials. At 10 mM, As2O3 first depolarized and then elicited irreversible bursts of potential (BoPs) at 60 minutes after administration. At 30 mM, As2O3 depolarized the resting membrane potential and abolished the spontaneous action potentials. The BoPs elicited by 10 mM As2O3 were blocked when neurons were pretreated with phospholipase C (PLC) inhibitors (10 mM U73122 or 3 mM neomycin). The BoPs elicited by As2O3 remained unchanged in the presence of KT5720, verapamil, or calcium replacement solution. Voltage-clamp studies revealed that 10 mM As2O3 decreased the fast inward current and had no effect on the steady-state outward current of the neuron. Conclusion: As2O3 at 10 mM elicits BoPs in central snail neurons and this effect may relate to the PLC activity of the neuron, rather than protein kinase A activity, or calcium influxes of the neuron. As2O3 at higher concentration irreversibly abolishes the spontaneous action potentials of the neuron. [Copyright &y& Elsevier]

Background/purpose: Adalimumab is a fully humanized monoclonal antibody that blocks tumor necrosis factor (TNF)-alpha, which is effective in the treatment of patients with rheumatoid arthritis (RA). The purpose of this study was to compare the efficacy and safety of adalimumab plus methotrexate (MTX) and MTX alone in Taiwanese patients with active RA.Methods: Forty-seven patients with active RA who were maintained on MTX therapy at a stable dose of 10-15 mg/week for 4 weeks were randomized blindly to receive adalimumab 40 mg (n = 35) or placebo (n = 12) by subcutaneous injection every other week over a period of 12 weeks. The primary endpoint was a reduction in tender and swollen joint counts of 20% (ACR20), 50% (ACR50) and 70% (ACR70), as determined by the American College of Rheumatology criteria in week 12. The occurrence of treatment-emergent adverse events (TEAEs) was the primary safety variable.Results: Addition of adalimumab to MTX resulted in a significant reduction in the number of swollen joints (12.6 vs. 5.6; p = 0.011), patients' global assessment of disease activity (18.0 vs. 4.8; p = 0.040), pain visual analog scale (18.3 vs. 1.3; p = 0.015), and disability indices of the Health Assessment Questionnaire (0.6 vs. 0.2; p = 0.031), compared with MTX alone after 12 weeks of therapy. Overall improvement in disease activity was assessed by ACR20 (54.3% vs. 33.3%), ACR50 (34.3% vs. 16.7%) and ACR70 (14.3% vs. 0%), and all favored the adalimumab plus MTX group. TEAEs were comparable between the treatment groups, except for a slightly higher incidence of severe infection in the adalimumab plus MTX group.Conclusion: Adalimumab in combination with MTX is well tolerated and provides significantly more clinical benefits than MTX alone in Taiwanese patients with active RA. [ABSTRACT FROM AUTHOR]

Background/purpose: Site-dependent profiles of chromosome imbalances (CIs) have been reported in gastrointestinal stromal tumors (GISTs). However, the role of specific CIs in association with metastasis is not clear.Methods: Thirteen resected liver metastatic GISTs, including seven from the stomach and six from the small intestine, were analyzed using comparative genomic hybridization (CGH). The CIs associated with metastatic risk were assessed by comparing them with those identified in our previous study of 25 primary GISTs, including 14 from the stomach and 11 from the small intestine.Results: Synchronous detection of liver metastasis was found more often in patients with intestinal than gastric GIST (5/6 vs. 2/7, p = 0.048). When compared with the primary tumors, the CI profile of liver metastases was similar in the intestinal group, but became more complex in the gastric group. Deletions of chromosomes 1p and 15q were very common (> 80%) in primary and metastatic tumors of the intestinal group, and exhibited a trend towards increase in the metastatic tumors of the gastric group. Both groups had a doubling in the frequency of 22q deletion in the liver metastases, which was not significantly different. Other CIs, including 9p deletion, increased significantly in the liver metastases of the gastric group, but not in the intestinal group.Conclusion: Our results, together with clinical findings, indicated a CGH profile associated with the intrinsic aggressiveness of the GISTs. Deletion of 1p and 15q play a critical role in the acquisition of aggressiveness during early GIST development. [ABSTRACT FROM AUTHOR]

Background/purpose: Chorioamnionitis (CAM) is one of the main causes of preterm labor. The specific aim of our study was to evaluate neonatal outcome and anthropometric growth at the corrected age of 2 years after exposure to an adverse intrauterine event of CAM in very low birth weight (VLBW, less than 1500 g) infants.Methods: One hundred and nineteen VLBW infants had adequate placental histological data available for the study. Maternal and perinatal characteristics and neonatal morbidity were determined. The infants were followed up prospectively and their anthropometric growth was recorded in the neonatal follow-up clinic for 2 years.Results: Histological CAM was evident in 64 cases (53.8%, CAM group). Patients with histological CAM delivered earlier (27.8 +/- 2.9 vs. 29.6 +/- 3.6 weeks, p = 0.003), and they had higher incidence of preterm premature rupture of membranes (PPROM, p less than 0.001) and longer ventilation days (p = 0.001). After adjusting for gestational age, sepsis (aOR, 3.355), bronchopulmonary dysplasia (aOR, 3.018) and mechanical ventilation (aOR, 4.094) had a higher incidence in the CAM group. At the corrected ages of 6, 12, 18 and 24 months, anthropometric measurements, including body weight, body height and head circumference, were similar for the study and control infants.Conclusion: Histological CAM was associated with a higher incidence of PPROM, sepsis, bronchopulmonary dysplasia, more mechanical ventilation and longer ventilation days. However, at the age of 2 years, CAM had no impact on anthropometric growth. [ABSTRACT FROM AUTHOR]

Background: We recently reported that an S140G mutation in human KCNQ1, an alpha subunit of potassium channels, was involved in the pathogenesis of familial atrial fibrillation (AF), but it is not clear whether the mutation is associated with other cardiac arrhythmias.Objective: The purpose of this study was to further explore the association of the KCNQ1 S140G mutation with cardiac arrhythmias.Methods: We produced a transgenic mouse model with myocardium-specific expression of the human KCNQ1 S140G mutation under the control of an alpha-cardiac myosin heavy chain promoter by standard transgenic procedure and evaluated the relationship between the KCNQ1 mutation and its phenotypes in a human family.Results: Four lines of transgenic mice were established with a high level of human KCNQ1 S140G expression in the heart. Frequent episodes of first-, second-, advanced-, or third-degree atrioventricular block (AVB) occurred in at least 65% of transgenic descendants from the four lines. However, none of the five wild-type transgenic lines presented with AVBs. HMR1556, a KCNQ1-specific blocker, can terminate the AVBs. With the exception of at most three AF individuals, at least 13 AF patients were found to show obviously slow ventricular response, which may be one manifestation of AVBs. Interestingly, AF was not detected in these transgenic mice.Conclusion: The results suggest that human KCNQ1 S140G is also likely to be a causative mutation responsible for AVBs. The transgenic mouse model is a potential tool to explore mechanisms of AVBs. [ABSTRACT FROM AUTHOR]

Background: Atrial Fibrillation (AF), the most common cardiac arrhythmia, is a significant public health problem in the United States, affecting approximately 2.2 million Americans. Recently, several chromosomal loci and genes have been found to be associated with familial AF. However, in most other AF cases, the genetic basis is still poorly understood.Objective: The purpose of this study was to investigate the molecular basis of familial AF in a Dutch kindred group.Methods: We analyzed a four-generation Dutch family in which AF segregated as an autosomal dominant trait. After the exclusion of linkage to 10q22-24, 6q14-16, 5p13, KCNQ1, KCNE2, KCNJ2 and some ion-channel-associated candidate genes, a genome-wide linkage scan using 398 microsatellite markers was performed.Results: Two-point logarithms of odds (LOD) scores >1 at recombination fraction [theta] = 0.00 and a haplotype segregating with the disorder were demonstrated only across regions of chromosome 10. Subsequent fine mapping gave a maximum two-point LOD score of 4.1982 at D10S568 at [theta] = 0.00. Distinct recombination in several individuals narrowed the shared region among all affected individuals to 16.4 cM on the Genethon map (flanking markers: D10S578 and D10S1652), which corresponds to chromosome 10p11-q21. Thirteen candidate genes residing in this region, which could be associated with AF, were screened. No mutation has been found in their coding regions including the intron splice regions.Conclusion: We identify a novel locus for AF on chromosome 10p11-q21, which provides further evidence of genetic heterogeneity in this arrhythmia. [ABSTRACT FROM AUTHOR]

Purpose: To describe a novel and straightforward conformal avoidance intensity-modulated radiation therapy (IMRT) technique for coverage of pelvis and inguinal/femoral nodes and to compare the dosimetry of the new method with that of other traditional methods of radiation treatment. Methods and Materials: Data of 2 patients with anal cancer were used as example cases to illustrate details and advantages of conformal avoidance IMRT technique. Conventional photons with enface electrons design was created first, thereby providing "outermost boundaries" defined as planning target volume (PTV) for subsequent conformal avoidance IMRT design. Organs at risk (OARs), including femoral head and neck and external genitalia, were contoured as conformal avoidance structures. A step-and-shoot inverse IMRT planning was subsequently generated. For dosimetric comparison, a recently published technique by modified segmental boost was also generated. These treatment techniques were evaluated by dose-volume histogram (DVH) of PTV and OARs. Dose profiles at four different depths from each treatment planning were generated for comparison. Results: The DVH of PTV showed that coverage of the PTV was comparable among three treatment techniques. Percent volume of PTV receiving more than 90% prescription dose was in the range 94-98% for the three treatment techniques, and all had only 0-2% of PTV receiving more than 110% of prescription dose. The DVH of OARs confirmed that both femoral head and neck and external genitalia could be spared well by conformal avoidance IMRT as compared with the other two techniques. Although greater inhomogeneity of dose distribution within the PTV was noted by conformal avoidance IMRT technique, as shown by dose profiles at four different depths, the maximum doses at different depths were less than 115%, which was comparable to those planned by modified segmental boost technique. Planning by photons and enface electrons technique, however, showed a greater dose variation up to 134% of the prescription dose at 1.5 cm depth along photon-electron match-line. Conclusions: To cover pelvis and inguinal/femoral nodes, conformal avoidance IMRT is technically simple to simulate, plan, and execute. Dosimetric study has demonstrated that it achieves comparable PTV coverage compared with other approaches while at the same time significantly sparing the surrounding OARs. [ABSTRACT FROM AUTHOR]

Little is known about the specificity of angiogenic properties of oral cancer cells and the possible mechanisms. Stimulatory effects on proliferation and migration of human umbilical vein endothelial cells (HUVEC) characterized the angiogenic properties of oral cancer cells but not normal oral keratinocytes (NOK). ELISA found the presence of vascular endothelial growth factors (VEGF) both in the tested oral cancer cells and NOK. Attenuation of the proangiogenic effects by neutralizing VEGF antibodies suggests VEGF play a key role in the acquisition of the angiogenic phenotype in oral cancer cells. Western blotting of p53 and murine double mutant 2 (Mdm2) together with p53 DNA sequencing analysis indicate that p53 function loss by mutation or overexpression of Mdm2 occurred in all tested oral cancer cells regardless of their etiology. In summary, the angiogenic property of oral cancer cells is mediated by many factors in addition to VEGF and the functional status of p53. [ABSTRACT FROM AUTHOR]

Background: This study investigated the applicability of the Chinese versions of Drug Abuse Screening Test (DAST) to detect illicit substance use in college students.Methods: The data arising from a campus prevention program, Screening for Illicit Substance Use in College (SISUC), were utilized to explore the psychometrics of 26 items (DAST-26) and 10 items (DAST-10) versions of DAST in college students (CS group). A group of youth with illicit substance use were enrolled as the Illicit Substance Use group (IS group). A set of self-report questionnaires, including the Chinese version of DAST, were administered.Results: A total of 1214 participants were recruited as the CS group and 208 as the IS group. The Cronbach's alpha of DAST-26 was 0.74 in CS and 0.90 in IS; while 0.59 in CS and 0.78 in IS for the DAST-10. At a cut-off of 4 for DAST-26, the sensitivity was 87 % and specificity 97 %. As to DAST-10, a cut-off of 2 produced the sensitivity of 86 % and specificity of 96 %. The area under the curve was 0.943 for DAST-26 and 0.940 for DAST-10. The confirmatory factor analyses found a single-factor solution for the DAST-26 and DAST-10.Conclusions: With comparison to the DAST-26, the shorter version, DAST-10, may offer promise for detecting illicit substance use in college students. [ABSTRACT FROM AUTHOR]

The multifractal analysis technique can reveal the details of a global and local evolution of a regional space at multiple levels and scales. Hence, the built-up land in Zhengzhou is used as an example in this paper to demonstrate multifractal analysis of its spatial pattern in 1988, 1995, 2006, and 2015, in which, based on the analysis of generalized multifractal (including atypical trend and typical evolutionary features), and through a generalized multifractal with historical evolution paradigm, to reveal the details of its evolution on multiple spatial scales. The analysis of global indicators shows that the regular change in the spatial pattern of built-up lands in Zhengzhou since the 1980s is a hierarchically fluctuating spatial system. Zhengzhou tended to expand in the low- and medium-density areas before the 2000s, and it managed to exhibit spatial agglomeration in high-density areas in the 2010s. The analysis of local indicators further shows: (1) the regular change with multifractal characteristics is only part of Zhengzhou's evolutionary system, but it is the primary driving force; (2) the spatial evolution of built-up lands in Zhengzhou has long been dominated by chaotic states and mediocre states, but the regularity of recent evolution has increased; and (3) changes in the spatial scale of built-up lands at different times are basically synchronized, But the specific characteristics of each year are different and the complexity is increasing. However, compared with Beijing's left-skewed and wide-regional f (a)- a (q) curves for all periods, the features of built-up lands in Zhengzhou are right-skewed and narrow-regional. The two cities have different types of evolutional features. Therefore, the spatial evolution of Beijing has some reference value for Zhengzhou, but it cannot be copied. In general, based on the spatial complexity analysis of multiple perspectives, this paper explains the overall change of spatial pattern and the basic evolution of multi-space scale in Zhengzhou in the past 30 years and verifies the feasibility of generalized multifractal in geospatial analysis. • Evolutionary Spatial Multifractal Mechanism for Built-up Lands. • Analysis of Global Indicators. • Comparative Studies on Evolutionary Spatial Multifractal Mechanism. [ABSTRACT FROM AUTHOR]

Increasing evidence indicates that the intra-uterine environment has consequences for later life. However, the mechanisms of this fetal programming remain unclear. We aimed to investigate the impact of diet-induced maternal hypercholesterolemia on the predisposition of offspring to nonalcoholic fatty liver diseases (NAFLD) and metabolic diseases and its underlying mechanisms. Female apolipoprotein (Apo) E-deficient mice were fed a control diet (CD) or high fat/high cholesterol Western-type diet (WD) before and throughout pregnancy and lactation, and their offspring were weaned onto a CD postnatally. Strikingly, male offspring of WD-fed dams developed glucose intolerance and decreased peripheral insulin sensitivity and exhibited hepatic steatosis. Hepatic steatosis could be attributed, at least in part, to increased hepatic lipogenesis in E18.5 embryos and decreased serum VLDL levels in adulthood. In addition, males born to WD-fed dams had lower serum ApoB levels and hepatic ApoB gene expression compared with males born to CD-fed dams. DNA methylation analysis revealed increased methylation of CpG dinucleotides on the promoter region of the ApoB genes in the livers of male offspring of WD-fed dams. Our findings suggest that maternal WD intake can exacerbate the development of NAFLD in male offspring potentially by affecting ApoB gene expression through epigenetic alterations. [ABSTRACT FROM AUTHOR]

Background: According to 3 randomized trials, the levonorgestrel-releasing intrauterine system significantly reduced recurrent endometriosis-related pelvic pain at postoperative year 1. Only a few studies have evaluated the long-term effectiveness of the device for preventing endometrioma recurrence, and the effects of a levonorgestrel-releasing intrauterine system as a maintenance therapy remain unclear.Objective: The objective of the study was to evaluate whether a maintenance levonorgestrel-releasing intrauterine system is effective for preventing postoperative endometrioma recurrence.Study Design: From May 2011 through March 2012, a randomized controlled trial including 80 patients with endometriomas undergoing laparoscopic cystectomy followed by six cycles of gonadotropin-releasing hormone agonist treatment was conducted. After surgery, the patients were randomized to groups that did or did not receive a levonorgestrel-releasing intrauterine system (intervention group, n = 40, vs control group, n = 40). The primary outcome was endometrioma recurrence 30 months after surgery. The secondary outcomes included dysmenorrhea, CA125 levels, noncyclic pelvic pain, and side effects.Results: Endometrioma recurrence at 30 months did not significantly differ between the 2 groups (the intervention group, 10 of 40, 25% vs the control group 15 of 40, 37.5%; hazard ratio, 0.60, 95% confidence interval, 0.27-1.33, P = .209). The intervention group exhibited a lower dysmenorrhea recurrence rate, with an estimated hazard ratio of 0.32 (95% confidence interval, 0.12-0.83, P = .019). Over a 30 month follow-up, the intervention group exhibited a greater reduction in dysmenorrhea as assessed with a visual analog scale score (mean ± SD, 60.8 ± 25.5 vs 38.7 ± 25.9, P < .001, 95% confidence interval, 10.7-33.5), noncyclic pelvic pain visual analog scale score (39.1 ± 10.9 vs 30.1 ± 14.7, P = .014, 95% confidence interval, 1.9-16.1), and CA125 (median [interquartile range], -32.1 [-59.1 to 14.9], vs -15.6 [-33.0 to 5.0], P = .001) compared with the control group. The number-needed-to-treat benefit for dysmenorrhea recurrence at 30 months was 5. The number of recurrent cases requiring further surgical or hormone treatment in the intervention group (1 of 40, 2.5%, 95% confidence interval, -2.3% to 7.3%) was significantly lower than that in the control group (8 of 40, 20%, 95% confidence interval, 7.6-32.4%; P = .031).Conclusion: Long-term maintenance therapy using a levonorgestrel-releasing intrauterine system is not effective for preventing endometrioma recurrence. [ABSTRACT FROM AUTHOR]

Mesona chinensis polysaccharide (MCP) has excellent gel-forming characteristic, previous studies showed that MCP could affect the gelling and structural properties of rice starch, but the effect of MCP on rice starch from different types is not clarified. In this study, the effects of MCP on the pasting, rheological, and structural characteristics of glutinous rice starch (GRS), japonica rice starch (JRS), and indica rice starch (IRS) were investigated. The results showed that GRS-MCP has the best viscosity, its peak and final viscosities are higher than JRS-MCP and IRS-MCP. The gel network structure was enhanced by MCP in the order of IRS > JRS > GRS, which was reflected by greater elasticity, higher gel strength and hardness, and less free water in JRS-MCP and IRS-MCP. MCP also enhanced the ordered structure and thermal stability of the three starch gels, which is conducive to their application in the market. These findings provide new theoretical insights to produce rice starch-based foods. • Mesona chinensis polysaccharide (MCP) affected the properties of three rice starches. • MCP increased the viscosity of glutinous rice starch significantly. • The effect of MCP in promoting gel formation was related to the types of starch. • MCP improved the order degree and thermal stability of three starch-MCP gels. [ABSTRACT FROM AUTHOR]

The analysis of the motion of subcellular particles in live cell microscopy images is essential for understanding biological processes within cells. For accurate quantification of the particle motion, compensation of the motion and deformation of the cell nucleus is required. We introduce a non-rigid multi-frame registration approach for live cell fluorescence microscopy image data. Compared to existing approaches using pairwise registration, our approach exploits information from multiple consecutive images simultaneously to improve the registration accuracy. We present three intensity-based variants of the multi-frame registration approach and we investigate two different temporal weighting schemes. The approach has been successfully applied to synthetic and live cell microscopy image sequences, and an experimental comparison with non-rigid pairwise registration has been carried out. [ABSTRACT FROM AUTHOR]

As a 3D extension of the High Efficiency Video Coding (HEVC) standard, 3D-HEVC is developed to improve the coding efficiency of multi-view video. However, the improvement of the coding efficiency is obtained at the expense of a computational complexity increase. How to relieve the computational burden of the encoder is becoming a critical problem in applications. In this paper, a fast encoder decision algorithm to encode the dependent texture views is proposed, where two strategies to accelerate encoder decision by exploiting inter-view correlations are utilized. The first one is an early merge mode decision algorithm, and the second one is an early CU splitting termination algorithm. Experimental results show that the proposed algorithm can achieve 47.1% encoding time saving with overall 0.1% BD-rate reduction compared to HTM (3D-HEVC test model) version 7 under the common test condition (CTC). Both of the two strategies have been adopted into the 3D-HEVC reference software and enabled as a default encoding process under CTC. [ABSTRACT FROM AUTHOR]

Abstract: Influenced by partial shade, PV module aging or fault, there are multiple peaks on PV array's output power–voltage (P–V) characteristic curve. Conventional maximum power point tracking (MPPT) methods are effective for single peak P–V characteristic under uniform solar irradiation, but they may fail in global MPP tracking under multi-peak P–V characteristics. Existing methods in literature for this problem are still unsatisfactory in terms of effectiveness, complexity and speed. In this paper, we first analyze the mathematical model of PV array that is suitable for simulation of complex partial shade situation. Then an adaptive MPPT (AMPPT) method is proposed, which can find real global maximum power point (MPP) for different partial shade conditions. When output characteristic of PV array varies, AMPPT will adjust tracking strategies to search for global peak area (GPA). Then it is easy for conventional MPPT to track the global MPP in GPA. Simulation and experimental results verify that the proposed AMPPT method is able to find real global MPP accurately, quickly and smoothly for complex multi-peak P–V characteristics. Comparison analysis results demonstrate that AMPPT is more effective for most shade types. [Copyright &y& Elsevier]

Background: To evaluate the likelihood of a future cardiovascular event (i.e., in-hospital mortality or cardiovascular disease [CVD] complications/interventions) among patients with CVD and major depressive disorder (MDD) compared to those without MDD, and the antidepressant use on future cardiovascular events between the two groups.Methods: This is a retrospective cohort with propensity score matching with 8941 patients with CVD and MDD, and 8941 non-MDD patients using data from the Longitudinal Health Insurance Database from 1999 to 2013 in Taiwan. The outcome was in-hospital mortality and the incidence of revascularization (i.e., percutaneous transluminal coronary angioplasty [PTCA] and coronary artery bypass graft surgery [CABG]).Results: Patients with CVD and MDD were more likely to need revascularization (an adjusted hazard ratio [aHR]: 1.26 and 95% CI: 1.12-1.43) than those without MDD, regardless of whether PTCA (aHR: 1.23 and 95% CI: 1.07-1.40) or CABG (aHR: 1.60 and 95% CI: 1.16-2.21) had occurred. Antidepressant use was associated with a tendency of reduced risk of mortality (aHR: 0.92 and 95% CI: 0.84-1.00). Although the magnitude of aHR ranged from 0.92 to 0.95 with revascularization, they did not reach significant levels.Limitations: Some covariates could not be controlled because they were not included in the national register dataset, and the causality is limited in an observational study.Conclusions: Patients with CVD with MDD are more likely to experience a cardiovascular complication requiring intervention than CVD patients without MDD. Antidepressant use is associated with reduced in-hospital mortality. [ABSTRACT FROM AUTHOR]

Abstract: The study assesses the effects of event rainfall on the soil erosion in terraced paddy fields under rice cropping, fallow, and green manure planting. A 0.75-ha terraced rice field was used to investigate the soil erosion under the regular cultivation of rice in 2005, fallow in 2006, and planting with green manure in 2007. The results show that infiltration rates significantly increase when a terraced paddy field is under fallow or is planted with green manure; the paddy is more vulnerable to embankment collapse and increased the rates of soil erosion. In an experimental field, suspended solid in run-off samples reached the maximal concentrations of 1700mg/l for fallow in 2006, and 3400mg/l for manure planted field in 2007, during heavy rainfall events. These values were significantly greater than the erosion rate of 500mg/l recorded for rice cropped field during 2005. The estimated annual erosion rate was 4.15tonha−1 yr−1 for green manure planted field, which was significantly higher than that of the rice-planted terraced paddy (0.77tonha−1 yr−1). Moreover, terraced paddy runoff significantly increased when planted with green manure. Soil erosion rates calculated by the Universal Soil Loss Equation (USLE) from the optimal available data were considerably higher than the field-measured values. The comparison revealed that soil conservation using rice-planted terraced paddy was more effective than that resulting from other uses. The government should formulate effective measures and maintain sustainable rice planting in the terraced paddies. [Copyright &y& Elsevier]