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BackgroundHypertension is a major cause of mortality in cardiac, vascular, and renal disease. Effective control of elevated blood pressure has been shown to reduce target organ damage. A Web-based self-titration program may empower patients to control their own disease, share decisions about antihypertensive dose titration, and improve self-management, ultimately improving health-related quality of life. ObjectiveOur primary aim was to evaluate the effects of a Web-based self-titration program for improving blood pressure control in patients with primary hypertension. Our secondary aim was to evaluate the effects of that program on improving health-related quality of life. MethodsThis was a parallel-group, double-blind, randomized controlled trial with assessments at baseline, 3 months, and 6 months. We included patients with primary hypertension (blood pressure>130/80 mm Hg) from a cardiology outpatient department in northern Taiwan and divided them randomly into intervention and control groups. The intervention group received the Web-based self-titration program, while the control group received usual care. The random allocation was concealed from participants and outcome evaluators. Health-related quality of life was measured by the EuroQol five-dimension self-report questionnaire. We used generalized estimating equations to evaluate the effects of the intervention. ResultsWe included 222 patients and divided them equally into intervention (n=111) and control (n=111) groups. Patients receiving the Web-based self-titration program showed significantly greater improvement in the systolic and diastolic blood pressure control than those who did not receive this program, at 3 months (–21.4 mm Hg and –5.4 mm Hg, respectively; P

Renal cell carcinoma (RCC) accounts for nearly 2% of cancers diagnosed worldwide. For metastatic RCC, targeted therapy is one of the most common treatment methods. It can include approaches that target vascular endothelial growth factor (VEGFR) or rely on immune checkpoint inhibitors or mTOR inhibitors. Adenosine A2A receptor (A2AR) is a type of widely distributed G-protein-coupled receptor (GPCR). Recently, an increasing number of studies suggest that the activation of A2AR can downregulate anti-tumor immune responses and prevent tumor growth. Currently, the data on A2AR antagonists in RCC treatment are still limited. Therefore, in this article, we further investigate the clinical trials investigating A2AR drugs in RCC. We also describe the epidemiology and current treatment of RCC, along with the physiological role of A2AR, and the types of A2AR drugs that are associated with tumor treatment. [ABSTRACT FROM AUTHOR]

This study examines the thermal performance of building walls under full sunlight conditions using various insulation strategies. Specifically, it evaluates: (1) the effects of heat on building walls and indoor spaces; (2) the impact of groundwater cooling systems on thermal environments; (3) the influence of phenolic aldehyde insulation layers on heat transfer; and (4) the combined effects of groundwater cooling and phenolic aldehyde thermal insulation. Fluent–CFD (Computational Fluid Dynamics) was used in the study to simulate temperature transmission between the sun, the groundwater cooling system, and both indoor and outdoor spaces. Experimental analysis and simulations reveal that both the phenolic aldehyde insulation layer and the groundwater cooling system effectively reduce heat transfer, with the groundwater cooling system demonstrating the most significant impact. The phenolic aldehyde layer decreases the temperature difference between inner and outer walls by approximately 8 °C. The groundwater cooling system further reduces both inner and outer wall temperatures, helping to maintain cooler indoor environments. Simulation results indicate that, while the phenolic aldehyde layer effectively prevents external heat from penetrating into the room, it does not eliminate heat accumulation. In contrast, the groundwater cooling system efficiently dissipates heat, mitigating this issue. Groundwater analysis shows that maximum temperature differences occur at specific times of the day, with water flow effectively cooling the space. The combined use of the phenolic aldehyde insulation layer and the groundwater cooling system offers superior thermal performance. The phenolic layer provides effective heat blocking, while the groundwater system facilitates heat dissipation, optimizing indoor temperature and reducing air conditioning loads. This combination enhances overall comfort and energy efficiency, with the groundwater cooling system benefiting from reduced flow velocity and lower energy consumption. [ABSTRACT FROM AUTHOR]

Compared to traditional morphological identification, DNA barcoding--molecular identification based on sequencing of a segment of mitochondrial cytochrome c oxidase subunit I (COI)--provides a shortcut to authenticating chelonian identifications. Here, we selected 63 government-seized chelonian specimens deposited at Taipei Zoo for DNA barcoding analysis. DNA barcoding and subsequent phylogenetic analysis successfully authenticated 36 chelonian species, including five that are listed in CITES Appendix I. Approximately 90% (57/63) of the specimens were successfully authenticated by our molecular approach, but lack or error of BOLD reference sequences, biological processes such as hybridization, and uncertain species delimitation all reduced the accuracy of DNA barcoding. To increase the accuracy of DNA barcoding, Taipei Zoo will continue to enrich the BOLD database and also establish a genetic database, to include additional genetic markers, by using government-seized chelonian specimens. A fast and accurate method to authenticate seized samples could assist law enforcement agencies to prosecute criminals and restrict illegal exploitation of wild chelonian resources. Key words: COI, turtle, tortoise, terrapin, BOLD. Lorsque comparé à des méthodes traditionnelles d'identification morphologique, le codage à barres de l'ADN--une identification moléculaire fondée sur le séquençage d'un segment du gène codant pour la sous-unité I de la cytochrome c oxydase (COI) mitochondriale--fournit un raccourci pour l'authentification de l'identification de spécimens de chéloniens. Dans ce travail, les auteurs ont choisi 63 spécimens de chéloniens saisis par le gouvernement et déposés au Zoo de Taipei pour analyse par codage à barres. Le codage à barres et l'analyse phylogénétique qui s'en est suivie a permis d'authentifier 36 espèces de chéloniens, dont cinq qui sont sur la liste de l'annexe I du CITES. Environ 90% (57/63) des spécimens ont été authentifiés avec succès par l'approche moléculaire, mais l'absence de séquences de référence BOLD ou des erreurs au sein de celles-ci, des processus biologiques comme l'hybridation ou encore une délimitation incertaine de l'espèce ont tous réduit la performance du codage à barres. Afin d'augmenter la justesse du codage à barres, le Zoo de Taipei va continuer à enrichir la base de données BOLD et établir une base de données génétiques, incluant des marqueurs génétiques additionnels, en exploitant les spécimens de chéloniens saisis par le gouvernement. Une méthode rapide et précise pour authentifier les échantillons saisis permettra d'aider les agences gouvernementales à poursuivre les criminels et à limiter l'exploitation illégale de chéloniens sauvages. [Traduit par la Rédaction] Mots-clés: COI, tortue, tortue terrestre, tortue d'eau douce, BOLD., Introduction Chelonians (Order Testudines) have long been exploited by humans. The ancient Chinese began carving words on turtle plastrons for record-keeping and auguring at least 3000 years ago (Sung 2013), [...]