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Purpose: To design a computer-aided detection (CADe) system for clustered microcalcifications in reconstructed digital breast tomosynthesis (DBT) volumes and to perform a preliminary evaluation of the CADe system. Methods: IRB approval and informed consent were obtained in this study. A data set of two-view DBT of 72 breasts containing microcalcification clusters was collected from 72 subjects who were scheduled to undergo breast biopsy. Based on tissue sampling results, 17 cases had breast cancer and 55 were benign. A separate data set of two-view DBT of 38 breasts free of clustered microcalcifications from 38 subjects was collected to independently estimate the number of false-positives (FPs) generated by the CADe system. A radiologist experienced in breast imaging marked the biopsied cluster of microcalcifications with a 3D bounding box using all available clinical and imaging information. A CADe system was designed to detect microcalcification clusters in the reconstructed volume. The system consisted of prescreening, clustering, and false-positive reduction stages. In the prescreening stage, the conspicuity of microcalcification-like objects was increased by an enhancement-modulated 3D calcification response function. An iterative thresholding and 3D object growing method was used to detect cluster seed objects, which were used as potential centers of microcalcification clusters. In the cluster detection stage, microcalcification candidates were identified using a second iterative thresholding procedure, which was applied to the signal-to-noise ratio (SNR) enhanced image voxels with a positive calcification response. Starting with each cluster seed object as the initial cluster center, a dynamic clustering algorithm formed a cluster candidate by including microcalcification candidates within a 3D neighborhood of the cluster seed object that satisfied the clustering criteria. The number, size, and SNR of the microcalcifications in a cluster candidate and the cluster shape were used to reduce the number of FPs. Results: The prescreening stage detected a cluster seed object in 94% of the biopsied microcalcification clusters at a threshold of 100 cluster seed objects per DBT volume. After clustering, the detection sensitivity was 90% at 15 marks per DBT volume. After FP reduction, at 85% sensitivity, the average number of FPs estimated using the data set containing microcalcification clusters was 3.8 per DBT volume, and that estimated using the data set free of microcalcification clusters was 3.4. The detection performance for malignant microcalcification clusters was superior to that for benign clusters. Conclusions: Our study indicates the feasibility of the 3D approach to the detection of clustered microcalcifications in DBT and that the newly designed enhancement-modulated 3D calcification response function is promising for prescreening. Further work is needed to assess the generalizability of our approach and to improve its performance. [ABSTRACT FROM AUTHOR]

Purpose: The Internet is a promising tool for delivering health behavior change programs although such interventions raise questions about participant engagement in this medium. In this study we sought to determine the characteristics of parents who engage in an Internet-based health intervention for their children (with asthma) and to distinguish parents who engage at the prescribed intervals versus those who engage less often.Methods: N=283 parents with children who had asthma were recruited and randomized to receive a web-based intervention. Participants filled out six surveys over a 6-month period asking them about demographic and clinical characteristics, outcome expectations and self-efficacy beliefs regarding asthma control for their child, and attitudes about computers and the Internet. Descriptive statistics were used to describe the population and analyze associations.Results: Controller use and being adherent to this medication as well as positive outcome and self efficacy expectations were associated with increased engagement. Parents who logged on only once reported significantly less frequent use of the Internet than parents who logged on to all sessions.Discussion and Conclusion: The results of this study suggest that it is important to find ways to increase engagement in a web-based intervention for parents who are not yet engaging in the recommended behaviors and/or who report less positive outcome and efficacy expectations around asthma management. [ABSTRACT FROM AUTHOR]

Abstract: ZnO thin films doped with Al concentrations of 1.0, 2.0, 3.0, 4.0, 5.0at% were prepared by a sol–gel spin-coating method on glass substrates and respectively annealed at 550°C for 2h in hydrogen and air. The X-ray diffraction and selected-area electron diffraction results confirm that the Al doped ZnO thin films are of wurtzite hexagonal ZnO. The scanning electron microscope results indicate that the Al doped ZnO nanorod thin films can be got by annealing in hydrogen rather than in air. The optical properties reveal that the Al doped ZnO thin films have obviously enhanced transmittance in the visible region. The electrical properties show that the resistivity of 1.0at% Al doped ZnO thin films has been remarkably reduced from 0.73Ωm by annealing in air to 3.2×10−5 Ωm by annealing in hydrogen. It is originated that the Al doped ZnO nanorod thin films annealed in hydrogen increased in electron concentration and mobility due to the elimination of adsorbed oxygen species, and multicoordinated hydrogen. [Copyright &y& Elsevier]

Effects of rice straw particle size and physically effective neutral detergent fiber (peNDF) on particle size distribution of different digestive tract, nitrogen (N) metabolism, blood biochemical parameters, microbial amino acid (AA) composition and intestinal AA digestibility in goats were investigated. A 4 × 4 Latin square design was employed using four mature Liuyang black goats fitted with permanent ruminal, duodenal, and terminal ileal fistulae. During each of the four periods, goats were offered one of four diets that were similar in chemical composition, but varied in particle sizes and peNDF through alteration of the theoretical cut length of rice straw (10, 20, 40 and 80 mm, respectively). Dietary peNDF contents of four diets were 17.4, 20.9, 22.5 and 25.4%, respectively. Results showed that increasing particle size of rice straw and dietary peNDF significantly affected the particle size distributions of digesta in rumen, duodenum and ileum, except feces. However, increasing particle size of rice straw and peNDF did not affected N metabolism in goats, except the increased apparent N digestibility in rumen and large intestine, and the decreased apparent N digestibility in small intestine. Furthermore, increasing particle size of rice straw and peNDF showed little influence on the profile of blood biochemical parameters, microbial AA composition and intestinal AA digestibility in goats. [ABSTRACT FROM AUTHOR]

Background: Internet addiction among US college students remains a concern, but robust estimates of its prevalence are lacking. Methods: We conducted a pilot survey of 307 college students at two US universities. Participants completed the Internet Addiction Test (IAT) as well as the Patient Health Questionnaire. Both are validated measures of problematic Internet usage and depression, respectively. We assessed the association between problematic Internet usage and moderate to severe depression using a modified Poisson regression approach. In addition, we examined the associations between individual items in the IAT and depression. Results: A total of 224 eligible respondents completed the survey (73% response rate). Overall, 4% of students scored in the occasionally problematic or addicted range on the IAT, and 12% had moderate to severe depression. Endorsement of individual problematic usage items ranged from 1% to 70%. In the regression analysis, depressive symptoms were significantly associated with several individual items. Relative risk could not be estimated for three of the twenty items because of small cell sizes. Of the remaining 17 items, depressive symptoms were significantly associated with 13 of them, and three others had P values less than 0.10. There was also a significant association between problematic Internet usage overall and moderate to severe depression (relative risk 24.07, 95% confidence interval 3.95 to 146.69; P = 0.001). Conclusion: The prevalence of problematic Internet usage among US college students is a cause for concern, and potentially requires intervention and treatment amongst the most vulnerable groups. The prevalence reported in this study is lower than that which has been reported in other studies, however the at-risk population is very high and preventative measures are also recommended. [ABSTRACT FROM AUTHOR]

Objective: To investigate the role of stomatin-like protein 2 ( SLP-2), a novel cancer-related gene, in pulmonary squamous cell carcinoma (PSCC) and its implications. Methods: Immunohistochemical detection of SLP-2 was performed on 96 cases of PSCC with a tissue microarray. Results: SLP-2 was overexpressed in lung cancer compared with normal lung tissue ( p <0.001). High-level SLP-2 expression was significantly correlated with distant metastasis ( p = 0.025), decreased overall survival ( p = 0.018) and disease-free survival ( p = 0.017). SLP-2 overexpression was an independent prognostic factor in multivariate analysis using the Cox regression model ( p <0.05). Conclusion: SLP-2 overexpression is associated with tumour distant metastasis and poor prognosis in PSCC. SLP-2 could be regarded as a new significant prognostic biomarker for patients with PSCC. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine whether nursing home patients are more likely than non-nursing home patients to present to the emergency department (ED) with delirium and to explore how variations in their delirium risk factor profiles contribute to this relationship. DESIGN: Prospective cross-sectional study. SETTING: Tertiary care academic ED. PARTICIPANTS: Three hundred forty-one English-speaking patients aged 65 and older. MEASUREMENTS: Delirium status was determined using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) administered by trained research assistants. Multivariable logistic regression was used to determine whether nursing home residence was independently associated with delirium. Adjusted odds ratios (ORs) with their 95% confidence intervals (95% CIs) were reported. RESULTS: Of the 341 patients enrolled, 58 (17.0%) resided in a nursing home and 38 (11.1%) were considered to have delirium in the ED. Of the 58, (22 (37.9%) nursing home patients and 16 of 283 (5.7%) non-nursing home patients had delirium; unadjusted OR=10.2, 95% CI=4.9–21.2). After adjusting for dementia, a Katz activity of daily living score less than or equal to 4, hearing impairment, and the presence of systemic inflammatory response syndrome, nursing home residence was independently associated with delirium in the ED (adjusted OR=4.2, 95% CI=1.8–9.7). CONCLUSION: In the ED setting, nursing home patients were more likely to present with delirium, and this relationship persisted after adjusting for delirium risk factors. [ABSTRACT FROM AUTHOR]

The latest deep neural networks for medical segmentation typically utilize transposed convolutional filters and atrous convolutional filters for spatial restoration and larger receptive fields, leading to dilution and inconsistency of visual semantics. To address such issues, we propose a novel attentional up-concatenation structure to build an auxiliary path for direct access to multi-level features. In addition, we employ a new structural loss to bring better morphological awareness and reduce the segmentation flaws caused by the semantic inconsistencies. Thorough experiments on the challenging optic cup/disc segmentation, cellular segmentation and lung segmentation tasks were performed to evaluate the proposed methods. Further ablation analysis demonstrated the effectiveness of the different components of the model and illustrated its efficiency. The proposed methods achieved the best performance and speed compared to the state-of-the-art models in three tasks on seven public datasets, including DRISHTI-GS, RIM-r3, REFUGE, MESSIDOR, TNBC, GlaS and LUNA. • A deep learning model, Up-Net, is proposed to overcome semantic inconsistency issue. • A lightweight up-concatenation structure and metric learning strategy is proposed. • We validated Up-Net in 3 challenging medical segmentation tasks across 7 datasets. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether anesthesia residents (physicians in training) performed clinical duties in the operating room differently during the day versus at night.Background: Fatigue from sleep deprivation and working through the night is common for physicians, particularly during residency training.Methods: Using a repeated-measures design, we studied 13 pairs of day-night matched anesthesia cases. Dependent measures included task times, workload ratings, response to an alarm light latency task, and mood.Results: Residents spent significantly less time on manual tasks and more time on monitoring tasks during the maintenance phase at night than during the day. Residents reported more negative mood at night than during the day, both pre- and postoperation. However, time of day had no effect on the mood change between pre- and postoperation. Workload ratings and the response time to an alarm light latency task were not significantly different between night and day cases.Conclusions: Because night shift residents had been awake and working for more than 16 hr, the observed differences in task performance and mood may be attributed to fatigue. The changes in task distribution during night shift work may represent compensatory strategies to maintain patient care quality while keeping perceived workload at a manageable level.Applications: Fatigue effects during night shifts should be considered when designing work-rest schedules for clinicians. This matched-case control scheme can also be applied to study other phenomena associated with patient safety in the actual clinical environment. [ABSTRACT FROM AUTHOR]

Digital tomosynthesis mammography (DTM) is one of the most promising techniques that can potentially improve early detection of breast cancers. DTM can provide three-dimensional (3D) structural information by reconstructing the whole imaged volume from a sequence of projection-view (PV) mammograms that are acquired at a small number of projection angles over a limited angular range. Our previous study showed that simultaneous algebraic reconstruction technique (SART) can produce satisfactory tomosynthesized image quality compared to maximum likelihood-type algorithms. To improve the efficiency of DTM reconstruction and address the problem of boundary artifacts, we have developed methods to incorporate both two-dimensional (2D) and 3D breast boundary information within the SART reconstruction algorithm in this study. A second generation GE prototype tomosynthesis mammography system with a stationary digital detector was used for PV image acquisition from 21 angles in 3° increments over a ±30° angular range. The 2D breast boundary curves on all PV images were obtained by automated segmentation and were used to restrict the SART reconstruction to be performed only within the breast volume. The computation time of SART reconstruction was reduced by 76.3% and 69.9% for cranio-caudal and mediolateral oblique views, respectively, for the chosen example. In addition, a 3D conical trimming method was developed in which the 2D breast boundary curves from all PVs were back projected to generate the 3D breast surface. This 3D surface was then used to eliminate the multiple breast shadows outside the breast volume due to reconstruction by setting these voxels to a constant background value. Our study demonstrates that, by using the 2D and 3D breast boundary information, all breast boundary and most detector boundary artifacts can be effectively removed on all tomosynthesized slices. [ABSTRACT FROM AUTHOR]

We have developed a false positive (FP) reduction method based on analysis of bilateral mammograms for computerized mass detection systems. The mass candidates on each view were first detected by our unilateral computer-aided detection (CAD) system. For each detected object, a regional registration technique was used to define a region of interest (ROI) that is “symmetrical” to the object location on the contralateral mammogram. Texture features derived from the spatial gray level dependence matrices and morphological features were extracted from the ROI containing the detected object on a mammogram and its corresponding ROI on the contralateral mammogram. Bilateral features were then generated from corresponding pairs of unilateral features for each object. Two linear discriminant analysis (LDA) classifiers were trained from the unilateral and the bilateral feature spaces, respectively. Finally, the scores from the unilateral LDA classifier and the bilateral LDA asymmetry classifier were fused with a third LDA whose output score was used to distinguish true mass from FPs. A data set of 341 cases of bilateral two-view mammograms was used in this study, of which 276 cases with 552 bilateral pairs contained 110 malignant and 166 benign biopsy-proven masses and 65 cases with 130 bilateral pairs were normal. The mass data set was divided into two subsets for twofold cross-validation training and testing. The normal data set was used for estimation of FP rates. It was found that our bilateral CAD system achieved a case-based sensitivity of 70%, 80%, and 85% at average FP rates of 0.35, 0.75, and 0.95 FPs/image, respectively, on the test data sets with malignant masses. In comparison to the average FP rates for the unilateral CAD system of 0.58, 1.33, and 1.63, respectively, at the corresponding sensitivities, the FP rates were reduced by 40%, 44%, and 42% with the bilateral symmetry information. The improvement was statistically significance (p<0.05) as estimated by JAFROC analysis. [ABSTRACT FROM AUTHOR]

Two series of new oligo(p-phenyleneethynylene)s (OPEs) O1–O4 and O5–O8, which have been proven to be one of the chief classes of molecules mainly used as the wires and other potential backbones of molecular electronic devices, have been synthesized by stepwise synthetic approach. The characterization of these oligomers was performed on MALDI TOF MS. Different cationization salts have been applied to investigate the ionization processes of these series of oligomers under MALDI conditions. The experimental results show that these oligomers display a strong tendency to undergo radical cationization and varied ionization efficiency with different cationization agents attributable to their difference in cationic diameters. Furthermore, we found that these two series of oligomers differed in ionization properties because of their different end-groups even when the same cationization agent was used. [Copyright &y& Elsevier]

In this work, strip casting was introduced, and the necessity of heat treatment was explained from the viewpoint of DTA thermo-analysis. The results showed that: Five exothermic peaks appeared in the DTA curves of LPCNi3.55Co0.75Mn0.4Al0.3 alloy in which the intensity of the second and third peak decreased strikingly with the decrease of cooling rate. It was sensitive to the grain sizes. The intensity of the fourth and fifth peak showed less correlation with cooling rate, and they located in the range of theoretical recrystallization temperature. It was possibly introduced by recrystallization. In addition, segregation and internal stress also contributed to exothermic peaks. All heat variation had finished during the first temperature-rising period of DTA test, which implied that there was no irreversible phase transformation in the hydrogen storage alloys during the whole heated-cooled process. Four kinds of AB5-type hydrogen storage alloys in our work showed similar exothermic characteristics. [Copyright &y& Elsevier]

Transfer learning from natural image datasets, such as ImageNet, is common for applying deep learning to medical imaging. However, the modalities of natural and medical images differ considerably, and the reason for the latest medical research preferring ImageNet to medical data is questionable. In this study, we investigated the properties of medical pre-training and its transfer effectiveness on various medical tasks. Through an intuitive convolution-based analysis, we determined the modality characteristics of images. Surprisingly, medical pre-training showed exceptional performance for a classification task but not for a segmentation task since medical data are visually homogeneous and lack morphological information. Using data with diverse modalities helped overcome such drawbacks, resulting in medical pre-training achieving performance comparable to pre-training with ImageNet with considerably fewer samples than ImageNet for both aforementioned tasks. Finally, a study of learned representations and realistic scenarios indicated that while ImageNet is the best choice for medical imaging, medical pre-training has significant potential. • We study the transfer learning effectiveness based on medical and natural images. • We evaluate medical pre-training on downstream medical image analysis tasks. • We reveal the shortcomings and future potential of medical pre-training. [ABSTRACT FROM AUTHOR]

Reducing the operating temperatures of solid oxide fuel cells (SOFCs) to the intermediate-temperature range (IT, 400–650 °C) can bring about several benefits including cost effectiveness, prolonged lifetime and flexible sealing. Nevertheless, the accompanying deterioration of cathodic activity for oxygen reduction reaction (ORR) introduces a large obstacle for commercial applications of IT-SOFCs. Herein, a new perovskite SrCo 0.8 Ti 0.1 Ta 0.1 O 3-δ (SCTT) is developed by co-doping titanium and tantalum into the B-site of parent SrCoO 3 oxide, which may tackle this problem. At 400–650 °C, SCTT shows high electrical conductivities (65–142 S cm−1), appropriate oxygen vacancy concentrations (0.23–0.27) and high bulk diffusion capability due to a synergy between the two dopants in SCTT. Consequently, SCTT exhibits a favorable ORR activity with an area-specific resistance of only 0.17 Ω cm2 at 500 °C on samaria-doped ceria electrolyte, and the corresponding cell generates a high peak power density (PPD) of 0.90 W cm−2 at 500 °C with negligible performance decay for 180 h. Additionally, SCTT performs well in protonic ceramic fuel cells, achieving a PPD of 0.78 W cm−2 at 650 °C and a high durability for ~176 h at 550 °C. This work provides a new promising cathode material that may accelerate the commercialization of IT-SOFC technology. [Display omitted] • A new SrCo 0.8 Ti 0.1 Ta 0.1 O 3-δ (SCTT) perovskite cathode is developed for SOFCs. • SCTT displays superior oxygen reduction activity in both O–SOFCs and PCFCs. • SCTT shows well-balanced electrical conductivity and oxygen vacancy concentration. • SCTT features large lattice free volume and high bulk diffusion capability. • SCTT exhibits excellent operational stability in both O–SOFCs and PCFCs. [ABSTRACT FROM AUTHOR]

In this paper, we proposed a semi-supervised common representation learning method with GAN-based Asymmetric Transfer Network (GATN) for cross modality retrieval. GATN utilizes the asymmetric pipeline to guarantee the semantic consistency and adopt (Generative Adversarial Network) GAN to fit the distributions of different modalities. Specifically, the common representation learning across modalities includes two stages: (1) the first stage, GATN trains source mapping network to learn the semantic representation of text modality by supervised method; and (2) the second stage, GAN-based unsupervised modality transfer method is proposed to guide the training of target mapping network, which includes generative network (target mapping network) and discriminative network. Experimental results on three widely-used benchmarks show that GATN have achieved better performance comparing with several existing state-of-the-art methods. • Asymmetric mappings can better model the differences in low level features. • Transfer learning mechanism ensures the training efficiency of cross modal retrieval. • Semantic constraint divides samples into several semantically discriminative clusters. • Adversarial learning ensures the alignment of distributions from two modalities. [ABSTRACT FROM AUTHOR]

Lung cancer has been the leading cause of cancer incidence and mortality in China for years. Benzo[ a ]pyrene (BaP) is a well-known carcinogen for lung cancer. To understand alternation of key proteins and their role in BaP-induced lung cancer, we compared proteome profiles between BaP-transformed 16HBE cell line T-16HBE-C1 (THBEc1) cells and control using label-free quantitative proteomic analysis. Forkhead box protein A1 (FOXA1) was selected and evaluated for its potential role in BaP-induced carcinogenesis in vitro and in vivo. Relationship between FOXA1 expression and survival of lung cancer patients were examined via The Cancer Genome Atlas (TCGA) database. A total of 183 differentially expressed proteins were identified, with 67 proteins including FOXA1 up-regulated and 116 proteins down-regulated in THBEc1 cells. Differentially expressed proteins mainly functioned in basic cellular metabolism, tumor related pathways and regulation of transcription factors. FOXA1 knockout inhibited colony formation and migration of THBEc1 cells in vitro. FOXA1 knockout inhibited tumor growth and metastasis in BALB/c-nude mice after subcutaneous and tail vein injection of FOXA1 knockout THBEc1 cells, respectively. FOXA1 mRNA expression was higher in tumor tissues for patients with lung squamous cell carcinoma, but not associated with survival of lung cancer patients. Our findings revealed oncogenic role of FOXA1 in BaP-induced lung cancer and improved understanding of mechanism in BaP-induced carcinogenesis. • There are significant protein expression changes in BaP-transformed 16HBE cells. • FOXA1 knockout inhibited colony formation and migration of THBEc1 cells. • FOXA1 knockout inhibited tumor growth and metastasis of THBEc1 cells. • FOXA1 is a key protein in BaP-induced lung cancer. [ABSTRACT FROM AUTHOR]

• The differentially expressed miRNAs between THBEc1 and 16HBE cells might participate in BaP-induced carcinogenesis. • MiR-152-3p/ ALCAM , miR-142-5p/ ALCAM and miR-211-5p/ ALCAM axes may be involved in BaP-induced carcinogenesis. • ALCAM plays the role of promoting tumor growth and inhibiting metastasis. Benzo[a]pyrene (BaP) is a potent carcinogen and microRNAs (miRNAs) may play an important role in carcinogenesis. Activated leukocyte cell adhesion molecule (ALCAM) was up-regulated in BaP-transformed 16HBE cell line (THBEc1), and may be a key molecule for THBEc1 cells to gain and maintain the malignant phenotype. Here we screened the differentially expressed miRNAs which resulted in up-regulation of ALCAM in THBEc1 cells by comparing miRNA expression profiles between THBEc1 and 16HBE (HBE) cells. Results showed that a total of 555 miRNAs differentially expressed between THBEc1 and HBE cells, of which 351 miRNAs were down-regulated and 204 miRNAs were up-regulated in THBEc1 cells. MiR-152-3p, miR-142-5p and miR-211-5p down-regulated in THBEc1 cells were demonstrated to participate in the regulation of ALCAM. With THBEc1 as a tumor cell model, we determined the role of ALCAM in tumor growth and metastasis employing two ALCAM knockout THBEc1 cell lines via CRISPR/Cas9 technology. Results showed that ALCAM knockout inhibited colony formation and tumor growth, but enhanced cell migration and lung metastasis of THBEc1 cells. In conclusion, miR-152-3p/ ALCAM , miR-142-5p/ ALCAM and miR-211-5p/ ALCAM axes may be involved in BaP-induced carcinogenesis. BaP might induce up-regulation of ALCAM via inhibiting miR-152-3p, miR-142-5p and miR-211-5p, which in turn allows ALCAM to exert its role promoting cell proliferation and tumor growth, and suppressing cell migration and metastasis. [ABSTRACT FROM AUTHOR]

Chemical protective clothing (CPC) is major equipment to protect human skin from hazardous chemical warfare agents (CWAs), especially nerve agents and blister agents. CPC performance is mainly dominated by the chemical protective material, which needs to meet various requirements, such as mechanical robustness, protective properties, physiological comfort, cost-effectiveness, and dimensional stability. In this study, polyvinylidene fluoride (PVDF) based sodium sulfonate membranes with different ion exchange capacities (IECs) are prepared simply from low-cost materials. Their mechanical properties, contact angles, permeations, and selectivities have been tested and compared with each other. Results show that membranes with IEC in the range of 1.5–2 mmol g−1 have high selectivities of water vapor permeation over CWA simulant vapor permeation and good mechanical properties. Therefore, PVDF-based sodium sulfonate membranes are potential materials for CPC applications. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study examined the use of the collaborative care model in treating Hispanic children diagnosed with attention-deficit hyperactivity disorder (ADHD) living in underserved communities. Methods: The study was implemented in two clinics, one in a rural and one in an urban setting. We evaluated model implementation and used standardized rating scales to assess pre/post-intervention changes in ADHD symptoms. All children were referred and treated by their pediatricians. A care manager conveyed medication recommendations from a child and adolescent psychiatrist to the pediatrician who in turn implemented recommendations. The care manager also provided psychoeducation regarding the causes and management of ADHD. Results: The model was successfully implemented. Differences were observed across the two clinics. The urban clinic provided more sessions in the first 2 months of treatment, collected more rating scales, provided more psychoeducation, made more medication adjustments, and prescribed higher medication doses. However, children at both sites showed comparable reductions in ADHD symptoms. Parents were satisfied with the collaborative care model. Staff expressed the need for more administrative support in implementing the model. Conclusions: Collaborative care appears feasible and acceptable for the treatment of Hispanic children with ADHD and shows preliminary evidence of effectiveness. [Copyright &y& Elsevier]

Dual-ion (oxygen ion and proton) conducting electrolyte BaZr 0.1 Ce 0.7 Y 0.1 Yb 0.1 O 3-δ (BZCYYb) is one of the most commonly used electrolyte materials for proton conducting fuel cells (PCFCs). Here, we improve conducting property and performance of BZCYYb electrolyte through simply introducing B-site cation deficiency. Dual-ion conductivities for Ba(Zr 0.1 Ce 0.7 Y 0.1 Yb 0.1) 0.95 O 3-δ (BZCYYb-0.95) electrolyte are improved to a large extent as 2.5 times protonic conductivity (4.6 × 10−2 S cm−1 at 700 °C) and 6.3 times oxygen ionic conductivity (1.2 × 10−2 S cm−1 at 900 °C) compared to BZCYYb electrolyte. Low-temperature (1350 °C) sinterability of BZCYYb-0.95 is achieved for the higher concentration of defect compared to the original material (BZCYYb, 1500 °C). Meanwhile, a cell with the BZCYYb-0.95 electrolyte illustrates prominent power density of 794 mW cm−2 at 650 °C, superior to the cell with BZCYYb (643 mW cm−2) at the same condition. The collaborative diffusions of dual-ion via two different conducting mechanisms enhance the cell performance with BZCYYb-0.95 electrolyte. The cell voltage and power density actually have no observable performance degradation during the course of the 300-h test. Therefore, it indicates the dual-ion diffusions of BZCYYb-0.95 electrolyte as the promising future for practical application. Image 1 • A dual-ion conducting electrolyte is developed by B-site cation deficiency strategy. • BZCYYb-0.95 shows superior sintering performance and chemical stability against CO 2. • BZCYYb-0.95 achieves an enhancement for both protonic and oxygen ionic conductivities. • Peak power density of ~0.8 W cm−2 is obtained at 650 °C with BZCYYb-0.95 electrolyte. [ABSTRACT FROM AUTHOR]

Many distinct characteristics of the social, natural, and built neighborhood environment have been included in walkability measures, and it is unclear which measures best describe the features of a place that support walking. We developed the Automatic Context Measurement Tool, which measures neighborhood environment characteristics from public data for any point location in the United States. We explored these characteristics in home neighborhood environments in relation to walking identified from integrated GPS, accelerometer, and travel log data from 681 residents of King Country, WA. Of 146 neighborhood characteristics, 92 (63%) were associated with walking bout counts after adjustment for individual characteristics and correction for false discovery. The strongest built environment predictor of walking bout count was housing unit count. Models using data-driven and a priori defined walkability measures exhibited similar fit statistics. Walkability measures consisting of different neighborhood characteristic measurements may capture the same underlying variation in neighborhood conditions. [ABSTRACT FROM AUTHOR]

Two nonporous MOFs [Ni(L) 0.5 (Mbpy)(H 2 O) 2 2 (1) and [Cd(H 2 L)(Mbpy)] n (2) (H 4 L = 5,5'-(butane-1,4-diylbis (oxy)) diisophthalic acid, Mbpy = 5,5′-dimethyl-2,2′-bipyridine) were obtained through hydrothermal reactions under different pH values reaction condition. Structure analyses reveal that there are uncoordinated deprotonated and protonated carboxylate groups in compounds 1 and 2 , respectively, which are confirmed by IR spectra. The XRD and TG studies indicate that both of compounds exhibit good water and thermal stability. The proton conductivities of the Nafion membrane doped by compounds 1 and 2 have been studied. It was revealed that compound 2 can enhance the proton conductivity of the composite membrane about 29% higher than that of pure Nafion. The water uptakes of 1 /Nafion and 2 /Nafion composite membrane are similar and slightly higher than that of pure Nafion membrane. The apparently high proton conductivity of 2 /Nafion membrane should be attributed to the high proton density of compound 2 framework, which is resulted by the protonated uncoordinated carboxylate acid groups. Image 1 • Two MOFs, with deprotonated and protonated free carboxylate groups respectively, were obtained under different pH values. • As the filler of Nafion membrane, compound 2 can enhance the proton conductivity of the composite membrane about 29% high. • The higher proton conductivity of 2 / Nafion membrane 1 should be attributed to the protonated of uncoordinated carboxylate groups. [ABSTRACT FROM AUTHOR]

Background: Adrenocortical carcinoma (ACC) is a rare malignant endocrine tumour. Due to a high tumour recurrence rate, the post-operative overall survival (OS) and disease-free survival (DFS) of ACCs is limited. Our research aims to identify the role of the epithelial-mesenchymal transition (EMT) related genes FSCN1 and FOXM1 in the tumour microenvironment and assess their prognostic value in ACCs.Methods: Clinical and specimen data from 130 adrenocortical carcinoma (ACC) patients was acquired from the Cancer Genome Atlas (TCGA) database (n = 79) and a West China Hospital (WCH) cohort (n = 51). In the WCH cohort, archived formalin-fixed paraffin embedded (FFPE) samples were collected for immunohistochemical analysis. The correlation between the EMT genes and the tumour microenvironment status was estimated based on the Tumour Immune Estimation Resource (TIMER) algorithm. Kaplan-Meier analysis, followed by univariate and multivariate regression analyses, were performed to identify the prognostic association of FSCN1 and FOXM1.Results: FSCN1 and FOXM1 were over-expressed in ACC tissue when compared with adrenocortical adenoma and normal adrenal tissue. Over-expression of FSCN1 or FOXM1 was associated with the tumour microenvironment and immune signatures in ACCs. Patients with higher expression of FSCN1 or FOXM1 were more likely to have worse prognoses. The prognostic effects were further verified in both early (stage I/II) and advanced (stage III/IV) ACCs. Furthermore, FSCN1 and FOXM1 appeared as independent prognostic factors in ACC.Conclusions: These results show that FSCN1 and FOXM1 are independent prognostic factors in ACCs and over-expression of FSCN1 or FOXM1 indicates a worse prognosis. [ABSTRACT FROM AUTHOR]

Due to its potent cytotoxicity in BRCA-mutated tumors, synthetic lethality elicited by poly (ADP-ribose) polymerase (PARP) inhibitor gives renewed enthusiasm to researching and developing anti-cancer therapies. Chronic myeloid leukemia (CML) is a type of cancers that starts in certain blood-forming cells of the bone marrow. Here, we showed that poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib could induce a concentration-dependent cytotoxicity in CML cells derived from pediatric patients. During talazoparib treatment, autophagy was markedly activated, which was confirmed by the accumulation of autophagosomes, decrease of SQSTM1 and up-regulation of LC3-II. Inhibition of autophagy by pharmaceutical inhibitor chloroquine or small-interfering RNA siATG5 significantly increased the cytotoxicity of talazoparib in pediatric CML cells and elicited synergistic anti-tumor effect in patient-derived xenograft model. Our data demonstrated that autophagy played a cyto-protective role in talazoparib-treated pediatric CML and co-treatment with talazoparib and autophagy inhibitor could induce synergetic anti-tumor effect, providing novel insights for pediatric CML treatment. [ABSTRACT FROM AUTHOR]

Background: Despite the known benefits of early, specialized intervention for toddlers with Autism Spectrum Disorder (ASD), access to such intervention remains limited. This pragmatic trial examines a novel healthcare delivery model (Screen-Refer-Treat [SRT]), which capitalizes upon existing health care and early intervention (EI) infrastructure to increase community capacity for ASD detection and treatment before age 3, when it is likely to have the greatest impact. This model comprises three components: (1) universal use of Stage 1 ASD screening by primary care providers (PCPs) at 18-month well-child visits (i.e., Screen); (2) immediate referral of positive screens to a community-based EI program (i.e., Refer); and (3) provision of an inexpensive, evidence-based ASD-specialized treatment by EI providers, after verifying ASD risk with a Stage 2 screen (i.e., Treat). This paper describes our research design and the initial successes, challenges, and adaptations made during the early implementation phase. Method/design: A stepped-wedge cluster RCT was used to implement the SRT model sequentially in four diverse Washington State counties ("clusters"). Counties are randomly assigned to the time of receipt of the SRT intervention, which comprises training workshops and technical assistance focused on the use of evidence-based ASD screening and intervention tools. Separate cohorts of families with toddlers (16–35 months old) with and without ASD concerns are recruited before and after the SRT intervention from participating PCP practices and EI programs. PCPs and EI providers complete measures on their screening, referral, and intervention practices before and after the SRT intervention. Each family cohort completes surveys about their well-being, parenting efficacy, health care satisfaction, and toddler's social-communicative behaviors. Conclusion: This trial is the first of its kind to work simultaneously with two service delivery systems with the goal of improving early detection and treatment for ASD. Our approach was successful in attaining buy-in from PCPs and EI providers, building and maintaining partnerships with providers, and achieving high levels of retention and survey completion. Fostering provider engagement and problem-solving issues together as partners were integral to overcoming the main challenges. Numerous lessons have been learned thus far, which have applicability for implementation researchers in ASD and those in other fields. Trial registration: The registration number for this trial is NCT02409303 and it was posted on ClinicalTrials.gov on April 6, 2015. [ABSTRACT FROM AUTHOR]

Background: Species diversity is determined by both local environmental conditions that control differentiation and extinction and the outcome of large-scale processes that affect migration. The latter primarily comprises climatic change and dynamic landscape alteration. In the past few million years, both Southeast Asia and Eastern Africa experienced drastic climatic and geological oscillations: in Southeast Asia, especially in China, the Tibetan Plateau significantly rose up, and the flow of the Yangtze River was reversed. In East Africa, lakes and rivers experienced frequent range expansions and regressions due to the African mega-droughts. To test how such climatic and geological histories of both regions relate to their respective regional species and genetic diversity, a large scale comparative phylogeographic study is essential. Bellamya, a species rich freshwater snail genus that is widely distributed across China and East Africa, represents a suitable model system to address this question. We sequenced mitochondrial and nuclear DNA for members of the genus from China and used published sequences from Africa and some other locations in Asia to investigate their phylogeny and distribution of genetic diversity. Results: Our phylogenetic analysis revealed two monophyletic groups, one in China and one in East Africa. Within the Chinese group, Bellamya species show little genetic differentiation. In contrast, we observe fairly deep divergence among the East African lakes with almost every lake possessing its unique clade. Our results show that strong divergence does not necessarily depend on intrinsic characteristics of a species, but rather is related to the landscape dynamics of a region. Conclusion: Our phylogenetic results suggest that the Bellamya in China and East Africa are independent phylogenetic clades with different evolutionary trajectories. The different climate and geological histories likely contributed to the diverging evolutionary patterns. Repeated range expansions and regressions of lakes likely contributed to the great divergence of Bellamya in East Africa, while reversal of the river courses and intermingling of different lineages had an opposite effect on Bellamya diversification in China. [ABSTRACT FROM AUTHOR]

Background: To increase understanding of human bacterial and parasitic pathogens in bats, we investigated the prevalence of Babesia spp., Rickettsia spp., Anaplasma spp. and Coxiella burnetii in bats from China. Methods: Bats were captured from Mengyin County, Shandong Province of China using nets. DNA was extracted from the blood and spleen of bats for molecular detection of Babesia spp., Rickettsia spp., Anaplasma spp. and Coxiella burnetii with specific primers for each species. Results: A total of 146 spleen samples and 107 blood samples of insectivorous bats, which belonged to 6 species within two families, were collected from Mengyin County, Shandong Province of China. We found that two Eptesicus serotinus (2/15, 13.3%) were positive for Babesia vesperuginis. We were unable to detect genomic sequences for Rickettsia spp., Anaplasma spp. and Coxiella burnetii. Conclusions: To our knowledge, our study showed for the first time the presence of Babesia vesperuginis in Eptesicus serotinus collected from China, suggesting that Babesia vesperuginis has a broad host species and geographical distribution. [ABSTRACT FROM AUTHOR]

We are developing a computerized system for bladder segmentation on CT urography (CTU), as a critical component for computer-aided detection of bladder cancer. The presence of regions filled with intravenous contrast and without contrast presents a challenge for bladder segmentation. Previously, we proposed a conjoint level set analysis and segmentation system (CLASS). In case the bladder is partially filled with contrast, CLASS segments the non-contrast (NC) region and the contrast-filled (C) region separately and automatically conjoins the NC and C region contours; however, inaccuracies in the NC and C region contours may cause the conjoint contour to exclude portions of the bladder. To alleviate this problem, we implemented a local contour refinement (LCR) method that exploits model-guided refinement (MGR) and energy-driven wavefront propagation (EDWP). MGR propagates the C region contours if the level set propagation in the C region stops prematurely due to substantial non-uniformity of the contrast. EDWP with regularized energies further propagates the conjoint contours to the correct bladder boundary. EDWP uses changes in energies, smoothness criteria of the contour, and previous slice contour to determine when to stop the propagation, following decision rules derived from training. A data set of 173 cases was collected for this study: 81 cases in the training set (42 lesions, 21 wall thickenings, 18 normal bladders) and 92 cases in the test set (43 lesions, 36 wall thickenings, 13 normal bladders). For all cases, 3D hand segmented contours were obtained as reference standard and used for the evaluation of the computerized segmentation accuracy. For CLASS with LCR, the average volume intersection ratio, average volume error, absolute average volume error, average minimum distance and Jaccard index were 84.2 ± 11.4%, 8.2 ± 17.4%, 13.0 ± 14.1%, 3.5 ± 1.9 mm, 78.8 ± 11.6%, respectively, for the training set and 78.0 ± 14.7%, 16.4 ± 16.9%, 18.2 ± 15.0%, 3.8 ± 2.3 mm, 73.8 ± 13.4% respectively, for the test set. With CLASS only, the corresponding values were 75.1 ± 13.2%, 18.7 ± 19.5%, 22.5 ± 14.9%, 4.3 ± 2.2 mm, 71.0 ± 12.6%, respectively, for the training set and 67.3 ± 14.3%, 29.3 ± 15.9%, 29.4 ± 15.6%, 4.9 ± 2.6 mm, 65.0 ± 13.3%, respectively, for the test set. The differences between the two methods for all five measures were statistically significant (p < 0.001) for both the training and test sets. The results demonstrate the potential of CLASS with LCR for segmentation of the bladder. [ABSTRACT FROM AUTHOR]

Background: Identifying neighborhood environment attributes related to childhood obesity can inform environmental changes for obesity prevention. Purpose: To evaluate child and parent weight status across neighborhoods in King County (Seattle metropolitan area) and San Diego County differing in GIS-defined physical activity environment (PAE) and nutrition environment (NE) characteristics. Methods: Neighborhoods were selected to represent high (favorable) versus low (unfavorable) on the two measures, forming four neighborhood types (low on both measures, low PAE/high NE, high PAE/low NE, and high on both measures). Weight and height of children aged 6–11 years and one parent (n=730) from selected neighborhoods were assessed in 2007–2009. Differences in child and parent overweight and obesity by neighborhood type were examined, adjusting for neighborhood-, family-, and individual-level demographics. Results: Children from neighborhoods high on both environment measures were less likely to be obese (7.7% vs 15.9%, OR=0.44, p=0.02) and marginally less likely to be overweight (23.7% vs 31.7%, OR=0.67, p=0.08) than children from neighborhoods low on both measures. In models adjusted for parent weight status and demographic factors, neighborhood environment type remained related to child obesity (high vs low on both measures, OR=0.41, p<0.03). Parents in neighborhoods high on both measures (versus low on both) were marginally less likely to be obese (20.1% vs 27.7%, OR=0.66, p=0.08), although parent overweight did not differ by neighborhood environment. The lower odds of parent obesity in neighborhoods with environments supportive of physical activity and healthy eating remained in models adjusted for demographics (high vs low on the environment measures, OR=0.57, p=0.053). Conclusions: Findings support the proposed GIS-based definitions of obesogenic neighborhoods for children and parents that consider both physical activity and nutrition environment features. [Copyright &y& Elsevier]

Background: GIS-based walkability measures designed to explain active travel fail to capture “playability” and proximity to healthy food. These constructs should be considered when measuring potential child obesogenic environments. Purpose: The aim of this study was to describe the development of GIS-based multicomponent physical activity and nutrition environment indicators of child obesogenic environments in the San Diego and Seattle regions. Methods: Block group–level walkability (street connectivity, residential density, land-use mix, and retail floor area ratio) measures were constructed in each region. Multiple sources were used to enumerate parks (∼900–1600 per region) and food establishments (∼10,000 per region). Physical activity environments were evaluated on the basis of walkability and presence and quality of parks. Nutrition environments were evaluated based on presence and density of fast-food restaurants and distance to supermarkets. Four neighborhood types were defined using high/low cut points for physical activity and nutrition environments defined through an iterative process dependent on regional counts of fast-food outlets and overall distance to parks and grocery stores from census block groups where youth live. Results: To identify sufficient numbers of children aged 6–11 years, high physical activity environment block groups had at least one high-quality park within 0.25 miles and were above median walkability, whereas low physical activity environment groups had no parks and were below median walkability. High nutrition environment block groups had a supermarket within 0.5 miles, and fewer than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Low nutrition environments had either no supermarket, or a supermarket and more than 16 (Seattle) and 31 (San Diego) fast-food restaurants within 0.5 miles. Income, educational attainment, and ethnicity varied across physical activity and nutrition environments. Conclusions: These approaches to defining neighborhood environments can be used to study physical activity, nutrition, and obesity outcomes. Findings presented in a companion paper validate these GIS methods for measuring obesogenic environments. [Copyright &y& Elsevier]

ZnO thin films co-doped with Al and Sb with different concentrations and a fixed molar ratio of AlCl3 to SbCl3 at 1:2, are prepared by a sol-gel spin-coating method on glass annealed at 550 degC for 2 h in air. The x-ray diffraction results confirm that the ZnO thin films co-doped with Al and Sb are of wurtzite hexagonal ZnO with a very small distortion, and the biaxial stresses are 1.03 x 108, 3.26x108, 5.23x108, and 6.97x108 Pa, corresponding to those of the ZnO thin films co-doped with Al and Sb in concentrations of 1.5, 3.0, 4.5, 6.0 at% respectively. The optical properties reveal that the ZnO thin films co-doped with Al and Sb have obviously enhanced transmittance in the visible region. The electrical properties show that ZnO thin film co-doped with Al and Sb in a concentration of 1.5 at% has a lowest resistivity of 2.5 O*cm. [ABSTRACT FROM AUTHOR]