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DNA damage and oncogenic viruses increase the risk of cancer post-kidney transplantation, including skin cancer, Kaposi's sarcoma, oral cancer, and non-Hodgkin lymphoma. Here we report an uncommon case of liver angiosarcoma that occurred 8 years after kidney transplantation. This study strictly complied with the Helsinki Congress and the Istanbul Declaration regarding donor source.A 57-year-old female patient received a cadaver kidney transplantation 8 years ago. She followed a long-term regimen of tacrolimus, mycophenolate sodium, and everolimus, with good renal function. She received annual regular abdominal ultrasound examinations after kidney transplantation, which showed no findings. The patient suffered from several symptoms for approximately 2 weeks before a scheduled abdominal ultrasound: diarrhea, epigastric pain, abdominal fullness, tea-colored urine, and little stool passage. The abdominal computerized tomography showed multiple hepatic tumors in both the hepatic lobes with engorged vasculatures and mild hemoperitoneum. A liver biopsy revealed the histopathology of angiosarcoma. The patient suffered multiple organ failure within one month of treatment.Various post-transplant malignancies are not uncommon after transplantation, warranting periodic screenings for any symptoms in these patients.

In this study, a deep learning based accurate drug detection, identification and confirmation mechanism (DLADDICM) for medication dispensing package is proposed for inpatients. In this proposed DLADDICM, a medication dispensing package with a printed QR code is photo taken and drugs in the image are detected and identified using a deep learning object detection algorithm, namely You Only Look Once (YOLO). The QR code information is deciphered and compared with the detected drugs to confirm the correctness of the medication dispensing. If there are mismatch situation(s), the computer with the proposed DLADDICM will generate different warning sound in responding to different incorrect situations. A data set with 30 drugs form the National Library of Medicine of NIH, USA is used for testing the DLADDICM using the object tracking and detection deep learning algorithm YOLOv3. Experimental results shown that the DLADDICM can detect and identify the incorrect drugs and generate the appropriate warning sound for the incorrect drug in pharma package for further human inspection. The experimental results also exhibits that by using the AI-enabled mechanism an accurate, safer, healthier with precision medication environment for the medical industries could also be achieved.

Introduction Nintedanib can inhibit processes involved in the progression of fibrosis and can reduce the decline in forced vital capacity in patients with idiopathic pulmonary fibrosis (IPF) and fibrotic-interstitial lung disease (fibrotic-ILDs). Although the adverse events associated with nintedanib in IPF patients are well known, its safety in other fibrotic-ILD patients remained unclear. Methods We searched PubMed, EMBASE, Cochrane CENTRAL and Cochrane CDSR for randomized controlled studies which compared nintedanib with a placebo in ILD patients. We estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs) for adverse events using the DerSimonian–Laird random-effects model. Results Six studies with a total of 2,583 patients were included in the meta-analysis. The pooled estimates showed that patients treated with nintedanib had a significantly higher likelihood of having any adverse events (OR = 2.39; 95% CI = 1.71–3.36) or adverse events leading to treatment discontinuation (OR = 1.73; 95% CI = 1.34–2.25). However, they had trend to lower likelihood of having fatal adverse events (OR = 0.69; 95% CI = 0.41–1.14) compared with the placebo group. Use of nintedanib was positively associated with diarrhea (OR = 5.96; 95% CI = 4.35–8.16), nausea (OR = 3.00; 95% CI = 1.93–4.66), vomiting (OR = 3.22; 95% CI = 2.17–4.76) and weight loss (OR = 3.38; 95% CI = 1.1.76–6.47). Whereas, patients treated with nintedanib were less likely to have a cough (OR = 0.73; 95% CI = 0.56–0.96) and dyspnea (OR = 0.70; 95% CI = 0.53–0.94). Conclusions Compared to a placebo, nintedanib was associated with a higher risk of adverse events, especially for diarrhea, nausea, vomiting and weight loss, but it was also associated with a lower risk of cough and dyspnea in IPF and fibrotic-ILD patients.

Drug inventory management is an important part of hospital management. The large amounts of drug data in hospitals bring challenges to optimizing the setting values for the safety stock and the maximum inventory of each drug. This study combined a two-stage clustering method with an inventory policy (s, S) and established a simulation optimization model for the case hospital’s outpatient pharmacy. This research used the simulation optimization software Arena OptQuest, developed by Rockwell Automation Inc (Rockwell Automation, Coraopolis, PA, USA), in order to determine the minimum and maximum values (s, S) of the best stock amounts for each drug under the considerations of cost and related inventory constraints. The research results showed that the minimum and maximum inventory settings for each drug in the simulation model were better than those set by the case outpatient pharmacy system. The average inventory cost was reduced by 55%, while the average inventory volume was reduced by 68%. The proposed method can improve management efficiency and inventory costs of hospital pharmacies without affecting patient services and increasing the inventory turnover rate of the drugs.

The Arctic is a vital component of the global climate, and its rapid environmental evolution is an important element of climate change around the world. To detect and diagnose the changes occurring to the coupled Arctic climate system, a state-of-the-art synthesis for assessment and monitoring is imperative. This paper presents the Arctic System Reanalysis, version 2 (ASRv2), a multiagency, university-led retrospective analysis (reanalysis) of the greater Arctic region using blends of the polar-optimized version of the Weather Research and Forecasting (Polar WRF) Model and WRF three-dimensional variational data assimilated observations for a comprehensive integration of the regional climate of the Arctic for 2000–12. New features in ASRv2 compared to version 1 (ASRv1) include 1) higher-resolution depiction in space (15-km horizontal resolution), 2) updated model physics including subgrid-scale cloud fraction interaction with radiation, and 3) a dual outer-loop routine for more accurate data assimilation. ASRv2 surface and pressure-level products are available at 3-hourly and monthly mean time scales at the National Center for Atmospheric Research (NCAR). Analysis of ASRv2 reveals superior reproduction of near-surface and tropospheric variables. Broadscale analysis of forecast precipitation and site-specific comparisons of downward radiative fluxes demonstrate significant improvement over ASRv1. The high-resolution topography and land surface, including weekly updated vegetation and realistic sea ice fraction, sea ice thickness, and snow-cover depth on sea ice, resolve finescale processes such as topographically forced winds. Thus, ASRv2 permits a reconstruction of the rapid change in the Arctic since the beginning of the twenty-first century–complementing global reanalyses. ASRv2 products will be useful for environmental models, verification of regional processes, or siting of future observation networks.

The Gridpoint Statistical Interpolation three-dimensional variational data assimilation (DA) system coupled with the Weather Research and Forecasting/Chemistry (WRF/Chem) model was utilized to improve aerosol forecasts and study aerosol direct and semi-direct radiative feedbacks during a US wild fire event. Assimilation of MODIS total 550 nm aerosol optical depth (AOD) retrievals clearly improved WRF/Chem forecasts of surface PM2.5 and organic carbon (OC) compared to the corresponding forecasts without aerosol data assimilation. The scattering aerosols in the fire downwind region typically cooled layers both above and below the aerosol layer and suppressed convection and clouds, which led to an average of 2% precipitation decrease during the fire week. This study demonstrated that, even with no input of fire emissions, AOD DA improved the aerosol forecasts and allowed a more realistic model simulation of aerosol radiative effects.

Objectives We investigated whether chronological changes in portal flow and clinical factors play a role in the liver regeneration (LR) process after right donor-hepatectomy. Materials and methods Participants in this prospective study comprised 58 donors who underwent right donor-hepatectomy during the period February 2014 to February 2015 at a single medical institution. LR was estimated using two equations: remnant left liver (RLL) growth (%) and liver volumetric recovery (LVR) (%). Donors were classified into an excellent regeneration (ER) group or a moderate regeneration (MR) group based on how their LR on postoperative day 7 compared to the median value. Results Multivariate analysis revealed that low residual liver volume (OR = .569, 95% CI: .367– .882) and high portal venous velocity in the immediate postoperative period (OR = 1.220, 95% CI: 1.001–1.488) were significant predictors of LR using the RLL growth equation; high portal venous velocity in the immediate postoperative period (OR = 1.325, 95% CI: 1.081–1.622) was a significant predictor of LR using the LVR equation. Based on the two equations, long-term LR was significantly greater in the ER group than in the MR group (p < .001). Conclusion Portal venous velocity in the immediate postoperative period was an important factor in LR. The critical time for short-term LR is postoperative day 7; it is associated with long-term LR in donor-hepatectomy.

Our goal was to evaluate the predictors of coagulopathic hemorrhage after living-donor liver transplant.We retrospectively evaluated 161 patients who had undergone living-donor liver transplant from July 2005 to April 2014 at a single medical institution. Of these patients, 32 developed hemorrhage after transplant. Patients were separated into those with coagulopathy-related hemorrhage (n=15) or noncoagulopathy-related hemorrhage (n=17) based on the results of computed tomography images. Predictors of hemorrhage after living-donor liver transplant evaluated in this study included preoperative, perioperative, and posttransplant factors and hemodynamic status.Patients who developed coagulopathy-related hemorrhage had significantly lower pretransplant platelet counts (P = .040), a longer cold-ischemia time (P = .045), more blood loss (P = .040), and earlier onset of hemorrhage (P = .048) than patients who had noncoagulopathy-related hemorrhage after transplant. Results of the generalized estimating equation analysis showed that heart rate and central venous pressure differed significantly between the 2 groups of patients. Heart rates increased significantly during hemorrhage (P.010). Central venous pressure was higher in the coagulopathic group (P = .005) than in the noncoagulopathic group.Lower pretransplant platelet counts, longer cold ischemia time, more blood loss, earlier onset of hemorrhage, and higher central venous pressure level are indicators of coagulopathic hemorrhage after living-donor liver transplant.

We investigate the tight focusing of radially polarized ultrashort pulse laser beam. It is found that pulse delay phenomenon occurs near the focus. This is, near the focus, the photon travels slower than the speed of light.

Total 550 nm aerosol optical depth, surface fine particulate matter (PM2.5), and meteorological observations were assimilated with continuously cycling three-dimensional variational (3DVAR), ensemble square root Kalman filter (EnSRF), and hybrid variational-ensemble data assimilation systems. The hybrid system's background error covariances (BECs) were a blend of those in 3DVAR and produced by the cycling EnSRF system, and the 3DVAR, EnSRF, and hybrid systems differed almost exclusively by their BECs. New analyses were produced every 6 h between 0000 UTC 1 June and 1800 UTC 14 July 2010 over a domain encompassing the contiguous United States (CONUS) and adjacent areas. Additionally, a control experiment that only assimilated meteorological observations was performed. Each 1800 UTC analysis initialized a 48 h Weather Research and Forecasting with Chemistry model forecast. These forecasts were evaluated with a focus on air quality prediction. The ensemble aerosol spread was generally insufficient, particularly over the western CONUS. However, despite the suboptimal ensemble spread, the hybrid system performed quite well and usually produced the best aerosol forecasts. Additionally, both the 3DVAR- and EnSRF-initialized forecasts typically outperformed the control. These results are encouraging and suggest the resiliency of the hybrid method. Improved aerosol ensembles should translate into even better future hybrid forecasts.

[1] The capability of assimilating surface PM10 (particulate matter with diameters less than 10 µm) observations has been developed within the National Centers for Environmental Prediction Gridpoint Statistical Interpolation three-dimensional variational (3DVAR) data assimilation (DA) system. It provides aerosol analyses for the Goddard Chemistry Aerosol Radiation and Transport aerosol scheme within the Weather Research and Forecasting/Chemistry model. Control and assimilation experiments were performed for June 2011 over China to explore in detail the impact of assimilating surface PM10. In the assimilation experiment, analyses were produced every 6 h to adjust the mass concentrations of different aerosol species. The statistical results from two parallel experiments demonstrate that the assimilation of surface PM10 observations can significantly reduce the uncertainty of initial aerosol fields and effectively improve the subsequent aerosol forecasts for at least 12 h. However, the benefit from the assimilation of PM10 diminishes rapidly with forecast range. Process analysis for PM10 formation indicates that the rapidly diminishing DA impact on aerosol forecasts, especially in early forecast hours, was dominated by vertical mixing with an additional contribution from advection. Both processes were mainly related to unbalanced aerosol fields in the horizontal and vertical after assimilating surface observations. These findings illustrate the importance of adjusting aerosol emission rates and the initial aerosol vertical profile.

Background Donor safety and preservation of donor health after living liver donation are of paramount importance. Diarrhea has a significant influence on gastrointestinal quality of life among donors who have undergone living donor hepatectomy. Thus, we aimed to investigate predictors of diarrhea after hepatectomy and its impact on gastrointestinal quality of life in living donors. Methods We retrospectively examined the medical records of 204 living liver donors who underwent hepatectomy during the period January 2010 to June 2013 at a single medical center. Diarrhea was defined as the passing of three or more liquid stools per day. The Chinese version of the Gastrointestinal Quality of Life Index (GIQLI) was used to assess the influence of diarrhea on quality of life in donors. Results During the study period, diarrhea was diagnosed in 62 (30.3%) of the 204 donors and the duration of diarrhea in the majority of them (n = 46, 74%) was

We investigate the spatial coherence of the light generated from high-power multi-chip red LEDs by using the van Cittert-Zernike theorem. It is theoretically demonstrated that the light generated from multi-chip LEDs evolves into partially coherent light after propagation, and the spatial coherence is increased with the increase of propagation distance. Moreover, the spatial coherence of the light is found to be closely related to the chip distribution of multi-chip LEDs. The distribution of the spatial coherence of the light is experimentally examined by Young’s double-slit interference. It is found that the experimental results are consistent with the theoretical ones.

Data assimilation is the process by which observations are combined with short-range NWP model output to produce an analysis of the state of the atmosphere at a specified time. Since its inception in the late 1990s, the multiagency Weather Research and Forecasting (WRF) model effort has had a strong data assimilation component, dedicating two working groups to the subject. This article documents the history of the WRF data assimilation effort, and discusses the challenges associated with balancing academic, research, and operational data assimilation requirements in the context of the WRF effort to date. The WRF Model's Community Variational/Ensemble Data Assimilation System (WRFDA) has evolved over the past 10 years, and has resulted in over 30 refereed publications to date, as well as implementation in a wide range of real-time and operational NWP systems. This paper provides an overview of the scientific capabilities of WRFDA, and together with results from sample operation implementations at the U.S. ...

chen m.-y., huang w.-c., peng y.-s., guo j.-s., chen c.-p., jong m.-c. & lin h.-c. (2011) Effectiveness of a health promotion programme for farmers and fishermen with type-2 diabetes in Taiwan. Journal of Advanced Nursing 67(9), 2060–2067. Abstract Aims. This paper is a report of a study examining the diabetes control and foot self-care capability in farmers and fishermen following introduction of a multi-stage, multi-disciplinary team and community-based small group health promotion programme. Background. Improving the control of diabetes is a critical issue in Taiwan because mortality rates are increasing dramatically, particularly in rural populations. Methods. A quasi-experimental research design was deployed from January to December 2009. A total of 387 participants living in nine rural districts with previous diagnoses of type-2 diabetes were randomly selected. Three hundred and twenty-three completed the 3-stage programme, including health assessment, health promotion education and individually tailored telephone counselling and evaluation over a 1-year period. Results. Most of the participants were fishermen or farmers who had

In this study, UV/H2O2 treatment was used to evaluate its efficacy for control of natural organic matter (NOM) in different water sources in Taiwan and the results were compared with the conventional water treatment process. The NOM fractions analysis showed that compositions of NOM could be very different between the various water sources, and the raw water quality in Kin-Men (an off shore island of Taiwan) was characteristic when compared to other water sources. Raw water taken from Kin-Men generally had high dissolved organic carbon (DOC) concentrations and ~ 50% of the NOM in the raw water was hydrophilic. After UV/H2O2 treatment, a portion of the hydrophobic fractions of NOM in raw waters were transformed into hydrophilic ones. In conventional water treatment process, coagulation and slow filtration treatments have better efficiency to reduce the NOM in water especially for the hydrophobic portion. However, the pre-chlorination treatment for raw water increased the DOC concentration due to the lysis of algae cells. This study concluded that hydrophobic acids portion is the most sensitive portion of NOM to UV/H2O2 and conventional treatment processes. Trihalomethanes formation potential (THMFP) tests showed that hydrophobic acids portion is also the main contributor to THMs formation after chlorination process.

Background: The standardized mortality rate of type 2 diabetes is higher in Taiwan than that in other developed countries. In Taiwan, the diabetes mortality rate in Chiayi County is the highest nationwide. Purpose: This study was designed to explore the health status (to measure six physiological indicators), the health-related behaviors, and the associated factors among type 2 diabetes sufferers living in rural communities. Methods: Researchers used a cross-sectional, correlation design and conducted the study at nine local health districts in Chiayi County, Taiwan. A total of 387 participants previously diagnosed with type 2 diabetes were randomly selected and invited to join in the program. Results: Fifty-nine percent of participants were women; their mean age was 68.7 years, and their mean duration with diabetes was 7.9 years. Most were treated at local health centers and took oral medications (90.7%). More than 40% did not exercise regularly and 33.9% did not practice diet control. Results found a higher percentage of abnormal health indicators in terms of participant body mass index, waist circumference, HbA1C, and peripheral neurovascular function. After controlling for potential confounding factors, researchers found smaller waist circumference, participating in community support groups, better foot self-care capability, and frequent exercise to be associated with better health indicators. Diabetes duration, lower education, and being of male gender were found to be negatively associated with health status. Conclusions/Implications for Practice: This study found that rural residents with diabetes do not adequately control their diabetes and exhibit inadequate health-related behavior. Joining community support groups, increasing exercise frequencies, and improving foot self-care capabilities should be employed in nursing strategies and health policies for diabetes control-especially for those who have less formal education or are male.

In this article, non-Fickian and non-Fourier models were used for the rapid heat and mass transfer problem in a slab. The boundaries are convective and insulated sides, and the solution takes the Soret effect into consideration. The Laplace transform method is used to obtain a local-analytic solution in the transformed domain and then inverted to obtain the results in physical quantities. The results show that the temperature and concentration curves possess discontinuities when the relaxation-time in the non-Fourier heat conduction and non-Fickian mass diffusion problem is considered. These discontinuities are caused by wave propagation. Propagated waves are reflected at the insulated side and grow weaker as time passes. When considering the Soret effect for mass transfer, the intensity of concentration rise in the discontinuities will increase.

The Weather Research and Forecasting (WRF) model–based variational data assimilation system (WRF-Var) has been extended from three- to four-dimensional variational data assimilation (WRF 4D-Var) to meet the increasing demand for improving initial model states in multiscale numerical simulations and forecasts. The initial goals of this development include operational applications and support to the research community. The formulation of WRF 4D-Var is described in this paper. WRF 4D-Var uses the WRF model as a constraint to impose a dynamic balance on the assimilation. It is shown to implicitly evolve the background error covariance and to produce the flow-dependent nature of the analysis increments. Preliminary results from real-data 4D-Var experiments in a quasi-operational setting are presented and the potential of WRF 4D-Var in research and operational applications are demonstrated. A wider distribution of the system to the research community will further develop its capabilities and to encourage testing under different weather conditions and model configurations.

Intensive nutritional support can reduce the catabolic response, improve protein synthesis, and promote liver regeneration. This study examined whether postoperative peripheral parenteral nutrition may improve recovery and reduce the length of hospital stay in right lobe liver donors.In this retrospective study, we enrolled liver donors with residual liver volume50%. Donors were classified into 2 groups: donors who received (n = 44) or did not receive (n = 40) postoperative peripheral parenteral nutrition. Liver function tests included alanine aminotransferase and total bilirubin levels, and postoperative complications included pleural effusion, atelectasis, and wound complications. Hospital length of stay was included as a potential risk factor for the evaluation of the effect of postoperative peripheral parenteral nutrition on recovery of right lobe liver donors.Male sex (β, 22.04; 95% confidence interval: 6.22 - 37.86) was a significant predictor of changes in postoperative alanine aminotransferase level. Male sex (β, 0.045; 95% confidence interval: 0.16 - 37.86) and receipt of peripheral parenteral nutrition (β, -0.045; 95% confidence interval: -0.72 - 0.17) were significant predictors of changes in total bilirubin level. Postoperative atelectasis (P.001), pleural effusion (P.011), and total complications (P = .015) had significantly lower incidence in the peripheral parenteral nutrition than control group. Multivariate logistic regression showed that recipients of peripheral parenteral nutrition (odds ratio, 0.161; 95% confidence interval: 0.043 - 0.598) and age (odds ratio, 0.870; 95% confidence interval: 0.782 - 0.968) were significant preoperative risk factors for postoperative complications.Postoperative peripheral parenteral nutrition is associated with a lower incidence of pleural effusion and atelectasis, a more rapid recovery of hyperbilirubinemia, and shorter length of stay in right lobe liver donors.

How to Obtain Contact Hours by Reading this Article Instructions 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf . To obtain contact hours you must: 1. Read the article, “Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing” found on pages 25–31, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until May 31, 2019. Contact Hours This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Activity Objectives 1. Identify the worldwide shortage of nurses specializing in gerontological nursing. 2. Describe the results of using music therapy to create positive attitudes toward older adults. Disclosure Statement Neither the planners nor the authors have any conflicts of interest to disclose. Nursing students generally have a negative attitude toward older adults. Preparing nurses to meet the care needs of an expanding aging population is a challenge for nursing educators. The purpose of the current study was to explore whether incorporating music therapy into a practical geriatric nursing course at a nursing home cultivates positive attitudes toward older adults, raises students' willingness to work with older adults, and increases their interest in specializing in gerontological nursing after graduation. Focus groups were conducted to collect data from three participant groups ( N = 20). Verbatim transcripts of audiorecorded interviews were analyzed using content analysis, which revealed four themes: (a) better appreciation and understanding of music therapy , (b) role modeling instructors' successful experience and positive attitude toward older adults , (c) changing attitudes toward older adults , and (d) improving interaction skills with older adults . Results suggested music can be integrated into a gerontological nursing course to enhance students' motivation to learn, empathize, and approach older adults. [ Journal of Gerontological Nursing, 42 (6), 25–31.]

Donor safety and preservation of donor health after living liver donation are of paramount importance. In addition, the preoperative mental state of a donor is an important factor in determining the psychological impact of donor hepatectomy. Thus, we aimed to explore the mental health status of living liver donors after hepatectomy. We enrolled 60 donors who were scheduled to undergo living donor hepatectomy during the period January 2014 to March 2015 at a single medical center. Mental health status was measured before and 3 months after surgery using 3 self-report questionnaires, namely the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms, the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to measure quality of life, and the Chinese Health Questionnaire (CHQ) to screen for minor psychiatric disorders. A comparison of the pre- and postdonation CES-D scores revealed a significant reduction in depressive symptoms after surgery (P = .031). There were significant improvements in the physical health domain (P = .031), the psychological health domain (P = .005), the social relationships domain (P = .005), and the environmental health domain (P = .010) of the WHOQOL-BREF. There were no significant changes in CHQ scores after donor hepatectomy (P = .136). All donors reported that they would donate again if required. Approximately one-third (33.3%) of donors experienced more pain than they had anticipated in the immediate postoperative period, and 20.0% of donors had complications after donor hepatectomy. Donor mental health status tended to improve as donors regained physical function during the 1st 3 months of recovery. Long-term monitoring of living donors’ mental health is needed to minimize the adverse psychological outcomes of living liver donation.

Objective To examine whether gonadotrophin-releasing hormone agonist or oestradiol can directly affect DNA in leiomyoma cells. Design In vitro explant culture of leiomyoma cells. Setting University research group. Sample Leiomyoma cells were cultured from the specimens of four premenopausal women at myomectomy. Methods The presence of gonadotrophin-releasing hormone receptor in leiomyoma cells was determined by reverse transcriptase–olymerase chain reaction. Leiomyoma cells were treated with gonadotrophin-releasing hormone agonist or cultured in different concentrations of oestrogen, progesterone or fetal calf serum for one, four or seven days. Main outcome measures Cell number, expression of proliferating cell nuclear antigen, and DNA damage after one, four or seven days of treatment. Results Gonadotrophin-releasing hormone receptor messenger ribonucleic acid was detected on cultured leiomyoma cells. Leiomyoma cell growth was not affected by the addition of gonadotrophin-releasing hormone agonist or progesterone, but increased with oestrogen or fetal calf serum supplementation. Overexpression of proliferating cell nuclear antigen was prevented in cultures added with oestrogen or fetal calf serum, but not related to gonadotrophin-releasing hormone agonist treatment. Significant decreases in DNA damage as indicated by decreased comet number were found in the leiomyoma cultures treated with oestrogen or fetal calf serum for four and seven days but not with gonadotrophin-releasing hormone agonist or progesterone. Furthermore, 5% fetal calf serum supplementation was more growth supporting and more significantly reduced the comet number than 250 pM 17 β-oestradiol. Conclusion Cell growth, proliferating cell nuclear antigen expression and DNA damage are dependent on oestrogen or fetal calf serum, but independent of gonadotrophin-releasing hormone agonist or progesterone. Our findings suggest that gonadotrophin-releasing hormone agonist-induced leiomyoma shrinkage may be due in part to a mechanism involving DNA damage, and support the hypothesis that gonadotrophin-releasing hormone agonist exerts its action indirectly through oestrogen action on the tumour level.

Ursolic acid (UA) is a pentacyclic triterpene acid that is present in a wide variety of medicinal herbs and edible plants. This study investigated the effect of UA on apoptosis and proliferation of hepatocellular carcinoma SK-Hep-1 cells. After treatment of SK-Hep-1 cells with different concentrations of UA, we observed that cell viability was reduced in a dose- and time-dependent manner. Furthermore, there was a dose-dependent increase in the percentage of cells in the sub-G1 and G2/M phases, with cells treated with 60 μM showing the highest percentages of cells in those phases. UA-induced chromatin condensation of nuclei was observed by using DAPI staining. The western blot results revealed that exposure to UA was associated with decreased expression of the anti-apoptotic proteins Mcl-1, Bcl-xL, Bcl-2, and TCTP and increased expression of apoptosis-related proteins TNF-α, Fas, FADD, Bax, cleaved caspase-3, caspase-8, caspase-9, and PARP. Immunocytochemistry staining showed that treatment with UA resulted in increased expression of caspase-3. Moreover, exposure to UA resulted in the inhibition of the PI3K/Akt and p38 MAPK signaling pathways. These findings suggest that UA inhibits the proliferation of SK-Hep-1 cells and induces apoptosis.

[1] Total 550 nm aerosol optical depth (AOD) retrievals from Moderate Resolution Imaging Spectroradiometer (MODIS) sensors and surface fine particulate matter (PM2.5) observations were assimilated with the National Centers for Environmental Prediction (NCEP) Gridpoint Statistical Interpolation (GSI) three-dimensional variational (3DVAR) data assimilation (DA) system. Parallel experiments assimilated AOD and surface PM2.5observations both individually and simultaneously. New 3DVAR aerosol analyses were produced every 6 h between 0000 UTC 01 June and 1800 UTC 14 July 2010 over a domain encompassing the continental United States. The analyses initialized Weather Research and Forecasting-Chemistry (WRF-Chem) model forecasts. Assimilating AOD, either alone or in conjunction with PM2.5 observations, produced better AOD forecasts than a control experiment that did not perform DA. Additionally, individual assimilation of both AOD and PM2.5 improved surface PM2.5 forecasts compared to when no DA occurred. However, the best PM2.5 forecasts were produced when both AOD and PM2.5 were assimilated. Considering the goodness of both AOD and PM2.5 forecasts, the results unequivocally show that concurrent DA of PM2.5 and AOD observations produced the best overall forecasts, illustrating how simultaneous DA of different aerosol observations can work synergistically to improve aerosol forecasts.

A numerical analysis has been made of the conjugate natural convection in a rectangular enclosure filled with a fluid-saturated porous medium and surrounded with four solid walls. The conductance of the walls is assumed to be much greater than that of the cavity filled with a porous medium. The main objective was to investigate the influences of the ratio of thermal conductivity of the wall to that of the fluid-porous matrix composite, the Darcy-modified Rayleigh number, the Prandtl number, and the aspect ratio. The streamlines and isotherms are presented; also, the local and average Nusselt numbers are presented along the interface between walls and cavity. A non-Darcian model was employed and the numerical method was SIMPLE-C. The numerical results indicate that the wall heat conduction effects decrease the heat transfer rate. When the wall heat conduction is considered, the greater the conductance of the solid walls surrounding the cavity, the greater is the rate of heat transfer.

[1] Assimilation of the Moderate Resolution Imaging Spectroradiometer (MODIS) total aerosol optical depth (AOD) retrieval products (at 550 nm wavelength) from both Terra and Aqua satellites have been developed within the National Centers for Environmental Prediction (NCEP) Gridpoint Statistical Interpolation (GSI) three-dimensional variational (3DVAR) data assimilation system. This newly developed algorithm allows, in a one-step procedure, the analysis of 3-D mass concentration of 14 aerosol variables from the Goddard Chemistry Aerosol Radiation and Transport (GOCART) module. The Community Radiative Transfer Model (CRTM) was extended to calculate AOD using GOCART aerosol variables as input. Both the AOD forward model and corresponding Jacobian model were developed within the CRTM and used in the 3DVAR minimization algorithm to compute the AOD cost function and its gradient with respect to 3-D aerosol mass concentration. The impact of MODIS AOD data assimilation was demonstrated by application to a dust storm from 17 to 24 March 2010 over East Asia. The aerosol analyses initialized Weather Research and Forecasting/Chemistry (WRF/Chem) model forecasts. Results indicate that assimilating MODIS AOD substantially improves aerosol analyses and subsequent forecasts when compared to MODIS AOD, independent AOD observations from the Aerosol Robotic Network (AERONET) and Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) instrument, and surface PM10 (particulate matter with diameters less than 10 μm) observations. The newly developed AOD data assimilation system can serve as a tool to improve simulations of dust storms and general air quality analyses and forecasts.

This paper is a report of a study examining the diabetes control and foot self-care capability in farmers and fishermen following introduction of a multi-stage, multi-disciplinary team and community-based small group health promotion programme.Improving the control of diabetes is a critical issue in Taiwan because mortality rates are increasing dramatically, particularly in rural populations.A quasi-experimental research design was deployed from January to December 2009. A total of 387 participants living in nine rural districts with previous diagnoses of type-2 diabetes were randomly selected. Three hundred and twenty-three completed the 3-stage programme, including health assessment, health promotion education and individually tailored telephone counselling and evaluation over a 1-year period.Most of the participants were fishermen or farmers who had6 years of education (79%) and were elders (68·9 ± 9·5 years). Most of the physiological variables and foot self-care capabilities showed statistically significant improvement after the programme. Furthermore, 37 participants with severe high risk of diabetic foot accepted additional referral treatments, and their peripheral nerve and vascular functions improved.The research outcomes support the value of community-based health promotion programmes in rural areas, incorporating a multidisciplinary health team and culturally competent materials to help the elder rural inhabitants with diabetes enjoy better health and quality of life.

Summary Objective To explore the perceptions of group music therapy among elderly nursing home residents in Taiwan. Methods Focus group methodology was used to explore the perceptions of elderly participants about their experience of group music therapy. Verbatim transcripts of audiotaped interviews were analysed by content analysis. Results In total, 3 focus groups were held with 17 wheelchair-bound elderly residents. Analysis of participants’ perceptions of group music therapy revealed two major themes: (1) strength derived from the group dynamic and (2) enhanced quality of life. The first theme included three subthemes: (1) sense of energy, (2) distraction from suffering, and (3) confirmation as a person. The second major theme included four subthemes: (1) variety added to life, (2) motivation to exercise, (3) learning positive behaviour, and (4) greater life satisfaction. Conclusion Elderly, wheelchair-bound residents of a nursing home in Taiwan positively viewed their experiences with our group music therapy programme, particularly its active component. The findings of this study suggest that healthcare providers should consider integrating group music therapy into their programmes for elderly nursing home residents and design the therapy to add variety to their life, give them a sense of autonomy by having them choose their preferred musical activities, and improve their cognitive function.

Steganographic technology acts as the important role which defends information security in the network. The information could be hidden in multimedia object. Even if transmitted in an unsafe channel, the information is invisible by human visual system to maintain security. This paper presents a reversible palette image steganography based on de-clustering and predictive coding. The information is embedded into the image during compression encoding. It does not only solve problems encountered in interception and theft over Internet. The proposed method reforms the drawback of distortion of other schemes. When retrieving the information from stego-image, the original image also can be recovered. The proposed method is robust and useful for keeping transmission secure.

[1] This paper reports the first effort on real-time ensemble predictions of precipitation during the 2000–2002 Mei-Yu seasons (May to June) over the Taiwan area. Six members were included, each using the fifth-generation Pennsylvania State University-National Center for Atmospheric Research Mesoscale Model (MM5) nesting down to 15-km grid size, with different combinations of cumulus and microphysics parameterizations. Rainfall forecasts were evaluated with the equitable threat score (ETS) and bias score (BS). On the basis of verifications on 15-km grid points over three Mei-Yu seasons, it was found that no one member persistently had the least root mean square error of 12–24 hours and 24–36 hours accumulated rainfalls. For rainfall occurrence, most members had better predictions over the northeastern mountainous area, the northwestern coastal plain, the central mountain slope, the southwestern coastal plan, and the southwestern mountainous area. These regions also corresponded to areas of more accumulated rainfalls during three Mei-Yu seasons. An ensemble prediction, using a multiple linear regression (MLR) method which performed a least-square fit between the predicted and observed rainfalls in postseason analysis, had the best ETS and BS skill. The MLR ensemble forecast outperformed the average forecast (for all six members), the average forecasts of cumulus (four-member) and microphysics (three-member) ensembles, and also a high-resolution (5-km) forecast; however, a high-resolution forecast still had better skill for heavy rainfall events. The MLR ensemble forecast, using the weightings determined from previous Mei-Yu seasons, still had similar ETS trend to that with weightings determined by current-year Mei-Yu season, albeit with less skill.

1. The present study was carried out to identify the specific protein kinase C (PKC) isoform involved in regulatory volume decrease (RVD) responses, and to investigate the signal transduction pathways underlying the activation of volume-sensitive chloride channels in human cervical cancer HT-3 cells. The role of Ca2+ in RVD and in the activation of chloride currents was also studied. 2. The time course of RVDs was prolonged by microinjection of PKC-alpha antibody but not by PKC-beta or PKC-gamma antibody, and also by exposure to Ca2+-free medium, in particular when combined with microinjection of EDTA. Immunofluorescence staining showed that hypotonic superfusion evoked the translocation of PKC-alpha to the cell membrane, whereas PKC-beta or PKC-gamma remained unaffected. The translocation of PKC-alpha was observed a few minutes after hypotonic stress, reaching peak intensity at 30 min, and returned to the cytoplasm 60 min after hypotonic exposure. Western blot analyses showed an increased PKC-alpha level in terms of intensity and phosphorylation in the cell membrane, while neither PKC-beta nor PKC-gamma was activated upon hyposmotic challenge. 3. Whole-cell patch-clamp studies demonstrated that neomycin and PKC blockers such as staurosporine and H7 inhibited volume-sensitive chloride currents. The inhibitory effect of neomycin on chloride currents can be reversed by the PKC activator phorbol 12-myristate, 13-acetate (PMA). Moreover, the PKC inhibitor and PKC-alpha antibody, but not PKC-beta or PKC-gamma antibody, significantly attenuated the chloride currents. The activation of volume-sensitive chloride currents were insensitive to the changes of intracellular Ca2+ but required the presence of extracellular Ca2+. 4. Our results suggest the involvement of PKC-alpha and extracellular Ca2+ in RVD responses and the activation of volume-sensitive chloride channels in HT-3 cells.

Based on vectorial Debye diffraction theory, the spatial correlation properties in the focal region of a J0-correlated azimuthally polarized vortex beam through a high numerical aperture (NA) are analyzed. The expressions for a pair of points on the axis of symmetry and for a pair of points in the focal plane are derived. It is found that the longitudinal and transverse coherence lengths in the focal region change with the variation in the topological charge and coherence parameter of the vortex field, together with the NA values. In addition, the degree of coherence is shown to possess phase singularities.

We experimentally study the generation of a partially coherent non-diffractive beam by focusing a partially coherent vortex beam with an axicon. The investigation results show that when the partially coherent vortex beam is focused by the axicon, the beam is transferred into a partially coherent higher-order non-diffractive beam. In the non-diffractive zone, the transverse intensity distribution of the partially coherent higher-order non-diffractive beam is invariant during propagation. In addition, the range of the non-diffractive zone is related to the coherence of the partially coherent vortex beam. The poorer the coherence of the partially coherent vortex beam, the shorter the range of the non-diffractive zone.