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The concentration of PM 2.5 (particulate matter with a diameter < 2.5 µm) on Sumatra Island has increased, mainly because of forest and peatland fires, transportation, and industry. Biomass burning releases partially burned carbon into the atmosphere, resulting in a smoky haze containing PM 2.5 . Air quality has deteriorated quickly, and PM 2.5 has become a major health hazard in Indonesia. Studies on long-term exposure to PM 2.5 have indicated its associations with both morbidity and mortality. Here, we measured long-term (2000-2014) exposure to PM 2.5 on the basis of satellite-derived aerosol optical depth measurements (1 × 1 km 2 ) used to predict ground-level PM 2.5 concentrations. Additionally, population data on Sumatra Island residents from the fourth wave of the Indonesian Family Life Survey (IFLS) were obtained. We investigated the association between long-term PM 2.5 exposure and mortality with a retrospective cohort study design. A total of 2409 subjects aged ≥ 40 years participated in the IFLS-3 beginning in November 2000, and we examined mortality outcomes until the IFLS-5 in September 2014. We used Cox regression models to calculate hazard ratios (HRs) of mortality associated with PM 2.5 exposure. According to the adjusted model, the mortality HRs per 10 µg/m 3 increase in PM 2.5 concentration were 1.10 (95% CI 1.03, 1.17) for all natural causes, 1.17 (95% CI 1.05, 1.25) for cardiovascular causes, and 1.19 (95% CI 1.04, 1.36) for respiratory causes. Long-term exposure to PM 2.5 was associated with all-natural, cardiovascular, and respiratory mortality on Sumatra Island, where PM 2.5 levels exceed the WHO and US-EPA air quality standards., (© 2024. The Author(s).)

The prone position is often used for patients with adult respiratory distress syndrome and specific surgical postures. When performing venous cannulation in this position, it is important to have a structured review to introduce the available major veins and ultrasound-guided procedure. In this review, we discuss the techniques of ultrasound-guided cannulation and provide insights into various aspects, including the anatomical locations of veins, vein sizes, placement techniques, surrounding structures at risk, and reported experiences with catheter placements. Eight major veins can be accessed in the prone position: the internal jugular vein, external jugular vein, brachiocephalic vein, basilic vein, mid-thigh femoral vein, popliteal vein, posterior tibial vein, and small saphenous vein. To minimize the risk of venous thromboembolism, the ratio of catheter diameter to vessel diameter should be less than 0.67. The review also presents the minimal requirement of venous diameter for different catheters in a tabulated form. For larger veins, real-time ultrasound guidance with the long-axis view/in-plane technique is suggested, while for smaller vessels, the short-axis view/out-of-plane technique is recommended. The review includes sonographic illustrations of the two techniques and surrounding arteries and nerves for the eight major veins. The aim of this review is to help clinicians assess the eight major veins and safely insert various types of catheters for patients in the prone position., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Malposition is a relatively rare complication associated with peripherally inserted central catheters (PICCs), particularly in cases of superficial femoral vein (SFV) catheterization. To the best of our knowledge, we are the first to report this rare case of SFV PICC malposition in the contralateral renal vein., Case Presentation: An 82-year-old woman underwent bedside cannulation of the SFV for PICC under ultrasound guidance. Subsequent radiographic examination revealed an unexpected misplacement, with the catheter tip positioned toward the contralateral renal vein. After pulling out the catheter on the basis of the X-ray result, it was observed that the catheter retained its function., Conclusion: Although rare, tip misplacement should be considered in SFV PICC placement. Prompt correction of the tip position is crucial to prevent catheter malfunction and further catastrophic consequences. For critical patients receiving bedside SFV PICC insertion, postoperational X-ray is crucial for enhancing safety., (© 2024 Ting-Chia Remus Young et al., published by Sciendo.)

Investigation on long-term effects of robot-assisted poststroke rehabilitation is challenging because of the difficulties in administration and follow-up of individuals throughout the process. A mobile hybrid neuromuscular electrical stimulation (NMES)-robot, i.e., exoneuromusculoskeleton (ENSM) was adopted for a single-group trial to investigate the long-term effects of the robot-assisted self-help telerehabilitation on upper limb motor function after stroke. Twenty-two patients with chronic stroke were recruited to attend a 20-session telerehabilitation program assisted by the wrist/hand module of the ENMS (WH-ENMS). Participants were evaluated before, after, as well as at 3 months and 6 months after the training. The primary outcome measure was the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), supplemented by secondary outcome measures of the FMA-UE of the shoulder and elbow (FMA shoulder/elbow), the FMA-UE of the wrist and hand (FMA wrist/hand), the Modified Ashworth Scale (MAS), the Action Research Arm Test (ARAT), the Wolf Motor Function Test (WMFT), the Functional Independence Measure (FIM), as well as electromyography (EMG) and kinematic measurements. Twenty participants completed the telerehabilitation program, with 19 returning for a 3-month follow-up, and 18 for a 6-month follow-up. Significantly improved clinical scores were observed after the training ( p  ≤ 0.05). These improvements were maintained after 6 months in the FMA-UE, FMA shoulder/elbow, MAS at the wrist flexor, WMFT score, WMFT time, and FIM ( p  ≤ 0.05). The maintained improvements in motor function were attributed to reduced muscular compensation, as indicated by EMG and kinematic parameters. The WH-ENMS-assisted self-help telerehabilitation could achieve long-lasting rehabilitative effects in chronic stroke., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor PZ declared a past co-authorship with the author XH., (Copyright © 2024 Qing, Nam, Shum, Chan, Yu, Ng, Yang and Hu.)

Three-dimensional (3D) printing is an emerging and booming industry in Taiwan. Compared to traditional manufacturing, 3D printing has various advantages, such as advanced customization, additive manufacturing, reduced mold opening time, and reduced consumption of precursors. In this study, the real-time monitoring of particulate matter (PM) and total volatile organic compound (TVOC) emissions from various filaments is investigated using fused deposition modeling with material extrusion technology, a liquid-crystal display, a stereolithography apparatus based on vat photopolymerization technology, and binder jetting for occupational settings. An exposure assessment for nearby workers using the 3D printing process was performed, and improvement measures were recommended. Nine 3D printing fields were measured. The generation rate of ultrafine particles ranged from 1.19 × 10 10 to 4.90 × 10 12 #/min, and the geometric mean particle size ranged from 30.91 to 55.50 nm. The average concentration of ultrafine particles ranged from 2.31 × 10 3 to 7.36 × 10 4 #/cm 3 , and the PM 2.5 and PM 10 concentrations in each field ranged from 0.74 ± 0.27 to 12.46 ± 5.61 μg/m 3 and from 2.39 ± 0.60 to 30.65 ± 21.26 μg/m 3 , respectively. The TVOC concentration ranged from 0.127 ± 0.012 to 1.567 ± 0.172 ppm. The respiratory deposition (RD UFPs ) dose ranged from 2.02 × 10 13 to 5.54 × 10 14 nm 2 /day. Depending on the operating conditions, appropriate control and protective measures should be employed to protect workers' health.

Madagascar is a global biodiversity hotspot, but its biodiversity continues to be underestimated and understudied. Of raft spiders, genus Dolomedes Latreille, 1804, literature only reports two species on Madagascar. Our single expedition to humid forests of eastern and northern Madagascar, however, yielded a series of Dolomedes exemplars representing both sexes of five morphospecies. To avoid only using morphological diagnostics, we devised and tested an integrative taxonomic model for Dolomedes based on the unified species concept. The model first determines morphospecies within a morphometrics framework, then tests their validity via species delimitation using COI. It then incorporates habitat preferences, geological barriers, and dispersal related traits to form hypotheses about gene flow limitations. Our results reveal four new Dolomedes species that we describe from both sexes as Dolomedes gregoric sp. nov. , D. bedjanic sp. nov. , D. hydatostella sp. nov. , and D. rotundus sp. nov. The range of D. kalanoro Silva & Griswold, 2013, now also known from both sexes, is expanded to eastern Madagascar. By increasing the known raft spider diversity from one valid species to five, our results merely scratch the surface of the true Dolomedes species diversity on Madagascar. Our integrative taxonomic model provides the framework for future revisions of raft spiders anywhere., Competing Interests: The authors declare that they have no competing interests., (© 2024 Yu and Kuntner.)

Introduction: After a stroke, individuals commonly experience visual problems and impaired cognitive function, which can significantly impact their daily life. In addition to visual neglect and hemianopia, stroke survivors often have difficulties with visual search tasks. Researchers are increasingly interested in using eye tracking technology to study cognitive processing and determine whether eye tracking metrics can be used to screen and assess cognitive impairment in patients with neurological disorders. As such, assessing these areas and understanding their relationship is crucial for effective stroke rehabilitation., Methods: We enrolled 60 stroke patients in this study and evaluated their eye tracking performance and cognitive function through a series of tests. Subsequently, we divided the subjects into two groups based on their scores on the HK-MoCA test, with scores below 21 out of 30 indicating cognitive impairment. We then compared the eye tracking metrics between the two groups and identified any significant differences that existed. Spearman correlation analysis was conducted to explore the relationship between clinical test scores and eye tracking metrics. Moreover, we employed a Mann-Whitney U test to compare eye tracking metrics between groups with and without cognitive impairment., Results: Our results revealed significant correlations between various eye tracking metrics and cognitive tests (p=<.001-.041). Furthermore, the group without cognitive impairment demonstrated higher saccade velocity, gaze path velocity, and shorter time to target than the group with cognitive impairment (p=<.001-.040). ROC curve analyses were performed, and the optimal cut-off values for gaze path velocity and saccade velocity were 329.665 (px/s) (sensitivity= 0.80, specificity = 0.533) and 2.150 (px/s) (sensitivity= 0.733, specificity= 0.633), respectively., Conclusions: Our findings indicate a significant correlation between eye tracking metrics and cognitive test scores. Furthermore, the group with cognitive impairment exhibited a significant difference in these metrics, and a cut-off value was identified to predict whether a client was experiencing cognitive impairment., (The Author(s). Published by S. Karger AG, Basel.)

Cooking oil smoke (COS) contains many harmful substances, such as particulate matter, formaldehyde, and phenyl esters. Currently, commercial COS treatment equipment is expensive and requires a large space. Furthermore, a large amount of agricultural waste is generated and is mainly burned onsite, producing large amounts of greenhouse gases and air pollutants. This waste could be reused as a precursor for biochar and activated carbon. Therefore, this research used saccharification and catalytic hydrothermal carbonization to process rice straw and produce compact carbon-based filters (steel wool-C) for removing cooking-induced pollutants. Scanning electron microscopy indicated that carbon layers were coated on the steel wool. The Brunauer-Emmett-Teller surface area of the carbon filter was 71.595 m 2 /g, 43 times larger than that of steel wool. The steel wool filter removed 28.9%-45.4% of submicron aerosol particles. Adding a negative air ionizer (NAI) to the filter system enhanced the particle removal efficiency by 10%-25%. The removal efficiency of total volatile organic compounds was 27.3%-37.1% with the steel wool filter, but 57.2%-74.2% with the carbon-containing steel wool filter, and the NAI improved the removal efficiency by approximately 1%-5%. The aldehyde removal efficiency of the carbon filter with NAI was 59.0%-72.0%. Conclusively, the compact steel wool-C and NAI device could be promising COS treatment equipment for households and small eateries., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The ubiquitous and refractory benzophenone (BP)-type ultraviolet filters, which are also endocrine disruptors, were commonly detected in the aquatic matrix and could not be efficiently removed by conventional wastewater treatment processes, thus causing extensive concern. Herein, a novel ternary nanocomposite, P-g-CN/α-Bi 2 O 3 /WO 3 (P-gBW), was successfully fabricated by mixing cocalcinated components and applied to the decomposition of BP-type ultraviolet filters. The dual-Z-scheme heterostructure of P-gBW enhances visible-light absorption, efficiently facilitates separation and mobility, and prolongs the lifetime of photoinduced charge carriers via double charge transfer mechanisms. The optimum 95 wt% P-gBW exhibited excellent photocatalytic activity, degrading 96% 4-hydroxy benzophenone (4HBP) within 150 min and 93% 2,2',4,4'-tetrahydroxybenzophenone (BP-2) within 100 min under visible-light illumination, respectively. The pseudo-first-order rate constant of 4HBP (1.15 h -1 ) was 6.8-, 3.1-, 3.3- and 2.2-fold higher than those of WO 3 , P-g-CN, α-Bi 2 O 3 , and P-g-CN/α-Bi 2 O 3 , respectively, while that of BP-2 (1.71 h -1 ) was 5.2-, 2.2-, 3.2- and 1.5-fold higher, respectively. The improved photocatalytic degradation was attributed to efficient photoinduced charge carrier separation and migration and prevented the recombination of electron holes, as verified by photoluminescence, transient photocurrent response, and electrochemical impedance spectroscopy. Trapping experiments, electron paramagnetic resonance, and band energy position indicated an efficient dual-Z-scheme heterostructure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Cooking events can generate household air pollutants that deteriorate indoor air quality (IAQ), which poses a threat to human health and well-being. In this study, the emission characteristics and emission factors (EFs) of air pollutants of different meats (beef, lamb, chicken, pork, and fish) cooked by a novel oil-free process and common with-oil processes were investigated. Oil-free cooking tends to emit lower total volatile organic compound (TVOC) levels and fewer submicron smoke particles and can reduce the intake of fat and calories. However, TVOC emissions during oil-free cooking were significantly different, and the lamb EFs were nearly 8 times higher than those during with-oil cooking. The particle-bound polycyclic aromatic hydrocarbon (ƩPPAH) and benzo( a )pyrene-equivalent (ƩBaP eq ) EFs during with-oil cooking ranged from 76.1 to 140.5 ng/g and 7.7-12.4 ng/g, respectively, while those during oil-free cooking ranged from 41.0 to 176.6 ng/g and 5.4-47.6 ng/g, respectively. The ƩPPAH EFs of chicken, pork, and fish were lower during oil-free cooking than during cooking with oil. Furthermore, the ƩBaP eq EFs of beef, chicken, pork, and fish were lower during oil-free cooking than during cooking with oil. Therefore, it is recommended to use the oil-free method to cook chicken, pork, and fish to reduce ƩPPAH and ƩBaP eq emissions, but not recommended to cook lamb due to the increase of ƩBaP eq emissions. The with-oil uncovered cooking EFs of aldehydes ranged from 3.77 to 22.09 μg/g, and those of oil-free cooking ranged from 4.88 to 19.96 μg/g. The aldehyde EFs were lower during oil-free covered cooking than with-oil uncovered cooking for beef, chicken, and fish. This study provides a better realizing of new cooking approaches for the reduction of cooking-induced emission, but further research on the effects of food composition (moisture and fat) and characteristics is needed., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Rehabilitation robots are helpful in poststroke telerehabilitation; however, their feasibility and rehabilitation effectiveness in clinical settings have not been sufficiently investigated. A non-randomized controlled trial was conducted to investigate the feasibility of translating a telerehabilitation program assisted by a mobile wrist/hand exoneuromusculoskeleton (WH-ENMS) into routine clinical services and to compare the rehabilitative effects achieved in the hospital-service-based group ( n = 12, clinic group) with the laboratory-research-based group ( n = 12, lab group). Both groups showed significant improvements ( p ≤ 0.05) in clinical assessments of behavioral motor functions and in muscular coordination and kinematic evaluations after the training and at the 3-month follow-up, with the lab group demonstrating better motor gains than the clinic group ( p ≤ 0.05). The results indicated that the WH-ENMS-assisted tele-program was feasible and effective for upper limb rehabilitation when integrated into routine practice, and the quality of patient-operator interactions physically and remotely affected the rehabilitative outcomes.

Tuberous Sclerosis Complex (TSC) is a multisystemic neurocutaneous disorder with autosomal dominant inheritance. We performed mutation analyses on 123 Chinese patients with "definite TSC" according to the latest diagnostic criteria. Pathogenic / likely-pathogenic variants were identified in 72.2% of all index patients (70/97), in which 35.7% (25/70) had TSC1 variants and 64.3% (45/70) had TSC2 variants. 84.5% (82/97) cases were sporadic and 15.5% (15/97) cases were familial. 62 unique variants were reported, in which 41.9% (26/62) were novel. Male patients had significantly more subependymal nodules (p=0.029) than females, whereas renal angiomyolipoma (p=0.032) occurred predominantly in females. Sporadic cases also had more renal angiomyolipoma (p=0.004), cortical tubers (p=0.008), hypopigmented macules (p=0.018) and fibrous cephalic plaques (p=0.028) than cases with known inheritance. Patients with TSC2 pathogenic variants were more likely to have mental retardation (p<0.001), cardiac rhabdomyoma (p=0.004), renal angiomyolipoma (p=0.006) and facial angiofibromas (p=0.026) than those with TSC1 pathogenic variants, while mutation-negative cases showed a mixed phenotype between those with TSC1 and TSC2 variants. There were no significant phenotypic differences between patients with and without TSC1/TSC2 variants, but TSC2 missense and in-frame variants were associated with higher frequencies of mental retardation (P<0.001), renal angiomyolipoma (p=0.001), cardiac rhabdomyoma (p=0.012) and facial angiofibroma (p=0.021) than those with TSC1 frameshift and splice site variants. Furthermore, a higher frequency of mental retardation (p=0.013) was observed in patients with TSC2 missense and in-frame variants than those with frameshift and splice site variants. All 14 antenatal-onset patients had cardiac rhabdomyoma. They had fewer seizures (p=0.028) than patients with paediatric-onset, but were more likely to have mental retardation (p=0.035) than individuals with adult-onset disease. Generally, paediatric-onset patients had more neurological manifestations, while initial presentations of adult-onset TSC were more diverse., Competing Interests: Declaration of competing interest We know no conflicts of interest associated with this manuscript., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

High-spin, late transition metal imido complexes have attracted significant interest due to their group transfer reactivity and catalytic C-H activation of organic substrates. Reaction of a new two-coordinate iron complex, Fe{N( t Bu)Dipp} 2 (1, Dipp = 2,6-diisopropylphenyl), with mesitylazide (MesN 3 ) afforded a three-coordinate Fe-imidyl complex, Fe{N( t Bu)Dipp} 2 ([double bond, length as m-dash]NMes) (2). X-ray crystallographic characterization of single crystals of 2 showed a long Fe-N distance of 1.761(1) Å. Combined magnetic and spectroscopic (Mössbauer and X-ray absorption near edge structure spectroscopy, XANES) characterization of 2 suggests that it has an S = 2 ground state comprising an S = 5/2 Fe(iii) center antiferromagnetically coupled to an S = 1/2 imidyl ligand. Reaction of 1 and 1-azidoadamantane (AdN 3 ) generated a putative, transient Fe{N( t Bu)Dipp} 2 ([double bond, length as m-dash]NAd) (3') complex that yielded an intramolecular C-H amination product, Fe{N( t Bu)Dipp}{κ 2 - N , N '-&#95;N(CMe 2 CH 2̲ NHAd)Dipp} (3). Quantum mechanical calculations further confirmed the spectroscopic assignment of 2 and 3', as well as the differences in their stability and reactivity. Importantly, imidyl radical delocalization onto the mesityl ring significantly increased the stability of 2 and reduced its reactivity toward potential hydrogen atom transfer (HAT) reagents. In contrast, quantum mechanical calculations of 3' revealed that the radical was solely localized on the imidyl N, leading to a high reactivity toward the proximal C-H bond of the N( t Bu)Dipp - ligand., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Neurofibromatosis type 1 (NF1; OMIM #162200) is the commonest multi-systemic neurocutaneous tumour-predisposition disorder. It has an age-related complete penetrance but a highly variable inter- and intra-familial expressivity. This article summarizes the clinical features and molecular characteristics of 832 clinically or molecularly confirmed NF1 patients from 697 unrelated families recruited from a single centre in Hong Kong diagnosed during the 16 years period from Jan 2005 to Jan 2021. In this study, we have estimated the incidences of clinical features, reported on the molecular findings and explored new genotype-phenotype correlations., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Exposure to particulate matter with a diameter < 2.5 µm (PM 2.5 ) increases the risk of cardiovascular disease (CVD), which is the leading cause of both morbidity and mortality in Indonesia, accounting for one-third of all deaths. Indonesian authorities started to monitor PM 2.5 levels in urban areas in 2015. However, there is still no study examining the association between long-term PM 2.5 exposure and CVD in Indonesia. In this study, we combined PM 2.5 data and health survey data. Long-term (2000-2007) exposure to PM 2.5 was measured based on satellite-derived aerosol optical depth measurements (1 × 1 km 2 ) that could be used to predict ground-level PM 2.5 concentrations. Population data on residents of Sumatra Island were obtained from the fourth wave of the Indonesian Family Life Survey (IFLS). A cross-sectional study was performed with 2324 participants who were aged ≥ 40 years old, and a report of doctor-diagnosed CVD determined CVD status. We used logistic regression to analyze the association between PM 2.5 and CVD prevalence, adjusting for multiple covariates. Of the sample, 52.1% were women, and 47.9% were men. The sample was divided into those aged 40-59 (adults) and those ≥ 60 (older adults). The CVD prevalence was 4.05% (n = 94), with a mean (standard deviation) PM 2.5 concentration of 14.4 (6.4) µg/m 3 . In adjusted models, a 10-µg/m 3 increase in annual average PM 2.5 levels was associated with 29% higher odds of having CVD (odds ratio = 1.29; 95% confidence interval: 1.02, 1.47). In this population-based IFLS data, long-term exposure to PM 2.5 is associated with a higher prevalence of CVD in Sumatera, Indonesia., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Anemia is the predominant cytopenia in myelodysplastic syndromes (MDS) and treatment options are limited. Roxadustat is a hypoxia-inducible factor prolyl hydroxylase inhibitor approved for the treatment of anemia of chronic kidney disease in the UK, EU, China, Japan, South Korea, and Chile. MATTERHORN is a phase 3, randomized, double-blind, placebo-controlled study to assess the efficacy and safety of roxadustat in anemia of lower risk-MDS. Eligible patients had baseline serum erythropoietin ≤ 400 mIU/mL, and a low packed RBC transfusion burden. In this open-label (OL), dose-selection, lead-in phase, enrolled patients were assigned to 1 of 3 roxadustat starting doses (n = 8 each): 1.5, 2.0, and 2.5 mg/kg. The primary efficacy endpoint of the OL phase was the proportion of patients with transfusion independence (TI) for ≥ 8 consecutive weeks in the first 28 treatment weeks. A secondary efficacy endpoint was the proportion of patients with a ≥ 50% reduction in RBC transfusions over an 8-week period compared with baseline. Adverse events were monitored. Patients were followed for 52 weeks. Of the 24 treated patients, TI was achieved in 9 patients (37.5%) at 28 and 52 weeks; 7 of these patients were receiving 2.5 mg/kg dose when TI was achieved. A ≥ 50% reduction in RBC transfusions was achieved in 54.2% and 58.3% of patients at 28 and 52 weeks, respectively. Oral roxadustat dosed thrice weekly was well tolerated. There were no fatalities or progression to acute myeloid leukemia. Based on these outcomes, 2.5 mg/kg was the chosen starting roxadustat dose for the ongoing double-blind study phase., (© 2021 Wiley Periodicals LLC.)

Background: The precaution of airborne transmission of viruses, such as influenza, SARS, MERS, and COVID-19, is essential for reducing infection. In this study, we applied a zero-valent nanosilver/titania-chitosan (nano-Ag 0 /TiO 2 -CS) filter bed, whose broad-spectrum antimicrobial efficacy has been proven previously, for the removal of viral aerosols to minimize the risk of airborne transmission. Methods: The photochemical deposition method was used to synthesize the nano-Ag 0 /TiO 2 -CS antiviral material. The surface morphology, elemental composition, and microstructure of the nano-Ag 0 /TiO 2 -CS were analyzed by a scanning electron microscopy/energy dispersive X-ray spectroscopy and a transmission electron microscopy, respectively. The MS2 bacteriophages were used as surrogate viral aerosols. The antiviral efficacy of nano-Ag 0 /TiO 2 -CS was evaluated by the MS2 plaque reduction assay (PRA) and filtration experiments. In the filtration experiments, the MS2 aerosols passed through the nano-Ag 0 /TiO 2 -CS filter, and the MS2 aerosol removal efficiency was evaluated by an optical particle counter and culture method. Results and Conclusions: In the MS2 PRA, 3 g of nano-Ag 0 /TiO 2 -CS inactivated 97% of MS2 bacteriophages in 20 mL liquid culture (2 ± 0.5 × 10 16 PFU/mL) within 2 hours. The removal efficiency of nano-Ag 0 /TiO 2 -CS filter (thickness: 6 cm) for MS2 aerosols reached up to 93%. Over 95% of MS2 bacteriophages on the surface of the nano-Ag 0 /TiO 2 -CS filter were inactivated within 20 minutes. The Wells-Riley model predicted that when the nano-Ag 0 /TiO 2 -CS filter was used in the ventilation system, airborne infection probability would reduce from 99% to 34.6%. The nano-Ag 0 /TiO 2 -CS filter could remain at 50% of its original antiviral efficiency after continuous operation for 1 week, indicating its feasibility for the control of the airborne transmission.

Background: We evaluated the efficacy and safety of roxadustat versus epoetin alfa for the treatment of chronic kidney disease-related anemia in patients new to dialysis., Methods: HIMALAYAS was a Phase 3, open-label, epoetin alfa-controlled trial. Eligible adults were incident to hemodialysis/peritoneal dialysis for 2 weeks to ≤4 months prior to randomization and had mean hemoglobin (Hb) ≤10.0 g/dL. Primary endpoints were mean Hb (g/dL) change from baseline averaged over Weeks 28-52 regardless of rescue therapy [non-inferiority criterion: lower limit of 95% confidence interval (CI) for treatment difference >-0.75] and percentage of patients achieving an Hb response between Weeks 1 and 24 censored for rescue therapy (non-inferiority margin for between-group difference -15%). Adverse events were monitored., Results: The intent-to-treat population included patients randomized to roxadustat (n = 522) or epoetin alfa (n = 521). Mean (standard deviation) Hb changes from baseline averaged over Weeks 28-52 were 2.57 (1.27) and 2.36 (1.21) in the roxadustat and epoetin alfa groups. Roxadustat was non-inferior [least squares mean difference: 0.18 (95% CI 0.08, 0.29)] to epoetin alfa. Percentages of patients with an Hb response were 88.2% and 84.4% in the roxadustat and epoetin alfa groups, respectively. Roxadustat was non-inferior to epoetin alfa [treatment-group difference 3.5% (95% CI -0.7%, 7.7%)]. Adverse event rates were comparable between treatment groups., Conclusions: Roxadustat was efficacious for correcting and maintaining Hb levels compared with epoetin alfa. Roxadustat had an acceptable safety profile., (© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Introduction: Erythropoiesis-stimulating agents, standard of care for anemia of end-stage kidney disease, are associated with cardiovascular events. We evaluated the efficacy and safety of roxadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that stimulates erythropoiesis., Methods: SIERRAS was a phase 3, randomized, open-label, active-controlled study enrolled adults on dialysis for end-stage kidney disease receiving erythropoiesis-stimulating agents for anemia. Patients were randomized (1:1) to thrice-weekly roxadustat or epoetin alfa. Doses were based on previous epoetin alfa dose and adjusted in the roxadustat arm to maintain hemoglobin at ∼11 g/dl during treatment. Epoetin alfa dosing was adjusted per US package insert. Primary efficacy endpoint was mean hemoglobin (g/dl) change from baseline averaged over weeks 28 to 52. Treatment-emergent adverse events were monitored., Results: Enrolled patients (roxadustat, n  = 370 and epoetin alfa, n  = 371) had similar mean (SD) baseline hemoglobin levels (10.30 [0.66] g/dl). Mean (SD) hemoglobin changes for weeks 28 to 52 were 0.39 (0.93) and -0.09 (0.84) in roxadustat and epoetin alfa, respectively. Roxadustat was noninferior (least squares mean difference: 0.48 [95% confidence interval: 0.37, 0.59]; P  < 0 . 001) to epoetin alfa. Tolerability was comparable between treatments., Conclusion: In end-stage kidney disease, roxadustat was noninferior to epoetin alfa in up to 52 weeks of treatment in this erythropoietin-stimulating agent conversion study. Roxadustat had an acceptable tolerability profile., (© 2021 International Society of Nephrology. Published by Elsevier Inc.)

The liquid impingers can be used for sampling of viral aerosols, such as COVID-19 virus, influenza, and measles. However, the lowest cutoff diameter of commercially available liquid impingers was about 0.3 μm, and the physical collection efficiency for nano-bioaerosol is only about 10-20%. Here, we enhanced the impinger's collection efficiency and recovery of viable viral aerosols by using packed glass beads and selected sampling media (1% peptone and lysogeny broth, LB). Single-stranded RNA (ssRNA) MS2 bacteriophage with uranine (as a physical tracer) was used as model viral aerosols. The effects of different sampling flow rates (4, 6, and 12.5 L per minute) and different sampling time (10, 20, and 30 min) on the collection efficiency and recovery of MS2 aerosols were also tested. Collection efficiency and recovery of viable viral aerosols were analyzed as a function of sampling media, flow rate, and sampling time and packed glass beads by using a general linear model. Although the packed glass beads considerably enhanced the collection efficiency of the liquid impinger for MS2 aerosols, the recovery of viable MS2 becomes lower due to the higher pressure drop across the impinger. Using peptone or LB as sampling media, reducing sampling flow rate, and decreasing sampling time was proven to improve the recovery of viable MS2. Conclusively, this study provides some practical methods to improve the collection efficiency of liquid impinger for viral aerosols and preserve their viability., (© The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021.)

Bainbridge-Ropers syndrome (BRPS) [OMIM#615485] is a neurodevelopmental disorder, characterized by delayed psychomotor development with generalized hypotonia, intellectual disability with poor or absent speech, feeding difficulties, growth failure, specific craniofacial and minor skeletal features. It was firstly reported in 2013 by Bainbridge et al., who observed a group of individuals sharing overlapping features with Bohring-Opitz syndrome which were caused by pathogenic variant in ASXL1, who indeed carried truncating mutations in ASXL3. To date, 33 cases were described in the literature. BRPS is caused by loss-of-function mutations in ASXL3 which are mostly located in two mutational cluster regions (MCR). The exact molecular mechanism of these mutations resulting in the disease phenotype is still uncertain due to the observation of LOF mutations in healthy population. Here, we report four individuals with BRPS carrying de novo LOF mutations in ASXL3, comparing and summarizing the clinical phenotype of all BRPS reported so far. Furthermore, we try to dissect the genotype-phenotype correlation among the two well reported MCRs in all BRPS from the literature., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

The authors describe the practice of psychodynamic psychiatry in the Philippines. They review features of contemporary psychodynamic psychiatry, the state of psychodynamic psychiatry in training programs, and its integration in national professional societies. Despite psychodynamic psychiatry's wide acceptance in the professional community in the Philippines and neighboring Southeast Asian countries, delivery of care to over 110 million residents of the archipelago requires creativity given the small number of psychiatrists. The authors discuss how psychodynamic psychiatry impacts the national mental health scene and propose future directions involving forging international linkages.

Introduction: Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that stimulates erythropoiesis and improves iron metabolism. We assessed the efficacy and tolerability of roxadustat in patients with chronic kidney disease (CKD)-related anemia not on dialysis., Methods: ANDES was a global Phase 3 randomized study in which adults with stage 3-5 CKD not on dialysis received roxadustat or placebo. Patients were initially dosed thrice weekly; dose was titrated to achieve a hemoglobin level ≥11.0 g/dl, followed by titration for maintenance. The primary endpoints were change in hemoglobin (weeks 28-52) and proportion of patients achieving a hemoglobin response (hemoglobin ≥11.0 g/dl and increase ≥1.0 g/dl [baseline >8.0 g/dl], or increase ≥2.0 g/dl [baseline ≤8.0 g/dl]) (week 24). Treatment-emergent adverse events (TEAEs) and serious adverse events (TESAEs) were recorded., Results: In roxadustat (n = 616) and placebo (n = 306) groups, hemoglobin mean (SD) change from baseline over weeks 28-52 was significantly larger for roxadustat (2.00 [0.95]) versus placebo (0.16 [0.90]), corresponding to least-squares mean difference of 1.85 g/dl (95% confidence interval [CI] 1.74-1.97; P < 0.0001). The proportion of patients achieving a response at week 24 was larger for roxadustat (86.0%; 95% CI 83.0%-88.7%) versus placebo (6.6%; 95% CI 4.1%-9.9%; P < 0.0001). The proportion of patients receiving rescue therapy at week 52 was smaller for roxadustat (8.9%) versus placebo (28.9%); hazard ratio, 0.19 (95% CI 0.14-0.28; P < .0001). The incidences of TEAEs and TESAEs were comparable., Conclusion: This study showed that roxadustat corrected and maintained hemoglobin and was well tolerated in patients with CKD-related anemia not on dialysis (ClinicalTrials.gov NCT01750190)., (© 2020 International Society of Nephrology. Published by Elsevier Inc.)

Roxadustat (FG-4592), an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that stimulates erythropoiesis, was evaluated in a phase 1b study in patients with end-stage renal disease with anemia on hemodialysis. Seventeen patients, on epoetin-alfa maintenance therapy with stable hemoglobin levels ≥10 g/dL, had epoetin-alfa discontinued on day 3 and were enrolled in this double-blind placebo-controlled study. Two cohorts were randomized 3:1 (roxadustat: placebo). Patients received single doses of roxadustat (1 or 2 mg/kg) or placebo 1 hour after hemodialysis on day 1 and 2 hours before dialysis on day 8. Maximum plasma concentration and area under the plasma concentration-time curve for patients receiving roxadustat were slightly more than dose proportional and elimination half-life ranged from 14.7 to 19.4 hours. Roxadustat was highly protein bound (99%) in plasma, and dialysis contributed a small fraction of the total clearance: only 4.56% and 3.04% of roxadustat recovered from the 1 and 2 mg/kg dose groups, respectively. Roxadustat induced transient elevations of endogenous erythropoietin that peaked between 7 and 14 hours after dosing and returned to baseline by 48 hours after dosing. Peak median endogenous erythropoietin levels were 96 mIU/mL and 268 mIU/mL for the 1- and 2-mg/kg doses, respectively, within physiologic range of endogenous erythropoietin responses to hypoxia at high altitude or after blood loss. No serious adverse events were reported, and there were no treatment- or dose-related trends in adverse event incidence., (© 2020 FibroGen. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.)

Open-air burning of rice straw (RS) on sites after harvesting produces tremendous amounts of air pollutants in Southeast Asia. Additionally, cooking oil smoke (COS) from high-temperature frying is classified as "Probably carcinogenic to humans" (Group 2A) by the International Agency for Research on Cancer. To mitigate the air pollution from COS, RS was recycled to prepare activated carbon (AC), which was used as a bed filter (BF) packing material for COS removal, and to our best knowledge, this study is the first one. Besides, a negative air ionizer (NAI) was firstly utilized to enhance the removal efficiency (η) of COS particles. Other biomass waste, including tea leaves (TL), wood dust (WD), rice hulls (RH), and coffee grounds (CG), were also used as packing materials for comparison. Specific surface area and pore volume of the packing materials were determined by nitrogen adsorption/desorption isothermal. Laser airborne particle counters and volatile organic compound (VOC) monitors (photoionization detector) were utilized for real-time recording of the particle and VOC concentration of COS. Economic assessments for the control of COS was also conducted. For submicron particles, the removal efficiency of the BFs ranged from 0 to 98% and the AC filter had the highest quality factor. The NAI remarkably enhanced the η value and filter quality factor. For the removal of particles larger than 2.5 μm, all BFs had η > 96%. The removal efficiency of volatile organic compounds (VOCs) (η VOC ) of the test BFs ranged from 18.22 to 90.8%. The AC filter had the largest pore volume (0.432 cm 3 /g) and surface area (877 m 2 /g) among all packing materials, causing this filter to have the highest η VOC and adsorption capacity (over 28.3 mg-VOCs/g-AC). The annual operating costs of the TL, WD, RH, CG, and AC filters were 319.4, 23.3, 29.1, 189.4, and 62.9 US$, respectively. Therefore, using RS to prepare an AC bed filter for the removal of COS is a practical and sustainable strategy for COS control.

Background: Roxadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that stimulates erythropoiesis and regulates iron metabolism. Additional data are needed regarding the effectiveness and safety of roxadustat as compared with standard therapy (epoetin alfa) for the treatment of anemia in patients undergoing dialysis., Methods: In a trial conducted in China, we randomly assigned (in a 2:1 ratio) patients who had been undergoing dialysis and erythropoiesis-stimulating agent therapy with epoetin alfa for at least 6 weeks to receive roxadustat or epoetin alfa three times per week for 26 weeks. Parenteral iron was withheld except as rescue therapy. The primary end point was the mean change in hemoglobin level from baseline to the average level during weeks 23 through 27. Noninferiority of roxadustat would be established if the lower boundary of the two-sided 95% confidence interval for the difference between the values in the roxadustat group and epoetin alfa group was greater than or equal to -1.0 g per deciliter. Patients in each group had doses adjusted to reach a hemoglobin level of 10.0 to 12.0 g per deciliter. Safety was assessed by analysis of adverse events and clinical laboratory values., Results: A total of 305 patients underwent randomization (204 in the roxadustat group and 101 in the epoetin alfa group), and 256 patients (162 and 94, respectively) completed the 26-week treatment period. The mean baseline hemoglobin level was 10.4 g per deciliter. Roxadustat led to a numerically greater mean (±SD) change in hemoglobin level from baseline to weeks 23 through 27 (0.7±1.1 g per deciliter) than epoetin alfa (0.5±1.0 g per deciliter) and was statistically noninferior (difference, 0.2±1.2 g per deciliter; 95% confidence interval [CI], -0.02 to 0.5). As compared with epoetin alfa, roxadustat increased the transferrin level (difference, 0.43 g per liter; 95% CI, 0.32 to 0.53), maintained the serum iron level (difference, 25 μg per deciliter; 95% CI, 17 to 33), and attenuated decreases in the transferrin saturation (difference, 4.2 percentage points; 95% CI, 1.5 to 6.9). At week 27, the decrease in total cholesterol was greater with roxadustat than with epoetin alfa (difference, -22 mg per deciliter; 95% CI, -29 to -16), as was the decrease in low-density lipoprotein cholesterol (difference, -18 mg per deciliter; 95% CI, -23 to -13). Roxadustat was associated with a mean reduction in hepcidin of 30.2 ng per milliliter (95% CI, -64.8 to -13.6), as compared with 2.3 ng per milliliter (95% CI, -51.6 to 6.2) in the epoetin alfa group. Hyperkalemia and upper respiratory infection occurred at a higher frequency in the roxadustat group, and hypertension occurred at a higher frequency in the epoetin alfa group., Conclusions: Oral roxadustat was noninferior to parenteral epoetin alfa as therapy for anemia in Chinese patients undergoing dialysis. (Funded by FibroGen and FibroGen [China] Medical Technology Development; ClinicalTrials.gov number, NCT02652806.)., (Copyright © 2019 Massachusetts Medical Society.)

Background: Roxadustat (FG-4592) is an oral inhibitor of hypoxia-inducible factor (HIF) prolyl hydroxylase that stimulates erythropoiesis and regulates iron metabolism. In phase 2 studies involving patients with chronic kidney disease, roxadustat increased levels of endogenous erythropoietin to within or near the physiologic range, along with increasing hemoglobin levels and improving iron homeostasis. Additional data are needed regarding the efficacy and safety of roxadustat for the treatment of anemia in patients with chronic kidney disease who are not undergoing dialysis., Methods: In this phase 3 trial conducted at 29 sites in China, we randomly assigned 154 patients with chronic kidney disease in a 2:1 ratio to receive roxadustat or placebo three times a week for 8 weeks in a double-blind manner. All the patients had a hemoglobin level of 7.0 to 10.0 g per deciliter at baseline. The randomized phase of the trial was followed by an 18-week open-label period in which all the patients received roxadustat; parenteral iron was withheld. The primary end point was the mean change from baseline in the hemoglobin level, averaged over weeks 7 through 9., Results: During the primary-analysis period, the mean (±SD) change from baseline in the hemoglobin level was an increase of 1.9±1.2 g per deciliter in the roxadustat group and a decrease of 0.4±0.8 g per deciliter in the placebo group (P<0.001). The mean reduction from baseline in the hepcidin level (associated with greater iron availability) was 56.14±63.40 ng per milliliter in the roxadustat group and 15.10±48.06 ng per milliliter in the placebo group. The reduction from baseline in the total cholesterol level was 40.6 mg per deciliter in the roxadustat group and 7.7 mg per deciliter in the placebo group. Hyperkalemia and metabolic acidosis occurred more frequently in the roxadustat group than in the placebo group. The efficacy of roxadustat in hemoglobin correction and maintenance was maintained during the 18-week open-label period., Conclusions: In Chinese patients with chronic kidney disease who were not undergoing dialysis, those in the roxadustat group had a higher mean hemoglobin level than those in the placebo group after 8 weeks. During the 18-week open-label phase of the trial, roxadustat was associated with continued efficacy. (Funded by FibroGen and FibroGen [China] Medical Technology Development; ClinicalTrials.gov number, NCT02652819.)., (Copyright © 2019 Massachusetts Medical Society.)

Effective determination of trends in sulfur dioxide emissions facilitates national efforts to draft an appropriate policy that aims to lower sulfur dioxide emissions, which is essential for reducing atmospheric pollution. However, to reflect the current situation, a favorable emission reduction policy should be based on updated information. Various forecasting methods have been developed, but their applications are often limited by insufficient data. Grey system theory is one potential approach for analyzing small data sets. In this study, an improved modeling procedure based on the grey system theory and the mega-trend-diffusion technique is proposed to forecast sulfur dioxide emissions in China. Compared with the results obtained by the support vector regression and the radial basis function network, the experimental results indicate that the proposed procedure can effectively handle forecasting problems involving small data sets. In addition, the forecast predicts a steady decline in China's sulfur dioxide emissions. These findings can be used by the Chinese government to determine whether its current policy to reduce sulfur dioxide emissions is appropriate.

The pathogenesis of Epstein-Barr virus (EBV) infection, including development of lymphomas and carcinomas, is dependent on the ability of the virus to transit from latency to the lytic phase. This conversion, and ultimately disease development, depends on the molecular switch protein, ZEBRA, a viral bZIP transcription factor that initiates transcription from promoters of viral lytic genes. By binding to the origin of viral replication, ZEBRA is also an essential replication protein. Here, we identified a novel DNA-binding motif of ZEBRA, N terminal to the canonical bZIP domain. This RRTRK motif is important for high-affinity binding to DNA and is essential for recognizing the methylation state of viral promoters. Mutations in this motif lead to deficiencies in DNA binding, recognition of DNA methylation, lytic cycle DNA replication, and viral late gene expression. This work advances our understanding of ZEBRA-dependent activation of the viral lytic cascade. IMPORTANCE The binding of ZEBRA to methylated and unmethylated viral DNA triggers activation of the EBV lytic cycle, leading to viral replication and, in some patients, cancer development. Our work thoroughly examines how ZEBRA uses a previously unrecognized basic motif to bind nonmethylated and methylated DNA targets, leading to viral lytic activation. Our findings show that two different positively charged motifs, including the canonical BZIP domain and a newly identified RRTRK motif, contribute to the mechanism of DNA recognition by a viral AP-1 protein. This work contributes to the assessment of ZEBRA as a potential therapeutic target for antiviral and oncolytic treatments., (Copyright © 2019 American Society for Microbiology.)

A novel antimicrobial composite of zero-valent silver nanoparticles (AgNPs), titania (TiO 2 ), and chitosan (CS) was prepared via photochemical deposition of AgNPs on a CS-TiO 2 matrix (AgNPs@CS-TiO 2 ). Electron microscopy showed that the AgNPs were well dispersed on the CS-TiO 2 , with diameters of 6.69-8.84 nm. X-ray photoelectron spectra indicated that most of the AgNPs were reduced to metallic Ag. Fourier-transform infrared spectroscopy indicated that some AgNPs formed a chelate with CS through coordination of Ag + with the CS amide II groups. The zones of inhibition of AgNPs@CS-TiO 2 for bacteria (Escherichia coli and Staphylococcus epidermidis) and fungi (Aspergillus niger and Penicillium spinulosum) were 6.72-11.08 and 5.45-5.77 mm, respectively, and the minimum (critical) concentrations of AgNPs required to inhibit the growth of bacteria and fungi were 7.57 and 16.51 µg-Ag/mm 2 , respectively. The removal efficiency of a AgNPs@TiO 2 -CS bed filter for bioaerosols (η) increased with the packing depth, and the optimal filter quality (qF) occurred for packing depths of 2-4 cm (qF = 0.0285-0.103 Pa -1 ; η = 57.6%-98.2%). When AgNPs@TiO 2 -CS bed filters were installed in the ventilation systems of hospital wards, up to 88% of bacteria and 97% of fungi were removed within 30 minutes. Consequently, AgNPs@TiO 2 -CS has promising potentials in bioaerosol purification., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The wall crab spider Selenops formosensis Kayashima, 1943 was described from three females collected from northern Taiwan (Kayashima 1943a), but subsequently referred to as S. formosanus and S. formosansis in an illustrated handbook on Taiwanese spiders written by the same author (Kayashima 1943b). The original descriptions lacked illustrations of the epigyne or vulva which are extremely useful in determining genera and species of Selenopidae.

Preschool children have a higher respiratory rate per unit body weight than adults, and their respiratory systems are not mature. Hence, children may have more health risks associated with particulate matter (PM) exposure. In this study, we assessed the exposure of preschool children and their caregivers to PM and the resulting health risks. The PM concentrations at heights of 60-80 cm (preschool children) and 150 cm (adults) were measured at ten indoor and eight outdoor sites in the Taipei metropolitan area from March 2015 to February 2017. Four PM 2.5 and seven PM 10 indoor measurements exceeded the indoor air quality standard of Taiwan, whereas only two PM 2.5 outdoor measurements exceeded the ambient air quality standard. The outdoor PM concentrations were related to traffic emissions, whereas the indoor PM concentrations were associated with ventilation rate and occupant density. The chronic daily PM 1 , PM 2.5 , and PM 10 intakes of preschool children were notably higher than those of adults. In addition, the hazard quotient resulting from PM 2.5 exposure indicated a significant health risk for preschool children (93.74% greater than 1). Consequently, reducing the exposure of preschool children to PM 2.5 is an emerging issue in the Taipei metropolitan area.

Nonylphenol (NP) and/or bisphenol A (BPA) may have reproductive effects. Although the mechanisms of action remain unclear, steroid hormones biosynthesis, hypothalamus pituitary adrenal axis activity, oxidative stress, and crosstalk interaction of NP and BPA mixture and its pathways may play a contributory role. This cross-sectional study examined whether the interactive effects of NP/BPA and oxidative stress biomarkers played a role in reproductive indices (penis length and anogenital distance (AGD)) in 244 mother-fetus pairs. Four biomarkers of oxidative stress, (8-hydroxy-2'-deoxyguanosine (8-OHdG), 8-nitroguanine (8-NO 2 Gua), 8-iso-prostaglandin F 2α (8-isoPF 2α ), and 4-hydroxy-2-nonenal-mercapturic acid (HNE-MA)) were simultaneously analyzed using the high-performance liquid chromatography-electrospray ionization tandem mass spectrometry method. No significant associations were found between reproductive indices and NP/BPA or oxidative stress biomarkers. Maternal exposure to a mixture of NP and BPA may enhance 8-OHdG. Interactive effects were found in the high 8-isoPF 2α group, and prenatal NP exposure was inversely associated with penis length (β = -3.68 mm; p = 0.01). Similar results were noted among boys who were born to mothers in the high 8-isoPF 2α group, in which BPA was inversely associated with penis length (β = -4.43 mm; p = 0.005). Our findings suggest important implications for prenatal exposure to oxidative stress, as evidenced by the 8-isoPF2α level. Thus, NP and BPA may interact to shape fetal reproductive tract development, particularly in boys. The interactive effects of NP/BPA, oxidative stress, and reproductive indices should be considered., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Epstein-Barr virus (EBV) ZEBRA protein activates the EBV lytic cycle. Cellular AP-1 proteins with alanine-to-serine [AP-1(A/S)] substitutions homologous to ZEBRA(S186) assume some functions of EBV ZEBRA. These AP-1(A/S) mutants bind methylated EBV DNA and activate expression of some EBV genes. Here, we compare expression of 67 viral genes induced by ZEBRA versus expression induced by AP-1(A/S) proteins. AP-1(A/S) activated 24 genes to high levels and 15 genes to intermediate levels; activation of 28 genes by AP-1(A/S) was severely impaired. We show that AP-1(A/S) proteins are defective at stimulating viral lytic DNA replication. The impairment of expression of many late genes compared to that of ZEBRA is likely due to the inability of AP-1(A/S) proteins to promote viral DNA replication. However, even in the absence of detectable viral DNA replication, AP-1(A/S) proteins stimulated expression of a subgroup of late genes that encode viral structural proteins and immune modulators. In response to ZEBRA, expression of this subgroup of late genes was inhibited by phosphonoacetic acid (PAA), which is a potent viral replication inhibitor. However, when the lytic cycle was activated by AP-1(A/S), PAA did not reduce expression of this subgroup of late genes. We also provide genetic evidence, using the BMRF1 knockout bacmid, that these genes are true late genes in response to ZEBRA. AP-1(A/S) binds to the promoter region of at least one of these late genes, BDLF3, encoding an immune modulator. IMPORTANCE Mutant c-Jun and c-Fos proteins selectively activate expression of EBV lytic genes, including a subgroup of viral late genes, in the absence of viral DNA replication. These findings indicate that newly synthesized viral DNA is not invariably required for viral late gene expression. While viral DNA replication may be obligatory for late gene expression driven by viral transcription factors, it does not limit the ability of cellular transcription factors to activate expression of some viral late genes. Our results show that expression of all late genes may not be strictly dependent on viral lytic DNA replication. The c-Fos A151S mutation has been identified in a human cancer. c-Fos A151S in combination with wild-type c-Jun activates the EBV lytic cycle. Our data provide proof of principle that mutant cellular transcription factors could cause aberrant regulation of viral lytic cycle gene expression and play important roles in EBV-associated diseases., (Copyright © 2018 American Society for Microbiology.)

Objective: To evaluate the effects of electric cortical stimulation (ECS) and transcranial direct current stimulation (tDCS) on motor and cognitive function recovery and brain plasticity in focal traumatic brain injury (TBI) of rats model., Methods: Forty rats were pre-trained to perform a single pellet reaching task (SPRT), rotarod test (RRT), and Y-maze test for 14 days, then a focal TBI was induced by a weight drop model on the motor cortex. All rats were randomly assigned to one of the three groups: anodal ECS (50 Hz and 194 μs) (ECS group), tDCS (0.1 mA, 50 Hz and 200 μs) (tDCS group), and no stimulation as a control group. Four-week stimulation, including rehabilitation, was started 3 days after the operation. SPRT, RRT, and Y-maze were measured from day 1 to day 28 after the TBI was induced. Histopathological and immunohistochemistry staining evaluations were performed at 4 weeks., Results: SPRT was improved from day 7 to day 26 in ECS, and from day 8 to day 26 in tDCS compared to the control group (p<0.05). SPRT of ECS group was significantly improved on days 3, 8, 9, and 17 compared to the tDCS group. Y-maze was improved from day 8 to day 16 in ECS, and on days 6, 12, and 16 in the tDCS group compared to the control group (p<0.05). Y-maze of the ECS group was significantly improved on day 9 to day 15 compared to the tDCS group. The c-Fos protein expression was better in the ECS group and the tDCS group compared to the control group., Conclusion: Electric stimulation in rats modified with a focal TBI is effective for motor recovery and brain plasticity. ECS induced faster behavioral and cognitive improvements compared to tDCS during the recovery period of rats with a focal TBI.

In this study, we evaluated the long-term antifungal effectiveness of 3 types of interior building materials (gypsum board [GB], cement board [CB], and softwood plywood [S-PW]) impregnated with thermally reduced silver nanoparticles supported by titanium dioxide (AgNPs/TiO 2 ) under 95% relative humidity for 4 weeks. AgNPs/TiO 2 was synthesized at 2 thermal reduction temperatures (TRTs, 120 and 200°C) with 2 different AgNP weight percentages (2 and 5 wt%). Four different silver-loading levels (SLLs, 0.025, 0.05, and 0.5 μg/cm 2 and the critical concentration required to inhibit fungal growth on agar plates) and 3 fungal species (Aspergillus niger, Penicillium spinulosum, and Stachybotrys chartarum) were used in the experiments. Higher temperature reduced more ionic Ag + to metallic Ag 0 and increased the dispersion of Ag on TiO 2 surface. The 200°C thermally reduced AgNPs/TiO 2 demonstrated excellent antifungal efficiency: Mold growth was almost completely inhibited for 28 days at the low SLL of 0.5 μg/cm 2 . Additionally, AgNPs/TiO 2 exhibited higher antifungal activity on GB and CB than on S-PW. The stepwise regression results indicated that the TRT of AgNPs/TiO 2 (β = -0.739 to -0.51), the SLL (β = -0.477 to -0.269), and the Ag 0 level in the AgNPs (β = -0.379 to -0.136) were the major factors influencing antifungal activity and TRT might be the most significant one., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Breast cancer-associated gene 3 (BCA3) is a recently identified adaptor protein whose functions are still being defined. BCA3 has been reported to be an important regulator of nuclear factor-κB (NF-κB) signaling. It has also been reported to interact with the small GTPase, Rac1. Consistent with that observation, in the present study, BCA3 was found to interact with nuclear Rac1 in 293 cells and influence NF-κB signaling. Additional experiments revealed that depending on cell type, BCA3 augmented, attenuated or had no effect on NF-κB signaling in vitro. Since canonical NF-κB signaling is a critical downstream target from activated receptor activator of nuclear factor κB (RANK) that is required for mature osteoclast formation and function, BCA3 was selectively overexpressed in osteoclasts in vivo using the cathepsin K promoter and the response to exogenous receptor activator of nuclear factor κB ligand (RANKL) administration was examined. Despite its ability to augment NF-κB signaling in other cells, transgenic animals injected with high-dose RANKL had the same hypercalcemic response as their wild‑type littermates. Furthermore, the degree of bone loss induced by a 2-week infusion of low-dose RANKL was the same in both groups. Combined with earlier studies, the data from our study data indicate that BCA3 can affect NF-κB signaling and that BCA3 plays a cell-type dependent role in this process. The significance of the BCA3/NF-κB interaction in vivo in bone remains to be determined.

Objective: To develop and test the validity and reliability of a new instrument for measuring the thigh-foot angle (TFA) for the patients with in-toeing and out-toeing gait., Methods: The new instrument (Thigh-Foot Supporter [TFS]) was developed by measuring the TFA during regular examination of the tibial torsional status. The study included 40 children who presented with in-toeing and out-toeing gaits. We took a picture of each case to measure photographic-TFA (P-TFA) in the proper position and to establish a criterion. Study participants were examined by three independent physicians (A, B, and C) who had one, three and ten years of experience in the field, respectively. Each examiner conducted a separate classical physical examination (CPE) of every participant using a gait goniometer followed by a TFA assessment of each pediatric patient with or without the TFS. Thirty minutes later, repeated in the same way was measured., Results: Less experienced examiner A showed significant differences between the TFA values depending on whether TFS used (left p=0.003 and right p=0.008). However, experienced examiners B and C did not show significant differences. Using TFS, less experienced examiner A showed a high validity and all examiner's inter-test and the inter-personal reliabilities increased., Conclusion: TFS may increase validity and reliability in measuring tibial torsion in patients who has a rotational problem in lower extremities. It would be more useful in less experienced examiners., Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

The antimicrobial efficacy of silver nanoparticles (AgNPs) is influenced by many factors, including the particle size, AgNP oxidation state and support materials. In this study, AgNPs are synthesized and supported by two types of TiO 2 powders (P25 and Merck TiO 2 ) using two heat-treatment temperatures (120 and 200°C). The formation of well-dispersed AgNPs with diameters ranging from 3.2 to 5.7nm was confirmed using transmission electron microscopy. X-ray photoelectron spectroscopy and X-ray diffraction indicated that the majority of the AgNPs were reduced from Ag + to Ag 0 at 200°C. The AgNP antimicrobial activity was determined by the zone of inhibition against three fungi, A. niger, P. spinulosum and S. chartarum, and two bacteria, E. coli (Gram-negative) and S. epidermidis (Gram-positive). The antimicrobial activity of metallic AgNPs was more pronounced than that of silver nitrate and some antimicrobial drugs. The AgNPs exhibited optimal antimicrobial efficacy when the AgNP dispersion on the surface of TiO 2 was in the region between 0.2 and 0.7μg-Ag/m 2 . The minimum (critical) AgNP concentrations needed to inhibit the growth of bacteria (E. coli) and fungi (A. niger) were 13.48 and 25.4μg/mL, respectively. The results indicate that AgNPs/TiO 2 nanocomposites are a promising disinfectant against both bacteria and fungi., (Copyright © 2017 Elsevier B.V. All rights reserved.)

The accessory sacroiliac (SI) joint is not rare and can be one of the causes of lower back pain. We present a case of a 35-year-old woman with chronic lower back pain. Conventional radiography was equivocal, and bone scintigraphy showed a focus of mildly increased uptake in left SI joint region. SPECT/CT revealed increased uptakes in the accessory articulations between both sacral alae and iliac bones, and confirmed the diagnosis of accessory SI joint. This case illustrates the SPECT/CT findings of the accessory SI joint.

Liquid impingers are utilized to collect bioaerosols for many advantages, such as avoiding dehydration of biological agents. However, many previous studies have reported that the liquid impingers are surprisingly inefficient for the collection of ultrafine bioaerosols, with collection efficiencies <30%. In the present work, we have successfully improved the collection efficiency of the liquid impinger (AGI30) to as high as 99% for particles in the size range of 20-400 nm with the aid of packed glass beads. We also systematically investigated the effects of influential factors on the collection efficiency. These factors include the volume of the sampling liquid (0, 20 and 30 mL), depth (0, 7 and 10 cm) of packed glass beads and sampling flow rate (4, 6 and 8 liter per min, lpm). According to our experimental results, increasing the depth of packed glass beads and the volume of sampling liquid can enhance the collection efficiency. Also, decreasing the sampling flow rate can increase the collection efficiency and reduce the loss of sampling liquid. For the sampling of viable MS2 phages, the collection efficiency of AGI30 sampler with packed glass beads is much higher than that without packed glass beads. Conclusively, this study validates that the granular bed filtration can enhance the collection efficiency of liquid impingers for submicron and ultrafine particles and viral aerosols., (© 2016 Elsevier Ltd. All rights reserved.)

Objective: To investigate the relationship between glycosylated hemoglobin A (HbA1c) and complex regional pain syndrome (CRPS) in stroke patients with type 2 diabetes mellitus (T2DM)., Methods: A retrospective chart review was performed of stroke patients from January 2012 to December 2013. We reviewed 331 patients and included 200 in the analysis. We divided them into CRPS and non-CRPS groups and compared them by age, gender, stroke lesion, cause of stroke, duration of T2DM, HbA1c (%), National Institutes of Health Stroke Scale score, affected shoulder flexor muscle strength, Fugl-Meyer Assessment score, motricity index, Functional Independence Measure, Korean version of Modified Barthel Index, blood glucose level on admission day, duration from stroke onset to HbA1c check, and duration from stroke onset to three-phase bone scan for CRPS diagnosis. Thereafter, we classified the patients into five groups by HbA1c level (group 1, 5.0%-5.9%; group 2, 6.0%-6.9%; group 3, 7.0%-7.9%; group 4, 8.0%-8.9%; and group 5, 9.0%-9.9%) and we investigated the difference in CRPS prevalence between the two groups., Results: Of the 200 patients, 108 were in the CRPS group and 92 were in the non-CRPS group. There were significant differences in HbA1c (p<0.05) between the two groups but no significant differences in any other factors. Across the five HbA1c groups, there were significant differences in CRPS prevalence (p<0.01); specifically, it increased as HbA1c increased., Conclusion: This study suggests that higher HbA1c relates to higher CRPS prevalence and thus that uncontrolled blood glucose can affect CRPS occurrence in stroke patients with diabetes., Competing Interests: No potential conflict of interest relevant to this article is reported.

Background and Objectives: Roxadustat (FG-4592), an oral hypoxia-inducible factor prolyl hydroxylase inhibitor that stimulates erythropoiesis, regulates iron metabolism, and reduces hepcidin, was evaluated in this phase 2b study for safety, efficacy, optimal dose, and dose frequency in patients with nondialysis CKD., Design, Setting, Participants, & Measurements: The 145 patients with nondialysis CKD and hemoglobin ≤10.5 g/dl were randomized into one of six cohorts of approximately 24 patients each with varying roxadustat starting doses (tiered weight and fixed amounts) and frequencies (two and three times weekly) followed by hemoglobin maintenance with roxadustat one to three times weekly. Treatment duration was 16 or 24 weeks. Intravenous iron was prohibited. The primary end point was the proportion of patients achieving hemoglobin increase of ≥1.0 g/dl from baseline and hemoglobin of ≥11.0 g/dl by week 17 (16 weeks of treatment). Secondary analyses included mean hemoglobin change from baseline, iron utilization, and serum lipids. Safety was evaluated by frequency/severity of adverse events., Results: Of the 145 patients enrolled, 143 were evaluable for efficacy. Overall, 92% of patients achieved hemoglobin response. Higher compared with lower starting doses led to earlier achievement of hemoglobin response. Roxadustat-induced hemoglobin increases were independent of baseline C-reactive protein levels and iron repletion status. Overall, over the first 16 treatment weeks, hepcidin levels decreased by 16.9% (P=0.004), reticulocyte hemoglobin content was maintained, and hemoglobin increased by a mean (±SD) of 1.83 (±0.09) g/dl (P<0.001). Overall mean total cholesterol level was reduced by a mean (±SD) of 26 (±30) mg/dl (P<0.001) after 8 weeks of therapy, independent of the use of statins or other lipid-lowering agents. No drug-related serious adverse events were reported., Conclusions: In patients with nondialysis CKD who were anemic, various starting dose regimens of roxadustat were well tolerated and achieved anemia correction with reduced serum hepcidin levels. After anemia correction, hemoglobin was maintained by roxadustat at various dose frequencies without intravenous iron supplementation., (Copyright © 2016 by the American Society of Nephrology.)